HomeMy WebLinkAbout20050451.tiff DIVISION ORDER
To: Petro-Canada Resources (USA) Inc. Date: January 7, 2005
f/k/a Prima Oil & Gas Company Effective Date: First Production
�u/ 1099 18th Street, Suite 400
Denver, CO 80202-1904
4'l-,
Property Number 004079 and 004080
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Well Name: KODAK 34-22 and KODAK 34-23 9 a m
Operator: Petro-Canada Resources (USA) Inc. r
County and State: Weld County, COLORADO 1/4. r'
Property Description: T6N, R67W, 6th P.M., Section 34: W/2NW(NWNW and SWNW)
Production: Oil X Gas X Other
Owner Name and Address: Owner Number:
SEE EXHIBIT"A"ATTACHED HERETO Type of Interest:
Decimal Interest:
The undersigned certifies the ownership of their decimal interest in production or proceeds as described on
Exhibit"A" payable by Petro-Canada Resources (USA) Inc. (Payor).
Payor shall be notified, in writing, of any change in ownership, decimal interest, or payment address. All such
changes shall be effective the first day of the month following receipt of such notice. Payor is authorized to
withhold payment pending resolution of a title dispute or adverse claim regarding the interest in production
claimed herein by the undersigned.
The undersigned agrees to indemnify and hold Payor harmless from and against any and all liability, loss,
costs, damage and expenses (including, but not limited to, attorneys' fees, court costs and interest at the
statutory prejudgment rate on funds improperly paid to the undersigned), relating to or in any way arising from
from payments made under this Division Order, including payments mistakenly made to the undersigned, or
otherwise attributable to the interest in production claimed by the undersigned. In the event of any mistake in
such payments made to the undersigned, the undersigned shall immediately refund such payments to Payor.
Payor may accrue proceeds until the total amount equals$25.00, or pay once a year whichever occurs first,
or as required by applicable state statute.
This Division Order does not amend any lease or operating agreement between the undersigned and the
lessee or operator or any other contracts for the purchase of oil or gas.
In addition to the terms and conditions of this Division Order, the undersigned and Payor may have certain
statutory rights under the laws of the state in which the property is located.
Special Clauses: None
Owner(s) Signature: 1-i i ii 1,.--f � � /
William H. er e, it
Owners Tax ID Numbers 2/7/grgf5 ,r,":;'-' ''
Owner(s) Number(s) 84-6000-813 ■ .. the Board
Daytime Telephone No. (970) 356-4000 X420'' � �•4���
FAX Telephone No. (970) 352-0242 ,' Clerk to the Board
Federal Law requires you to furnish your Social Security or Taxpayer Identification Number.
Failure to comply will result in 31%tax withholding and will not be refundable by Payor. 2005-0451
c,2—& 05
EXHIBIT "A"
REPORT NO: JIB150 PETRO-CANADA RES(USAI INC PAGE NO: 1
RUN DATE : 01/07/2005 DIVISION OF INTEREST TIME: 16:54:23
DETAIL
SEQ: DOI
DIVISION ORDER NOS: 004079 WELLS: KODAK 34-22
004080 KODAK 34-23
INT. EFFECT. EFFECT. AEC DIST CRE SUS WPT ST EXEMPT PAY
OWNER NO/NAME TYPE DATE TO DESCRIPTION DECIMAL REV BILL ENT CDE CDE 1 2 3 4 5 TO
000001 PETRO-CANADA RES. (USA) INC WI 09/01/2003 12/01/9999 OIL .85785687 Y Y Y 00 NNNNN
1099 18th STREET SUITE 400 NO NET A/R GAS .85785687 Y Y Y 00 NNNNN
DENVER CO 80202 AD VALOREM .85785687 Y Y Y 00 NNNNY
LEASEHOLD 1.00000000 N Y
BEFORE CASI 1.00000000 N Y
AFTER CASIN 1.00000000 N Y
OPERATING C 1.00000000 N Y
10 WELD COUNTY BOARD OF COUNTY RI 09/01/2003 12/01/9999 OIL .01036968 Y Y Y 1 00 YYYYY
1PkCOMMISSIONERS GAS .01036968 Y Y Y 1 00 YYYYY
WELD COUNTY CENTENNIAL CENTER AD VALOREM .01036968 Y Y Y 1 00 YYYYY
915 10TH ST
GREELEY CO 80632
103463 A. JOYCE CARTER RI 09/01/2003 12/01/9999 OIL .01445732 Y Y Y 1 00 NNNNN
6330 GLENEAGLE AVE. SW GAS .01445732 Y Y Y 1 00 NNNNN
PORT ORCHARD WA 98367 AD VALOREM .01445732 Y Y Y 1 00 NNNNN
104106 EASTMAN KODAK COMPANY RI 09/01/2003 12/01/9999 OIL .10285881 Y Y Y 1 00 NNNNN
9952 EASTMAN PARK DR GAS .10285881 Y Y Y 1 00 NNNNN
WINDSOR CO 80551-1580 AD VALOREM .10285881 Y Y Y 1 00 NNNNN
110620 PEGGY E PITSENBARGER RI 09/01/2003 12/01/9999 OIL .01445732 Y Y Y 1 00 NNNNN
2725 DIERICX DRIVE GAS .01445732 Y Y Y 1 00 NNNNN
MOUNTAIN VIEW CA 94040 AD VALOREM .01445732 Y Y Y 1 00 NNNNN
NET NET REVENUE INTEREST NET 00/00/0000 12/31/9999 OIL 1.00000000
GAS 1.00000000
AD VALOREM 1.00000000
TOTALS PRODUCTS WORKING NET WI NET REV ROYALTY OVERRIDES WI+RI+OR EXPENSES
OIL .85785687 1.00000000 .85785687 .14214313 .00000000 1.00000000 LEASEHOLD 1.00000000
GAS .85785687 1.00000000 .85785687 .14214313 .00000000 1.00000000 BEFORE CASING POINT 1.00000000
AFTER CASING POINT 1.00000000
OPERATING COSTS 1.00000000
AD VALOREM .85785687 1.00000000 .85785687 .14214313 .00000000 1.00000000
a WELD COUNTY ATTORNEY'S OFFICE
915 TENTH STREET
P.O. BOX 758
GREELEY, CO 80632
WEBSITE: vavw.co.weld.co.us
WIIsePHONE: (970) 336-7235
FAX: (970) 352-0242
COLORADO
January 27, 2005
Janet L. Frase
Senior Division Order Analyst
Petro-Canada Resources (USA), Inc.
1099 18th Street, Suite 400
Denver, CO 80202-1904
RE: Division Orders for Weld County, Colorado
Dear Ms. Frase:
The Board of County Commissioners of Weld County, Colorado has received from you two
Division Orders for the West Half(W'/2) of Section 34-6-67 for the Kodak 34-22, 34-23, 34-32,
and 34-33 wells. Copies of the Division Orders are enclosed.
1 am somewhat uncertain as to how the royalty interests included in the Division Orders were
calculated. I therefore respectfully request that you provide me with information showing the
calculations.
If you should have any questions or if I maybe of any assistance, please feel free to call me at
(970) 356-4000, extension 4390.
Sincerely, ;
•
ruc8"P`Barker?
Weld County Attorney
Enclosures
pc: Clerk to the Board
LE 0J-?
Pl!
PETRo-w1ADA, Petro-Canada Resources(USA) Inc.
January 18, 2005
TO: Interest Owners
Re: Kodak Wells
Section 34-T6N-R67W
Weld County, CO
Ladies and Gentlemen:
Petro-Canada Resources (USA) Inc., f/k/a Prima Oil & Gas Company (as"OPERATOR") recently drilled
and completed several Kodak wells located in Section 34-T6N-R67W of Weld County, Colorado.
Therefore, enclosed are two (2) identical original Division Orders (FOR EACH WELL YOU OWN AN
INTEREST IN)for your further handling. Please follow the procedures on the enclosed Instruction Sheet
and return one (1)fully executed Division Order to my attention in the postage paid envelope. The second
original marked "YOUR COPY" is for your files.
NOTE: YOUR INTEREST (FOR EACH WELL THAT YOU HAVE AN INTEREST IN)WILL REMAIN IN
SUSPENSE PENDING RECEIPT OF THE FULLY EXECUTED DIVISION ORDER(S).
If you should have any questions or concerns, please do not hesitate to call me at 303-350-1189. Thank
you for your cooperation to our request.
Very truly yours,
PETRO-CANADA RESOURCES (USA) INC.
f/k/a Prima Oil& Gass Company
net L. Frase
Senior Division Order Analyst
/jlf
Enclosure
Suite 400, 1099 18th Street • Denver, CO 80202-1904
INSTRUCTIONS TO INTEREST OWNERS
This instrument should not be altered in any way unless accompanied by documentary evidence supporting the
change.
If name and interest are correctly shown:
1. Interest owner should sign as shown on the instrument as it reflects record title. If owner's name has
changed, please alter the Division Order when executing it and attach a copy of the marriage certificate,
divorce decree,change of name certificate or other supporting document.
2. All individual signatures should be witnessed by two disinterested and unrelated parties.
3. For joint interest or life estate interests, execution should include signatures of all joint owners or
remaindermen,as appropriate.
4. If signed by agent, attorney-in-fact, or arty party other than the named interest owner, evidence of the
rights vested in the signatory party must be furnished(if not already furnished).
5. All partners must sign for a partnership unless signature is that of an authorized partner, and a certified
copy of his authority must be furnished (if not already furnished).
6. For a limited liability company or similar entity, the signature of the signing party must be duly
authorized by the entity and a certified copy of his authority must be furnished (if not already furnished).
7. If the signature is that of an officer of a corporation,the signature must be attested,title of signatory party
shown and corporate seal affixed.
8. Verify address to which checks are to be mailed and make corrections if necessary. (If a subsequent
change of address is necessary, please notify us promptly in writing, including your Owner Number,
which appears on your check).
9. Tax Identification Number or Social Security Number must be inserted in the space provided. The
Internal Revenue Service requires that we withhold 31% of the proceeds payable to any owner who does
not furnish such number. If qualified under Federal Regulation as TAX EXEMPT, copy of Certification of
Tax Exemption should be furnished.
RETURN ONE FULLY EXECUTED INSTRUMENT PROMPTLY TO THE ADDRESS BELOW. KEEP
THE OTHER COPY FOR YOUR RECORDS.
Petro-Canada Resources (USA) Inc.
f/k/a Prima Oil (Sr Gas Company
Attention: Janet L. Frase
1099 18th Street,Suite 400
Denver,CO 80202-1904
Direct Telephone Number: 303-350-1189
Main Telephone Number: 303-297-2300
FAX Telephone Number: 303-297-7708
Checks will be issued by our accounting department monthly upon receipt of the fully executed Division Orders.
However,funds will be held until the account totals $25.00 and/or on an annual basis.
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