HomeMy WebLinkAbout20051428.tiff Ot.AND GAS DIVISION ORDE!
OPERATOR: KERR-MCGEE ROCKY MOUNTAIN CORPORATION Date: April 18,2005
1999 BROADWAY,SUITE 3600 Effective Date: Date of First Production
DENVER,CO 80202 Well Number: 110200
(303)296-3600
Well Name: HSR-Inouye 11-31A Copy for your fits
Description: T2N-R66W,SECTION 31:NESW S2
Formation: J SAND
County and State: WELD COUNTY,COLORADO
Owner: Address: Decimal Interest:
WEL210 915 100"STREET 0.00198979 RI
WELD COUNTY BOARD OF GREELEY,CO 80632
COMMISSIONER
The undersigned certifies the ownership of the decimal interest in production or proceeds as described above payable by Kerr-McGee Rocky
Mountain Corporation.
Kerr-McGee Rocky Mountain Corporation shall be held harmless in the event of,and is hereby released from any and all damage or loss which
might arise out of any overpayment or underpayment.The Owner executing this Division Order,in consideration of payments by Kerr-McGee Rocky
Mountain Corporation,agrees to pay any overriding royalty or royalty owners and/or all other persons who may have right,title or interest in the
interest in production set out above and further agrees to protect,indemnify and hold Kerr-McGee Rocky Mountain Corporation harmless from and
against any and all loss,cost or expense which it may suffer or sustain by reason of such payment regardless of how any such claim or demand may
arise,including all costs or expenses incurred by Kerr-McGee Rocky Mountain Corporation in defending its position in any such claim,suit or action.
The undersigned agrees to notify Kerr-McGee Rocky Mountain Corporation,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.
Kerr-McGee Rocky Mountain Corporation.is authorized to withhold payment pending resolution of a title dispute or adverse claim asserted regarding
the interest in production claimed herein by the undersigned. The undersigned agrees to indemnify and reimburse Kerr-McGee Rocky Mountain
Corporation any amount attributable to an interest to which the undersigned is not entitled.
Kerr-McGee Rocky Mountain Corporation may accrue proceeds until the total amount equals twenty-five dollars($25.00),or pay annually,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 Kerr-McGee Rocky Mountain Corporation may have certain
statutory rights under the laws of the state in which the property is located.
The undersigned authorizes Kerr-McGee Rocky Mountain Corporation to withhold from the proceeds of any and all production referred to herein the
amount of any tax placed thereon by any governmental authority and to pay the same on our behalf.
Witness/Attest:
Owner(s)Signature(s): 'frvfd/i2/12,4
William H. Jerk
e, Chair Clerk 7to the
�Boa�d
05/09/2005 4'4-t,--7-27,-7<-47
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Owner(s)S.S.or Tax I.D.# 84-6000-813 BY f �tf
to the Board
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Owner Daytime Telephone# (970) 356-4000 X4200
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Owner Fax Telephone# (970) 352-0242
PS- OS
Federal Law requires you to furnish your Social KMG USE ONLY",,r
Security or Taxpayer Identification Number. Rec'd by Date: l EO XOO
Failure to comply will result in 31%tax Rels'd by Date:
withholding and will not be refundable by Payer
Approv'd by Date:
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