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Home My WebLink About20032717.tiff VALERO MARKETING AND SUPPLY COMPANY Page I of I DIVISION ORDER 198269 Property Number:960010127 Date:September 4,2003 Product Type:OIL Property Name:RUDOLPH#2-33,2-34 State ID: Operator: PETROLEUM DEVELOPMENT CORPORAT County and State: WELD,CO Owner Number:30092771 Analyst: HOPKINS,LINDA 210.370.5827 WELD COUNTY PER NEW LEASE SET UP WE HAVE PREPARED TWO SETS OF OUR FORM DIVISION P O BOX 758 ORDER.PLEASE HAVE THE FORMS EXECUTED GREELEY,CO 80632-0758 AND RETURN ONE COPY TO THIS OFFICE TO VALERO MARKETING P O BOX 696000 SAN ANTONIO TEXAS 78269-6000 Legal Description: I SECTION 2,TOWNSHIP 5 NORTH,RANGE 67 WEST,WELD COUNTY,COLORADO IMPORTANT: You must provide your social security number or tax identification number. Your signature and those of two witnesses must also be provided. Your signature confirms the interest identifed below to Owner#30092771,and binds you to the terms on the reverse side of this division order document effective as of 7:00 A.M.as shown below. Please return one copy of the executed division order to Valero Marketing and Supply Company,Attention: Division Order Section,PO Box 696000,San Antonio,Texas 78269-6000,(800)475-4171. Please refer to the Instructions for Execution on the reverse side of this document. To ensure complete information for state and federal tax reporting,please circle the appropriate response to the following: . Are you a foreign citizen or foreign corporation? Yes/No Are you a US Citizen residing in a foreign country? Yes/No . Are you c i porated? Yes/No Ar you a tax-exemot entity? Yes/No es.please provide documentation) C.141 EN, David E. Long, Chair Owne s Si na a 09/22/ 1',`► / ��J Owner(s) 'I a / Board of Weld COUnt8y mmissioner= ♦ 441 . 84-6000-813 )iu� /; I :; Social Security or Tax ID# : .61 • '1Y a Sigler..tL itness#1 C, erk to the Board 915 10th Street PO Box 7 8 �'n_ rg ,. , _ . Address (.� ,,.• - : -2 p `. �w> ,\&fF`�n /I • CC De tut t Greeley, Colorado 80632 � " 970)356-4000 (fax) (97831 2-0942he :oard City,State and Zip Code Voice/FAX Telephone Number Effective Owner Name Interest Type Decimal Interest Date SR BROADHEAD DEBRA L&KOHLS THERESA D Royalty Interest 0.032025000 07-01-2003 DATZ STEVEN R Royalty Interest 0.013310500 07-01-2003 • DATZ TERRY A Royalty Interest 0.013310500 07-01-2003 HATTON CONNIE W Royalty Interest 0.000882810 07-01-2003 , PETROLEUM DEVELOPMENT CORPORATION(LB)Working Interest 0.792865780 07-01-2003 PRIMA OIL&GAS (SXOP-LB) Override Interest 0.025167350 07-01-2003 RUDOLPH DANIEL J Royalty Interest 0.013310500 07-01-2003 RUDOLPH JAMES L Royalty Interest 0.013310500 07-01-2003 ' RUDOLPH WILLIAM F&BETTY J Royalty Interest 0.013310500 07-01-2003 SHUR VIEW LIMITED PATNERSHIP Royalty Interest 0.076350310 07-01-2003 WELD COUNTY Royalty Interest 0.006156250 07-01-2003 2003-2717 YOUR COPY Lam-©/s? 11 1 IE I 11 i 410 Valero Marketing&Supply Company Division Order Department P.O.Box 500 San Antonio,TX 78292-0500 (210)370-2000 or(800)475-4171 Each interest owner set out on the reverse side hereof("owner"),severally and not jointly,certifies to be the legal owner of the interest set out on the reverse side hereof("division of interest")of all the oil and related liquid hydrocarbons produced from the property described on the reverse side hereof("pi up.,,ty"). THIS AGREEMENT DOES NOT AMEND ANY LEASE OR OPERATING AGREEMENT BETWEEN THE INTEREST OWNERS AND THE LESSEE OR OPERATOR OR ANY OTHER CONTRACTS FOR THE PURCHASE OF OIL OR GAS. The following provisions apply to each owner who executes this agreement with Valero Marketing and Supply Company("payor"): TERMS OF SALE:Owner will be paid in accordance with the division of interest set out on the reverse side hereof. The payor shall pay all parties at the price agreed to by the operator for oil to be sold pursuant to this division order. Purchaser shall compute quantity and make corrections for gravity and temperature and make deductions for impurities. PAYMENT:From the effective date,payment is to be made monthly by payor's check,based on this division of interest, for oil run during the preceding calendar month from the property,less taxes required by law to be deducted and remitted by payor as purchaser. Payments of less than$100 may be accrued before disbursement until the total amount equals$100 or more,or until 12 months'proceeds accumulate,whichever occurs first. However,the payor may hold accumulated proceeds of less than$10 until production ceases or the payor's responsibility for making payment for production ceases,whichever occurs first. Owner agrees to refund to payor any amounts attributable to an interest or part of an interest that owner does not own. INDEMNITY:Owner agrees to indemnify and to hold payor harmless from all liability resulting from payments made to owner in accordance with such division of interest,including but not limited to attorney fees or judgments in connection with any suit that affects owner's interest to which payor is made a party. DISPUTE,WITHHOLDING OF FUNDS: If a suit is filed that affects the interest of owner,written notice shall be given to payor by owner together with a copy of the complaint or petition filed. In the event of a claim or dispute that affects title to the division of interest credited herein,payor is authorized to withhold payments accruing to such interest,without interest unless otherwise required by applicable statute,until the claim or dispute is settled. TERMINATION: Termination of this agreement is effective on the first day of the month that begins after the 301° day after the date written notice of termination is received by either party. NOTICES: Owner agrees to notify payor in writing of any change in the division of interest,including changes of interest contingent on payment of money or expiration of time. No change of interest is binding.an.payor until a recorded copy of the instrument of change or documents satisfactorily evidencing such change are furnished to payor at the time the change occurs. Any change of interest shall be made effective on the first day of the month following receipt of such notice by payor. Any correspondence regarding this agreement shall be furnished to the addresses set out herein,unless otherwise advised by either party. In addition to the legal rights provided by the terms and provisions of this division order,an owner may have certain statutory rights under the laws of this state. FAILURE TO FURNISH YOUR SOCIAL SECURITY/TAX I.D. NO. WILL RESULT IN A 31% WITHHOLDING TAX IN ACCORDANCE WITH FEDERAL LAW,AND ANY TAX WITHHELD WILL NOT BE REFUNDABLE BY PAYOR. INSTRUCTIONS FOR EXECUTION Read all terms and conditions before signing. Individuals must sign their name as shown on the Division Order. If executing on behalf of a Corporation,please indicate your official capacity as President or Vice President,impress the corporate seal,and have your signature attested by the secretary or assistant secretary of the corporation. If executing on behalf of Partnership,or association, please indicate your official capacity and provide documentation of your authority to execute on behalf of such organization. Signatures by Agents,Attorneys-in-Fact,Trustees,Guardians,Estate Representatives or any party other than the named interest owner, must be verified by attaching evidence of the rights vested in the signatory party. Insert the Address to which checks am to be mailed. Please be sure to notify us promptly of any changes in your mailing address. Please do not change or alter the division order unless such changes are accompanied by documentary evidence justifying the change. Please retain one copy of the Division Order for your records. Please return one copy to Valero Marketing and Supply Company. 12071.doc(12003) COUNTY ATTORNEY STAFF APPROVAL This is to affirm the attached Division Order and Authorization to Receive Payment for an Oil and Gas Well has been reviewed by the County Attorney's staff as to form, legal de iption, and percentage of ro - 'es, if applicable. BY: Cow Attorney DATE g ( 0� } I,IIi Hello