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Home My WebLink About20012976.tiff OIL AND GAS DIVISION ORDER OPERATOR: HS RESOURCES,INC. Date: October 9,2001 1999 BROADWAY,SUITE 3600 Effective Date: Date of First Production DENVER,CO 80202 Well Number 920441 I :O. O;- (303)296-3600 fI - Well Name: HSR-ATHERTON 5-20A Description: T3N R66W, SEC. 20: N/2 Formation: J Sand County and State: Weld, Colorado Owner: Address: Decimal Interest: WEL210 WELD COUNTY BOARD OF 915 Tenth Street 0.03125000 RI COMMISSIONERS Greeley, CO 80632 The undersigned certifies the ownership of the decimal interest in production or proceeds as described above payable by HS RESOURCES,INC. HS RESOURCES, INC. 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. The Owner executing this Division Order, in consideration of payments by HS RESOURCES,INC., 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 HS Resources, Inc. 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 HS Resources, Inc. in defending its position in any such claim,suit or action. The undersigned agrees to notify HS RESOURCES, INC., 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. HS RESOURCES, INC. 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 HS RESOURCES, INC.any amount attributable to an interest to which the undersigned is not entitled. HS RESOURCES, INC. 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 HS RESOURCES,INC.may have certain statutory rights under the laws of the state in which the property is located. The undersigned authorizes HS RESOURCES, INC.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. Wit Owner(s)Signature(s): 277 166] ,{ (!� M. J. Celle. Chair (10111fe2&31) <' Deputy Clerk `^ •e Owner(s)S.S.or Tax I.D.# 84-6000-813 �O'R\q Owner Daytime Telephone# (970)356-4000 X4200 Owner Fax Telephone# (970)352-0242 Federal Law requires you to furnish your Social Security or Taxpayer Identification Ni Failure to comply will result in 31%tax withholding and will not be refundable by Pt 2001-2976 EXHIBIT "A" HSR-ATHERTON 5-20A--"J"SAND FORMATION Well No. 920441 TOWNSHIP 3 NORTH-RANGE 66 WEST, Section 20: N% 320 ACRES,MORE OR LESS WELD COUNTY,COLORADO ([* {y, ty1,1W'� l xa.... .v:_. ixy.m....n.. 13278 Weld County Road 32 BEL410 BELLA HOLSTEINS, INC. Platteville, CO 80651 0.02136230 RI Department 161 BEN860 BENSON MINERALS GROUP, INC. Denver,CO 80271 0.02454660 RI BOARD OF CHURCH EXTENSION OF P.O. Box 7030 BOA724 DISCIPLES OF CHRIST Indianapolis, IN 46207 0.00048828 RI _ 410 17th Street, Suite 1151 BRE490 KENNETH A. BREITENBACH Denver, CO 80202 0.00119280 RI 475 17th Street, Suite 980 BRO960 JAMES D. BROWNLIE Denver, CO 80202 _0.00119280 RI 475 17th Street,Suite 1390 BWA100 BWAB INCORPORATED Denver, CO 80202 0.00312500 RI 2424 Martin Luther King Jr. Drive FLA554 FLANNER HOUSE Indianapolis, IN 46208 0.00039063 RI _ Bank of Oklahoma,Agent P.O. Box 1588 FLY556 EMILY FLYNN HOME AT MARION INDIANA Tulsa, OK 74101 0.00048829 RI TRUSTEES OF GARDEN CITY CHRISTIAN 5201 Rockville Road GAR223 CHURCH Indianapolis, IN 46224 0.00048828 RI 734 Oregon HAG250 MARY ANN HAGEN Gooding, ID 83330-1450 0.01562500 RI Bank One Trust Company, N.A. INDIANAPOLIS FOUNDATION CONSOLIDATED P.O. Box 2605 IND413 FUND 2835003610 Ft.Worth,TX 76113-2605 0.00117187 RI KENT K. KRAMER AND RHONDA S. KRAMER, 1407 Dexter St. KRA520 JOINT TENANTS Broomfield,CO 80020 0.00068359 RI c/o Dean Shavers 8200 Mountain Road NE, Suite 203 NAT483 NATIVE AMERICAN SCHOLARSHIP FUND Albuquerque, NM 87110-7835 0.00048828 RI THE OLIN FAMILY LIMITED PARTNERSHIP, 13478 Weld County Road 32 OLI501 LLLC Platteville,CO 80651 0.00457096 RI 505 Sherri Drive PAT735 MARGARET L. PATTERSON Loveland, CO 80537-7254 0.01562500 RI 3100 N. Meridian Street SAL818 THE SALVATION ARMY Indianapolis, IN 46208 0.00039062 RI 13452 WCR 32 SCH654 DEBORAH A. SCHONEMAN Platteville, CO 80651 0.00072689 RI 475 17th Street, Suite 980 WAL405 JOHN R.WALLACE Denver, CO 80202 0.00119280 RI 915 Tenth Street WEL210 WELD COUNTY BOARD OF COMMISSIONERS Greeley,CO 80632 0.03125000 RI Page 1 of 2 10/9/2001 EXHIBIT "A" HSR-ATHERTON 5-20A--"J"SAND FORMATION Well No. 920441 TOWNSHIP 3 NORTH -RANGE 66 WEST, Section 20: NY 320 ACRES,MORE OR LESS WELD COUNTY, COLORADO iiviggioftaittgaliggingREIlegiaSitiWiniftlifitt 1580 Lincoln Street, Suite 650 m_ - FRE220 NORMA JEAN FREEDMAN Denver,CO 80203 0.00156250 OR Errol J. McBride,Trustee Route 4, Box 8 GRA572 LENA MAE GRANT IRREVOCABLE TRUST Crawfordsville, IN 47933 0.00027345 OR 4222 Jennie Avenue HIX000 BILLYE L. NIX Amarillo,TX 79106-6031 0.00032813 OR 1999 Broadway, Suite 3600 HSR001 HS RESOURCES, INC. Denver, CO 80202 0.00683594 OR '600 S. Excelsior NOR730 NORTH AMERICAN RESOURCES COMPANY Butte, MT 59701 0.00015625 OR Box 1310 PIR940 ROBERT S. PIRTLE Tyler,TX 75710 0.00031250 OR 403 Brighton Court PIR946 WILLIAM PIRTLE Tyler,TX 75701 0.00031250 OR 3737 14th Street SE ROG270 MARTIN L. ROGERS Loveland, CO 80537 0.00017968 OR P.O. Box 370053 TIA360 TIAGO CORPORATION Denver, CO 80237 0.00312500 OR 1999 Broadway, Suite 3600 HSR001 HS RESOURCES, INC. Denver, CO 80202 0.86191406 WI TOTAL: 1.00000000 Tract 1: W'%NW'/.(80 ac.) Tract 2: A tract in NE''/.NW'/.co'wining 2 ac. Tract 3: The West 550'in the North 3/4 of NE'/.NW'/.,containing 12.5 ac. Tract 4: A tract in the NE'ANW%containing 2.42 ac. Tract 5: Lot A of Recorded Exemption No.1211-2-03-RE2004,being a tract in the NE%NW'/.,containing 1.32 ac. Tract 6: Lot B of Recorded Exemption No.1211-2-03-RE2004,bing a tract in the NE'ANW'/.,containing 11.76 ac. Tract 7: The SEANW%and the South 10 acrea of NE'/.NW'/.,containing 50 ac Tract 8: NE'/.(160 ac.) Page 2 of 2 10/9/2001 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 description, and percentage of royalties, if applicable. BY: l C County Attorney DATE: Hello