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Home My WebLink About20013151.tiff OIL AND GAS DIVISION ORDER OPERATOR: KERR-MCGEE ROCKY MOUNTAIN CORPORATION Date: October 29,2001 1999 BROADWAY,SUITE 3600 Effective Date: Date of First Production DENVER,CO 80202 I r..l Allkell)Nlramber: 110180 (303)296-3600 - I�L :__. . L_L) Well Name: HSR—KUNZMAN FEDERAL 16—6A Description: T2N R66W,SEC.6:S/2 Formation: J SAND ^^y County and State: Weld,Colorado / Owner: Address: Decimal Interest: WEL210 Weld County Board of 915 10th Street 0.00070770 RI Commissioners Greeley,CO 80632 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. 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. Wit e-/•,� tGr Owner(s)Signature(s): ,x ► ill M. J. Geile, Chair (11/05/2001) -� � � - �_��,;,�(_ Deputy Clerk t Beard Owner(s)S.S.or Tax I.D.# 84-6000-813 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 Number. Failure to comply will result in 31%tax withholding and will not be refundable by F 2001315/ (lgervi.a , LEO°9a- ulos/ai EXHIBIT "A" HSR-KUNZMAN FEDERAL 16.6A T2N,R66W Sec.6:S/2 _- -- - - 321.48 Acres J Sand Formation Well#110180,_____ Owner Decimal Interest Number Owner Name Mailing Address I Interest _ Interest Calculation Type 2996 25th Street BRA330 George Scott Bragg Boulder,CO 80304-2808 0.01986910 2/3 x.50 MI x.125 RI x 153.30/321.48 acres RI HSR001 HS Resources, Inc. 0.00414330 RI HSR001 HS Resources, Inc. 0.85373160 NRI HSR001 HS Resources, Inc. 0.00894110 ORR 10952 Hwy.85 KUN945 Kunzman Family LLC Fort Lupton,CO 80621-9602 0.01443070 2/3 MIX.125 RI x 55.67/321.48 acres RI Franz R. Kunzman and Carmie Kunzman, ;6166 E.Thunder River Dr. KUN955 joint tenants _ ITucson,AZ 85706 10.007215301 1/3 MI x.125 RI x 55.67/321.48 acres RI Longmont United Hospital Foundation P.O.Box 1159 LON357 First National Bank of Longmont,Agent i Longmont,CO 80502-159 0.00993440 1/3 x.50 MI x.125 RI x 153.30/321.48 acres RI 3250 Ocean Park Blvd.-Suite 140 MAC345 Machii-Ross Petroleum Company Santa Monica,CA 90405 0.00596070 .025 ORR x.50 x 153.30/321.48 acres ORR Go Jack Levine-Jack Levine&Associates, Inc. Magness Land Holdings LLC,a Colorado limited 4643 S.Ulster St.,#1480 i MAG525 liability company Denver,CO 80237 '.0.01490180 .50 x.50 MI x.125 RI x 153.30/321.48 acres RI 12251 Weld County Rd.22 1/2 MIL430 Catherine Miller FL Lupton,CO 80621 0.01506310 1/2 X.50 MI x.125 RI x 154.96/321.48 acres RI 12251 Weld County Rd.22 1/2 - - - - MIL553 Elton N.Miller Ft. Lupton,CO 80621 0.01506310 1/2 X.50 MI x.125 RI x 154.96/321.48 acres RI Minerals Management Service P.O.Box 5810-MS652 MIN275 Royalty Management Program Denver,CO 80217-5810 10.00946020 _ 1.00 MI x.125 RI x 24.33/321.48 acres RI i 1357 43rd Ave., Unit#15 QIO559 Thomas F.and Mildred L.QuinnJ_oint tenants (Greeley,CO 80634-2444 0.01490180 .50 x.50 MI x.125 RI x 153.30/321.48 acres RI P.O.Box 843169 UNI660 RME Petroleum Company Dallas,TX 75284-3169 0.00567610 .075 ORR x 24.33/321.48 acres ORR 915 10th Street WEL210 Weld County Board of Commissioners Greeley,CO 80632 0.00070770 1.00 MI x.125 RI x 1.82/321.48 acres RI TOTAL:11.000000001 Page 1 Coper KERR-MCGEE ROCKY MOUNTAIN CORPORATION 1999 BROADWAY•SUITE 3600•DENVER,COLORADO 80202 PHONE.303/2963600 FAX.303/296-3601 INSTRUCTIONS FOR EXECUTION OF OIL AND GAS DIVISION ORDERS Please read the following instructions carefully before signing the enclosed division order: 1. Be sure that your interest is correct. 2. Sign your name in the space provided exactly as it is shown BEFORE TWO WITNESSES. 3. Your SOCIAL SECURITY NUMBER or TAX IDENTIFICATION NUMBER must be shown in the space provided. Failure to provide the number may result in withholding of your production proceeds, as required by law, and you may also be subject to a penalty imposed by the Internal Revenue Service. 4. Verify the address to which checks should be mailed. 5. If the interest is owned by a CORPORATION, the division order must be signed by a duly authorized officer and attested. The corporate seal must be affixed and the title of the signing officer shown. 6. If the interest is owned by a PARTNERSHIP, the division order must be signed by the general partner or managing partner and evidence of such authority to sign must be furnished. 7. If the division order is signed by anyone abet than the named owner such as an AGENT, ATTORNEY-IN-FACT, or GUARDIAN, evidence of authority must be provided. After you have completed and signed the division order,please return the original to us. The copy is for your records. Should you have any questions,please do not hesitate to call. WENDY L. HOPKINS KERR-McGEE ROCKY MOUNTAIN CORPORATION 1999 BROADWAY, SUITE 3600 DENVER, CO 80202 (303) 296-3600, EXT. 452 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. t. County Attorney DATE: I ' / I C Hello