HomeMy WebLinkAbout920849.tiff RESOLUTION
AR23o3s62
RE: APPROVE OIL AND GAS DIVISION ORDER TO NATIONAL COOPERATIVE REFINERY
ASSOCIATION AND AUTHORIZE CHAIRMAN TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado,
pursuant to Colorado statute and the Weld County Home Rule Charter, is vested
with the authority of administering the affairs of Weld County, Colorado, and
WHEREAS, Weld County, Colorado, has received an Oil and Gas Division Order
to National Cooperative Refinery Association, P.O. Box 1404, McPherson, Kansas
67460-1404, and
WHEREAS, said Division Order covers land more particularly described as
follows:
Township 6 North, Range 65 West, 6th P.M.
Section 22: NW! NE!
Weld County, Colorado
WHEREAS, Weld County is entitled to a one-eighth royalty interest on
production, and
WHEREAS, in order to receive said royalty interest, Weld County must
execute said Division Order, a copy of which is attached hereto and incorporated
herein by reference, and
WHEREAS, said Division Order has been reviewed by a member of the Weld
County Attorney's staff and found to be in order, and
WHEREAS, the Board deems it advisable to approve said Division Order on the
parcel of land described herein.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Oil and Gas Division Order to National Cooperative
Refinery Association, P.O. Box 1404, McPherson, Kansas 67460-1404, on the
hereinabove described parcel of land be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chairman be, and hereby is,
authorized to sign said Division Order.
B 1351 REC 02303562 09/15/92 15 :11 $0 .00 1/005
F 0374 MARY ANN FEUERSTEIN CLERK & RECORDER WELD CO, CO
920849
Lam'�t
L G C. ,�l�t� ! C
DIVISION ORDER - NCRA
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded,
adopted by the following vote on the 9th day of September, A.D. , 1992.
// BOARD OF COUNTY COMMISSIONERS
ATTEST: ad/ � WELD CO TY, COLORADO/Weld County C1 Fo the ,Board
�� j eor Ken dy, Chairman
BY: by , ., ;),, / +,'. : 6'�i/�jT��'l_r_a
Deputy Clerk to ,Ibe Board Constance L. Harbert, Pro-Tem
APPROVED AS 0 ORM: t~' t
C. W. Kirb
C A? .; lGe
F
County Attorney Gord acy
<�c/t% 1u
W. H. We ster
$0 .00 2/005
B 1351 REC 02303562 09/15/92 15 :11
F 0375 MARY ANN FEUERSTEIN CLERK & RECORDER WELD CO, CO
920849
DIVISION ORDER
NATIONAL .:OOPERATIVE REFINERY ASSL.,IATION
Analyst : RLK
tt
TO: NCRA \Re [ DATE: August 26, 1992
P. O. Box 1404 "p111 LEASE NAME: MEL BICKLING
McPherson, KS 67460-1404 31-22
LEASE NO: 06686
Attention: Division Order
Department
The undersigned, and each of them, guarantee and warrant that they are the legal owners in the proportions set
out below of all the oil and gas produced from the following described premises and until further written notice
you are authorized to receive oil and gas therefrom, giving credit as directed below, effective as of 7:00 a.m. ,
Date of First Run (8-1-92)
Township 6 North, Range 65 West
Section 22: NW/4 NE/4
Weld County, Colorado
Credit to Division and Kind of Interest
FOR DIVISION OF INTEREST SEE
EXHIBIT "A" ATTACHED HERETO AND
MADE A PART OF THIS DIVISION ORDER
The following covenants are a part of this division order and shall be binding on the undersigned, their
successors, legal representatives, and assigns:
FIST: Saidotl shall become your property upon the delivery thereof to you or loony earner,pipeline,person,firm or Corporation designated by you to receive saido.l.
SFElac The oil purchased and received hereunder shall bedelivered l.ob lowly carrier.pipeline,tanksorother facilities designated by you which gathers and receives said oil,and you agree to
paylor such oil to the respective owners according to the division of interest herein speolied al the price posted by NCRA for oil of thesamegrade gravity and quality from the held or area in which the
aloredesmtbed base orpremisesis located on the date said oil is received by you,less any tax you mayb
arrangements made with the operator. erequiredto pay anti loss applicable trucking
opipaline gathering charges in accordance with
1)a Quantitiesof oil purchased hereunder shall be computed in accordance with thecorditionsspeciliee in the price posting of NCRA.You have theunquaklied right to refuse toreceiveanyoil net
considered merelanmble by you or of acceptable quality.
F(X TIt The
pprC00eds ,such
aocerdmgte the divisionanany
f tares
es or other scout here es as arcre herein
pprovided
anti except as is provided in paragraph SIXTH.shall be paid monthly(circa received and purchased
widen their herein designated,except if the amount payable to any party shall be
less than$25.00 payment shall be made semi-annually.
FIFTH: Operators and/or working interest owners,and each of them by execution of Ihisdivision order,herebycertifyand warrant that all oil sold hereunder has been and will be produced and handled
in compliance with the Fair Labor Standards Am of 1938,any amendments thereto,the regulationsprom,ulgated thereunder,and all other applicable federal,state and municipal laws,rules and mg
u lations.
SIXTH: Abstracts or other ot itt N�tisfactory to you,will be furnished upondemand.lf,in your opinion the undersigned does not have good and merchantableIdle.or in case of adverse([Emit
f title to the land and/or oil you are authonaed to withhold,without interest and without liability.the
been furnished or untilsuch title is mate acceptable to you or until such adverse claim is settled to purchase price or posses of and oft,endlindemn writtecorye teams
shall bagmen you at the above address by the partyor parties eflecled,together with acertified pyurcadco,npon Ifrptte on.file The
panytrparties&felerryhee undersigned,agetol indemnity
you against
any
judgement rendered therein and torelmburseyou for any cost,attorneys teaser otherex copy con complaint ether petition.hhe perry operates alledted thereby agreeeindemndy you against any penes incurred in connection therewith.
Stsba.H: You will not be responsible for anychsgeot ownership the absence of actual notice and pool thereof sattsfaol
signed by transferor and transleree together wither certified copy of the recorded instrument evidencing such transfer.An cry eranand receipt byyou of aprctive aeexecuted beam me
hrst day°I the calendar month following the receipt of said notice.Withoutr to whether an contingencyYchresslygeor tt teadin oflnteeionorder,you are effective relieved
eiveo am.on
wbtaty for determining when any of the interest hereinshall shed be anyermndiherpaexpreaal reeteoftheilsinnerichargeof money,
y,predction orothe
increase,receive
ivei diminish,or said onceextinguished or creelrever and to wan lerord orders
to thelco the completion,youwr ord
payments v Irma of said masted or lev any theaforesanand antdypureeeiv9a tort'proofandttan f rorderaa a not rndaree by yrue6 a thaabe held armareftor rrorresuong in ov,r oeducerpayoher
above paymentol any sums.evMl lhne aforesaid written tulip,satisfactory proof and transfer orderable not receivedcloy authorized to remit pursuant to the
ma wrong payment of any sums.'
byYou.You shaa 0e hew harmless tor error resulting in over or under payment,
IMPORTANT To Avoid Delay In Payment - Your Correct Address and Social
Security Number or Tax Account N
mber Must Be Shown.
G:2
Witness: Aft s : a Owner's signature:
WE D C tutu CL RK 0 BOARD Weld County Board of County Commissioners
KEG I � By: sz
YOU RtrO) R TO B A � P^ 09/14/9-
Tit le: CHAIRMAN
Owner's Address:
915 10TH STREET
P.O. BOX 758
GREELEY, CO 80632
Owner's Social Security or Tax Account No. 84-6000813
If an individual your signature must be witnessed. If a partnership all partners must sign. If a corporation
execution and attestation must be by authorized officer, indicating the officer's corporate title.
B 1351 REC 02303562 09/15/92 15 : 11 $0 . 00 3/005
F 0376 MARY ANN FEUERSTEIN CLERK & RECORDER WELD CO, CO
920849
August 26, 1992
MEL BICKLING 31-22 - 06686
Weld County, Colorado
EXHIBIT "A"
PAGE ONE
ROYALTY INTEREST DECIMAL OF INTEREST
Janice Louise Wojciak . 0153165 RI
Harlan Robert Stoffregen . 0153165 RI
Weld County Board of County Commissioners . 0011953 RI
Melvin T. Bickling & Imogene M. Bickling . 0204220 RI
Florence F. Bickling . 0204220 RI
Margaret Ruth Bickling . 0102110 RI
Becky Jane Hamilton . 0025528 RI
James Spencer Bickling . 0025527 RI
John Daniel Bickling . 0025527 RI
Estate of Herbert C. Bickling . 0204220 RI
Estate of Mary F. Koeneman . 0204220 RI
Sharon F. Heinz . 0025528 RI
The New Cache La Poudre Irrigating Company . 0012727 RI
TOTAL ROYALTY INTEREST . 1352110 RI
OVERRIDING ROYALTY INTEREST
Robert L. Armantrout . 0022141 ORI
Chris L. Christensen, Jr. . 0032675 ORI
Energy Minerals Corporation . 0039211 ORI
C. A. Patchen . 0016337 ORI
Wally Bakken . 0032675 ORI
Theodore D. Sheldon . 0181212 ORI
Charles E. Tatham, III . 0022141 ORI
John G. Brant, Trustee of . 0024183 ORI
of Doussard, Brant, Model &
Markham Profit Sharing Trust
TOTAL OVERRIDING ROYALTY INTEREST .0370575 ORI
B 1351 REC 02303562 09/15/92 15 : 11 $0 . 00 4/005
F 0377 MARY ANN FEUERSTEIN CLERK & RECORDER WELD CO, CO
9Z0849
August 26, 1992
MEL BICKLING 31-22 - 06686
Weld County, Colorado
EXHIBIT "A"
PAGE TWO
WORKING INTEREST DECIMAL OF INTEREST
Oxford Exploration Company .2826399 WI
Nichols Oil Company . 0999334 WI
Prima Exploration, Inc. — . 0056528 WI
A/C H & C Colton Co .
Gerrity Oil & Gas Corporation . 2998001 WI
Frank Wilson, Jr. . 0169584 WI
Prima Exploration, Inc. . 0399735 WI
J. Cleo Thompson, & James . 0399735 WI
Cleo Thompson, Jr. A Partnership
SBH Associates , Inc. . 0427999 WI
TOTAL WORKING INTEREST .8277315 WI
TOTAL LEASE INTEREST 1 .0000000
B 1351 REC 02303562 09/15/92 15 : 11 $0 .00 5/005
F 0378 MARY ANN FEUERSTEIN CLERK & RECORDER WELD CO, CO
90 ',49
W-9 Request Give this form
Form \t•9 for Taxpayer to the requester. Do
(Rev.April 1990) Identification Number and Certification NOT send to IRS.
Department of the Treasury
Internal Revenue Service
Y
Name (If joint names,list first and circle the name of the person or entity whose number you enter in Part I below.See Instructions under"Name"it your name has changed.)
0.
W DO
s s st'gs List account number(s)
Address(number and street) here(optional)915 10TH STREET
City,state,and ZIP code GREELEY, CO 80631 84-6000813
e • rt li For Payee s Exempt (om
Backup rt I Tax•a er Identification Number(TIN)
Instructions)
Enter your taxpayer identification number in social security number
the appropriate box. For individuals and sole
proprietors,this is your social security number.
For other entities, it is your employer OR
identification number. If you do not have a Requester's name and address(optional)
number,see How To Obtain a TIN, below. Employer identification number
Note:If the account is in more than one name, I
see the chart on page 2 for guidelines on whose 8 4 x 6 0 0 0 8 1 3
number to enter.
Certification.—Under penalties of perjury,I certify that: number to be
(1) The number shown on this form is my correct taxpayer identification number(or I am waiting for a h have not beenissued
ito byme),
),aand
(2) I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I
Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)
the IRS has notified me that I am no longer subject to backup withholding.
Certification Instructions.—You must cross out item withholding because of underreporting interest or dividends on youabove if r tax return.ou have For ealen lestaed te transactions,IRS that ou ritem e r(2)does not apply.For
p
mortgage interest paid,the acquisition or abandonment of secured property,contributions to an individual retirement arrangement(IRA),
and TIN.(Also see payments
ymen the than
interest and
Specific Instructions,you
ouio are
e,o not
n parequired
e r 2.d to sign the Certification,but you must provide your correct gPlease pp 1992
Sign �/ �G/X Date SEPTEMBER 9,
Here Signature►✓� ,..,i��'.-- (2)IRS notifiestherequester that you
Instructions requester.For reportable interest or dive furihed an incorrect TIN,or
payments,the payer must exercise one o the is You are ic notified INby,or that you are
(Section references are to the Internal Revenue following s options0 day perod concerning
option(1),withholdingsubject to backup withholding because you failed
Code.) a er must backup withhold on any withdrawals to report all your interest and dividends on your
fPurposeinformation of tm.—A personwith
is required ob obtain
to payer
make from your account after 7 business tax return(for reportable interest and dividends
your ile an rettaxpayer
return do must ber(T you ays after the requester receives this form back only),or
r port income paid d to you.real estate number(TIN) from you.Under option(2),the payer must (4)You fail to certify to the requester that you
to report income g to ne ,real t backup withhold on any reportable interest or are not subject to backup withholding under(3)
transactions,mortgage interest you paid,the dividend payments made to your account, above(for reportable interest and dividend ac-
acquisition or abandonment of secured property, regardless of whether you make any withdrawals. counts opened after 1983 only),or
re retirement
arrangement r you n (Ito). rm The backup withholding under option(2)mustf 5 You fail to certify your TIN.This applies
furnemeot cotTINto the h . eUque ter the-9 to begin no later than 7 business days after the (5)
person
your k g you to TIN to your TIN),and, requester receives this form back.Under option only to reportable interest,dividend,broker,or
2 barter exchange accounts opened after 1983,or applperson asking you furnish TIN),and,when the broker accounts considered inactive in 1983.
furnishing
1)tocertor that the o are you arewithhelG if yourcertified TIN is receiveddwthins
furbe is issued),(that)to cerayehai you for a the 60-day period and you were not subject to Except as explained in(5)above,other
I
number to t issued), h lding,andtyouare backup withholding during that period. reportable payments are subject to ba'ku
not subjectejempoon from
bwackup
withholdinghd to
claim ies.
re exemption payee.
Fucks)nourcorrect
if you Note:you Writing ve already
eady applied on the forTIN m hat withholdingCertain payees and payments are s exempt
are pa Furnishing Certifications
TIN that o itendato apply for en the ORneaNt , from backup withholding and information
and making the rai appropriate ymen cm being suswill y
prevent certain payments from being subject to As soon as you receive your TIN,complete reporting.See Payees and Payments Exempt
the 20%backup withholding. another Form W-9,include your TIN,sign and From Backup Withholding,below,and Exempt
Note:If a requester gives you a form other than date the form,and give it to the requester. Payees and Payments under Specific
a W-9 to request your TIN,you must use the What Is Backup Withh ladle er-required to Sw makingld Instructions,pay on page 2,if you are an exempt
requester's form. certain paypayees and Payments Exempt From Backup
How To Obtain a TIN.—If you do not have a TIN, and pay to IRS 20%of such payments under is apply for one immediately.To apply,get Form certain conditions.This is called"backup I Withholding—Thefolllowingis aantlof payees
es
SS-5,Application for a Social Security Number withholding."Payments that could be subject to backup . g
Card(for individuals),from your local office of backup withholding include interest,dividends, no information reporting is required.For interest
the Social Security Administration,or Form SS-4, broker and barter exchange transactions,rents, and item dividends,all
lFos listed
pa eenare exempt
emcayees
Application for Employer Identification Number royalties,nonemployee compensation,and
(for businesses and all other entities),from your certain payments from fishing boat operators,but listed in(1)through(13)and a person registered
do not include real estate transactions. under the Investment Advisers Act of 1940 who
local Internal RevForm enue Service ufdo not If you give the requester your correct TIN, regularly acts as a broker are exempt.Payments
To complete""Applied
W-9 the f space ac have TIN mak th appropriate certifications,and report all subject to reporting under sections 6041 and
TIN,Part I,sign and
For"in , forgive the your taxable interest and dividends on your tax 6041A are generally exempt from backup
in e I, date you ur form, and it to the
requester.Generally, will then have 60 days return,your payments will not be subject to withholding only if made to payees described in
to obtain a TIN and furnish it to the requester.If backup withholding.Payments you receive will be itemChats provides through except that a carecorporation
the requester does not receive your TIN within 60 subject to backup withholding if: that and medical e ca a nth for such a is
days,backup withholding,if applicable,will begin (1)You do not furnish your TIN to the
and continue until you furnish your TIN to the requester,or Form W-9.(Rev.4-90)
9r0: 4°)
vVPttt .5
Read r-refully before signing you 7ivision Order
:s:s =NSTRUMENT SHOULD NOT BE ALTERED IN ANY WAY UNLESS
ACCOMPANIED BY DOCUMENTARY EVIDENCE JUSTIFYING THE CHANGE. ANY
JORRECTIONS IN SPELLING OF YOUR NAME SHOULD BE MADE IN INK AND
YOUR INITIALS SHOWN ABOVE THE CORRECTION.
SIGNATURE: Sign your name as shown on the Division Order, in the
space provided. Have your signature witnessed.
SIGNING FOR A CORPORATION, title of signatory party must
be shown, corporate seal affixed, and attested.
SIGNING FOR A PARTNERSHIP, all partners must sign unless
signed by an authorized party and we are furnished a
certified copy of his/her authority. If an interest is
shown jointly, each party must sign the instrument in
the manner that their name is shown. In the event one
party has been designated agent for the joint interest,
or if they have been granted a power of attorney for the
other party(ies ) , we must have evidence to support this .
SIGNATURE BY SECOND PARTY: If the Division Order is
signed by agent, attorneys-in-fact, guardian, trustee or
any party other than the designated interest owner, we
must have evidence of the rights vested in the signatory
party.
MAILING ADDRESS: Indicate the address to which checks are to be
mailed. Print or type as clearly as possible. Do not abbreviate.
If you are already receiving checks from our company, be sure to
use the same address to which we are now mailing your checks.
Make sure to include your zip code number.
TAXPAYER'S IDENTIFICATION OR SOCIAL SECURITY NUMBER: As required
by :eaeral law, please indicate your Taxpayer Identification
Number or Social Security Number, whichever is applicable, in the
space provided.
LEASE NUMBER: In the upper right hand corner of the Division
Order is a five-digit number. This number will appear on the
checkstub and should always be used when corresponding with our
company.
CHANGE OF ADDRESS: It is very important that you notify us
immediately of any change in your mailing address. Be sure to
include your owner number, which appears on your check from our
company, your old address, then state your new address. This
should be accompanied by your initials and/or signature.
RETURN THE EXECUTED DOCUMENT WITHOUT DELAY TO THE ADDRESS BELOW.
KEEP ONE COPY FOR YOUR RECORDS.
NATIONAL COOPERATIVE REFINERY ASSOCIATION
ATTENTION: DIVISION ORDER DEPARTMENT
NCRA BLDG. 2000 SOUTH MAIN, P.O. BOX 1404
MCPHERSON, KS 67460-1404
920:;49
7•r7/ NA .ONAL COOPERATIVE REFI. :RY ASSOCIATION
2000 South Main Street, P.O. Box 1404, McPherson, Kansas 67460
_ 4
HELPFUL HINTS CHANGES AFFECTING PAYMENT FROM NCRA
Following are the most commonly encountered situations that result in either a change of ownership or a
change to the payee, along with the documents most frequently needed to effect the change.
Obviously, we cannot address all situations. There may be some changes in our requirements due to the
laws of each jurisdiction. If you are in doubt or require additional information relating to your particular
set of circumstances, contact our office. For the most complete response, these questions should be
submitted in writing. However, you may call us at (316) 241-9187 or fax us at (316) 241-5582.
Situation Documentation Required by our Office
to Effect the Change
Sale of an Interest
1. Royalty Interest (RI) Certified copy of the appropriate conveyance
Working Interest (WI) or filed of record in the county in which the
Overriding Royalty Interest (ORI) property is located
•
Estate Proceedings If probate is not complete
1. Owner died with a Will (testate) and probate a Certified copy of Last Will and Testament
proceedings are to be conducted in the same
state in which the properties are located. a Order Admitting Will to Probate
a Letters Testamentary
a Affidavit of Heirship
When probate is complete
All of the above plus:
a Evidence debts and taxes have been paid
Final Decree of Distribution (if appropriate)
a Recorded conveyances (if appropriate)
2. Owner died with a Will (testate) and probate a Documentation of ancillary probate
proceedings are to be conducted in a state proceedings in all affected states
other than the state in which the property (Requirements vary according to state Law)
is located.
a Recorded conveyances (if appropriate)
3. Owner died without a Will (intestate). a Letters of Administration (if available)
a Affidavit of Heirship (individual state laws
of Descent and Distribution will apply as
relevant)
a Evidence debts and taxes have been paid
a Recorded conveyances (if appropriate)
97',0...;49
CHANGES AFFECTING PAYMENT FROM NCRA page 2
Documentation Required by our Office
Situation to Effect the Change
Name Changes
1. An individual's name changes due to a Copy of marriage certificate, divorce decree
marriage, divorce, etc. reinstating maiden name or other document
affecting name change
2. Company or corporation changes its a Certificate of Name Change (Tax ID should
name only be included)
3. Company or corporation's name changes a Certificate of Merger (Tax ID should
due to a merger be included)
4. Attorney-in-fact appointed a Certified copy of recorded Power
of Attorney
Trusts
1. Trust is created a Copy of Trust Agreement and appropriate
recorded document conveying the property
interest to Trust
2. Trust is terminated a Copy of Dissolution of Trust and appropriate
recorded conveyances to beneficiary
3. Changes in Trustee a Copy of recorded instrument whereby the
successor trustee was appointed
Changes of ownership due to divorce a Copy of complete Divorce Decree,
including Settlement Agreement
n Recorded conveyances (if appropriate)
Bankruptcy
1. Chapter 11 a Plan of Reorganization
Order Confirming the Plan of Reorganization
2. Chapter 7 a Recorded conveyances as appropriate
Owner having a Life Estate dies a Copy of life tenant's death certificate
a Names and address of remaindermen
(If additional documentation is required, you
will be notified at that time).
Interest is Owned as Joint Tenants a Copy of death certificate of joint tenant
and one dies
9E0,::413
ti National Cooperative Refinery Association
2000 SOUTH MAIN ST. • P.O. BOX 1404 • McPHE6E1414CAAUSi6T8�480 • 318/241-2340
A')1 32 Ali 9: 06
C!E«;(
August 26, 1992 TO THE SC;;ID
Weld County Board of
County Commissioners
Weld County Centennial Center
915 10th St .
Greeley, CO 80631-1123
RE: MEL BICKLING 31-22 - 06686
Weld County, Colorado
Dear Interest Owner:
Effective August 1 , 1992 , National Cooperative Refinery
Association (NCRA) began purchasing the crude oil production from
the referenced property.
Enclosed are two copies of NCRA' s Division Orders for your
execution . Please sign them before witness, making sure to
affix your mailing address and either your social security number
or federal id number in the spaces provided. Without the
appropriate tax information included, we are required by the IRS
to withhold twenty per cent (20%) of all payments .
One copy of the Division Order, when fully signed, is to be
returned to this office in the enclosed envelope. The remaining
copy is for your files .
If you have any questions, please contact me.
Sincerely,
NATIONAL COOPERATIVE
REFINERY ASSOCIATION
tAGACta- @t5 t
Rhonda L. Klatt
Title Analyst
Enclosures
RLK:ag
920;1:49
Supplying Refined Fuels FARMERS UNION CENTRAL EXCHANGE, INC., (GENE%), SAINT PAUL, MINNESOTA• FARMLAND INDUSTRIES, INC., KANSAS CRY, MISSOURI
To Our Member-Owners GROWMARK,INC.,BLOOMINGTON,ILLINOIS• MFA OIL COMPANY,COLUMBIA MISSOURI
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