HomeMy WebLinkAbout20181467.tiffNADOA Model Form Division Order (Adopted 9/95)
DIVISION ORDER
To: PDC Energy, Inc Date:
1775 Sherman Street, Suite 3000
Denver, CO 80203
Attn: Joshua Schumacher (303) 318-6178 or Joshua.Schumacher@pdce.com
Property Number: 105.101286 AVIMCSaila3",021141 Effective Date: March 22, 2017
Property Name: Klein 19N -202S1 NB
Operator: PDC Energy, Inc
County and State: Weld, Colorado
Property Township 5 North, Range 64 West
Description: Section 19: NWNE ( Spaced: Section 19:NE/4, Section 20: N/2 )-487.67 acres
April 23, 2018
Production: X Oil X Gas X Other: all products
Owner Name
and Address:
Weld County Board of Comm
PO Box 758
Greeley, CO 80632-0758
OWNER NUMBER: 43444
Type of Interest: RI
Decimal Interest: 0.00014055
The undersigned certifies the ownership of their decimal interest in production or proceeds as described above payable by PDC
Energy, Inc. (Payor).
Payor shall be notified, 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.
Payor 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 Payor any amount attributable to
an interest to which the undersigned is not entitled.
Payor may accrue proceeds until the total amount equals $50.00, or pay yearly 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 Payor may have certain statutory
rights under the laws of the state in which the property is located.
Special Clauses: A (None or See Attached Exhibit)
SIGNATURE:
BOARD OF
ATTEST.
CLER
BY:
DEPUTY CLERK
Owner Email Address:
20Th Weld County Government
1150 "O" Street
Greeley, CO 80634
Phone: 970-336-7204
Fax: 970-336-7233
Tax ID: 84-6000-813
2018-1467 (,1
i _
Federal Law requires you to furnish your Social Security or Taxpayer Identification Number.
Failure to comply will result in 24% tax withholding and will not be refundable by Payor
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Exhibit A
105.101286 - Klein 19N-202ST NB
Owner No.
Credit To Type Interest
43444 Weld County Board of Comm
+(0.3705/487.6754* 100%* 18.5%) =
RI 0.00014055 « Your Interest
PDC
ENERGY
Corporate Office
1775 Sherman Street, #3000
Denver, Colorado 80203
303.860.5800
www.pdce.com
April 23, 2018
Re: Revised Klein Division Orders
Dear Interest Owner:
RECEIVED
MAY 012018
WELD COUNTY
COMMISSIONERS
Enclosed are two copies of our Division Orders for the above referenced well/wells. These division orders
lay out your proportionate share of revenue from the well/wells which started producing last year. Recently
we have been notified that during the drilling process, the well was not drilled as planned, causing a
shrinkage of the original spacing unit.
If you would like, you can return the signed Division Orders by fax (303-860-5838) or email. Please note,
PDC will only issue a check once the accrued amount has reached $50 or more or it will be paid annually,
whichever occurs first. Our checks are cut and mailed around the 24th of each month.
Please follow the enclosed "Instructions to Interest Owners"for executing and returning one copy of the
Division Order to this office. The extra copy is for your records.
The cut-off for changes in accounting is the 10th of the month. If we receive your Division Orders after the
10th, the pay change will take place the following month.
If you have any questions pertaining to the calculation of your interest on the Division Order, please feel
free to contact me by e-mail at Joshua.S(.huracher@pdec.com and I will email you the calculations. If you
have general Division Order questions, please visit our website: www.pdce.com/division-orders. Changes
in ownership or address should also be directed to my attention. If you have questions pertaining to revenue
or revenue checks, please contact the Revenue Department at the Bridgeport Office.
Sincerely,
7)
Josh Schumacher
Division Order Analyst
(303) 318-6178
Enclosures
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 and legal
description.
Well Name(s): Klein 19N-202ST
File Location(s): LE0328 6, LE0387, 7, LE0388, 8, LE0391
91
BY:
Bruce Barker - County Attorney
DATE:
NOTES: 0.3705 mineral acres/ 487.6754 acres spacing unit * 18.5% = 0.00014055 MATCH
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