HomeMy WebLinkAbout20160176.tiff NADOA Model Form Division Order (Adopted 9/95)
DIVISION ORDER
To: Great Western Oil & Gas Company, LLC Date: January 6,2016
1801 Broadway, Suite 500
Denver, CO 80202
Attn: Caitlin McEwen
Property Number: W10976 Effective Date: First Sales
Property Name: KODAK NORTH FD 28-082HC
Operator: GREAT WESTERN OPERATING CO LLC
County and State: Weld, Colorado
Property Township North, Range 67 West /- /2J 65-m3-3?-3g5-
Description: Section 26: NW
Production: X Oil X Gas X Other: all products
OWNER NAME AND ADDRESS: OWNER NUMBER: 1381
WELD COUNTY ATTN: BARB CONNOLLY TYPE OF INTEREST: RI
PO BOX 758 DECIMAL INTEREST: 0.00074529
GREELEY , CO 80632
The undersigned certifies the ownership of their decimal interest in production or proceeds as described above
payable by Great Western Oil & Gas Company, LLC (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$100.00, 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 Payor may have certain
statutory rights under the laws of the state in which the property is located.
SIGNATURE: JAN 1 3 2016
BOARD OF • LD COUN OMM SI• ��e��
ATTE . • Weld County Government
CLE K T / E BO 1150"O"Street
r / _ � , ��++r�� Greeley,CO 80634
BY
�� ��� ( = tkt Phone:970-336-7204
DEPUTY CLER TO TH BOAR , ` ''•i4 ' Fax:970-336-7233
0 A Tax ID:84-6000-813
•
Federal Law requires you to furnish rity or Taxpayer Identification Number.
Failure to comply will result in 31 %to"`;'" . ding and will not be refundable by •--
CJM 2016-0176
Retain this copv�r vo rs�
� L3 6/
I - I3-I /-- �3-/� ( n?IO
in m
c a v .....i
4a it
CO 4,4
F Co
F,14 W
'400 a o
O a w o
H
a, w d- r.
0 � G o 0
O O O
C4 .a o 0
d-
u Cd 0 0
L
p o 0
E. 0 0
0 0
s r
1-, v) M M
'.. L 00 oo
r7 ai
Q el
ca
VO d' O
U � ~
L v r-+ O
Q a]
ala A N co
•�R. a.)
'E
0 v vco
ax q a,
.b y oo
g4 CC o o
0
ca
a)
at
a -g
= c4 `"
vi
`O M S,O
+-' O
R
I. .�
E-0 0
U
at
4 E 0 0 2
A > a UL cd
Qao a) a
aa :. 33 Q
Great Western Operating Company, LLC September 15, 2015
Page 106
1.088794% (LOR)
17.5%LOR[Lease AAAA]x 100%MI
[Tract 120]x(34.740/558.370 acres)
0.387391% (LOR)
18.25%LOR[Lease XXX]x 100%MI
[Tract 116]x(10.030/558.370 acres)
Plus
17.5%LOR[Lease AAAA]x 100%MI
[Tract 119]x(1.240/558.370 acres)
Plus
17%LOR[Lease ZZZ]x 100%MI
[Tract 118]x(0.680/558.370 acres)
0.317128% (LOR)
15%LOR[Lease Al x 100%MI
[Tracts 2,5,8]x(11.805/558.370 acres)
0.15075 1% (LOR)
17.5%LOR[Lease F]x 100%MI
[Tract 12]x(4.810/558.370 acres)
eld County,Colorado 0.074529% (LOR)
18.5%LOR[Lease RRRR]x 100%MI
[Tract 13]x(1.840/558.370 acres)
Plus
12.5%LOR[Lease B]x 100%MI
[Tract 6]x(0.606/558.370 acres)
0.049322% (LOR)
17%LOR[Lease V VV]x 100%MI
[Tract l 14]x(1.620/558.370 acres)
0.026928% (LOR)
17%LOR[Lease PPPP]x 50.83%MI
[Tract 115]x(1.740/558.370 acres)
0.026048% (LOR)
17%LOR[Lease WWW]W]x 49.17%MI
[Tract 115]x(1.740/558.370 acres)
0.023748% (LOR)
17%LOR[Lease YYY]x 100%MI
[Tract 117]x(0.780/558.370 acres)
0.012425% (LOR)
18.75%LOR[Leases SSSS,VVVV]x 100%MI
[Tracts 18,57]x(0.370/558.370 acres)
0.010960% (LOR)
17%LOR[Lease IIII]x 100%MI
[Tract 100]x(0.360/558.370 acres)
0,010656% (LOR)
1 %LOR[Lease KKK]x 100%MI
[Tract 90]x(0.350/558.370 acres)
------ 0.010352% (LOR)
17%LOR[Lease JJJJ]x 100%MI
[Tract 103]x(0.340/558.370 acres)
0.010047% (LOR)
17% ease FIT]x 100%MI
Tract 70 x 0.330/558.370 acres)
° 0.010047% (LOR)
17%LOR[Lease RR]x 100%
[Tract 69]x(0.330/558.370 acres)
N
CO
2
,w M
et
O
N
O
0
N
N � M
O
Y I
COGIS - WELL Information Page 1 of 1
COGIS - WELL Information
Scout Card I'' Related O Insp.4 MIT GIS a Doc .COA Wellbore 'Orders
Surface Location Data for API # 05-123-39385 Status: DG 12/14/2014
Well Name/No: Kodak North FD#28-082HC(click well name for production)
Operator: GREAT WESTERN OPERATING COMPANY LLC- 10110
Status Date: 12/14/2014 Federal or State Lease#:
County: WELD#123 Location: SENW 26 6N 67W 6 PM
Field: WATTENBERG -#90750 Elevation: 4,761 ft.
Planned Location 2252 FNL 1970 FWL Lat/Long:40.459011/-104.863283 Lat/Long Source: Field Measured
Frac F Job Date: 5/25/2015 Reported: 6/19/2015 Days to report: 16
Chemical Disclosure Registry Job End Date: 6/3/2015
Wellbore Data for Sidetrack#00 Status: DG 12/14/2014
Spud Date: 12/14/2014 Spud Date is: ACTUAL
Wellbore Permit HORIZONTAL
Permit#: Expiration Date: 5/2/2016 12:20:16 PM
Prop Depth/Form: 14230 Surface Mineral Owner Same:
Mineral Owner: FEE Surface Owner: FEE
Unit: Unit Number:
Formation and Spacing: Code:CODL,Formation:CODELL,Order: , Unit Acreage:560, Drill Unit:GWA
Casing: String Type:CONDUCTOR, Hole Size:24,Size: 16,Top:0, Depth:80,Weight:42
Cement: Sacks: 121,Top:0, Bottom:80,Method Grade:
Casing: String Type:SURF, Hole Size: 13.5,Size:9.625,Top:0, Depth: 1054,Weight:36
Cement: Sacks:475,Top:0, Bottom: 1068,Method Grade:
Casing: String Type: 1ST,Hole Size:7.875, Size:5.5,Top:0,Depth: 15101,Weight: 17
Cement: Sacks: 1625,Top:0, Bottom: 15101,Method Grade:
Casing: String Type: 1ST LINER,Hole Size:6.125,Size:4.5,Top:6800, Depth: 14231,Weight: 11.6
Cement: Sacks:403,Top:6800,Bottom: 14231, Method Grade:
Wellbore Completed
Completion Date: N/A
Measured TD: Measured PB depth:
True Vertical TD: True Vertical PB depth:
Top PZ Location: Sec:26 Twp:6N 67W Footage: 1084 FNL 1825 FWL Depth
Bottom Hole Location: Sec:28 Twp:6N 67W Footages: 1084 FNL 300 FEL Depth
Formation Log Top Log Bottom Cored DSTs
Completed information for formation N-COM Status: PR 12/14/2014
1st Production Date: N/A Choke Size:
Status Date: 12/14/2014 Open Hole Completion:
Commingled: Production Method:
Formation Name: NOT COMPLETED Status: PR
Tubing Size: Tubing Setting Depth:
Tubing Packer Depth: Tubing Multiple Packer:
Open Hole Top: Open Hole Bottom:
No Initial Test Data was found for formation N-COM.
No Perforation Data was found for formation N-COM.
http://cogcc.state.co.us/cogis/FacilityDetail.asp?facid=12339385&type=WELL 1/5/2016
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): Kodak North FD 28-082HC File Location(s): LE0239
LE0330
BY: DATE: /(' '(
Bruc Barker - County Attorney
NOTES: .606 mineral acres/ 558.37 acres spacing unit * 12.5% = 0.0001356
1.84 mineral acres/ 558.37 acres spacing unit * 18.5% = 0.0006096
Add together to = .0007452 = MATCH
Hello