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Kerr-McGee Onshore LP Division Order
WELD COUNTY BOARD OF COMMISSIONER See reverse for list of
Properties and Interests.
PO Box: 758
GREELEY, CO 80632 Effective Date: Date of First Sales
The undersigned certifies the ownership of their decimal interest in production as described above payable by Kerr-McGee
Onshore LP (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, or Sept. 30 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.
Note: NADOA Model Form Division Order(Adopted 9/95)
Special Clause(s): Payee agrees that by execution of this DO and returning the signature page to Payor that the signature page
will be attached to Payor's duplicate original of this instrument and treated as an original for all purposes.
RECEIVED
N0V 1 7 2015
WELD COUNTY
COMMISSIONERS
RV37471404
WELD COUNTY BOARD OF COMMISSIONER
XXX-XX-0813
JAN 1 3 20i
SIGNATURE:
2016
i'ro-Tem s (/ue Weld County Government
BOARD OF WE COUNTY OMMIS I `S, 1150"O"Street
ATTES ��, �r Greeley,CO 80634
CLER T. E BO' : " Phone:970-336-7204
BY: ism Qom'/ Fax:970-336-7233
t Tax ID:84-6000-813
DEPUTY CLERK "4:4-61v
P THE BOARD I I
2016-0181
YOUR COPY
*Failure to furnish your Social Security/Tax ID number will result in withholding tax in accordance with federal law and any tax withheld
will not be refundable by payor.
**All individual parties must complete and return the enclosed W9 to ensure proper payment.Additional forms may be obtained at www.irs.gov
Please return to: _ Date Prepared: November 11, 2015
Kerr-McGee Onshore LP X 1330 V
Z Prepared By: BERNADETTE FOSTER -MT
P.O.HOUSTON, TX 77251-9874 O fze_ /1_
4/o Escheat Flag: N Suspense Flag:
L�b0 3
1-800-359-1692 oirrw rr-
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Property Property Name Product State/County Int Type Int Seq Interest
333742 THOMSEN 4N-18HZ NBRR All Products CO/WELD RI 1 0.01785714
Legal Description: AP)2N65WSE5: SWSW- SOA
SEC 6: SESE - NO SOA
SEC 7: E2E2 - SOA
SEC 8: W2W2 - NO SOA
SFC 17: W2NW- NO SOA
SFC 18: E2NE - NO SOA
560.00 ACS M/L
WELD COUNTY, CO
NIOBRARA FORMATION
*Failure to furnish your Social Security/Tax ID number will result in withholding tax in accordance with federal law and any tax withheld
will not be refundable by payor.
**All individual parties must complete and return the enclosed W9 to ensure proper payment.Additional forms may be obtained at www.irs.gov
Please return to: Date Prepared: November 11, 2015
Kerr-McGee Onshore LP Prepared By: BERNADETTE FOSTER - MT
P.O. BOX 1330 Suspense Flag: N
HOUSTON, TX 77251-9874 Escheat Flag: N
1-800-359-1692
Page 2 of 2
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COGIS - WELL Information Page 1 of 1
COGIS - WELL Information
Scout Card 21-'4 Related Insp. MIT •GIS a Doc a COA Yf Wellbore i Orders
Surface Location Data for API # 05-123-40312 Status: PR 6/5/2015
Well Name/No: THOMSEN#4N-18HZ (click well name for production)
Operator: KERR MCGEE OIL&GAS ONSHORE LP-47120
Status Date: 6/5/2015 Federal or State Lease#:
County: WELD#123 Location: NENE 7 2N 65W 6 PM
Field: WATTENBERG -#90750 Elevation: 4,911 ft.
Planned Location 472 FNL 875 FEL Lat/Long:40.159147/-104.700241 Lat/Long Source:Field Measured
Frac Foas
Job Date: 3/26/2015 Job End Date: 4/6/2015 Reported: 5/19/2015 Days to report: 43
Chemical Disclosure Registry
Wellbore Data for Sidetrack#00 Status: PR 6/5/2015
Spud Date: 10/9/2014 Spud Date is: ACTUAL
Wellbore Permit HORIZONTAL
Permit#: Expiration Date: 9/24/2016 4:40:20 PM
Prop Depth/Form: 14737 Surface Mineral Owner Same:
Mineral Owner: FEE Surface Owner: FEE
Unit: Unit Number:
Formation and Spacing: Code:NBRR,Formation: NIOBRARA,Order: ,Unit Acreage:560,Drill Unit:GWA
Casing: String Type:SURF,Hole Size: 13.5,Size:9.625,Top:0, Depth: 1279,Weight:36
Cement: Sacks:480,Top:0, Bottom: 1279, Method Grade:
Casing: String Type: 1ST, Hole Size:8.75,Size:7,Top:0,Depth:7787,Weight:26
Cement: Sacks:820,Top:0,Bottom:7787,Method Grade:
Casing: String Type: 1ST LINER,Hole Size:6.125,Size:4.5,Top:6789,Depth: 14737,Weight: 11.6
Cement: Sacks: ,Top: , Bottom: , Method Grade:
Wellbore Completed
Completion Date: N/A
Measured TD: Measured PB depth:
True Vertical TD: True Vertical PB depth:
Top PZ Location: Sec:6 Twp:2N 65W Footage:534 FSL 352 FFELL Depth
Bottom Hole Location: Sec: 18 Twp:2N 65W Footages: 1123 FNL 66 FFELL Depth
Formation Log Top Log Bottom Cored DSTs
Completed information for formation N-COM Status: PR 6/5/2015
1st Production Date: N/A Choke Size:
Status Date: 6/5/2015 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=12340312&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): Thomsen 4N-18HZ NBRR File Location(s): LE0063-1
LE0063-2
BY: DATE: j Ca 15-
Bru e Barker - County Attorney
NOTES: 80 mineral acres/ 560 acres spacing unit * 12.5 % = .01785714 MATCH
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