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RESOLUTION
RE : AUTHORIZATION TO SIGN AMENDED OIL AND GAS DIVISION ORDER
REGARDING AMOCO PRODUCTION COMPANY , P . O . BOX 591 , TULSA ,
OKLAHOMA 74102 , LOCATED IN WELD COUNTY , COLORADO .
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 is the holder of a certain
lease with Amoco Production Company . Said lease covers land
more particularly described as follows , to - wit :
West Half of Section 21 , Township 3 North ,
Range 67 West in Weld County , Colorado
WHEREAS , Amoco Production Company has submitted an amended
Oil and Gas Division Order on the subject property .
NOW , THEREFORE , BE IT RESOLVED by the Board of County
Commissioners of Weld County , Colorado , that said Board does
hereby execute the amended Oil and Gas Division Order and further
authorizes the Chairman of the Board of County Commissioners to
sign the same .
The above and foregoing Resolution was , on motion duly made
and seconded , adopted by the following vote on the 16th day of
August , A . D . , 1978 .
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY , COLORADO
Ler4
-- -tozeY4 e'anzpic
77ra
•
ATTEST : ' i :. .�c ' Ut'v o.�, 4"{/ 1'tt iain}
Weld County Clerk and Recorder
and Clerk to the Boar • �"
By :
Deputy County Cl -' rJk-
//
APPROVED AS TO FORM :
o
County Attorney
Date Presented : August 21 , 1978
cc : Moor ° / C- 007634
14Q 4 780003 --- a
L-628883
WGA:ct/7148
T AMENDED
� Oil and Gas Division Order
To: Amoco Production Company Property No. 400169
P. O. Box 591,Tulsa, Oklahoma 74102 August 1 19 78
Each of the undersigned OWNERS guarantees and warrants he is the owner of the interest set out opposite his name on the reverse side
hereof in oil and gas or the proceeds from the sale of oil and gas from the property described on the reverse side hereof, and until further
written notice either from you or from us,the undersigned owner and all other parties executing this instrument hereby authorize you, your
successors or assigns to receive and measure such sales in accordance with applicable governmental rules and regulations and to give credit
as set forth on the reverse side hereof.
The following covenants are parts of this instrument and shall be binding on the undersigned,their successors, legal representatives, and
assigns:
Oil: Oil sold hereunder shall be delivered f.o.b.to the carrier designated to gather and receive such oil, and shall become your property
upon receipt thereof by the carrier designated by you or by any other purchaser to whom you may resell such oil. The term "oil"as
used in this division order shall include all marketable liquid hydrocarbons.
Should the oil produced from the herein described land be commingled with oil produced from one or more other separately owned
tracts of land prior to delivery to the designated carrier,the commingled oil sold hereunder shall be deemed to be the interest of the
undersigned in that portion of the total commingled oil delivered which is allocated to the herein described land on the basis of lease
meter readings or any other method generally accepted in the industry as an equitable basis for determining the quantity and quality
of oil sold from each separately owned tract. Such formula shall be uniformly applied to all owners of an interest in the tracts of land
involved.
Should the interest of the undersigned in the oil produced from the herein described land be unitized with oil produced from one or
more other tracts of land,this instrument shall thereafter be deemed to be modified to the extent necessary to conform with the
applicable unitization agreement or plan of unitization, and all revisions or amendments thereto,but otherwise to remain in force and
effect as to all other provisions. In such event,the portion of the unitized oil sold hereunder shall be the interest of the undersigned
in that portion of the total unitized oil delivered which is allocated to the herein described land and shall be deemed for all purposes
to have been actually produced from said land.
You agree to pay for the oil sold hereunder at the price posted by you for oil of the same grade and gravity in the same producing
field or area on the date said oil is received by you or the designated carrier. If you do not currently post such a price, then until
such time as you do so,you agree to pay the price established by you. You are authorized to reduce the price by those truck, barge,
tankcar,or pipe line transportation charges as determined by you.
Should the oil sold hereunder be resold by you to another purchaser accepting delivery thereof at the same point at which you take
title, you agree to pay for such oil based upon the volume computation made by such purchaser and at the price received by you
for such oil, reduced by any transportation charges deducted by such purchaser.
Quality and quantity shall be determined in/accordance with the conditions specified in the price posting. You may refuse to receive
any oil not considered merchantable by you.
Gas: Settlements for gas shall be based on the net proceeds realized from the sale thereof, after deducting a fair and reasonable charge
for compressing and making it merchantable and for transporting if the gas is sold off the property. Where gas is sold subject to
regulation by the Federal Power Commission or other governmental authority,the price applicable to such sale approved by order of
such authority shall be used to determine the net proceeds realized from the sale.
Settlements:Settlements shall be made monthly by check mailed to the respective parties according to the division of interest herein
specified at the latest address known by you, less any taxes required by law to be deducted and paid by you applicable to owner's
interest.
Evidence of Title:The oil and gas lease or leases, and any amendents, ratifications,or corrections thereof, under which said gas and/or oil
is produced are hereby adopted, ratified, and confirmed as herein and heretofore amended. In the event any dispute or question
arises concerning the title to the interest of the undersigned in said land and/or the oil or gas produced therefrom or the proceeds
thereof, you will be furnished satisfactory abstracts or other evidence of title upon demand. Until such evidence of title has been
furnished and/or such dispute, defect, or question of title is corrected or removed to your satisfaction, or until indemnity satisfactory
to you has been furnished, you are authorized to withold the proceeds of such oil or gas received and run, without interest. In the
event any action or suit is filed in any court affecting the title to the interest of the undersigned in the herein described land or the
oil or gas produced therefrom or the proceeds thereof to which the undersigned is a party,written notice of the filing of such suit or
action shall be immediately furnished you by the undersigned,stating the court in which the same is filed and the title of such suit or
action.You will not be responsible for any change of ownership in the absence of actual notice and satisfactory proof thereof.
Contingent Interests: Whether or not any contingency is expressly stated in this instrument,you are hereby relieved of any responsibility for
determining when any of the interests herein shall increase,diminish,terminate, be extinguished or revert to other parties as a result
of the completion or discharge of money or other payments from said interest, or as a result of the expiration of any time or term
limitation(either definite or indefinite,and, unless you are also the operator of the property, as a result of an increase or decrease in
production,or as a result of a change in the depth,the methods or the means of production, or as a result of a change in the allocation
of production affecting the herein described land or any portion thereof under any agreement or by order of Governmental authority,
and until you receive notice in writing to the contrary,you are hereby authorized to continue to remit without liability pursuant to the
division of interest shown herein.
Warranties: Working Interest Owners and/or Operators,and each of them, by signature to this instrument, certify, guarantee and warrant,
for your benefit and that of any pipe line or other carrier designated to run or transport said oil or gas,that all oil or gas tendered here-
under has been and shall be produced from or lawfully allocated to the herein described land in accordance with all applicable Federal,
state and local laws, orders, rules and regulations.
This instrument may be executed by one or more, but all covenants herein shall be binding upon any party executing same and upon
his'heirs,devisees,successors,and assigns irrespective of whether other parties have executed this instrument.
•
` (at t l�✓w t 7�G r1$/L9�,C�(r.,
ATTEST: _chairman
Weld County Clerk and
Recorder and Clerk 2/ Commissioner
to the Board
- „c-t; Comm
Commissioner
By; Commissionerissioner
y County Clem
Form 697 2-77
Oil and Gas Division Order
Property described as.
L-628883 (400169) ALBERT D. KURT 26.U. "C" (NAV)
W/2 Section 21-T3N-R67W as to gas and associated liquid hydrocarbons.
in Weld 9dfx
County, State of_ Colorado and
commencing with First Runs, or at 7 a.m.
Credit To (Name of Owner) Division of Interest
(See Division of Interest Digest of even date attached and made a part hereof)
Amoco Production Compdoy
_ - Ba,r.1�tin �,
r- •) Division of Interest Digest
Ddled .. 8/.1/78 _.. Cat
(OD of
ALBERT D. KURTZ GAS UNIT "C" FAC Code IOD
,"---` Property Name r
Operator-._ AMOCO — land No - .528883 ..... .--- .4001.69--. __- i (.9.._> I. ._ ..._. ID i ;;
_......___.___ t a 7 B
Field — ----- -- ---WA_TTENB .RG --.... 0.'0 No . .._.._. . . .. . ...
,=_,.• State_ COLORADO _T County/Kt .._ _.. ..._.. ._WELD . -
' • Purchasers D!0 No. or Contract No. and Purchasers Name • Card No. 13.1 Change Code L3 J
Oil -— .__ _ ____i —. --_. . .__._ ... iJ 13
[1j condensate-52974 -- / KOCH OIL COMPANY -_-- _ -__ -. -_-- F-1
M Nat) Gas - 81.060 --_---_ / PANHANDLE EASTERN P/i CQ,. ._ __ Sequence Code t iie B _
ri C/H Gas - . to..--�-_• . .---'--. ..._.. . ._ .......--� (Enter '!<' d:(Pphcable)
WGA:rt/621 1 '
Business i i
m . Aswcrote Taxpayer Identification No. cv x
Number I o e I v I - I Cumuli I e
o Name and Address ` o Interest . 0 5 k
U
t T` a_ I a ta
a I s ' + 100 Not Kevpunchl
BBY.C �
— �-- --�— 1(25.26) (27.28) (29J9) (31.38) 1381 140411
�(16) 1 (16-211 122231(1241 -1- 39 -T- -
1 I i I
0 617000 001. 5 AMOCO PRODUCTION COMPANY 01 1871414
• 302.86/320 x .875 WI ( .8281328) I
Less: 5% x 1 .52/320 ORI (.0002375) !
81 .25% x 17.14/320 WI (.0435195) 1
I
1 798191 00 3 X 0 EXPLORATION COMPANY 02 I !000237
5% x 1 .52/320 ORI I !
1 511851 00 8 GREAT WESTERN SUGAR COMPANY 04 ! '000593 !
• 1 .52/320 x 1/8 RI I I
ii
1 765255 100 .5 I WELD COUNTY COLORADO 04 II I .0005469(
1
c/o Board of County Commissioners I (Tax Exlempt)
1 1 .40/320 x 1/8 RI I • 11
1 1 525778 4001 7 KURTZ, ALBERT D 04 1 I I 117164d13634 Rd 17 I i $
i 1 . Platteville, Colorado 80651 . ?
I 299.94/320 x 1/8 RI ! `
602816 0 1 CHAMPLIN PETROLEUM COMPANY 04 1 0100430
1 I
•
17.14/320 x 18.75%
I
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Instructions To All Interest Owners
Read Carefully Before Signing The Instrument
This instrument should not be altered in any way unless accompanied by documentary
evidence to support the change.
If your name and interest are correctly shown:
Signature: Sign name as shown on the instrument. Have your signature witnessed.
If signing for a corporation, signature must be attested, corporate seal affixed,
and title of signatory party shown.
Signature by Second If the instrument is signed by agent, attorney-in-fact, guardian or any party
Party: other than the named interest owner, we must have evidence of the rights
vested in the signatory party.
Taxpayers Identification Insert your number in the space provided below your name on the instrument
Number or Social in accordance with the instructions reproduced on the reverse side hereof.
Security Number:
Mailing Address: Insert the address to which checks are to be mailed. Print or type. Do not
abbreviate. If you are already receiving checks from this company, be sure to
use the same address to which we are now mailing checks.
Property Number: In the upper right corner of the instrument you will find the number assigned
to this property. This number will appear on the statement attached to your
check and should always be used when corresponding with this company.
Settlement for your Upon receipt of the properly executed instrument and evidence of clear title,
Interest: the interest credited to you will be authorized for payment. Instruments must
be received in our office by the 20th of the month for checks to be issued the
following month. Checks will be mailed monthly when accruals to your interest
equal $25.00 or more. In November of each year payment will be made for all
accumulated sums of more than $1 .00.
Change of Address: You should notify us promptly of any change in your mailing address. This
notice must be over your own signature, or the signature of your appointed
agent. Always include your business associate number and your old address,
then state your new address with zip code.
Return the executed instrument without delay to the address below. Keep one copy for
your records.
Amoco Production Company
(Attention: Division Order Section)
P.O. Box 591
Tulsa, Oklahoma 74102
�_,m "^"-77 (See reverse side for additional information)
Instructions for furnist...tg Taxpayer Identification Number o. Social Security Number:
If this account is in the name of:
An individual, furnish the individual's own social security number. A widow 62 or over
who received social security benefits before January 1, 1963, and who has no number of
her own may use the benefit number for tax purposes. All other persons must have their
own number.
Two or more persons (for example, "A and B as joint owners" or "A, B, and C as tenants
in common"), only one number need be furnished. Ordinarily, the number of any one of the
persons will be sufficient, except that if the choice is between husband and wife, furnish the
social security number of the husband—or if between adult and minor, furnish the social
security number of the adult. Underline the name of the person whose number is furnished.
A designated guardian, custodian, committee, etc., and one or more wards, minors,
incompetents, or other individuals, furnish the social security number of the ward, minor,
incompetent, etc., and underline the name of the individual whose number is furnished
(for example, "A as custodian for B under the Uniform Gifts to Minors Act'
furnish B's social security number and underline B's name).
A so-called trust, which is not a legal or valid trust, furnish the social security number
of the person named as trustee and underline his name (for example, a savings account,
not formalized by a trust instrument, in the name of "A in trust for B7 furnish the social
security number of A and underline A's name).
A trust, estate, pension trust, corporation, partnership, broker, registered nominee, etc.,
furnish the employer identification number of the entity (for example, "A, trustee under the
will of S for benefit of Y," furnish the employer identification number of the trust). If an
employer identification number is needed, contact any Internal Revenue Service office.
If you do not now have a Social Security Number:
You may obtain the form upon which to make application for a number at your nearest Social
Security or Internal Revenue Service Office. When you have obtained your number notify
this company of the same without delay at the Address appearing on the face hereof.
How to read your check statement
BUSINESS ASSOCIATE NO. PURCHASED OR SOLD QUANTITY YOUR INTEREST
Number assigned to you as an Month and Year of Sales or Barrels. Tons or MCF (Thou- Before Tax is your decimal in-
interest owner. Purchases included in this sand Cubic Feet) sold from terest in gross value,after tax
payment. the Lease. column is your decimal in-
terest in net value after
severance and other produc-
tion taxes.
aco Production Company summer a(rand an oah.W wsae
nss o ao.ssI Tuba.ouanonta�a .o.n.n.,,u.ren ma pw.ns o.w�..a.,ol.m,..n.a
volt,Interest
686516 X00 6
Properly No ua v. rno v. 'L C puanrily lolel ia. To al Value alter Tax B...to Ali.Tam
260200 00 1 01 71 01 1 010 92 202 18 2 699 16 362 67 337 39
260200 00 1 01 71 02 2 742 46
22 436 40 60 33 54 55
423 00 391 94
.Lc. -e..„em -
I GreSS 90,9 Cost n, a-c . .,oth
LEGEND CODE TOTAL VALUE
Identifies what each line AFTER TAX
represents. Net value of total sales
from the property after
all taxes are paid.
TOTAL TAX
PROPERTY NO. Severance and other Produc-
Number assigned to the lease,Unit, etc. First six numbers are tion taxes paid on the oil or
basic property number.The next two numbers are the sub prop- gas sold from the property.
erly numbers to enable different types of sales to be recorded Federal income taxes are not TOTALS
from the same property.The last number is a"Check digit"to deducted except for non- Total of all your interest pay-
:__..__..____..._....... .........en.... .�ho. resident aliens. able on this check.
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