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Home My WebLink About20150673.tiff RETAIN ESN 0.18 Gat \4801 Anrctrl eornt nh ision tinfr 1,,00,r(.1 9 g[)_ DIVISION ORDER l o: Extraction Oil and Gas. I_If Date: 12/17/2014 1888 Sherman Street.Suite 200 Demur,Colorado 80203 Well/Property Name: See Attached Exhibit Well API Number: See Attached Exhibit Well/Property Number: See Attached Exhibit County and State: Weld County,Colorado Property Description: Township 6 North,Range 67 West,Section 28 N/2 Spacing Unit Acres: 314.63 gross acres Production Type: X Oil X Gas Other: Owner Number Owner Name Interest Type Interest 3771 Weld County RI .00241078 The undersigned certifies the ownership of their decimal interest in production or proceeds as described above payable by Extraction Oil and Gas. I If(-Payor-). Payor shall be notified. in writing.of any change in ownership.decimal interest,or payment address. All such changes shall be eticetivc the first day of the month following receipt of such nonce. Payor is authorized to withhold payment pending resolution of a title dispute or ads erse 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 LIMO mil equals S100.00.or pay annually,winches er occurs first or as required by applicable state statute. 1 his 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 Dix ision Order,the undersigned and Payor may have certain statutory rights under the Laws of the stale in which the property is located. A timsimilc or scanned copy of a signed copy of this Division Order shall be deemed an original. Federal Law requires you to furnish your Social Security or Taxpayer Identification Number. Failure to comply will result in 28%tax withholding and will not be refundable by Payor. Signal of�W-t assets: „AdaOs ter(s)Signature, Otcnerls)Tax I.D.(SSN or LIN), Atte t`! � " � la(y ,1G ,e,t— 84-6000-813 Clerk to the Board Name:Barbara Kirkmayor l i 44rta r, Board of Weld MAR 1 1 2015 / • o Cy Commissioners Phone Number (optional): eput •Cle is1 a>t.R9n'�t ' Pt, 1O, ,nail Address(optional). arm, l_ L e sa2Name 2015-0673 ( m ± AT nc / ILL LEO 330 3 1l- 1 `j .3 is EXTR CTION asp. Well# Well Name API# 14*230 KODAK#4 05-123-37258 14*228 KODAK#8 05-123-37253 14*231 KODAK#11 05-123-37251 14*232 KODAK#12 05-123-37254 EXTRACTION OIL AND GAS,LLC,1888 SHERMAN ST,SUITE 200,DENVER,CO 80203-PHONE 720-557-8300 E EXTR CTION 11 EC o,le�a, DEC 2 3 L", INSTRUCTIONS TO ALL INTEREST OWNERS (' EXTRACTION OIL AND GAS LLC. (`EXTRACTION') HAS ENCLOSED A DIVISION ORDER FOR YOUR EXECUTION. PLEASE REVIEW, AND EXECUTE ONE COPY TO BE RETURNED TO OUR OFFICES, AND ONE COPY FOR YOUR RECORDS. THE ATTACHED DOCUMENT SHOULD NOT BE ALTERED IN ANY WAY EXCEPT TO CORRECT SPELLING ERRORS, UNLESS ACCOMPANIED BY DOCUMENTARY EVIDENCE TO SUPPORT THE CHANGE. If your name and interest are correctly shown: 1. Sign your name as shown on the Division Order. 2. Have your signature witnessed by two competent witnesses. 3. If your name has changed due to marriage or divorce,execute the Division Order using your present name and furnish a copy of the marriage certificate or divorce decree. 4. If signing for a corporation, signature must be attested,corporate seal fixed and title of signatory party reflected. 5. If signed by agent, attorney-in-fact,guardian or any party other than the named interest owner,a certified copy of the power of attorney or other evidence of such party's right to sign must be furnished. 6. Division Orders for partnerships must be executed by all partners or by an authorized partner. A certified copy of the instrument giving said partners authority to sign must be furnished. 7. Federal law requires that you furnish a correct social security or taxpayer identification number. Failure to comply will result in 28% tax withholding required by the Internal Revenue Service and will not be refunded by Extraction.You may also be subject to a further penalty levied by the Internal Revenue Service.The enclosed W-9 form must be completed and return with your division order. 8. If the Division Order or Exhibit contains an incorrect mailing address,your correct mailing address should be noted on the exhibit to insure prompt receipt of production proceeds. Please print or type the correct mailing address using no abbreviations. 9. The top copy or the"Original"of the Division Order should be returned to: EXTRACTION OIL AND GAS LLC. 1888 Sherman St., Suite 200 Denver, Colorado 80203 Attn: Holly Graham 10. Should you have any further questions regarding the enclosed Oil Division Order, please contact Holly Graham at hgrahamCextractionog.com 11. Please DO NOT DETACH the exhibit from the Division Order if one is included. EXTRACTION OIL AND GAS,LLC,1888 SHERMAN ST,SUITE 200,DENVER,CO 80203-PHONE 720-557-8300 Weld County Information for Kodak Wells, Habitat Wells and Rubyanna Wells KODAK 4 KODAK 11 1st Production: 11/2014 1st Production: 8/2014 KODAK 8 KODAK 12 1st Production: 8/2014 1st Production: 8/2014 Calculations: Mineral Interest x Royalty x Tract Acres/Unit Acres = NRI Royalty Mineral Tract Unit Owner Interest Royalty Acres Acres NRI Weld County 1.00 0.18500000 4.10 314.63 0.00241077_ Reception #4046794 Colorado OH and Gas Conservation Commission Home Page Page 1 of 1 HOME Conservation Oil and Gas MI Conservation Commission aim ._ ,J .i.mt il,.�c omc, J.} iinsol 1 i lir<ot i.. l;x to ar_r Cinlu I .,rl!l �l'i PRINT PAGE HELP COGIS - WELL Information CONTACTS COMPLAINTS DATABASE Scout h 6 Related O Insp. Q MIT 0 GIS la Doc a CO/ FORMS Card GENERAL HEARINGS Surface Location Data for API # 05-123-37258 St IMAGES DG 1/13/2014 KIDS' PAGE Well Name/No: KODAK#4 (click well name for production) LIBRARY LOCAL GOV Operator: EXTRACTION OIL & GAS LLC - 10459 MAPS Status Date: 1/13/2014 12:00:00 PM Federal or State Lease #: MISSION County: WELD#123 Location: NEWS/MEDIA Field: WATTENBERG -#90750 Elevation: ORDERS Planned Location 1261 FNL 1043 FWL Lat/Long: 40.46171/-104.88538 PERMITS POLICIES Wellbore Data for Sidetrack #00 Sta RULES Spud Date: 1/13/2014 Spud Date is: STAFF RPT Wellbore Permit HORIZONTAL Permit#: Expiration Date: Prop Depth/Form: 11736 Surface Mineral Owner Same: Mineral Owner: FEE Surface Owner: F Unit: Unit Number: Formation and Spacing: Code: CODL , Formation: CODELL , Order: , Unit Acreage: 320, I Formation and Spacing: Code: NBRR , Formation: NIOBRARA , Order: , Unit Acreage: 32 Casing: String Type: SURF , Hole Size: 12.25, Size: 9.625, Top: 0, Depth: YPp Cement: Sacks: 265, Top: 0, Bottom: 500, Method Grade: Casing: String Type: 1ST , Hole Size: 8.75, Size: 7, Top: 0, Depth: 7702, 1 Cement: Sacks: 719, Top: 3000, Bottom: 7702, Method Grade: Casing: String Type: 1ST LINER , Hole Size: 6.125, Size: 4.5, Top: 6519, 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: 28 Twp: 6N 67W Footage: 495 FFNLL 460 FFNLL Bottom Hole Location: Sec: 28 Twp: 6N 67W Footages: 495 FFNLL 460 FFWLL Formation Log Top Log Bottom No additional interval records were found for sidetrack 00. http://eogcc.state.co.us/ 2/18/2015 Colorado Oil and Gas Conservation Commission Home Page Page 1 of 1 HOME Colorado Oil and Gas Conservation Conurussion h:a:•u,n,_the Coloua du fly,L( '.ni.,r Math: I:ar:,Par;nct unlinc P ow,21(I()1'1 PRINT PAGE HELP COGIS - WELL Information CONTACTS COMPLAINTS DATABASE Scout Ei C. Related Q Insp. q MIT O GIS a Doc a co/ FORMS Card GENERAL HEARINGS Surface Location Data for API # 05-123-37253 St IMAGES DG 1/14/2014 KIDS' PAGE Well Name/No: KODAK#8 (click well name for production) LIBRARY LOCAL GOV Operator: EXTRACTION OIL & GAS LLC- 10459 MAPS Status Date: 1/14/2014 12:00:00 PM Federal or State Lease#: MISSION County: WELD#123 Location: I' NEWS/MEDIA Field: WATTENBERG -#90750 Elevation: 2 ORDERS Planned Location 1309 FNL 1042 FWL Lat/Long: 40.46157/-104.88538 PERMITS I POLICIES Wellbore Data for Sidetrack #00 Sta { RULES Spud Date: 1/14/2014 Spud Date is: F' STAFF RPT Wellbore Permit HORIZONTAL Permit#: Expiration Date: Prop Depth/Form: 11865 Surface Mineral Owner Same: P Mineral Owner: FEE Surface Owner: F Unit: Unit Number: Formation and Spacing: Code: CODL , Formation: CODELL , Order: , Unit Acreage: 320, I Casing: String Type: SURF , Hole Size: 12.25, Size: 9.625, Top: 0, Depth: Cement: Sacks: 265, Top: 0, Bottom: 500, Method Grade: Casing: String Type: 1ST , Hole Size: 8.75, Size: 7, Top: 0, Depth: 7610, 1 Cement: Sacks: 165, Top: 6533, Bottom: 7610, Method Grade: Casing: String Type: 1ST LINER , Hole Size: 6.125, Size: 4.5, Top: 6583, 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: 28 Twp: 6N 67W Footage: 1320 FFNLL 460 FFELL [ Bottom Hole Location: Sec: 28 Twp: 6N 67W Footages: 1320 FFNLL 460 FFWLL [ Formation Log Top Log Bottom No additional interval records were found for sidetrack 00. http://cogcc.state.co.us/ 2/18/2015 Colorado Oil and Gas Conservation Commission Home Page Page 1 of 1 HOME Colorado Oil and Gas IMP Conservation Commission glim i! .0,twilCV WV) PRINT PAGE HELP COGIS - WELL Information CONTACTS COMPLAINTS DATABASE Scout 6 Related Q Insp. MIT 0 GIS a Doc a CO/ FORMS Card GENERAL HEARINGS Surface Location Data for API # 05-123-37251 S1 IMAGES DG 1/14/2014 KIDS' PAGE Well Name/No: KODAK#11 (click well name for production) LIBRARY LOCAL GOV Operator: EXTRACTION OIL & GAS LLC - 10459 MAPS Status Date: 1/14/2014 12:00:00 PM Federal or State Lease #: MISSION County: WELD#123 Location: NEWS/MEDIA Field: WATTENBERG -#90750 Elevation: ORDERS Planned Location 1357 FNL 1042 FwL Lat/Long: 40.46144/-104.88538 L PERMITS POLICIES Wellbore Data for Sidetrack #00 Sta RULES Spud Date: 1/14/2014 Spud Date is: STAFF RPT Wellbore Permit HORIZONTAL Permit#: Expiration Date: Prop Depth/Form: 11899 Surface Mineral Owner Same: Mineral Owner: FEE Surface Owner: F Unit: Unit Number: Formation and Spacing: Code: CODL , Formation: CODELL , Order: , Unit Acreage: 320, I Formation and Spacing: Code: NBRR , Formation: NIOBRARA , Order: , Unit Acreage: 32 Casing: String Type: SURF , Hole Size: 12.25, Size: 9.625, Top: 0, Depth: Cement: Sacks: 265, Top: 0, Bottom: 500, Method Grade: Casing: String Type: 1ST , Hole Size: 8.75, Size: 7, Top: 0, Depth: 7473, 1 Cement: Sacks: 684, Top: 3000, Bottom: 7473, Method Grade: Casing: String Type: 1ST LINER , Hole Size: 6.125, Size: 4.5, Top: 6449, 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: 28 Twp: 6N 67W Footage: 1980 FFNLL 460 FFELL L Bottom Hole Location: Sec: 28 Twp: 6N 67W Footages: 1980 FFNLL 460 FFWLL [ Formation Log Top Log Bottom No additional interval records were found for sidetrack 00. http://cogcc.state.co.us/ 2/18/2015 COGIS - WELL Information Page 1 of 1 COGIS - WELL Information Scout M-►CD Related Q Insp. Q MIT 0 GIS ,ac Doc a COA if Wellbore ,, Card Surface Location Data for API # 05-123-37254 Status: DG 1/14/2014 Well Name/No: KODAK#12 (click well name for production) Operator: EXTRACTION OIL & GAS LLC - 10459 Status Date: 1/14/2014 12:00:00 PM Federal or State Lease#: County: WELD#123 Location: SWNW 27 6N 67W E Field: WATTENBERG -#90750 Elevation: 4,770 ft. Planned Location 1373 FNL 1042 FWL Lat/Long: 40.4614/-104.88538 Lat/Long Source: Fielc Wellbore Data for Sidetrack #00 Status: DG 1/' Spud Date: 1/14/2014 Spud Date is: NOTICE Wellbore Permit HORIZONTAL Permit#: Expiration Date: 4/28/2015 12:50:37 PP Prop Depth/Form: 11750 Surface Mineral Owner Same: N Mineral Owner: FEE Surface Owner: FEE Unit: Unit Number: Formation and Spacing: Code: CODL , Formation: CODELL , Order: , Unit Acreage: 320, Drill Unit: GWA Formation and Spacing: Code: NBRR , Formation: NIOBRARA , Order: , Unit Acreage: 320, Drill Unit: GWA Casing: String Type: SURF , Hole Size: 12.25, Size: 9.625, Top: 0, Depth: 500, Weight: 36 Cement: Sacks: 265, Top: 0, Bottom: 500, Method Grade: Casing: String Type: 1ST , Hole Size: 8.75, Size: 7, Top: 0, Depth: 7657, Weight: 26 Cement: Sacks: 712, Top: 3000, Bottom: 7657, Method Grade: Casing: String Type: 1ST LINER , Hole Size: 6.125, Size: 4.5, Top: 6629, Depth: 11916, Weigh 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: 28 Twp: 6N 67W Footage: 2145 FFNLL 460 FFELL Depth Bottom Hole Location: Sec: 28 Twp: 6N 67W Footages: 2145 FFNLL 460 FFWLL Depth Formation Log Top Log Bottom Cored No additional interval records were found for sidetrack 00. http://cogcc.state.co.us/cogis/FacilityDetail.asp?facid=12337254&type=WELL 2/18/2015 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 4 File Location(s): LE0330 Kodak 8 Kodak 11 Kodak 12 BY: , T ; oo_1C(2> DATE: t IS Brad Y:•tabe - Assistant County Attorney NOTES: 4.11 mineral acres/ 314.63 acres spacing unit * 18.5% = .0024107 MATCH Hello