HomeMy WebLinkAbout20150235.tiff NADOA Model Form Division Order (Adopted 9/95)
DIVISION ORDER
To: Bonanza Creek Energy, Inc. Date: December 23, 2014
410 17th Street, Suite 1400
Denver, CO 80202
Attn: John McLoughlin
Property Number: CO001091 Effective Date: April 13, 2013
Property Name: PRONGHORN F-J-I5HNB
Operator: BONANZA CREEK ENERGY INC
County and State: Weld, Colorado
Property Township 5 North, 'laze 61 West
Description: Section 15: ALL
API 05- 123 - 3611 &
Production: X Oil X Gas X Other: all products
Owner Name OWNER NUMBER: 1041
and Address:
WELD COUNTY BOARD OF COMMISSIONERS Type of Interest: RI
P O BOX 758 Decimal Interest: 0.06250000
GREELEY, CO 80632-0758 Interest Calculation:
The undersigned certifies the ownership of their decimal interest in production or proceeds as described above payable by
Bonanza Creek Energy, Inc. (Payor).
(Company Name)
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 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.
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. Unless otherwise required by law, Payor shall not be required to pay interest on
payments withheld due to a title dispute or adverse claim.
Special Clauses: (1V ne or ee Att c ed Exhibit)
Owner(s) Signature(s): 1. t„' �?� ra Kirkmeyer , Chair
ELD COUNT BO O WWII*
Owner Daytime Telephone 970-336-7204 I � t z
1161 sS r o the Boar . LEOO $I - 5
Owner FAX Telephone #: 970-336-7233 I
�� fc`,••7 I erk to the Boaan
Federal Law requires you to furnish your Social �. . `. i≥ , " er Identification Number.
Failure to comply will result in 31 % tax withholdin_ . l a not be refundable by I
2015-0235
Cement lova) Retain this copy for your recordsJM
RECEIVED
DEC 2 4 201
1'" ''.D COUNTY
INSTRUCTIONS TO ALL INTEREST OWNERS COMMISSIONERS
BONANZA CREEK ENERGY, INC.. HAS ENCLOSED AN OIL DIVISION ORDER OR TRANSFER ORDER FOR
YOUR EXECUTION. IF YOU ARE RECEIVING A DIVISION ORDER FROM GWSI FOR THE FIRST TIME,
PLEASE BE ADVISED THAT WE ARE THE NEW OIL PURCHASER. IF A TRANSFER ORDER IS ENCLOSED
WE ARE EVIDENCING CHANGES OF OWNERSHIP IN AN EXISTING WELL.
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 Oil Division Order or Oil Transfer Order.
2. Have your signature witnessed by two competent witnesses.
3. If your name has changed due to marriage or divorce,execute the Oil Division Order or Oil Transfer 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. Oil Division Orders or Oil Transfer 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. Should you fail to provide your correct Social Security Number or Tax Identification Number,the law
provides that we withhold 28%of all production proceeds due you. You may also be subject to a further
penalty levied by the Internal Revenue Service.
8. Your correct mailing address should be noted in the space provided to insure prompt receipt of production proceeds.
9. The top copy or the"Original"of the Oil Division Order or Oil Transfer Order should be returned to:
Bonanza Creek Energy,INC
410 171h Street,Suite 1400
Denver,Co 80202
Attn: John McLoughlin
10. Should you have any further questions regarding the enclosed Oil Division Order or Oil Transfer Order,
please contact your Operator.
11. Please DO NOT DETACH the exhibit from the Oil Division Order or Oil Transfer Order if one is included.
PRONGHORN F-J-15HNB
SPUD:3/13/2013
DOFP:4/13/2013
NW ATTORNEYS At LAW
tai RASHC HAPMAN
RAMS p
April 18,2013
SECOND SUPPLEMENTAL
DIVISION ORDER TITLE OPINION
Bonanza Creek Energy,Inc.
410 17th Street
Suite 1500
Denver,CO 80202
Attention: Mr.Jared Rush
RE: PRONGHORN 31-34-15HZ WELL and PRONGHORN F-J-15HNB WELL
situated on the following land located in Weld County,Colorado:
All of Section 15,Township 5 North,Range 61 West,6s'PM,containing 640 acres,more
or less(the"Captioned Land").
DESCRIPTION OF LAND
Tract 1: The NW/4 of Section 15, Township 5 North, Range 61 West, 61° PM, Weld
County,Colorado,containing 160 acres,more or less.
Tract 4: The SE/4 of Section 15, Township 5 North, Range 61 West, 6i° PM, Weld
County,Colorado,containing 160 acres,more or less.
nE TITLE
MINERALSt
Tract 1 (NW/4): /
Weld County,Colorado(Lease No. J)---------- -All L U0 v2/14
Tract 4(SE/4): c/)
Weld County,Colorado(Lease No. 4) -- - All Ll.-1°81—5
LEASEHOLD TITLE
(Tract basis; Division of Interest is set out below)
Lease No 1:3'4
Dated:-- July 9,2003.
Recorded:---- -----August 18, 2003 at Reception No. 3096555
in the Office of the Clerk and Recorder of
Weld County,Colorado.
Lessors: ---Weld County,Colorado.
Original Lessee:---- --El Camino Resources/Raymond A.Tonella.
Land Covered:---- —Township S North.Range 61 Weak 6°P.M.
Section 15:NW/4
Weld County, Colorado. containing 160
acres,more or less.
Interest Coveted: MI of the oil and gas estate located in and
under NW/4 of Section 15(Tract 1).
Primary Term: — ----3 years.
Royalty:— —125%on oil and gas.
AanualRental: —$160.00 per year, both before and after
commencement of production.
Pooling:---- Yes, to facilitate orderly well pattern or
comply with governmental requirements.
Lease No.4: 7's
Dated: -----_ — - - ------July 9,2063.
Recorded:--- ---------------Reception No. 3096556 in the Office of the
Clerk and Recorder of Weld County,
Colorado.
Lessor;----- ----- --Weld County,Colorado.
Lessee: ---El Camino Resources,Inc./R.A.Tonella.
Land Covered: -----------Townsbin 5 North.Ranee 61 West._61°P.M.
Section 15:SE/4
Weld County, Colorado, containing 160
acres,more or less.
Interest Covered:— — All of the oil and gas estate located in and
under SE/4 of Section 15(Tract 4).
Primary Term:--- -- 3 years(to July 8,2006).
Rentals Paid: --------Not shown by materials examined.
Royalty:----- 123%on oil and gas.
Pooling:— ---- ----Yes.
Shut-In Gas Clause:--------------Yes.
Special Provisions: --See Drilling and Division Order Title
Opinion dated February 7. 2006 (listed as
Item No. 1 under Prior Opinions,above).
DIVISION OF INTEREST IN THE EVENT OF PRODUCTION
(640 acre unit)
Royalty:
Weld County, Colorado ------ - -- -___.._- ....__...0.06250000
[100%x 25%x 12.5%+ 100%x 25%x 12.5%]
The above calculation represents:
(100%ownership of Tract 1 with a tract participation of.25 and.125 royalty)
(100%ownership of Tract 4 with a tract participation of.25 and .125 royalty)
Lat40°, Inc_ 1635 Foxtrail Drive, Suite 325 Loveland, CO 970-776-3321
WELL LOCATION CERTIFICATE �; N: 13N
THIS 1/-1P DOES NOT REPRESENT A BOUNDARY SURVEY RANCE: 51W
MAD#6 RE1)AR 1M74
LAT:40•C.f2+u 7.5' ALL*. CAP is 13895 LAT.4a.40046N
LC..4:104.2042 V* �..— w_ _' ��" . _ _ — .... LANG Ie47L15t9Y,
i 7 r N 88'19'07'1F-5305.25' i.
PRONGHORN F-J-15HN9 433. 470' M�
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-t1N.o• ror establbhmert of fusee.bulking. or other r.4w.bnprovaneM limos.
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') Barris thorn ore Grid timings elf the Colorado State FUN!Coordnatt LA T, 40 40714T4 • 40.4070319 A .0.1949614
Syster,. North ?ore. North American parer 1981/9007. The Area LOh0d 104.19999V LCAIG 104.10949V LONG) 104.19963'9
dice re,ans at coy tolled herein are based span the 11.5.Sur.ry root.' POCP: 1.0 1/4,1/4: N*1/414W1/4 1/4,1/4; 5(1/45W1/4
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shoe to,year site,the dolt or tb.certificate /'1 a Colorado Licensed Pr- an 1l�.rn, a, it/Ce/7oi
ttww' hors,. (1!--00-10C.RS.) ''.f CALCJLA1ED POSITIYt 4: cAaaa��; t ia201217,1land Surveyor No. 07
COGIS - WELL Information Page 1 of 2
COGIS - WELL Information
Scout Card VmG' Related Q Insp. % MIT O GIS EA Doc EA COA V Wellbore ,
Surface Location Data for API # 05-123-36416 Status: PR 6.
Well Name/No: Pronghorn#F-J-15HNB (click well name for production)
Operator: BONANZA CREEK ENERGY OPERATING COMPANY LLC -8960
Status Date: 6/4/2013 Federal or State Lease#:
County: WELD#123 Location: NWNW 15 5N 61\
Field: WATTENBERG -#90750 Elevation: 4,648 ft.
Planned Location 430 FNL 1187 FWL Lat/Long: 40.40714/-104.19999 Lat/Long Source: F
II"Kip Job Date: 4/3/2013 Reported: 11/8/2013 Days to report 211
Job End Date: 4/4/2013
L���i`t- Job Date: 4/3/2013
Chemical Disclosure Registry Job End Date: 4/4/2013 Reported: 11/8/2013 Days to report: 211
Job Date: 4/3/2013 Reported: 11/8/2013 Days to report: 21i
Job End Date: 4/4/2013
Job Date: 4/3/2013 Reported: 11/8/2013 Days to report 211
Job End Date: 4/4/2013
Job Date: 4/3/2013 Reported: 12/26/2013 Days to report: 26;
Job End Date: 4/3/2013 p
Wellbore Data for Sidetrack #00 Status: PR 6/4
-., ,W 4/1,3,9131 Spud Date is: ACTUAL
e ore ermit HORIZONTAL
Permit#: Expiration Date: 12/17/2014 8:01:4E
Prop Depth/Form: 10891 Surface Mineral Owner Same: N
Mineral Owner: FEE Surface Owner FEE
Unit: Unit Number:
Formation and Spacing: Code: NBRR , Formation: NIOBRARA, Order: 407-633 , Unit Acreage: 640, Drill Ur
Casing: String Type: SURF , Hole Size: 13.5, Size: 9.625, Top: 0, Depth: 410, Weight: 36
Cement: Sacks: 200, Top: 0, Bottom: 410, Method Grade:
Casing: String Type: 1ST , Hole Size: 8.75, Size: 7, Top: 0, Depth: 6536, Weight 26
Cement: Sacks: 500, Top: 2500, Bottom: 6536, Method Grade:
Casing: String Type: 1ST LINER , Hole Size: 6.125, Size: 4.5, Top: 6436, Depth: 10891, We
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: 15 Twp: 5N 61W Footage: 470 FFNLL 1326 FFWLL Depth
Bottom Hole Location: Sec: 15 Twp: 5N 61W Footages: 470 FFSLL 1333 FFWLL Depth
Formation Log Top Log Bottom Core
Completed information for formation N-COM Status: PR
1st Production Date: N/A Choke Size:
Status Date: 4/1/2013 Open Hole Completion:
Commingled: Production Method:
Formation Name: NOT COMPLETED Status: PR
Tubing Size: Tubing Setting Depth:
Tubing Packer Depth: Tubing Multiple Packer:
http://cogccstate.co.us/cogis/FacilityDetail.asp?facid=12336416&type=WELL 12/31/2014
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): Pronghorn F-J-15HNB File Location(s): LEOO81-5
LE0214
BY: , , DATE: / ' /6 ' P j
Brad Y abe - Assistant County Attorney
NOTES: 320 mineral acres/ 640 acres spacing unit * 12.5% = 0.0625 = Match
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