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HomeMy WebLinkAbout20153020 (e) NADOA Model Form Division Order(Adopted 9/95) DIVISION ORDER To: PDC Energy,Inc. Date: July 21,2015 1775 Sherman Street,Suite 3000 Denver,CO 80203 Attn:Jenni L Mosier (303)831-3914 or Jenni.Mosier(ciJpdce.com Property Number: 105.101246 Effective Date:March 5,2015 Property Name: Thornton 18L-401 CD e p I O C5- 123 _ 3 °/5(0 p� Operator: PDC Energy,Inc T�f County and State: Weld,Colorado Property Townshiy 7 NorthiRanae 65 West_ Description: Section 18: SWSW(spaced W2—337.87 acres) Production: X Oil X Gas X Other: all products Owner Name OWNER NUMBER: 43444 and Address: Weld County Board of Comm Type of Interest: RI PO Box 758 Decimal Interest: 0.00047089 Greeley,CO 80632-0758 (0.86/337.87*100%*18.5%) (Net Acres/Acres in Spacing Unit*%of net acres*Royalty Interest) The undersigned certifies the ownership of their decimal interest in production or proceeds as described above payable by PDC Energy,Inc.(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$50.00,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. Special Clauses: (None or See tt ched Exhibit) Owner(s)Signature(s): 4f1C14"- ` Barbara KirkmPyPr, Chair Weld Coun y Commissioners Owner(s)SSN/Tax I.D.Number(s): 84-6000-813 •�. a��t�r - •— datxdov 4 Owner Daytime Telephone: 970-3 6— 2� �,�..� • � ��` Cl= k the Bo •r. Owner Email Address: � • `—v�- • Deputy Cl k to t '- Rnard !t: ����- k payer Identification Number. Federal Law requires you to furnish , - ,� p Y use► "1 Failure to comply will result in 2%o t., :. �11 not be refundable by Payor .1114 JLM .4 Retain t �., , �! cords 2015-3020(i) Ca / LEo313 INSTRUCTIONS TO ALL INTEREST OWNERS Dear Interest Owner, PDC Energy, Inc. has enclosed a Division Order for your execution. 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 . 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. 3 . If signing for a corporation, signature must be attested, corporate seal fixed and title of signatory party reflected. 4. 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. 5. Your correct mailing address should be noted in the space provided to insure prompt receipt of production proceeds. 6. The top copy or the "Original" of the Division Order should be returned to: PDC Energy, Inc. 1775 Sherman Street, Suite 3000 Denver, Colorado 80203 Attn : Jenni L. Mosier 7 . Should you have any further questions regarding the enclosed Division Order, please contact PDC Energy, Inc. at (303) 860- 5836 or (888) 860-5836. 8 . Please DO NOT DETACH the exhibit from the Division Order or Transfer Order if one is included. ( PDC 4) ENERGY Corporate Office 1775 Sherman Street, #3000 RECEIVED Denver, Colorado 80203 303.860. 5800 JUL Z www.pdce .com �� t� WELD COUNTYCOMMISS 1ONE RS July 21 , 2015 Weld County Board of Comm PO Box 758 Greeley , CO 80632-0758 Re : Division Order: Thornton 18L-401 ( 105. 101246 ) Dear Interest Owner: Enclosed are two copies of our Division Orders for the above referenced well . PDC drilled the above listed well at the end of 2014 and it started to produce in March of 2015 . These division orders lay out your proportionate share of revenue from this well . As soon as I receive an executed Division Order back from you , I will place your interest into pay status . Please note , PDC will only issue a check once the accrued amount has reached $50 or more or it will be paid annually , whichever occurs first. Our checks are cut and mailed around the 24th of each month . Please follow the enclosed " Instructions to Interest Owners " for executing and returning one copy of the Division Order to this office . The extra copy is for your records . The cut-off for changes in accounting is the 10th of the month . If we receive your Division Orders after the 10th , the pay change will take place the following month . If you have any questions pertaining to the calculation of your interest on the Division Order, please feel free to contact me by e-mail at Jenni . Mosier@pdce . com . Changes in ownership or address should also be directed to my attention . If you have questions pertaining to revenue or revenue checks , please contact the Revenue Department at the Bridgeport Office . Sincerely , PDC Energy , Inc . 'Cri(jAAN4) 4 Jenni L . 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MIT GIS a Doc COA � �` Wellbore Surface Location Data for API # 05 - 123 - 39562 Status : PR Well Name/No : Thornton # 18L-401 ( click well name for production ) Operator: PDC ENERGY INC - 69175 Status Date : 5/ 12/2015 Federal or State Lease #: County : WELD # 123 Location : SWSW 18 7N 6 `. Field : WATTENBERG - #90750 Elevation : 4 , 904 ft. Planned Location 482 FSL 479 FWL Lat/Long : 40 . 5695/- 104 . 71413 Lat/Long Source : Job Date : 2/27/2015 FráitFrac Focus Job End Date : 2/27/2015 Reported : 3/2/2015 Days to report: 3 Chemical Disclosure Registry Wellbore Data for Sidetrack #00 Status : PR 5� Spud Date : 10/22/2014 Spud Date is : ACTUAL Wellbore Permit HORIZONTAL Permit #: Expiration Date : 6/5/2016 3 : 52 : 51 Prop Depth/Form : 11899 Surface Mineral Owner Same : Mineral Owner: FEE Surface Owner: FEE Unit: Unit Number: Formation and Spacing : Code : CODL , Formation : CODELL , Order: , Unit Acreage : 320 , Drill Unit: GWA Casing : String Type : SURF , Hole Size : 12 . 25 , Size : 9 . 625 , Top : 0 , Depth : 875 , Weight: 36 Cement : Sacks : 830 , Top : 0 , Bottom : 875 , Method Grade : Casing : String Type : 1ST , Hole Size : 8 . 75 , Size : 7 , Top : 0 , Depth : 8063 , Weight : 26 Cement: Sacks : 650 , Top : 500 , Bottom : 8063 , Method Grade : Casing : String Type : 1ST LINER , Hole Size : 6 . 125 , Size : 4 . 5 , Top : 6749 , Depth : 11899 , W 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: 18 Twp : 7N 65W Footage : 734 FSL 1396 FFWLL Depth Bottom Hole Location : Sec : 18 Twp : 7N 65W Footages : 500 FNS 1395 FFWLL Depth Formation Log Top Log Bottom Con Completed information for formation N -COM Status : PR 1st Production Date : 10/22/2014 Choke Size : Status Date : 5/ 12/2015 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 . 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OA } ii ) le nt �O cr. 73 7* ' 0 > V I I 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 ) : Thorson 18L - 401 CD File Location ( s ) : LEO333 BY : DATE : / truce Barker - County Attorney NOTES : . 86 mineral acres/ 337 . 87 acres spacing unit * 18 . 5 % = . 00047089 MATCH Hello