HomeMy WebLinkAbout20143654.tiff 4035916 08/05/2014 10:58 AM
Total Pages: 4 Rec Fee: $26.00
Steve Moreno -Clerk and Recorder,Weld County, CO
Document processing fee RECEIVED
If document is filed on paper $150,00
If document is filed electronically Currently Not Available JUL 2 2 2014
Fees&forms/cover sheets are
subject to change
To file electronically,access instructions $ACRE rA�OFBUSINES STATE
for this formicover sheet and other
information or print copies of filed
documents,visit www.sos.state.co.us
and select Business.
Paper documents must be typewritten or machine printed.
ABOVE SPACE FOR OFFICE USE OW.Y
Statement of Merger
(Surviving Entity is a Domestic Entity)
filed pursuant to§7-90-203.7 of the Colorado Revised Statutes(C.R.S.)
I. For each gaming entity,its ID number(if applicable),entity name or true name,form of entity,jurisdiction
under the law of which it is formed,and principal address are
ID Number 20141340611
(Colorado Secretary efSmte ID member)
Entity name or true name Flight Resources,LLC
Form of entity Limited Liability Company
Jurisdiction Colorado
am address 2352 Main Street
Suite 201 (Snen number end nome)
Concord MA 01742
Ply) (J$A m1 (LIP/Posma►Code)
(Province-((applicable) (Colour')
.Mailings
(leave blank if same as street address) (Stream number and name or Port Office Box bifcn rmron)
ICiry) Moe) (ZIP/Postai Code)
(Province—y applicable) (Cowry)
ID Number
(Colorado Secretary of State ID number)
Entity name or true name
Form of entity
Jurisdiction
MERGE DOM Page I of 4
Rev.5/29/2007
2014-3654
LA,obea - L
4035916 08/05/2014 10:58 AM
Page 2 of 4
Street address
(Seer newtse and none)
pry) Omit? MP/Postal Code)
(Province-rappaceSM) (Cautay)
Mailing address
(lave blank if same as street address) Corm number and name or Pau Office Box etforendora
tKV) Male) MP/➢oaadCock)
(Province-(T ppilmbk) ([aweby)
ID Number
(Colorado Secretary of State ID number)
Entity name or true name
Form of entity
Jurisdiction
Street address
(Slrtn mender oedemas)
(Clryl (Siam) (ZIP/Pond Code)
(Prue/ace-(IWPamUe) Mooney)
Mailing address
(leave bleak frame assaeet address) glover member and nano a Pon Of)ke Bo:kinematic&
(Cla9 (Saul (ZIP/Portal Cody
(Province "applicable) tow,ny/
(1Jthe fallanMB snrwer*Peat ode,die statue,.by marling the box and Whale an atucMeet)
There are more than three merging entities and the ID number(if applicable),entity name or true
name,form of entity,jurisdiction under the law of which it is formed,and the principal address of
each additional merging entity is stated in an attachment
2. For the surviving entity,its entity ID number(if applicable),entity name or true name,form of entity,
jurisdiction under the law of which it is formed,and principal address are
ID Number 20101621965
(Colorado Secretary of Stare ID,amber)
Entity name or true name Grisly Petroleum Company,LLC
MERGE_DOM Page 2 of 4
Rev.5/29/2007
4035916 08/05/2014 10:58 AM
Page 3 of 4
Form of entity Limited Liability Company
Jurisdiction Colorado
Street address 1801 Broadway
•
Suite 500 (Stns maths.
Denver CO 80202
tow US Ana) (ZIP/halalCady
(Prorace-(applicable) leow oil
Mailing address
(leave Mask if same as aeeet address) char minute aid name arPaa Office Box htantanag
(City) Mate) (ZIP/Postal Code)
(Amino (applicable) Camay)
3. Each merging entity has been merged into the surviving entity.
4.pf the/ollartq swaths whoa adytth,etwmav by staking the bas)
❑The plan of merger provides for amendments to a constituent filed document of the surviving entity and
an appropriate statement of change or other document effecting the amendments will be delivered to the
Secretary of State for filing pursuant to Part 3 of Article 90 of Title 7,C.R.S.
5.Ofdtefolbwtg aatt.wv entire,adopt the maims by narking the box and step rite appropriate document number(O)
❑ One or more of the merging entities is a registrant of a trademark described in a filed document in the
records of the secretary of state and the document number of each filed document is
Document number
Document number
Document number
f9'erien eafaanatnrr rsow.yew the statement by ernkhe the ben ad include an aaaelattn)
T+�ereere s ii tea tidemarks and the document number of each additional tmdanerk is
stated in an attachment.
6. Ofappaa.bk.adapt the follows,aaenw by..m#ag the box adbchde en enactment)
❑ This document contains additional information u provided by law.
7.raeaon: !time Mark(the document doss not how a delayed 4((.ctlw dote. Stating a delayed effective date hat si 1 legal ca ar.aequen Read Inahuaa Wont entering a date.) sn�anr
Of the M?wtq want oppllee adopt the eterenrent by entering o daft and,tfapplicah f.INN mug the remand fennel)
The delayed effective date and,if applicable,time of this document are
(madM/pyy laa:dnte~par)
MERGE 0OM Per 3 of 4 Rev S/1!V1oo7
4035916 08/05/201410:58 AM
Page 4 of 4
Notice:
Causing this document to be delivered to the Secretary of State for filing shall constitute the affirmation or
acknowledgment of each individual causing such delivery,under penalties of perjury,that such document is
such individual's act and deed,or that such individual in good faith believes such document is the act and deed
of the person on whose behalf such individual is causing such document to be delivered for filing,taken in
conformity with the requirements of part 3 of article 90 of title 7,C.R.S.and,if applicable,the constituent
documents and the organic statutes,and that such individual in good faith believes the facts stated in such
document are true and such document complies with the requirements of that Par,the constituent documents,
and the organic statutes.
This perjury notice applies to each individual who causes this document to be delivered to the Secretary of
State,whether or not such Individual is identified in this document as one who has caused it to be delivered.
8. The true name and mailing address of the individual causing this document to be delivered for filing are
Crow Trevor A.
hall)950 Seventeenth Street fPtm1 `1 mss)
Suite 1600 (Steel number adw ou or Pau Office Bar Wonoamay
Denver CO 80202
(Cl7'1 USA(Salo) RIP/Pawl Code!
(Pmebxe ((rppllerbhl (Corna39
(yappllabk,adopt the lrllaahg ewmnew by mating the bar and welds an awt/rmtn)
O This document contains the true name and mailing address of one or more additional individuals
causing the document to be delivered for filing.
Disclaimer.
This form/cover sheet,and any related instructions,are not intended to provide legal,business or tax advice,
and are furnished without representation or warranty. While this form/cover sheet is believed to satisfy
minimum legal requirements as of its revision date,compliance with applicable law,as the same may be
amended from time to time,remains the responsibility of the user of this form/cover sheet. Questions should
be addressed to the user's legal,business or tax advisor(s).
MER0E D0M Page 4 of 4
Rev.5292007
Karla Ford
From: Karla Hillman[khillman@gwogco.com]
Sent: Friday,October 31,2014 12:10 PM
To: Karla Ford
Subject: Whitewing Acquisition-Ottesen and Perry Wells
Attachments: Asgn and BOS dtd eff 12.1.2013 4027777.pdf;Statement of Merger-Flight Resources, LLC rec'd 4035916.pdf
Karla,
Attached please find the following instruments which document our acquisition of the Ottesen and Perry wells:
1) Assignment and Bill of Sale dated eff 12/1/13 into Flight Resources
2) Merger document reflecting Flight was merged into Grizzly Petroleum Company (Internal entity of GWOC that
holds all record title interest)
Thank you.
Karla
Great \\listeII]
Karla Hillman
Manager, Land Administration
Great Western Operating Company, LLC
1801 Broadway,Suite 500
Denver, CO 80202
Office: 303-398-0409
Cell: 303-886-9178
Fax: 866-742-1784
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