HomeMy WebLinkAbout870607Form 3100 -lib
(October 1992)
The undersigned (reverse) offers to lease all or any of the lands in Item 2 that are available for lease pursuant to the Mineral Leasing Act of 1920, as amended and supplemented (30 U.S.C. 181
et seq.), the Mineral Leasing Act for Acquired Lands of 1947, as amended (30 U.S.C. 351 -359), the Attorney General's Opinion of April 2, 1941 (40 Op. Atty. Gen. 41), or the
READ INSTRUCTIONS BEFORE COMPLETING
(1RO •'1.':C.P4IBE OIL aj•
1 Name
H10 (1 tl()[1 I ON3 ST i`%"()llO
Street
}-;'I' W)RTQ, TX. it 11e t. :J
City, State; Zip Code
2 Thi$ application /offer /lease is for: (Check only One) n PUBLIC DOMAIN LANDS ACQUIRED LANDS (percent U.S. interest
Surface managing agency if other than BLM• Unit /Project
Legal description of land requested: *Parcel No *Sale Date (m /d /y):
*SEE ITEM 2 IN INSTRUCTIONS BELOW PRIOR TO COMPLETING PARCEL NUMBER AND SALE DATE.
T. R. Meridian State Court ►►yy
BOOK `PRPAGE 832
Amount remitted: Filing fee
3 Land included in lease:
T.
,f ±(IN
(Continued on reverse)
UNITED STATES
DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT
OFFER TO LEASE AND LEASE FOR OIL AND GAS
Meridian
Other
870607
Rental fee
DO NOT WRITE BELOW THIS LINE
This lease is issued granting the exclusive right to drill for, mine, extract, remove and dispose of all the oil and gas (except helium) in the lands described in Item 3 together with the right to build
and maintain necessary improvements thereupon for the term indicated below, subject to renewal or extension in accordance with the appropriate leasing authority. Rights granted are subject to
applicable laws, the terms, conditions, and attached stipulations of this lease, the Secretary of the Interior's regulations and formal orders in effect as of lease issuance, and to regulations and formal
orders hereafter promulgated when not inconsistent with lease rights granted or specific provisions of this lease.
t s. PEE a.
NOTE: This' Ie& Is issued to the high bidder his/her
nomination and those specified on this form.
Type and primary term of lease:
Noncompetitive lease (ten years)
Competitive lease (ten years)
State County
STATES OF AMERICA
Serial No.
Future rental payments must be made
on or before the anniversary date to:
Minerals Management Service
Royalty Management Program
P.O. Box 5640
Denver, CO 80217
RECEIVED
LINCOLN COUNTY CLERK
01 JAN —.5 As1 8: 311
J E» A t Y N a t[0R
KEMME1J WYOMING
Total acres in lease
td t t
Rental retained
(Title) 01 2000 (Date)
EFFECTIVE DATE OF LEASE DEC (`v
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State
TOTAL BID
087460'7
THE BID IS FOR (Check one)
Oil and Gas Parcel Number
Geothermal Parcel Number
Name of Known Geothermal Resource Area (KGRA)
The appropriate regulations applicable to this bid are: (1) for oil and gas leases -43 CFR 3120; (2) for National Petroleum Reserve Alaska(NPR -A)
leases -43 CFR 3132; and (3) for Geothermal resources leases -43 CFR 3220. (See details concerning lease qualifications on reverse.)
I CERTIFY THAT I have read and am in compliance with, and not in violation of, the lessee qualification requirements under the applicable regulations
for this bid.
I CERTIFY THAT this bid is not in violation of 18 U.S.C. 1860 which prohibits unlawful combination or intimidation of bidders. I further certify that
this bid was arrived at independently and is tendered without collusion with any other bidder for the purpose of restricting competition.
IMPORTANT NOTICE: Execution of this form, where the offer is the high bid, constitutes a binding lease offer, including all applicable terms and
conditions. Failure to comply with the applicable laws and regulations under which this bid is made shall result in rejection of the bid and forfeiture of
all monies submitted.
City
INSTRUCTIONS FOR OIL AND GAS BID
(Except NPR -A)
1. Separate bid for each parcel is required. Identify parcel by the parcel
number assigned in the Notice of Competitive Lease Sale.
2. Bid must be accompanied by the national minimum acceptable bid,
the first year's rental and the administrative fee. The remittance must
be in the form specified in 43 CFR 3103.1 -1. The remainder of the
bonus bid, if any, must be submitted to the proper BLM office within
10 working days after the last day of the oral auction. Failure to
submit the remainder of the bonus bid within 10 working days will
result in rejection of the bid offer and forfeiture of all monies paid.
3. If bidder is not the sole party in interest in the lease for which the bid
is submitted, all other parties in interest may be required to furnish
evidence of their qualifications upon written request by the authorized
officer.
4. This bid may be executed (signed) before the oral auction. If signed
before the oral auction, this form cannot be modified without being
executed again.
5. In view of the above requirement (4), bidder may wish to leave
AMOUNT OF BID section blank so that final bid amount may be
either completed by the bidder or the Bureau of Land Management
at the oral auction.
Title 18 U.S.C. Section 1001 and Title 43 U.S.C. Section 1212 make it a crime for any person knowingly and willfully to make to any department or agency of the United
States any false, fictitious, or fraudulent statements or representations as to any matter within its jurisdiction.
(Continued on reverse)
UNITED STATESfi
DEPARTMENT OF THE INTERIOR
BUREAU OF LAND MANAGEMENT
COMPETITIVE OIL AND GAS OR
GEOTHERMAL RESOURCES LEASE BID
30 U.S.C. 181 et seq.; 30 U.S.C. 351 -359;
30 U.S.C. 1001 -1025; 42 U.S.C. 6508
`rf
PARCEL NUMBER
S
Print or Type Name of Lessee
Address of Lestsee
'State
t
Zip Code
INSTRUCTIONS
OPTIONAL USE COPY
FORM APPROVED
OMB NO. 1004 -0074
Expires: May 31, 2000
Date of sale
1
is,../...
834
AMOUNT OF BID (See Instructions below)
Signature of Lessee or Bidder
PAYMENT SUBMITTED
WITH BID
_0
INSTRUCTIONS FOR GEOTHERMAL OR
NPR -A OIL AND GAS BID
1. Separate bid for each parcel is required. Identify parcel by the
number assigned to a tract.
2: Bid must be accompanied by one -fifth of the total amount of bid. The
remittance must be in the form specified in 43 CFR 3220.4 for a
Geothermal Resources bid and 3132.2 for a NPR -A lease bid.
3. Mark envelope Bid for Geothermal Resources Lease in (Name of
KGRA) or Bid for NPR -A Lease, as appropriate. Be sure correct
parcel number of tract on which bid is submitted and date of bid
opening are noted plainly on envelope. No bid may be modified or
withdrawn unless such modification or withdrawal is received prior
to time fixed for opening of bids.
4. Mail or deliver bid to the proper BLM office or place indicated in the
Notice of Competitive Lease Sale.
5. If biti.er is not t)ie -sole party in interest in the Pease for which bid is
submitted, all other patties in interest may be required to furnish
evidence of their qualifications upon written request by the authorized
officer.
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14090480
03'7060 7
5. Within 1/4 mile of occupied dwellings.
6. Material sites.
GUIDANCE:
LEASE NOTICE NO. 1
837
o
l:
Under Regulation 43 CFR 3101.1 -2 and terms of the lease (BLM Form 3100 -11), the authorized officer may require
reasonable measures to minimize adverse impacts to other resource values, land uses, and users not addressed in lease
stipulations at the time operations are proposed. Such reasonable measures may include, but are not limited to,
modification of siting or design of facilities, timing of operations, and specification of interim and final reclamation
measures, which may require relocating proposed operations up to 200 meters, but not off the leasehold, and prohibiting
surface disturbance activities for up to 60 days.
The lands within this lease may include areas not specifically addressed by lease stipulations that may contain special
values, may be needed for special purposes, or may require special attention to prevent damage to surface and/or other
resources. Possible special areas are identified below. Any surface use or occupancy within such special areas will be
strictly controlled or, if absolutely necessary, prohibited. Appropriate modifications to imposed restrictions will be made
for the maintenance and operation of producing wells.
1. Slopes in excess of 25 percent.
2. Within 500 feet of surface water and/or riparian areas.
3. Construction with frozen material or during periods when the soil material is saturated or when watershed
damage is likely to occur.
4. Within 500 feet of Interstate highways and 200 feet of other existing rights -of -way (i.e., U.S. and State
highways, roads, railroads, pipelines, powerlines).
The intent of this notice is to inform interested parties (potential lessees, permittees, operators) that when one or more
of the above conditions exist, surface disturbing activities will be prohibited unless or until the permittee or the
designated representative and the surface management agency (SMA) arrive at an acceptable plan for mitigation of
anticipated impacts. This negotiation will occur prior to development and become a condition for approval when
authorizing the action.
Specific threshold criteria (e.g., 500 feet from water) have been established based upon the best information available.
However, geographical areas and time periods of concern must be delineated at the field level (i.e., "surface water and/or
riparian areas" may include both intermittent and ephemeral water sources or may be limited to perennial surface water).
The referenced oil and gas leases on these lands are hereby made subject to the stipulation that the exploration or drilling
activities will not interfere materially with the use of the area as a materials site/free use permit. At the time operations
on the above lands are commenced, notification will be made to the appropriate agency. The name of the appropriate
agency may be obtained from the proper BLM Field Office.
087060'7
NOTICE TO LESSEE
838
Provisions of the Mineral Leasing Act (MLA) of 1920, as amended by the Federal Coal Leasing
Amendments Act of 1976, affect an entity's qualifications to obtain an oil and gas lease. Section 2(a)(2)(A)
of the MLA, 30 U.S.C. 201 (a)(2)(A), requires that any entity that holds and has held a Federal coal lease
for 10 years beginning on or after August 4,1976, and who is not producing coal in commercial quantities
from each such lease, cannot qualify for the issuance of any other lease granted under the MLA.
Compliance by coal lessees with Section 2(a)(2)(A) is explained in 43 CFR 3472.
In accordance with the terms of this oil and gas lease, with respect to compliance by the initial lessee with
qualifications concerning Federal coal lease holdings, all assignees and transferees are hereby notified that
this oil and gas lease is subject to cancellation it (1) the initial lessee as assignor or as transferor has falsely
certified compliance with Section 2(a)(2)(A), or (2) because of a denial or disapproval by a State Office
of a pending coal action, i.e., arms-length assignment, relinquishment, or logical mining unit, the initial lessee
as assignor or as transferor is no longer in compliance with Section 2(a)(2)(A). The assignee, sublessee
or transferee does not qualify as a bona fide purchaser and, thus, has no rights to bona fide purchaser
protection in the event of cancellation of this lease due to noncompliance with Section 2(a)(2)(A).
Information regarding assignor, sublessor or transferor compliance with Section 2(a)(2)(A) is contained
in the lease case file as well as in other Bureau of Land Management records available through the State
Office issuing this lease.