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Executed this 1 s t
STATE OF COLORADO
SS.
COUNTY OF DENVER
On this sr day of J une 2000, before me appeared F. S. Di
Grappa, to me personally known, who being by me duly sworn did say that he is the
Vice President of Great Northern Gas Company, a Colorado corporation, and that he
executed the foregoing instrument as the act and deed of said corporation, for the
purposes designated therein and in the capacity therein stated.
Witness my hand and official seal.
My commission expires:
s1/4003
day of June
CORPORATE ACKNOWLEDGMENT
2. Assignee certifies as follows: (a) Assignee is a citizen of the United States; an association of such citizens; a municipality; or a corporation organized under the
laws of the United States or of any State or territory thereof. For the assignment of NPR -A leases, assignee is a citizen, national, or resident alien of the United
States or association of such citizens, nationals, resident aliens or private, public or municipal corporations, (b) Assignee is not considered a minor ander the
laws of the State in which the lands covered by this assignment are located; (c) Assignee's chargeable interests, direct and indirect, in each public domain and
acquired lands separately in the same State, do not exceed 246,080 acres in oil and gas leases (of which up to 200,000 acres may be in oil and gas options), or
300,000 acres in leases in each leasing District in Alaska of which up to 200,000 acres may be in options, if this is an oil and gas lease issued in accordance
with the Mineral Leasing Act of 1920, or 51,200 acres in any one State if this is a geothermal lease; (d) All parties holding an interest in the assignment are
otherwise in compliance with the regulations (43 CFR Group 3100 or 3200) and the authorizing Acts; (e) Assignee is in compliance with reclamation
requirements for all Federal oil and gas lease holdings as required by sec. 17(g) of the Mineral Leasing Act; and (1) Assignee is not in violation of sec. 41 of the
Mineral Leasing Act.
3. Assignee's signature to this assignment constitutes acceptance of alt applicable terms, conditions, stipulations and restrictions pertaining to the lease described
herein.
For geothermal assignments, an overriding royalty may not be less than one -fourth (1/4) done percent of the value of output, nor greater than 50 percent of the rate of
royalty due to the United States when this assignment is added to all previously created overriding royalties (43 CFR 3241).
I certify that the statements made herein by me are true. complete, and correct to the best of my knowledge and belief and are made in good faith.
Executed this J day of June
(jX 2000
Name of Assignor as show ;.:rren 1 /_i 6. 1 1 i;
/Please type or print
Assignor 146�i�uwI/►
or P.S. Di Grappa, (S g naturC) i ce- President
Attorney -in -fact
(Signature)
621 17th Street, Suite 2150
(Assignor's Address)
Denver, Colorado 80293
(City) (State)
(Zio Code)
OMPANY HS RESOURCES, INC.
327
iAR
7i u L ...t •f' (J B �.;1C'
Notary Public O v y
O F C O
X 2000
Public reporting burden for this form is estimated to average 30 minutes per response including the time for reviewing instructions, gathering and maintaining data, and
completing and reviewing the form. Direct comments regarding the burden estimate or any other aspect of this form to U.S. Department of the Interior, Bureau of Land
Management (1004- 0034), Bureau Clearance Officer, (WO -630), Mail Stop 401 LS, 1849 C Street, N.W., Washington, D.C. 20240.
Title 18 U.S.C. Sec. 1001 makes 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.