HIPTERRAOrder Form · e-Signature

Order Form

Complete the fields below, draw your signature, and submit. A signed PDF will be generated and emailed to you. This Order Form is entered into pursuant to the Master Services Agreement (MSA) between Hipterra, LLC and Client.

Download original Order Form PDF

Agreement Details

1. Project Area

Project Area Map is attached as Schedule 1-A (required). Email the map to Hipterra if not already provided.

2. Governing State Law for this Order Form

Per MSA Sec. 21.2, select the State Law applicable to the Project Area. The MSA itself remains governed by Utah law per MSA Sec. 21.1.

3. Scope of Services

Check all that apply.

4. Fees

$
Or $1.75/mile each direction
$
Or $1.75/mile each direction
$
Per field day
$
Range: $2,000–$12,000 per sq mi
$
Payment Terms: Net 30 from invoice date (per MSA Sec. 5.2). Invoice Cadence: Monthly (per MSA Sec. 5.2), unless otherwise specified. Extraordinary expenses (per MSA Sec. 5.5) require Client's prior written approval and are billed at cost plus reasonable markup.

5. Compensation Model (Royalty / Working Interest)

Per MSA Sec. 7.1, select ONE primary compensation model. The standard default is Flat ORRI at 2.0%.

6. Optional ORRI Sunset

By default, Hipterra's economic interest under this Order Form is perpetual (no sunset).

7. Area of Mutual Interest (AMI)

15 years is the default.
1,500 ft is default. May be increased but not decreased.
Initial AMI Map attached as Schedule 7-A (a more precise AMI to be finalized post-mapping per MSA Sec. 7.8). Lease-Release / Direct-Contact Right per MSA Sec. 7.10 applies to any surrender, abandonment, lapse, release, sale, farmout, or assignment of any lease within the AMI.

8. Deliverables

Check all that will be provided to Client.

9. Timeline

Project Start: within 30 days of the Order Form Effective Date.
Typical: 3–6 weeks

10. Points of Contact

Client Primary Contact
Hipterra Project Lead

11. Special Terms / MSA Modifications

Per MSA Sec. 22.2, project-specific modifications to the MSA (solely for this engagement). If none, leave as "None."

Insurance Acknowledgment. As of the Order Form Effective Date, Hipterra is in the process of binding the insurance coverages referenced in MSA Article 11. Per MSA Sec. 11.1, the absence of any specific coverage as of the Effective Date is not a breach, and Hipterra will provide certificates of insurance promptly upon binding such coverage.

12. Invoice / Billing Detail

Late-Payment Interest: 1.5% per month or max permitted by law (per MSA Sec. 5.2). Currency: U.S. Dollars (USD). Remit-To: Wire / ACH details on Hipterra invoice header.

Signature

By signing, the Client executes this Order Form as of the Order Form Effective Date.

Hipterra, LLC
Robb Miller, Manager
Countersigned by Hipterra upon receipt.
Client
Draw your signature above
Preview the signed Order Form before you submit.