THE MANITOBA SECURITIES COMMISSION MSC RULE 2003-5 (Section 149.1, The Securities Act) FORM 51-101F2 REPORT ON RESERVES DATA BY INDEPENDENT QUALIFIED RESERVES EVALUATOR OR AUDITOR This is the form referred to in item 2 of section 2.1 of National Instrument 51-101 Standards of Disclosure for Oil and Gas Activities ("NI 51-101"). 1. Terms to which a meaning is ascribed in NI 51-101 have the same meaning in this form. 1 2. The report on reserves data referred to in item 2 of section 2.1 of NI 51-101, to be executed by one or more qualified reserves evaluators or auditors independent of the reporting issuer, shall in all material respects be as follows: Report on Reserves Data To the board of directors of [name of reporting issuer] (the "Company"): 1. We have [audited] [evaluated] [and reviewed] the Company’s reserves data as at [last day of the reporting issuer's most recently completed financial year]. The reserves data consist of the following: (a) (i) proved and proved plus probable oil and gas reserves estimated as at [last day of the reporting issuer's most recently completed financial year] using forecast prices and costs; and (ii) the related estimated future net revenue; and (b) (i) proved oil and gas reserves estimated as at [last day of the reporting issuer's most recently completed financial year] using constant prices and costs; and (ii) the related estimated future net revenue. 2. The reserves data are the responsibility of the Company’s management. Our responsibility is to express an opinion on the reserves data based on our [audit] [evaluation] [and review]. We carried out our [audit] [evaluation] [and review] in accordance with standards set out in the Canadian Oil and Gas Evaluation Handbook (the "COGE Handbook") prepared 1 For the convenience of readers, Appendix 1 to Companion Policy 51-101CP sets out the meanings of terms that are printed in italics in sections 1 and 2 of this Form or in NI 51-101, Form 51-101F1, Form 51-101F3 or the Companion Policy.
- 2 jointly by the Society of Petroleum Evaluation Engineers (Calgary Chapter) and the Canadian Institute of Mining, Metallurgy & Petroleum (Petroleum Society). 3. Those standards require that we plan and perform an [audit] [evaluation] [and review] to obtain reasonable assurance as to whether the reserves data are free of material misstatement. An [audit] [evaluation] [and review] also includes assessing whether the reserves data are in accordance with principles and definitions presented in the COGE Handbook. 4. The following table sets forth the estimated future net revenue (before deduction of income taxes) attributed to proved plus probable reserves, estimated using forecast prices and costs and calculated using a discount rate of 10 percent, included in the reserves data of the Company [audited] [evaluated] [and reviewed] by us for the year ended xxx xx, 20xx, and identifies the respective portions thereof that we have [audited] [evaluated] [and reviewed] and reported on to the Company's [management/board of directors]: Independent Description and Location of Qualified Reserves Preparation Date of Reserves (Country Evaluator or [Audit/Evaluation/ or Foreign Auditor Review] Report Geographic Area) Evaluator A xxx xx, 20xx Evaluator B xxx xx, 20xx Totals 5. In our opinion, the reserves data respectively [audited] [evaluated] by us have, in all material respects, been determined and are in accordance with the COGE Handbook. We express no opinion on the reserves data that we reviewed but did not audit or evaluate. 6. We have no responsibility to update our reports referred to in paragraph 4 for events and circumstances occurring after their respective preparation dates. 7. Because the reserves data are based on judgements regarding future events, actual results will vary and the variations may be material. Executed as to our report referred to above: Evaluator A, City, Province or State / Country, Execution Date Evaluator B, City, Province or State / Country, Execution Date Net Present Value of Future Net Revenue (before income taxes, 10% discount rate Audited Evaluated Reviewed Total xxxx $xxx $xxx $xxx $xxx xxxx xxx xxx xxx xxx $xxx $xxx $xxx $xxx [signed] [signed]
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