Garden Banks Gas Pipeline, LLC

Original Volume No. 1

 Contents / Previous / Next / Main Tariff Index

 

 

Effective Date: 05/10/2010, Docket: RP10-594-000, Status: Effective

Second Revised Sheet No. 298 Second Revised Sheet No. 298

Superseding: First Revised Sheet No. 298

 

FORM OF SERVICE REQUEST FORM

 

V. Maximum Daily Quantity (MDQ) Requested: ______________________ Dth

Dates of Service: Commencing ______________ Ending _____________

_____ Evergreen: _____Month to Month _____ Year to Year

_____ Life of Reserves/Lease

 

VI. Receipt Point(s): ____________________________

Delivery Point(s): ____________________________

 

VII. Agent ( ) or Marketer ( ):

____________________________________________________

Company Name: ______________________________________

Address: ___________________________________________

Telephone No.: ________________

Facsimile No.: ________________

Email address: ________________

If Agent, is Agent responsible for: Accounting, Invoices Y ___ N ___

Nominations, Scheduling Y ___ N ___

 

VIII. Credit Evaluation - A Shipper seeking service from Transporter

under Rate Schedules FT-1, FT-2 or IT-1 must comply with the

creditworthiness criteria as described in the General Terms and

Conditions of the Garden Banks Tariff.

Representatives of Shipper (up to two) who are authorized to receive

notices regarding Shipper's creditworthiness, including requests for

additional information:

Name Email Address

_______________________________ ___________________________________

_______________________________ ___________________________________

 

 

IX. Shipper understands that this request form, complete and unrevised as to

format, must be received by Transporter before the transportation

request will be accepted and processed.

 

Shipper, by its signature, certifies to Transporter (1) that the

information above is correct and accurate and that all necessary

transportation arrangements with the upstream and downstream

transporters have been or will be secured prior to the commencement of

the requested transportation service and (2) that Shipper will have

title to the gas that is to be delivered to Transporter and (3) that

Shipper will advise Transporter of any changes in the information

provided.

 

X. Requested by:_____________________________(signature)

 

Name:___________________________________

Title:__________________________________

Telephone: _____________________________

Email Address: ________________________