Nautilus Pipeline Company, LLC

Original Volume No. 1

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Effective Date: 04/05/2010, Docket: RP10-475-000, Status: Effective

Third Revised Sheet No. 326A Third Revised Sheet No. 326A

Superseding: Second Revised Sheet No. 326A

 

EXHIBIT "B"

INTERACTIVE INTERNET WEBSITE ACCESS REQUEST FORM

 

SHIPPER (Complete Legal Name)________________________________________________

 

Mailing Address: ___________________________________________________________

 

City: ____________________________ State: ___________________ Zip:___________

 

DUNS No.: ____________________________ Federal Tax ID No.: __________________

 

Authorized Employee's/Agent's Full Name: _________________________________

Email Address: __________________________________________________________

Authorized Employee's/Agent's Employer: __________________________________

Mailing

Address:______________________City:________________State:_________Zip:_______

 

Phone No.: _________________________ Fax No.: ___________________________

 

Indicate Update Capabilities for this Authorized Employee/Agent:

_____ Execute Contracts, Amendments and Accept Discounts

_____ Make Imbalance Elections/Trades

_____ Request New Service, Amendments and Discounts

_____ Receive and administer the payment of any and all invoices

_____ Submit Capacity Release Offers, Bids, Recall and Reput

_____ Submit Confirmations, PDAs, Storage Transfers

_____ Submit Nominations and Storage Transfers

_____ View only access to Interactive Internet Website screens, email,

web page and reports for SHIPPER will be available to SHIPPER'S

authorized employees

 

Signed by SHIPPER'S Authorized Employee/Agent:

__________________________________________________ Date: ________________

 

Approved by Shipper:____________________________________________

 

Title: ___________________________________________ Date: ___________________

 

FOR INTERNAL USE ONLY

Nautilus Pipeline Company, L.L.C.

_____________________________________________________________________________

 

_____________________________________________________________________________

 

 

USER ID: ______________________________ Shipper# (if no DUNS): ______________

 

Security approved by:___________________ Date: _____________________________

 

PLEASE FAX COMPLETED FORM TO (832) 214-5791