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. 346 Third Revised Sheet No. 346

Superseding: Second Revised Sheet No. 346

SHIPPER NOMINATION FORM

Shipper Name:___________________________ Nautilus Pipeline Company, LLC

Master Contract No.:____________________ Transportation Services

Service Contract No.:___________________ 1100 Louisiana, Suite 3300

Type of Service:________________________ Houston, Texas 77002

Effective Date:_________________________ Telephone ______________

End Date:_______________________________ Fax (832) 214-5791

Shipper Contact:________________________

Title:__________________________________

Date:___________________________________

Phone No.:______________________________

Fax No.:________________________________

Email Address:__________________________

Recpt Point Meter Code Intr. Owner Suppl. Recpt Dth Upstm Contrct Del. Meter Del. Dth Dwnstm

Contr. Rank Make-up Volume Dth

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