American Midstream (AlaTenn), LLC

Fifth Revised Volume No. 1

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Effective Date: 05/01/2010, Docket: RP10-493-000, Status: Effective

Original Sheet No. 345 Original Sheet No. 345

 

CUSTOMER NOMINATION FORM

American Midstream (AlaTenn), LLC

 

Service Requested Contact: _________________________________ Type

of

Service:______________________________________

Company Name:________________________________________________

Attention:____________________________________________

 

Receipt DELIVERY

 

PI Ref/ Duns # U/S Fuel PI Ref/ Duns # D/S Pkg. Cap.

Trans. Nom.

Begin

Nomn. End

Meter # (Int.) Cont. Dth Rank Dth Meter (Int.) Cont. Dth Rank ID. Type

Type Date

Time

Date Time

______ ______ ______ _____ _____ _____ _____ ____ ____ ____ ____

___ ____

____

______ ______ ______ _____ _____ _____ _____ ____ ____ ____ ____

___ _____

_____

______ ______ ______ _____ _____ _____ _____ ____ ____ ____ ____

___ _____

_____

______ ______ ______ _____ _____ _____ _____ ____ ____ ____ ____

___ _____

_____

______ ______ ______ _____ _____ _____ _____ ____ ____ ____ ____

___ _____

_____

______ ______ ______ _____ _____ _____ _____ ____ ____ ____ ____

___ _____

_____

 

Notes: One-sided nominations only require receipt or deliver Customer

Contact:__________________________________

meter data (i.e. confirmation agreements, receipt/delivery

operator). Duns Number is required at pipeline

Date:______________________________________________

interconnects.

Phone

#:___________________________________________

Transaction Type Capacity Type

(optional-default to 01) (optional) Fax

#:_____________________________________________

01-Current Business PP-Primary to Primary

02-Authorized Overrun PS-Primary to Secondary

03-Imbalance Payback from Pipeline SS-Secondary to Secondary

04-Imbalance Payback to Pipeline SP-Secondary to Primary

09-Imbalance Trading

AlaTenn Phone Number: (720) 457-6077

Nomination Fax Number: (720) 457-6040