Carolina Gas Transmission Corporation

Original Volume No. 1

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Effective Date: 11/01/2006, Docket: CP06- 71-001, Status: Effective

Original Sheet No. 381 Original Sheet No. 381 : Effective

 

4. If Requesting Party is acting as agent in arranging this service, specify

below each principal (complete legal name, type of legal entity, D-U-N-S®

Number, and State of incorporation) and its respective type of company

(see 3(d) above). Requesting Party must supply an Agency Authorization

Agreement for each principal.

 

_________________________________________________________________________

 

_________________________________________________________________________

 

 

5. Are additional or new facilities required to be installed or constructed

by any party to implement this request? If so, please specify:

 

_________________________________________________________________________

 

_________________________________________________________________________

 

_________________________________________________________________________

 

 

6. Name and full title of officer (or general partner) of Requesting Party

who will execute service agreement with Pipeline:

 

_________________________________________________________________________

 

 

7. Business contact person for this request:

 

Name & Title: ___________________________________________________________

 

Mailing Address:

 

_________________________________________________________________________

 

_________________________________________________________________________

 

_________________________________________________________________________

 

Phone: ____________________ Facsimile: __________________________

 

E-mail address: _________________________________________________________