Columbia Gas Transmission LLC

Third Revised Volume No. 1

 Contents / Previous / Next / Main Tariff Index

Effective Date: 03/03/2009, Docket: RP09-340-000, Status: Effective

Original Sheet No. 512 Original Sheet No. 512

[For ITS Rate Schedule]

Revision No. ________

Appendix A to Service Agreement No. ___________

Under Rate Schedule ITS

between Columbia Gas Transmission, LLC (Transporter)

and ________________________________ (Shipper)

Transportation Quantity

Begin End Transportation

Date Date Quantity Dth/day

The Master List of Interconnects (MLI) as defined in Section 1 of the General Terms and Conditions is

incorporated herein by reference for purposes of listing valid interruptible receipt points and delivery points.

Service changes pursuant to this Appendix A shall become effective as of ___________, 20___. This Appendix A

shall cancel and supersede the previous Appendix A effective as of _______________, 20___, to the Service

Agreement referenced above. With the exception of this Appendix A, all other terms and conditions of said

Service Agreement shall remain in full force and effect.

(SHIPPER) COLUMBIA GAS TRANSMISSION, LLC

By______________________________ By___________________________________

Its_____________________________ Its__________________________________

Date____________________________ Date_________________________________