Columbia Gas Transmission LLC

Third Revised Volume No. 1

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

Original Sheet No. 569 Original Sheet No. 569

REQUEST FOR SEGMENTATION (Cont'd)

4. Identify receipt and delivery points on existing agreement for which segmentation is requested. If service

agreement has multiple receipt and/or delivery points, Requestor must select one receipt and one delivery

point.

5. Identify daily quantity (Dth) to be segmented

____________ Dth

6. Identify segments being requested. (Receipt and delivery meters available through Transporter's EBB)

Segment Receipt Segment Delivery

Point MLI Point MLI

General Comments

_____________________________________________________________________________________________________

Requestor hereby certifies that the information contained in this Request for Segmentation is complete and

accurate to the best of Requestor's knowledge, information and belief.

Requestor Company: _________________________________________________________

Signed By: _________________________________________________________

_________________________________________________________

Title

Date: _________________________________________________________