Dominion Cove Point LNG, LP

Original Volume No. 1

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Effective Date: 05/02/2009, Docket: RP09-498-000, Status: Effective

Fifth Revised Sheet No. 475 Fifth Revised Sheet No. 475

Superseding: Fourth Revised Sheet No. 475

FORM OF SERVICE AGREEMENT

UNDER RATE SCHEDULES LTD-1, LTD-2, FPS-1, FPS-2, FPS-3, FTS, ITS and OTS

Appendix B

to

[LTD-1, LTD-2, FPS-1, FPS-2, FPS-3, FTS, ITS or OTS] Service Agreement

Between Dominion Cove Point LNG, LP (Operator)

and ______________________________ (Buyer)

Rates and Charges:

Contractual Right of First Refusal (if applicable):

Term provisions agreed to pursuant to Section 5.(b) (2) of the GT&C of Operator's FERC Gas Tariff (if

applicable):

Minimum or maximum pressures at delivery points agreed to pursuant to Section 9(a) of the GT&C of Operator's

FERC Gas Tariff (if applicable):

This Appendix B shall become effective as of ____________________________ and shall cancel and supersede the

previous Appendix B to the Service Agreement dated__________________. With the exception of this Appendix B,

all other terms and conditions of said Service Agreement shall remain in full force and effect.

[BUYER] DOMINION COVE POINT LNG, LP

By ____________________________________ By ___________________________________

Title ____________________________________ Title ___________________________________

Date ____________________________________ Date ___________________________________