Crossroads Pipeline Company

First Revised Volume No. 1

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Effective Date: 11/01/2001, Docket: RP02- 14-000, Status: Effective

Original Sheet No. 514 Original Sheet No. 514 : Effective

REQUEST FOR SERVICE

(Continued)

4. a. If the request is for firm service or capacity release and assignment, please answer the

following:

_____ Parcel Number (required only for capacity release and assignment or auction.)

_____ Bid Rate

b. State Bid Offer Contingencies

_______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________

5. Term of service requested:

Beginning Date Ending Date Evergreen Clause

/ / / / (yes/no)

6. Please enter the appropriate quantities.

_____ Transportation Demand/Quantity (Dth/d) for services under all Rate Schedules

_____ 7. Will a partial offer of the amount requested be acceptable? YES/NO