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. 523 Original Sheet No. 523 : Effective

 

REQUEST FOR SERVICE

(Continued)

 

For items 4 and 5, list the following for each requested receipt and/or delivery point:

 

(i) Transaction Type:

 

A - add new point of receipt or delivery;

I - increase an existing contracted receipt/delivery point by the amount stated;

R - reduce an existing contracted receipt/delivery point by the amount stated;

D - delete an existing receipt/delivery point.

 

(ii) Receipt/Delivery meter (Available through Transporter's EBB);

 

The explicit receipt and/or delivery meter(s) must be identified if firm

service is being requested.

 

(iii) Daily quantities (Dth) to be delivered to/by Transporter.

 

4. (i) A - Add (ii) Receipt Point (iii) Daily Quantity

I - Increase

R - Reduce

D - Delete

 

_______________ _______________ _______________

_______________ _______________ _______________

_______________ _______________ _______________

_______________ _______________ _______________

 

5. (i) A - Add (ii) Delivery Point (iii) Daily Quantity

I - Increase

R - Reduce

D - Delete

 

_______________ _______________ _______________

_______________ _______________ _______________

_______________ _______________ _______________

_______________ _______________ _______________

_______________ _______________ _______________

 

General Comments

 

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

and accurate to the best of Requestor's knowledge, information, and belief; that transportation agreements

with all downstream and upstream third-party transporters have been either executed or requested; and that all

State and Federal approvals that are necessary for gas to be received into and delivered from Transporter's

facilities have been applied for or obtained.

 

 

Requestor Company: ________________________________________________________________

 

Signed By: ________________________________________________________________________

 

Title: ____________________________________________________________________________

 

Date: _____________________________________________________________________________