Crossroads Pipeline Company

First Revised Volume No. 1

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Effective Date: 10/01/2002, Docket: RP02-461-000, Status: Effective

First Revised Sheet No. 567 First Revised Sheet No. 567 : Effective

Superseding: Original Sheet No. 567

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 EXCEPT IPP.

 

_____ 7. Will a partial offer of the amount requested be acceptable?

YES/NO

 

For items 8 and 9, list the following for each requested receipt and/or

delivery point:

 

Note, for service under the IT -1 Rate Schedule, all points contained in

the Master List of Interconnects (MLI) as defined in Section 1 of the

General Terms and Conditions are deemed to be valid receipt and/or delivery

point(s).

 

8.

(i) Receipt Point (ii) Dth/d

 

_____________ _______________

_____________ _______________

_____________ _______________