Crossroads Pipeline Company

First Revised Volume No. 1

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Effective Date: 04/01/2004, Docket: RP00-333-005, Status: Effective

Second Revised Sheet No. 618 Second Revised Sheet No. 618 : Effective

Superseding: First Revised Sheet No. 618

REQUEST FOR SEGMENTATION

OF EXISTING TRANSPORTATION SERVICE AGREEMENT

COLUMBIA GAS TRANSMISSION CORPORATION

COLUMBIA GULF TRANSMISSION COMPANY

CROSSROADS PIPELINE COMPANY

 

 

1. Changes are applicable to:

 

Rate Schedule Agreement No.

 

2.

a. Identity of Requestor

 

Legal company name _____________________________________________

 

Abbreviation or Short Name (if applicable) ______________________

 

Phone Number ___________________________________________________

 

E-mail Service ________________________________________________

 

b. Identity of Shipper (if different than Requestor)

 

Written documentation must be submitted to support Requestor's legal

authorization to negotiate and/or bind the Shipper contractually.

 

Legal company name _____________________________________________

 

Abbreviation or Short Name (if applicable) ______________________

 

Phone Number ________________________________________________

 

Facsimile Number ________________________________________________

 

E-mail Service ________________________________________________

 

3. Requested beginning date for segmentation

 

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4. Requested ending date for segmentation

 

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