Kentucky West Virginia Gas Company

Third Revised Volume No. 1

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Effective Date: 07/01/1993, Docket: RS92- 18-002, Status: Effective

Original Sheet No. 81 Original Sheet No. 81 : Superseded

 

Service Request Form (Continued)

 

 

(e) Name and full title of officer (or general partner) of Customer who will

execute service agreement with Pipeline:_____________________________

 

_____________________________________________________________________

 

(f) Maximum Daily Contract Quantity to be delivered by Pipeline (state in dth

and Mcf):

 

 

 

 

 

Maximum estimated total quantity to be gathered and/or transported during

term of service (state in dth and Mcf):

 

(g) Points of Receipt (see attachment)

 

(h) Points of Delivery (see attachment)

 

(i) (1) Date Service is requested to commence:__________________________

 

(2) Date Service is requested to terminate:_________________________

 

(j) If Customer is requesting service under either FTS or FGS Rate Schedules,

this Service Request Form must be accompanied by a prepayment, not to

exceed $10,000, of the total Reservation Charge provided in Rate

Schedules FTS or FGS contained in Pipeline's FERC Gas Tariff.

 

(k) Customer must execute and submit the attached Customer's certification.

 

 

III

 

At the time of execution of the Service Agreement, Customer shall inform

Pipeline of the state in which the ultimate consumer of the gas is located.

If Equitable Resources Energy Company (EREC) is a supplier of gas to Customer,

Customer agrees to cause EREC to inform Pipeline in the event EREC incurs a

loss on the sale to Customer and the amount of such loss.