Millennium Pipeline Company, L. L. C.

Original Volume No. 1

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Effective Date: 12/22/2008, Docket: CP98-150-011, Status: Effective

Original Sheet No. 564 Original Sheet No. 564

 

REQUEST FOR SERVICE

NEW AGREEMENT

 

1.a. Identity of Requestor

 

Legal Company Name

__________________________________________________________________

 

Abbreviation or short name (if applicable)

__________________________________________________________________

 

Phone Number _____________________________

 

Facsimile Number _________________________

 

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 _________________________

 

 

ADDRESSES FOR NEW AGREEMENT

 

MAILING

Street

__________________________________________________________________________

 

City

__________________________________________________________________________

 

State ______________

 

Zip Code ____________

 

Contact Person (Mr., Mrs., Miss, Ms.)______________________________________