American Midstream (Midla), LLC

Sixth Revised Volume No. 1

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Effective Date: 05/01/2010, Docket: RP10-483-000, Status: Effective

Original Sheet No. 320 Original Sheet No. 320

 

FORM OF SERVICE AGREEMENT

(APPLICABLE TO RATE SCHEDULE FTS)

 

EXHIBIT D

 

To the Agreement under Rate Schedule FTS between American Midstream (Midla), LLC

(Pipeline) and ___________________________________ (Customer) concerning

discount or negotiated rate information.

 

Discount Information

 

 

Dated: ______________________________________

 

Discounted Transportation Rate: ___________________________

 

Discounted Rate Effective: From: _____________ To: __________________

 

___ Evergreen: ___ Year-to-Year

___ Month-to-Month

 

Condition for Discounted Transportation Rate (check applicable condition(s)):

 

____ Discounted Transportation Rate applicable to specified quantities under Shipper's

Service Contract(s):

 

_____________ MMBtu

 

____ Discounted Transportation Rate applicable to specified quantities above or below

a certain level or all quantities if quantities exceed a certain level:

 

Discounted Transportation Rate applicable to ________ MMBtu above/below

_____________ MMBtu

or