Northern Border Pipeline Company

First Revised Volume No. 1

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Effective Date: 11/01/2003, Docket: RP03-629-000, Status: Effective

Third Revised Sheet No. 424 Third Revised Sheet No. 424 : Effective

Superseding: Substitute Second Revised Sheet No. 424

Submitted For

Offer No. _____

Contract No. _____

NORTHERN BORDER PIPELINE COMPANY

SERVICE AGREEMENT

RATE SCHEDULE T-1R

BID/EXHIBIT A

Name of Shipper: _______________________________________________________

Individual Authorizing Acquisition of Capacity:

Name: _________________________________________________________

Title: _________________________________________________________

Address: _________________________________________________________

Phone No: _________________________________________________________

FAX No: _________________________________________________________

Maximum Receipt Quantity Bid/Contracted: _________ [Mcf/day]

Transportation Path:

Point of Receipt Point of Delivery

---------------- -----------------

Describe Point Describe Point

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