Portland Natural Gas Transmission System

Second Revised Volume No. 1

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Effective Date: 09/01/2006, Docket: RP06-449-000, Status: Effective

Original Sheet No. 553 Original Sheet No. 553 : Effective

 

(4) Agents

For each Receipt and Delivery Point listed above in item (3), identify

all parties who will tender or receive gas for Requester's account, or

who will otherwise act on behalf of Requester as an agent. Describe

fully the particulars of that arrangement. Throughout the term of

Shipper's executed Service Agreement, Shipper must use this form of

"Request for Service" to designate any changes in such third party

designations.

 

(5) Term

The proposed dates for service commencement and termination are

(Date) and_______(Date) , respectively.

 

(6) Certification

Requester hereby certifies that it has title to the subject gas or that

Requester will enter into all contractual agreements to acquire title to

the gas for which transportation is requested. Requester furthermore

hereby certifies that it has or will enter into all contractual

agreements necessary to ensure that all upstream and downstream

transportation is in place prior to the date on which service is

requested to commence.

 

(7) Facilities

The identification and location of facilities, to be constructed or

installed by any party, that are necessary for receipt of gas by PNGTS

or for delivery to and/or utilization of gas by the Requester, or direct

or indirect customers of Requester, are as follows:

 

Facilities Location

(Identification and Description) (Description)

 

(8) Rate

Describe Rate Schedule, percentage of maximum posted rate, the level(s)

of a negotiated rate, etc., as applicable.

 

(9) Officer

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

execute service agreement with Portland Natural Gas Transmission System:

 

 

(10) Contact

Contact person for service request: