Mississippi Canyon Gas Pipeline, LLC

First Revised Volume No. 1

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Effective Date: 09/01/2005, Docket: RP05-454-000, Status: Effective

Second Revised Sheet No. 312A Second Revised Sheet No. 312A : Effective

Superseding: First Revised Sheet No. 312A

EXHIBIT "B"

INTERACTIVE INTERNET WEBSITE ACCESS REQUEST FORM

 

Shipper (Complete Legal Name):

_________________________________________

 

Mailing Address:

______________________________________________________

 

City:__________________________________ State: __________

Zip:__________

 

DUNS No.:___________________________ Federal Tax ID:

____________________

 

Authorized Employee's/Agent's Full Name:

_______________________________

E-Mail Address:

________________________________________________________

Authorized Employee's/Agent's Employer:

________________________________

Mailing

Address:______________________City:________________State:________

_Zip:_______

 

Phone No.: _________________________ Fax No.:

___________________________

 

Indicate Update Capabilities for this Authorized Employee/Agent:

_____ Execute Contracts, Amendments and Accept Discounts

_____ Make Imbalance Elections/Trades

_____ Request New Service, Amendments and Discounts

_____ Receive and administer the payment of any and all

invoices

_____ Submit Capacity Release Offers, Bids, Recall and Reput

_____ Submit Confirmations, PDAs, Storage Transfers

_____ Submit Nominations and Storage Transfers

_____ View only access to Interactive Internet Website

screens, e-mail, web page and reports for Shipper will

be available to Shipper's authorized employees

 

Signed by Shipper's authorized

Employee/Agent:_________________________________________ Date:

_____________

 

Approved by

(Shipper):________________________________________________

 

Title: ___________________________________________ Date:

___________________

 

FOR INTERNAL USE ONLY

Mississippi Canyon Gas Pipeline, LLC Officer

Signature:_____________________

Printed Name: _________________________

Title: ________________________________

Date:________________________

 

 

USER ID: ______________________________ Shipper# (if no DUNS):

______________

 

Security approved by:___________________ Date:

_____________________________

 

PLEASE FAX COMPLETED FORM TO (832) 214-5716