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