Mississippi Canyon Gas Pipeline, LLC
First Revised Volume No. 1
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Effective Date: 11/01/2009, Docket: RP10-12-000, Status: Pending
Third Revised Sheet No. 312A Third Revised Sheet No. 312A
Superseding: Second Revised Sheet No. 312A
EXHIBIT "B"
INTERACTIVE INTERNET WEBSITE ACCESS REQUEST FORM
Shipper (Complete Legal Name): _________________________________________
Mailing Address: ______________________________________________________
City:__________________________________ State: __________ Zip:__________
Physical 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: _____________
Printed Name of Shipper's Authorized Employee/Agent: ________________________
Approved by (Shipper):________________________________________________
Title: ___________________________________________ Date: ___________________
FOR INTERNAL USE ONLY
USER ID: ______________________________ Shipper# (if no DUNS): ______________
Security approved by:___________________ Date: _____________________________
Printed Name: _________________________
Title: ________________________________ Date:________________________
PLEASE FAX COMPLETED FORM TO (832) 214-5791