Mississippi Canyon Gas Pipeline, LLC

First Revised Volume No. 1

 Contents / Previous / Next / Main Tariff Index

 

 

Effective Date: 09/07/2006, Docket: RP06-468-000, Status: Effective

Third Revised Sheet No. 314 Third Revised Sheet No. 314 : Effective

Superseding: Second Revised Sheet No. 314

 

SERVICE REQUEST FORM (Continued)

 

 

VII. Receipt Point(s): ____________________________

Delivery Point(s): ____________________________

 

VIII. If additional or new facilities are required to receive or

deliver gas for the transportation service requested herein,

please provide description of facilities required, location

and requested in-service date:

 

____________________________________________________________

____________

 

 

____________________________________________________________

____________

 

IX. Agent ( ) or Marketer ( ):

____________________________________________________

Company Name: ______________________________________

Address: ___________________________________________

Telephone No.: ________________

Fax No.: _________________

E-mail address: ________________

If Agent, is Agent responsible for: Accounting, Invoices Y

___ N ___

Nominations, Scheduling Y

___ N ___

 

 

X. Credit Evaluation - A Shipper seeking service from

Transporter under Rate Schedules FT-1, FT-2 or IT-1 must

comply with the creditworthiness criteria as described in

the General Terms and Conditions of the Mississippi Canyon

Tariff.

 

Representatives of Shipper (up to two) that are authorized

to receive notices regarding Shipper's creditworthiness,

including requests for additional information:

 

Name E-Mail Address

_______________________ ________________________

 

_______________________ ________________________

 

XI. Shipper understands that this request form, complete and

unrevised as to format, must be received by Transporter

before the transportation request will be accepted and

processed.