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.