Mississippi Canyon Gas Pipeline, LLC
First Revised Volume No. 1
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Effective Date: 03/01/1999, Docket: RP99-228-000, Status: Effective
First Revised Sheet No. 317 First Revised Sheet No. 317 : Superseded
Superseding: Original Sheet No.317
SERVICE REQUEST FORM (Continued)
12. Is Shipper affiliated with Mississippi Canyon Gas
Pipeline, LLC?
____ Yes ___ No
If yes, what is the percentage of affiliation?
%
13. Is your supplier affiliated with Mississippi Canyon Gas
Pipeline, LLC? ___ Yes ___ No
If yes, what is the percentage of affiliation? _____%
If applicable, Shipper agrees by its signature below to
provide this information within twenty-five calendar days
after the month in which the transportation service
occurred.
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.
Shipper, by its signature, certifies to Transporter (1) that
the information above is correct and accurate and that all
necessary transportation arrangements with the upstream and
downstream transporters have been or will be secured prior
to the commencement of the requested transportation service
and (2) that Shipper will have title to the gas transported
pursuant to its Transportation Service Agreement and (3)
that Shipper will advise Transporter of any changes in the
information provided in item 13 five business days prior to
the end of any month for the preceding month's
transportation business in which a change occurred.
Very truly yours,
[Shipper]
_____________________________________
By:_________________________________