Gulf South Pipeline Company L P
Sixth Revised Volume No. 1
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Effective Date: 05/14/2010, Docket: RP10-601-000, Status: Effective
Second Revised Sheet No. 4803 Second Revised Sheet No. 4803
Superseding: First Revised Sheet No. 4803
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EXHIBIT "A"
GULF SOUTH PIPELINE COMPANY LP ("Gulf South")
INTERNET USERID/PASSWORD REQUEST FORM
TYPE OF REQUEST: ADD NEW USER_____ Change USERID_____ Delete USERID_____
Applicant Proprietary Data Rights: UPDATE ONLY_____ VIEW ONLY_____
Company:____________________________________________________________________________________
Company DUNS Number:________________________________________________________________________
Address:____________________________________________________________________________________
City, State, and Zip Code:__________________________________________________________________
EMPLOYEE (Applicant) NAME:__________________________________________________________________
(PLEASE PRINT)
WORK PHONE:_________________________________________FAX:____________________________________
E-mail Address:___________________________________________________________________________
It is recognized that the userid and password ("USERIDS") established to access password protected
portions of the Internet Web Site are confidential and are to be used solely by the Applicant
hereto. Applicant agrees to keep USERIDS confidential. Applicant agrees to promptly notify Gulf
South if there is any indication that a security breach has occurred with regard to their USERIDS.
Applicant agrees to contact Gulf South in regard to any change in job status where access to
password protected information is no longer necessary or if Applicant ceases to be employed by the
Company referenced above. Such notification shall be made to technical support immediately by
telephone and shall be followed by written notification within five (5) business days. Gulf South
may terminate any USERIDS, which Gulf South believes in its reasonable judgment to be used in an
inappropriate manner.
This Exhibit "A" is associated with the Internet Web Site Customer Agreement dated ____________
between Customer and Gulf South and is subject to the complete terms and conditions thereof.
APPLICANT'S SIGNATURE: ____________________________________ DATE: ______________
RETURN TO: GULF SOUTH PIPELINE COMPANY LP
Attn: Quantium Technical Support
P O BOX 1478
HOUSTON, TX 77251-1478
FAX# (713) 479-1852