Viking Gas Transmission Company
First Revised Volume No. 1
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Effective Date: 01/01/2000, Docket: RP00-110-000, Status: Effective
Second Revised Sheet No. 113 Second Revised Sheet No. 113 : Superseded
Superseding: First Revised Sheet No. 113
SERVICE REQUEST FORM (Continued)
Viking Gas Transmission Company
Page 7
* 16. If Shipper is purchasing gas, provide the name of producer(s) of the
gas, seller (if different from producer), location (FERC Geographic
Area) of the source(s) of supply, indication of the FERC Geographic
Area associated with the anticipated primary source of supply,
contract quantity, and the effective and termination date(s) of
executed Agreement(s) between Shipper and seller(s):
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
* 17. If Shipper is selling gas, provide the name of purchaser(s) of the
gas, contract quantity, and the effective and termination date(s) of
executed Agreement(s) between Shipper and purchaser(s):
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
18. Credit Evaluation - Please provide a copy of Shipper's most recent
quarterly financial statement, most recent annual report and Form 10K
and a complete list of all affiliates including parent and subsidiary
companies.
19. Is requestor affiliated with Viking Gas Transmission Company?
______ Yes
______ No
If yes, what is the percentage of affiliation? ______%
* This information is not required at the time of the request but is required
at the time Shipper executes the Gas Transportation Agreement or Gas Park
and Loan Agreement.