Viking Gas Transmission Company

Original Volume No. 1

Effective Date: 11/01/1993, Docket: RS92- 52-001, Status: Effective

Original Sheet No. 112 Original Sheet No. 112 : Superseded

TRANSPORTATION SERVICE REQUEST FORM (Continued)

Viking Gas Transmission Company

Page 6

14. For firm transportation only, the name and description of Point(s) of Delivery where

Viking will redeliver the gas and the maximum daily quantities expressed in Dth of gas

to be redelivered by Viking for each point:

_____________________________________________________________________________________

(The sum of the maximum daily quantities above must equal the maximum daily quantity set

forth in No. 12 above.)

15. For firm transportation only, the names of those entities delivering gas into Viking'

system and the names of those entities taking gas off Viking's system:

Viking Point of Receipt Name/Delivering Entity

_________________________ _________________________

Viking Point of Delivery Name/Taking Entity

_________________________ _________________________