Oktex Pipeline Company

Original Volume No. 1

 Contents / Previous / Next / Main Tariff Index

Effective Date: 02/01/2010, Docket: RP10-205-001, Status: Effective

First Revised Sheet No. 60M First Revised Sheet No. 60M

Superseding: Original Sheet No. 60M

EXHIBIT

DATED TO BE EFFECTIVE (date)

1. Contact Information:

Company:

Street Address:

City:

State/Province/Commonwealth:

Zip/Postal Code:

Attention [Name, Title]:

Telephone:

Fax:

Email Address:

Legal Entity Common Code (D-U-N-S((Number):

(A registered trademark of Dun & Bradstreet Corporation)

Company:

Street Address:

City:

State/Province/Commonwealth:

Zip/Postal Code:

Attention [Name, Title]:

Telephone:

Fax:

Email Address:

Legal Entity Common Code (D-U-N-S((Number):

(A registered trademark of Dun & Bradstreet Corporation)

2. Terms and Conditions: (If no special terms and conditions have been agreed upon, enter

"None.")

3. Limitation on Direct Damages: (If no limitation has been agreed upon, enter "None.")

4. Confidential Information: (See Section 3.4. If no limitation has been agreed upon, enter

"None.")

The undersigned do hereby execute this Exhibit pursuant to the Agreement attached and do hereby

ratify said Agreement for all purposes set forth in this Exhibit.

Company Name: Company Name:

By: By:

Printed Name: Printed Name:

Title:______________________________________ Title:___________________________________________