Natural Gas Pipeline Company Of America

Seventh Revised Volume No. 1

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Effective Date: 04/18/2008, Docket: RP08-319-000, Status: Effective

Original Sheet No. 620 Original Sheet No. 620 : Pending

 

RO No.: .......

 

PALS REQUEST ORDER FORM

DATED ..........

 

Shipper: ........................................... Type of Service: Park ........ Loan ........

Point Name: ........................................ MAQ RO: ................................. (Dth)

Delivery Pressure: ................................. PALS Agreement #: .............................

PIN: ............................................... Rate: .........................................

Term: Start ................. End ................

 

Schedule:

 

Date(s) Service to be Provided Daily Quantity (Dth)

------------------------------ ---------------------------------------------------------------------

From Through Park or Loan Payback Loan or Park Withdrawal

------------- ------------- -------------------------------- -------------------------------

............. ............. ................................ ...............................

............. ............. ................................ ...............................

............. ............. ................................ ...............................

............. ............. ................................ ...............................

............. ............. ................................ ...............................

............. ............. ................................ ...............................

............. ............. ................................ ...............................

............. ............. ................................ ...............................

............. ............. ................................ ...............................

 

MAQ RO (total of daily volumes): ................................ = ...............................

Park or Loan Payback = volumes which Natural RECEIVES from Shipper.

Loan or Park Withdrawal = volumes which Natural DELIVERS to Shipper.

 

Service will be ON BEHALF OF:

...... Shipper or

...... Other: ....................................................., a ..............................

 

SHIPPER'S CONTACT AND ADDRESS

......................................................................................................

......................................................................................................

......................................................................................................

Phone: .......................................... Fax: ...........................................

 

Other Conditions (if any): ...........................................................................

 

Agreed to by:

NATURAL SHIPPER

 

/s/: ............................................ /s/: ............................................

NAME: ........................................... NAME: ...........................................

TITLE: .......................................... TITLE: ..........................................