Wyoming Interstate Company, Ltd.

Second Revised Volume No. 2

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Effective Date: 04/12/2010, Docket: RP10-491-000, Status: Effective

Fifth Revised Sheet No. 49A Fifth Revised Sheet No. 49A

Superseding: Fourth Revised Sheet No. 49A

 

GENERAL TERMS AND CONDITIONS

(Continued)

 

4. REQUESTS FOR SERVICES (Continued)

 

4.7 Transportation Service Request Form

 

REQUEST FOR

NEW

TRANSPORTATION SERVICE

 

1. SHIPPER: TRANSPORTER:

 

Legal Company Name:__________________ Wyoming Interstate Company, L.L.C.

Street Address:______________ Zip:_____P. O. Box 1087

P.O. Box: ___________________Zip:_____Colorado Springs, CO 80944

City: ______________________State:_____Attn: Vice President, Marketing

Attn: ___________________ c/o Customer Service

Telephone: ______________ Representative

Fax: ____________________ Telephone: (719) 520-4465

Dispatcher: _____________ Telecopier: (719) 520-4878

Dun & Bradstreet (DUNS) Number: ______ Verification: (719) 520-4371

 

Billing Address (To Whom Invoices Should Be Addressed):

 

Legal Company Name: _________________________

Street Address: ___________________Zip: ____________

P.O. Box: ___________________Zip: ____________

City: __________________ State: _______________

Attn: __________________

Telephone: _____________

Fax: __________________

 

Would you like your invoice faxed? _______

 

Requestor (If Different From Shipper):

_________________________

_________________________

_________________________

 

Attn: ___________________

Telephone: ______________

 

2. SHIPPER TYPE: ___ LDC ___ Interstate Pipeline

___ Intrastate Pipeline ___ End User

___ Producer

___ Marketer/Broker

___ Other (Please Specify)