U S G Pipeline Company

ORIGINAL VOLUME NO. 1

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Effective Date: 04/01/2000, Docket: CP99-211-001, Status: Effective

Original Sheet No. 97 Original Sheet No. 97 : Effective

 

SERVICE REQUEST FORM

 

14. Credit Evaluation - Provide all information required in Section 6 of

Transporter's General Terms and Conditions. Shippers requesting service under

Rate Schedule FT shall submit, with their request for service, a check or wire

transfer in an amount equal to the lesser of $10,000 or the total Reservation

Charge applicable to the proposed service for a one month period. This amount

shall be credited to Shipper's bill for the first month of the requested

transportation service. If the requested service is not available, Transporter

shall refund the entire amount of the prepayment within thirty days of

notification by Transporter that service can not be provided. All prepayments

made to Transporter are to be sent by check or wire transfer to Transporter or

Transporter's designated bank at an address to be furnished by Transporter.

 

15. Is requestor affiliated with USG Pipeline Company?

 

______ Yes ______ No

 

If yes, what is the percentage of affiliation? ______%

 

16. Is shipper affiliated with USG Pipeline Company?

 

______ Yes ______ No

 

If yes, what is the percentage of affiliation? ______%

 

17. Is your supplier affiliated with USG Pipeline Company?

 

______ Yes ______ No

 

If yes, what is the percentage of affiliation? ______%

 

18. For marketing affiliates of USG Pipeline Company only, does the cost

of gas exceed the sales price, less associated costs including transportation,

i.e. is the gas being sold at a loss?

 

______ Yes _________ No ______ Unknown

 

If so, by how much? ____________

 

If applicable, Shipper agrees by its signature below to provide this

information within twenty-five calendar days after the month in which

the transportation service occurred.