Arlington Storage Company, LLC

First Revised Volume No. 1

Effective Date: 11/08/2009, Docket: RP10-67-000, Status: Effective

Original Sheet No. 244 Original Sheet No. 244

Exhibit A

to the Hub Services Agreement

between ASC and________________ (Customer)

CUSTOMER: ___________________, pursuant to the Hub Services Agreement executed by Customer

and ASC, hereby directs and requests ASC, as Hub Administrator, to do the following:

Title Transfer: (from)

Company Name: ___________________________

Address____________________________________

____________________________________

Phone:______________ Fax:__________________

Title Transfer: (from)

Company Name: ___________________________

Address____________________________________

____________________________________

Phone:______________ Fax:__________________

POINT(S) OF RECEIPT FOR TITLE TRANSFERS

Flow Date:______________________________________________________

Pipeline Name:__________________________________________________

Location - Meter Name & Meter Number:___________________________

Volume (Dth/d):_________________________________________________

Shipper's Name:_________________________________

Shipper's Contract Number:______________________

POINT(S) OF DELIVERY FOR TITLE TRANSFERS