White River Hub, LLC

Original Volume No. 1

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Effective Date: 10/01/2009, Docket: RP09-1027-000, Status: Effective

First Revised Sheet No. 202 First Revised Sheet No. 202

Superseding: Original Sheet No. 202

 

Contract No.________

 

FORM OF INTERRUPTIBLE TRANSPORTATION SERVICE AGREEMENT

Rate Schedule IT

 

1. SHIPPER'S NAME AND ADDRESS:

_____________________________

_____________________________

_____________________________

 

2. SHIPPER'S STATUS:

________ Local Distribution Company (LDC)

________ Intrastate Pipeline Company

________ Interstate Pipeline Company

________ End User

________ Producer

________ Marketer

________ Pipeline Sales Operating Unit

 

3. TRANSPORTATION AUTHORITY:

 

________ 18 C.F.R. § 284, Subpart G

________ 18 C.F.R. § 284, Subpart B (NGPA § 311)

Transportation on Behalf of: (only applicable to § 311)

________ LDC or Intrastate Pipeline Company

________ Interstate Pipeline Company or Shipper

 

4. QUANTITY TO BE TRANSPORTED:

 

________ Dth/day

 

5. USAGE CHARGE:

________ The systemwide rate on White River's Statement of Rates.

________ See additional terms

 

Receipt Pt. Delivery Pt. Type of Usage Rate

MAP No. MAP No. Charge $/Dth

________ ________ ________ ________