High Island Offshore System, L.L.C.

Third Revised Volume No. 1

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Effective Date: 12/15/2007, Docket: RP08- 65-000, Status: Effective

Seventh Revised Sheet No. 174 Seventh Revised Sheet No. 174 : Effective

Superseding: Sixth Revised Sheet No. 174

HIGH ISLAND OFFSHORE SYSTEM, L.L.C.

NOMINATION REQUEST FORM

----------------------------------- Time/Date Stamp: _______________________

Service Provider Name: ________________________________________

Service Provider ID #: ________________________________________

 

Service Requester Name: ________________________________________ Beginning Date: ______________________________

Service Requester ID#: ________________________________________ Beginning Time: ______________________________

Representative: ________________________________________ Ending Date: ______________________________

Telephone No.: ________________________________________ Ending Time: ______________________________

Facsimile No.: ________________________________________

 

Capacity Type Indicator (FT-1, FT-2, IT): __________________ Model Type: _____________________________________

Service Requester Contract Number: _____________________________ Quantity Type Indicator: ________________________

Longhaul: ____________________ Transaction Type: _______________________________

Shorthaul: ____________________

 

ALWAYS FACSIMILE NOMINATION REQUESTS TO THE FOLLOWING LOCATION:

 

High Island Offshore System, L.L.C.

P. O. Box 4324

Houston, Texas 77210-4324

Attn: Manager, Contract Administration

Facsimile No.: (713) 381-7996

Telephone No.: (713) 381-7940

 

Upstream Producer HIOS Electronic Downstream

Identifier Operator Measurement Lateral Downstream Contract Quantity

Code Name Location Dth/D Transporter Shipper Number Dth/D

 

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By signing this Nomination/Schedule, Shipper certifies that Shipper has title to the gas or right to deliver the gas which is to be transported by

HIOS.

 

By: __________________________________________

 

Title: __________________________________________