Caledonia Gas And Storage

First Revised Volume No. 1

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Effective Date: 09/30/2010, Docket: RP10-1032-000, Status: Effective

Original Sheet No. 128 Original Sheet No. 128

Acceptance of a service request is contingent upon a satisfactory

credit appraisal by Caledonia. Customer must provide evidence of

creditworthiness as outlined in Section 4 of the General Terms and

Conditions of Caledonia’s currently effective FERC Gas Tariff.

By submitting this request, Customer certifies further that it will

execute, if tendered by Caledonia, a Service Agreement for the level

of service requested herein.

THIS SERVICE REQUEST IS SUBMITTED THIS _____ DAY OF _______________,

_____.

By:______________________________________________________

Title:____________________________________________________

Telephone Number(s):______________________________________

Customer/(Company Name)__________________________________