TransColorado Gas Transmission Company
Original Volume No. 1
Contents / Previous / Main Tariff Index
Effective Date: 11/01/2001, Docket: RP02- 5-000, Status: Effective
Original Sheet No. 425 Original Sheet No. 425 : Superseded
RO No. ______
PALS REQUEST ORDER FORM
DATED __________
Shipper: __________________ Type of Service: Park _____ Loan _____
Initiation Points Name(s) and PIN(s)________________ MAQ RO: (Dth)
Completion Point Name(s) and PIN(s)______ Minimum Aggregate Quantity ___
______________
Term: Start _____ End _____ PALS Agreement #: ________________________
Schedule:
Date(s) Service to be Provided Daily Quantity (Dth)
(May Reflect a Range of Dates) (May Reflect a Range of Volumes)
From Through Park or Loan Payback Loan or Park Withdrawal
Minimum Maximum Minimum Maximum
__________ ___________ ___________________ ______________________
__________ ___________ ___________________ ______________________
__________ ___________ ___________________ ______________________
__________ ___________ ___________________ ______________________
__________ ___________ ___________________ ______________________
__________ ___________ ___________________ ______________________
__________ ___________ ___________________ ______________________
__________ ___________ ___________________ ______________________
Rates: Rates may vary based on volume, time period, etc., as set out in
the Pro Forma Service Agreement.
Park or Loan Payback=volumes which TransColorado receives from Shipper.
Loan or Park Withdrawal=volumes which TransColorado delivers to Shipper.
Initial Rate: __________________________________________________________
Completion Rate: _______________________________________________________
Park/Loan Balance Rate: ________________________________________________
Service will be ON BEHALF OF:
_____ Shipper [ ] or ___Other [ ]_______ ____________________________,
a __________________________
SHIPPER S CONTACT AND ADDRESS
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Phone: ___________________________ Fax: ______________________________
Other Conditions, (if any): ___________________________________________
Agreed to by:
TRANSCOLORADO SHIPPER
By:____________________________ By:________________________________
NAME: __________________________ NAME:_______________________________
TITLE: _________________________ TITLE: _____________________________