U-T Offshore System, L.L.C.

Third Revised Volume No. 1

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Effective Date: 06/01/1997, Docket: RP97-146-001, Status: Effective

First Revised Sheet No. 106 First Revised Sheet No. 106 : Superseded

Superseding: Original Sheet No. 106

 

 

U-T OFFSHORE SYSTEM

 

TRANSPORTATION SERVICE REQUEST FORM

 

 

 

Send to: U-T Offshore System (U-TOS)

c/o ANR Pipeline Company, Operator

500 Renaissance Center

Detroit, Michigan 48243 Date Received ___________

 

Time Received ____________

Attention: Manager, Business Operations

Telecopier Number: (313) 496-3684

Verification: (313) 496-3683

 

NOTE: A check, as required by Section 2.1 of the General Terms and Conditions, must

accompany each Transportation Service Request to be valid.

 

 

INFORMATION REQUIRED FOR VALID TRANSPORTATION REQUEST

-----------------------------------------------------

 

NOTE: ANY CHANGE IN THE FACTS SET FORTH BELOW, WHETHER BEFORE OR AFTER SERVICE BEGINS, MUST

BE PROMPTLY COMMUNICATED TO U-TOS IN WRITING.

 

1. Requester's Name and Address (Do not complete if same as Shipper, see No. 2 below):

Requester's Affiliation With U-TOS or Any Partner in U-TOS, and the extent of the

affiliation, if any:

_____________________________________________________________________________________

_____________________________________________________________________________________

 

 

2. Shipper's Name and Address (Note: The "Shipper" is the party which proposes to

execute the Transportation Agreement with U-TOS).

_____________________________________________________________________________________

_____________________________________________________________________________________

 

Attention: _________________________ Telephone: _____________________________________

 

 

Nature of Shipper (check one):

 

__________ Interstate pipeline

__________ Intrastate pipeline

__________ Local distribution company

__________ End-user

__________ Producer

__________ Marketer

__________ Other (explain) __________________________________