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First Revised Sheet No. 106 First Revised Sheet No. 106 : Superseded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