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
Second Revised Sheet No. 109 Second Revised Sheet No. 109 : Superseded
Superseding: First Revised Sheet No. 109
U-T OFFSHORE SYSTEM
TRANSPORTATION SERVICE REQUEST FORM
12. Nature and Extend of Supplier's Affiliation with U-TOS or Any Partner in U-TOS
13. State where the ultimate end user of the gas will use such gas.
End User State of End Use
14. (To be completed only if Shipper is affiliated with U-TOS or any partner in
U-TOS, and will be marketing the gas to be transported).
Amount by Which the Gas Will Be Sold At a Loss ($/Dth): __________________
15. Dun & Bradstreet Number: __________________________________
16. Internet E-Mail Address: __________________________________
17. Certified Statement
By submitting this request, Shipper certifies that Shipper has or will have by
the time of execution of an Agreement with U-TOS, title to or right to deliver
the Gas which is to be transported and owns facilities or contractual rights
which will cause such Gas to be delivered to and received from U-TOS.
THIS TRANSPORTATION SERVICE REQUEST IS HEREBY SUBMITTED
this ______________ day of________________________________________, 19________.
Telephone Number _____________________________________________________________