Enbriidge Pipelines (Midla) L. L. C.
FIFTH REVISED VOLUME NO. 1
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Effective Date: 10/01/2009, Docket: RP09-980-000, Status: Effective
Original Sheet No. 363 Original Sheet No. 363
EXHIBIT B
INTERACTIVE INTERNET WEBSITE ACCESS REQUEST FORM
CUSTOMER (Complete Legal Name)________________________________________________
Mailing Address: ___________________________________________________________
City: ____________________________ State: ___________________ Zip:___________
DUNS No.: ____________________________ Federal Tax ID No.: __________________
Authorized Employee's Full Name: _________________________________
E-Mail Address: __________________________________________________________
Authorized Employee's Employer: __________________________________
Mailing
Address:______________________City:________________State:_________Zip:_______
Phone No.: _________________________ Fax No.: ___________________________
Authorized Agent's Full Name: _________________________________
E-Mail Address: __________________________________________________________
Authorized Agent's Employer: __________________________________
Mailing
Address:______________________City:________________State:_________Zip:_______
Phone No.: _________________________ Fax No.: ___________________________
Indicate Update Capabilities for this Authorized Employee/Agent:
_____ Execute Contracts, Amendments and Accept Discounts
Employee / Agent (circle one)
_____ Make Imbalance Elections/Trades
Employee / Agent (circle one)
_____ Request New Service, Amendments and Discounts
Employee / Agent (circle one)
_____ Receive and administer the payment of any and all invoices
Employee / Agent (circle one)
_____ Submit Capacity Release Offers, Bids, Recall and Reput
Employee / Agent (circle one)