Arlington Storage Company, LLC

Original Volume No. 1

Effective Date: 08/24/2009, Docket: RP09-872-001, Status: Effective

Substitute Original Sheet No. 244 Substitute Original Sheet No. 244

Superseding: Original Sheet No. 244

Exhibit A

to the Hub Services Agreement

between ASC and________________ (Customer)

CUSTOMER: ___________________, pursuant to the Hub Services Agreement executed by Customer

and ASC, hereby directs and requests ASC, as Hub Administrator, to do the following:

Title Transfer: (from) Title Transfer: (to)

Company Name: ___________________________ Company Name:_______________________

Address____________________________________ Address:____________________________

___________________________________ __________________________________

Phone:______________ Fax:__________________ Phone:______________ Fax:__________________

POINT(S) OF RECEIPT FOR TITLE TRANSFERS

Flow Date Pipeline Location Volume

Name Meter Name & Meter Number (Dth/d)

_________ _________________ _________________________ _______

Shipper's Name Shipper's

Contract

Number

____________ __________

POINT(S) OF DELIVERY FOR TITLE TRANSFERS