Arlington Storage Company, LLC
Original Volume No. 1
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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
Flow Date Pipeline Location Volume
Name Meter Name & Meter Number (Dth/d)
_________ _________________ _________________________ _______
_________ _________________ _________________________ _______
_________ _________________ _________________________ _______
Shipper's Name Shipper's
Contract
Number
____________ __________
____________ __________
Comments:________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________