NorAm Gas Transmission Company
Fourth Revised Volume No. 1
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Effective Date: 08/01/1995, Docket: RP95- 53-000, Status: Effective
1st Rev Original Sheet No. 330 1st Rev Original Sheet No. 330 : Superseded
Superseding: Original Sheet No. 330
Form of Request for Pooling Service
D. AGREEMENT TERMS:
Date Service is to commence ____________________
Rate Schedule SBS option: _____ Yes _____ No
If yes check requested service(s) and specify maximum(s):
____ Advance Receipt Maximum Quantity _____ MMBtu
____ Advance Delivery Maximum Quantity _____ MMBtu
E. Are New/Modified Facilities Required? _____ Yes _____ No. If yes, please describe.
F. Pool Manager must submit a complete credit application in the form provided for in Transporter's
Tariff. Transporter shall have no obligation to accept Pool Manager's request for service or to
perform service if Pool Manager has not qualified under Transporter's credit policies.
G. Unless Pool Manager designates otherwise, Pool Manager's signature below shall constitute its
agreement to execute a Service Agreement as provided in Section 1( c) of Rate Schedule PS and to
comply with the terms and conditions of Transporter's Tariff . Yes____ No____
H. Pool Manager shall provide, in writing, such other information as is required to comply with
regulatory reporting and/or filing requirements and Transporter's Tariff.
Pool Manager or Pool Manager's agent by its signature, certifies to Transporter (1) that it has
good title to the gas or a current contractual right to acquire title or the full right to deliver
all Gas delivered or caused to be delivered, and (2) that it has entered into all necessary
arrangements to assure that upstream and downstream transportation will be in place prior to the
commencement of the requested service.
Pool Manager or Pool Manager's agent also certifies that the information herein is complete and
accurate to the best of Pool Manager's knowledge, information and belief.