Southern Natural Gas Company, L.L.C.
Service Request Form
TheShipperlisted belowherebyrequestsservicefrom Southern NaturalGasCompany,L.L.C.(Southern)and is providing Southern the followinginformation inconnection with this request:
1.Shipper’sfulllegal name:
Dun andBradstreetnumber:
Type of Legal Entity:
If a corporation, state of incorporation:
Address:
Whether Shipper is an affiliate of Southern: Yes ______No ______
Contact Person for Critical Notices:
24-hour telephone number:
Email:
Contact Person for Invoices:
Telephone number:
Email:
2.Type ofservice requested is:
newfirm contract(to acquire capacity from Southern or a firm shipper)
modification to existingfirm serviceunder Contract No.
new interruptible contract
forthe following service type:
FirmTransportation(FT)
FirmTransportation-No Notice (FT-NN)
Firm Contract Storage Service (CSS)
Interruptible Storage Service (ISS)
Interruptible Transportation (IT)
Park and Loan (PAL)
Supply Pool Balancing Agreement (POOL)
3.Date service is requested to start:
End of primary term requested (for firm service from Southern):
To beconsidered a validrequest,FT, FTNN or CSS service must be requestedto begin within 60 daysof thedate ofthe request,except if therequest involvesthe construction of facilities orthe issuance of anynecessarycertificateauthorization to Southern, oris part of an open season initiated bySouthernunderSection 2.1 (b) (iii) ofthe General Terms and Conditions of its FERC Gas Tariff.
4.Firm Contract Quantity requested from Southern (if applicable):
- Firm transportation service: ______Dth per dayof Transportation Demand
(Please provide firm Receipt Point and firm Delivery Point information on Attachment 1 equal to the Transportation Demand requested. For FTNN service, the firm receipt point will be the Storage PIN related to the companion CSS service.)
- Firm storage service: ______Dth of Maximum Storage Quantity (withdrawal and injection rights will be calculated per Southern’s Tariff)
5.Submit Shipper’s most recent audited financial statements, annual report, Form10-K,threecreditreferences, andalist of affiliates, in order to enable Southern toevaluate Shipper’s creditworthiness.[1]
6.Ifbiddinginto an open season, pleasestate whether anyaffiliate of Shipper isbiddinginto the same open seasonand,if so, thebusiness purposeof eachaffiliatedcompany.
Shipperunderstandsthatbefore this request is deemed to be validbySouthern, Southern mustreceive this request form, completeand unrevisedas to format. Shipperherebyagrees topaySouthern’s currentlyeffective transportation rate applicable to this serviceorsuchotherdiscounted or negotiatedrateagreed upon bySouthernand Shipper. Shipper,byitssignature,represents to Southern that the information aboveis correct andaccurate.
Shipper,byits signaturebelow,certifiesthat (i)it hasentered into or willenter into thosearrangements necessarytoassureallupstream anddownstreamtransportation will beinplace priorto thecommencement of service underthe serviceagreementrequestedherein;(ii) it has titleora currentcontractual right to acquiretitleto thegas to bedelivered to Southern fortransportation tothe deliverypoint; and (iii) if Shipperand itsaffiliate arebiddinginto the sameopen season thatShipperhas a different businesspurpose than its affiliateforenteringinto such open season.
Verytruly yours,
Signature:
Name (please print):
TItle:
Contact Person for questions about this Request:
Telephone: ______Email: ______
ATTACHMENT1
Firm Transportation Point Information
Shipper:
Receipt Point Identification Number (PIN) / Receipt Point Name or Description / Maximum Daily Receipt Quantity (Dth) / DeliveryPoint Identification Number (PIN) / Delivery Point Name or Description / Maximum Daily Delivery Quantity (Dth)Total Firm MDRQ*:______Total Firm MDDQ*:______
*Total MDRQ and Total MDDQ must equal.
[1] Maynot beapplicable ifShipperis an existingcreditworthyShipperon Southern’ssystemand its creditinformation is up to date and sufficient for the new capacity requested. However, Southern mayrequireadditionalcreditinformation forincremental firm capacityorif the proposed request involves theconstruction of newfacilities.