Request for Gas Transportation Florida Gas Transmission Company

An ENRON/SONAT Affiliate

Please Send Request To:

Internal Use Only

Date Received:

Legal Entity No.:

Request No.:

SHIPPER INFORMATION

Full Legal Name:

D-U-N-S Number:

Address:

Status

  • End User LDC
  • Hinshaw Marketer
  • Interstate Producer
  • Intrastate Other:

Telephone Number/Telecopy Number:

Shipper Contact: (Name) (Title):

State of Incorporation or Formation:

Address for Notices:

Address for Billing and Invoices:

Telephone Number:

SERVICE REQUIRED

Request Status Service Type Authority

IPS PNR * NGPA 311

New Service

SFTS FTS – 1 Blanket Certificate

Amendment

(Contract No. ______ ) ITS – 1 FTS – WD

ITS FTS - 2

Term:

Projected ID Date:

QUANTITY INFORMATION

Maximum Daily Transportation Quantity (MMBtu/Day)

FTS & SFTS

 

 

 

ITS, IPS, & PNR

UPSTREAM AND DOWNSTREAM TRANSPORTERS

Identity of upstream and downstream transporters involved in the transaction:

 

 

MARKETING AFFILIATE INFORMATION

YES NO Is marketing affiliate of Transporter involved in transaction?

If YES, what is the specific role?

 

 

 

FOR MARKETING AFFILIATES ONLY:

YES NO Is gas being sold at a loss?

If YES, how much?

311 PARTY INFORMATION

If the service requested is "on behalf" of a 311 entity, please complete the following as it pertains to the

311 party:

Name:

Address:

 

 

Telephone Number:

311 Party Status: Hinshaw LDC Interstate

Location (by state) of 311 Party’s Facilities:

ULTIMATE DESTINATION

Ultimate destination of gas to be transported. List State(s)

 

 

Shipper will be required to meet the creditworthiness provisions of Florida Gas Transmission Company prior to commencement of service.

Shipper by execution of this form warrants that Shipper will be in compliance with the title provisions of Florida Gas Transmission’s F.E.R.C. Gas Tariff. Shipper also certifies that it entered or will have entered, prior to commencement of service, into all necessary arrangements for upstream or downstream transportation of such gas, if applicable.

On behalf of Shipper, the undersigned represents and warrants that the information provided herein is correct to the best of his/her knowledge and belief.

 

Signature:

Title:

Date