SOUTHERN LNG SERVICE REQUEST FORM

Transcription

1 SOUTHERN LNG SERVICE REQUEST FORM Southern LNG Company, L.L.C. Post Office Box 2563 Birmingham, AL Gentlemen: (Customer) hereby requests services from Southern LNG Company, L.L.C. (Southern LNG) and is providing Southern LNG the following information in connection with this request: 1. Type of service requested is: new service new contract to bid on temporary capacity release of firm capacity and: firm service interruptible service 2. Full legal name of Customer, Dun and Bradstreet number, type of legal entity and, if corporation, state of incorporation. Contact person, address and telephone number for Customer in areas of responsibility shown below, a 24-hour telephone or beeper number, and three contact persons for Customer for emergencies or OFO s, and a facsimile machine number (if available): General Notices and Correspondence: Dispatching Notices: Nominations/Confirmations

2 OFOs/Capacity Allocation Invoices: Emergency Contact Persons: (1) (2) (3) 24-hour Emergency Telephone or Beeper No: Facsimile Machine No.: 3. Whether Shipper is affiliated with Southern LNG Yes No 4. Customer is: a local distribution company (LDC) (Code 1) an interstate pipeline (Code 2) an intrastate pipeline Code 3) an end-user (Code 4) a producer (Code 5) a marketer/broker (Code 6) pipeline sales operating unit (Code 7) other (fill in) (Code 8): SLNG PF03 2

3 5. Date service is requested to commence: Date Service is requested to terminate: To be considered a valid request service must be requested to begin months of the date of the request, except if the request involves the construction of facilities or the issuance of any necessary certificate authorization to Southern LNG. 6. Maximum Storage Quantity (MSQ requested: Mcf Submit, pursuant to Section 2.1(a) of the General Terms and Conditions of Southern s LNG Tariff, (i) Customer s DUN & BRADSTRET (DUNS) number; (ii) Customer s most recent audited financial statements, annual report, Form 10- K; (iii) three credit references; and (iv) a list of affiliates, in order to enable Southern LNG to evaluate Customer s creditworthiness. On the Attachment A hereto, provide the information related to each of Customer s vessel(s) from which Southern LNG would receive LNG for Customer s account. Customer shall provide as requested, any additional information that Southern LNG requires to determine whether Customer s vessel(s) will interface with Southern LNG s facilities without any modification. Customer understands that before this request is logged in by Southern LNG, Southern LNG must receive this request form, complete and unrevised as to format. Customer hereby agrees to pay Southern LNG s currently effective rates applicable to the Rate Schedule. Customer, by its signature and seal below, represents to Southern LNG that the information above is correct and accurate. SLNG PF03 3

4 Customer, by its signature and seal below, certifies (i) that is has entered into or will enter into those arrangements necessary to assure all upstream and downstream transportation will be in place prior to the commencement of service under the service agreement requested herein; (ii) that upon the commencement of service hereunder, but not as a condition precedent thereto, Customer will provide the names of all upstream and downstream transporters involved in the transportation of gas hereunder; (iii) that Customer has title or a current contractual right to acquire title to the gas to be delivered to Southern LNG; and (iv) that Customer has all necessary permission, licenses, and certificates from all government agencies having jurisdiction over its delivery of gas to, and receipt of gas from, Southern LNG. Very truly yours, By Its Date SLNG PF03 4

5 ATTACHMENT A SERVICE REQUEST FORM VESSEL INFORMATION Customer: LNG Tanker(s) Register LNG Cargo LNG Tanker Name(s) Register Number Flag Capacity (Mcf) Owner/Operator/Manager

6 SOUTHERN LNG COMPANY, L.L.C. CUSTOMER SERVICES DEPARTMENT NOMINATION Customer: Contract No.: Time: CCT Begin Date: Month/Day/Year End Date: Month/Day/Year DAILY QUANTITIES TO BE DELIVERED FOR CUSTOMER S ACCOUNT Delivery Point Force Point Point Associated Associated Balancing Package Scheduled Storage Offer Quantity-Dth Code Name Contract(1) Shipper (1) Priority ID Service (2) Service(3) No Dry 1. If delivery point is a pipeline interconnect, associated downstream shipper and contract number are required. 2. Used to nominate volumetric capacity release. Associated offer number of release is required. 3. Firm or interruptible service.