| Send to: |
Honeoye Storage Corporation
4511 Egypt Road
Canandaigua, NY 14424
Attention: Vice President of Operations
Fax: 585-229-2015
Telephone: 585-229-5161 |
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| Date Received: |
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| NOTE: |
A check, if required by Section 2.1 of the General Terms and Conditions, must
accompany each Storage Service Request to be valid. |
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| INFORMATION REQUIRED FOR VALID STORAGE REQUEST |
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| NOTE: |
ANY CHANGES IN THE FACTS SET FORTH BELOW, WHETHER BEFORE OR AFTER SERVICE BEGINS,
MUST BE PROMPTLY COMMUNICATED TO SELLER IN WRITING. |
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| 1. |
Requestor: (Do not complete if same as Customer, See No. 3 below)
Requestor’s Name:______________________________________________
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| 2. |
Is Requestor affiliated with Seller? YES______ NO_______
If yes, type of affiliation and the percentage of ownership between Seller and
Requestor ______________________________
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| 3. |
Customer’s Name and Address: (Note: The "Customer" is the party which
proposes to execute the Storage Agreement with Seller).
_________________________________________________________________
_________________________________________________________________
Attention:___________________________ Telephone:_____________________
Fax No.:____________________________ Email address:__________________
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| 4. |
Is Customer affiliated with Seller? YES_____ NO_____
If yes, type of affiliation and the percentage of ownership between Seller and Customer
____________________________________________ |
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| 5. |
Customer is a(n): (Check One)
_____ Local Distribution Company ______ Producer
_____ Intrastate Pipeline Company ______ End-User
_____ Interstate Pipeline Company ______ Marketer/Broker
_____ Other (Describe)____________________________________________
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| 6. |
Customer is Acting: (Check One)
_____ for Itself
_____ as Agent for ______________________________________________
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| 7. |
This request is for: (Check One)
_____ Firm Storage Service under Rate Schedule FSS
_____ Interruptible Storage Service under Rate Schedule ISS
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Maximum Daily Injection Quantity |
________ Dth/d |
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Maximum Daily Withdrawal Quantity |
________ Dth/d |
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Storage Overrun Quantity |
________ Dth |
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| 8. |
Requested Maximum Storage Quantity_________________Dth |
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| 9. |
Point of Injection_______________________________________ |
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| 10. |
Point of Withdrawal_____________________________________ |
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| 11. |
Term of Service:
Date service is requested to commence:________________________
Date service is requested to terminate:_________________________
(Unless otherwise agreed to by Seller, Agreements for FSS shall commence on April 1 and
terminate on March 31 of any following year)
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| 12. |
Rate Information:
Customer will agree to pay for service requested as follows:
| FIRM STORAGE SERVICE (FSS)* |
| Deliverability Reservation Rate - Monthly |
$________ per Dth/mo |
| Capacity Reservation Rate- Monthly |
$________ per Dth/mo |
| Injection Rate |
$________ per Dth |
| Withdrawal Rate |
$________ per Dth |
| Overrun Injection Rate (minimum $0.03 per Dth) |
$________ per Dth |
| Overrun Withdrawal Rate (minimum $0.03 per Dth) |
$________ per Dth |
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INTERRUPTIBLE STORAGE SERVICE (ISS)*
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| Injection Rate |
$________ per Dth |
| Withdrawal Rate |
$________ per Dth |
| Inventory Charge |
$________ per Dth/day |
| Late Withdrawal Rate |
$________ Dth/day |
| Overrun Storage Commodity Rate |
$________ Dth/day |
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*All quantities of natural gas are measured in dekatherms (Dth)
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| 13. |
Certified Statement:
By submitting this request, Customer certifies that customer has or will have by the
time of execution of an Agreement with Seller, title to, or the legal right to cause to be
delivered to Seller, for Storage, the gas which is to be stored and facilities or
contractual rights which will cause such Gas to be delivered to and received from Seller.
In the event Customer purchases Storage Overrun Quantity, Customer shall certify that
Customer shall have such title to and rights to deliver gas to Seller upon the termination
of the Storage Overrun Service in an amount equal to Storage Overrun Service. |
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| 14. |
Credit Evaluation: as required by Section 2.2(j) of the General Terms and
Conditions.
THIS STORAGE SERVICE REQUEST IS HEREBY SUBMITTED
This ___ day of ________, ____
By_________________________
Telephone Number ( )______________
Fax Number ( )____________
e-mail address ____________________
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| Click here to Access the FSS Service Agreement |
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| Click here to Access the ISS Service Agreement |