Contract No. _______
FORM OF STORAGE SERVICE AGREEMENT
Rate Schedules FSS and ISS
1. SHIPPER'S NAME AND ADDRESS:
_________________________________
_________________________________
_________________________________
2. SHIPPER'S STATUS:
________ Local Distribution Company
________ Intrastate Pipeline Company
________ Interstate Pipeline Company
________ Marketer/Broker
________ Producer
________ End-User
________ Other
3. STORAGE SERVICE:
________ firm (Rate Schedule FSS)
________ interruptible (Rate Schedule ISS)
4. VOLUMES/QUANTITIES TO BE INJECTED AND WITHDRAWN:
Firm service in Mcf/Dth
________ annual working gas volume
________ annual working gas quantity at a Btu conversion
factor of _____.
________ minimum required deliverability (MRD) quantity at
a Btu conversion factor of _____.
MRD = Annual Working Gas
150 days x .80
Actual quantities of gas will vary, except for billing
purposes, if the Btu content of shipper's gas differs
from the average of _____.
Interruptible service in Dth
________ annual working gas volume
5. RATES:
FIRM SERVICE - RATE SCHEDULE FSS
RESERVATION CHARGES:
Deliverability:
________ the maximum rate on Questar's Statement of Rates
________ a discounted rate of ______/Dth
________ see additional terms
Inventory Capacity:
________ the maximum rate on Questar's Statement of Rates
________ a discounted rate of ______/Dth
________ see additional terms