Notice ID: *  
Customer Name: *  
Customer Contact Person: *  
Phone Number: *  
Facsimile Number: *  
Email Address: *

Commencement Date: * mm/dd/ccyy  
Termination Date: * mm/dd/ccyy  
Receipt Point: Aberdeen Ackley Amana BP Canada TPB Balaton Beaman Brandt Buford-Bearpaw Buford-WBI CEESI Channahon Charbonneau Clear Lake Cordova Crystal Lake Logical Point Darling Lake Logical Point Davenport Davis Deer Creek Des Plaines Edmunds Elm Creek Elwood Elwood-Nicor Elwood-Peoples Fraser GP-MidAmerican GP-Nicor GP-Peoples Glen Ullin Goose Lake Logical Point Goose Lakes Logical Point Groton Grundy Ctr Harper Hayworth* Hebron Integrys TPB Integrys TPB A/B Iowa City Ivanhoe Jackson Creek Jeffers Joliet Kurtz Lakefield Logical Point Lakota Lanark Ledyard Limited Use Long Point Linton Mallard Lake Mallard Lakes Manhattan Manhattan South Manning Marshall Martin County Milbank Mina Minooka NICOR TPB Nelson Lake Logical Point Nicor TPB Noel North Hayden PEWM TPB Peoples TPB Port of Morgan Princeton Prophetstown Prophetstown - ADM Prophetstown - Equistar Prophetstown - PSC Rutland Saskana Seqeng TPB Sequent TPB Slayton Spring Creek Spring Creek Buyback Squaw Creek Stony Stony Buyback Tama Tenaska TPB Torrence Trimont Troy Grove Tyler Ventura Warner Watertown Watford City Webster Welcome Westbrook Will County Wilton Center Windom Yale Zuma *  
Receipt Quantity (MCF): *  
Delivery Point: Aberdeen Ackley Amana BP Canada TPB Balaton Beaman Brandt Buford-Bearpaw Buford-WBI CEESI Channahon Charbonneau Clear Lake Cordova Crystal Lake Logical Point Darling Lake Logical Point Davenport Davis Deer Creek Des Plaines Edmunds Elm Creek Elwood Elwood-Nicor Elwood-Peoples Fraser GP-MidAmerican GP-Nicor GP-Peoples Glen Ullin Goose Lake Logical Point Goose Lakes Logical Point Groton Grundy Ctr Harper Hayworth* Hebron Integrys TPB Integrys TPB A/B Iowa City Ivanhoe Jackson Creek Jeffers Joliet Kurtz Lakefield Logical Point Lakota Lanark Ledyard Limited Use Long Point Linton Mallard Lake Mallard Lakes Manhattan Manhattan South Manning Marshall Martin County Milbank Mina Minooka NICOR TPB Nelson Lake Logical Point Nicor TPB Noel North Hayden PEWM TPB Peoples TPB Port of Morgan Princeton Prophetstown Prophetstown - ADM Prophetstown - Equistar Prophetstown - PSC Rutland Saskana Seqeng TPB Sequent TPB Slayton Spring Creek Spring Creek Buyback Squaw Creek Stony Stony Buyback Tama Tenaska TPB Torrence Trimont Troy Grove Tyler Ventura Warner Watertown Watford City Webster Welcome Westbrook Will County Wilton Center Windom Yale Zuma *  
*Total Res Bid Rate: * (Per Dkt)  

Comments:

*Maximum commodity rate and Surcharges are not included in the reservation bid rate.

Please print this form for your records and also fax to 1.402.492.7488 prior to submittal. Thank you.