Northern Border Pipeline Company Firm Capacity Bid Form

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: *  
Receipt Quantity (DTH): *  
Delivery Point: *  
*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.