Gulfstream New Business Associate Form including access to 1Line
COMPANY
Reason for Request
Select One New Entity Name Change Merger/Acquisition
Party Type:
End User Marketer Interstate Pipeline Intrastate Pipeline Hinshaw Pipeline Producer/Operator Storage Operator Residential Other Distributor Electric Co-op Generator
Company Legal Name:
State of Incorporation:
Please Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware D.C. Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan England Northern Ireland Scotland Wales
Legal Entity Type:
Corporation Sole Proprietorship Limited Partnership Partnership Other
DUNS Number:
Federal Tax ID:
* Please email a copy of your W-9 to: 1LineNewBAID@williams.com
Physical Address:
City
State:
Zip:
Country
USA Canada UK
Mailing Address:
City:
Telephone Number:
Fax Number:
Company Web Site:
Gulfstream Affiliate?
Yes No
(Optional) What is the nature/geographical region of your business with the pipeline?:
SSA
The 1Line System Security Administrator (SSA) must be the first 1Line system user entered for your company. The SSA has the authority to setup, maintain, and manage security information for other users at your company.
SSA Name:
Title:
Street Address:
Country: USA Canada UK
Mobile Number:
Pager Number:
SSA Work E-Mail:
Secondary E-mail:
Text Messaging E-mail:
Would the SSA like to receive critical notices via email? Yes No
Would the SSA like to receive non-critical notices via email? Yes No
BILLABLE/REFUNDS/PAYMENTS/PARTY CONTACT
The Billable Party Contact information will be used when mailing invoices, and other billing related correspondence, and/or refunds/payments
Contact Name:
Billable Party Address County:
Work E-Mail :
Invoicing/Billing correspondence should be delivered via: ONLINE U.S. Mail Priority-FedEx Priority-UPS
Priority Acct No (if FedEx or UPS selected):
Would the Billable Party Contact like to receive critical notices via email? Yes No
Would the Billable Party Contact like to receive non-critical notices via email? Yes No
Does your company prefer check or wire for payments? Check Wire ACH If wire or ACH is preferred, please provide the following information, where applicable:
Bank Name:
Bank ID Transit or ABA# :
Bank Account No. :
Bank City :
Bank State :
Swift/BIC Code:
Intermediary/Correspondent (Bank Name, Address, ABA Routing Number):
Beneficiary:
CONTRACT NOTICE PARTY CONTACT
The Contract Notice Party Contact information will be used for all Contract Notices.
Work E-Mail:
Would the Contract Notice Party Contact like to receive critical notices via email? Yes No
Would the Contract Notice Party Contact like to receive non-critical notices via email? Yes No
CAPACITY RELEASE CONTACT
The Capacity Release Contact is the primary contact for capacity release.
Will your company be doing Capacity Release? Yes No If No, skip this section.
Would this contact like to receive critical notices via email? Yes No
Would this contact like to receive non-critical notices via email? Yes No
BALANCE TRADE CONTACT
The Balance Trade Contact is the primary contact for the trading of imbalances.
Does this entity have any Parent or Affiliates currently doing business with Gulfstream? Yes No
This entity will be:
An operator of a Location on Gulfstream?
A Producer on a location on Gulfstream?
Will transport on Gulfstream?
Will be an agent for "others" on Gulfstream?
Will have an agent helping it conduct business with Gulfstream?
Are you currently working with anyone at Gulfstream to get this entity set up?
Yes No If Yes, who?
PERSON SUBMITTING THIS FORM
I am the:
Refund/Billable Party Contact System Security Administrator Contract Notice Party Contact Other Contact (Entered Below) Capacity Release Contact Balance Trade Contact Agent Select One
Would you be a 1Line System user?
Would you like to receive critical notices via email?
Would you like to receive non-critical notices via email?
You may submit this form online or by mail. To submit by mail, send to Transportation Services at the following
address:
Gulfstream Natural Gas System, L.L.C. Transportation Services Attn: New BA Group P.O. Box 1396 Houston, Texas 77251-1396
Revised 2-18-2010