New Shipper Form

Section 1 (Information)

Please complete the form, print and fax to Centennial Marketing, attn: Andy Riley, at 419-421-4043 :

First Name:
Last Name:
Company Name:  
Street Address:
City:
  State:
    Zip Code:
Phone Number:  
  Fax Number:
E-Mail Address:

Have you been a shipper on the TEPPCO Systems in the past? Yes No

If yes, move to section 5. If no, continue with section 2.

Section 2 (Needs)

Please provide a brief explanation of your company's shipping needs on the Centennial Pipeline System.

Section 3 (Financial)

Please provide the following information:

DUNS number:
FEIN number:
Bank Reference:
Name – (Bank Representative):  
Bank Name:
Street Address:
City: State:   Zip Code:
Phone Number: Fax Number:  
Please enter the web address where we can find your annual report:

or send us a printed copy to:

Manager, Product Movements
Room 761M
539 South Main Street
Findlay, OH 45840

Section 4 (Trade References)

Reference 1:

Name – (Trade Reference):
Company Name:
Street Address:
City:  State:   Zip Code:
Phone Number:

Reference 2:

Name – (Trade Reference):
Company Name:
Street Address:
City:  State:   Zip Code:
Phone Number:

Section 5 (Forecast):

Please provide a forecast of anticipated product movements in BPD over the next 12 months:

Destination

Gasoline (230-450)

Jet Fuel (510-590)

Low Sulfur Diesel (740)

High Sulfur Diesel (760-770)

Princeton, IN:

Norris City, IL:

Seymour, IN

Indianapolis, IN:

Griffith, IN:

Chicago, IL:

Lebanon, OH:

Lima, OH:

Martinsville, IL:

 
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Centennial Pipeline
419-421-4087
centennial@marathonpetroleum.com

Last updated 3/23/07
©2004-2007 Centennial Pipeline LLC