New Business Associate Form

including access to 1Line

COMPANY
Reason for Request
Party Type:
   
Company Legal Name:
State of Incorporation:
   
Legal Entity Type:
DUNS Number:
   
Federal Tax ID:
* Please email a copy of your W-9 to:  wgp-transco@williams.com        
Physical Address:
City
   
State:
Zip:
Country
Mailing Address:
City:
   
State:
Zip:
Country
Telephone Number:
Fax Number:
   
Company Web Site:
Transco, Pine Needle, Cardinal or 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:
City:
   
State:
Zip:
Country:    
Telephone Number:
Fax Number:
   
Mobile Number:
Pager Number:
   
SSA Work E-Mail:
Secondary E-mail:
   
Text Messaging E-mail:
       
Does this contact have the authority to execute contract requested via the 1Line system? Yes No
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 PARTY CONTACT
The Billable Party Contact information will be used when mailing invoices and other billing related correspondence.
Contact Name:
Title:
   
Street Address:
City:
   
Billable Party Address County:
     
State:
Zip:
Country:    
Telephone Number:
Fax Number:
   
Mobile Number:
Pager Number:
   
Work E-Mail :
Secondary E-mail:
   
Text Messaging E-mail:
       
Invoicing/Billing correspondence should be delivered via:
Priority Acct No (if FedEx or UPS selected):  
Contact has authority to execute contracts requested via the 1Line system? Yes No  
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
REFUNDS \ PAYMENTS
The Refund\Payments contact information will be used when sending payments to your company
Contact Name:
Title:
   
Street Address:
City:
   
State:
Zip:
Country:    
Telephone Number:
Fax Number:
   
Mobile Number:
Pager Number:
   
Work E-Mail:
Secondary E-mail:
   
Text Messaging E-mail:
       
Contact has authority to execute contracts requested via the 1Line system?  Yes No
Would the Refund\Payment contact like to receive Critical Notices via Email?  Yes No
Would the Refund\Payment 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):
For Further Credit (Account Owner Name and Account Number):
   
Beneficiary:
   
CONTRACT NOTICE PARTY CONTACT
The Contract Notice Party Contact information will be used for all Contract Notices.
Contact Name:
Title:
   
Street Address:
City:
   
State:
Zip:
Country:    
Telephone Number:
Fax Number:
   
Mobile Number:
Pager Number:
   
Work E-Mail:
Secondary E-mail:
   
Text Messaging E-mail:
       
Contact has authority to execute contracts requested via the 1Line system? Yes No
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.
Contact Name:
Title:
   
Street Address:
City:
   
State:
Zip:
Country:    
Telephone Number:
Fax Number:
   
Mobile Number:
Pager Number:
   
Work E-Mail:
Secondary E-mail:
   
Text Messaging E-mail:
       
Contact has authority to execute contracts requested via the 1Line system?   Yes No
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.
Contact Name:
Title:
   
Street Address:
City:
   
State:
Zip:
Country:    
Telephone Number:
Fax Number:
   
Mobile Number:
Pager Number:
   
Work E-Mail:
Secondary E-mail:
   
Text Messaging E-mail:
       
Contact has authority to execute contracts requested via the 1Line system?   Yes No
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

Business Unit(s)  for which this entity is requesting 1Line access:
Pine Needle
Yes No
Cardinal
Yes No
Transco
Yes No
Does this entity have any Parent or Affiliates currently doing business with BU(s) selected above? Yes No
This entity will be:
 An operator of a Location on the BU?
Yes No
A Producer on a location on the BU?
Yes No
 Will transport on BU specified?
Yes No
Will be an agent for "others" on BU?
Yes No
  Will have an agent helping it conduct business with BU?
Yes No
Are you currently working with anyone at BU specified to get this entity set up?
Yes No    If Yes, who?
PERSON SUBMITTING THIS FORM
I am the:
       
Contact Name:
Title:
   
Street Address:
City:
   
State:
Zip:
Country:    
Telephone Number:
Fax Number:
   
Mobile Number:
Pager Number:
   
Work E-Mail:
Secondary E-mail:
   
Text Messaging E-mail:
       
Would you be a 1Line System user? Yes No
Contact has authority to execute contracts requested via the 1Line system?
Yes No
Would you like to receive critical notices via email?
Yes No
Would you like to receive non-critical notices via email? 
Yes No



You may submit this form online or by mail. To submit by mail, send to Commercial Services at the following address:
Williams Gas Pipe Line
Transportation Services-Transco
Attn: New BA Group
P.O. Box 1396
Houston, Texas 77251-1396
Revised 5-27-2009