MANDATORY ANNUAL ASSESSMENT SURVEY of Competitive Natural Gas Suppliers
Exact Legal Name of the Company PHMSA ID

(Include any name used in providing service)

 
1. Please provide the following contact information:
Person completing this form
Telephone eg: 2021016010
E-mail
 
Regulatory Contact Consumer Service Contact
Name
Title
Street Address
City, State, Zip
Telephone No. eg: 2021016010 eg: 2021016010
E-mail
Web Address
 
2. Anytime during the calendar year January 2015 through December 2015:
    A. Were you supplying natural gas to end users in the District of Columbia?
         Yes No
    B. What was your gross jurisdictional revenue from providing natural gas to end users in the District of Columbia? (Please indicate dollars and cents below)
     $ 
 
3. Are you currently providing service in the District of Columbia as a(n):
Aggregator?
Broker?
Marketer?
Retail Natural Gas Provider?
A Combination of the above or other? (please explain)
 
4. Please provide the following information for natural gas supplied to end users in the District of Columbia:

    Anytime during the calendar year January 2015 through December 2015:
 
Residential
Non Residential
Grand Total
  Single Family Master-Metered Apartments Subtotal - Residential   (Residential + Non-Residential)
Number of Customers
Number of Therms Sold
 
5. Please list all of your Tariffs that provide revenues for this Assessment Survey: