Date of Submission: ___________________
Nomination for Billing Month Number: ___________________
Calendar Day | Nominated Daily Quantity (NDQ) (m3) |
1 |
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2 |
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3 |
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4 |
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5 |
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6 |
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7 |
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8 |
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9 |
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10 |
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11 |
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12 |
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13 |
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14 |
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15 |
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xxx |
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Submitted by AGENCY: | Accepted by COMPANY: |
|
|
Name | Name |
Date | Date |
Signature | Signature |