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Third-Party Attachment Agreement Request

UGI requires all third-party attachers to submit a signed contract prior to submission of any applications for attachment on UGI Utilities, Inc. owned facilities. Third-party attachers who do not already have a signed contract can fill out the form below.

All forms in this field are required to be completed to process a new third-party attachment contract agreement.

Company Information

Legal Company Name

Street Address

City, State, Zip

Phone Number

Fax Number

Email Addresss

*Competitive Licensed Exchange Carriers (CLECs) must provide copies of their Tariff Filing and Certificate of Public Convenience issued by the Pennsylvania Public Utility Commission (PUC).

Agreement (Contracts) Contact

Full Name

Street Address

City, State, Zip

Primary Phone

FAX Number

Email Address

TITLE

Billing Contact

Full Name

Street Address

City, State, Zip

Primary Phone

FAX Number

Email Address

TITLE