LIMITED BASIS MEMBER APPLICATION
The applicant does hereby apply to become a limited basis member of the Oil and Gas Producers Underground Protection Service, a non-profit corporation organized under the laws of the State of Ohio.

All Limited Basis Members hereby agree to support the purposes for which the Oil and Gas Underground Protection Service was formed which are:

To undertake all functions and provide all services of an underground protection service pursuant to Sections 153.64, 3781.25 to 3781.32, and other applicable sections of the Ohio Revised Code, as may be amended, including but limited to the operation statewide system to receive notification prior to excavation or prior to any activity that may damage underground facilities and to provide such notification to members of this corporation or others required by statute in order to reduce dig-in damages, disruption of service, and the risk of injury to persons and property.

All Limited Basis Members agree to abide by and follow the Code of Regulations and Code of Operating Procedures. All Limited Basis Members agree to pay the registration fees and dues as established and set by the Board of Trustees and set forth in the Code of Regulations and/or Code of Operating Procedures.

All Limited Basis Members have the responsibility to provide Oil and Gas Producers Underground Protection Service with registration information by county/place, for existing facilities and to update this registration information for new facilities. Limited Basis Members are not entitled to receive notification from the protection service. Rather, the protection service will provide the developer or excavator with the names of Limited Basis Members within a requested location.

Contemporaneous with the execution of this Application Form, all Limited Basis Members shall complete exhibit A hereto, providing the location of their underground facilities by county, township or municipal corporation, and section/lot numbers.

This application can be mailed or faxed to:

Oil and Gas Producers Underground Protection Service (OGPUPS)

1718 Columbus Rd. SW, PO Box 206, Granville, OH 43023-0206
(740) 587-0486
(800) 925-0988
Fax: (740) 587-0446