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WORK ASSIGNMENT SUPPLEMENT
<br />FORM OF EASEMENT
<br />THE STA'T'E OF TEXAS
<br />KNOW ALL MEN BY THESE PRESENTS:
<br />COUNTY OF
<br />That for good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the undersigned
<br />GRAN'T'OR does hereby GRANT, SELL, and CONVEY unto Atmos Energy Corporation ("GRANTEE"), its successors and assigns, a
<br />free and unobstructed right-of-way and casement to lay, construct, inspect, maintain, repair, alter, operate, replace, relocate, change the
<br />size of, all within the easement herein described, abandon in place, and remove at will, in whole or in part, all material, appurtenances,
<br />and facilities used in the transportation and processing of oil, gas, petroleum products, or any other liquids, gases, or substances that can
<br />be transported through a pipeline, including, but not limited to, valves, regulators, meters, metering stations, separators, purification
<br />equipment, pumps, tanks, compressors, pressure relief stations, cathodic protection equipment, aerial markers, communication towers,
<br />pipelines, and all related equipment and facilities, both above and below ground, on the following described land situated in the County
<br />of , State of Texas:
<br />[Description of Easement] Please see attached Exhibit "A"
<br />Grantee will have all rights and benefits necessary or convenient for the full enjoyment or use of the rights herein granted,
<br />including, but without limiting the same to, the free right of ingress to and egress over and across said property to and from said right-of-
<br />way and easement, and the right from time to time to cut all trees, undergrowth, and other obstructions that may injure, endanger, or
<br />interfere with the use of said site.
<br />TO HAVE AND TO HOLD unto said GRANTEE, its successors and assigns, so Iong as the rights and easements herein
<br />granted, or any one of them, are used by, or useful to, GRANTEE for the purposes herein granted, %with ingress to, and egress from, the
<br />premises for the purposes of operating and maintaining pipeline facilities, including, but not limited to, constructing, inspecting,
<br />repairing, maintaining, replacing, and removing the property of GRANTEE herein described. GRANTOR will not interfere with the
<br />exercise of GRANTEF.'s rights by constructing or permitting to be constructed any pennanent structure upon the easement herein
<br />conveyed and GRANTOR further agrees not to change the grade, remove dirt from the surface of the easement, or impound water over
<br />the easement without the prior approval of GRANTEE.
<br />All covenants and agreements herein contained will extend to and be binding upon the respective heirs, legal representatives,
<br />successors, and assigns of the parties hereto and are further assignable in whole or in part, The undersigned GRANTOR binds itself, its
<br />heirs, executors, administrators, successors, and assigns to warrant and forever defend all and singular said premises unto GRANTEE,
<br />its successors and assigns, against every person whomsoever lawfully claiming or to claim the same or any part thereof.
<br />It is hereby understood that the party securing this grant on behalf of GRANTEE is without authority to make any covenant or
<br />agreement not herein expressed.
<br />WITNESS THE EXECUTION HEREOF, on this day of 20,
<br />By: ._.... ...... ..
<br />Signature
<br />Title:
<br />STATE OF
<br />COUNTY OF
<br />GRAN'T'OR
<br />BEFORE ME, the undersigned authority, on this day personally appeared _ , of
<br />a .. ITITmmmmm , known to me to be the person whose name is subscribed to the
<br />foregoing instrument, and acknowledged to me that he/she executed the same for the purposes and consideration therein expressed, in
<br />the capacity therein stated, and as tic act and deed of said company.
<br />GIVEN UNDER MY HAND AND SEAL OF OFFICE, on this them„ _ _ day of _._. ............... ._r,.,_,,, 20—.
<br />Notary Public, State of
<br />Commission expires:
<br />Gas Contract Work Assignment Stipp lement_021522_'1'exas Easement Fonn.doc
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