Download Declaration on the selected option for the annual fee for the

To the Management Board
of the Polish Power Exchange
APPLICATION
for admission to operation on the Commodity Market
of the Polish Power Exchange
...............................................................................................................................................................
/Applicant's name/
hereby applies to the Management Board of the Polish Power Exchange (hereinafter also referred to
as “POLPX”), pursuant to the Trading Rules for the Commodity Market of the Polish Power Exchange
(hereinafter also referred to as “the Rules”) for admission to operation on the following markets within
the Commodity Market:
Day-Ahead Market and Intraday Market (DAM&IDM)
 Proposed date of the first session: ....................................................................,
Gas Day-Ahead Market and Intraday Market (DAM&IDMg)
 Proposed date of the first session: ....................................................................,
Commodity Forward Instruments Market with Physical Delivery (CFIM)
 for electricity-based forward contracts with physical delivery
Proposed date of the first session: ....................................................................,
 for gas-based forward contracts with physical delivery
Proposed date of the first session: ....................................................................,
Property Rights Market (PRM)
 Proposed date of the first session: .....................................................................,
Emission Allowance Market (CO2Spot)
 Proposed date of the first session: ......................................................................,
The Applicant undertakes to advise the Polish Power Exchange of any changes to the details provided
in this Application, and to submit, on demand from the Polish Power Exchange, up-to-date versions of
the documents submitted as attachments to this Application.
….............................
/place and date/
........................................................................................
/signatures of authorised representatives of the Applicant/
Page 1
The list of Attachments required in accordance with the Trading Rules for the Commodity Market of
the Polish Power Exchange for the consideration of the Application:
The documents required for all the markets the Applicant intends to operate on:
1. The list of commodity brokers employed by the Applicant (in case of brokerage houses and
commodity brokerage houses please include also stock brokers when the Applicant intends to
operate on the CFIM), authorised to represent the Applicant in market transactions together with
the copies of their licences, signature specimens, telephone numbers and email addresses and
the undertaking to observe the regulations of the Polish Power Exchange. (based on Forms No 1
and 2).
2. A document evidencing the capability of correct settlement of the market transactions formed, as
referred to in § 22 a) of the Rules.
3. A permission from the Polish Financial Supervision Authority to maintain accounts or commodity
registers certified as a true copy of the original, or a document evidencing the execution of a
transaction settlement agreement with a commodity brokerage house being a member of the
Clearing House – applies to the entities mentioned in § 12 sub-paragraph 1 point c) of the Rules.
4. A permission from the Polish Financial Supervision Authority to carry out brokerage activities –
applies to the entities mentioned in § 12 sub-paragraph 1 points a) and b) of the Rules.
The additional documents required for specific markets the Applicant intends to operate on:
5. For Applicants submitting an application concerning the DAM&IDM or CFIM with respect to
electricity-based derivative instruments:
 The list of contact persons for electricity scheduling authorised by the Applicant (based on
Form No 3);

A copy of the relevant electricity licence granted by the President of the Energy Regulatory
Office, if required under the Energy Law Act, certified as true copy of the original;

A declaration of the Management Board of the Applicant confirming the execution of a
transmission contract (based on Form No 4) or an Application for the consent to use Shared
Scheduling Units, as referred to in § 11 sub-paragraph 4 of the Rules together with a
Declaration of the Sharing Party (based on Forms No 5 and 5a);

A declaration on the selected option for the annual fee for the participation in the DAM&IDM
(based on Form No 6).
6. For Applicants submitting an application concerning the DAM&IDMg or CFIM with respect to gasbased derivative instruments:
 The list of contact persons for reconciliation of nominations, authorised by the Applicant
(based on Form No 7);

A copy of the relevant gas licence granted by the President of the Energy Regulatory Office, if
required under the Energy Law Act, certified as true copy of the original;

A declaration of the Management Board of the Applicant confirming the execution of a
transmission contract (based on Form No 8) or an Application for the consent to use a Shared
Shipper Code, as referred to in § 111 sub-paragraph 4 of the Rules together with a Declaration
of the Sharing Party (based on Forms No 9 and 9a);

A declaration on the selected option for the annual fee for the participation in the DAM&IDMg
(based on Form No 10).
7. For Applicants submitting an application concerning the PRM:

An Application for the Membership in the Certificate of Origin Register in the form consistent
with the Rules for the Certificate of Origin Register maintained by the Polish Power Exchange
when the Applicant is not a Member of the Register.
Page 2
Form No 1: The list of brokers employed in the Applicant's company.
The list of brokers authorised
to represent the Applicant on the Polish Power Exchange
........................................................................................................................................
/full Company name/
No
Name and Surname
Position
Landline
phone:
Mobile
phone:
Address
e-mail:
Licence
No
Specimen signature
1
2
3
4
5
6
7
………………………............................................................
/date and signatures of persons authorised to represent the Applicant/
Attached are the copies of licences of the authorised brokers.
Page 3
Form No 2: Undertaking of the broker to observe the POLPX regulations.
Undertaking
……....................................................................................................................................................
/Applicant's name/
..........................................................................................................................................................
/name and surname of the broker authorised by the Applicant/
I undertake to observe the Trading Rules for the Commodity Market of the Polish Power Exchange
and other regulations being in force on the exchange market operated by the Polish Power Exchange.
...................................................
/broker's signature/
Page 4
Form No 3: The list of contact persons for electricity scheduling authorised by the Applicant
The list of authorised contact persons for electricity scheduling
....................................................................................................................................................
/full Company name/
No
Name and Surname
Position
Landline
phone:
Mobile phone:
Address
e-mail:
1
2
3
4
5
6
7
………………………............................................................
/date and signatures of persons authorised to represent the Applicant/
Page 5
Form No 4: Declaration of the Applicant confirming the execution of a transmission contract with PSE
Operator S.A.
/Place, date dd-mm-yyyy/
The Management Board of the Polish
Power Exchange
ul. Poleczki 23
02-822 Warsaw
Declaration
The Management Board of /Applicant's name and place of business/ declares that:
-
/Applicant's name/ is a participant of the Balancing Market operated by PSE Operator S.A.;
-
/Applicant's name/ is a party to a transmission contract with PSE Operator S.A. and such contract
covers transactions entered into on the exchange market operated by the Polish Power Exchange;
-
/Applicant's name/ was assigned the identification and configuration data for the participation in
the Balancing Market in accordance with the attached authenticated copy of the attachment to the
transmission contract with PSE Operator S.A.
/Applicant's name/ undertakes to promptly advise the Polish Power Exchange of any changes to the
identification and configuration data contained in the attachment to the above-mentioned contract, as
well as of the expiry of the contract or the suspension of its performance by PSE Operator S.A.
On behalf of /Applicant's name/
..........................................................................................................
/signatures of persons authorised to represent the Applicant/
Page 6
Form No 5: Application for consent to use shared scheduling units
/Place, date dd-mm-yyyy/
The Management Board of the Polish
Power Exchange
ul. Poleczki 23
02-822 Warsaw
Application for consent to use Shared Scheduling Units
On behalf of /Applicant's name and place of business/ (“the Applicant”), acting pursuant to § 11 subparagraph 3 of the Trading Rules for the Commodity Market of the Polish Power Exchange we hereby
request your consent for the use of the Shared Scheduling Units /code of scheduling units/ shared by
/name of the Sharing Party/, as of /dd-mm-yyyy/ deemed to be the first day of trading.
Attached to this Application is a declaration of the Sharing Party and the current excerpt from the
Register of Entrepreneurs for the Sharing Party.
.........................................................................................
/signatures of persons authorised to represent the Applicant/
Page 7
Form No 5a: Declaration of the party sharing the scheduling units.
/Place, date dd-mm-yyyy/
The Management Board of the Polish
Power Exchange
ul. Poleczki 23
02-822 Warsaw
Declaration of the Sharing Party confirming the sharing of the Scheduling Units
We the undersigned, acting on behalf of /Applicant's name and place of business/, entered into the
register of entrepreneurs maintained by the District Court in /place, department number/ Commercial
Department of the National Court Register under the number KRS /KRS number/ (“the Sharing Party”)
declare that:
1. The Sharing Party has a valid transmission contract in place.
2. The Sharing Party entered into an agreement with /name and place of business of the entity using
the shared scheduling units/ (“the Operating Party”) and thereunder has shared its scheduling
units (“the Shared Scheduling Units”) with the Operating Party.
3. The Shared Scheduling Units have the following designations:
OR Code; Full OR name;
JG Code; Full JG name;
URB Code; Full URB name;
4. The Operating Party may use the Shared Scheduling Units for the purposes of technical
notification of electricity buy or sell transactions entered into by the Operating Party on the
exchange market for physical execution on the Balancing Market.
5. The use of the Shared Scheduling Units by the Operating Party must not infringe upon the
principles applicable to the operation of the Operating Party on the exchange market.
6. The Sharing Party is responsible for the correct notification of the Shared Scheduling Units to the
transmission system operator and the notification of the transactions entered into by the Operating
Party on the exchange market, which are to be notified through the Shared Scheduling Units.
7. The Sharing Party declares that it will notify the Polish Power Exchange in writing of its intention to
amend or terminate the agreement pursuant to which it has shared the Scheduling Units with the
Operating Party.
8. The Sharing Party will promptly notify the Polish Power Exchange of any events that could affect
the proper operation of the Operating Party on the electricity exchange operated by the Polish
Power Exchange.
9. In case of providing untrue information or a failure to notify the Polish Power Exchange of the
events described in sections 7 and 8 above, the Sharing Party undertakes to cover any losses
incurred by the Polish Power Exchange as a result of its failure to respect this undertaking.
On behalf of the Sharing Party
/signatures of authorised representatives of the Sharing Party/
Page 8
Form No 6: Declaration on selection of the annual fee option
Declaration on the selected option for the annual fee
for the participation in the DAM&IDM in year ..................
Pursuant to the attachment to the Trading Rules for the Commodities Market of the Polish Power
Exchange titled “Exchange fees”
The Exchange Member
....................................................................................
/Applicant's name/
hereby selects the following option for the annual fee for the participation in the DAM&IDM in year:
..................................................
/please indicate the year/
(Please indicate the selected option with “X”)
Option I
annual fee: PLN 100,000 *)
Option II
annual fee: PLN 1.000 *)
The selection of Option I for the annual fee for the participation in the DAM&IDM entails the selection
of Option I for the session transaction fee at the DAM&IDM. The selection of Option II entails the
selection of Option II for the session transaction fee at the DAM&IDM. The transaction fee for OTC
Deals on the DAM&IDM is identical under either Option.
………………………............................................................
/date and signatures of persons authorised to represent the Applicant/
NOTE:
The above information is necessary for the Polish Power Exchange in order to assign the appropriate
amount of the transaction fee in the IT system to each Member of the Polish Power Exchange,
depending of the selected option.
*) The fees are exclusive of VAT tax at 23%
Page 9
Form No 7: The list of contact persons for reconciliation of nominations, authorised by the Applicant
The list of authorised contact persons for reconciliation of nominations
...................................................................................................................................................
/full Company name/
No
Name and Surname
Position
Landline
phone:
Mobile phone:
Address
e-mail:
1
2
3
4
5
6
7
………………………..............................................................
/date and signatures of persons authorised to represent the Applicant/
Page 10
Form No 8: Declaration of the Applicant confirming the execution of a transmission contract with GTO
GAZ-SYSTEM S.A.
/Place, date dd-mm-yyyy/
The Management Board of the Polish
Power Exchange
ul. Poleczki 23
02-822 Warsaw
Declaration
The Management Board of /Applicant's name and place of business/ declares that:
-
/Applicant's name/ is a party to transmission contract with GTO OGP GAZ-SYSTEM S.A., contract
number: /contract number/ and thereunder it is entitled to transmission ability allocation (PZ)
covering the entry point and the exit point for the transactions entered into on the exchange
market operated on the Polish Power Exchange, i.e. WPWEGG (170001) and WPWYGG (100001);
-
/Applicant's name/ was assigned the identification and configuration data, including the Shipper
Code /designation of the Shipper Code/, in accordance with the requirements of GTO GAZSYSTEM S.A. enabling the submission by the Polish Power Exchange of a nomination
corresponding to the balance of gas buy or sell transactions entered into by the Applicant on the
exchange market operated by the Polish Power Exchange.
/Applicant's name/ undertakes to promptly advise the Polish Power Exchange of any changes to the
capacity allocation for points WPWEGG (170001) and WPWYGG (100001), as well as of any changes
to the identification and configuration data contained in the transmission contract, the expiry of the
contract or the suspension of its performance by GTO GAZ-SYSTEM S.A.
On behalf of /Applicant's name/
..........................................................................................
/signatures of persons authorised to represent the Applicant/
Page 11
Form No 9: Application for consent to use a Shared Shipper Code
/Place, date dd-mm-yyyy/
The Management Board of the Polish
Power Exchange
ul. Poleczki 23
02-822 Warsaw
Application for consent to use a Shared Shipper Code
On behalf of /Applicant's name and place of business/ (“the Applicant”), acting pursuant to § 111 subparagraph 3 of the Trading Rules for the Commodity Market of the Polish Power Exchange we hereby
request your consent for the use of the Shared Shipper Code /designation of the Shipper Code/
shared by /name of the Sharing Party/, as of /dd-mm-yyyy/ deemed to be the first day of trading.
Attached to this Application is a declaration of the Sharing Party and the current excerpt from the
Register of Entrepreneurs for the Sharing Party.
.........................................................................................
/signatures of persons authorised to represent the Applicant/
Page 12
Form No 9a: Declaration of the Sharing Party confirming the sharing of the Shipper Code.
/Place, date dd-mm-yyyy/
The Management Board of the Polish
Power Exchange
ul. Poleczki 23
02-822 Warsaw
Declaration of the Sharing Party confirming the sharing of the Shipper Code
We the undersigned, acting on behalf of /Applicant's name and place of business/, entered into the
register of entrepreneurs maintained by the District Court in /place, department number/ Commercial
Department of the National Court Register under the number KRS /KRS number/ (“the Sharing Party”)
declare that:
1. The Sharing Party has a valid transmission contract with GTO GAZ-SYSTEM S.A. having its
registered office in Warsaw /contract number/ and thereunder it is entitled to transmission ability
allocation (PZ) covering the entry point and the exit point for the transactions entered into on the
exchange market operated on the Polish Power Exchange, i.e. WPWEGG (170001) and WPWYGG
(100001)
2. The Sharing Party was assigned the relevant identification and configuration data, including the
Shipper Code /designation of the Shipper Code/.
3. The Sharing Party entered into an agreement with /name and place of business of the entity using
the shared Shipper Code/ (“the Operating Party”) and thereunder has shared its Shipper Code
(“the Shared Shipper Code”) with the Operating Party.
4.
The Operating Party may use the Shared Shipper Code for the purpose of the submission by the
Polish Power Exchange (“POLPX”) of a nomination corresponding to the balance of the gas buy
or sell transactions entered into by the Operating Party on the commodity exchange market
operated by POLPX (“the exchange market”).
5. The use of the Shared Shipper Code by the Operating Party must not infringe upon the principles
applicable to the operation of the Operating Party on the exchange market.
6. The Sharing Party declares that it will notify POLPX in writing of its intention to amend or terminate
the agreement pursuant to which it has shared the Shipper Code with the Operating Party.
7. The Sharing Party shall promptly notify POLPX of any events that could affect the proper
operation of the Operating Party on the exchange market.
8. In case of providing untrue information or a failure to notify POLPX of the events described in
sections 6 and 7 above, the Sharing Party undertakes to cover any damage resulting from its
failure to respect this undertaking.
On behalf of the Sharing Party
/signatures of authorised representatives of the Sharing Party/
Page 13
Form No 10: Declaration on selection of the annual fee option
Declaration on the selected option for the annual fee
for the participation in the DAM&IDMg in year ..................
Pursuant to the attachment to the Trading Rules for the Commodities Market of the Polish Power
Exchange titled “Exchange fees”
The Exchange Member
....................................................................................
/Applicant's name/
hereby selects the following option for the annual fee for the participation in the DAM&IDMg in year:
..................................................
/please indicate the year/
(Please indicate the selected option with “X”)
Option I
annual fee: PLN 100,000 *)
Option II
annual fee: PLN 1.000 *)
The selection of Option I for the annual fee for the participation in the DAM&IDMg entails the selection
of Option I for the session transaction fee at the DAM&IDMg. The selection of Option II entails the
selection of Option II for the session transaction fee at the DAM&IDMg. The transaction fee for OTC
Deals on the DAM&IDMg is identical under either Option.
………………………...........................................................
/date and signatures of persons authorised to represent the Applicant/
NOTE:
The above information is necessary for the Polish Power Exchange in order to assign the appropriate
amount of the transaction fee in the IT system to each Member of the Polish Power Exchange,
depending of the selected option.
*) The fees are exclusive of VAT tax at 23%
Page 14