Application form

Basic information

The Company*

Description of the company's main activity*

Stage of the company’s development*

Competitors*

Goals*

Rationale of success*

Time frame*

Demand for capital*

Can the product be implemented in the PGE Capital Group?*

Team

Contact details

Name and surname of the contact person*

E-mail*

Phone*

City*

Additional informations

Comments

Additional information

Attach files

Fields marked with (*) are mandatory

I authorize the PGE Ventures Sp z o. o., Mysia 2 street, 00-496 Warsaw, to send me information with the use of means of distance communication in order to establish cooperation as part of start-up support projects as well as entities from the PGE Polska Grupa Energetyczna SA with headquarters in Warsaw (00-496) at Mysia 2 street and entities acting for the benefit of PGE Ventures sp. o.o., to the phone number provided. (*)

I accept the terms and conditions set out in the investment policy to establish on the their basis cooperation with PGE Ventures Sp. z o.o. with headquarters in Warsaw at Mysia 2 street. (*)

I authorize the PGE Ventures Sp z o. o., Mysia 2 street, 00-496 Warsaw, to share my personal data indicated in the above application form with PGE Polska Grupa Energetyczna SA with headquarters in Warsaw (00-496) at Mysia 2 street, in order to establish cooperation within the project of supporting start-ups in accordance with the conditions included in the investment policy. (*)

I declare that I am familiar with the rules regarding the Management of Conflicts of Interest in PGE Ventures and I undertake to strictly comply with them. At the same time, I declare that at the moment, as part of my all activities related in an indirect and/or direct way with the activities of PGE Ventures, I have not identified situations which, in accordance with the Management of Conflict of Interest of PGE Ventures’ Policy may be a Conflict of Interest. In addition, pursuant to the provisions of the above mentioned Policy principles, I am aware of the need to promptly report an identified potential or existing Conflict of Interest to adequate PGE Ventures bodies. (*)

I declare that I have read the following information: (*)

Information clause for the Offerer:

According to art. 13 para. 1-2 of the Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of individuals with regard to the processing of personal data and on the free movement of such data and repealing Directive 95/46 / EC (general regulation on data protection) (hereinafter "GDPR") we would like to inform you that:

A. The data cotroller of the Offerer's personal data is PGE Ventures Sp. z o.o. with headquarters at Mysia 2 street, 00-496 Warsaw.

B. On the protection of personal data, the Offerer may contact the Data Protection Officer via the contact form on the website: www.pgeventures.pl, at the following e-mail address: iod.pgeventures@gkpge.pl, or in writing to the address of our registered office indicated in item a) above.

C. PGE Ventures sp. o.o. will process the Offerer's data:

1) for the purpose of marketing products and services of entities conducting jointly with PGE Ventures sp. z o.o. projects in the field of support for start-ups, if the Offerer gives his consent (the basis of Article 6 paragraph 1 point a) of the GDPR);

2) in order to conclude an Investment Agreement (the basis of Article 6 paragraph 1 letter b of the GDPR);

3) for execution and under the Investment Agreement, after the conclusion of the Investment Agreement (the basis of Article 6 paragraph 1 letter b of the GDPR);

4) for archival purposes (evidence) being the implementation of PGE Ventures sp. z o.o. the legitimate interest of safeguarding information in the event of a legal need to prove facts (the basis of Article 6 (1) (f) of the GDPR);

5) in order to possibly establish, investigate or defend against claims being the realization of PGE Ventures sp. z o.o. legitimate interest (the basis of Article 6 (1) (f) of the RODO);

D. The Offerer is entitled to object to the processing of the Offerer's data processed for the purposes and on the grounds indicated above at any time. PGE Ventures sp. z o.o. will stop processing the Offerer's data for these purposes, unless it can prove that there are valid, legally justified grounds that are overridden by the Offerer’s the interests, rights and freedoms or the Offerer's data will be necessary for the possible determination, investigation or defense of claims by PGE Ventures sp. z o.o.. At any time, the Offerer has the right to object to the processing of the Offerer's data for marketing purposes. If the Offerer makes use of this right - PGE Ventures sp. z o.o. will cease data processing for this purpose.

E. According to the GDPR, the Offerer has the right to access his data and receive a copy thereof, to rectify (correct) his data, erasure, restrict or object to processing, right to data portability, to lodge a complaint with a supervisory authority.

F. The Offerer has the right to withdraw consent to the processing of personal data, but the withdrawal of consent does not affect the legality of the processing, which was carried out on the basis of the Offerer's consent prior to its withdrawal.

G. PGE Ventures sp. z o.o. will store the Offerer's data:

1) the Offerer's personal data resulting from the application form available on the website www.pgeventures.pl will be processed for the period for which the Investment Agreement was concluded and for the period in which claims from the Investment Agreement may be disclosed;

2) data processed on the basis of the consent of the Offerer, PGE Ventures sp. z o.o. may process until the Offerer withdraws its consent or is determined that data is outdated;

3) if there is no conclusion of the Investment Agreement, the Offerer's personal data shall be immediately removed, except for the data needed to propose other cooperation possibilities;

4) data processed for marketing purposes, PGE Ventures sp. z o.o. may process until the Offerer objects to their processing for this purpose or it is determined that they have become obsolete.

H. The Offerer's personal data may be transferred to the following recipients, i.e. (i) Grupa Kapitałowa PGE, PGE Ventures sp. o.o. partners, ie companies with which PGE Ventures sp. z o.o. cooperates, among others as part of the scouting program, institutions defined by law, eg the Tax Office or others, URE, UOKIK, UKE and (ii) subcontractors of PGE Ventures sp. o.o. (to processors) eg to accounting, legal, IT and marketing agencies.

I. Providing data is voluntary but necessary to start the assessment and selection process in accordance with the Investment Policy of PGE Ventures sp. z o.o..