Application Form For Parties Wishing To Offer, Render, Furnish, Or Supply Electricity Or Electric Generation Services To The Public In The Commonwealth Of Pennsylvania Page 27
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31Appendix G
Page 1 of 3
Sample Disclosure Statement Format
for Electric Generation Suppliers
This is an agreement for electric generation service, between __EGS name__ and __customer’s name and full
address .
Background
-
We at _______EGS’s name______ are licensed by the Pennsylvania Public Utility Commission to
offer and supply electric generation services in
Pennsylvania. Our PUC license number is _A-XXXX-XXXXXXX.
-
We set the generation prices and charges that you pay. The Public Utility Commission regulates
distribution prices and services. The Federal Energy Regulatory Commission regulates
transmission prices and services.
-
Include one of the two following options:
1) You will receive a single bill from billing agent name that will contain distribution utility name
charges and EGS’s name charges.
2) You will receive a separate bill from EGS Name for generation charges and a separate bill from
distribution utility name for its charges.
-
Right of Rescission - You may cancel this agreement at any time before midnight of the third
business day after receiving this disclosure.
Definitions
-
Generation Charge - Charge for production of electricity.
-
Transmission Charge - Charge for moving high voltage electricity from a generation facility to the
distribution lines of an electric distribution company.
-
Nonbasic Charges - Define each nonbasic service being offered.
Terms of Service
1. (a)
Basic Service Prices - Itemize Basic Services you are billing for and their prices.
You will pay
___EGS rate ___ per kWh for electric generation service.
Suppliers are to include any variable pricing conditions and limits, if charging a variable rate.
(Note to EGS applicants: this statement should include transmission charges if applicable. Contact the electric
distribution utility to determine if transmission charges are included in their price-to-compare.)
(b) Nonbasic Service Prices - Itemize Nonbasic Services you are offering and their prices.
2.
Length of Agreement
You will buy your electricity generation service for the above street address from EGS’s name beginning date through
date of expiration, if any.
24
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