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Exhibit A-3 - Form of Acknowledgement Letter <br />Page 3 <br />[Alternative to be used if Licensee obtains all Regulatory Approvals within 365 (366 in any <br />leap year) days after Pole License is issued.] <br />Dear [Licensee]: <br />This countersigned copy of your Acknowledgment Letter serves as the City’s notice to <br />Licensee that the City has: (1) received the Security Deposit and First Year’s License Fee for <br />this Pole License; (2) approved the requested Pole Locations and the plans and specifications <br />for installation of Equipment on the License Area; (3) received satisfactory evidence of <br />insurance, including contractors’ insurance, bonds and Business License; and (4) received <br />copies of the Regulatory Approvals listed above, as well as a copy of the Emissions Report <br />Licensee submitted to the Community Development Department. <br />The City concurs with the Commencement Date for this Pole License as specified above. <br />[After reviewing the Regulatory Approvals, the City has determined that the correct <br />Commencement Date for this Pole License is:, 20 .] The Licensee Fee and <br />Default Fee Schedule and City Installation Guidelines for the Pole License are attached. Upon <br />receipt, they will be deemed to be attached to the Pole License as Exhibits A-4 and A-5, <br />respectively. <br />Licensee is authorized proceed with the installation of Equipment on the License Area <br />identified in Exhibit A-1 to the Pole License in accordance with the Approved Plans and other <br />requirements of the Master License. <br />CITY OF SAN LEANDRO, a California charter city <br />By: <br />Jeff Kay (or designee) <br />City Manager <br />Date: <br />Enc. <br />[ ]Licensee Fee and Default Fee Schedule <br />[ ]City Installation Guidelines