Agmt 2019 MLA for Small Cell Pole Attachment

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EXHIBIT A FORM OF POLE LICIEVIS Master License between [Wireless Company] and City of San Leandro Pole License No. [Start with Year -1 and numbereach subsequent application consecutively (e.g. 2018-1).] In accordance with Section 6.5 of the Master License, Licensee submits k)the City two partially executed counterparts of this form of Pole License and each of the following as its Pole License 1. Exhibit A,1, designating BU Pole LOC8toDS that Licensee seeks to be included in the License Area under this Pole License and noting (if known) whether any requested City Pole is 8 Nonstandard City Pole; 2. Exhibit A-2, COnlp|e1e and final p|8OS and specifications for Equipment to be installed in the License Area subject toRegulatory Approvals; 3. The sum Of for the initial Administrative Payment inamounts based on the number of City PO|8S identified in Exhibit A-1. subject to Section 6.7 of the Master License; and 4. If not previously provided, the Emissions Report. Licensee acknowledges that: (a) this Pole License will not beeffective until the City returns 8fully executed copy to Licensee; (b) the City may require Licensee Losupplement the Administrative Payment on conditions specified in Section G.8Ofthe Master License; (c) Licensee will not have the right toaccess Orinstall Equipment Onthe License Area Und| after Licensee has, (i) submitted a complete Acknowledgment Letter [Othe City with all information and funds required; (ii) submitted insurance information to City as specified in Article 19; and (iii) the City has provided notice to proceed by returning to Licensee a countersigned copy of the Acknowledgment Letter. This Pole License is executed and effective as of the |@at date vvhUen be|Ovv and, upon execution will be the City's authorization for the City's Engineering and Transportation Department to begin its review Ofthe Pole Locations and plans and specifications proposed in this PO|a License [Wireless Company] By-. Its: Exhibit Form ofPole License