Agmt 2019 MLA for Small Cell Pole Attachment

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EXHIBIT A-3 Form of Acknowledgment Letter [Licensee to complete and submit.] [Alternative to be used if Licensee obtains all Regulatory Approvals within 365 (366 in any leap year) days after Pole License is issued.] [Date] City of San Leandro 835 East 14th Street San Leandro, CA 94577 Attention: Michael Stella, P.E., Principal Engineer Re: Pole License No. Dear Mr. Stella: This letter will confirm the following: (1) that Licensee has obtained the Encroachment Permit and all other Regulatory Approvals required for the Permitted Use under this Pole License, copies of which are attached to this letter, as specified below; and (2) the Commencement Date of this Pole License is , 20 , which is the first day of the month after Licensee obtained all Regulatory Approvals. This letter also confirms that Licensee has submitted all required insurance information to the City. A check or surety bond for the Security Deposit (if not already provided) and the License Fee for the first License Year of this Pole License is attached [or funds for the Security Deposit and the License Fee for the first License Year of this Pole License have been paid to the City]. Please acknowledge the City's receipt of this letter and the items listed below, and issue the City's approval for Licensee to begin installation of Equipment on the License Are by signing and returning a copy of this letter. Very truly yours, Enc. [ ] Encroachment Permit Title: [List other Regulatory Approvals.] [List other Regulatory Approvals.] [List other Regulatory Approvals.] Insurance certificates and endorsements Contractor's bonds, insurance certificates, Business Licenses, and endorsements Security Deposit by check, wire transfer, or surety bond, (if applicable) First License Year's License Fee First License Year's License Fee Typical Photo -simulations (as applicable) Exhibit A-3 — Acknowledgement Letter