APPENDIX B TO DIVISION 5 OF TITLE VIII APPLICATION FOR OVS FRANCHISE
1. Please provide the following information on a separate attachment:
a. The name and address of the Applicant.
b. Identify who owns and controls the Applicant. Your answer should list the names and addresses of the ten (10) largest holders of an ownership interest in the Applicant the names and addresses of all persons in the Applicant’s direct ownership chain, showing their relation to one another. If there are contracts for the management and operation of the OVS, or arrangements for use of the OVS by an Affiliate, the entities involved and their ownership, and their relationship to the Applicant should be described.
2. Please provide information sufficient to show that you have the technical resources to construct and maintain the proposed OVS. Identify the companies and personnel that will be involved in the construction and maintenance, and references for the entities identified.
3. Please check the appropriate box.
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Is Applicant willing to comply with the provisions of the Humboldt County Code and other applicable laws; and to comply with such requirements of an OVS Agreement as the Humboldt County may lawfully require? |
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Does Applicant, or its affiliates hold a cable system Franchise for Humboldt County Humboldt County, or have a pending request a cable system Franchise (whether a initial or renewal Franchise, or transfer request)? |
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Has Applicant had a request for cable or OVS Franchise denied by Humboldt County? |
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If so, did the denial occur, or was a challenge to the denial resolved adversely to Applicant, in the last 36 months? |
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Has Applicant had cable or OVS Franchise revoked by Humboldt County? |
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If so, did the revocation occur, or was a challenge to the revocation resolved adversely to Applicant, in the last 36 months? |
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Does Applicant must have the necessary authority under California and federal law to operate an OVS? (If yes, please provide proof of the authorization). |
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During the ten (10) years preceding the submission of the Application, was Applicant found guilty of violating an consumer protection laws, or laws prohibiting anticompetitive acts, fraud, racketeering, or other similar conduct? |
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Does an elected official of the Humboldt County hold a controlling interest in the Applicant or an Affiliate of the Applicant? |
In any case where the answer to a question was "yes," please provide a detailed explanation of your answer.
4. Please provide a statement prepared by a certified public accountant showing that Applicant has the financial resources necessary to construct and operate the OVS as proposed.
5. Please identify the area of the Humboldt County that will be served by the OVS, with accompanying maps.
6. Provide a schedule for construction of the OVS, including an estimate of plant mileage and its location; whether or not an institutional network will be con structed information on the availability of space in conduits including, where appropriate, an estimate of the cost of any necessary rearrangement of existing facilities; and a description, where appropriate, of how services will be converted from existing facilities to new facilities.
7. Describe in detail the channels, facilities and other support you propose to provide for public, educational and government use of the system.
The undersigned hereby certifies the truth and accuracy of the information in the Application, and all attachments thereto, acknowledges the enforceability of Application commitments, and certifies that the Application meets all requirements of Applicable Law.
FOR:_____________________________
BY_____________________________
ITS_____________________________
Subscribed and sworn before me this ____ day of ____, ________.