HomeMy WebLinkAboutResolution 2019-058 Application and Affidavit for Uniform Video Service License and Uniform Video Service License Agreement Forms Adopted by Ordinance 2019.013MARANA RESOLUTION NO. 2019-058
RELATING TO BUSINESS REGULATIONS; DECLARING AS A PUBLIC RECORD
FILED WITH THE TOWN CLERK THE APPLICATION AND AFFIDAVIT FOR
UNIFORM VIDEO SERVICE LICENSE AND UNIFORM VIDEO SERVICE LICENSE
AGREEMENT FORMS ADOPTED BY MARANA ORDINANCE NO. 2019.013
BE IT RESOLVED BY THE MAYOR AND COUNCIL OF THE TOWN OF
MARANA, ARIZONA, that the Application and Affidavit for Uniform Video Service
License and Uniform Video Service License Agreement forms adopted by Marana Or-
dinance No. 2019.013, copies of which are attached to and incorporated in this resolu-
tion as Exhibit A and Exhibit B respectively, one paper copy and one electronic copy of
which are on file in the office of the Town Clerk, are hereby declared to be a public rec-
ord and ordered to remain on file with the Town Clerk.
PASSED AND ADOPTED BY THE MAYOR AND COUNCIL OF THE TOWN
OF MARANA, ARIZONA, this 18th day of June, 2019.
Mayor Ed Honea
ATTES
Cherry L. L son, Town Clerk
G.
MARANA AZ
ESTABLISHED 1977
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EXHIBIT A TO MARANA RESOLUTION NO. 2019-058
Application and Affidavit for Uniform Video Service form adopted by
Marana Ordinance No. 2019.013
Model Uniform Video Service License Agreement
Date of Issuance:
This Uniform Video Service License Agreement ("License") is made on the date of
issuance hereof by and between the Town of Marana, an Arizona municipal corporation
("Licensor") and a
("Licensee").
WHEREAS, Licensee has filed a completed application and affidavit under Title 9,
Chapter 13, Arizona Revised Statutes ("Licensing Statute"), for Licensor to issue a
Uniform Video Service License to Licensee; and
WHEREAS, Licensee is authorized under the laws of the State of Arizona to
provide Cable Service.
NOW THEREFORE, in consideration of the foregoing recitals, which are
incorporated herein and the mutual covenants set forth herein, the Parties agree as
follows:
1. Definitions. Capitalized terms that are not defined herein have the same
meaning prescribed in the Licensing Statute, including A.R.S. Section 9-1401.
2. Licensee Information. The following appear on Exhibit A attached hereto and
are incorporated herein by this reference:
2.1. The name of Licensee, its type of entity and its jurisdiction of formation.
2.2. The address and telephone number of Licensee's principal place of
business.
2.3. The names, titles and addresses of Licensee's principal executive
officers or general partners.
2.4. The names, titles, telephone and fax numbers and email addresses of
any persons authorized to represent Licensee before Licensor.
3. Grant of License. Under the Licensing Statute, Licensor hereby issues to
Licensee, and Licensee hereby accepts from Licensor, a nonexclusive Uniform Video
Service License.
3.1. The Service Area in which this License authorizes Licensee to provide
Video Service in the area described on Exhibit B attached hereto and incorporated
herein by this reference.
3.2. Licensor grants Licensee authority in the delivery of Video Service to
use and occupy, and to construct and operate a Video Service Network in,
Highways in the Service Area in compliance with the Licensing Statue and this
License.
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EXHIBIT A TO MARANA RESOLUTION NO. 2019-058
Application and Affidavit for Uniform Video Service form adopted by
Marana Ordinance No. 2019.013
3.3. Licensee may operate and maintain facilities installed in the Highways
in the Service Area to provide services pursuant to and subject to all the following:
A.R.S. Section 9-584 and A.R.S. Title 9, Chapter 5.
4. Licensee Compliance with Law. Licensee shall comply with and be subject to:
4.1. All valid and enforceable federal and state laws.
4.2. All generally applicable, nondiscriminatory Local Laws, including
highway use, mapping, insurance, performance bonds, security fund,
indemnification, letter of credit or similar requirements that apply to the use and
occupation of any highway and that conform to the Licensing Statute.
4.3. All public, education and government programming requirements of the
Licensing Statute.
4.4. All customer service rules of the Federal Communications Commission
under 47 Code of Federal Regulations Section 76.309(c) applicable to Cable
Operators.
4.5. All consumer privacy requirements of 47 United States Code
Section 551 applicable to Cable Operators.
5. Commencement of Video Service; Revocation. If Licensee is an incumbent
cable operator, Licensee shall begin to provide Video Services under this License on the
date of issuance of this license. If Licensee is not an incumbent cable operator, Licensee
shall provide video service to at least one subscriber within each service area authorized
by this License not laterthan twenty-four months after the date of issuance of this License.
Failure of a non -incumbent cable operator to provide video service to at least one
subscriber within each service area as set forth above shall result in revocation of this
License unless the Licensee establishes to the satisfaction of the Licensor that such
failure was for reasons beyond the Licensee's control.
6. License Fee. Licensee is required to pay the License Fees required under the
Licensing Statute and all other lawful fees, taxes and charges imposed by Licensor. The
initial rate of the License Fee shall be five (5) percent.
7. Federal Filinq Requirement. Licensee is required to file in a timely manner with
the Federal Communications Commission all forms required by that agency before
Licensee offers Video Service in the Service Area, including the forms required by
47 Code of Federal Regulations Section 76.1801.
8. Term. The term of this License is ten (10) years and shall begin on the date of
issuance.
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EXHIBIT A TO MARANA RESOLUTION NO. 2019-058
Application and Affidavit for Uniform Video Service form adopted by
Marana Ordinance No. 2019.013
9. Compliance with Law. Licensor and Licensee agree that they are subject to and
must comply with the Licensing Statute. This License is subject to A.R.S. Section 38-511.
Licensor
Town of Marana, an Arizona municipal
corporation
Bv:
Keith Brann, Town Engineer
Date:
ATTEST:
Cherry L. Lawson, Town Clerk
APPROVED AS TO FORM:
Frank Cassidy, Town Attorney
Licensee
[Name & state of incorporation)
By :_
Its:
Date:
STATE OF )
)ss.
County of )
The foregoing instrument was acknowledged before me this day
of 20_ by , the of
a on behalf of Licensee.
(Seal)
Notary Public
STATE OF ARIZONA
) ss.
County of Pima )
The foregoing instrument was acknowledged before me this day
of , 20_ by Keith Brann, the Town Engineer of the Town of Marana, an
Arizona municipal corporation, on its behalf.
(Seal)
Notary Public
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EXHIBIT A TO MARANA RESOLUTION NO. 2019-058
Application and Affidavit for Uniform Video Service form adopted by
Marana Ordinance No. 2019.013
EXHIBIT A
[Information about Licensee]
1. Licensee:
Date.
Applicant's Name:
Principal Place of Business
Phone: Address:
_
City: State:
zip:
Type of Entity: Jurisdiction of Formation:
Email:
II. Licensee's principal executive officers or general partners:
Name:
Title:
Address:
Name:
Title:
Address:
Name:
Title:
Address:
Name:
Title:
Address:
III. Person(s) authorized to represent Licensee before Local Government:
Name: Title:
Address:
Phone: Fax: --1Email:
Name: Title:
Address:
Phone: Fax: Email:
Name: Title:
Address:
Phone: Fax: Email.
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EXHIBIT A TO MARANA RESOLUTION NO. 2019-058
Application and Affidavit for Uniform Video Service form adopted by
Marana Ordinance No. 2019.013
[Service Area]
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EXHIBIT B TO MARANA RESOLUTION NO. 2019-058
Uniform Video Service License Agreement form adopted by Marana Ordinance No. 2019.013
APPLICATION AND AFFIDAVIT FOR UNIFORM VIDEO SERVICE LICENSE
(Pursuant to Title 9, Chapter 13, Arizona Revised Statutes)
Local Government: Town of Marana, an Arizona municipal corporation
I. Applicant:
Date .___
Applicant's Name:
Principal Place of Business-
......
Phone. Address:
City/Town: State: Zip:
Type of Entity: Jurisdiction of Formation: Email:
II. Applicant's principal executive officers or general partners:
Name: _Title .:............................. ................. _........................._._......._...._.........._......_...........^........... _............M............
._..... .... ..__�............._......................................................................................................................................
Address:
Name: Title:
Address:
Name: Title:
Address:
Name: Title:
Address:
III. Person(s) authorized to represent Applicant before Local Government:
_._... ... ._......
Name: Title:
Address:
Phone: Fax: Email:
Name: Title:
Address:
..... ..........
Phone. I Fax Email:
IV. Check one pursuant to Arizona Revised Statutes Section 9-1411(C)(4):
O Applicant is an Incumbent Cable Operator as provided in Arizona Revised Statutes,
Section 9-1401(13).
LI Applicant is not an Incumbent Cable Operator. The date on which the Applicant expects to
provide Video Services in the Service Area identified below under Section 9-1411(C)(5) is:
Date:
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EXHIBIT B TO MARANA RESOLUTION NO. 2019-058
Uniform Video Service License Agreement form adopted by Marana Ordinance No. 2019.013
V. For All Applications:
A. Applicant will timely file with the Federal Communications Commission all forms required by that
agency before Applicant offers Video Service in the Service Area, including the forms required
by 47 Code of Federal Regulations Section 76.1801.
B. The term of the uniform video service license shall be (not to exceed ten years):
I Years
C. Applicant agrees to pay all lawful fees and charges imposed by Local Government as provided in
Arizona Revised Statutes, Section 9-1414(8)(4).
D. Applicant agrees to notify Local Government in writing of changes to the above information within
thirty days after the change occurs as provided in Arizona Revised Statutes, Section 9-1414(B)(2).
E. Provide an exact description of the Service Area as set forth in Arizona Revised Statutes,
Section 9-1411(C)(5), as identified by a geographic information system digital boundary meeting
or exceeding national map accuracy standards.
Select one:
❑ The Service Area consists of all the territory within the Boundaries of Local Government
❑ The Service Area consists of all the territory within the area described on attached Exhibit A.
Applicant Verification
I certify that the information contained in this application for a video service license in the Town of Marana is true
and correct. I further affirm that I am authorized by (NAME OF APPLICANT] to file this
application on behalf of applicant and to bind the applicant with respect to the representations made in Section
V, Paragraphs A through D of this application. A copy of the authorization is attached to this application.
Local Government Receipt
The foregoing Application and Affidavit for Uniform Video Service License was received by Local Government
this day of , 20_; at
TOWN OF MARANA, an Arizona municipal
corporation ("Local Government")
By:
Cherry L. Lawson, Town Clerk
11555 W. Civic Center Dr.
Marana, Arizona 85653
Office: (520)382-1900
Fax: (520) 382-1901
Email: Clawson@maranaaz.gov
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EXHIBIT B TO MARANA RESOLUTION NO. 2019-058
Uniform Video Service License Agreement form adopted by Marana Ordinance No. 2019.013
APPLICATION AND AFFIDAVIT FOR UNIFORM VIDEO SERVICE LICENSE
(Pursuant to Title 9, Chapter 13, Arizona Revised Statutes)
Local Government: Town of Marana,an Arizona municipal corporation
I. Applicant:
Date:
Applicant's Name:
Principal Place of Business=
Phone. Address'
City/Town: State: Zip:
Type of Entity: Jurisdiction of Formation: Email:
II. Applicant's principal executive officers or general partners:
Name: Title.
Address:.
Name: Title:
Address:
Name: Title:
Address: —
Name: 1 Title:
Address:
III. Person(s)authorized to represent Applicant before Local Government:
Name: Title:
Address:
Phone: Fax: ( Email:
Name: Title:
Address:
Phone: Fax: rEiaiI:
IV. Check one pursuant to Arizona Revised Statutes Section 9-1411(C)(4):
❑ Applicant is an Incumbent Cable Operator as provided in Arizona Revised Statutes,
Section 9-1401(13).
❑ Applicant is not an Incumbent Cable Operator. The date on which the Applicant expects to
provide Video Services in the Service Area identified below under Section 9-1411(C)(5)is:
Date:
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EXHIBIT B TO MARANA RESOLUTION NO. 2019-058
Uniform Video Service License Agreement form adopted by Marana Ordinance No. 2019.013
V. For All Applications:
A. Applicant will timely file with the Federal Communications Commission all forms required by that
agency before Applicant offers Video Service in the Service Area, including the forms required
by 47 Code of Federal Regulations Section 76.1801.
B. The term of the uniform video service license shall be(not to exceed ten years):
Years
C. Applicant agrees to pay all lawful fees and charges imposed by Local Government as provided in
Arizona Revised Statutes,Section 9-1414(B)(4).
D. Applicant agrees to notify Local Government in writing of changes to the above information within
thirty days after the change occurs as provided in Arizona Revised Statutes,Section 9-1414(B)(2).
E. Provide an exact description of the Service Area as set forth in Arizona Revised Statutes,
Section 9-1411(C)(5), as identified by a geographic information system digital boundary meeting
or exceeding national map accuracy standards.
Select one:
❑ The Service Area consists of all the territory within the Boundaries of Local Government
❑ The Service Area consists of all the territory within the area described on attached Exhibit A.
Applicant Verification
I certify that the information contained in this application for a video service license in the Town of Marana is true
and correct. I further affirm that I am authorized by [NAME OF APPLICANT]to file this
application on behalf of applicant and to bind the applicant with respect to the representations made in Section
V, Paragraphs A through D of this application.A copy of the authorization is attached to this application.
Name and Title(printed):
Signature:: Date:
Local Government Receipt
The foregoing Application and Affidavit for Uniform Video Service License was received by Local Government
this day of ,20_; at
TOWN OF MARANA,an Arizona municipal
corporation("Local Government")
By:
Cherry L. Lawson, Town Clerk
11555 W. Civic Center Dr.
Marana, Arizona 85653
Office: (520)382-1900
Fax: (520)382-1901
Email: clawson@maranaaz.gov
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