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Council Member: Phil Bacerra ®Yes El No ❑Yes ❑No Council Member: Juan Villegas ®Yes ❑No ❑Yes ❑No Council Member: Nelida Mendoza ®Yes ❑No ❑Yes ❑No Council Member: ❑Yes El No ❑Yes ❑No Council Member: ❑Yes ❑No ❑Yes ❑No Council Member: ❑Yes El No ❑Yes ❑No Alien Ownership Questions if the answer is Yes, provide an attachment explaining the circumstances) 1) Is the Customer/Lessee a foreign government or the representative of any foreign government? ❑Yes MN 9. Basic Qualification Information 1) Has the Customer or any party to this application had any FCC station authorization, license, or construction permit revoked or had any application for an initial, modification or renewal of FCC station authorization, license or construction ❑Yes ®No permit denied by the Commission? 2) Has the Customer or any party to this filing, or any party directly or indirectly controlling the Customer or any party to ❑Yes ®No this filing ever been convicted of a felony by any state or federal court? 3) Has any court finally adjudged the Customer or any party directly or indirectly controlling the Customer guilty of unlawfully monopolizing or attempting to unlawfully monopolize radio communication, directly or indirectly, through control ❑Yes ®No of manufacture or sale of radio apparatus, exclusive traffic arrangement, or any other means or unfair methods of I competition? I I 10. Customer/Lessee Certification Statements 1)The Customer/Lessee agrees that the Lease is not a sale or transfer of the license itself. ®Yes 2) The Customer/Lessee acknowledges that it is required to comply with the Commission's Rules and Regulations and other applicable law at all times, and if the Customer/Lessee fails to so comply, the Lease may be revoked, cancelled, or ®Yes terminated by either the Licensee or the Commission 3) The Customer/Lessee certifies that neither it nor any other party to the Application/Notification is subject to a denial of Federal benefits pursuant to Section 5301 of the Anti -Drug Abuse Act of 1988, 21 U.S.0 § 862, because of a conviction for ®Yes possession or distribution of a controlled substance (See Section 1.2002(b) of the rules, 47 CFR § 1 2002(b), for the definition of ",party to the application" as used in this certification.) 4) The Customer/Lessee hereby accepts Commission oversight and enforcement consistent with the license and lease authorization. The Lessee acknowledges that it must cooperate fully with any investigation or inquiry conducted either by the Commission or the Licensee, allow the Commission or the Licensee to conduct on•site inspections of transmission Nye$ facilities, and suspend operations at the direction of the Commission or the Licensee and to the extent that such suspension of operation would be consistent with applicable Commission policies. 5) The Customer/Lessee acknowledges that in the event an authorization held by a Licensee that has associated with it a spectrum leasing arrangement that is the subject of this filing is revoked, cancelled, terminated, or otherwise ceases to be in effect, the Customer/Lessee will have no continuing authority to use the leased spectrum and will be required to ®Yes terminate its operations no later than the date on which the Licensee ceases to have any authority to operate under the license, unless otherwise authorized by the Commission. 6) The Customer/Lessee agrees the Lease shall not be assigned to any entity that is not eligible or qualified to enter into a ®Yes spectrum leasing arrangement under the Commission's Rules and Regulations. 7)The Customer/Lessee waives any claim to the use of any particular frequency or of the electromagnetic spectrum as against the regulatory power of the United States because of the previous use of the same, whether by spectrum lease or ®Yes otherwise. 8) The Customer/Lessee certifies that it is not in default on any payment for Commission licenses and that it is not Nye$ delinquent on any non -tax debt owed to any federal agency. The Customer/Lessee certifies that all of its statements made in this Application/Notification and in the schedules, exhibits, attachments, or documents incorporated by reference are material, are part of this Application/Notification, and are true, complete, correct, and made in good faith. The Customer/Lessee shall notify Sensus in writing in the event any information supplied on this form changes. CITY OF SANTA ANA CA By: Title: Name: Date: FAILURE TO SIGN THIS APPLICATION MAY RESULT IN DISMISSAL OF THE APPLICATION AND FORFEITURE OF ANY FEES PAID. WILLFUL FALSE STATEMENTS MADE ON THIS FORM OR ANY ATTACHMENTS ARE PUNISHABLE BY FINE ANDIOR IMPRISONMENT (U.S. Code, Title 18, Section 1001) ANDIOR I REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. Code, Title 47, Section 312(a)(1)) AND/OR FORFEITURE (U.S. Code Title 47, Section 503). 1 Confidential I Page 3 of 14 25H-149