Policy and Licensing Procedures for the Auction of Spectrum Licences in the 2300 MHz and 3500 MHz Bands – Appendix 4

Appendix 4 – Application to Participate in the Auction of Spectrum Licences for the 2300 MHz and 3500 MHz Bands

Appendix 4 – Application to Participate in the Auction of Spectrum Licences for the 2300 MHz and 3500 MHz Bands
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Part 1. Applicant Details

1. Applicant Name: space to insert applicant name

2. Address (Street, P.O. Box, etc.): space to insert address

3. City, Town: space to insert city and town 4. Province: space to insert province

5. Postal Code: space to insert postal code

6. Language Preference:  Checkbox-case à cocher English   Checkbox-case à cocher French

7. Applicant Classification

Checkbox-case à cocher Corporation   Checkbox-case à cocher Individual   Checkbox-case à cocher Partnership   Checkbox-case à cocher Joint Venture
Checkbox-case à cocher Other space to insert text

Details of the beneficial ownership for every entity that owns more than 10% of the Applicant's voting shares, non-voting shares, partnership interests, or any other beneficial interests, as the case may be, must be submitted with this application.


Part 2. Authorized Representative

The person listed below is nominated by the Applicant as its authorized representative. Unless otherwise indicated by the Applicant, all documentation pertaining to the 2300/3500 MHz Auction will be forwarded to the Authorized Representative.

8. (a) Authorized Representative

Name

 

Title

 

Telephone No.

 

E-mail address

 

Fax No.

(   )

Mailing Address

 

Part 3. Designated Bidders

The persons listed below are nominated by the Applicant as its designated bidders.

9. (a) Designated Bidder No. 1

Name

 

Title

 

Date

 

Signature of Bidder No. 1

 

Telephone No.

(   )

Fax No.

(   )

E-mail address

 

Mailing Address

 

9. (b) Designated Bidder No. 2

Name

 

Title

 

Date

 

Signature of Bidder No. 2

 

Telephone No.

(   )

Fax No.

(   )

E-mail address

 

Mailing Address

 

9. (c) Designated Bidder No. 3

Name

 

Title

 

Date

 

Signature of Bidder No. 3

 

Telephone No.

(   )

Fax No.

(   )

E-mail address

 

Mailing Address

 

Part 4. Desired Initial Level of Eligibility Points and Calculation of Required Financial Deposit

Enter the initial total number of points worth of licences on which you wish to be able to bid in any round in Box A below. This will be your initial level of eligibility points. Refer to Section 8.3 of Policy and Licensing Procedures for the Auction of Spectrum Licences in the 2300 MHz and 3500 MHz Bands.

 

Calculate your required financial deposit by multiplying the value in Box A the appropriate dollar value. For the first forty eligibility points the deposit is equal to $500 per point and $3,000 per eligibility point requested thereafter. Enter the appropriate value in Box B below. This will be the value of your required pre-auction deposit, in the form of an irrevocable standby letter of credit which meets, and is subject to, the terms and conditions contained in Appendix 6.

$


Part 5. Consent and Authority

12. Prohibition of Collusion

I certify that the Applicant has not entered into and will not enter into any agreements or arrangements of any kind with any competitor regarding the amount to be bid, bidding strategies or the particular licence(s) on which the Applicant or competitors will or will not bid. For the purposes of this certification the word competitor means any entity, other than the Applicant or its Affiliates and/or Associated Entities, who could potentially be a bidder in this auction based on its qualifications, abilities or experience. I understand that if this certification is found not to be true and complete in every respect, then:

  1. the Applicant will be disqualified from bidding or continuing to bid;
  2. the Applicant's standing high bids will be deemed to have been withdrawn, and the appropriate penalties will apply; and
  3. any licence that may already have been issued to the Applicant as a result of this auction process may be revoked.

(See Section 7.1 of Policy and Licensing Procedures for the Auction of Spectrum Licences in the 2300 MHz and 3500 MHz Bands)

13. Canadian Ownership and Control

I certify that I have read and I understand the contents of the Canadian carrier eligibility criteria as set out in section 10 of the Radiocommunication Regulations and I comply, or will comply, with the Canadian carrier ownership and control requirements, as applicable.

14. Release of Information

I consent to the publication by Industry Canada of all the information contained in this application and attachments, except for the Deed of Acknowledgement, the List of Designated Bidders, and the irrevocable standby letter of credit.

15. Back-up

I certify that the Applicant has thoroughly reviewed the back-up recommendations provided in Section 8.12 of the Policy and Licensing Procedures for the Auction of Spectrum Licences in the 2300 MHz and 3500 MHz Bands document. Should the Applicant wish to change one or more of their designated bidders or information related to their designated bidders such as fax or phone numbers I will notify the Manager, Wireless Networks (address given in Section 1 of the Policy and Licensing Procedures for the Auction of Spectrum Licences in the 2300 MHz and 3500 MHz Bands document) and provide the revised information.

16. Signature

I certify that I am the authorized representative of the above-named Applicant, that I have read the Policy and Licensing Procedures for the Auction of Spectrum Licences in the 2300 MHz and 3500 MHz Bands document and understand the policies and rules specified therein, and that the foregoing certifications and all matters and things stated in this application and attachments are true and correct.

Signed this space to insert date day of space to insert month , 2003


space to insert signature
Signature of Applicant or Individual Authorized to Sign for the Applicant


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