PFI2020-00262 pF12ow-oo2( 2
III
City of Tigard
RIGHT-OF-WAY LICENSE APPLICATION
Pursuant to Chapter 15.06.070 of the Tigard Municipal Code, all person engaging in any activity within or using the City
of Tigard's rights-of-way must first apply and be approved for a right-of-way license. Submit the following information
and applicable fee to: City of Tigard, Attn: ROW Licenses, 13125 SW Hall Blvd., Tigard, OR 97223.
Application fee of$300.00
1. Name of Entity proposed to provide services (licensee/applicant).
Google Voice Inc.
2. Tax ID of Entity.
20-3699496
3. Physical address and website.
1600 Amphitheatre Pkwy Mountain View CA 94043
4. City of Tigard business license number or application date.
02585
5. Authorized contact information (name, email, address, phone, etc).
Mark Lammert mark@csilongwood.com 242 Rangeiine Rd Longwood FL 32750 407 260 1011
6. Description of proposed activities or services (e.g. VoIP, Internet, Cable, Voice, Infrastructure Provider,
Reseller (if reseller indicate whose service is being resold)).
Voip
7. Does Applicant plan to install facilities or own any facilities currently located in Tigard? If, so provide map
pursuant to TMC 15.06.090(G). Does Applicant have or plan to have facilities installed underground, aerial or
both? No
8. Date services started or date of first ROW usage.
6/01/20
9. List any other municipalities in Oregon for which Applicant has an existing agreement for the provision of
service(s). Eugene
Portland
10. Has the Applicant or any affiliate been found in violation by a regulatory authority? If so, identify the judicial
or administrative proceeding, giving the date, name of tribunal, and result or disposition of proceeding.
No
Revised 7-2020
Er
„r City of Tigard
RIGHT-OF-WAY LICENSE APPLICATION
11. Attach the following documentation:
a. Valid certificate from the Oregon Public Utility Commission, if applicable.
b. Management/organizational chart, showing the management structure including name and unique
contact information (physical address, email, direct phone, etc).
c. Chart or description showing the relationship to all general partners, parent corporation, subsidiaries,
affiliates and all other subsidiaries of the parent corporations, include a brief description of each
entity's relationship.
d. Detailed map of the City's rights-of-way which applicant intends to use, also listing the exact linear
feet or dimensions of the proposed facilities that will occupy the right-of-way. If Applicant is using a
third parties' facilities, indicate the owner(s) of the facilities to be used.
I hereby certify, on behalf of Applicant, that to the best of my knowledge and belief this information is true and correct
as of the date hereof. Licensee agrees to comply with the provisions in the Tigard Municipal Code, including, but not
limited to Chapter 15.06.
By executing this application, the undersigned affirms that she/he is an authorized representative of the Applicant with
the authority to execute the ROW license application and bind applicant to all provisions of the Tigard Municipal Code.
( Attorney-in-Fact 7/21/20
Signature & P nted Name Title Date
After reviewing the application, the City or its designee may grant the license, deny the application, or find the
application incomplete and require additional information or clarification.
For additional information, please contact ROW Consultants LLC at 503.724.0766 or Reba@ROWManagers.com
Revised 7-2020