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PFI2020-00235 III . . TIGARD City of Tigard December 22, 2020 Global Strategic Accountants,LLC 6250 Shiloh Rd, #100 Alpharetta, GA 30005 Re:Permit No. PFI2020-00235 Dear Applicant: The City of Tigard has processed a refund for overpayment of permit fees on the above referenced permit for the following: Site Address: 2S102DA00401 Project Name: QuantamShift Communications Job No.: N/A Refund: ® Check#237556 in the amount of$250.00. ❑ Credit card"return"receipt in the amount of$ ❑ Trust account"deposit"receipt in the amount of$ . Notes: Refund difference of overpayment of permit fees. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Coordinator Enc. I:\Building\RefunR1g1§d3tioh R�fifnvsktp gkr�,�pg�gon 97223 • 503.639.4171 TTY Relay: 503.684.2772 • www.tigard-or.gov 11111 lit _ City of Tigard Lic,nizl, Accela Refund Request This form is used for refund requests of land use, development engineering and building permit application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must be attached to this request form. Refund requests are due to Accela System Administrator by each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts Payable will route refund checks to Accela System Administrator for distribution to applicant. PAYABLE Global Strategic Accountants, LLC DATE: 12/9/2020 TO: 6250 Shiloh Rd, #100 Alpharetta, GA 30005 REQUESTED BY: Dianna Omelas AL TRANSACTION INFORMATION: Receipt#: 430019 Case#: PFI2020-00235 Date: 6/30/2020 Address/Parcel: 2S102DA00401 Pay Method: Check Project Name: QuantamShift Communications EXPLANATION: Refund different of overpayment of permit fees. REFUND INFORMATION: Fee Description From Receipt Revenue Account No. Refund Example: Building Permit Fee Example: 2300000-43104 $Amount ROW License Fee 630-0000-43142 S2.50.00 TOTAL REFUND: $250.00 APPROVALS: SIGNATURES/DATE: If under$5,000 Professional Staff 7 If under$12,500 Division Manager D. L. Ory e.l4 If under$25,000 Department Manager If under$100,000 City Manager If over$50,000 Local Contract Review Board FOR ACCELA SYSTEM ADMINISTRATION USE ONLY"? Case Refund Processed: Date: cf/312-7 By: ,CX d I:\Building\Refunds\RefundRequest.doc x 09/01/2010 u CITY OF TIGARD RECEIPT ■ ' 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Project Name: Right of Way Lic. QuantamShift Communications, Inc dba vCom Solutions Site Address: Receipt Number: 435839 - 08/13/2021 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID PF12020-00235 $-250.00 Total: $-250.00 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 237556 DHOWSE 08/13/2021 $-250.00 Payor: Global Strategic Accountants LLC Total Payments: $-250.00 Balance Due: $250.00 Page 1 of 1 CITY OF TIGARD RECEIPT i 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 TIGARD Project Name: QuantamShift Communications, Inc dba vCom Solutions Site Address: Receipt Number: 430019 - 06/30/2020 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID PFI2020-00235 ROW License Fee 630-0000-43142 $300.00 Total: $300.00 PAYMENT METHOD CHECK# AUTH CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 14840 ALINDOR 06/30/2020 $300.00 Payor: Global Strategic Accountants LLC Total Payments: $300.00 Balance Due: $0.00 Page 1 of 1 v City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT .lhl 11 Request for Permit Action TIGARD 13125 SW Hall Blvd. • Tigard,Oregon 97223 • 503-718-2439 • www.tigard-or.gov TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner ❑ Applicant 0 Contractor El City Staff Check(1)one REFUND OR Name: INVOICE TO: (Business or Individual) Gib 2 j\ s- I v Accam-l.-Imw„ts 1, C LC_ Mailing Address: CO 2-5 0 ski l I D k 12.61 I Old City/State/Zip: A I'r tip.r -t j / , A- 3doO 5 Phone No.: PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): C OID PERMIT APPLICATION. �4 REFUND P IT FEES (attach copy of original receipt and provide explanation below). FOR FEES DUE (attach case fee schedule and provide explanation below). 1" Permit#: P.I jOZo, Do 235 Site Address or Parcel #: $'f J i09 &O 2 / Project Name: QU Vrtini 17 v V61 Z I Subdivision Name: Lot#: EXPLANATION: ()till 4cD - rC4.it►rA • Signature: V T� _- Date: 07 -7/1/ZDC Print Name: U /}-,)ytes (A1p(4- Refund Policy 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. FOR OFFICE USE ON 1.1 Route to Sys Admin: Date By Route to Records: Date .`/5 J f I- /401 Refund Processed: Date %Zf// Zi By je Invoice Processed: Date By Permit Canceled: Date n/ 4— By Parcel Tag Added: Date By I:\Building\Forms\RegPermitAction_120 18.doc City of Tigard UN 3 0 2132(1 RIGHT-OF-WAY LICENSE APPLICATION CITY OF-1 14 '' ?ursuant to Chapter 15.06.070 of the Tigard Municipal Code, all person engaging in any activity within or using the City Df Tigard's rights-of-way must first apply and be approved for a right-of-way license. Submit the following information and applicable fee to: City of Tigard, Attn: ROW Licenses, 13125 SW Hall Blvd., Tigard, OR 97223. 4pplication fee of$: 1. Name of Entity proposed to provide services (licensee/applicant). QuantumShift Communications, Inc. dba vCom Solutions 2. Tax ID of Entity. 68-0426815 3. Physical address and website. 12657 Alcosta Blvd., Ste 418 San Ramon, CA 94583 www.vcomsolutions.com 4. City of Tigard business license number or application date. 06/19/2020 5. Authorized contact information (name, email, address, phone, etc). Asa Morgan - Attorney in Fact asamorgan@gsaudits.com (678) 723-1324 6. Description of proposed activities or services (e.g. VoIP, Internet, Cable, Voice, Infrastructure Provider, Reseller (if reseller indicate whose service is being resold)). Telecommunication Retail - Local, Long Distance & Postpaid Wireless 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? We will not have a physical presence in the city of Tigard. 8. List any other municipalities in Oregon for which Applicant has an existing agreement for the provision of service(s). Please see the following: Hillsboro devised 4-2020 9. 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 10. 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 3s of the date hereof. Licensee agrees to comply with the provisions in the Tigard Municipal Code, including, but not imited to Chapter 15.06. By executing this application, the undersigned affirms that she/he is an authorized representative of the Applicant with :he authority to execute the ROW license application and bind applicant to all provisions of the Tigard Municipal Code. Asa Morgan ; Attorney in Fact 06/19/2020 signature & Printed Name Title Date 4fter 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.co Revised 4-2020 Gary Storm Chief Executive Officer Gary Storm is the President, CEO and Founder of vCom Solutions, Inc. vCom Solutions is a Telecom Expense Management Firm that helps multi-site companies reduce and manage their communication costs. In 2005, vCom Solutions was ranked as the#1 Fastest Growing Private Company in the San Francisco Bay Area. In 2006, vCom was ranked as the#51 Fastest Growing Company in the United States (Entrepreneur Magazine). Mr. Storm has worked in the telecommunications industry for more than 15 years. Prior to founding vCom Solutions in 2001, Gary was the former President & CEO of Networld Communications. Gary was instrumental in shaping Networld into one of the leading next generation voice and data equipment providers in the country. Under his leadership Networld made the Inc. 500 list as the 62nd fastest growing private company in America. He successfully led Networld's second round of funding that enabled Networld to introduce its Hosted IP Telephony service, which was later spun off into a separate company, CallTower. Prior to Networld Communications, Gary held sales positions with Nortel Networks and Williams Communications. Mr. Storm is on the Board of Directors for Junior Achievement of Northern California and also The First Tee of the Tri Valley. He is also on the Board for COMPTEL. Mr. Storm received a Bachelor of Arts degree from UC Berkeley.