Ordinance No. 1065 (3)1
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ORDINANCE NO. 1065
AN ORDINANCE OF THE CITY COUNCIL OF THE CITY OF
VERNON GRANTING A NON-EXCLUSIVE FRANCHISE TO
METRICOM, INC., TO ATTACH, INSTALL, MAINTAIN AND
OPERATE EQUIPMENT FOR A WIRELESS DIGITAL
COMMUNICATIONS RADIO NETWORK AT VARIOUS LOCATIONS
IN THE PUBLIC STREETS, ALLEYS AND RIGHTS -OF -WAY
IN THE CITY OF VERNON
WHEREAS, Metricom, Inc., a Delaware corporation, is a
public utility that provides subscribers to its services with
access to the internet by means of a wireless digital
communications radio network; and
WHEREAS, Metricom wishes to attach, install, operate, and
maintain equipment for its wireless digital communications radio
network on facilities located in the Public Rights -of -Way for
purposes of operating its Ricochet' wireless digital
communications radio network (the "Network"); and
WHEREAS, under California law the City has the right and
power to regulate the time, location, and manner of attachment,
installation, operation, and maintenance of wireless digital
communications radios in the Public Rights -of -Way within the
limits of the City; and
WHEREAS, the City Council is authorized by City Charter
Section 8.9. to grant a franchise in the City of Vernon to any
person, firm, corporation, or other entity and to set terms
conditions, restrictions and limitations by ordinance.
THE CITY COUNCIL OF THE CITY OF VERNON HEREBY ORDAINS:
SECTION 1: Findings.
The City Council of the City of Vernon hereby finds and
determines that the recitals contained hereinabove are true and
correct.
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SECTION 2: A franchise (hereinafter "Franchise") shall
be, and the same is hereby, granted by the City Council of the
City of Vernon to Metricom, Inc., to attach, install, maintain and
operate equipment for a wireless digital communications radio
network in the Public Rights -of -Way, as hereinafter defined,
subject to the terms and conditions set forth in this Ordinance.
The City Council of the City of Vernon also grants this Franchise
subject to the terms and conditions set forth in the Code of the
City of Vernon, California, 1959, Chapter 22, Article VI, to the
extent they are not in conflict with any paramount authority of
the State or Federal government, and the acceptance hereof shall
evidence the Franchisee's agreement to all terms and conditions of
said articles and the additional conditions herein contained.
SECTION 3: DEFINITIONS. The following definitions shall
apply generally to the provisions of this agreement:
3.1 "Agency" means any governmental or quasi -
governmental agency other than the City, including the
FCC and the PUC (as such terms are defined in §§ 3.3 and
3.8 below).
3.2 "Effective Date" means the effective date of this
ordinance as specified in Section 15, which shall also be
the effective date of the Franchise.
3.3 "FCC" means the Federal Communications Commission.
3.4 "Fee" means any assessment, license, charge, fee,
imposition, tax (but excluding any utility user's tax or
encroachment license fees), or levy of general
application to Persons doing business in the City
lawfully imposed by any governmental body.
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3.5 "Franchise" means the nonexclusive franchise granted
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by this Ordinance and may also refer to the associated
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right to encroach upon the Public Rights -of -Way conferred
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hereunder.
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3.6 "Gross Revenues" mean the gross dollar amount
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accrued on Metricom's books for Services provided to its
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customers with billing addresses in the City, excluding
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(i) the franchise fees, if any, payable pursuant to § 6
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et seq. below; (ii) local, state, or federal taxes
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collected by Metricom that have been billed to the
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subscribers and separately stated on subscribers' bills;
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and (iii) revenue uncollectible from subscribers (i.e.,
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bad debts) with billing addresses in the City that was
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previously included in Gross Revenues.
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3.7 "Laws" mean any and all statutes, constitutions,
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ordinances, resolutions, regulations, judicial decisions,
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rules, tariffs, administrative orders, certificates,
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orders, or other requirements of the City or other
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governmental agency having joint or several jurisdiction
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over the parties to this Franchise, in effect either at
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the time of execution of this Franchise or at any time
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during the presence of Radios in the Public Rights-of-
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Way.
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3.8 "PUC" means the California Public Utilities
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Commission.
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3.9 "Person" means an individual, a corporation, a
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limited liability company, a general or limited
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partnership, a sole proprietorship, a joint venture, a
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business trust, or any other form of business entity or
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association.
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3.10 "Provision" means any agreement, clause, condition,
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covenant, qualification, restriction, reservation, term,
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or other stipulation in this Franchise that defines or
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otherwise controls, establishes, or limits the
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performance required or permitted by any party to this
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Franchise. All Provisions, whether covenants or
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conditions, shall be deemed to be both covenants and
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conditions.
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3.11 "Public Rights -of -Way" means in, upon, above,
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along, across, and over the public streets, roads, lanes,
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courts, ways, alleys, boulevards, and places, including
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all public utility easements and public service easements
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as the same now or may hereafter exist that are under the
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jurisdiction of the City. This term shall not include
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any property owned by any Person or Agency other than the
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City, except as provided by applicable Laws or pursuant
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to an agreement between the City and any such Person or
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Agency.
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3.12 "Radio" means the radio equipment, whether referred
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to singly or collectively, to be installed and operated
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by Metricom hereunder and more particularly shown and
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described in Exhibit A attached hereto and made a part
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hereof by reference.
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3.13 "Radio Month" means a calendar month during which a
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Radio occupies space on a City -owned pole or other City-
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owned property, even if such occupancy is less than the
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entire month.
3.14 "Ricochet"' or "Ricochet' MCDN" means Ricochet'm
MicroCellular Digital Network, a wireless, microcellular
digital radio communications network owned and operated
by Metricom.
3.15 "Services" means the wireless digital
communications services provided through Ricochet"" by
Metricom to subscribers with billing addresses within the
City.
SECTION 4: TERM. The term of this Franchise shall
commence on the Effective Date for a period of five (5) years
unless it is earlier terminated by either party in accordance with
the provisions herein. At the expiration of the said five-year
term, the Franchise shall be automatically renewed for an
additional term of five (5) years without public hearing, unless
the City gives written notice to Metricom not less than sixty (60)
days before the expiration of said term that the Franchise shall
not be renewed. The maximum cumulative term of this Franchise
shall not exceed twenty-five (25) years.
SECTION 5: SCOPE OF FRANCHISE. Any and all rights
expressly granted to Metricom under this Franchise, which shall be
exercised at Metricom's sole cost and expense, shall be subject to
the prior and continuing right of the City under applicable Laws
to use any and all parts of the Public Rights -of -Way exclusively
or concurrently with any other Person or Persons and shall be
further subject to all deeds, easements, dedications, conditions,
covenants, restrictions, encumbrances, and claims of title which
may affect the Public Rights -of -Way. Nothing in this Franchise
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shall be deemed to grant, convey, create, or vest a perpetual real
property interest in land in Metricom, including any fee,
leasehold interest, or easement.
5.1 Attachment to City -Owned Property. The City hereby
authorizes Metricom to attach, install, operate,
maintain, remove, reattach, reinstall, relocate, and
replace Radios in or on light poles, lighting fixtures,
electroliers, or other City -owned property located within
the Public Rights -of -Way for the purposes of providing
Services to Persons located within or without the limits
of the City.
5.2 Attachment to Third -Party Property. Subject to
obtaining the permission of the owner(s) of the affected
property, the City hereby authorizes Metricom to attach,
install, operate, maintain, remove, reattach, reinstall,
relocate, and replace such number of Radios in or on
poles or other structures owned by public utility
companies or other property owners located within the
Public Rights -of -Way as may be permitted by the public
utility company or property owner, as the case may be.
Metricom shall furnish to the City documentation of such
permission from the individual utility or property owner
responsible.
5.3 No Interference. Except as permitted by applicable
Laws or this Franchise, Metricom in the performance and
exercise of its rights and obligations under this
Franchise shall not interfere in any manner with the
existence and operation of any and all public and private
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rights -of -way, sanitary sewers, water mains, storm
drains, gas mains, poles, and underground electrical and
telephone wires, electroliers, cable television, and
other telecommunications, utility, or municipal property,
without the express written approval of the owner or
owners of the affected property or properties.
5.4 Compliance with Laws. Metricom shall comply with
all applicable Laws in the exercise and performance of
its rights and obligations under this Franchise.
5.4.1 Construction permits. Any and all
construction work performed pursuant to the rights
granted under this Franchise, including the
installation, operation, maintenance, location, and
attachment of the Radios in the Public Rights -of -
Way, shall be subject to the prior review and
approval of the City by means of submission of an
encroachment permit application, payment of any
applicable permitting fees, and the City's ordinary
administrative review. Metricom shall apply for and
obtain all appropriate permits required by
applicable Laws prior to the commencement of any
work of construction in the Public Rights -of -Way.
The locations of Metricom's proposed initial
installation of Radios are shown in Exhibit B,
attached hereto and made a part hereof by reference.
After the initial deployment of the Radios, new
attachments, removals, and relocations of Radios
shall also be subject to the City's encroachment
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permit process. If the location of any Radio is
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different from that applied for in the applicable
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permit, the location of such Radio installed by
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Metricom or its designee shall be disclosed in
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writing to the City by Metricom within ten (10) days
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after its installation, removal, or relocation and
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shall .be approved by the Director of Community
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Services.
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5.4.2 As -Built drawings. Upon the completion of
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construction work, Metricom promptly shall furnish
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to the City, in hard copy and in Metricom's
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electronic format, suitable documentation showing
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the exact location of the Radios in the Public
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Rights -of -Way.
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5.5 Modification of Service Voltage. The City reserves
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the right to modify the service voltage delivered to or
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at any street light pole or utility pole on which a Radio
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may be located. Metricom shall replace or modify any
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Radio that will be affected by such voltage modifications
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within thirty (30) days of receiving notice of voltage
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modifications. In the event that Metricom fails to
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replace or modify any Radio within the thirty -day notice
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period before the voltage modification, the City may
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disconnect any such Radio until Metricom performs and
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completes the necessary work and advises City
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accordingly.
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5.6 Electric Service Connection and Rates. Each Radio
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shall be interconnected to the electrical power of a
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light pole or utility pole in accordance with the
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drawings and specifications attached hereto as Exhibit C
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and made a part hereof by reference. Modular plug-in
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connections on light poles may be made by Metricom
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employees in accordance with said specifications. Any
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other electrical wiring shall be performed only by City
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employees or City's contractor, the costs of which shall
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be paid by Metricom. Metricom shall take electric
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service at the then applicable electric schedule for
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small single-phase general service with the following
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conditions:
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(a) A single customer charge for the network shall
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be paid semi-annually at a rate of Seventy-five
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Dollars ($75) which shall be adjusted at the same
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rate as other Fees pursuant to Section 6.3 of this
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Agreement.
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(b) Energy use shall be deemed to be 3.8 kWh per
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month per RicochetTm Ethernet Radio - Mod 21040.
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Energy use shall be adjusted by the Light and Power
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Department for any other Radio devices installed.
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(c) Bills for energy use shall be mailed within two
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(2) weeks of the date of the first Radio
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installation and shall be paid within twenty (20)
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days of receipt. Said bills shall be based on the
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number of Radios Metricom estimates it will install
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on City -owned poles or other City -owned property
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during the succeeding six (6) months.
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(d) Bills for electric service shall be submitted
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3 billing period and for the estimated new
4 installation for the subsequent six-month period.
5 (e) All other provisions of said rate schedule
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7 5.7 Annual Business License. Metricom shall obtain an
8 annual City business license prior to the Effective Date
9 and maintain the same throughout the term of this
10 Franchise.
11 5.8 Nonexclusive Use. This Franchise does not provide
12 Metricom with exclusive use of any City -owned poles or
13 property and City shall have the right to allow other
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15 equipment or devices in the Public Rights -of -Way;
16 however, City shall endeavor promptly to notify Metricom
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18 communications equipment or devices in the Public Rights-
19 of -Way, regardless of whether a franchise or license is
20 required by the FCC for the operation thereof.
21 SECTION 6: FEES AND TAXES. Metricom shall pay all
22 lawful Fees, utility user's taxes, electrical rates and franchise
23 fees in connection with the exercise of Metricom's rights under
24 this Franchise including those set forth below.
25 6.1 Franchise Fees. Notwithstanding any other provision
26 of this Franchise, Metricom shall pay to City an initial
27 franchise fee in the amount of Two Hundred Fifty Dollars
28 and No Cents ($250.00) and an annual fee thereafter in
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the amount of Thirty-eight Dollars and Thirty-three Cents
($38.33) on each anniversary of the Effective Date. City
recognizes Metricom's concern that its competitors be
treated similarly with regard to fees for access to
similar City facilities. In drafting and adopting any
such fee, City will make a reasonable effort to assure
that such charges are equivalent for Metricom and its
competitors, subject to allowances for the nature of City
property utilized, the market demand for such use of such
facilities, and City's legal authority to impose such
charges. As used in this § 6.1, the term competitor
means any entity which supplies wireless data
communications services within the City and operates
radios or other equipment within the Public Rights -of -
Way.
6.2 Annual Radio Fee. Metricom shall pay to the City an
annual fee (the "Annual Radio Fee") in the amount of
Sixty Dollars ($60.00) for the use of each City -owned
pole or other structure or piece of City -owned property
upon which a Radio has been installed pursuant to this
Franchise. The initial Annual Radio Fees shall be due
and payable not later than the date of installation of
the first Radio on City -owned poles or other City -owned
property under this Franchise (the "Installation Date")
and shall be computed based upon the number of Radios
Metricom estimates as of the Installation Date that it
will install on City -owned poles or other City -owned
property during the succeeding twelve (12) months. The
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Annual Radio Fees for subsequent years shall be due and
payable not later than thirty (30) days following each
anniversary of the Installation Date based on the total
number of Radios then installed on City -owned poles or
other City -owned property pursuant to the License. The
total of Annual Radio Fees shall be adjusted by either
increasing or decreasing a subsequent year's aggregate
Annual Radio Fees to account for the installation or
removal of Radios during the prior year. Such adjustment
shall equal the difference between (i) the estimate of
Radio Months used to calculate the prior year's aggregate
Annual Radio Fees and (ii) the actual number of Radio
Months which occurred during such year, multiplied by
one -twelfth of the Annual Radio Fees.
6.3 CPI Adjustment. At the commencement of each five
(5) year renewal term, all Fees set forth herein with
respect to such term shall be adjusted effective January
1st of the first year of such renewal term by a
percentage amount equal to the percentage change in the
U.S. Department of Labor, Bureau of Labor Statistics,
Consumer Price Index of all items, Base 1982-1984, which
occurred during the previous term or renewal term, as the
case may be, for the Los Angeles -Anaheim -Riverside
Consolidated Metropolitan Statistical Area.
6.4 Municipality Access Program. As additional
consideration for this Franchise, City shall have the
right throughout the term of this Agreement to purchase a
number of subscriptions based upon the City's population,
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up to the maximum number set forth below, to Metricom's
lowest base rate RicochetTM subscription service when
such service is commercially available in the City at the
rate of fifty percent (50%) of the base rate for such
service, as modified from time to time. The number of
subscriptions which the City may purchase at the
Municipality Access Program rate shall be determined in
accordance with the City's official population, as shown
on the latest available census data, as follows: (a) for
cities with a population of less than 100,000, up to a
maximum of twenty (20) discount subscriptions; (b) for
cities with a population of 100,000 to 249,000, up to a
maximum of thirty (30) discount subscriptions; (c) for
cities with a population of 250,000 to 500,000, up to a
maximum of forty (40) discount subscriptions; and (d) for
cities with a population of over 500,000, up to a maximum
of fifty (50) discount subscriptions. City understands
and agrees that Metricom's modems, subscriptions or
service options the City may desire are expressly
excluded from this special Municipality Access Program
rate and may be obtained from either Metricom or an
authorized retailer at market rates current from time to
time or under other promotional programs which may be
available from time to time in addition to the
Municipality Access Program rate. City shall use all
subscriptions provided pursuant to this § 6.4 solely for
its own use and shall not be entitled to resell,
distribute, or otherwise permit the use of the same by
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any other party.
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6.5 Reimbursement of City's Expenses. Metricom shall
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reimburse the City at City's standard rates for all
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reasonable expenses relating to the preparation,
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issuance, and implementation of the Franchise, promptly
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upon receipt of bills, paid invoices, and such other
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documentation as Metricom shall reasonably require. The
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reimbursement provided for in this S 6.5 shall not
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replace or excuse Metricom from the payment of any
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applicable City permit fee for work undertaken in
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connection with this Franchise.
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6.6 Potential Utility User's Tax. Metricom acknowledges
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and agrees that the City may require users of the
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Services to pay a utility user's tax to the City pursuant
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to a duly adopted City ordinance. If the City adopts
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such an ordinance making the Services subject to a
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utility user's tax, Metricom agrees to collect the tax
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from Service users and remit such tax to the City.
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6.7 Most -Favored Nation Clause. Should Metricom after
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the Effective Date enter into a similar agreement with
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another municipality with a population of 55,000 persons
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or less in the Los Angeles Metropolitan Statistical Area,
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which agreement contains financial benefits for such
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municipality which, taken as a whole and balanced with
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other terms of such agreement, are substantially superior
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to those in this Franchise, on request of the City,
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Metricom shall consent to a modification of this
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Franchise to incorporate the substantially similar
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superior benefits.
SECTION 7: REMOVAL AND RELOCATION OF RADIOS. Metricom
understands and acknowledges that City may require Metricom to
relocate one or more of its Radios, and Metricom shall at City's
direction relocate such Radios at Metricom's sole cost and
expense, whenever City reasonably determines that the relocation
is needed. If Metricom shall fail to relocate any such Radio,
City shall be entitled to remove or relocate the Radio at
Metricom's sole cost and expense, without further notice to
Metricom.
7.1 Metricom Desires Relocation. In the event Metricom
desires to relocate any Radio from one City -owned pole or
other property to another City -owned pole or other
property, Metricom shall so advise City. City will use
its best efforts to accommodate Metricom by making
another functionally equivalent City -owned pole or other
property available for use in accordance with and subject
to the terms and conditions of this Franchise.
7.2 Discontinuation of Service. In the event that any
Radio subject to this Franchise is abandoned and no
longer placed in service for a period of six (6) months
or more, Metricom promptly shall notify the City, and the
City, at its option, may require Metricom promptly to
remove the abandoned Radio(s) at Metricom's sole cost and
expense. In the alternative, Metricom, at the City's
request, may dedicate the same to the City. The City
shall not require removal of Radios unless and until the
City first gives fifteen (15) days' prior written notice
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to Metricom to remove the Radios. If Metricom shall fail
to remove the Radios as required by the City, the City
shall be entitled to remove the Radios at Metricom's sole
cost and expense. At City's request for dedication,
Metricom shall execute such documents of title as will
convey all right, title, and interest in the abandoned
Radios to the City, but in no other Metricom property,
intellectual or otherwise.
7.3 Damage to Rights -of -Way. Whenever the removal or
relocation of Radios is required under this Franchise,
and such removal or relocation shall cause the Public
Rights -of -Way to be damaged, Metricom, at its sole cost
and expense, shall promptly repair and return the Public
Rights -of -Way in which the Radios are located to a safe
and satisfactory condition to the satisfaction of the
City's Director of Community Services. If Metricom does
not so repair the site, then the City shall have the
option, upon fifteen (15) days' prior written notice to
Metricom, to perform or cause to be performed such
reasonable and necessary work on behalf of Metricom and
to charge Metricom for the proposed costs to be incurred
or the actual costs incurred by the City at City's
standard rates. Upon the receipt of a demand for payment
by the City, Metricom shall reimburse the City for such
costs.
7.4 Advice of Displacement. To the extent the City has
actual knowledge thereof, the City will attempt to inform
Metricom of the displacement of any pole on which any
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Radio is located.
SECTION 8: INDEMNIFICATION, WAIVER AND BOND. Metricom
shall indemnify, defend (with legal counsel reasonably acceptable
to the City), protect, and hold harmless the City, its council
members, officers, employees, and agents from and against any and
all claims, demands, losses, damages, liabilities, fines, charges,
penalties, administrative and judicial proceedings and orders,
judgments, remedial actions of any kind, all costs and cleanup
actions of any kind, and all costs and expenses incurred in
connection therewith, including reasonable attorney's fees and
costs of defense (collectively, the "Losses") arising, directly or
indirectly, in whole or in part, out of the activities or
facilities described in this Franchise, except to the extent
arising from or caused by the sole negligence or willful
misconduct of the City, its council members, officers, employees,
agents, or contractors.
8.1 Waiver of Claims. Metricom waives any and all
claims, demands, causes of action, and rights it may
assert against the City on account of any loss, damage,
or injury to any Radio or any loss or degradation of the
Services as a result of a sudden or gradual loss or
change of electrical power caused by, among others, an
Act of God, an event or occurrence which is beyond the
reasonable control of the City, a power outage, a
lightning strike, or occasioned by -the installation,
maintenance, replacement or relocation of any City -owned
facility to which such Radio is attached.
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8.2 Limitation of City's Liability. The City shall be
liable only for the cost of repair to damaged Radios
arising from the negligence or willful misconduct of City
or its employees or agents, and the City shall not be
responsible for any damages, losses, or liability of any
kind occurring by reason of anything done or omitted to
be done by the City or by any third party, including
damages, losses, or liability arising from the issuance
or approval by the City of a permit to any third party or
any interruption of Services.
8.3 Bond or Other Security. Prior to the commencement
of any work under this Franchise, Metricom shall furnish
or cause to be furnished to City a good and sufficient
bond, substantially in the form attached hereto as
Exhibit D entitled Surety Bond, in the amount of Ten
Thousand Dollars ($10,000), or such other comparable
security instrument as may be approved by the City's
attorney or risk manager, securing the faithful
performance by Metricom of all of the work, construction,
installation, and removals required to be performed by
Metricom under this Franchise within the time periods set
forth hereunder. If the surety cancels or withdraws from
said Bond, Metricom shall submit a new bond effective on
or before the date of such cancellation or withdrawal, or
a letter of credit in a form and manner acceptable to the
City Administrator. Metricom's right to exercise the
franchise rights granted by this ordinance shall be
suspended during any period of time that Metricom shall
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fail to maintain the bond or other form of security
required by this section 8.3.
SECTION 9: INSURANCE. Metricom shall obtain and
maintain at all times during the term of this Franchise (including
the period between the expiration hereof and Metricom's removal of
its Radios or other equipment from the Public Rights -of -Way)
insurance in the amounts set forth in Exhibit E, Schedule of
Insurance, attached hereto and made a part hereof by reference.
9.1 Contractor's and Subcontractors' Insurance.
Metricom shall require that all contractors and
subcontractors obtain insurance meeting the criteria set
forth herein and shall furnish to the City copies of all
certificates evidencing such policies of insurance.
9.2 Insurance and Indemnification Obligation.
Metricom's compliance with the insurance requirements
herein shall not excuse, or otherwise affect Metricom's
duty to indemnify and defend the City pursuant to § 8 of
this Franchise.
SECTION 10: NOTICES. All notices which shall or may be
given pursuant to this Franchise shall be in writing and delivered
personally or transmitted (a) through the United States mail, by
registered or certified mail, postage prepaid; (b) by means of
prepaid overnight delivery service; or (c) by facsimile
transmission, if a hard copy of the same is promptly sent by such
delivery, through the U. S. mail or by overnight delivery service
addressed as follows:
-19-
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rA41 W4
MR. BRUCE V. MALKENHORST
CITY ADMINISTRATOR/CITY CLERK
CITY OF VERNON
4305 SANTA FE AVENUE
VERNON CA 90058-0805
METRICOM
METRICOM, INC.
ATTN: PROPERTY MANAGER
980 UNIVERSITY AVENUE
LOS GATOS CA 95030
Notices shall be deemed given (i) upon receipt in the case of
personal delivery, (ii) three (3) days after deposit in the mail,
or (iii) the next day in the case of overnight delivery. Either
party may from time to time designate any other address for this
purpose by written notice to the other party delivered in the
manner set forth above.
SECTION 11: TERMINATION. This Agreement may be
terminated by either party upon thirty (30) days' prior written
notice to the other party upon default of any material covenant or
term hereof by the other party, which default is not cured within
thirty (30)) days of receipt of written notice of default (or, if
such default is no curable with thirty (30) days, if the
defaulting party fails to commence such cure within thirty (30)
days or fails to thereafter diligently prosecute such cure to
completion), provided that the cure period for any monetary
default is ten (10) days from receipt of notice.
SECTION 12: ASSIGNMENT. This Franchise shall not be
assigned by Metricom without the express written consent of the
City, which consent shall not be unreasonably withheld,
conditioned, or delayed. Any attempted assignment in violation of
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this § 12 shall be void.
12.1 Notwithstanding the foregoing, the transfer of the
rights and obligations of Metricom hereunder to a parent,
subsidiary, or financially viable affiliate of Metricom
or to any successor -in -interest or entity acquiring all
or substantially all of Metricom's outstanding voting
stock or assets shall not be deemed an assignment or
transfer for the purposes of this Franchise, provided
that (i) any such transferee will have a financial
strength after the proposed transfer at least equal to
that of Metricom prior to the transfer, (ii) any such
transferee assumes all the obligations of Metricom
hereunder, and (iii) Metricom.shall not be released from
the obligations of this Franchise by virtue of such
transfer.
12.2 If such criteria are satisfied, it shall not be
deemed reasonable for the City to withhold its consent to
the proposed transfer, unless the proposed transferee has
a record of performance under similar agreements which is
unacceptable to the City under a reasonable standard of
evaluation. Lack of prior specific experience in
administering a system providing the Services described
in this Franchise shall not, by itself, be deemed a
reasonable basis for refusing or conditioning the City's
consent.
12.3 Metricom shall give to the City thirty (30) days'
prior written notice of any transfer for which notice is
required hereunder. In the case of any proposed transfer
-21-
I for which the City's consent is required hereunder,
2 Metricom agrees to reimburse the City for its reasonable
3 expenses incurred in reviewing such transfer proposal.
4 12.4 Successors and Assigns. This Franchise is binding
5 upon the successors and assigns of the parties hereto.
6 SECTION 13: MISCELLANEOUS PROVISIONS. The provisions
7 which follow shall apply generally to the obligations of the
8 parties under this Franchise.
9 13.1 Severability of Provisions. If any one or more of
10 the Provisions of this Franchise shall be held by court
11 of competent jurisdiction in a final judicial action to
12 be void, voidable, or unenforceable, such Provision(s)
13 shall be deemed severable from the remaining Provisions
14 of this Franchise and shall in no way affect the validity
15 of the remaining portions of this Franchise.
16 13.2 Waiver of Breach. The waiver by a party of any
17 breach or violation of any Provision of this Franchise by
18 the other party shall not be deemed to be a waiver or a
19 continuing waiver by such party of any subsequent breach
20 or violation of the same or any other Provision of this
21 Franchise.
22 13.3 All -Hours Contact. Staff employees of Metricom
23 shall be available twenty-four (24) hours a day, seven
24 (7) days a week to any City department having
25 jurisdiction over Metricom's activities, regarding
26 problems or complaints resulting from the attachment,
27 installation, operation, maintenance, or removal of the
28 Radios. The City may contact by telephone the network
-22-
1
control center operator at telephone number (800) 556-
2
6123 regarding such problems or complaints.
3
13.4 Governing Law; Jurisdiction. This Franchise shall
4
be governed and construed by and in accordance with the
5
laws of the State of California. In the event that suit
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is brought by a party to this Franchise, the parties
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agree that trial of such action shall be vested
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exclusively in the state courts of California, County of
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Los Angeles, or in the United States District Court,
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Central District of California in the County of Los
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Angeles.
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13.5 Attorneys' Fees. Should any dispute arising out of
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this Franchise lead to litigation, the prevailing party
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shall be entitled to recover its costs of suit, including
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reasonable attorneys' fees.
16
13.6 Exhibits. All exhibits. referred to in this
17
Franchise and any addenda, attachments, and schedules
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which may from time to time be referred to in any duly
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executed amendment to this Franchise are by such
20
reference incorporated in this Franchise and shall be
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deemed a part of this Franchise.
22
13.7 Rules, Regulations, and Specifications. Metricom
23
acknowledges that the City may develop rules,
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regulations, and specifications, including a general
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ordinance or other regulation governing wireless
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telecommunications in the City (the "Regulations"), for
27
the attachment, installation, and removal of Radios and
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any similar purpose devices on the City -owned facilities,
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including poles, and that such Regulations, when
finalized, shall govern Metricom's activities hereunder
as if they had been in effect at the time this Franchise
was executed by the City; provided, however, that in no
event shall such Regulations materially interfere with or
affect Metricom's right to install Radios or Metricom's
ability to transmit or receive radio signals from Radios
installed pursuant to and in accordance with this
Franchise or materially increase Metricom's obligations
hereunder.
13.8 Consent Criteria. In any case where the approval
or consent of one party hereto is required, requested or
otherwise to be given under this Franchise, such party
shall not unreasonably delay, condition, or withhold its
approval or consent.
13.9 Amendments. The terms and conditions of this
Franchise may be amended only by an ordinance duly
approved and adopted by the City Council of the City of
Vernon.
13.10 Acceptance of Franchise. Not later than thirty
(30) days from the effective date of this ordinance,
Metricom shall provide the City with written acceptance
of the Franchise in the form and manner specified in
Exhibit "F" attached hereto. The written acceptance
shall be executed on behalf of Metricom in the manner
prescribed in Section 313 of the California Corporations
Code.
CMIC
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SECTION 14: PUBLICATION. There being no newspaper
printed, published or circulated in the City of Vernon, the City
Clerk is hereby directed to certify to the passage of this
ordinance and shall post the same, or cause the same to be posted,
within fifteen (15) days after its passage in accordance with
Section 36933 of the Government Code, in three (3) of the most
public places in the City of Vernon, to wit: the northwest corner
of 38th Street and Santa Fe Avenue, the northeast corner of Leonis
Boulevard and Pacific Boulevard, and on the bulletin board in the
lobby of the City Hall of said City, located at 4305 Santa Fe
Avenue, all in the City of Vernon, County of Los Angeles, State of
California.
SECTION 15: EFFECTIVE DATE. This ordinance shall be in
full force and effect thirty (30) days from and after its passage
by the City Council.
APPROVED AND ADOPTED this 29th day of June, 1999.
LEONIS C. MA URG, M yor
ATTEST• '
2E-
BRUCE V. MALKENHORST, City Clerk
Sdifl
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STATE OF CALIFORNIA )
) ss
COUNTY OF LOS ANGELES )
I, BRUCE V. MALKENHORST, City Clerk of the City of
Vernon, do hereby certify that the foregoing Ordinance, being
Ordinance No. 1065 was duly and regularly introduced at a regular
meeting of the City Council of the City of Vernon, held on
Tuesday, June 15, 1999, and thereafter finally adopted at an
adjourned regular meeting of said City Council held on Tuesday,
June 29, 1999, and thereafter was duly signed by the Mayor of the
City of Vernon, by the following vote:
AYES: ALL Councilmen: Malburg, Ybarra, Davis
Gonzales, McCormick
(SEAL)
NOES: NONE Councilmen:
ABSENT: NONE Councilmen:
BRUCE V. MALKENHORST, City Clerk
-26-
EXHIBIT A
EXHIBIT "A"71
DESCRIPTION OF RADIOS
General
Operating Frequency Range
Spreading Technique
Hopping Technique
Number of Channels
Channel Spacing
RF Data Rate
Transmitter
R.F. Output Power
Omni Antenna Gain
Baseband Modulation
Field Strength at 10 Ft
Power Density at 50 Ft
Environmental
Operating temperature Range
Storage Temperature range
Operating Vibration
5 to 7.5 Hz
7.5 to 500 Hz
Operating Shock
Humidity
Salt Spray
Transportation Vibration
Rain Tightness
Power and Power Line Susceptibility
Input Voltage
Input Current (Receive 100%, Typ)
Input Current (Transmitter On 100%, Typ)
Power Consumption (Receive 100%, Typ)
Power Consumption (Transmitter On 100%, Typ)
Power Consumption (Network Operation 2.5%, Typ)
Surge
Mechanical
Enclosure
Weight
Size
FCC Certification
General Certification
EXHIBIT "A"
Page 1 of 3
902 - 928 MHz
Frequency Hopping
Pseudo Random, Asynchronous
162
160 kHz
100 kbps
+30d6m (1 Watt) Maximum
+3 d8i
Gaussian two -level FSK
5 V/m
.000036 mW / square cm
-40 to + 60 C
-60 to + 80 C
.5 in. Double Amplitude
1.5 g
40 g ,11 ms .Half Sine
90% RH Non Condensing @ 60 C
Per ASTM B117-85, for 5 days
In Shipping Container per
ASTM D999-75
4'Mr rainfall @ 70 MPH Per
Mil Std 810E, Method 506.1-1
120 - 230 VAC nominal
55 ma Average
105 ma Average
6.6 VA Average
12.6 VA Average
6.7 VA Average
6kV @ 500A and 6kV @ 1.2J50 us
Die Cast Aluminum
5.65 Lb.
11.82"W x 9.30"D x 6.57"H
FCC Part 15
EXHIBIT "All
DESCRIMON OF D•
W
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EXHIBIT "A"
Page 2 of 3
lbictricota I�
930 IIaivasitp. Ave.
Los Crites, CA 9M30
Poletop Radio
Mounting
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EXHIBIT "A"
Page 3 of 3
EXHIBIT B
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EXHIBIT "C"
Page 1 of 1
.S P []li e-
EXHIBIT D
EXHIBIT D
[FORM OF SURETY BOND]
Bond Number: J73 /
SURETY BOND
KNOW ALL MEN BY THESE PRESENTS.
That METMCOM, INC. as Principal, and
incorporated under the laws of the State of PC�t vani�t. n o��
execute bonds and undertakings as sole sure and authorize to
l`.i'ni cF �ZYnon � ty, are held and firmly bound unto
as Obligee, in the sum of 0 1 oCDC). ie�lha�,d 1�i(�,•j
($ IO,o,
Q�.OI� 1; for the payment thereof, well truly to be made, said Principal and
Surety bind themselves, their administrators, successors and assigns, jointly and
severally, firmly by these presents.
The condition of the foregoing obligation is such that
WHEREAS, the above bounden principal is about to enter into a certain agreement with
the Obligee for the following: the
award of which said agreement was made to the Principal by the Obligee, on
NOW THEREFORE, if the Principal shall well, truly and faithfully perform its
duties, all the undertakings, covenants, terms, conditions, and provisions of said
agreement during the original term thereof, and any extensions thereof which may be
granted by the Obligee, with or without notice to the Surety, and if he shall satisfy all
claims and demands incurred under such agreement, and shall fully indenunifyf and
save harmless the Obligee from all costs and damages which it may suffer. by reason of
failure to do so, and shall reimburse and repay the Obligee all outlay and expenses
which the Obligee may incur in making good any default, then this obligation shall be
void; otherwise to remain in full force and effect.
PROVIDED, FURTHER, that the said Surety, for value received, hereby
stipulates and agrees that no change, extension of time, alteration or addition to the
terms of the agreement or to the work to be performed thereunder or the specifications
accompanying the same shall in any way affect its obligation on this bond, and it does
hereby waive notice of any such change, extension of time, alteration or addition to the
terms of the agreement or to the work or to the specifications.
EXHIBIT "n" EXHIBIT D
Page 1 of 2
EXHIBIT E
EXHIBIT E
INSURANCE SCHEDULE (FRANCHISEE)
The Franchisee shall. provide proof of insurance, including a standard
certificate of insurance, in at least the following amounts and coverage
(combined single limit permitted):
I. 9—overacre and Limits
Bodily Iniury Property Damage
Iazards Each Person Each Accident Each Accident
Automobile Liability
Owned Automobiles $ 500,0o0 $1,000-,000 $ 500,000
Hired Automobiles $ 500,000 $1,000,000 $ 500,000
Non -Owned Automobiles $ 500 000 $1 000 000 $ 500 000
Workersm ' Coensation $ Statutory
o e s' Liability $1 000 000 per emplover
II. General Liability
Premises Operations
Elevators
1
$1,000,000 $2,000,o00
$1,000,000
(if applicable)
Independent
$1,000,000 $2,000,000
$1,000,000
Contractors
Products - Completed
$1,000,000 $2,000,000
$1,000,000
Operations $1,000,000 $2,000,000
Contract Liability
$1,000,000
Umbrella Liabilitv
1 000 000 $2,000,000
$1,000,000 1 000,000
44,1. 000 000
1 000 000
a. The general liability policy shall contain the following coverage which
shall be noted on or attached to the standard
certificate
of insurance:
1. An endorsement
employees as additional
naming the City of Vernon,
insureds
its officers, and
2. An endorsement
notice
under the policy.
providing the City of Vernon thirty (30) days
of cancellation or material reduction of coverage.
3. An endorsement providing covers e f
Agreement. g or a 1 operations under this
4. Such other endorsement as may be reasonably required by addendum
hereto.
b. In addition to the standard certificate of insurance, proof of general
and umbrella liability coverage shall be furnished in the form checked
below. Certification of the followin roofs b the insurance a ent or
broker will not be accepted:
X For each policy, a notarized letter from the underwriter or
carrier certifying that the coverage and statements in the
standard certificate of insurance (attached thereto) are true and
correct and that the signature is an officer authorized to so
certify.
A copy of each policy certified by an officer of the underwriter
or carrier and notarized.
E - 1 EXHIBIT E
EXHIBIT F
EXHIBIT F
ACCEPTANCE OF FRANCHISE
[company letterhead]
[date]
TO: Honorable Mayor and
Council Members of the
City of Vernon
Re: Acceptance of Franchise Granted by Ordinance No.
Dear Sirs:
Metricom, Inc., a corporation organized and existing under
the laws of the State of Delaware, accepts the grant by the City
of Vernon of a franchise entitling Metricom to attach, install,
maintain and operate equipment for a wireless digital
communications network at various locations in the public
streets, alleys and rights -of -way in the City of Vernon, as
specified in Ordinance No. Metricom, Inc. agrees to and
accepts all the terms and conditions of the franchise, and waives
any objections to the reasonableness or legality of any of the
franchise provisions or the legal right or authority of the City
of Vernon to impose them.
ATTEST:
By:
Title:
METRICOM, INC., a Delaware
Corporation
By:
Title:
F - 1 EXHIBIT F
t
;
PROVIDED, HOWEVEI., this bond is issued subject to the following express conditions:
1. This bond shall be deemed continuous in form and shall remain in full force and
effect until canceled under Section after which all liability ceases except as
to any liability incurred or accrued prior to the date of such cancellation.
2. The aggregate liability of the Surety hereunder on all claims whatsoever shall not
exceed the penal sum of this bond in any event.
3. The surety reserves the right to withdraw as surety from this bond, except as to
any liability incurred or accrued, and may do so upon giving the Obligee sixty
(60) days written notice.
SIGNED AND SEALED this day of 19
PRINCIPAL
Title:
SURETY
(Type Company Name)
By:
Title:
Address:
Telephone:
(Affix Corporate Seals)
(Attach Acknowledgments of both Principal and Surety signatures)
EXHIBIT "D"
Page 2 of 2
SUPPORTING
DOCUMENTS
OFFICE OF THE CITY ADMINISTRATOR/CITY CLERK
INTER -OFFICE MEMORANDUM
DATE: December 11, 2000
TO: Kevin Wilson, Director of Community Services & Water
Carol Dacey, Customer Services
& Information System Manager
FROM: Gloria J.P__Vgto, Chief Deputy City Clerk
RE: Metricom, Inc.
Transmitted,herewith is a copy of the Acceptance of Franchise from
Metricom, Inc. which was required by Ordinance No. 1065. Also
attached is a copy of their list of poles they have attached
equipment to which they have provided to us.
The originals are being retained in this office for our files.
Thank you.
GJO/mt
Acceptance of Franchise
To: Honorable Mayor and Council Members of the City of Vernon
Re: Acceptance of Franchise Granted by Ordinance No. 1065
Dear Sirs:
Metricom, Inc., a corporation organized and existing under the laws of the state of
Delaware, accepts the grant by the City of Vernon of a franchise entitling Metricom, Inc. to attach,
install, maintain and operate equipment for a wireless digital communications network at various
locations in the public streets, alleys and rights -of -way in the City of Vernon, as specified in
Ordinance 1065. Metricom, Inc. agrees to and accepts all of the terms and conditions of the
franchise, and waives any objections to the reasonableness or legality of any of the franchise
provisions or the legal right or authority of the City of Vernon to impose them.
METRICOM, INC., a Delaware Corporation
-1)
rZ
By:
ick Au
Vice President, Corporation Operations
DEC-11-2000 MON 03:40 PM METRICOM FAX NO. 5629887790 P. 02
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CITY COUNCIL
LEONIS C. MALBURG
Mayor
THOMAS A. YBARRA
Mayor Pro-Tem
WM. 'BILL" DAVIS
Councilman
H. "LARRY" GONZALES
Councilman
W. MICHAEL MCCORMICK
Councilman
BRUCE V. MALKENHORST
City Administrator / City Clerk
FAX (323) 581-7924
CITY HALL
4305 SANTA FE AVENUE, VERNON, CALIFORNIA 90058
TELEPHONE (323) 583-8811
June 6, 2000
Ms. Heidi Sargent
Metricom, Inc.
1460 E. 33rd Street
Signal Hill, CA 90807
Re: Ordinance No. 1065
Dear Ms. Sargent:
EDUARDO OLIVO
City Attorney
FAX: (562) 927-8722
KEVIN WILSON
Director of Community Services & Water
FAX: (323) 588-2761
KENNETH J. DeDARIO
Director of Municipal Utilities
FAX: (323) 583-1983
DAVE TELFORD
Fire Chief
FAX: (323) 581-1385
BRUCE W. OLSON
Police Chief
FAX: (323) 583-5236
This letter is a follow up and a reminder that this office is
still waiting to receive the following items:
• Surety Bond in the amount of $10,000 as outlined in Section
8.3 of said ordinance
• Written acceptance of Franchise as outlined in Section 13.10
of said ordinance (was due no later than 30 days from the
effective date, August 29, 1999, of this ordinance as
specified in Exhibit "F").
Your prompt assistance to this matter would be greatly
appreciated.
Very,my yours,
Glor' J. Oros
Chief Deputy it Clerk
GJO:rcm
cc: Richard A. Bartoccini
Kevin Wilson
Joan Francone
Legal Dept.
6
40
OV.
ricochet'
Metricom
980 University Ave.
Los Gatos, CA 95030
May 31, 2000
RE: Surety Bond # 2.3?1 3
Dear Sirs,
Enclosed please find the fully executed bond for franchise agreement between Metricom
and the c, %-" Q � V e-y- nu-0 . Please let me know
if I can be of any further assistance.
Sincerely,
Lisa Richardson
Contracts Assistant - Right of Way
408-388-8227
Metricom, Inc., 980 University Avenue, Los Gatos, CA 95032, Phone.408.399.8200, Fax.408.354.1024
[EXHIBIT D]
[FORM OF SURETY BOND]
Bond Number:237731
SURETY BOND
KNOW ALL MEN BY THESE PRESENTS:
That METRICOM, INC. as Principal, and The Insurance Company of the
State of Pennsylvania, incorporated under the laws of the State of Pennsylvania, and
authorized to execute bonds and undertakings as sole surety, are held and firmly bound
unto CITY OF VERNON, as Obligee, in the sum of TEN THOUSAND AND NO/100
($10,000.00) DOLLARS; for the payment thereof, well truly to be made, said Principal
and Surety bind themselves, their administrators, successors and assigns, jointly and
severally, firmly by these presents.
The condition of the foregoing obligation is such that:
WHEREAS, the above bounden Principal is about to enter into a certain agreement with
the Obligee for the following: To secure the faithful performance by Metricom of all of
the work, construction, installation and removals required to be performed by Metricom
under Ordinance No. 1065 within the time periods set forth hereunder, the award of
which said agreement was made to the Principal by the Obligee, on
NOW THEREFORE, if the Principal shall well, truly and faithfully perform its
duties, all the undertakings, covenants, terms, conditions, and provisions of said
agreement during the original term thereof, and any extensions thereof which may be
granted by the Obligee, with or without notice to the Surety, and if he shall satisfy all
claims and demands incurred under such agreement, and shall fully indemnify and save
harmless the Obligee from all costs and damages which it may suffer by reason of failure
to do so, and shall reimburse and repay the Obligee all outlay and expenses which the
Obligee may incur in making good any default, then this obligation shall be void;
otherwise to remain in full force and effect.
PROVIDED, FURTHER, that the said Surety, for value received, hereby
stipulates and agrees that no change, extension of time, alteration or addition to the terms
of the agreement or to the work to be performed thereunder or the specifications
accompanying the same shall in any way affect its obligation on this bond, and it does
hereby waive notice of any such change, extension of time, alteration or addition to the
terms of the agreement to the work or to the specifications.
PROVIDED, HOWEVER, this bond is issued subject to the following express
conditions:
1. This bond shall be deemed continuous in form and shall remain in full force and
effect until canceled under Section 11, after which all liability ceases except as to
any liability incurred or accrued prior to the date of such cancellation.
2. The aggregate liability of the Surety hereunder on all claims whatsoever shall not
exceed the penal sum of this bond in any event.
3. The Surety reserves the right to withdraw as surety from this bond, except as to
any liability incurred or accrued, and may do so upon giving the Obligee
THIRTY (30) days written notice.
SIGNED AND SEALED this I" day of JUNE, 2000.
PRINCIPAL
METRICOM, INC.
SURETY
Address: Two Rincon Center
121 Spear Street
San Francisco, CA 94105
(415) 836-2979
(Affix Corporate Seals)
(Attach Acknowledgements of both Principal and Surety Signatures)
Metricom Bond Form
H/surety/metricom/bondform
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California }
}
County of Santa Clara }
On June 4, 2000, before me, Anthony E. Rodriguez, Notary Public, personally appeared
Dick Au , personally known to me to be the person whose name is subscribed to the
within instrument and acknowledged to me that he executed the same in his authorized
capacity and that by his signature on the instrument the person, or the entity upon behalf
of which the person acted, executed the instrument.
�s WITNESS my hand and official seal
Place Notary Seal Above / Signature of Public
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document and could
prevent fraudulent removal and reattachment to another document
Description of Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above:
Capacity (ies) Claimed by Signei
Signer's Name:
❑
Individual
❑
Corporate Officer
❑
Partner - ❑ Limited
❑
Attorney in Fact
❑
Trustee
❑
Guardian or Conservator
❑
Other:
Signer is Representing:
❑ General
Number of Pages:
California All Purpose Acknowledgment
State of California
County of
San Mateo
On June 1, 2000
Date
before me, Erin Bautista, Notary Public
Name & Title of Officer/Notary
personally appeared Jeff Prevost
Names(s) of Signers(s)
personally known to me, evielet to be the
person(s) whose names) is/aye subscribed to the within instrument and acknowledged to me
that he/sheAhey executed the same in hisiheFAhei; authorized capacity(ies , and that by
hisi"�ir signatures) on the instrument the persons , or the entity upon behalf of which the
personal acted, executed the instrument.
WITNESS my hand and official seal.
Notary Public
ERIN BAI STA
Commission # 1181074 =
..� Notary Public - Califomia >
Z San Mateo CZ2'5,2j002
y
My Comm. Expires
OPTIONAL
(The information below is not required by law)
Description of Attached Document
Title/type of Document
Date of Document
Other Signer(s)
h:\docs\surety\forms\notary.doc
No. of Pages
The Insurance Company of the State of Pennsylvania POWER OF ATTORNEY
Principal Bond Office: 70 Pine Street, New York, N.Y. 10270
No.05-B-53217
KNOW ALL I\ EN BY THESE PRESENTS:
That The Insurance Company of the State of Pennsylvania, a Pennsylvania corporation, does hereby appoint
---Mark Roppo, Katherine G. Zerounian, Erin Bautista,.leff Prevost, James B. Shea, Jason Jenkins: of Belmont, California ---
its true and lawful Attorney(s)-in-Fact, with full authority to execute on its behalf bonds, undertakings, recognizanees and other contracts
of indemnity and writings obligatory in the nature thereof, issued in the course of its business, and to bind the company thereby.
IN WITNESS 'WHEREOF, The Insurance Company of the State of Pennsylvania has executed these presents
this 25th day of April, 2000.
j
�IawreneCarlstrom, Vice President
STATE OF NEW YORK I
COUNTY OF NENW YORKIss.
],. A
On this 25th day of April, 2000 before me came the above I�L�' h
named officer of The Insurance Company of the State of
Pennsylvania, to me personally known to be the individual and 6MMMIAAr4TA
officer described herein, and acknowledged that he executed the Notary PW)k of Plate
foregoing instrument and affixed the seal of said corporation No. 02TA60366&3
thereto by authority of his office. Con 4uW fod In Bronx County
�+ Expires Feb. 14, 2OC2
CERTIFICATE
Excerpts of Resolution adopted by the Board of Directors of The Insurance Company of the State of Pennsylvania, on May IS, 1976:
"RESOLVED, that the Chairman of the Board, the President, or any Vice President be, and hereby is, authorized to appoint Attorneys -in -Fact to
represent and act for and on behalf of the Company to execute bonds, undertakings, recognizanees and other contracts of indemnity and writings
obligatory in the nature thereof, and to attach thereto the corporate seal of the Company, in the transaction of its surety business;
"RESOLVED, that the signatures and attestations of such officers and the seal of the Company may be affixed to any such Power of Attorney or to any
certificate relating thereto by facsimile, and any such Power of Attorney or certificate bearing such facsimile signatures or facsimile seat shall be valid
and binding upon the Company when so affixed with respect to any bond, undertaking, recognizance or other contract of indemnity or writing
obligatory in the nature thereof;
"RESOLVED, that any such Attorney -in -Fact delivering a secretarial certification that the foregoing resolutions still be in effect may insert in such
certification the date thereof, said date to be not later than the date of delivery thereof by such Attorney -in -Fact."
I, Elizabeth M. Tuck, Secretary of The Insurance Company of the State of Pennsylvania, do hereby certify that the foregoing excerpts of Resolution
adopted by the Board of Directors of this corporation, and the Powcr of Attorney issued pursuant thereto, are true and correct, and that both the
Resolution and the Power of Attorney are in full force and effect.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed the facsimile seal of the corporation
this 'St day of June 2000
j Elizabeth M. Tuck, Secretary
2323S (4/99)
7
March 21, 2000
TO: Gloria Orosco, Chief Deputy City Clerk
FROM: '6-J Bill Wilson, Community Services
SUBJECT: ORDINANCE No. 1065
I have had several phone conversations with Richard Bartoccini of
Metricom, in which I have been unsuccessful in getting Metricom to supply
the City with a surety bond so that we may release Ordinance 1065.
SKW:ps
C:\My Documents\MEM0S\BMW2g1oria.doc
AFFIDAVIT OF POSTING
STATE OF CALIFORNIA )
COUNTY OF LOS ANGELES ) ss
CITY OF VERNON )
I, Gloria, J. Orosco, Chief Deputy City Clerk of the
City of Vernon, do hereby certify that on the 1st day of July,
1999, I did have posted three (3) copies of:
ORDINANCE NO. 1065 - An Ordinance of the City
Council of the City of Vernon Granting a Non -
Exclusive Franchise to Metricom, Inc., to
Attach, Install, Maintain and Operate
Equipment for a Wireless Digital
Communications Radio Network at Various
Locations in the Public Streets, Alleys, and
Rights -of -Way in the City of Vernon.
One in each of the following places, to wit: at the
northwest corner of 381h Street and Santa Fe Avenue; the
northeast corner of Leonis Blvd., and Pacific Blvd.; and on the
bulletin board in the Lobby of the City Hall of the City of
Vernon, located at 4305 Santa Fe Avenue, all in said City, there
being no newspaper of general circulation printed and published
in the City of Vernon.
Subscribed and sworn to before
oria J. 0 sco me this of �.��y 1999
Chief Deput City Clerk
Date:
Notary Public iA and for the
County of Los Angeles, State of
California
SHARON L JOHNSON
Commission # 1225459
Notary Public - Califomia
Z Los Angeles County
ray Comm. BOres Jun 21, 2003
,M
Woodruff -Sawyer & Co.
••• an Assurex Partner
May 7, 1999
Ms. Joan Francone
City of Vernon
4305 Santa Fe Avenue
Vernon, CA 90058
Re: Lease Agreement with Metricom, Inc.
Certified Copy of Workers Compensation Policy
St. Paul Fire & Marine Insurance Company #WVA9401217
Dear Ms. Francone:
In accordance with Exhibit E of the Lease Agreement with Metricom, Inc., enclosed please find a certified copy of the
worker compensation policy as issued to the named insured for the term September 30, 1998 to September 30, 1999.
Should you have any questions as respects the enclosed, please do not hesitate to call.
Regards,
j
Sharon Davis
encl.
cc: N. Luker, Metricom, Inc.
Insurance Brokers Risk Management Employee Benefits Consultants
220 Bush St., 7th Floor, San Francisco, CA 94104-3509 License No, 0329598 Telephone 415.391,2141 Fax 415.989.9923
CHUBB GROUP OF INSURANCE COMPANIES
UZ
May 11, 1999
City Clerk
City of Vernon
4305 Santa Fe Avenue
Vernon, CA 90058
Re: InNurarlce for Metricom, Inc. (City of Vernon as Additional Insured)
Policy Number(s): 3529-19-48
7316-45-41
7907-23-75
Policy Term: September 30, 1998 - September 30; 1999
Named Insured: Metricom. Inc.
City Clerk:
1 hereby certify that the certificate of insurance attached hereto and made a part hereof by
reference truly and accurately represents the above cited insurance policies and the
insurance coverage of each for the named insured issued by Federal Insurance
Compga.
The City of Vernon, its officers, and employees are included in said policies as additional
insureds as respects Metricom's liability arising out of the work or lease of property
owned by the city. The City of Vernon will be provided with thirty (30) days written
notice of cancellation or material reduction of coverage.
I certify that I am an officer of the insruance carrier named herein and that I am
authorized to sign this certificate on behalf of said insurance carrier.
Sybil Baffoe '
Assistant Vice President
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of
CALIFORNIA
County of SAN FRANCISCO
On May 11, 1999 before me, LORNA E. DECLINES NOTARY PUBLIC
Date Name and Title of Officer (e.g., "Jane Doe, Notary Public")
personally appeared Sybil Baffoe
Name(s) of Signer(s)
Upersonally known to me - OR - ❑ proved to me on the basis of satisfactory evidence to be the person
whose name(s) isA=subscribed to the within instrument
and acknowledged to me that hehdtslti=Aexecuted the
same in his/booftsa authorized capacity(is* and that by
_ his/' : 1u 1 r signature*# on the instrument the person($),
LORNA E. DECLINES or the entity upon behalf of which the person(s) acted,
o COMM. #1212148 executed the instrument.
L ' f>s NOTARY PUBLIC-CALIFORNIA
SAN FRANCISCO COUNTY WITNESS my hand and official seal.
Alp Comm. Expires Mar. 29. 2003
Signature of Notary Public
OPTIONAL
Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent removal and reattachment of this form to another document.
Description of Attached Document
Title or Type of Document:
Certificate of Insurance
Document Date: May 11, 1999
Signer(s) Other Than Named Above:
Capacity(ies) Claimed by Signer(s)
Signer's Name:
In Individual
Corporate Officer
Title(s): Assistant Vice -President
❑ Partner — ❑ Limited ❑ General
❑ Attorney -in -Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other: Top of thumb here
Signer Is Representing:
Signer's Name:
70
Number of Pages: 1
Individual
Corporate Officer
Title(s):
Partner — ❑ Limited ❑ General
Attorney -in -Fact
Trustee
Guardian or Conservator
Other:
Signer Is Representing:
RIGHT THUMBPRINT
OF SIGN. R .. of here
® 1994 National Notary Association • 8236 Remmet Ave., P.O. Box 7184 • Canoga Park, CA 91309-7184 Prod. No. 5907 Reorder. Call Toll -Free 1-800.876-6827
MEMORANDUM
TO: Bill Wilson, Engineering Aide
FROM: Joan Francone, Risk Manager Ir
DATE: June 1, 1999
SUBJECT: ORDINANCE NO.1065 - METRICOM, INC.
This is to advise you that the above referenced contractor has provided acceptable
insurance coverage.
Please contact me if you have any questions.
JF/ca
Enclosures
` ACORDCERTIFICATE OF
INSURANCE DATE
'LIABILITY
OS26/M 99
/26/ 9
PRODUCER WSSF
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Woodruff -Sawyer & Co.
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
220 Bush Street, 7th Floor
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
San Francisco,CA 94104-0000
COMPANIES AFFORDING COVERAGE
415-391-2141
COMPANY
A Chubb/Vigilant Insurance Co.
INSURED 007815
COMPANY
Metricom, Inc.
B Chubb/Federal Insurance Co.
COMPANY
980 University Avenue
Los Gatos , CA 95032-2375
C St. Paul Fire & Marine Insurance Co.
COMPANY
D REVISED CERTIFICATE OF INSURANCE
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM
OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LT
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/DD/YY)
POLICY EXPIRATION
DATE (MM/DD/YY)
LIMITS
GENERAL
LIABILITY
GENERAL AGGREGATE
$ 1,000,000
COMMERCIAL GENERAL LIABILITY
T
PRODUCTS - COMP/OP AGG
$ 1,000,000
A
CLAIMS MADE F� OCCUR
35291948
09/30/98
09/30/99
PERSONAL & ADV INJURY
$ 1,000,000
EACH OCCURRENCE
$ 1,000,000
OWNER'S & CONTRACTOR'S PROT
77
FIRE DAMAGE (Any one fire)
$ 1,000,000
Ll
MED EXP (Any one person)
$ 10,000
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
$ 1,000,000
❑
ALL OWNED AUTOS
g
JLJ
SCHEDULED AUTOS
73164541
09/30/98
09/30/99
BODILY INJURY
(Per person)
$
❑✓
HIRED AUTOS
BODILY INJURY
$
❑✓
NON -OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN AUTO ONLY:
ANY AUTO
❑
EACH ACCIDENT
$
❑
AGGREGATE
$
EXCESS LIABILITY
EACH OCCURRENCE
$ 2,000,000
B
`�, UMBRELLA FORM
79072375
09/30/98
09/30/99
AGGREGATE
$ 2,000,000
$
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
,/ WC STATU- OTH
TORY LIMITS ER
EMPLOYERS' LIABILITY
EL EACH ACCIDENT
$ 1,000,000
C
THE PROPRIETOR/ INCL
W VA9401217
09/30/98
09/30/99
EL DISEASE - POLICY LIMIT
$ 11000,000
PARTNERS/EXECUTIVE
EL DISEASE - EA EMPLOYEE
$ 1,000,000
OFFICERS ARE: EXCL
OTHER
jt)
�+
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
The City of Vernon, its officers, agents & employees are additional
insureds as respects the lease agrmt. & Right of Way Agrmt. per Ordinance
41065 and work performed by Metricom, Inc.per Form 40020004 .This ins. is primary & non-contributory.
CERTIFICATE HOLDER
CANCELLATION 10 Day Notice For Non -Payment of Premium
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Vernon
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL IXXXXXXNMAIL
Attn: City Administrator/City Clerk
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
4305 Santa Fe Avenue
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX)
Vernon , CA 90058-0805
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX3
AUTHORIZEDREPRESENTATIVE
ACORD 25-S (1/96)
0 ACORD CORPORATION 1988 '
cm -BB & SON
#40-02-0004
Commercial Insurance
Coverage
Amendment effect+:ve 09/30/98
WHO IS INSURED: THE WHO IS .INSURED PROVISION IS AMENDED TO INCLUDE
AS AN ADDITIONAL INSURED THE PERSON OR ORGANIZATION DESIGNATED
BELOW, INCLUDING E ECTEn OR APPOINTED MEMBERS, OFFICERS AND EMPLOYEES,
BUT ONLY -WITH RESPECT TO THE COMMERCIAL GENERAL LIABILITY PROVIDED
BY THIS POLICY AND ARISING OUT OF THE OPERATIONS OF THE NAMED INSURED
IN CONNECTION WITH THE ACRE=11ENT FOR WORK PERFORMED BETWEEN THE
NAMED INSURED AND THE PERSON OR ORGANIZATION DESIGNATED BELOW.
IT IS FURTHER ACRE=D. THIS INSURANCE IS PRIMARY OVER ANY OTHER
COLLECTI_L= INSURANCE ONLY AS RESPECTS THE OPERATION OF THE NAMED
INSURED.
ANY MUNICIPALITY RE:;UIRED TO BE NAMED BY ANY CONTRACT OR AGREEMENT,
PROVIDED SUCH CONTRACT OR AGREEMENT I5 EXECUTED PRIOR TO ANY LOSS,
AND ONLY AS RESPECTS CPERAT:rNS OF OR ON BEHALF OF THE NAMED INSURED.
j tze_ terms and conditions rey.ain u-cha.n.g'
Au-"w v' am d F:.su.Ted: METR I COM , INC.
j ry Nr rrber: 3!!29 19 4e
F-od::cer: WOODRUFF -SAWYER Co.
SAN FSRANCIcCO CA —
/E=C
K]
OFFICE OF THE CITY ADMINISTRATOR/
CITY CLERK
INTER -OFFICE MEMORANDUM
DATE: September 1, 1999
TO: Kevin Wilson, Dire or of Community Services
FROM: Gloria J. Orosco, Deputy City Clerk
RE: Ordinance No. 1065 - Performance Bond
JUST A REMINDER!
With reference to Ordinance No. 1065, which was approved by City
Council on June 29, 1999, this office is still holding a fully
executed duplicate original that was to be sent to Metricom upon
receipt of their Surety Bond in the amount of $10,000 as
indicated in Section 8.3 of said ordinance which also reads that
"Prior to commencement of any work under this Franchise, Metricom
shall furnish or cause to be furnished to City..."
Would you please follow up with Metricom as to the status of the
Surety Bond.
Thank you.
Gloria
OFFICE OF THE CITY ADMINISTRATOR/
CITY CLERK
INTER -OFFICE MEMORANDUM
DATE: July 12, 1999
TO: Kevin Wilson, Director of Community Services & Water
FROM: Gloria J. Oro „ Chief Deputy City Clerk
RE: Ordinance No. 1065 - Performance Bond
The above referenced Ordinance was read for a second and final
reading on June 29, 1999 and is now fully executed. However, as
outlined in Section 8.3 of said ordinance, I am still waiting to
receive the Surety Bond from Metricom, prior to my sending them
their fully executed original of said Ordinance.
MEMORANDUM -
TO: Kevin Wilson, Director of Community Services & Water
FROM: Joan Francone, Risk Manager/Personnel Assistant
DATE: June 21, 2000
SUBJECT: METRICOM LICENSE AGREEMENT
The Surety Bond provided by Metricom as required in Ordinance No. 1065 is
acceptable to the City.
JF/ca
c: Gloria Orosco
(6 ,
Writer's Local Address: 214 Rennie Avenue
Venice, CA 90291
Office: 310-450-8975
Fax: 310-450-8976
Cell: 310-989-5235
E-mail: bart@Metricom.com
FT� 1GIGO E,-ist 33r(1 Stroet
W j) Metricom Signal Hill, CA 90807
June 17,1999 R, 7__``r'"�✓1Fryb
Mr. Kevin Wilson, PE 'JUN 2 1 1999
Director of Community Services
City of Vernon GCi71{7iutiirc�;;.
Vernon, CA 90058
RE: Finalizing the Approved Agreement and Closing the File
Dear Kevin:
Thank you for your assistance in having our agreement approved by Council. Once the Ordinance is attested
to please send an executed original to:
Ms. Heidi Sargent
Metricom, Inc.
1460 E. 33rd Street
Signal Hill, CA 90807
_ 562-988-0039
Once the City has itemized it's expenses associated with the processing of this application in accordance with
Section 6.5 of the Ordinance, please remit the invoice to Heidi Sargent.
Finally, there are several items required by Metricom in order for me to close out the file and transfer it to the
Property Management/Deployment Team:
1. Maps (paper copies or electronic copies) showing the locations of city owned streetlights. If the City does
not have the time or ability to copy paper maps, please call a bonded duplication service to come, pick up,
copy and ship to Metricom the required maps. The maps should be sent to me at my local address. The
company we use and have an account with is Continental Graphics, 800-826-8630. Our Account Number
is: 050281.
2. A blank copy of an encroachment permit and fee schedule and business license application.. Pleaes send
directly to me at my local address.
3. A copy of the Agenda and staff report.
Kevin, thanks again for your help. With the above information in the file, the installation of the radios should go
very smoothly.
Sincerely, �2
Richard A. Bartoccini
Right -of -Way Representative
Visit our websites: www.ricochet.net or www.metricom.com
�e�e�hone: F4X:
h 01) 3O !)6'')") i i Vr t
TheMaul
Insurer:
ST. PAUL FIRE AND MARINE INS CO
385 WASHINGTON ST
ST. PAUL MN 55102
NCCI COMPANY NO. 13706
NJERN
INFORMATION PAGE
WORKERS COMPENSATION AND
EMPLOYERS LIABILITY INSURANCE
POLICY
POLICY NUMBER from POLICY PERIOD to .PREV.COVERAGE AGENCY A/C MO
f-WVA9401217 09/30/98 09/30/99 WVA9400567 0461042 09/98
NAMED INSURED AND ADDRESS AGENT
ITEM 1.
METRICOM INC WOODRUFF-SAWYER/WC
980 UNIVERSITY AVENUE 220 BUSH ST RM 750
LOS GATOS CA 95030 SAN FRANCISCO CA 94104
FEIN 770294597 Risk I.D. No. 2590375F
INSURED IS CORPORATION
OTHER WORKPLACES NOT SHOWN ABOVE: SEE EXTENSION OF INFORMATION PAGE
ITEM 2. POLICY PERIOD: FROM 09/30/98 TO 09/30/99
1 2:01 AM STANDARD TIME AT THE INSURED'S MAILING ADDRESS.
ITEM 3. A. WORKERS COMPENSATION INSURANCE: PART ONE OF THE POLICY APPLIES TO THE WORKERS
COMPENSATION LAW OF THE STATES LISTED HERE:
AZ,CA,CO,DC,GA,IL,MA,NY,PA,TX,VA
B. EMPLOYERS LIABILITY INSURANCE: PART TWO OF THE POLICY APPLIES TO WORK
IN EACH STATE LISTED IN ITEM 3.A. THE LIMITS OF OUR LIABILITY UNDER PART TWO ARE:
BODILY INJURY BY ACCIDENT $1 , 000 , 000 EACH ACCIDENT
BODILY INJURY BY DISEASE $1 , 000 , 000 POLICY LIMIT
BODILY INJURY BY DISEASE $1 , 000, 000 EACH EMPLOYEE
C. OTHER STATES INSURANCE: PART THREE OF THE POLICY APPLIES TO THE STATES LISTED HERE: ALL
STATES EXCEPT THOSE DESIGNATED IN ITEM 3.A ABOVE, AND NV,ND,OH,WA,WV,WY.
D. THIS POLICY INCLUDES THESE ENDORSEMENTS AND SCHEDULES:
SEE EXTENSION OF INFORMATION PAGE FORMING PART OF THIS POLICY.
ITEM 4. THE PREMIUM FOR THIS POLICY WILL BE DETERMINED BY OUR MANUALS OF RULES, CLASSIFICATIONS,
RATES, AND RATING PLANS. ALL INFORMATION REQUIRED BELOW IS SUBJECT TO VERIFICATION AND
CHANGE BY AUDIT.
CLASSIFICATION OF OPERATIONS PRM-BASIS RATE EST
ST LOC CODE TYP TOT -EST PER $100 ANNUAL
NO RSK ANN-REMUN REMUN PREMIUM
SEE EXTENSION OF INFORMATION PAGE
MINIMUM PREMIUM $752 TOTAL ESTIMATED COST
DEPOSIT
PREMIUM ADJUSTMENTS DUE TO AUDIT WILL BE MADE UPON POLICY EXPIRATION
COUNTERSIGNED THIS DAY OF
OFFICE:
NORTHERN CALIFORNIA
#2 EMBARCADERO CENTER
SUITE 1300
SAN FRANCISCO CA 94111
415-732-1540
WC 00 00 01 A
M
AUTHORIZED REPRESENTATIVE
This is a true and cer ified copy of the
original policy is the term indicated
above.
Signed By & Date
ISSUE DATE 10/06/98
3139 Rev. 1-89 Printed in U.S.A. Copyright 1987 National Council on
Compensation Insurance.
TheStPhill
Insurer:
ST. PAUL FIRE AND MARINE INS CO
385 WASHINGTON ST
ST. PAUL MN 55102
NCCI COMPANY NO. 13706
NJERN
WORKERS COMPENSATION AND
EMPLOYERS LIABILITY INSURANCE
POLICY
AMENDED EXTENSION OF INFORMATION PAGE
EFF. 09/30/98 SUPERSEDES ANY PREV. DECLARATIONS W/ SAME # FOR THIS POL. PERIOD
POLICY NUMBER from POLICY PERIOD to PREV.COVERAGE AGENCY A/C MO
WVA9401217 09/30/98 09/30/99 WVA9400567 0461042 09/98
NAMED INSURED AND ADDRESS AGENT
ITEM 1.
METRICOM INC WOODRUFF-SAWYER/WC
980 UNIVERSITY AVENUE 220 BUSH ST RM 750
LOS GATOS CA 95030 SAN FRANCISCO CA 94104
FEIN 770294597 Risk I.D. No. 2590375F
**ENDORSEMENT SCHEDULE** SCHEDULE
PAGE
1
STATE NUMBER DESCRIPTION EFFECTIVE
DATE
40506 Countersignature Endorsement
WC990607 Policy Change Endorsement
WC990607 Miscellaneous Endorsement
990609 General Change Endorsement
WC000106A Longshore And Harbor Workers Compensation Act Coverage
WC000311A Voluntary Compensation And Employers Liability Coverage
WC000406 Premium Discount Endorsement
WC000406A Premium Discount Endorsement
WC000414 Notification Of Change In Ownership Endorsement
WCO20601 Arizona Cancellation Endorsement
WC040101A Longshore And Harbor Workers Compensation Act Coverage
WC040301 Policy Amendatory Endorsement - California
WC040305 California Voluntary Compensation And Employers Liability
WC040310 Duty To Defend - California
WC040360 California Employers' Liability Coverage Amendatory Endt
WC040601A California Cancelation Endorsement
WC050402 Colorado Classification Endorsement
WC050403 Colorado Premium Credit For Certified Risk Management
WC080601 District Of Columbia Cancelation Endorsement
WC100601A Georgia Cancelation, Nonrenewal And Change Endorsement
WC120601B Illinois Amendatory Endorsement
WC200301 Massachusetts Limits Of Liability Endorsement
WC200302 Massachusetts - Assessment Charge
* THESE FORMS APPLY TO THE STATE OF CALIFORNIA
WC 00 00 01 A
ISSUE DATE 10/15/98
3139 Rev 1-89 Printed in U.S.A. Copyright 1987 National Council on
Compensation Insurance.
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
09/30/98
ihestphill
Named Insured: METRICOM INC Policy Number: WVA9401217
AMENDED EXTENSION OF INFORMATION PAGE
**ENDORSEMENT SCHEDULE (Cont.)**
SCHEDULE
PAGE
2
STATE
NUMBER DESCRIPTION
EFFECTIVE
DATE
WC200303A
Massachusetts Notice To Policyholder Endorsement
09/30/98
WC200401
Massachusetts Pending Premium Change Endorsement
09/30/98
WC200601
Massachusetts Cancelation Endorsement
09/30/98
WC310308
New York Limit Of Liability Endorsement
09/30/98
WC310319
New York Construction Classification Premium Adjustment
09/30/98
WC370405
Pennsylvania Merit Rating Plan Endorsement
09/30/98
WC370601
Special Pennsylvania Endorsement - Inspection Of Manuals
09/30/98
WC370602
Pennsylvania Notice
09/30/98
WC370603A
Pennsylvania Act 86-1986 Endorsement Nonrenewal, Notice
0 09/30/98
WC420301E
Texas Amendatory Endorsement
09/30/98
WC420306A
Texas Maintenance Tax Surcharge Recoupment Endorsement
09/30/98
WC450602
Virginia Amendatory Endorsement
09/30/98
WC990301
Colorado Operations Endorsement
09/30/98
WC 00 00 01 A
ISSUE DATE 10/15/98
3139 Rev 1-89 Printed in U.S.A. Copyright 1987 National Council on
Compensation Insurance.
7heStPaUl
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
99 06 09
GENERAL CHANGE ENDORSEMENT
This endorsement changes the policy to which it is attached and is effective on the date issued
unless otherwise stated.
(The following "attaching clause;' need be completed only when this endorsement is issued subsequent to preparation of the policy.)
This endorsement, effective on 09/30/98 at 12:01 A.M. standard time, forms a part of
(Date)
Policy No. WVA9401217 Endorsement No.
of the ST. PAUL FIRE AND MARINE INSURANCE COMPANY NCCI Carrier Code 13706
(Name of Insurance Company)
issued to: METRICOM INC
Policy Expiration Date: 09/30/99
Premium (if any) $
Authorized Representative
This endorsement applies only in Texas.
MULTIPLE COMPANY INFORMATION:
THE INSURER SHOWN ON THE INFORMATION PAGE IS CHANGED TO
ST. PAUL GUARDIAN INS CO
385 WASHINGTON ST
ST. PAUL MN 55102
NCCI COMPANY NUMBER 14230, FOR THE STATE(S) OF
CA
THE INSURER SHOWN ON THE INFORMATION PAGE IS CHANGED TO
ST. PAUL FIRE AND CASUALTY INS
20800 SWENSON DR, SUITE 300
WAUKESHA WI 53186
NCCI COMPANY NUMBER 21342, FOR THE STATE(S) OF
GA
THE INSURER SHOWN ON THE INFORMATION PAGE IS CHANGED TO
ST. PAUL INS CO OF ILLINOIS
500 W. MADISON ST., SUITE 2600
CHICAGO IL 606062501
NCCI COMPANY NUMBER 13463, FOR THE STATE(S) OF
IL
ISSUE DATE 10/06/98
Ed. 11-93 Printed in U.S.A.
7heStPaUl
Named Insured: METRICOM INC
Effective Date: 09/30/98
Policy Number: WVA9401217
Page 2
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
99 06 09
GENERAL CHANGE ENDORSEMENT (Cont.)
MULTIPLE COMPANY INFORMATION CONTINUED:
THE INSURER SHOWN ON THE INFORMATION PAGE IS CHANGED TO
ST. PAUL INDEMNITY INS CO
9001 WESLEYAN ROAD, SUITE 400
INDIANAPOLIS IN 462581176
NCCI COMPANY NUMBER 21350, FOR THE STATE(S) OF
PA
THE INSURER SHOWN ON THE INFORMATION PAGE IS CHANGED TO
ST. PAUL INS CO
2925 BRIARPARK, SUITE #300
HOUSTON TX 772422486
NCCI COMPANY NUMBER 12823, FOR THE STATE(S) OF
TX
THE ENTIRE NAMED INSURED FROM ITEM 1 OF YOUR WORKERS COMPENSATION POLICY
INCLUDES THE FOLLOWING:
INSURED NAME DBA
METRICOM INC
METRICOM INC, METRICOM INVESTMENTS DC
INC,METRICOM DC, LLC, & METRICOM NY,
LLC
Ed. 11-93 Printed in U.S.A.
7wStFhul
Insurer:.
ST. PAUL FIRE AND MARINE INS CO
385 WASHINGTON ST
ST. PAUL MN 55102
NCCI COMPANY NO. 13706
NJERN
WORKERS COMPENSATION AND
EMPLOYERS LIABILITY INSURANCE
POLICY
EXTENSION OF INFORMATION PAGE
POLICY NUMBER from POLICY PERIOD to PREV.COVERAGE AGENCY A/C MO
WVA9401217 09/30/98 09/30/99 WVA9400567 0461042 09/98
NAMED INSURED AND ADDRESS AGENT
ITEM 1.
METRICOM INC WOODRUFF-SAWYER/WC
980 UNIVERSITY AVENUE 220 BUSH ST RM 750
LOS GATOS CA 95030 SAN FRANCISCO CA 94104
FEIN 770294597 Risk I.D. No. 2590375F
**ADDITIONAL LOCATIONS— SCHEDULE
PAGE
1
LOCATION
ADDRESS
NUMBER
002
845 MCGLINCEY LANE
CAMPBELL CA 95008-5320
003
ROUTE 3 BOX 258
" JEFFERSON GA 30549 -
004
5-55 REPUBLIC DRIVE #200
PLANO TX 75074
005
1919 GALLOWS RD
VIENNA VA 22180
006
SIXTH AVE
..264
BROOKLYN NY 11215
007
1%r800 GREENSPOINT PARK DRIVE #240
11-'HOUSTON TX 77060
008
1410 SPRING HILL RD
MCLEAN VA 22180
009
983 UNIVERSITY AVE
,LOt GATOS CA 95032
WC 00 00 01A ISSUE DATE 10/06/98
3139 Rev 1-89 Printed in U.S.A. Copyright 1987 National Council on
Compensation Insurance.
7wStlhul
Named Insured:
METRICOM INC Policy Number:
WVA9401217
EXTENSION OF INFORMATION PAGE
—ADDITIONAL LOCATIONS (Cont.)**
SCHEDULE
PAGE
2
LOCATION
ADDRESS
NUMBER
010
1919 GALLOWS RD
VIENNA OVA 22180
O11
O IRONTON ST, UNIT H
�_4
' DENVER CO 80201
012
9-20 MADISON AVE
NORRISTOWN PA 19403 i
013
WA:LNUT BUS PARK 11041 ABLES LANE
;6ALLAS TX 75200
014
THOANDALE BUS PARK 1260 MARK ST
.BENSEN IL 60106
015
25�OLYMPIA AVE
OBURN MA 01801
016
1.MAIN ST
.WASHINGTON DC 20000
017
441 S 48TH ST
TEM-PE AZ 85281
WC 00 00 01A ISSUE DATE 10/06/98
3139 Rev 1-89 Printed in U.S.A. Copyright 1987 National Council on
Compensation Insurance.
TMeStFhul
Insurer:
ST. PAUL FIRE AND MARINE INS CO
385 WASHINGTON ST
ST. PAUL MN 55102
NCCI COMPANY NO. 13706
NJERN
WORKERS COMPENSATION AND
EMPLOYERS LIABILITY INSURANCE
POLICY
EXTENSION OF INFORMATION PAGE
POLICY NUMBER from POLICY PERIOD to PREV.COVERAGE AGENCY
WVA9401217 09/30/98 09/30/99 WVA9400567 0461042
NAMED INSURED AND ADDRESS AGENT
ITEM 1.
METRICOM INC WOODRUFF-SAWYER/WC
980 UNIVERSITY AVENUE 220 BUSH ST RM 750
LOS GATOS CA 95030 SAN FRANCISCO CA 94104
FEIN 770294597 Risk I.D. No. 2590375F
**SCHEDULE OF OPERATIONS*
ITEM 4
ST LOC CODE TYP CLASSIFICATION OF OPERATIONS
NO RSK
CA 001 3578 RADIO OR TELEVISION BROADCAST
RECEIVING EQUIPM MFG
CA 001 3578 F RADIO OR TELEVISION BROADCAST
RECEIVING EQUIP. MFG
CA 001 5128 INSTRUMENT -PROFESSIONAL OR
SCIENTIFIC -INSTALLATION,
SERVICE OR REPAIR -AWAY FROM
SHOP -NOT OFFICE MACHINES
CA 001 5128 F INSTRUMENT -PROFESSIONAL OR
SCIENTIFIC -INSTALLATION,
SERVICE OR REPAIR -AWAY FROM
SHOP -NOT OFFICE MACHINES
CA 001 8742 SALESPERSONS --OUTSIDE
CA 001 8742 F SALESPERSONS --OUTSIDE
CA 001 8810 CLERICAL OFFICE EMPLOYEES-
N.O.C.
CA 001 8810 F CLERICAL OFFICE EMPLOYEES-
N.O.C.
PRM-BASIS RATE
TOT-ESTPER$100
ANN-REMUN REMUN
1,400,663 1.54
IF ANY 2.32
105"000 2.12
IF ANY 3.19
993_,738 .93
IF ANY 1.40
7,38 , 738 .80
WC 00 00 01 A AGENT COPY
ISSUE DATE 10/06/98
IF ANY 1.20
3139 Rev 1-89 Printed in U.S.A. Copyright 1987 National Council on
Compensation Insurance.
A/C MO
09/98
SCHEDULE
PAGE
1
EST ANNUAL
PREMIUM
21,570
0
2,226
0
9,242
0
59,118
I
iheStPaVl
Named Insured: METRICOM INC Policy Number:
WVA9401217
EXTENSION OF INFORMATION PAGE
**SCHEDULE OF OPERATIONS(Cont.)**
SCHEDULE
PAGE
2
ST
LOC CODE
TYP CLASSIFICATION OF OPERATIONS PRM-BASIS
RATE
EST ANNUAL
NO
RSK TOT -EST
PER$100
PREMIUM
ANN-REMUN
REMUN
CA
9812
PREMIUM FOR INCREASED LIMITS PART TWO
.000%
0
CA
TOTAL PREMIUM SUBJECT TO THE EXP MOD
92,156
CA
9897
PREM MODIFIED 09/30/98 TO REFLECT EXP MOD OF
.7400
68,195
OTHER PREMIUM CHARGES:
CA
9887
PREMIUM CREDIT - SCHEDULE RATING PLAN
.5600
30,006-
TOTAL ESTIMATED STANDARD PREMIUM
38,189
CA
0063
PREMIUM DISCOUNT, WHEN APPLICABLE
3,723-
CA
0900
EXPENSE CONSTANT, WHEN APPLICABLE
185
TOTAL ESTIMATED PREMIUM
34,651
CA
CALIFORNIA WC ADMIN REVOLVING
.0000%
0
FUND ASSESSMENT
CA
USER FUNDING ASSESSMENT
.1994%
69
CA
FRAUD SURCHARGE
.3226%
112
TOTAL ESTIMATED COST
34,832
CALIFORNIA DEPOSIT PREMIUM
34,832
WC 00 00 01A AGENT COPY
ISSUE DATE 10/06/98
3139 Rev 1-89 Printed in U.S.A. Copyright 1987 National Council on
Compensation Insurance.
TMeStFAul
IMPORTANT NOTICE
TO ALL WORKERS COMPENSATION POLICYHOLDERS DOING
BUSINESS IN THE STATE OF CALIFORNIA
We are required by law to provide you with loss control consultative services as required by the
State of California, Department of Industrial Relations - Division of Occupational Safety and
Health, section 339.4(b), at no additional charge. The consultative services that you may request
consist of the following items:
Industrial Hygiene Sampling
OSHA Training
Emergency Preparedness
Employee Selection
Supervisor Training
Safety Audit
Driver Improvement Program
Crisis Management
Job Site Inspections
Exposure Analysis and Control
Fall Management Program
Ergonomics
Customized Training and Consulting
Behavioral Safety Program
Workers Compensation policyholders may register comments about St. Paul Companies loss
control consultative services by writing to the following:
State of California
Department of Industrial Relations
Division of Occupational Safety and Health
P.O. Box 420603
San Francisco, CA 94102
Occupational Safety and Health Act requires all employers to provide safe and healthful working
conditions for their employees. We encourage you to utilize our services to assist you in this
responsibility.
To obtain these services, please write or phone:
Loss Control Services Department
St. Paul Fire & Marine Insurance Company
385 Washington Street
Loss Control Services
St. Paul, MN 55102
Phone: 612-310-2729
DSF-WC04007A Ed. 10-97 Printed in U.S.A.
'heMbul
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
WC 04 01 01 A
LONGSHORE AND HARBOR WORKERS COMPENSATION ACT
COVERAGE ENDORSEMENT — CALIFORNIA
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.)
This endorsement, effective on 09/30/98 at 1 2:01 A.M. standard time, forms a part of Policy No. WVA9401217
Endorsement Number of the ST. PAUL FIRE AND MARINE INSURANCE COMPANY
NCCI Carrier Code 13706 Issued To METRICOM INC
Policy expiration date 09/30/99 Premium (if any)
Authorized Representative
This endorsement applies only to work subject to the Longshore and Harbor Workers Compen-
sation Act in California. The policy applies to that work as though California were listed in item
3.A of the Information Page.
General Section C. Workers Compensation Law is replaced by the following:
C. Workers Compensation Law
Workers Compensation Law means the workers or workmens compensation law and occupa-
tional disease law of each state or territory named in Item 3.A. of the Information Page and the
Longshore and Harbor Workers Compensation Act (33 USC Sections 901-950). It includes any
amendments to those laws that are in effect during the policy period. It does not include any
other federal workers or workmens compensation law, other federal occupational disease law
or the provisions of any law that provide nonoccupational disability benefits.
Part Two (Employer's Liability Insurance), C. Exclusions., exclusion 8. does not apply to work
subject to the Longshore and Harbor Workers Compensation Act.
This endorsement does not apply to work subject to the Defense Base Act, the Outer Continental
Shelf Lands Act, or the Nonappropriated Fund Instrumentalities Act.
The estimated premium for the Longshoremen's and Harbor Workers' Compensation Act coverage
provided by this endorsement is as shown in the Schedule below or item 4 of the Information Page.
Schedule
Estimated Rate per
Annual $100 of
Code No. Classification Remuneration Remuneration
3578 RADIO OR TELEVISION BROADCAST IF ANY BASIS 50.4
RECEIVING EQUIPMENT MFG
8742 SALESPERSONS OUTSIDE
8810 CLERICAL OFFICE EMPL
5128 OUTSIDE INSTALLATION
DSF-WC040101A Ed. 4-92 Printed in U.S.A.
IF ANY BASIS 50.4
IF ANY BASIS 50.4
IF ANY BASIS 50.4
Estimated
Annual
Premium
Total Estimated Annual Premium $0.00
$0.00
$0.00
$0.00
r*Stlhul
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
WC040301
POLICY AMENDATORY ENDORSEMENT — CALIFORNIA
This endorsement changes the policy to which it is attached and is effective on the date issued
unless otherwise stated.
(The following "attaching clause' need be completed only when this endorsement is issued subsequent to preparation of the policy.)
This endorsement, effective on 09/30/98 at 12:01 A.M. standard time, forms a part of
(Date)
Policy No. WVA9401217 Endorsement No.
of the ST. PAUL FIRE AND MARINE INSURANCE COMPANY NCCI Carrier Code 13706
(Name of Insurance Company)
issued to: METRICOM INC
Policy Expiration Date: 09/30/99
Premium (if any) $
Authorized Representative
It is agreed that, anything in the policy to the contrary notwithstanding, such insurance as is
afforded by this policy by reason of the designation of California in Item 3 of the information page
is subject to the following provisions:
1. Minors Illegally Employed — Not Insured. This policy does not cover liability for additional
compensation imposed on you under Section 4557, Division IV, Labor Code of the State of
California, by reason of injury to an employee under sixteen years of age and illegally
employed at the time of injury.
2. Punitive or Exemplary Damages — Uninsurable. This policy does not cover punitive or exemplary
damages where insurance of liability therefor is prohibited by law or contrary to public policy.
3. Increase in Indemnity Payment — Uninsurable. This policy does not cover an increase in indem-
nity payment as provided for in subdivision (e) of Section 4650 of the Labor Code, if the late
indemnity payment which gives rise to the increase in the amount of payment is due less than
seven (7) days after we receive the completed claim form from you. You are responsible for
the amount of increase in indemnity payments not covered under this policy and will reimburse
us for any increase in indemnity payment not covered under the policy when the aggregate
total amount of the reimbursement payments paid in a policy year exceeds one hundred dollars
($100).
Ed 1-91 Printed in U.S.A.
WC 04 03 05 (Ed. 1-85)
VOLUNTARY COMPENSATION AND EMPLOYERS LIABILITY COVERAGE
ENDORSEMENT—CALIFORNIA
This endorsement changes the policy to which it is attached and is effective on the date issued
unless otherwise stated.
(The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.)
This endorsement, effective on 09/30/98 at 12:01 A.M. standard time, forms a part of
(Date)
Policy No. WVA9401217 Endorsement No.
of the ST. PAUL FIRE AND MARINE INSURANCE COMPANY NCCI Carrier Code 13706
(Name of Insurance Company)
issued to: METRICOM INC
Policy Expiration Date: 09/30/99
Premium (if any) $ 0.00
Authorized Representative
If the employer named in item 1 of the Information Page has in his employment persons not enti-
tled to compensation under Division 4 of the Labor Code of the State of California, this policy
shall operate as an election on the part of the employer to come under the compensation
provisions of Division 4 with respect to those persons described in the Schedule below.
This policy applies to those persons described in the Schedule below as employees.
Schedule
7heStFalll
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
WC 04 03 10
DUTY TO DEFEND — CALIFORNIA
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.)
This endorsement, effective on 09/30/98 at 12:01 A.M. standard time, forms a part of Policy No. WVA9401217
Endorsement Number of the ST. PAUL FIRE AND MARINE INSURANCE COMPANY
NCCI Carrier Code 13706 Issued To METRICOM INC
Policy expiration date 09/30/99 Premium (if any)
Authorized Representative
The insurance afforded by Part One, Section C, "We Will Defend", is hereby deleted and replaced
with the following:
WE WILL DEFEND
We have the right and duty to defend at our expense any claim or proceeding against you before
the California Workers Compensation Appeals Board or its equivalent in any other state (and any
appeal of a decision therefrom) for the benefits payable by this workers compensation insurance.
We have the right to investigate and settle these claims or proceedings.
We have no duty to defend a claim, proceeding, or suit that is not covered by this insurance.
Nothing contained in this Section shall amend, modify, restrict or otherwise alter any obligations
or conditions under Part Two -Employer's Liability Insurance of the policy.
DSF-WC040310 Ed. 1-95 Printed in U.S.A.
WC 04 03 60
(Ed. 8-86)
EMPLOYER'S LIABILITY COVERAGE AMENDATORY ENDORSEMENT—
CALIFORNIA
This endorsement changes the policy to which it is attached and is effective on the date issued
unless otherwise stated.
(The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.)
This endorsement, effective on 09/30/98 at 12:01 A.M. standard time, forms a part of
(Date)
Policy No. WVA9401217 Endorsement No.
of the ST. PAUL FIRE AND MARINE INSURANCE COMPANY NCCI Carrier Code 13706
(Name of Insurance Company)
issued to: METRICOM INC
Policy Expiration Date: 09/30/99
Premium (if any) $
Authorized Representative
The insurance afforded by Part Two (Employers' Liability Insurance) by reason of designation of
California in item 3 of the information page is subject to the following provisions:
A. "How This Insurance Applies", is
amended to read as follows:
A. How This Insurance Applies
This employers' liability insurance
applies to bodily injury by accident
or bodily injury by disease. Bodily
injury means a physical or mental
injury, including resulting death.
Bodily injury does not include
emotional distress, anxiety, discom-
fort, inconvenience, depression,
dissatisfaction or shock to the nerv-
ous system, unless caused by either
a manifest physical injury or a
disease with a physical dysfunction
or condition resulting in treatment
by a licensed physician and surgeon.
1. The bodily injury must arise out
of and in the course of the injured
employee's employment by you.
2. The employment must be neces-
sary or incidental to your work in
California.
3. Bodily injury by accident must
occur during the policy period.
4. Bodily injury by disease must be
caused or aggravated by the condi-
tions of your employment. The
employee's last day of last expo-
sure to the conditions causing or
aggravating such bodily injury by
disease must occur during the policy
period.
5. If you are sued, the original suit
and any related legal actions for
damages for bodily injury by acci-
dent or by disease must be brought
in the United States of America, its
territories or possessions, or
Canada.
P*StFhul
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY
WC040601A
CALIFORNIA CANCELATION ENDORSEMENT
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.)
This endorsement, effective on 09/30/98 at 12:01 A.M. standard time, forms a part of Policy No. WVA9401217
Endorsement Number of the ST. PAUL FIRE AND MARINE INSURANCE COMPANY
NCCI Carrier Code 13706 Issued To METRICOM INC
Policy expiration date 09/30/99 Premium (if any)
Authorized Representative
This endorsement applies only to the insurance provided by the policy because California is shown
in Item 3.A. of the Information Page.
The cancelation condition in Part Six (Conditions) of the policy is replaced by the these conditions:
Cancellation
1. You may cancel this policy. You must mail or deliver advance written notice to us stating
when the cancelation is to take effect.
2. We may cancel this policy for one or more of the following reasons:
a. Non-payment of premium;
b. Failure to report payroll;
c. Failure to permit us to audit payroll as required by the terms of this policy or of a previous
policy issued by us;
d. Failure to pay any additional premium resulting from an audit of payroll required by the
terms of this policy or any previous policy issued by us;
e. Material misrepresentation made by you or your agent;
f. Failure to cooperate with us in the investigation of a claim;
g. Failure to comply with Federal or State safety orders;
h. Failure to comply with written recommendations of our designated loss control represen-
tatives;
i. The occurrence of a material change in the ownership of your business;
j. The occurrence of any change in your business or operations that materially increases the
hazard for frequency or severity of loss;
k. The occurrence of any change in your business or operation that requires additional or
different classification for premium calculation;
I. The occurrence of any change in your business or operation which contemplates an activity
excluded by your reinsurance treaties.
DSF-WC040601A Ed. 12-93 Printed in U.S.A.
We have no duty to de'
proceeding or suit that
this insurance.
D. We Will Also Pay
J a claim, If we make an ayments in excess of the
is not covered by benefits regularly provided by the workers
compensation law on your behalf, you will
reimburse us promptly.
We will also pay these costs, in addition
to other amounts payable under this
insurance, as part of any claim, proceed-
ing or suit we defend:
1. reasonable expenses incurred at our
request, but not loss of earnings;
2. premiums for bonds to release
attachments and for appeal bonds in
bond amounts up to the amount payable
under this insurance;
3. litigation costs taxed against you;
4. interest on a judgment as required by
law until we offer the amount due under
this insurance; and
5. expenses we incur.
E. Other Insurance
We will not pay more than our share of
benefits and costs covered by this insur-
ance and other insurance or self-insu-
rance. Subject to any limits of liability
that may apply, all shares will be equal
until the loss is paid. If any insurance or
self-insurance is exhausted, the shares
of all remaining insurance will be equal
until the loss is paid.
F. Payments You Must Make
You are responsible for any payments in
excess of the benefits regularly
provided by the workers compensation
law including those required because:
1. of your serious and willful miscon-
duct;
2. you knowingly employ an employee
in violation of law;
3. you fail to comply with a health or
safety law or regulation; or
4. you discharge, coerce or otherwise
discriminate against any employee in
violation of the workers compensation
I aw.
1991 National Council on Compensation Insurance
G. Recovery From Others
We have your rights, and the rights of
persons entitled to the benefits of this
insurance, to recover our payments from
anyone liable for the injury. You will do
everything necessary to protect those rights
for us and to help us enforce them.
H. Statutory Provisions
Page 3 of 8
These statements apply where they are
required by law.
1. As between an injured worker and us, we
have notice of the injury when you have
notice.
2. Your default or the bankruptcy or insol-
vency of you or your estate will not relieve
us of our duties under this insurance after an
injury occurs.
3. We are directly and primarily liable to
any person entitled to the benefits payable
by this insurance. Those persons may
enforce our duties; so may an agency
authorized by law. Enforcement may be
against us or against you and us.
4. Jurisdiction over you is jurisdiction over
us for purposes of the workers compen-
sation law. We are bound by decisions
against you under that law, subject to the
provisions of this policy that are not in
conflict with that law.
5. This insurance conforms to the parts of
the workers compensation law that apply to:
a. benefits payable by this insurance;
b. special taxes, payments into security
or other special funds, and assessments
payable by us under that law.
6. Terms of this insurance that conflict
with the workers compensation law are
changed by this statement to conform to
that law.
Nothing in these paragraphs relieves you of
your duties under this policy.
or work classifications. T ;e classifica-
tions were assigned based on an estimate of
the exposure you would have during the
policy period. If your actual exposures are
not properly described by those classifica-
tions, we will assign proper classifications,
rates and premium basis by endorsement to
this policy.
C. Remuneration
Premium for each work classification is
determined by multiplying a rate times a
premium basis. Remuneration is the most
common premium basis. This premium
basis includes payroll and all other remuner-
ation paid or payable during the policy
period for the services of:
1. all your officers and employees engaged
in work covered by this policy; and
2. all other persons engaged in work that
could make us liable under Part One (Work-
ers Compensation Insurance) of this policy.
If you do not have payroll records for these
persons, the contract price for their services
and materials may be used as the premium
basis. This paragraph 2 will not apply if you
give us proof that the employers of these
persons lawfully secured their workers
compensation obligations.
D. Premium Payments
You will pay all premium when due. You
will pay the premium even if part or all of a
workers compensation law is not valid.
E. Final Premium
The premium shown on the Information
Page, schedules, and endorsements is an
estimate. The final premium will be deter-
mined after this policy ends by using the
actual, not the estimated, premium basis
and the proper classifications and rates that
lawfully apply to the business and work
1991 National Council on Compensation Insurance
covered by th. olicy. If the final premium
is more than the premium you paid to us,
you must pay us the balance. If it is less,
we will refund the balance to you. The final
premium will not be less than the highest
minimum premium for the classifications
covered by this policy.
If this policy is canceled, final premium will
be determined in the following way unless
our manuals provide otherwise.
1. If we cancel, final premium will be calcu-
lated pro rata based on the time this policy
was in force. Final premium will not be less
than the pro rata share of the minimum
premium.
2. If you cancel, final premium will be more
than pro rata; it will be based on the time
this policy was in force, and increased by
our short -rate cancelation table and proce-
dure. Final premium will not be less than
the minimum premium.
F. Records
You will keep records of information
needed to compute premium. You will
provide us with copies of those records
when we ask for them.
G. Audit
Page 7 of 8
You will let us examine and audit all your
records that relate to this policy. These
records include ledgers, journals, registers,
vouchers, contracts, tax reports, payroll and
disbursement records, and programs for
storing and retrieving data. We may
conduct the audits during regular business
hours during the policy period and within
three years after the policy period ends.
Information developed by audit will be used
to determine final premium. Insurance rate
service organizations have the same rights
we have under this provision.
Pursuant to Section 11752. of the California Insurance Code, are informing you of
the following changes in laws affecting workers compensation insurance rating enacted
during the 1993 session of the California Legislature:
Changes Effective on or before January 1, 1994
1. You must notify us if you know facts that prove any aspect of an employee's claim is false.
You have the right to dispute whether a claim is compensable. If you dispute compensability
and you notify us and the Workers Compensation Appeals Board (WCAB) in writing, and if the
WCAB determines that claim noncompensable, you may be entitled to reimbursement of
premium you paid due to the inclusion of that claim in your experience modification.
2. When a claim is made, we set a "case reserve" which includes our estimates of medical -legal
costs, vocational rehabilitation costs, and all other estimated expenses and benefits to be paid
on that claim. At your request, we will provide you a written justification for any case reserve
that affects your premium.
3. At your request, we will provide you with all parts of a claim file that affect your premium, and
we will discuss the file with you. We cannot provide you, however, with documents that are
protected by legal privilege (such as attorney -client privilege) or any documents we are prohib-
ited by law from disclosing.
4. We cannot surcharge your policy by applying a plan or method that is unfairly discriminatory.
Prior to January 1, 1995, we will report annually all surcharge plans or methods we use to the
Insurance Commissioner.
5. California Insurance Code Section 676.8, which specifies the reasons for which we may cancel
your policy, provides as follows:
676.8 (a) This section applies only to policies of workers compensation insurance.
(b) After a policy is in effect, no notice of cancellation shall be effective unless it
complies with the notice requirements for this section and is based upon the occur-
rence, after the effective date of the policy, of one or more of the following:
(1) The policyholder's failure to make any workers compensation insurance premium
payment when due.
(2) The policyholder's failure to report payroll, to permit the insurer to audit payroll as
required by the terms of the policy or of a previous policy issued by the insurer, or
to pay any additional premium as a result of a audit of payroll as required by the
terms of the policy or of a previous policy.
(3) The policyholder's material failure to comply with federal or state safety orders or
written recommendations of the insurer's designated loss control representative.
(4) A material change in ownership or any change in the policyholder's business or
operations that materially increases the hazard for frequency or serverity of loss,
requires additional or different classifications for premium calculations, or
contemplates an activity excluded by the insurer's reinsurance treaties.
(5) Material misrepresentation by the policyholder or its agent.
(6) Failure to cooperate with the insurer in the insurer's investigation of a claim.
(c) A policy shall not be canceled for the conditions specified in paragraph (1), (2), (5), or
(6) of subdivision (b) except upon 10 days' written notice to the policyholder by the
insurer. A policy shall not be canceled for the conditions specified in paragraph (3) or
(4) of subdivision (b) except upon 30 days' written notice to the policyholder by the
insurer, provided that no notice is required if an insured and insurer consent to the
cancellation and reissuance of a policy effective upon a material change in ownership
DSF—WC04004 Ed. 1-95 Printed in U.S.A.