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Application Form Abridged Page 1 of 18 Application to Renew a Broadcasting Licence for an INDIVIDUAL Cable Distribution Undertaking OR Application to Obtain a REGIONAL Broadcasting Licence for Cable Distribution Undertakings GENERAL INSTRUCTIONS 1. Filing File electronically via Access Key by attaching the application to the Cover page. Access Key allows secure transmissions to the Commission and also authenticates your identity. Therefore, a signature is not required when using Access Key. Applicants who file their application in this manner are not required to submit a hard copy of the application and its related documents. Applicants who cannot send their application electronically with the Access Key service can contact the Commission at 1-877-249-CRTC (2782). Applicants who need further information relative to the CRTC processes can contact a Commission specialist at 1-866-781-1911. 2. Confidentiality requests At your request, portions of the application may be treated as confidential, pursuant to section 20 of the CRTC Rules of Procedure. The onus is on the applicant to request confidentiality for the information or material and to clearly demonstrate that the public interest will best be served by treating the information as confidential. For further information, refer to Circular No. 429 dated 19 August 1998. Applicants must ensure that documents that they request be treated as confidential are submitted in a separate electronic file and must indicate confidential in the name of the file. It is incumbent upon applicants to clearly identify the confidential documents by indicating confidential on each page and, in such cases, to file an abridged version of the document for the public file. Please refer to Broadcasting Circular CRTC 2006-5, Guidelines for the filing of confidential information to the Commission. 3. Instructions The following questionnaire is in HTML format and may be downloaded to the word processing software of your choice. This enables you to complete the downloaded questionnaire by inserting your response in bold letters immediately following the question. You may add lines to the tables if necessary but do not alter or delete any text from the questionnaire. The application must be divided into sections as set out in the questionnaire, and include the numbered questions followed by the corresponding response. Responses must be provided, at a # Filed in confidence with the CRTC. Abridged Page 2 of 18 minimum, in a size 10 font. Naming convention for the electronic documents The following documents should be submitted as separate electronic documents using the naming convention specified below. The document number (Doc#) indicates the ascending order in which the documents should appear on the public file. • The Covering Letter (if any) - APP - Doc1 - Cover Letter dated ____ • The Application Form - APP - Doc2 - Form 136 « Application to Renew a Broadcasting Licence for an INDIVIDUAL Cable Distribution Undertaking OR Application to Obtain a REGIONAL Broadcasting Licence for Cable Distribution Undertakings» • Appendix 1A - APP - Doc3 - Appendix 1A - Supplementary Brief • Appendix 2A - APP - Doc4 - Appendix 2A - Amendments to constituting documents • Appendix 5A - APP - Doc5 - Appendix 5A - Service Area Map(s) • Appendix 6A - APP - Doc6 - Appendix 6A - Service Area Maps • Each confidential document - NOT WEB - APP - Doc - CONFIDENTIAL - "brief description of the document" • Each abridged version of each confidential document - APP - Doc - ABRIDGED VERSION - "same description of document for which confidentiality is requested" The Commission may return the application if it has not been duly completed or if the required technical documentation has not been filed with Industry Canada. The onus will be on the applicant to submit a clear application that provides all of the relevant information, identifies all regulatory issues raised in the application and provides supporting documentation. 4. Public examination file Copies of the Commission's letters requesting further information and copies of your replies form part of the application and must be available for examination by the public. Canadian Radio-television and Telecommunications Commission Application to Renew a Broadcasting Licence for an INDIVIDUAL Cable Distribution Undertaking OR Application to Obtain a REGIONAL Broadcasting Licence for Cable Distribution Undertakings 1. GENERAL INFORMATION Specify licence type: Regional ( X ) Individual ( ) Type of undertaking: Class 1 ( X ) Class 2 ( ) Class 3 ( ) Location: Montréal, Gatineau, Sherbrooke, Québec City, # Filed in confidence with the CRTC. Abridged Page 3 of 18 (To be identified on the licence) Drummondville, Joliette, Saint-Jerome, Trois-Rivières, Longueuil and surrounding area at each location in Quebec 1.1 Identification of applicant/licensee Name: Bell Canada Address: Floor 19 – 160 Elgin Street, Ottawa, Ontario K2P 2C4 Fax: (613) 560-0472 E-mail: [email protected] Contact person representing the applicant/licensee (if there is no appointed agent under question 1.2) Name: Barry Chapman Title: Vice-President – Regulatory Affairs / BCE Inc. Telephone: (613) 785-6341 Please indicate the E-Mail address and FAX number that should be specified in a Notice of Consultation. E-mail: [email protected] Fax: (613) 560-0472 1.2 Appointment of agent NOT APPLICABLE I, _________________________, the applicant/licensee, hereby appoint _____________________ as my agent for and on my behalf and in my name to sign, file and complete (if necessary) an application with the Canadian Radio-television and Telecommunications Commission and to sign and file a reply with respect thereto and I do hereby ratify, confirm, and adopt as my own act, such application and all replies made thereto. Date: At: Signature: Address of agent: Title: Telephone: Fax: E-mail: 1.3 Declaration of the applicant/licensee or its appointed agent I, Barry Chapman, SOLEMNLY DECLARE THAT: a) I am the representative of the applicant/licensee named in this Application Brief and as such have knowledge of all matters declared therein. b) The statements made in this application, or any document filed pursuant to any request for further information by the Commission, are (will be) to the best of my knowledge and belief true in all respects. c) The opinions and estimates given in this application, or any document filed pursuant to any request for further information by the Commission, are (will be) based on facts as known to # Filed in confidence with the CRTC. Abridged Page 4 of 18 me. d) I have examined the provisions of the Broadcasting Act and the broadcasting regulations relevant to this application. And I have signed Signature: NOT APPLICABLE Date: 31 January 2011 Witnessed by Signature: NOT APPLICABLE Name (Printed): Jack Grant Date: 31 January 2011 At: Ottawa, Ontario 1.4 Examination by the public For each undertaking, indicate a location, within the area served, where the application may be examined by the general public. Address: Bell Canada Regulatory Information Services Floor 19 – 160 Elgin Street Ottawa, Ontario K2P 2C4 For the public’s convenience regardless of location, an electronic version of this application is also accessible at the following Web site: http://www.bell.ca/shopping/PrsShp_CRTC_renewApplication.page Respond to question 1.5 if already operating the authorized cable distribution undertaking(s) 1.5 Compliance The undertaking(s) previously licensed is(are) operating in compliance with the provisions of its(their) licence(s), the Broadcasting Act, all applicable regulations, policies and mandatory orders of the CRTC. YES ( X ) NO ( ) If NO, provide the full details of any non-compliance during the licence term, including the reasons, any remedial action and, where applicable, the period of time expected before the undertaking(s) is(are) operating in compliance. # Filed in confidence with the CRTC. Abridged Page 5 of 18 Date: 31 January 2011 At: Ottawa, Ontario Signature of Licensee or its appointed agent: NOT APPLICABLE 2. OWNERSHIP Definitions: (1) VOTING SHARES: The shares to which are attached one or more votes, and includes securities that are convertible into such shares at all times at the option of the holder. (2) COMMON SHARES: The shares that represent the residual equity in the earnings of the corporation, and includes securities that are convertible into such shares at all times at the option of the holder and the preferred shares to which are attached rights to participate in the earnings of the corporation with no upper limit. If all of the ownership information requested in questions 2.1 to 2.3 has already been submitted to the Commission within the last 12 months and is still current, complete the following: • The application number or the date where this information was last supplied: Broadcasting Ownership Information Annual Filing (Rapids Number 446460); 15 October 2010 • I hereby attest that the information last supplied is accurate and that no changes have been made since then. YES ( X ) NO ( ) • Go to section 3. 2.1 For the applicant/licensee, complete the following tables providing: a) A list of the directors and officers, including the Chief Executive Officer. Name of the corporation for which the following table pertains: DIRECTORS AND OFFICERS Name Complete Home Address Citizenship Directors; Officers; Date of Position Appointment Held (1) b) A list of shareholders holding 10% or more of the voting shares , of the voting rights (when (2) different from the voting shares), and of the Common (participating)
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