To be filed in DMM Matter Number: 09-01904 State of New York Department of Public Service Three Empire State Plaza, Albany, New York 12223-1350 Internet Address: http://www.dps.ny.gov APPLICATION FOR SMALL COMPANY EXEMPTION I HEREBY DECLARE THAT TO THE BEST OF MY KNOWLEDGE, THIS STATEMENT IS ACCURATE. I UNDERSTAND THIS INFORMATION MAY BE SUBJECT TO VERIFICATION BY THE COMMISSION: Name of Company .b ta" 3s2. .210 mo.," S+-. G,erm41\.to~n Y\J J)..s2.1., Address HAD UNDER 1,000 SUBSCRIBERS AS OF DECEMBER 31, 2011. Signature Geoem.l ToMer Title . ( Sl8) 5?>7- '-l'l3S- fr Telephone (include area code) Tf4n\l. bosc.a.r:\\o @~dcorp.~ Email Address Instructions: This Application, and a copy of your most recent rate card, must be completed and returned each year, on or before April 1st, to claim small company exempt status for the previous year, pursuant to Section 213.2 of the Public Service Law. Mail completed Application to the attention of the Carrier Operations Section, Office of Telecommunications, New York State Department of Public Service, Three Empire State Plaza, Albany, New York 12223. If you have any questions or require assistance in this matter, please call (518) 474-4500. 1 List below the name of each municipality granting a franchise and each area you serve in which a franchise has not been granted. In addition, provide information for each municipality and area served as indicated on table below. Indicate operation in a non­ franchised area by placing the letter "N" after the area served. All fractional numbers should be rounded to the nearest tenth. Use a continuation page if addition space is required. A. B. C. D. E. Franchise Area Number of Estimated% Total Miles Total Route Served Subscribers of Penetration of Plant Miles in Franchise Completed Area SAMPLE a. Anywhere, V. 100 50.0 10.0 12.5 ~ j 1 i!re<lflLl/(fQu~ I. .355 1./ 1 2 C. \e.(mont, · ~~1 SD :J 3 l-i'li n ~ T. lo •'-I 4' .,,I 4 G,CL Cl in ' . 'l I I 5 To1h ka.oi~ , T. J ,3 dL I 6 1 t All plaid- bd~ fD a C:,ermant'ok>" ~9bi,ne, 9 10 ...A-\\ l!_otnelb~ Obt.l 11 :r.P:rv ~ no a.naloj rrma.in 12 13 14 15 16 17 18 19 20 Total (oOi A. Identify whether a locality is a city, town, village or unincorporated area by using the following codes: 'C' - City, 'T' - Town, 'V' - Village B. Total amount of first or primary outlets not to include additional outlets or other services. C. % of penetration equals the number of subscribers in Column B divided by number of homes passed by cable. D. Total plant miles completed E. Total miles of plant required to be constructed in municipality. 2 Monthly Miscellaneous Rates: Local Basic TV $29.99/mo Wired Set Top Box (each) $5.00 G Tel N Tutorial Wireless Set Top Box (each) $8.00 2 GTel Community Channel Cloud DVR (50GB) $8.95 3 WMHT (PBS) (HD 479)* Whole-Home Cloud DVR (250GB) $10.95 Whole-Home Cloud DVR (500GB) $15,95 4 WNYA (My4) 5 QVC (HD 446)* 6 WRGB (CBS) (HD 406)* Digital TV Installation Rates: 7 Home Shopping Network New Digital TV Service Installation (1 Set) $ 75.00 8 WXXA (FOX) (HD 408)* Each Additional Set at Time of Installation $50.00 9 Shop HQ Installation of Additional Sets Separate Visit $60.00 10 WTEN (ABC) (HD 4 10)* Relocate Service at Same Address (Per Set> $60.00 (Internal or External> 11 WCWN (The CW) Reinstall Existing Cable Service (Per Set) $50.00 12 The Weather Cha nnel VCR/DVD Setup During Original Installation $40.00 13 WNYT (NBC) (HD413)* VCR/DVD Installation Separate Visit $60.00 Program TV Service Call $50.00 14 MeN Reconnect from Non-Payment $40.00 15 OTB Maintenance Visit Charge (1st 1/2 hour) $25.00 16 Trinity Broadcast Network Service Order Charge $10.00 17 GetN Charges will be Applied for all Unreturned Boxes 18 EWTN ·Certain restrictions apply. Call for delails 19 CSPAN 20 CSPAN2 W ch V 21 CSPAN3 g···te 134 TBDN Eve-ywhe 135 CometN I 136 Charge! N Digital 142 Court N Mystery Watch your TV shows when and 143 Justice where you want! On your Channel 144 LAFF computer. mobile phone, or 145 Bounce tablet! Only from GTel! Lineup WIVE includes occess to subscribed nelW0<1< apps only. You may incur adtfitional costs 146 Stadium by utilizing this service from your wireless o, broadband provider. Please make sure you understand the terms of your se<vice plan prio, to use. ~bnimum GTef Basic TV plan 147 LightN required. Visit www.watchtveverywhere.com fo, mo,e infOllTlation. 154 BUZZR 155 thisTV q -tel' 300-349 Stingray Music ; P.O. Box 188 · Germantown, NY 600 GTel RiverCam • 518.537-GTEL · www.gtel.net rev 120119 Basic S96.991mo 47 National Geographic 114 GAC 75 Lifetime Real Women 413 11&1 WNYTHD 455 11D DIY HO 481 111D Showcase HD" The Leaming 115 BET 82 FXM GTelTV 48 414 ll!l Discovery HD 456 El Comedy Cenlral HD 482 CID SHO2 HD" Channel (TLC) 118 SyFy 83 Fusion 2 Community Chann el 41 5 GIii Animal Planet HD 457 B Paramount Network HD 485 111D TMCHD" 49 Animal Planet 119 Reelz Channel 84 LOGO 3 WMHT(PBS) 416 111D National Geographic HD 458 E SECHD HBO Premium $18.95/mo 50 Discovery Channel 120 Outdoor Channel 88 Cooking Channel 4 WNYA (My4) 41 7' 111!1 Destination America HD 459 llll FX HD 225 SD HBO 51 OWN 121 FYI 97 Teen Nick 5 41 8' GIi Science HD 467 ml Nickelodeon HD ave 226 SD HBO 2 54 History 122 Crime & Investigation 98 Nick 2 6 WRGB(CBS) 419 1119 Golf HD 468 El TV Land HD 55 A&E 123 History en Espanol 99 Nicktoons 227 SD HBO Signatu re 7 HSN 420 Ill!> LMN HD 469 ID CMT HD 58 Discovery Life Channel 124 ViceLand 100 Boomerang 228 SD HBO Family 8 WXXA(FOX) 421 DIil MTV Live HD 475 11D MTV HD 59 Investigation Discovery 125 Military Histo ry 105 Nick Music 229 SD HBO Comedy 9 Shop HQ 422 1111 TLC HD 476 1111) VH1 HO 62 Travel Channel 126 TruTV 106 BET Jams 230 SD HBO Zone 10 WTEN (ABC) 423 llil Olympic HD 477 Ii) MLB HD 231 SD HBO Latino 63 Hattmark Channel 130 Universo 107 MTVTr3s 11 WCWN 424 lllil SyFy HD 478 NHL HD 460 GI!> HBO HD" 64 CNN 131 CNN en Espanol 109 MTV Classic Ii> 13 WNYT (NBC) 461 Ill!) HBO2 HD" 65 HLN 133 ESPN Deportes 110 BET Soul 425 Cllil USA HD 479 ID WMHT HD 14 MeTV 134 TBDTV 462 Ill!) HBO Signalure HD" 66 Fox News 111 MTVu 426 llli) Food Network HD 486 Ii> Reelz Channel HD 15 OTB 135 CometTV 113 CMT Music 67 Fox Business News 427 111D HGTV HD 487 Iii) Hallmark HD 463 Ill!) HBO Family HD .. 16 TBN 136 Charge! TV 116 BET Gospel 68 CNBC 428 lll!l TNT HD 488 11D Big Ten HD 464 G1!1 HBO Comedy HD" 17 GetTV 138 Big Ten Network 117 BET Her 70 MSNBC 429 lll!l TBS HD 489 E AMCHD 465 ml) HBO Zone HD" 18 EWTN 139 Sundance 127 RFDTV 71 Weather Channel 430 ll!il Lifetime HD 490 1111 Sundance HD 466 111D HBO Latino HD" 19 C-Span 140 IFC 128 Discovery en Espanol 73 Lifetime 431 11111 E! HD 491 11!> IFC HD 20 C-S pan 2 141 WE TV 129 Discovery Fam ilia 74 Lifetime Movie 432 Ill!) Investigation Discovery HD 492 CID WE TV HD 21 C-Span 3 142 Court TV Mystery 132 CNNI 76 TCM 433' lllil Discovery Family HD 493 ll!l Hallmark Drama HD 240 SD Cinemax 23 MLB 143 Justice 137 Fox Deportes Hallmark Movies and 434 lll!l Br~HD 241 SD MoreMax 77 144 LAFF STARZ Prem ium S9.95/mo 24 SEC Mysteries 201 Starz Encore 242 SD Action Max 435 lll!l CNBC HD 208 SD Slarz 78 Disney Jr. 145 Bounce 202 Starz Encore Action 25 AMC 243 SD 5 Star Max 436 Ill!) History HD 209 SD Starz Cinema 79 E! 146 Stadium 203 Starz Encore Black 26 ESPN 244 SD OulerMax 437 lllil Outdoor HD 210 SD Starz Comedy 80 Olympic 147 Light TV 204 Starz Encore Classics 27 ESPN News 470 IDD Cinemax Ho·· 81 Oxygen 154 BUZZR 205 Starz Encore Suspense 438 mil FOX Sports 1 HD 211 SD Starz Edge 28 ESPN Classic 471 IDD MoreMax HD"' 85 Bravo 155 thisTV 206 Starz Encore Family 439 Ill!) Fox News HD 212 SD Slarz in Black 29 ESPN U 300-349 Stingray Music 472 1111) Aclion Max HD" 86 Hallmark Drama 207 Starz Encore Westerns 440 lllil CNN HD 213 SD Starz Kids 30 ESPN 2 600 GTel RiverCam 483 Ii> Starz HD" 473 II!) 5 Star Max HD" 87 DIY 441 llli) Headline News HD 31 FOX Sports 1 HD $10/mo 1000 Primetime OnDemand 484 11D Starz Kids HD" 474 am Ouler Max HD" 89 Food Network 442 Ill!) TCM HD 33 Golf Channel 400 It!> Disney HD 90 HGTV Expanded s171mo Showtime/ TMC Premium . NFL RedZone . 34 N8C Sports Netwo!k 401 II1J FreeForm HD 443 1B TruTV HD $17.95/mo $49.951sc,1son 91 Universal Kids 22 Mav TV · Premium 36 YES Nelwork 402 G!il Disney XO HD 444 lllil Cartoon Network HD 214 SD Flix 277 SD NFL RedZone 92 Disney Channel 32 FXX 37 Sports Net NY 403 lllil A&E HD 445 Ill!) Travel HD 215 SD Showtime 499" llil NFL RedZone HD 38 NHL 93 FreeForm 35 FOX Sports 2 404 G!il ESPN HD 446 ll!!l ave HD 216 SD Showtime2 39 TVG2 94 Disney XO 52 Destination America 405 11:!J ESPN2 HD 447 GI!> MSNBC HD 21 7 SD Showlime Extreme 40 NFL Network 95 Nickelodeon 53 Discovery Family 218 SD Showtime Next 406 II1J WRGB HD 448 11111 Fox Business News HD 41 USA Network Nick Jr 56 BBC America 96 219 SD Showcase 407 G!il NBC Sports Network HD 449 1111 OWN HD 41 USA Network 57 BBCWor1d 101 Cartoon Network 220 SD Showtime Beyond 408 ll!il WXXA HD 450 ll!il Discovery Life HD 42 TNT 102 TV Land American Heroes 60 221 SD Showtime Family Zone Channel 409 llill YES HD 43 FX 451 Ill!) Crime & Investigation HD 103 MTV 222 SD Showtime Women 61 Science 410 II1J WTEN HD 44 Comedy Cenlral 104 MTV2 452 II!!) Haff mark Movies & Mysleries 223 SD TMC: The Movie Channel 69 CNBCWor1d • Must subscribe to Expanded Basic 411 Ill> NFL Network HD lo view these channels in HD.