Amendment Application (USA)

(Tab through the Fields to Enter Info; if at Any Time You Need to UNLOCK the Form to Manually Add Something, you Must Add the “Lock” Icon to your WORD Toolbar to Unprotect Form, NO Password Needed)

5900 Broken Sound Pkwy NW

Boca Raton, FL 33487d
Attention: Property Management / Main Tel: 561-995-7670 / 800-487-7483
Fax: 561-226-3577
E-mail:
Site Information
Date: / Tenant: / Contact Info:
SBA Site Name: / Tenant Site Name/ID #:
SBA Site ID #: / Tel/Fax: () - / Email: @.
Leasing Information
Name of Company to Appear on Amendment:
Note:If Tenant’s entity name is other than the entity name as entered into under the original lease, Tenant will need to provide copies of the assignment/transfer documents associated with the entity change. / State Incorporated:
Signatory Name: / Signatory Title:
Corporate Address: / Notice Address:
Name/Phone & Address to Send Amendment For Execution: / Email: @.
Equipment Specifications(NOTE: PLEASE USE AMERICAN STANDARD MEASUREMENTS, NOT METRIC)
Tower Attachment
/
LEASED
(#) Make/Model/Dimensions/Weight /
PROPOSED CHANGE
(#) Make/Model/Dimensions/Weight / TOTAL FINAL CONFIGURATION
(#) Make/Model/Dimensions/Weight
# PANELS / Total:
() ///
() ///
() ///
() ///
() ///
() /// / Total:
() ///
() ///
() ///
() ///
() ///
() /// / Total:
() ///
() ///
() ///
() ///
() ///
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# TMAs: / () ///
() /// / () ///
() /// / () ///
() ///
# RETs: / () /// / () /// / () ///
# RRUs: / () ///
() /// / () ///
() /// / () ///
() ///
# DIPLXs: / () ///
() /// / () ///
() /// / () ///
() ///
# ODUs: / () ///
() /// / () ///
() /// / () ///
() ///
# MISC: / () /// / () /// / () ///
Panels Centerline Mount Height:
Downtilt:
Orientation:
# MW’s: / Total:
() ///
() /// / Total:
() ///
() /// / Total:
() ///
() ///
Dish Orientation:
Dish Centerline Mount Height:
Mount Using Existing?
YES or NO*
*If NO, please provide specs
including weight
(# of Lines) / Cable Size: / Panels: () /
Dish: () /
RET cable: () /
Fiber cable: () /
DC Power cable: () / / Panels: () /
Dish: () /
RET cable: () /
Fiber cable: () /
DC Power cable: () / / Panels: () /
Dish: ()/
RET cable: () /
Fiber cable: () /
DC Power cable: () /
List Frequencies
Specify TX and/or RX
List specific operating frequencies and not entire range for all antennas existing and new ‘Even if there are No Changes’ / TX:
RX:
Dish: / TX:
RX:
Dish: / TX:
RX:
Dish:
GROUND Specifications
GROUND SPACE
/
LEASED
/
PROPOSED CHANGE
/ TOTAL FINAL GROUND SPACE
Shelter or Pad:
Exact Dimensions: / x / x / x
Special Requirements/Detailed Description of Proposed Changes:
Construction Information
Contact Name: / Phone: () - / Email: @. / Fax: () -

Please use the following as a Checklist & Guidelines for submitting Amendment Applications to SBA. Please always verify the Application in its entirety for completeness and accuracy before submitting to SBA.

  1. All applications must include the correct SBA Site ID/SBA Site Name.
  1. TENANT/CARRIER Site ID & Site Name, if applicable, must also be included on all applications.
  1. Full name and any initials, if required by the authorized TENANT/CARRIER signatory, along with their official title for signatory and notary block purposes. If unknown and/or will be hand written in at time of execution, please fill the requested field in with “LEAVE BLANK”.
  1. TENANT/CARRIER’s entity name and associated state of incorporation the amendment is to be entered in should match TENANT/CARRIER’s entity name as shown on the original agreement or the latest amendment, if applicable. If the TENANT/CARRIER entity name does not match the agreement or prior amendment, the official transfer (i.e. assignment, merger, conversion, name change) documentation must be provided with the Amendment Application.

Note: If a copy of the official documentation cannot be provided, SBA has standard waive defense language that can be included in the amendment in lieu of such documentation.

  1. Site Acqs/Consultants should obtain any associated due diligence (i.e. prior amendments, leases, misc. documentation, etc.) from the requesting TENANT/CARRIER.
  1. Full specifications/dimensions/weight must be provided for all equipment, along with associated mount specifications. Equipment datasheets for such equipment should be provided with the Amendment Application. If applicable, equipment measurements should be converted from metric to U.S. measurement standards.
  1. In the event TENANT/CARRIER has any reserved loading and/or a retained rights requirement for any particular site, such equipment must be fully identified (i.e. quantities, associated cables, full dimensions and weight) and listed as part of the “Final Configuration” on the Application.
  1. All frequencies to be used at the site going forward for which the lease is being amended must be licensed by TENANT/CARRIER, listed clearly on the Application, and identified as TX and/or RX, as applicable. Full spectrums (i.e. 1900-2100) will not be accepted & will delay Amendment processing.
  1. Downtilt and Orientation information should be included with the amended equipment as part of the “Final Configuration” section.
  1. If a NPA Letter is needed, it must be requested at the time the Amendment Application is submitted.
  1. The sooner the Site Acqs/Consultants request any required Structural Purchase Orders from TENANT/CARRIER and provide to the appropriate SBA Regional Site Manager, the sooner we can proceed with and provide the Structural Analysis Report or Letter.
  1. Remote Electronic Tilts (RETs), Tower Mounted Amplifiers (TMAs) and/or similar equipment that come as separate units are subject to additional rental charges. All such ancillary equipment must be listed on the Amendment Application, with an indication as to whether such equipment is integrated/built into the antenna or mounted to the antenna, along with the related equipment specifications and datasheet confirming the same.