ApplicationforICTLicence(s)
(TypeA, B, or C Networks, and/orType 1 to 5 Services)
•Print clearly – illegible, unclear or incompleteapplicationformsmaydelayprocessing.
•LicenceTypesaredefinedinaSection23(2)NoticepublishedfromtimetotimeintheGazette by theUtilityRegulationCompetitionOffice('OfReg'orthe'Office').Acopyof the current notice isattachedtothisapplicationform.
•Youshouldusethisform(ICTForm1)ifyou
requirealicenceforTypeA,B,orCNetworksand/orType1to5Services.
•YoushoulduseICTForm2ifyourequireonlyaTypeDtoTypeFnetworklicence.
•Youmay use this form to apply for TypeD,EorSnetworklicencesONLYifyoualsoare applying for aTypeA, B, or C Network licence or a Type1 to 5ServiceLicence.
•Queriesconcerningthecompletionofthisform shouldbe directedtotheOfficeat1-(345)-946-4282,
fax1-(345)-945-8284,.
TheOfficewillpublishacopyofyourcompletedapplicationandanyattachmentsonitswebsiteunlessitisaccompaniedbyaclaimforconfidentialityinaccordancewiththeICTConfidentialityRegulations.Ifaclaimofconfidentialityismade,theapplicationmustbeaccompaniedbyaredactedversionforthepublicrecord.
1.Clientnumber(IFKNOWN)7.Postaladdress
2.Organisationname8.Physicaladdress
3.TradingName(IFAPPLICABLE)9.ContactName SURNAME
4.C.I.CompanyRegistrationNumberGIVENNAMES
5.DoesCompanyhaveacurrentTradeBusinessLicence?
(IFYES,PLEASEATTACHCOPY)
YesNo
DESIGNATION
6a.GeneralInquiryEmailaddress(IFANY)
10.Telephone
WORKHOME
6b.WebAddress(IFANY)MOBILEFAX
AtleastoneofthefollowingtypesofICTNetworksorICTServicesMUSTbeselected
Networks:
TypeA–FixedwirelineTypeB–FixedwirelessTypeC–Mobile(celluar)
Services:
Type1–FixedTelephony
Type2*–Fall-backInternationalVoiceDataComms.
Type3–MobileTelephonyType4–ResaleofTelephonyType5–InternetTelephony
*AvailableonlytoaTypeE2Licenseeorapplicant.
ThefollowinglicencetypesmaybeincludedinthisapplicationPROVIDEDatleastoneoftheabovehasbeenselected.
Networks:
TypeD1–FibreOpticCable-DomesticTypeD2–FibreOpticCable-InternationalTypeE1–Satellite(inclVSAT)-Domestic
TypeE2–Satellite(inclVSAT)-International
TypeS–Spectrum
Checkthisboxifyouplantomakeuseofanyspectrum,andprovidefulldetailsinanswertoquestion28below.There is an annual fixed fee for each transmissionfrequencyorchanneltobeused.SeethedescriptionintheSection23(2)Notice.Thereisnoapplicationfee.
CheckforApplicationFeeRequiredtobe
Enclosedandmadeoutto'OfReg'.
Services:
Type9–InternetServiceProvider(ISP)Type11–ProvisionofICTInfrastructuretoaLicensee,otherthandarkfibre
Type11a-Provisionofdarkfibretoa
Licensee
Type12**–RetailsaleofICTequipment
Type13–PublicationofdirectoriesType14–ApplicationsServiceProvider(ASP)
**AvailableonlytoType1orType3licensees.AllothersmustobtainalicenceundertheTradeandBusinessLicensingLaw(currentRevision).
(SeeseparateScheduleofICTApplicationFees)CI$
Whereappropriate,thefollowinginformationshouldbeprovidedasanattachmenttothisapplication:
13.AttachdetailsofalldirectorsandofficersoftheCompany.
a.Fullname
b.Appointment
c.Dateappointed
d.PrivateAddress
e.Age
f.Nationality
g.Occupation
h.Otherdirectorshipsheldduringthepast5years
i.Otherbusinessinterests
j.WhetherornotresidentintheCaymanIslands
k.Acurriculumvitaeincludingasummaryofbackground,andany experience relevant torunning the networks andservicesappliedfor
14.Haveanydirectorsor officers ofthe Companyever declaredpersonalbankruptcy or been adirector or officerofacompanywhich has goneintoliquidation,official receivership,administration,or become insolvent (eitherwhilehewasadirectororofficerorwithin3yearsofhis ceasingtobe adirectoror officer)?
No
Yes. Please attach details.
15.HaveanydirectorsoftheCompanybeenadirectorofacompanywhoseICTlicence(orequivalent)hasbeenrevokedbyanycountry’sregulatoryauthorityforbreachoflicencecondition(s)(eitherwhilehe wasadirectororwithin3yearsofhisceasingtobeadirector)?
No
Yes. Please attach details.
16.Attach names and addresses ofallshareholdersoftheCompany(unlessa publiclytraded company). Include nationalityandplaceof residence.
List of shareholders attached.
We are a publicly traded company. Ourcompany registrars are:
17.HasanydirectoroftheCompanyor anymemberoftheCompany’smanagerialstaffever been, or arethey now, the defendant or respondent in anyproceedingsinanycourtinanyjurisdictioninvolvingnon payment of debt, dishonesty, fraud, theft,restitutionorviolence?
18.Provide a diagrammatic representation oftheapplicant’s majorshareholders, includingthepercentageofsharesheld.
No
Yes. Please attach details
19.ProvideadiagrammaticrepresentationandnarrativedescriptionoftheCompany’smanagementstructure.Includebriefresumesofkeymanagerialstaffindicatingrelevantpriorexperience,qualifications,andnationality.DetailanyothersourcesofexpertiseavailabletotheCompany.
20.Listanyactivitieswhichwillbecontractedouttoagencies,consultants,etc.,includingnumbersofpersonneluponwhomtheapplicantwillbeableto draw,ifknown.
21.Attachnames,addressesandcontactdetailsforthe / a. / Attorney / c. AuditorsfollowingprofessionaladvisorstotheCompany. / b. / Accountant / d. Banker
22.DoestheCompanyoranyaffiliatecurrentlyhold,orhasiteverheld,atelecommunications,broadcastingor
ICTlicenceintheCaymanIslandsoranothercountry?No
Yes.Pleaseattachdetails.
23.HastheCompanyoranyaffiliateeverhadanapplicationforatelecommunications,broadcastingorICTlicenceintheCaymanIslandsoranothercountryrefused?
No
Yes. Please attach details.
24.HastheCompanyoranyaffiliateeverhadatelecommunications,broadcastingorICTlicenceinthe
CaymanIslandsoranothercountryrevoked?No
Yes. Please attach details.
25.Generaldescriptionofthenetworkorservice,including:
a.LicenceType
b.Narrativedescription
c.Geographicalcoverage
d.Numberandcategoriesofcustomersanticipatedtobeserved
e.Arrangementsforinterconnectionandinfrastructuresharing,whereappropriate
f.Anticipatedlaunchdate–GrandCayman
g.Anticipatedlaunchdate–CaymanBrac
h.Anticipatedlaunchdate–LittleCayman
i.Anticipateddevelopmentsoverthenext3years
j.Ifwholesaleserviceswillbeofferedtootherlicensees
26.Explainfullythetechnicalandoperationalconfiguration,including:
a.Descriptionoftheequipmenttobeused
b.Technicalspecification
c.Conformancewithstandards
d.Sourceandavailability
e.Networksecurityandresilience
f.Environmentalimpact
27.Provideacleardiagramshowing:a. Theconveyanceofmessagesfromthebeginning(i.e.waysofaccessingtheapplicant’ssystem)totheend(i.e.terminationofthemessage).
b.Directionalarrows
c.Labelsshowingwhichcompanyownsandoperateseachpartofthenetwork.(Thoughtheapplicant’ssystemmightrepresentasmallpartoftheoverallnetwork,itisimportantfortheAuthoritytoknowwheretheapplicant’ssystemfitsintothechainofconveyanceofamessageandwhattheapplicant’ssystemdoeswiththatmessage.)
28.Foreachelementofthenetworkthatinvolvesradiotransmission(ifany),pleaseprovideanengineer’stechnicalreportthatincludesthefollowinginformation(includenetworklinks,localloopandcellularasappropriate):
a.Technicalnarrative
b.Equipmenttabulationandtechnicalspecifications
c.Transmittersitemap
d.Antennaelementsketch
e.Frequencyallocationstudy
f.Frequencycoveragemap
g.Verticalplaneelevationpattern
h.Frequencieschannelsorband(s)required
i.AntennaMode
j.Effectiveradiatedpower(averagehorizontal)
k.Effectiveantennaheight
l.Transmittingsitecoordinates
29.Doyouwishtoapplyforanallocationofnumbers?Ifso,pleasechecktheappropriatebox(es):
Providedetailsofyourrequirements.
CarrieraccesscodesCarrierselectioncodesEndusernumbersOthernumbers
30. Attachadetailedbusinessplancoveringaperiodofatleast5yearsthatincludes:
NB. Theapplicantmayberequiredtofileamoreprecisebusinessplanfollowingcompletionofitsinterconnectionandinfrastructurearrangements
a.Majorassumptionsused
b.Sourcesoffunding,debtlevels,equityandindependentconfirmationasappropriate
c.Proformafinancialstatementsfor3years,toinclude
balancesheet,cashflowandincomestatements.Inadditiontohardcopies,financialstatementsshouldbeprovidedinspreadsheetformatwithallinputdata,formulasandcalculationsleftintact.
d.Anindicationofwhentheapplicantanticipatesbecomingprofitable
31. Attachamarketingstrategythatincludesforeachofthenetworksorservicestobeprovided:
a.Maintargetmarkets(e.g.wholesaleorretail,residentialorbusiness)
b.Salesplan
32. Providedetailsofyourproposedrates.
33.Providecopiesofyourtermsandconditionsfortheprovisionoftheproposednetworksandservices.
34.Providecopiesofrepresentativesamplesofexistingcontractswithallclassesofcustomer(ifany).
35.HowmanystaffdoyouproposetoemployOUTSIDEtheCaymanIslands?
Initially:After1 yearAfter3 year
36.HowmanystaffdoyouproposetoemployWITHINtheCaymanIslands?
a.Initially
CaymanianExpatriate
b.After 1 year
CaymanianExpatriate
c.After 3 year
CaymanianExpatriate
37.Explainfullyhowthefollowingserviceswillbeprovided:a. Customerserviceandcomplaintresolution
b.Customerbilling
c.Directoryservicestothepublic,andhowdirectoryinformationontheapplicant’sowncustomerswillbemaintainedandmadeavailabletootherslegitimatelyseekingit
d.Accessto911emergencyservices
38. Providedetailsofanyqualityofservicetargetssupportedbytheapplicant.
AnoriginalsignedapplicationandthreepapercopiesmustbefiledwiththeOffice.Allpapercopiesmustbeheldtogetherwithrubberbandsorfasteners.Theapplicantistoprovideanelectroniccopyofitsapplicationviaemailordatastoragedeviceclearlylabelledwiththeapplicant’sname,dateoffiling,andthenamesoftheelectronicfiles.TheOfficeprefersthatelectronicdocumentsbeprovidedintheiroriginalformat(suchaswordprocessingorspreadsheetformat)ratherthanasscannedimagesorpdffiles.TheapplicationfeesmustaccompanytheapplicationinorderfortheOfficetoconsidertheapplication.
1.TheApplicantbysubmittingthisformandanyattachmentstheretorepresents,warrantsandundertakestoandwithOfRegthatallinformation,factsandmatters(togetherthe‘Information’)containedorreferredtointheformandanyattachmentstheretoaretrueandaccurateasatthedateoftheapplicationandcorrectinallrespectsandthatnothing hasbeenomittedwhichrendersanyofsuchInformationincomplete,falseormisleading.
2.SofarassuchInformationrelatesinwholeorinparttopastorpresentmattersoffactuponsubmissionoftheform,theyshallalsobedeemedtoconstitutefundamentalrepresentationsuponthefaithofwhichOfRegmaygranttheLicenceorLicencesappliedfor.
3.PromptlyupontheoccurrenceoforpromptlyupontheApplicantbecomingawareoftheimpendingorthreatenedoccurrence ofanyeventwhichwouldormightreasonablybeexpectedtocauseorconstituteabreachoftherepresentations,warrantiesandundertakingsinsub-clause1above(orwouldhavecausedorconstitutedabreachofthe representations,warrantiesandundertakingsinsub-clause1hadsucheventoccurredorbeenknowntotheApplicantpriortothedateofapplication),theApplicantshallgivewrittennoticeofthesametoOfRegandshalluseitsbestendeavourspromptlytopreventorremedythesame.
4.WheretheInformationconsistsofanyauditedaccountsoftheApplicant,theApplicantbysubmittingthisformandanyattachmentstheretorepresents,warrantsandundertakestoandwithOfRegthatthoseaccountsareaccurateinallmaterialrespectsandshowatrue,completeandfairviewofthestateofaffairs,financialposition,assetsandliabilitiesoftheApplicantandofitsresultsforthefinancialperiodthereinstated.
5.TheApplicantfurthercertifiesthat,tothebestofitsknowledge,anymatterswhichmightinfluenceOfReg’sjudgementastowhethertheApplicant,itsdirectorsandsubstantialshareholdersarefitandproperpersonstoholdanICTlicencehavebeenmadeknowntoOfReg.
SignedonbehalfoftheApplicant:
Fullname(s)ofSignatory(ies):Position:
Date(dd/mm/yyyy)