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Exhibit A <br /> STATEMENT OF ACCEPTANCE <br /> Seattle SMSA Limited Partnership, a Delaware limited partnership, d/b/a Verizon Wireless <br /> ("Verizon Wireless"), for itself, its successors and assigns, hereby accepts and agrees to be bound <br /> by all lawful terms, conditions and provisions of the non-exclusive telecommunications franchise <br /> granted to Verizon Wireless pursuant to Ordinance No. XXX-XX, which became effective on <br /> XX, 20 . The undersigned is an officer of Verizon and is authorized to accept this <br /> franchise on behalf of Verizon Wireless <br /> SEATTLE SMSA LIMITED PARTNERSHIP <br /> d/b/a VERIZON WIRELESS <br /> By: Cellco Partnership, its General Partner <br /> By: Date: <br /> Name: <br /> Title: <br /> STATE OF ) <br /> )ss. <br /> COUNTY OF ) <br /> On this day of , 201X, before me the undersigned, a Notary Public in and <br /> for the State of , duly commissioned and sworn, personally appeared, <br /> of Cellco Partnership, General Partner of Seattle SMSA Limited <br /> Partnership, a Delaware limited partnership, d/b/a Verizon Wireless, the company that executed <br /> the within and foregoing instrument, and acknowledged the said instrument to be the free and <br /> voluntary act and deed of said company,for the uses and purposes therein mentioned, and on oath <br /> stated that he/she is authorized to execute said instrument. <br /> IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal on the date <br /> hereinabove set forth. <br /> Signature <br /> NOTARY PUBLIC in and for the State of <br /> , residing at <br /> MY COMMISSION EXPIRES: <br /> Seattle SMSA Limited Partnership <br /> (Verizon Wireless) <br /> Small Cell Franchise 33 of 33 <br />