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' Orange County NC <br />51 <br />Radio Communication Tower and System Infrastructure Upgrade <br />RF Coverage and Sites/Towers <br />Bank References: Please complete attached form. Bank reference form must be signed by an authorized account signer. <br />No. Employees: Est. Annual Sales $: Sales Territory: <br />Has the firm or any of its Principals ever Inen bankrupt? ❑ Yes ❑ No <br />if yes, explain: <br />Company Contact for Account Information: <br />Name Title <br />Phone E -mail address <br />Crown Castle Account Executive you are working with: <br />Will you be requiring Site Acquisition or Construction Services? ❑ Yes ❑ No <br />If yes, and Information is different than Page i of the Credit Application, please complete the additional information below. <br />Business Entity Name: <br />Address: <br />Street <br />Federal Tax I.D. Number: <br />Contact Name: <br />Contact Phone Number: <br />Contact Fax Number: <br />Invoices- Email Address: <br />Invoices -Fax Address: <br />City State ZIP Code <br />*Please note that if no Email or Fax designation Is provided; an invoice will be sent via regular mail <br />August 30, 2013 Page 50 of 51 <br />U <br />