Public Computer Center Annual Performance Report

omb control no. 0660-xxxx

expiration date: xx-xx-xxxx

Public Computer Center Annual Performance Report Introduction

SUBMISSION REQUIREMENTS:

All Broadband Technology Opportunities Program (BTOP) grant recipients are required to complete an annual performance report. The attached performance report form must be completed and submitted after the end of every calendar year, and reports must be submitted separately for each BTOP award. The prime recipient is solely responsible for the accurate completion and timely submission of this form.

DEADLINE:

All recipients are required to submit their annual performance report each year on January 30^th, by 11:59pm ET. The timely submission of performance reports is a requirement of all BTOP awards as stated in the special award conditions. Incomplete submissions will be sent back to the recipient for further information Annual reports are to be submitted in addition to the required quarterly report which is due concurrently. The reports are different in scope and must be answered separately.

COMPLETING THE PERFORMANCE REPORT:

The BTOP performance report form consists of three main sections:

• Section 1: General Information

• Section 2: Report Data Fields

Each question must be answered fully and accurately (within word limits). If your answer to certain questions does not fit in the space provided, please provide additional information in a separate document or spreadsheet, using the format provided in the performance report form. If particular questions do not apply to your project, please write “N/A.” All fields should be filled out with the requested data or “N/A.” Please note that to the extent that only your subrecipient, contractor, and/or subcontractor has access to any of the information requested in the performance report, the prime recipient is responsible for collecting this information and submitting it to NTIA.

Please reference the attached line item instructions for assistance. If you have additional questions, please contact your assigned Federal Program Officer.

DATA REVIEW:

Program Office staff will be responsible for reviewing performance reports and may need to follow up with recipients regarding the submitted data. Recipients must promptly respond to any and all Program Office follow-up questions regarding the submitted data; in some cases, recipients will be required to revise and re-submit performance reports. The data provided will be compared to each recipient’s Baseline Project Plan and will help the Program Office monitor the progress and performance of each BTOP project.

All progress reports will be made publicly available via the Internet.  To the extent that recipients believe that the information they are providing is confidential, recipients may make a request for such information to be kept private and identify any information they believe should not be released to the public.  They should also file both a redacted and an unredacted version of their report.  Recipients should note, however, that the Recovery Act requires substantial transparency and that NTIA may not necessarily approve such requests.  If NTIA does approve, the agency will keep such information private from public disclosure to the extent permitted by law, including the Freedom of Information Act, as amended (5 U.S.C. 552), the Trade Secrets Act, as amended (18 U.S.C. 1905), and the Economic Espionage Act of 1996 (18 U.S.C. 1831 et seq.).

Proposed Annual Performance Report Questions for Public Computer Centers

General Information
		Page	of	Pages
1. Federal Agency and Organization Element to Which Report is Submitted	2. Award Identification Number	3a. DUNS Number
		3b. EIN
4. Recipient Organization (Name and complete address including county, congressional district, and zip code)
5. Current Reporting Period End Date (MM/DD/YYYY)		6. Is this the Last Report of the Award Period?		□ Yes □ No
7. Certification: I certify to the best of my knowledge and belief that this report is correct and complete for performance of activities for the purposes set forth in the award documents.
7a. Typed or Printed Name and Title of Certifying Official		7c. Telephone (area code, number and extension)
		7d. Email Address
7b. Signature of Certifying Official		7e. Date Report Submitted (MM/DD/YYYY)

Project Indicators

1. Are you establishing new Public Computer Centers (PCCs) or improving existing PCCs?

____New

____Improved

____Both

2. How many PCCs were established or improved, and what type of institution(s) were they associated with? Please provide actual total numbers to date. Unless otherwise indicated in the instructions, figures should be reported cumulatively from award inception to the end of the most recent calendar year. Recipients should only count the PCCs that were fully established or in which improvements have been fully completed in that year (that is, partial improvements should not be counted).

Institutions

Established

Improved

Total

Schools (K-12)

Libraries

Community Colleges

Universities/Colleges

Medical/Healthcare Facilities

Public Safety Entities

Job-Training and/or Economic Development Institution

Other Community Support-Governmental (please specify):

Other Community Support-Non-Governmental (please specify):

3. Please complete the following chart for each PCC established or improved using BTOP funds. Please provide actual total numbers to date.

3.a. New PCCs

New PCC Address

Number of Workstations Available to the Public

Total Hours of Operation per 120-hour Business Week

Total Hours of Operation per 48-hour Weekend

Speed of Broadband Access to Facility (Mbps)

Average Number of Users per Week

3.b. Improved PCCs

Improved PCC Address

Number of Workstations Available to the Public

Total Hours of Operation per 120-hour Business Week

Total Hours of Operation per 48-hour Weekend

Speed of Broadband Access to Facility (Mbps)

Average Number of Users per Week

Prior to Improvement

After Improvement

4.a. Please check the primary uses of the PCCs funded by this award. (Check all that apply.)

____Open Lab Time

____Training

____Other

4.b. If "other," please specify the primary use of the PCCs:

5. Please list all of the PCC broadband equipment and/or supplies you have purchased using BTOP grant funds or other (matching) funds, including any customer premises equipment or end-user devices. If additional space is needed, please attach a list of equipment and/or supplies. Unless otherwise indicated in the instructions, figures should be reported cumulatively from award inception to the end of the most recent calendar year. Please also describe how the equipment and supplies have been deployed (100 words or less).

Manufacturer

Item

Unit Cost per Item

Number of Units

Narrative description of how the equipment and supplies were deployed

Totals

6. For PCC access and training provided with BTOP grant funds, please provide the information below. Unless otherwise indicated in the instructions, figures should be reported cumulatively from award inception to the end of the most recent calendar year.

Types of Access or Training

Number of People Targeted

Number of People Participating

Total Hours of Training Offered

Open Lab Access

Multimedia

Office skills

ESL

GED

College Preparatory Training

Basic Internet and Computer Use

Certified Training Programs

Other (please specify):

Total

7a. Please describe how your Public Computer Center(s) promotes economic recovery in your area, such as through providing job training, access to job searches, online course offerings, certifications and the like (150 words or less).

7b. Please describe the extent to which your project has resulted in users obtaining new or improved jobs (150 words or less).

8. To the extent that you have made any subcontracts or subgrants, please identify any subcontracts or subgrants that have been made to socially and economically disadvantaged small business concerns as defined by 8(a) of the Small Business Act, 15 U.S.C. 647, as modified by NTIA’s adoption of an alternative small business size standard for use in BTOP.

9. Please describe any best practices/lessons learned that can be shared with other similar BTOP projects (250 words or less).

Public Computer Center Performance Report Instructions

Line Item Instructions for the Performance Report Attachment

(BTOP Annual Report for Public Computer Center Projects)

Question Number	Reporting Item	Instructions	Clarification and Definitions
General Information
1	Federal Agency and Organizational Element to Which Report is Submitted	Enter the name of the Federal agency and organizational element identified in the award document or otherwise instructed by the agency.	Enter “Department of Commerce, National Telecommunications and Information Administration.”
2	Award Identification Number	Enter the award number assigned to each award by the Federal agency.	Enter your 10 digit grant award number listed on your award package CD-450 form.
3a	DUNS Number	Enter the recipient organization’s Data Universal Numbering System (DUNS) number or Central Contract Registry extended DUNS number.	The number entered should match the DUNS number listed on your award package CD-450 form.
3b	EIN	Enter the recipient organization’s Employer Identification Number (EIN).	The number entered should match the EIN number listed on your award package CD-450 form.
4	Recipient Organization	Enter the name and complete address of the recipient organization including zip code.	The data entered should match the data listed on your award package CD-450 form.
5	Reporting Period End Date	Enter the last day of the current reporting period.	The date entered should match a calendar year quarterly end date.
6	Is this the last report of the award period?	Check yes or no.	The last report is the final performance report submitted during the closeout of the grant.
7a	Certifying Official	Enter the name of your organization’s Certifying Official.	The Certifying Official should be the AOR or the Principal Investigator/Project Manager designated by the AOR.
7b	Certifying Official Signature	Enter the signature of your organization’s Certifying Official.	The Certifying Official should be the AOR or the Principal Investigator/Project Manager designated by the AOR.
7c	Telephone Number	Enter the telephone number of the Certifying Official.	The number may be needed in case of any follow-up questions regarding the performance report.
7d	Email Address	Enter the email address of the Certifying Official.	The email address may be needed in case of any follow-up questions regarding the performance report.
7e	Report Submission Date	Enter the date the report was submitted.	Reports are to be submitted by the quarterly due dates.
Project Indicators
1	Project Purpose	Please identify whether your project establishes new PCCs, improves existing PCCs, or both.	A new PCC includes all PCCs that do not replace or improve upon previously existing PCCs. New PCCs can include new construction or the conversion of previous building space. An improved PCC includes all previously existing PCCs; improvements can involve renovating the physical location of the PCC, expanding the number of workstations, improving the level of technology and type of equipment available, etc.
2	Associated Institutions	How many PCCs were established or improved, and what type of institution(s) were they associated with? Please provide actual total numbers to date. Figures should be reported cumulatively from award inception to the end of the most recent calendar year. Recipients should only count the PCCs that were fully established or in which improvements have been fully completed in that year (that is, partial improvements should not be counted).	If a PCC served more than one type, enter data for each applicable institution. Multi-use facilities should be classified as one type or another and not counted twice. Enter “N/A” if your project’s PCCs are not associated with a particular type of institution.
3a	New PCCs	Please complete the following chart for each PCC established using BTOP funds. Please provide actual total numbers to date.	Number of Workstations Available to the Public: Please provide the total number of individual workstations that can be accessed by members of the public. Total Hours of Operation per 120-hour Business Week: Please provide the total number of hours that the PCC is open and accessible to the public Monday through Friday (a maximum of 24 hours per day or 120 hours). Total Hours of Operation per 48-hour Weekend: Please provide the total number of hours that the PCC is open and accessible to the public on Saturday and Sunday (a maximum of 24 hours per day or 48 hours). Speed of Broadband Access at the Facility (Mbps): Please provide the average speed of access for the facility. Average Number of Users per Week: Please provide the average number of individuals who use the services and equipment offered by the PCC under this grant program. To calculate this number, record the number of users in your center each week during the reporting period, eliminate any outlier numbers (e.g., during a week where your center was closed more than 50% of the normal operating time), and then average for a given week.
3b	Improved PCCs	Please complete the following chart for each PCC improved using BTOP funds. Figures should be reported cumulatively from award inception to the end of the most recent calendar year. Please count only the PCCs whose improvements have been fully completed in that year; partial improvements should not be recorded.	Figures are requested for each PCC before improvement and after improvement. Number of Workstations Available to the Public: Please provide the total number of individual workstations that can be accessed by members of the public. Total Hours of Operation per 120-hour Business Week: Please provide the total number of hours that the PCC is open and accessible to the public Monday through Friday (a maximum of 24 hours per day or 120 hours). Total Hours of Operation per 48-hour Weekend: Please provide the total number of hours that the PCC is open and accessible to the public on Saturday and Sunday (a maximum of 24 hours per day or 48 hours). Speed of Broadband Access at the Facility (Mbps): Please provide the average speed of access for the facility. Average Number of Users per Week: Please provide the average number of individuals who use the services and equipment offered by the PCC under this grant program. To calculate this number, record the number of users in your center each week during the reporting period, eliminate any outlier numbers (e.g., during a week where your center was closed more than 50% of the normal operating time), and then average for a given week.
4	PCC Primary Use	Please provide the primary uses or the PCCs funded by this award. (Check all that apply.)	Open Lab Time: Open access to services and equipment for the public. Training: Scheduled training courses offered to the public. Other: If the primary use of the PCC is neither open lab time or training, please describe.
5	PCC Equipment and/or Supplies	Please list all of the PCC broadband equipment and/or supplies you have purchased using BTOP grant funds or other (matching) funds, including any customer premises equipment or end-user devices. If additional space is needed, please attach a list of equipment and/or supplies. Figures should be reported cumulatively from award inception to the end of the most recent calendar year. Please also describe how the equipment and supplies have been deployed.	Equipment is defined as tangible, nonexpendable, personal property having a useful life of more than one year and an acquisition cost of $5,000 or more per unit. Supplies are defined as all tangible personal property other than “equipment”. Please limit narrative descriptions to 100 words or less.
6	PCC Access and Training	For PCC access and training provided with BTOP grant funds, please provide the information requested. Figures should be reported cumulatively from award inception to the end of the most recent calendar year.	Participants may be counted more than once if they attended multiple types of training. You may specify additional types of training or access as needed. To calculate “Total Hours of Training Offered,” multiply the hours per program by the number of participants. For example, if 10 people took a one hour class, that program provided 10 training hours.
7a	Economic Recovery	Please describe how your Public Computer Center(s) promotes economic recovery in your area, such as through providing job training, access to job searches, online course offerings, certifications and the like.	Include in your narrative how your project meets the statutory purposes of BTOP and the Recovery Act. Please limit narrative descriptions to 150 words or less.
7b	Economic Recovery	Please describe how your project has helped users obtain new or improved jobs.	To the extent that your project provides job training, job search, or job placement services, please identify your project’s success in placing individuals in new or improved jobs. Please limit narrative descriptions to 150 words or less.
8	Small Business Concern	To the extent that you have made any subcontracts or subgrants, please identify any subcontracts or subgrants that have been made to socially and economically disadvantaged small business concerns as defined by 8(a) of the Small Business Act, 15 U.S.C. 647, as modified by NTIA’s adoption of an alternative small business size standard for use in BTOP.	BTOP defines a “socially and economically disadvantaged small business concern as “ a firm, together with its controlling interests and affiliates, with average revenues not exceeding $40 million for the preceding three years, and that meets the definition of a socially and economically disadvantaged small business concern under the Small Business Act.”
9	Best Practices	Please describe any best practices/lessons learned that can be shared with other similar BTOP projects, if any.	Please limit narrative descriptions to 250 words or less.

Notwithstanding any other provision of law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB control number. Public reporting burden for this collection of information is estimated to average 2.48 hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Anthony G. Wilhelm, Director, Broadband Technology Opportunities Program, Office of Telecommunications and Information Applications, National Telecommunications and Information Administration, U.S. Department of Commerce (DOC), 1401 Constitution Avenue, N.W., HCHB, Room 4887, Washington, D.C. 20230

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