OMB 3060-0806 DRAFT VERSION
FCC Form 471 Approval by OMB
3060-0806
Schools and Libraries Universal Service
Services Ordered and Certification Form
Estimated Average Burden Hours Per Response: 4 hours
Instructions for Completing the
Schools and Libraries Universal Service
Services Ordered and Certification Form (FCC Form 471)
Contents
B. Who Can Provide E-rate Eligible Services 3
C. When, Where, and How Many FCC Forms 471 to File 3
D. Assistance in Completing This Form 4
A. Block 1: Billed Entity Information 4
B. Block 4: Discount Calculation Worksheets 6
The FCC Form 471 is filed to request discounts on eligible services for eligible schools, libraries, and consortia of those entities under the E-rate program (more formally known as the schools and libraries universal service support program). Starting in Funding Year 2015, the FCC Form 471 must be completed online. The FCC Form 471 must reference services that were competitively bid with an FCC Form 470 posted on the USAC website for at least 28 days before the FCC Form 471 is filed, unless you are specifically exempted by FCC rules from the FCC Form 470 posting requirement. The 28-day waiting period begins after the FCC Form 470 is posted on the USAC website, www.usac.org/sl, or after a request for proposal (RFP) is made publicly available, whichever is later. This 28-day waiting period must occur before you may execute any contracts for contracted services, as applicable; before you select your service provider for tariffed or month-to-month services; and before you submit your completed FCC Form 471. It is possible that an FCC Form 470 posted in a prior funding year may be used where such a form resulted in a multi-year contract. (See FCC Form 470 Instructions.)
All participants are required to file a FCC Form 471 application. Specifically, every entity responsible for making payments directly to a service provider, the “billed entity,” must file an FCC Form 471 application. Even if several billed entities together file a single FCC Form 470, each billed entity must file a separate FCC Form 471. An entity that receives a bill, but does not make payments to the service provider on that bill, is not a billed entity, and therefore should not be filing an FCC Form 471 application.
While all applicants must file an FCC Form 471, some applicants seeking funding for a multi-year contract in Funding Year 2015 can fill out a streamlined application in subsequent funding years. These applicants will be required to provide only basic information identifying the applicant, confirm that the funding request is a continuation of an FRN from a previous year based on a multi-year contract, and identify and explain any changes to their application, such as changes in the discount rate, the membership of a consortium, or the services ordered. This simplified application process will be available to any applicant, beginning in Funding Year 2016, that has: (1) submitted a complete FCC Form 471, in Funding Year 2015 or later, for the first funding year they are seeking E-rate support under a multi-year contract that is no longer than five years; and (2) any changes in the requested services or to the terms and conditions under which those services are provided are within the scope of the establishing FCC Form 470 and the applicable contract.
For purposes of the schools and libraries universal service support program, schools must meet the statutory definition of elementary and secondary schools found in the No Child Left Behind Act of 2001, 20 U.S.C. § 7801(18) and (38). This definition says that an elementary school is a non-profit institutional day or residential school, including a public elementary charter school that provides elementary education, as determined under state law. See 47 C.F.R. § 54.500 and 20 U.S.C. § 7801(18). A secondary school is a non-profit institutional day or residential school, including a public secondary charter school, that provides secondary education, as determined under state law, and does not include schools that offer education beyond grade 12. See 47 C.F.R. § 54.500; 20 U.S.C. § 7801(38). In addition, schools operating as for-profit businesses or who have endowments exceeding $50 million are not eligible. See 47 C.F.R. § 54.501(a)(3).
Libraries must meet the statutory definition of library or library consortium found in the Library Services and Technology Act, 20 U.S.C. § 9121 et seq. (1996) (LSTA), and must be eligible for assistance from a state library administrative agency under that Act. A library includes: “(1) a public library; (2) a public elementary school or secondary school library; (3) an academic library; (4) a research library, which for the purposes of this definition means a library that: (i) makes publicly available library services and materials suitable for scholarly research and not otherwise available to the public; and (ii) is not an integral part of an institution of higher education; and (5) a private library, but only if the state in which such private library is located determines that the library should be considered a library for purposes of this definition.” See 47 C.F.R. § 54.500. A library's eligibility for universal service funding also depends on its funding as an independent entity. Only libraries whose budgets are completely separate from any schools’ (including, but not limited to, elementary and secondary schools, colleges, and universities) shall be eligible to receive discounted services under the universal service support mechanism. See 47 C.F.R. § 54.501(b)(2). For example, an elementary school library would only be eligible to receive discounted services if its budget were completely separate from the elementary school. If its budget were not completely separate from the elementary school, the elementary school library would not be eligible for support independent from the school with which it is associated. Libraries operating as for-profit businesses shall not be eligible for discounts. See 47 C.F.R. § 54.501(b)(3).
A consortium is “any local, statewide, regional, or interstate cooperative association of schools and/or libraries eligible for E-rate support that seeks competitive bids for eligible services or funding for eligible services on behalf of some or all of its members.” See 47 C.F.R. § 54.500.
A library consortium is “any local, statewide, regional, or interstate cooperative association of libraries that provides for the systematic and effective coordination of the resources of school, public, academic, and special libraries and information centers, for improving services to the clientele of such libraries.” See 47 C.F.R. § 54.500.
To provide eligible services under this program, service providers must secure a SPIN from USAC and certify that they will comply with program rules.
The FCC Form 471 must be filed during a specific application window each year. In general, the application filing window opens about six months before the start of the funding year and is open for about two and a half months. Applicants should check the USAC website, www.usac.org/sl, or contact the USAC Client Service Bureau (CSB) at 1-888-203-8100 to obtain the filing window dates.
All materials associated with the FCC Form 471 must be filed by 11:59 p.m. ET on or before the last day of the FCC Form 471 application filing window in order for the request to receive consideration as inside the window. It is your responsibility to check the USAC website or contact CSB to obtain the announcement of the filing window dates.
The required materials are:
The FCC Form 471 itself;
The Block 6 certification pages of the FCC Form 471 with the signature of the authorized person (online with PIN or on paper).
Note that while the FCC Form 471 can be filed anytime during the application filing window, the filing of any FCC Form 471 must be done at least 28 days after the FCC Form 470 is posted, if one is required. The FCC Form 470 Receipt Notification Letter will identify the earliest date – the Allowable Vendor Selection/Contract Date – on which you may choose a service provider and, if applicable, execute a contract, and sign and submit an FCC Form 471. The Allowable Vendor Selection/Contract Date will also be indicated on the FCC Form 470 posted on the USAC website.
All FCC Forms 471 and certifications submitted by the close of the application filing window are considered as if they had arrived on the same day, and have priority over those postmarked after the closing date of the window.
Where:
You must complete and submit the FCC Form 471 by filing the form online on USAC’s Schools and Libraries program website at www.usac.org/sl.
After you have completed the form, you may submit your FCC Form 471 certifications online if you have a Personal Identification Number (PIN). If the authorized person does not yet have a PIN, one will be automatically issued once USAC successfully processes a paper certification for any FCC Form 470, 471, or 486. The PIN can be used by that authorized person for any forms filed on behalf of that Billed Entity. When you submit your certifications online with the PIN, you will receive a confirmation so that you can be assured that your submission has met any filing deadlines.
If the authorized person has forgotten the PIN and needs USAC to issue a replacement PIN, contact CSB at 1-888-203-8100. The Change or Disable Applicant PIN tool can be used to disable a PIN, change a PIN or provide a new e-mail address if the original e-mail address has changed. Mailing addresses cannot be changed, but you can provide a new e-mail address. The only way to change the mailing address is to file a new form or form certification on paper and include your mailing address in the authorized person's mailing address fields.
You may file more than one FCC Form 471 and, in fact, you must file separate applications for Category One (Internet Access, Telecommunications Services, and/or Voice Services) and Category Two (Internal Connections, Managed Internal Broadband Services, and/or Basic Maintenance of Internal Connections). This separation allows USAC to process applications more quickly. If there are questions about your application, decisions on both Category One and Category Two requests may be delayed.
You will be assisted in the process by step-by-step prompts when completing this form online. Applicants are also urged to consult the Reference Area of USAC’s Schools and Libraries program website for guidance in completing this form. Complete program information is also available by contacting CSB via e-mail using the “Submit a Question” link on the USAC’s Schools and Libraries program website, via fax at 1-888-276-8736, or via toll-free telephone at 1-888-203-8100.
“You” refers throughout this form to the Billed Entity – the party actually paying bills for the eligible schools and libraries listed in this application form.
Applicant’s Form Identifier – Applicants may assign a unique number or letter of your own devising to facilitate communication with us about THIS particular FCC Form 471. This Applicant’s Form Identifier can be very simple; for example, if you are filing three FCC Forms 471, you might label them “A,” “B,” and “C.” The Applicant’s Form Identifier can also be descriptive, such as “Internet.” Choose identifiers that suit your own record keeping needs.
Block 1 of FCC Form 471 asks you for your address and other contact information, if not already on file. Prior to completing this form, you must have a Billed Entity Number. If you do not have one, contact the USAC CSB at 888-203-8100. Much of the information in Block 1 will appear in the designated fields after the Billed Entity Number is entered.
Item 1 – Lists the name of the Billed Entity. As the Billed Entity, you may be an individual school, a school district that is the Billed Entity for its schools, a library (outlet/branch, system), or a consortium of those entities. A Billed Entity may also be a city, a state, or an entity created solely to participate in this universal service discount mechanism, provided that the entity actually pays the bills for the service to the service provider. The billed entity itself does not have to be eligible for discounts.
Item 2 – The Funding Year will appear automatically on your application. Funding years begin on July 1 and end on the following June 30. For example, Funding Year 2015 runs from July 1, 2015 to June 30, 2016.
Items 3a – Your Billed Entity Number (BEN) is a unique number assigned to your organization or institution by USAC as a means of identifying you every time you file an application or otherwise communicate with us. If you have applied for funds in previous years, or have been identified in an application filed on your behalf, you should have already been assigned this number. If you do not have a record of your Billed Entity Number, or if you believe you have never been assigned such a number, please contact CSB at 1-888-203-8100. (See also “Assistance in Completing this Form” above.)
Items 3b – The FCC Registration Number is a unique number assigned to your organization or institution by the FCC as a means of identifying you every time you file an application or otherwise communicate with us. Note that if you share a tax ID with other entities, you will also share a single FCC Registration Number. If you have applied for funds in previous years you should have already been assigned this number. If you do not have a record of your FCC Registration Number or if you believe you have never been assigned such a number, please contact the FCC Registration Number website at https://apps.fcc.gov/coresWeb/publicHome.do, or call the FCC Registration Number help line at 1-877-480-3201 (Mon.-Fri. 8 a.m.-6 p.m. ET).
Items 4a-4c – Provide the full mailing address, whether a street address, Post Office Box number, or route number of the Block 1 entity. In addition, please provide your telephone number with area code and extension and your fax number.
Item 5a – Check the one box that best describes the type of application you are filing. If you are filing as an individual school, you should check the first box. If you are filing as a public or non-public school district or local education agency (LEA), you should check the second box, even if this application only contains funding requests for a single school from within your school district. If you are filing as a library (outlet/branch, system, or library consortium as defined under LSTA), you should check the third box. If you are filing as a consortium, you should check the fourth box. (You may be a consortium of schools, libraries, or some combination of the above, which may include eligible and ineligible entities.) If you check the fifth box, you must also check one or more of the three choices provided in this item – all public schools/districts in the state, all non-public schools in the state, and/or all libraries in the state – and indicate the two-letter state code. Please note that if your application represents SOME but not ALL of any of these three types of entities, you should NOT check the statewide application box.
In addition, if you are a consortium that includes non-governmental entities ineligible for universal service support, you should note that you cannot negotiate pre-discount prices below tariff rates for interstate services from incumbent local telephone companies.
Item 5b – Check all boxes that apply to you or any of the entities included in this specific form.
Item 6a – Provide the name of the person who should be contacted with questions about this application. This person should be able to answer questions regarding the information included on this form and the services you request.
Items 6b-6f – Provide your correspondence address. USAC will use this address to mail correspondence about this form, including the Funding Commitment Decision Letter. If the contact person’s address information is the same as Item 4 above, check the appropriate box instead, or if you are using a consultant, you may indicate that the correspondence should go to their address. You must enter an email address, which will be used by USAC for all contact regarding this application. Also provide the contact person’s phone and number and fax number. Finally, in Item 6f, you may choose to provide an alternate telephone number, address, or an alternate contact name that we may use during holiday/vacation/summer periods. Item 6f should contain only the name of the alternate contact person – if appropriate – and an alternate phone number, fax number, and/or e-mail address.
Item 6g – If a consultant is assisting you with your E-rate process, provide the Consultant Registration Number (CRN). A consultant is any non-employee of the entity applying for funding that assists in filling out the application materials for a fee. “Non-employee” includes contractors or others who are employed by the entity on a contract or short-term basis who do not receive a W-2 application from the entity filling out the application. Once you enter the CRN, the system will provide the contact information for that consultant. If the consultant does not have a Consultant Registration Number, the consultant can contact CSB to obtain one at 1-888-203-8100. (See also “Assistance in Completing this Form” above.)
The basic discount calculation is performed at the school district level. Individual schools within a school district and library outlets/branches within a library system do not calculate individual discounts. Independent schools not part of a public or non-public school district or library system will calculate their discounts based on the own student population. Independent libraries, not part of a library system, will calculate their discounts based on the NSLP data for the school district in which they are located.
All the individual schools in a public or non-public school district use the school district average discount.
Library systems and library outlets/branches use the NSLP information of the public school district in which the main branch of the library is located, though they calculate the urban/rural status based on the location of their own library outlets.
A consortium or statewide application uses a simple average of the discounts of its member entities. The consortium includes the school district calculation for each school district entity number that will be featured in any worksheet on the form.
Individual schools applying as if they were a school district or as if they were a consortium – for example, diocesan schools – use the school district or consortium model, respectively. If they are applying as a consortium, each individual school will be treated as a consortium member and will complete a school district calculation for that individual school in addition to the entity-specific information in Item 7a.
To assist you in completing the Block 4, there are two tools that applicants can use to save time.
Copy Block 4: The Copy Block 4 feature allows users to copy the Block 4 data from another FCC Form 471. In Funding Year 2015, this functionality may be limited to pulling information from this Funding Year FCC Forms 471.
Block 4 Bulk Upload: This allows users to upload Block 4 information from a spreadsheet, which will then populate the fields on the FCC Form 471. More information is available from USAC’s website.
|
Category One schools and libraries discount matrix |
Category Two schools and libraries discount matrix |
||
Discount level |
Discount level |
|||
Percent of students eligible for National School Lunch Program |
Urban |
Rural |
Urban |
Rural |
< 1…………………….. |
20 |
25 |
20 |
25 |
1-19…………………… |
40 |
50 |
40 |
50 |
20-34………………….. |
50 |
60 |
50 |
60 |
35-49………………….. |
60 |
70 |
60 |
70 |
50-74………………….. |
80 |
80 |
80 |
80 |
75-100…………………. |
90 |
90 |
85 |
85 |
Voice Services (Category One) are subject to a 20 percentage point reduction each year beginning with Funding Year 2015. For example, if you are eligible for a 70 percent discount for Category One services, your discount on Voice Services will be 50 percent for FY2015 and 30 percent for FY2016.
Item 7 – All Entities in the School District or Library System
For each school district or library system, you will need to provide a list of all of the members of that school district or library system, regardless of whether they are receiving service on this application or not.
Enter the School District or Library System BEN, and the system will return the name of the school district or library system.
If you are filing as a consortium, you will need to complete a worksheet for each of your consortium members (school districts, library systems, or independent schools and/or libraries) listing all of the individual schools in each school district and all of the library outlets/branches in each library system. These worksheets will then be combined by the online system to generate the consortium level worksheet and discount calculation.
Item 7a – List of all Schools and Libraries in the School District or Library System
Instructions for Schools and School Districts:
Please provide a complete list of all of the entities in your school district or library system, including Non-Instructional Facilities (NIF), even if they are not receiving service on this application. For each individual school or NIF in the school district, provide:
Entity number, and the system will then provide the individual school or NIF name.
National Center for Education Statistics (NCES) code: The NCES is the primary federal entity for collecting and analyzing data related to education. A school or school district’s NCES number can be found at: http://nces.ed.gov/globallocator/. Some entities, such as private schools, non-instructional facilities, or new schools or schools under construction may not have codes. Private schools can request to be added to the NCES database at: http://nces.ed.gov/surveys/pss/privateschoolsearch/school_requestform.asp
Urban or Rural status: The FCC’s definition of rural is new for Funding Year 2015. The system will automatically provide the Urban/Rural status of the entity based on the physical address for that entity in USAC’s systems. If you disagree with that determination, you may override this result; however, such actions will cause a delay in the processing of your application. To verify the entity’s address in USAC’s systems, please contact the USAC CSB at 888-203-8100. A separate lookup tool is also available on USAC’s website, http://www.usac.org/sl. A school district that that has more than 50% of its schools in a rural areas that meet the statutory definition of eligibility for E-rate support will qualify for the additional rural discount (NIFs are not included in this determination).
Indicate if this is a non-instructional facility (NIF): A NIF is a school district building that has not been designated by the state as a school. Examples of NIFs include, but are not limited to, administrative buildings, school bus barns and garages, offices, and facilities associated with athletic activities that are separate from any school.
State school IDs (LEA code and school code): Please provide this information which is assigned by the state where the school is located.
Indicate the total number of students in the school and indicate if the entry is an estimate (this entry should be the same for each entity within a single school). The student count in Item 7a is used to determine the number of students for the purposes of Category Two funding and should not be confused with the student count for calculating the discount. Students who attend multiple schools, such as those that attend vocational schools part-time, may be counted by both schools in Item 7a in order to ensure appropriate local area networks (LANs) and wireless local area networks (WLANs or Wi-Fi networks) deployment for both buildings.
Indicate if the number of students in the school is based on an estimate: If it is impossible to calculate the number of students in a school because of new construction or another valid reason, applicants are permitted to make a reasonable estimate of the number of students who will be attending a school during a particular funding year and seek support for Category Two services for the estimated number of students. However, if an applicant overestimates the number of students who enroll in that school, it must return to USAC by the end of the next funding year any Category Two funding in excess of that to which it was entitled based on the actual number of enrolled students.
Indicate if an alternative discount mechanism was used to calculate the number of students eligible for NSLP. Schools may use mechanisms other than actual school lunch participation to determine a school's level of need, as long as those mechanisms are based on, or do not exceed, the same measure of poverty used by NSLP. For further information, see Alternative Discount Mechanisms on the usac.org/sl website. Examples of alternative discount mechanisms include:
Surveys: Starting in FY 2015, applicants may no longer extrapolate results of surveys conducted to determine the number of students eligible for NSLP.
Community Eligibility Option: Schools increasingly have the option of participating in the CEP, which neither requires nor permits schools to collect individual student eligibility information. A school is eligible for community eligibility if at least 40 percent of its students are “directly certified,” i.e., identified for free meals through means other than household applications (for example, students directly certified as receiving benefits from the Supplemental Nutrition Assistance Program). To compensate for low-income families not reflected in the direct certification data, schools apply a standard, national factor (multiplier) to their identified student population in order to determine the total percentage of meals for which they will be reimbursed by the USDA. Each school that participates in CEP must determine on a school-by-school basis the number of students to be counted as eligible for NSLP for purposes of E-rate. In making that determination, a school should multiply the percentage of directly certified students by the CEP national multiplier. This percentage should then be applied to the total number of students attending the school as their home school to determine the number of students eligible for NSLP for purposes of E-rate at that school location, provided that the number of eligible students may not exceed the number of students attending the school. If the student count calculation results in a fraction, applicants must round up (if 0.5 or above) or down (if less than 0.5) to the closest whole number.
School Attributes: Indicate if the school serves a special population (such as pre-kindergarten, Head Start, adult education, or juvenile justice) or if it is an Educational Service Agency, includes dormitory facilities, serves tribal students, or is charter school. Indicate all that apply.
For each school, the system will then calculate the Category Two School Budget and display both the pre-discount and post-discount amounts. NIFs do not qualify for their own Category Two budget. Starting in Funding Year 2015, the FCC made a significant change in the way that funding for Category Two services is allocated. Schools in districts that seek Category Two funding during Funding Years 2015 or 2016 will be eligible to request E-rate discounts on purchases of up to $150 (pre-discount) per student for Category Two services over a five-year period. It is important to note that this amount is before the Category Two discount has been applied (pre-discount). Therefore, schools at the highest Category Two discount rate of 85 percent will be eligible for up to $127.50 per student. Schools with a lower discount rate will qualify for less. The Commission also established a pre-discount funding floor which will ensure that all schools qualify for a minimum of $9,200. If an applicant receives funding for Category Two in Funding Year 2015 or 2016, the five year budget will apply in the remaining funding years, in lieu of the existing “two-in-five” rule. Applicants may choose to spend their budget in one year, or may spread their purchases across the five funding years. If the E-rate program provides commitments up to the applicant’s five-year Category Two budget in the first year, and the school’s enrollment does not increase, the applicant will not receive any Category Two funding commitments in the subsequent four funding years. Finally, note that the budget is set on a per school basis and is not shared within the school district. For further information about Category Two Applicant Budgets, please check the USAC website or contact CSB at 1-888-203-8100.
Instructions for Libraries and Library Systems:
Please provide a complete list of all of the library outlet/branches in your library system, including Non-Instructional Facilities, even if they are not receiving service on this application. For each individual library or non-instructional facility (NIF) in the library system, provide:
Entity number, and the system will then provide the individual library or NIF name.
Federal-State Cooperative System (FSCS) code: This is the identification code assigned by NCES to libraries and library systems. The FSCS for public libraries is a cooperative program between the federal government and the states, whose data on public libraries is received from The Institute of Museum and Library Services (IMLS). A library or library system’s FSCS code can be found at http://nces.ed.gov/surveys/libraries/librarysearch/.
Urban or Rural status: The FCC’s definition of rural is new for Funding Year 2015. The system will automatically provide the Urban/Rural status of the entity based on the physical address for that entity in USAC’s systems. If you disagree with that determination, you may override this result; however, such actions will cause a delay in the processing of your application. To verify the entity’s address in USAC’s systems, please contact the USAC CSB at 888-203-8100. A separate lookup tool is also available on USAC’s website, http://www.usac.org/sl. A library system that that has more than 50% of its outlets/branches in a rural areas that meet the statutory definition of eligibility for E-rate support will qualify for the additional rural discount (NIFs are not included in this determination). Note that even though libraries use the NSLP data from the school district in which the main branch is located, it derives its own urban/rural status based on the location of the library system’s outlets/branches. This may result in the library system qualifying for a rural discount even though the school district does not.
Indicate if this is a non-instructional facility (NIF): A NIF is a library building without public areas. Examples of non-instructional facilities on library property include, but are not limited to, administrative buildings, bookmobile garages, interlibrary loan facilities, and library technology centers.
Indicate the total square footage (including non-public areas): This is the area on all floors enclosed by the outer walls of the library. Include all areas occupied by the library, including those areas off-limits to the public. This does not include any spaces outside the library building’s outer walls, such as patios and parking lots.
Indicate if this is the main branch of the library system. If so, provide the Billed Entity number of the school district in which the main branch of the library system is located.
Library Attributes: Indicate if the library is a public, private, academic, research, or tribal library. Also indicate if the library is a bookmobile or kiosk. Check all that apply.
For each library, the system will then calculate the Category Two School Budget and display both the pre-discount and post-discount amounts. NIFs do not qualify for their own Category Two budget. Starting in Funding Year 2015, the FCC made a significant change in the way that funding for Category Two services is allocated. Libraries that seek Category Two funding during Funding Years 2015 or 2016 will be eligible to request E-rate discounts on purchases of up to $2.30 per square (pre-discount) for Category Two services over a five-year period. It is important to note that this amount is before the Category Two discount has been applied (pre-discount). Therefore, libraries at the highest Category Two discount rate of 85% will be eligible for up to $1.96 per square foot. Libraries with a lower discount rate will qualify for less. The Commission also established a pre-discount funding floor which will ensure that libraries with less than 4,000 square feet qualify for a minimum of $9,200. If an applicant receives funding for Category Two in Funding Year 2015 or 2016, the five year budget will apply in the remaining funding years, in lieu of the existing “two-in-five” rule. Applicants may choose to spend their budget in one year, or may spread their purchases across the five funding years. If the E-rate program provides commitments up to the applicant’s Category Two budget in the first year, and the library’s square footage does not increase, the applicant will not receive any Category Two funding commitments in the subsequent four years. Finally, note that the budget is set on a per library basis and is not shared within the library system. For further information about Category Two Applicant Budgets, please check the USAC website or contact CSB at 1-888-203-8100.
Item 7b – School District Discount Calculation
For each school district entity number that will be featured on the form, provide the following information:
The school district name and BEN will be populated from Item 7.
Total number of students in the school district is used to determine the district-wide discount calculation and should include all of the students in the school district as a whole, counting each student only once. This number should not be confused with the number of students listed on a school by school basis for the purposes of Category Two funding in Item 7a. If any students in the school district attend more than one school, this number will not equal the sum of the student counts in Item 7a. This is because that item allows students to be at each of the schools that they attend. In Item 7b, students that attend multiple schools should only be counted one time.
Note that USAC provides an optional online worksheet to assist applicants with completing Item 7b. This optional worksheet allows you to provide school-level information that will then be summed by the system to provide your total student and total student NSLP numbers.
Total number of students in the school district eligible for the National School Lunch Program (NSLP).
Each school that participates in Community Eligibility Program (CEP) must determine on a school-by-school basis the number of students to be counted as eligible for NSLP for purposes of E-rate. In making that determination, a school should multiply the percentage of directly certified students by the CEP national multiplier. This percentage should then be applied to the total number of students attending the school as their home school to determine the number of students eligible for NSLP for purposes of E-rate at that school location, provided that the number of eligible students may not exceed the number of students attending the school. If the student count calculation results in a fraction, applicants must round up (if 0.5 or above) or down (if less than 0.5) to the closest whole number.
The system will then calculate the percentage of students in the school district eligible for NSLP and will display the appropriate discount rates based on the NSLP data and the urban/rural status of the district’s schools or library system’s branches/outlets.
Item 8 – Connectivity
All applicants filing as a school, school district, library or library consortium must complete the survey questions in Item 8a-8f for school district or library system referenced in Item 7. If you are filing for an individual school or library that is not part of a district or library system, complete the information for that individual school or library.
Consortia and Statewide applicants do not complete these questions.
Instructions for Schools and School Districts:
Item 8a – Internet access for schools
Provide the speed of the Internet access.
Item 8c – Wide Area Networking for schools
Provide the number of schools in the school district that have Wide Area Networking connections scalable to 10 Gbps.
Instructions for Libraries and Library Systems:
Item 8b – Internet access for libraries
Provide the number of libraries that are part of the library system.
Provide the number of libraries that serve a population of less than 50,000.
For the libraries that serve a population of less than 50,000, provide the speed of their Internet access.
Provide the number of libraries that serve a population of 50,000 or greater.
For the libraries that serve a population of 50,000 or greater, provide the speed of the Internet access.
Item 8d – Wide Area Networking for libraries
Provide the number of libraries in the library system that have Wide Area Networking connections scalable to 10 Gbps.
Instructions for All Applicants
Item 8f – Local Area Networks for schools and libraries
Provide the number of schools or libraries that have Local Area Network/Wireless Local Area Network (LAN/WLAN) for each sufficiency of coverage indicated.
Item 8g – Insufficient LAN/WLAN capacity and coverage for schools and libraries
If any of your answers in Item 8f indicated that your LAN/WLAN capacity and coverage were less than completely sufficient, indicate the reason(s) below. If you check Other, please provide a short explanation.
Item 9 – Consortium or Statewide Discount Calculation
If you selected Consortium or Statewide Application in Item 5a of this form, the system will have prompted you to complete Item 7, 7a and 7b for each consortium member. Once you have completed entering those preparatory worksheets, the system will then display your consortium discount calculation. There is no applicant data entry in this item. The system will display:
Name and Billed Entity Number of the Consortium member
The Category One discount for the member entity from the Discount Matrices
The Category Two discount for the member entity from the Discount Matrices
At the bottom of the table, the system will sum the member discounts and count the number of consortium members. It will also display the consortium discount (the simple average) for both Category One and Category Two services.
Block 5 asks you to provide information about the eligible services that you have ordered, their cost, and the discount you are requesting based on the entities to receive service. The following information will highlight the features of Block 5.
You will complete one Block 5 for each Funding Request. In general, you should complete a separate Funding Request for:
Each service provider identified by a unique Service Provider Identification Number (SPIN) that will be providing you with service.
Each separate contract (but not necessarily the individual service within that contract, as long as they are the same service type, e.g., Internal Connections Other than Basic Maintenance).
Each service type provided by the same provider. Check the Eligible Services List and any updates on the USAC website to identify the service type.
Any voice services, so that the appropriate discount reduction can be applied. The online application system will not allow you to mix voice and non-voice services in a single funding request.
Long distance voice service (if, for example, your long distance service is billed separately from your local phone service on a bill from a different service provider).
Services ordered based on different FCC Forms 470 or that qualify for an exemption from the FCC Form 470 requirement. Services corresponding to each FCC Form 470 must be reported on separate Funding Requests with the relevant FCC Form 470 Application Numbers. This includes services ordered from the same service provider for the same service type if the order is based on different FCC Forms 470.
You may request discounts only for products and services delivered in the relevant funding year. Recurring services must be delivered between July 1 and June 30 of the funding year. Non-recurring services must generally be delivered between July 1 and the September 30 following the close of the funding year. Starting in Funding Year 2015, applicants seeking Category Two non-recurring services are permitted to seek support for services purchased on or after April 1, three months prior to the start of funding year on July 1. For more information, please refer to the Service Delivery section on the USAC website.
Note that if you are seeking support on multi-year contracts, you may request funding only for that portion of the contract that is delivered in the relevant funding year.
Ineligible costs: You may not seek support for ineligible services, entities, and uses, nor should you inflate your funding request beyond what you are able to substantiate as your likely costs during the funding year. Block 5 will guide you through deducting any ineligible costs from your total cost of services before calculating your discount request. If you have any questions about whether a service is eligible for support, please check the Eligible Services List on the USAC website or contact CSB at 1-888-203-8100.
Signed contracts: You MUST have a signed contract or written legally binding agreement for all services you order on your FCC Form 471 except:
Tariffed services: Telecommunications services that you purchase at prices regulated by your state regulatory commission and/or the FCC, for which you do not have a signed, written contract.
Month-to-Month Services: Month-to-month services for which you do not have a signed, written contract. Your billing arrangement signifies that you are receiving your services on a month-to-month basis.
State Master Contracts: A signed state master contract between a state and a service provider meets the FCC’s signed contract requirement. There may be additional state master contract and/or local or state procurement requirements.
Note: You must file an FCC Form 470 and seek competitive bids for non-contracted tariffed or month-to-month services each funding year, unless the services are part of a multi-year contract or are exempt from the FCC Form 470 filing requirement.
No FCC Form 470 is required for:
Business-class Internet access services. Starting with Funding Year 2015, certain commercially available business-class Internet access services are exempt from the requirement to post an FCC Form 470. Please see the USAC website for more information.
Preferred master contracts. Starting with Funding Year 2015, contracts designated by the Wireline Competition Bureau of the FCC as preferred master contracts are exempt from the requirement to post an FCC Form 470. Please see the USAC website for more information.
Item-by-Item Instructions
Funding Request Number (FRN) – USAC’s online system assigns a unique number to each funding request.
Optional Applicant FRN Identifier – You may use this space to assign a unique name or code of your own devising to facilitate communication with us about THIS particular funding request. Choose identifiers that suit your own record keeping needs.
Item 10 – If this is a duplicate funding request (e.g., of an FRN from this or another funding year that is not yet approved, under appeal, etc.), check this box and enter the original FRN in the space provided.
Item 11 – Check the correct service type for the service(s) listed on this funding request. You may check only ONE service type. Please consult the Eligible Services List and any updates on the USAC website or contact CSB at 1-888-203-8100. The online system will not allow you to include both Category One and Category Two funding requests on the same application. Combining both Categories of Service on a single application will cause funding delays.
Applicants seeking support for voice services must use a separate FRN from other eligible services. Voice services are subject to a yearly 20 percentage point reduction beginning with Funding Year 2015. Combining voice and non-voice services in a single FRN would cause delays in processing if USAC had to separate out the services during the application review process.
Item 12 – Provide only ONE of the following:
Item 12a: The 15-digit FCC Form 470 Application Number of the FCC Form 470 in which the services ordered here were sought. If you filed the FCC Form 470, this number appears on your FCC Form 470 Receipt Notification Letter.
Item 12b: Check this box to indicate that this funding request is for an eligible commercially available business-class Internet access service exempt from the requirement to post an FCC Form 470.
Item 12c: Check this box to indicate that this funding request is for an eligible preferred master contract exempt from the requirement to post an FCC Form 470.
Item 13 – Enter the 9-digit SPIN for the service provider that will provide service(s) on this funding request. You must provide a valid SPIN for the service provider indicated in Item 14 below. Each service provider should give you its SPIN on request. You may refer to the View SPIN information tool of the website for service provider contact information. A service provider who does not have a SPIN must file an FCC Form 498 to obtain one. The FCC Form 498 and Instructions can be downloaded from the Forms area of the USAC website.
Item 14 – The online system will provide the full legal name of the Service Provider Identification Number entered in Item 13.
Item 15 – Provide the appropriate contract information for this service.
Item 15a – If this funding request is for a non-contracted tariffed or month-to-month service, check the corresponding box.
Tariffed services. A tariffed service is a telecommunications service that you purchase at prices (rates) regulated by your state regulatory commission and/or the FCC, for which you do not have a signed, written contract.
Month-to-month services. Certain services are commonly offered on the basis of a month-to-month arrangement where there may be no contract between the customer and the service provider, e.g. Internet access. These arrangements are different from tariffed services, which may also be offered month-to-month but at regulated prices.
Item 15b – If you are receiving services under a contract, enter the contract number in Item 15b.
If this is a contracted service and the contract does not have a contract number but has some other reference number, you should note that number in Item 15b.
If you are buying off of a preferred master contract or a master contract signed by a state, regional or local procurement agency on behalf of eligible schools and libraries, you may use either the master contract number or the number of your own purchase agreement executed pursuant to that master contract. Whichever number you use, be certain that you use the corresponding dates in Item 18 and Item 19c.
Item 15c – Check this box if this funding request is covered under a master contract – a contract negotiated by a third party, the terms and conditions of which are then made available to an eligible entity that purchases directly from the service provider.
Item 15d – Check this box if this funding request is a continuation of an FRN from a previous funding year based on a multi-year contract. If so, enter that FRN in the space provided.
Starting in Funding Year 2016, checking Item 15d will allow applicants seeking funding for a multi-year contract to fill out a streamlined application. This simplified application process will be available to applicants with multi-year contracts that are five years or less in duration that have: (1) submitted in Funding Year 2015 or later a complete FCC Form 471 for the first funding year they are seeking E-rate support for services under that contract; and (2) changes in the requested services or to the terms and conditions under which those services are provided are within the scope of the establishing FCC Form 470 and the applicable contract.
Item 15e – Check this box if there is a restriction that prevents information provided in the Item 21 from becoming public. Applicants must certify that there is a state law or statute, local rule, court order, or contract executed before the effective date of the E-rate Modernization Order (FCC 14-99) barring publication of the information provided in the Item 21. Select the type of restriction and provide a precise cite to the law, statute, or court order or, in the case of a contract, provide the contract number, paragraph number that contains the restrictive terms and the date the contract was executed. Note that contracts and other agreements executed after September 18, 2014 may not prohibit pricing disclosure, and any such restrictions will have no effect. Also, you must retain the documents necessary to demonstrate the restriction.
Item 16 – Provide the account number that your service provider has established with you for billing purposes. This information will help your service provider provide you with discounted bills for service. In the case of telephone services, this is most often the billed telephone number associated with the service. If there are multiple billed telephone numbers or multiple Billing Account Numbers, provide one main number in Item 16a, check the box in Item 16b, and include all of the numbers in the space provided. If this service is already established (for example, a service provided under a qualified existing contract, or tariffed services for which you have selected the same service provider who already provides you with service), you should be able to find your account number on past bills, or you can request your account number from the service provider. If you have not yet established an account number, your service provider may have a “pre-account” identifier for you to use.
Item 17 – If you entered an FCC Form 470 number in Item 12a, the system will list the Allowable Vendor Selection/Contract Date for this service. The Allowable Vendor Selection/Contract Date is the earliest date after posting the FCC Form 470 that you are permitted to select your service provider and to sign a contract for newly contracted services, as applicable. This Allowable Vendor Selection/Contract Date for the FCC Form 470 cited in Item 12a above is identified in your Receipt Notification Letter and – in the FCC Form 470 posted – on the USAC website. Note, however, that if you issued a Request for Proposal (RFP) after you posted your FCC Form 470, your Allowable Vendor Selection/Contract Date may be later than the date identified on your FCC Form 470 Receipt Notification Letter. If you selected Item 12 b or 12c, this item will not appear on your online form.
Item 18 – For contracted services, enter the date that your contract for this service was executed. This item will not appear if you indicated in Item 15a that you are purchasing tariffed or month-to-month services.
If this funding request is covered under a state master contract but the state did not file an FCC Form 470, enter the date that you chose the state master contract as the most cost-effective offering pursuant to your posted FCC Form 470, rather than the date that the state master contract was actually signed.
Item 19a – For all services, provide the date when services will start in the funding year for which you are applying. With the exception Category Two non-recurring services (see below), discounts are not provided for services delivered before the beginning of the Funding Year, which starts on July 1. Thus, if this service has already started by the time you file this FCC Form 471, you will use July 1 of the funding year as your Service Start Date.
Starting in Funding Year 2015, applicants seeking Category Two non-recurring services are permitted to seek support for services purchased on or after April 1, three months prior to the start of funding year on July 1.
Item 19b – If you indicated in Item 15a that you are purchasing tariffed or month-to-month services, enter the date that services will end in the funding year for which you are applying. This item will not appear if you are filing for contracted services.
Item 19c – For contracted services, enter the date the contract expires. This item will not appear if you indicated in Item 15a that you are purchasing tariffed or month-to-month services.
Item 19d – For contracted services, indicate whether the contract for this FRN includes a clause that permits the parties to extend or renew the agreement at the end of the initial contract period. If so, check the box and indicate the number of possible extensions remaining and the total number of years the contract can be extended if all extensions are exercised. This item will not appear if you indicated in Item 15a that you are purchasing tariffed or month-to-month services.
Item 20 – Calculations:
Based on the information provided in the Item 21 for this funding request, the system will automatically sum the monthly recurring eligible, monthly recurring ineligible, one-time eligible, and one-time ineligible total costs. Using the information provided in Item 19, the system will also calculate the months of service you a requesting. Using the information provided in Block 4, the system will them apply the relevant discount rate (Category One or Category Two) to derive the total funding commitment request.
NOTE: If you checked Voice Services as the service type in Item 11, your discount will be automatically reduced each year by 20 percentage points. For example, if the discount you calculated for the entities receiving Voice Services is 90 percent for Funding Year 2015, your discount for Voice Services will be 70 percent for Funding Year 2015.
Item 21 – Each Funding Request must include a description of the products and services for which discounts are being sought. Applicants complete one or more line-item entries for all products or services in the funding request for the service type identified in Item 11.
Complete Item 21a for Telecommunications (including Voice) and Internet Access
Complete Item 21b for Internal Connections
Complete Item 21c for Managed Internal Broadband Services
Complete Item 21d for Basic Maintenance of Internal Connections
In all cases, you will be asked for the following information. Additional guidance for completing Items 21a, 21b, 21c, and 21d is provided below.
Provide a narrative overview or description of the service(s) included in the funding request.
For each product or service sought, use a separate line to describe the products or services. If you have the several of the same product or service but they are delivered at different speeds, use a separate line for each. The system will automatically assign an FRN line item number to track the specific request.
Recipients of Service:
For Category One requests, the system will display the list of entities you entered in Block 4 and will allow you to select all or some of the entities to indicate who is receiving that service. If the service is a Last Mile connection, the system will also prompt you to specify, on a per entity basis, the specific quantity and types of circuits that form that last mile connection.
For Category Two requests, the system will display the list of entities you entered in Block 4 and will allow you to select all or some of the entities to indicate who is receiving that service. In addition, you will need to allocate the cost of the service among the recipients of service. In order to assist you, the system will offer to split the cost equally based on either the number of entities served, or proportionately based on the student population, or you can enter your own cost allocation. Remember that all cost allocations must be based on tangible criteria and reach a realistic result.
Cost of the product or service: After describing the services sought, you will be asked to list the costs associated with the specific product or service. Provide the following information:
Monthly Recurring Eligible Cost: Enter your total monthly cost for this service. If the cost of service fluctuates from month to month, you may use the average of past bills to estimate the monthly cost.
Monthly Recurring Ineligible Cost: Enter the total cost associated with ANY ineligible services, entities, or uses included in your monthly charges. The following represent some common ways in which eligible and ineligible costs are bundled together, and how you can go about deducting the ineligible costs.
Eligible services bundled with ineligible services: While you may contract with the same service provider for both eligible and ineligible services, your contract must clearly break out costs for eligible services from those for ineligible services. If the eligible and ineligible services were purchased together at a special “bundled” price, a proportionate cost allocation is required between the eligible and ineligible components. You will use this reduced price when requesting universal service discounts on the eligible service. For example, if a provider offers to sell a school an eligible service for $10.00 and an ineligible service for $20.00, but also offers them as a bundle for $24.00, this would indicate that the provider is offering a $6.00, or 20%, price reduction. Therefore, the school could treat $10.00 * 80% = $8.00 as eligible for universal service support.
Services shared by eligible and ineligible entities: When you share a service with an ineligible entity, the provider may receive reimbursement only for that portion of the service that eligible entities are receiving. To help auditors confirm that this rule is being observed, you must keep and retain careful records of how you have allocated the costs of shared services and facilities among eligible and ineligible entities. You are required to maintain these records consistent with any measures that may be established by the FCC, the USAC, or state commissions.
Bundled services from an Internet service provider: You may receive discounts on access to the Internet but not on separate charges for content (such as access to a library of videos supplied by the service provider) or other information services. In addition, if you choose a package including content and conduit, you may only receive a discount on the conduit portion of the package. The only exception is when the bundled package includes minimal content and provides a more cost-effective means of securing access to the Internet than other non-content-providing alternatives. Thus, if a service provider bundles Internet access with a package of content that is available to all customers free of charge, the entire price of that bundle will be eligible for support if that package is the most cost-effective solution. However, if the service provider a) does not offer an access-only service, and b) offers Internet users access to its proprietary content for a price, then you must treat the difference between the content-only price and the price the service provider charges for its bundled access as the price of non-content Internet access.
One-time Eligible Cost: Enter your one-time or non-recurring costs for the product or service. If you expect to pay a non-recurring charge in multiple installments over the funding year, you should either amortize this charge as monthly amount or include the full amount of this charge as a one-time charge. DO NOT include this amount under both recurring and non-recurring charges. If you amortize this charge as a monthly amount, you will not be eligible for discounts on any non-recurring services in this funding request provided after June 30 of the funding year.
One-time Ineligible Cost: Enter the total cost associated with ANY ineligible services, entities, or uses included in your one-time charges. See above for common ways in which eligible and ineligible costs are bundled together, and how you can go about deducting the ineligible costs.
Pre-discount Extended Eligible Line Item Cost – The system will automatically calculate the total pre-discount amount for this FRN line, based on the information that you have provided.
Note about applicant Category Two Budgets: As you enter funding requests on this application, the system will track the total pre-discount dollars on a per school or library basis and compare that to the Category Two Applicant Budgets displayed in Block 4. If the pre-discount costs featured on the funding requests on this form exceed that amount, you will be notified by the system that some funds may be denied because you appear to have exceeded your Category Two budget. Although applicants can request more than their Category Two Applicant budget, commitments will be capped based on the school or library’s budgeted pre-discount amount. Applicants should also carefully review any other applications they filed, or by other organizations on their behalf, such as consortia, to determine if an individual school or library has exceeded its Category Two budget.
Specific instructions for Items 21a, 21b, 21c, and 21d
Item 21a – Telecommunications (including Voice) and Internet Access
For each unique service, provide the information below in addition to the narrative description. If you have several services that are the same type of service but are delivered at different speeds, use a separate line for each.
Type of service (from the types of services on the Eligible Services List for the appropriate funding year) – e.g., Digital Transmission Service, Telephone Service, Internet Access, etc.
Type of connection (from the types of connections on the Eligible Services List for the appropriate funding year) – e.g., fiber, T-1, T-3.
Purpose (transport, Internet, both transport and Internet, voice). Note that if you cannot combine voice services with any other type of service in an FRN. Therefore, if you select Voice in this column, and you are also seeking support for other non-voice Category One services, you must complete a separate funding request for that request.
Quantity or number of lines.
Bandwidth upload speed: Enter the upload speed in megabits per second (Mbps or Gbps). If the line has an industry-standard definition for speed, it will be populated for you by the system.
Bandwidth download speed: If different than bandwidth upload speed, enter the download speed in megabits per second (Mbps or Gbps).
Maximum speed if you have burstable bandwidth: If your service contains an option to increase the bandwidth when requested, indicate Yes and enter the burstable speed in megabits per second (Mbps or Gbps).
Note if basic firewall protection is included in the cost of the service.
From the list you entered in Block 4, select the schools, libraries and NIFs that are receiving this service.
Last Mile Connection: Indicate whether the broadband or Internet Access connection is a last-mile connection that connects individual schools and libraries to a central aggregation point. If so, you will need to provide specific allocation of the lines on a per-school or per-library basis.
WAN Connection: Indicate whether the Internet Access connection is part of a wide area network (WAN) that serves the entire district.
Enter the costs for the service, as described above.
The system will calculate the extended total cost for each line item.
Item 21b – Internal Connections
Internal Connections: For each unique product or service, provide the information below in addition to the narrative description.
Type of Internal Connections – e.g., wireless data distribution, cabling or connectors.
Type of Product – e.g., router, firewall, cabling, coax.
Quantity and unit.
Make.
Model.
Indicate if this is being procured under a lease or non-purchase arrangement.
Enter the costs for the service, as described above.
From the list you entered in Block 4, select the schools, libraries and NIFs that are receiving this service. As indicated above, you will need to allocate the cost of the service among the recipients of service. The system can help you with straight line cost allocations or you can use another method for allocating the costs, as long as the cost-allocation methodology is based on tangible criteria and reaches a realistic result.
Item 21c –Managed Internal Broadband Services
Managed Internal Broadband Services: For each unique service and/or product, provide the information below in addition to the narrative description.
Type of managed service agreement – Select the service arrangement that most closely matches your contract: (1) managed and leased from a third party service provider; (2) managed by third party service provider; (3) purchased from them or other vendors; or (4) managed services contract of already installed equipment.
Enter the costs for the service, as described above.
From the list you entered in Block 4, select the schools, libraries and NIFs that are receiving this service. As indicated above, you will need to allocate the cost of the service among the recipients of service, keeping in mind that NIFs are not eligible for their own Category Two budget. However, you can use some of the budget from the schools that are sharing the equipment located in that central site to purchase equipment shared by the schools and housed at the NIF. You will need to cost-allocate the equipment among all of the schools that are sharing that piece of equipment. The system can help you with straight line cost allocations or you can use another method for allocating the costs, as long as the cost-allocation methodology is based on tangible criteria and reaches a realistic result.
Item 21d – Basic Maintenance of Internal Connections
For each unique service, provide the information below in addition to the narrative description.
Type of internal connections being maintained, such as Data Distribution Equipment.
Type of product being maintained, such as Router or WAP
Quantity and unit
Make of covered equipment
Model of covered equipment
Cost allocation percentage (if either the product being maintained not 100 percent eligible or the cost of the maintenance itself is not fully eligible).
Enter the costs for the service, as described above.
From the list you entered in Block 4, select the schools, libraries and NIFs that are receiving this service. As indicated above, you will need to allocate the cost of the service among the recipients of service. The system can help you with straight line cost allocations or you can use another method for allocating the costs, as long as the cost-allocation methodology is based on tangible criteria and reaches a realistic result.
Block 6 requires program participants to certify certain information. This information is required to ensure that only eligible entities receive support under the universal service discount mechanism.
When you have completed the online filing of Blocks 1-5, please print your application to retain a copy for your records.
You must also submit the Block 6 certification.
If you have a PIN and wish to submit your Block 6 certification online, follow the directions online. When you submit your certification online, you will receive a confirmation. If you use the online certification, do not mail any part of your FCC Form 471 to USAC.
If you wish to submit the completed and signed Block 6 certification on paper, print Block 6 using your browser. When you print Block 6 using the browser, the form will automatically include your FCC Form 471 Application Number, Applicant Name, and Applicant Address. Item 36 requires the signature of the authorized person who certifies to the accuracy of the information on the form. Also, you must complete Items 22-40e. Mail the signed Block 6 to: USAC-Form 471, P. O. Box 7026, Lawrence, KS 66044-7026. For express delivery services or U.S. Postal Service Return Receipt Requested, send to USAC-Forms 471, ATTN: USAC Form 471, 3833 Greenway Drive, Lawrence, KS 66046. If the Block 6 certification is submitted on paper, you are advised to keep proof of the date of mailing.
The FCC Form 471 cannot be submitted by mail. With the exception of the Block 6 certification, the FCC Form 471 must be completed and submitted online.
Item 22 – Certify that the entities represented are eligible schools and/or libraries.
Item 23 – Check this box to certify that you can demonstrate that you have secured access to all of the resources necessary to make effective use of the products and services for which they receive discounts.
As part of our review of your Item 23 certification, USAC may request additional documentation to support your certification. The certification in Item 31 below states that you will retain for at least 10 years (or whatever retention period is required by the rules in effect at the time of certification), after the last day of service delivered any and all worksheets and other records that you rely upon to fill out your FCC Form 471. For Item 23, these worksheets and records include:
Paying your share of E-rate eligible costs. You may be asked to provide documentation of your ability to pay the non-discount portion of the products and services for which you have applied for discounts. You are required to already have the funds identified in your budget to pay for these costs. If your budget is not yet final, we may request additional documentation to substantiate your certification.
Paying for ineligible costs. You may be asked to provide more detailed estimates of hardware, software, professional development, retrofitting (construction and electrical work necessary to prepare a building for technology), maintenance investments and other resources that are necessary to make effective use of the E-rate discounts you have requested. If these resources will be purchased under your budget, you must already have the funds identified in your budget to pay for them. However, these resources may also be ones that you already have or own, such as computers purchased or donated in a prior year.
Item 23a – Add your entries from Items 20I, Total funding year pre-discount amount, on all Block 5 Discount Funding Requests and enter the total here. The online system will calculate this figure for you.
Item 23b – Add your entries from Items 20K, Funding Commitment Request, on all Block 5 Discount Funding Requests and enter the total here. The online system will calculate this figure for you.
Item 23c – Subtract Item 23b from Item 23a and enter the result here. This is the total non-discount share for the funding requests on this FCC Form 471. Remember that applicants are required to pay this non-discount portion of the cost of E-rate eligible products and services to their service providers. The online system will calculate this figure for you.
Item 23d – Enter the total amount in your budget that has been allocated for resources not eligible for E-rate support. These are the resources that are necessary for you to support and improve education and library services and to make effective use of the eligible services you have requested in all Block 5 funding requests across all FCC Forms 471 you will submit for this funding year. These resources may include, but are not limited to:
Hardware, such as computers, printers, fax machines, video equipment, scanners, CD-ROM drives, and servers;
Professional development, such as ongoing technology-related training for technical staff, teachers and/or librarians;
Software, such as end-user applications;
Maintenance, such as systems maintenance and operations costs for ineligible hardware and software and salaries of technical staff;
Retrofitting, such as electrical wiring, asbestos removal, building modifications, renovations, and repairs.
If you file multiple FCC Forms 471 for this funding year, you must calculate your total budgeted amount allocated for these resources and enter that total on Item 23d of each FCC Form 471. Consortia must add the budgeted amounts for all of their member entities and enter that total on this line.
Item 23e – Add your entries for Item 23c and Item 23d and enter the total here. This is the amount necessary to pay the non-discount share of the services requested on this FCC Form 471 AND to make effective use of the discounts requested on all your applications for this funding year. This amount will not include amounts necessary to pay the non-discount share of requests on other FCC Forms 471.
Item 23f – Check this box if your service provider has provided direct financial assistance to you for any of the funds in Item 23c or Item 23d. Also, check this box if your service provider assisted you in locating funding for any of the funds in Item 23c or Item 23d. Service providers may assist applicants in locating grants and donations consistent with program rules and the Obligation to Pay Non-Discount Portion notice on the USAC website. Service providers may provide assistance to applicants for ineligible products and services consistent with program rules and the Free Services Advisory as explained on the website.
Items 24-26 –Check the appropriate box(es) to certify that you are citing an FCC Form 470 that formed the basis of a competitive bidding process that complied with all program rules and/or that the services you have ordered are exempt from the requirement to post an FCC Form 470.
Item 27 – Check this box to certify that the entity responsible for selecting the service provider has reviewed all applicable competitive bidding requirements and complied with them.
Item 28 – Check this box to certify that services you order pursuant to the universal service discount mechanism will be used primarily for educational purposes and will not be sold, resold, or transferred for gain except as permitted under program rules. Additionally, you certify that the entities listed on this application have not received anything of value in connection with this request for services.
Item 29 – Check this box to certify that you and the entity(ies) you represent have complied with all program rules, including recordkeeping requirements, and that you acknowledge failure to do so may result in denial of discount funding and/or cancellation of funding commitments. You also certify that there are signed contracts or legally binding agreements covering all of the services listed on this FCC Form 471 except for those services provided under non-contracted tariffed or month-to-month arrangements. You acknowledge that failure to comply with program rules could result in civil or criminal prosecution by the appropriate law enforcement authorities.
Item 30 – Check this box to certify that you understand that the discount level used for shared services is conditional, for future years, upon ensuring that the most disadvantaged schools and libraries that are treated as sharing in the shared services receive an appropriate share of benefits from those services.
Item 31 – Check this box to certify that required documents will be retained for a period of at least 10 years (or whatever retention period is required by the rules in effect at the time of this certification), after the last day of service delivered and to acknowledge that you may be audited pursuant to participation in the schools and libraries program.
Item 32 – Check this box to certify that you are the person authorized to order telecommunications and other supported services on behalf of the eligible entity(ies) and are authorized to submit and certify to the accuracy of this form.
Item 33 – Check this box to acknowledge that FCC rules provide that persons who have been convicted of criminal violations or held civilly liable for certain acts arising from their participation in the schools and libraries support mechanism are subject to suspension and debarment from the program. You agree to institute reasonable measures to be informed, and will notify USAC should you be informed or become aware that you or any of the entities named on this FCC Form 471, or any person associated in any way with your entity and/or the entities named on this FCC Form 471, is convicted of a criminal violation or held civilly liable for acts arising from their participation in the schools and libraries support mechanism.
Item 34 – Check this box to certify that if any of the Funding Request Numbers on this FCC Form 471 contain requests for discounts for products or services that contain both eligible and ineligible components, that you have allocated the cost of eligible and ineligible components as required by the Commission's rules.
Item 35 – Check this box to certify that the non-discount portion of the costs for eligible services will not be paid by the service provider, and that the pre-discount costs of eligible services featured on this FCC Form 471 are net of any rebates or discounts offered by the service provider.
Item 36 – Requires the signature of the authorized person.
Item 37 – Provide the date of signature of the FCC Form 471. Note that for applications requesting new services based on the filing of an FCC Form 470, this date CANNOT be earlier than any Allowable Vendor Selection/Contract Date in Item 17 of any Block 5 submitted with this application.
Item 38 – Print the name of the authorized person whose signature is provided in Item 36.
Item 39 – Provide the title or position of the authorized person whose signature is provided in Item 36. If the consultant in Item 6g is the Authorized Person, check the appropriate box.
Item 40a-40d – Provide the mailing address, the telephone number, the fax number and the e-mail address of the authorized person whose signature is provided in Item 36.
Item 40e – Provide the name of the authorized person’s employer. If a consultant is acting as the authorized person, provide the name of the company that employs the consultant, not the name of the applicant organization.
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Catriona Ayer |
| File Modified | 0000-00-00 |
| File Created | 2021-01-26 |