OMB 3060-0806 Approval by OMB FCC Form 471 December 2018 Description of Services Ordered and Certification Form 471

FCC Form 471 Application Information Nickname JEFFERSON PARISH SCHOOL DISTRIC Application Number 201011140 T CAT. 1 Funding Year 2020 Category of Service Category 1

Billed Entity Contact Information JEFFERSON PARISH SCHOOL DIST Teri Lawrence 4600 RIVER ROAD MARRERO LA 70072 - 1943 225-224-2786 504-349-8929 [email protected]

Billed Entity Number 139210 FCC Registration Number 0011632742 Applicant Type School District

Consulting Firms Name Consultant City State Zip Phone Email Registration Code Number Number Educational Professional Services 16071123 Pine Grove LA 70453 225-224-2786 [email protected]

Entity Information

School District Entity - Details BEN Name Urban/ State State NCES School District Endowment Rural LEA ID School Code Attributes ID 139210 JEFFERSON PARISH SCHOOL Urban Public School District None DIST

Related Entity Information

Related Child School Entity - Details BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 79715 HEARST PHOEBE Urban Pre-K; Public School None SCHOOL 79719 EAST JEFFERSON HIGH Urban None Public School None SCHOOL 79720 BRIDGEDALE Urban Pre-K; Public School None ELEMENTARY SCHOOL

Page 1 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 79723 DOLHONDE ELLA Urban Pre-K; Public School None ELEMENTARY 79728 GRACE KING HIGH Urban None Public School None SCHOOL 79731 MEISLER J.D. MIDDLE Urban None Public School None 79733 ADAMS MIDDLE SCHOOL Urban None Public School None 79734 KELLER HAROLD Urban Pre-K; Public School None ELEMENTARY 79739 BISSONET PLAZA Urban Pre-K; Public School None SCHOOL 79741 AIRLINE PARK ACADEMY Urban Pre-K; Public School None FOR ADVANCED STUDIES 79742 HARRIS T.H. MIDDLE Urban None Public School None 79743 MATAS RUDOLPH Urban Pre-K; Public School None SCHOOL 79751 GREEN PARK Urban Pre-K; Public School None ELEMENTARY SCHOOL 79755 RIVIERE MARIE Urban Pre-K; Public School None ELEMENTARY 79757 ELLIS, J.C. SCHOOL Urban Pre-K; Public School None 79758 HAYNES ACADEMY FOR Urban None Public School None ADVANCED STUDIES 79764 METAIRIE ACADEMY Urban Pre-K; Public School None FOR ADVANCED STUDIES 79767 BIRNEY ELEMENTARY Urban Pre-K; Public School None SCHOOL 79820 MCDONOGH Urban Pre-K; Public School None 26-HOMEDALE ELEMENTARY SCHOOL 79821 HART WILLIAM Urban Pre-K; Public School None ELEMENTARY 79825 GRETNA NO 2 ACADEMY Urban Pre-K; Public School None FOR ADVANCED STUDIES 79827 GRETNA MIDDLE Urban Public School None SCHOOL 79828 JOHNSON SHIRLEY Urban Pre-K; Public School None T.-GRETNA PARK ELEMENTARY 79833 TERRYTOWN Urban Pre-K; Public School None ELEMENTARY SCHOOL 79834 BOUDREAUX, Urban Pre-K; Public School None GERALDINE ELEMENTARY SCHOOL 79835 LIVAUDAIS MIDDLE Urban None Public School None SCHOOL 79838 COX GEORGE A. Urban Pre-K; Public School None ELEMENTARY 79839 SOLIS PAUL J. Urban Pre-K; Public School None ELEMENTARY 79846 PITTMAN ELLA C. Urban Pre-K; Public School None ELEMENTARY 79849 WOODLAND WEST ELEM Urban Pre-K; Public School None SCHOOL

Page 2 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 79850 HELEN COX HIGH Urban None Public School None SCHOOL 79852 WEST JEFFERSON HIGH Urban None Public School None SCHOOL 79856 CLANCY-MAGGIORE Urban Pre-K; Public School None ELEMENTARY SCHOOL FOR THE ARTS 79859 WASHINGTON Urban Pre-K; Public School None MONTESSORI SCHOOL 79862 CHATEAU ESTATES Urban Pre-K; Public School None SCHOOL 79864 A.C. ALEXANDER Urban Pre-K; Public School None SCHOOL 79865 GREENLAWN TERRACE Urban Pre-K; Public School None ELEM SCHOOL 79866 SCHNECKENBURGER Urban Pre-K; Public School None WALTER ELEMENTARY 79868 TOM BENSON Urban Pre-K; Public School None SCHOOL (ROOSEVELT THEODORE MIDDLE) 79869 AUDUBON, JOHN JAMES Urban Pre-K; Public School None SCHOOL 79870 WOODS GRANVILLE T. Urban Pre-K; Public School None ELEMENTARY 79871 BONNABEL MAGNET Urban None Public School None ACADEMY HIGH SCHOOL 79873 LEO E. KERNER JR. Rural Pre-K; Public School None ELEMENTARY 79874 FISHER MIDDLE-HIGH Rural None Public School None SCHOOL 79891 JUDGE LIONEL COLLINS Urban Pre-K; Public School None ELEMENTARY SCHOOL 79894 MARRERO L.H. MIDDLE Urban Public School None 79897 LINCOLN SCHOOL FOR Urban Pre-K; Public School None THE ARTS 79901 EHRET HIGH SCHOOL Urban None Public School None 79903 HIGGINS L.W. HIGH Urban None Public School None 79905 RUPPEL ACADEMY FOR Urban Public School None ADVANCED STUDIES 79907 HARRY S TRUMAN Urban Pre-K; Public School None SCHOOL 79911 ALLEN ELLENDER Urban Pre-K; Public School None SCHOOL 79913 ESTELLE SCHOOL Urban Pre-K; Public School None 79955 CHERBONNIER- Urban Pre-K; Public School None RILLIEUX SCHOOL (LUCILLE CHERBONNIER SCHOOL) 79958 STREHLE COMMUNITY Urban Public School None SCHOOL (Catherine Strehle Elem) 79959 Emmett C. Gilbert School Urban Pre-K; Public School None of Excellence at Ford (FORD HENRY MIDDLE) 79960 HARRIS MILDRED S. Urban Pre-K; Public School None ELEMENTARY Page 3 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 79963 MYRTLE C. THIBODEAUX Urban Pre-K; Public School None ELEMENTARY SCHOOL 79964 BUTLER, JOSHUA Urban Pre-K; Public School None ELEMENTARY SCHOOL 79965 WORLEY STELLA Urban Public School None MIDDLE 79966 PITRE VIC A. Urban Pre-K; Public School None ELEMENTARY 80103 JEFFERSON Urban Pre-K; Public School None ELEMENTARY SCHOOL 80109 RIVERDALE HIGH Urban None Public School None SCHOOL 80110 RIVERDALE MIDDLE Urban None Public School None SCHOOL 80138 HAZEL PARKHILDA Urban Pre-K; Public School None KNOFF ELEMENTARY SCHOOL 80142 HARAHAN ELEMENTARY Urban Pre-K; Public School None SCHOOL 80275 GRAND ISLE SCHOOL Rural Pre-K; Public School None 203410 CONGETTA TRIPPE Urban Pre-K; Public School None JANET ELEMENTARY 227000 WESTBANK COMMUNITY Rural Public School None SCHOOL 16038033 JEFFERSON THOMAS Urban None Public School None HIGH SCHOOL FOR ADVANCED STUDIES 16056479 PATRICK F TAYLOR Urban None Public School None SCIENCE AND TECHNOLOGY REGIONAL ACADEMY 16056742 RAY ST. PIERRE Urban Pre-K; Public School None ACADEMY FOR ADVANCED STUDIES (MARRERO ACADEMY FOR ADVANCED STUDIES) 17004445 Bonella A. St. Ville Urban Pre-K; Public School None Elementary 17004446 Frederick Douglass Urban Pre-K; Public School None Elementary 79898 CUILLIER JOSEPH A. SR. Urban None Public School None CAREER CENTER 17012534 Ralph J Bunche Urban Pre-K; Public School None Elementary 17016628 Woodmere School Urban Pre-K; Public School None 17022883 RUPPEL ACADEMIE Urban Pre-K; Public School None FRANCAISE

Related Child School Entity - Discount Rate Calculation Details BEN Name Urban/ Number of Students CEP Rural Students Count Based Percentage on Estimate 79715 HEARST PHOEBE SCHOOL Urban 651 N/A 56.25% 79719 EAST JEFFERSON HIGH SCHOOL Urban 1125 N/A 79720 BRIDGEDALE ELEMENTARY SCHOOL Urban 599 N/A 56.25% Page 4 BEN Name Urban/ Number of Students CEP Rural Students Count Based Percentage on Estimate 79723 DOLHONDE ELLA ELEMENTARY Urban 520 N/A 56.25% 79728 GRACE KING HIGH SCHOOL Urban 1335 N/A 79731 MEISLER J.D. MIDDLE Urban 983 N/A 79733 ADAMS MIDDLE SCHOOL Urban 538 N/A 79734 KELLER HAROLD ELEMENTARY Urban 741 N/A 56.25% 79739 BISSONET PLAZA SCHOOL Urban 588 N/A 56.25% 79741 AIRLINE PARK ACADEMY FOR ADVANCED STUDIES Urban 378 N/A 56.25% 79742 HARRIS T.H. MIDDLE Urban 876 N/A 79743 MATAS RUDOLPH SCHOOL Urban 599 N/A 56.25% 79751 GREEN PARK ELEMENTARY SCHOOL Urban 458 N/A 56.25% 79755 RIVIERE MARIE ELEMENTARY Urban 582 N/A 56.25% 79757 ELLIS, J.C. SCHOOL Urban 616 N/A 56.25% 79758 HAYNES ACADEMY FOR ADVANCED STUDIES Urban 862 N/A 79764 METAIRIE ACADEMY FOR ADVANCED STUDIES Urban 380 N/A 56.25% 79767 BIRNEY ELEMENTARY SCHOOL Urban 580 N/A 56.25% 79820 MCDONOGH 26-HOMEDALE ELEMENTARY SCHOOL Urban 260 N/A 56.25% 79821 HART WILLIAM ELEMENTARY Urban 342 N/A 56.25% 79825 GRETNA NO 2 ACADEMY FOR ADVANCED STUDIES Urban 362 N/A 56.25% 79827 GRETNA MIDDLE SCHOOL Urban 576 N/A 62.82% 79828 JOHNSON SHIRLEY T.-GRETNA PARK ELEMENTARY Urban 654 N/A 56.25% 79833 TERRYTOWN ELEMENTARY SCHOOL Urban 583 N/A 56.25% 79834 BOUDREAUX, GERALDINE ELEMENTARY SCHOOL Urban 606 N/A 56.25% 79835 LIVAUDAIS MIDDLE SCHOOL Urban 709 N/A 79838 COX GEORGE A. ELEMENTARY Urban 414 N/A 56.25% 79839 SOLIS PAUL J. ELEMENTARY Urban 648 N/A 56.25% 79846 PITTMAN ELLA C. ELEMENTARY Urban 498 N/A 56.25% 79849 WOODLAND WEST ELEM SCHOOL Urban 645 N/A 56.25% 79850 HELEN COX HIGH SCHOOL Urban 1076 N/A 79852 WEST JEFFERSON HIGH SCHOOL Urban 1497 N/A 79856 CLANCY-MAGGIORE ELEMENTARY SCHOOL FOR THE ARTS Urban 668 N/A 56.25% 79859 WASHINGTON MONTESSORI SCHOOL Urban 268 N/A 56.25% 79862 CHATEAU ESTATES SCHOOL Urban 725 N/A 56.25% 79864 A.C. ALEXANDER SCHOOL Urban 623 N/A 56.25% 79865 GREENLAWN TERRACE ELEM SCHOOL Urban 515 N/A 56.25% 79866 SCHNECKENBURGER WALTER ELEMENTARY Urban 428 N/A 56.25% 79868 TOM BENSON SCHOOL (ROOSEVELT THEODORE MIDDLE) Urban 589 N/A 62.82% 79869 AUDUBON, JOHN JAMES SCHOOL Urban 574 N/A 56.25% 79870 WOODS GRANVILLE T. ELEMENTARY Urban 318 N/A 56.25% 79871 BONNABEL MAGNET ACADEMY HIGH SCHOOL Urban 1354 N/A 79873 LEO E. KERNER JR. ELEMENTARY Rural 485 N/A 56.25% 79874 FISHER MIDDLE-HIGH SCHOOL Rural 526 N/A 79891 JUDGE LIONEL COLLINS ELEMENTARY SCHOOL Urban 346 N/A 56.25% 79894 MARRERO L.H. MIDDLE Urban 931 N/A 51.63% 79897 LINCOLN SCHOOL FOR THE ARTS Urban 479 N/A 56.25% 79901 EHRET HIGH SCHOOL Urban 1970 N/A Page 5 BEN Name Urban/ Number of Students CEP Rural Students Count Based Percentage on Estimate 79903 HIGGINS L.W. HIGH Urban 1105 N/A 79905 RUPPEL ACADEMY FOR ADVANCED STUDIES Urban 234 N/A 51.63% 79907 HARRY S TRUMAN SCHOOL Urban 834 N/A 62.82% 79911 ALLEN ELLENDER SCHOOL Urban 632 N/A 56.25% 79913 ESTELLE SCHOOL Urban 819 N/A 56.25% 79955 CHERBONNIER-RILLIEUX SCHOOL (LUCILLE CHERBONNIER S Urban 385 N/A 56.25% CHOOL) 79958 STREHLE COMMUNITY SCHOOL (Catherine Strehle Elem) Urban 120 N/A 56.25% 79959 Emmett C. Gilbert School of Excellence at Ford (FORD HENRY MID Urban 652 N/A 62.82% DLE) 79960 HARRIS MILDRED S. ELEMENTARY Urban 400 N/A 56.25% 79963 MYRTLE C. THIBODEAUX ELEMENTARY SCHOOL Urban 310 N/A 56.25% 79964 BUTLER, JOSHUA ELEMENTARY SCHOOL Urban 420 N/A 56.25% 79965 WORLEY STELLA MIDDLE Urban 628 N/A 62.82% 79966 PITRE VIC A. ELEMENTARY Urban 266 N/A 56.25% 80103 JEFFERSON ELEMENTARY SCHOOL Urban 337 N/A 56.25% 80109 RIVERDALE HIGH SCHOOL Urban 1169 N/A 80110 RIVERDALE MIDDLE SCHOOL Urban 855 N/A 80138 HAZEL PARKHILDA KNOFF ELEMENTARY SCHOOL Urban 365 N/A 56.25% 80142 HARAHAN ELEMENTARY SCHOOL Urban 508 N/A 56.25% 80275 GRAND ISLE SCHOOL Rural 143 N/A 56.25% 203410 CONGETTA TRIPPE JANET ELEMENTARY Urban 633 N/A 56.25% 227000 WESTBANK COMMUNITY SCHOOL Rural 42 N/A 56.25% 16038033 JEFFERSON THOMAS HIGH SCHOOL FOR ADVANCED STUDIE Urban 382 N/A S 16056479 PATRICK F TAYLOR SCIENCE AND TECHNOLOGY REGIONAL A Urban 787 N/A CADEMY 16056742 RAY ST. PIERRE ACADEMY FOR ADVANCED STUDIES (MARRE Urban 359 N/A 56.25% RO ACADEMY FOR ADVANCED STUDIES) 17004445 Bonella A. St. Ville Elementary Urban 425 N/A 56.25% 17004446 Frederick Douglass Elementary Urban 307 N/A 56.25% 79898 CUILLIER JOSEPH A. SR. CAREER CENTER Urban 0 N/A 17012534 Ralph J Bunche Elementary Urban 324 N/A 56.25% 17016628 Woodmere School Urban 325 N/A 56.25% 17022883 RUPPEL ACADEMIE FRANCAISE Urban 136 N/A 51.63%

Related Child School Annexes School BEN School Name Annex Name 79850 HELEN COX HIGH SCHOOL #79898 - CUILLIER JOSEPH A. SR. CAREER CENTER 79852 WEST JEFFERSON HIGH SCHOOL #79898 - CUILLIER JOSEPH A. SR. CAREER CENTER 79874 FISHER MIDDLE-HIGH SCHOOL #79898 - CUILLIER JOSEPH A. SR. CAREER CENTER 79901 EHRET HIGH SCHOOL #79898 - CUILLIER JOSEPH A. SR. CAREER CENTER 79903 HIGGINS L.W. HIGH #79898 - CUILLIER JOSEPH A. SR. CAREER CENTER

Related School District NIFs

Page 6 School School District Name NIF BEN NIF Name District BEN 139210 JEFFERSON PARISH SCHOOL DIST 16066436 PAUL E EMENES SPECIAL SERVICES BUILDING 139210 JEFFERSON PARISH SCHOOL DIST 16066444 ADMINISTRATION BUILDING 139210 JEFFERSON PARISH SCHOOL DIST 16073043 ADMINISTRATION BUILDING ANNEX

Discount Rate School District School District School District School District Category One Category Two Enrollment NSLP Count NSLP Percentage Urban/Rural Status Discount Rate Discount Rate 45982 36762 80.0% Urban 90% 85%

Page 7 Funding Request for FRN #2099013717 Funding Request Nickname: COX INTERNET AND WAN

Service Type: Data Transmission and/or Internet Access

What is the FRN number from the previous 1999046813 year ?

Agreement Information - Contract Contract Number 126-0352429 -02, 126-O440168-0 Account Number 126-0352492-02, 126-0440168-01 1,125-0464788-01 Service Provider Cox Louisiana Telcom, LLC (SPN: Establishing FCC Form 470 190006257 143016765)

Was an FCC Form 470 posted Yes Based on State Master No for the product and/or services Contract? you are requesting? Based on a multiple award No Award Date March 13, 2019 schedule?

How many bids were received 4 Includes Voluntary Extensions? Yes for this contract? Remaining Voluntary 3 What is the service start date? July 01, 2020 Extensions

Total Remaining Contract 48 Length

What is the date your contract June 30, 2021 expires for the current term of the contract?

Document Name Document Description

JP Schools RFP-3207 - Countersigned with extenstion.pdf Attached is the Cox WAN and Internet Contract with the first of 4 extensions available. The origin al contract is for 1 year + 4 one-year extensions.

Pricing Confidentiality Is there a statute, rule, or other restriction which prohibits No publication of the specific pricing information for this contract?

This request is for WAN and Internet Access for all sites in Jefferson Parish School District. Narrative There are 2 ineligible items listed in the extended agreement. They are (2) GPS Clean Traffic and $40 for Ethernet Performance Mgmt. These items will be paid with school district funding. This request DOES NOT include the $1,040 per month for ineligible services. (2) INTERNET circuits for 4500 each, 82 circuits for $1,000 each, 2 EPO Dual Entry Fiber- Intrastate $2,500 each, 2 10 x 20 GIG circuits for $1,570 each.

Page 8 Line Item # 2099013717.001

Product and Service Details Internet access service that includes a connection from any applicant site directly to the Internet Service Purpose Provider

Function Fiber

Type of Connection Switched Multimegabit Data Service Bandwidth Speed Upload Speed 10.0 Gbps Download Speed 10.0 Gbps

Connection Information Does this include firewall services? No Is this a connection between eligible schools, Yes libraries and NIFs (i.e., a connection that provides a “Wide area network”)?

Is this a direct connection to a single school, No library or a NIF for Internet access?

Cost Calculation for FRN Line Item # 2099013717.001

Monthly Cost One-Time Cost Monthly Recurring Unit Cost $4,500.00 One-time Unit Cost $0.00 Monthly Recurring Unit Ineligible - $0.00 One-time Ineligible Unit Costs - $0.00 Costs One-time Eligible Unit Cost = $0.00 Monthly Recurring Unit Eligible = $4,500.00 One-time Quantity x 0 Costs Monthly Quantity x 2 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $9,000.00 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $108,000.00 Total Eligible Recurring Costs = $108,000.00 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $108,000.00 Line Item Cost

Page 9 Recipients of Services BEN Name 79715 HEARST PHOEBE SCHOOL 79719 EAST JEFFERSON HIGH SCHOOL 79720 BRIDGEDALE ELEMENTARY SCHOOL 79723 DOLHONDE ELLA ELEMENTARY 79728 GRACE KING HIGH SCHOOL 79731 MEISLER J.D. MIDDLE 79733 ADAMS MIDDLE SCHOOL 79734 KELLER HAROLD ELEMENTARY 79739 BISSONET PLAZA SCHOOL 79741 AIRLINE PARK ACADEMY FOR ADVANCED STUDIES 79742 HARRIS T.H. MIDDLE 79743 MATAS RUDOLPH SCHOOL 79751 GREEN PARK ELEMENTARY SCHOOL 79755 RIVIERE MARIE ELEMENTARY 79757 ELLIS, J.C. SCHOOL 79758 HAYNES ACADEMY FOR ADVANCED STUDIES 79764 METAIRIE ACADEMY FOR ADVANCED STUDIES 79767 BIRNEY ELEMENTARY SCHOOL 79820 MCDONOGH 26-HOMEDALE ELEMENTARY SCHOOL 79821 HART WILLIAM ELEMENTARY 79825 GRETNA NO 2 ACADEMY FOR ADVANCED STUDIES 79827 GRETNA MIDDLE SCHOOL 79828 JOHNSON SHIRLEY T.-GRETNA PARK ELEMENTARY 79833 TERRYTOWN ELEMENTARY SCHOOL 79834 BOUDREAUX, GERALDINE ELEMENTARY SCHOOL 79835 LIVAUDAIS MIDDLE SCHOOL 79838 COX GEORGE A. ELEMENTARY 79839 SOLIS PAUL J. ELEMENTARY 79846 PITTMAN ELLA C. ELEMENTARY 79849 WOODLAND WEST ELEM SCHOOL 79850 HELEN COX HIGH SCHOOL 79852 WEST JEFFERSON HIGH SCHOOL 79856 CLANCY-MAGGIORE ELEMENTARY SCHOOL FOR THE ARTS 79859 WASHINGTON MONTESSORI SCHOOL 79862 CHATEAU ESTATES SCHOOL 79864 A.C. ALEXANDER SCHOOL 79865 GREENLAWN TERRACE ELEM SCHOOL 79866 SCHNECKENBURGER WALTER ELEMENTARY 79868 TOM BENSON SCHOOL (ROOSEVELT THEODORE MIDDLE) 79869 AUDUBON, JOHN JAMES SCHOOL 79870 WOODS GRANVILLE T. ELEMENTARY 79871 BONNABEL MAGNET ACADEMY HIGH SCHOOL 79873 LEO E. KERNER JR. ELEMENTARY 79874 FISHER MIDDLE-HIGH SCHOOL

Page 10 BEN Name 79891 JUDGE LIONEL COLLINS ELEMENTARY SCHOOL 79894 MARRERO L.H. MIDDLE 79897 LINCOLN SCHOOL FOR THE ARTS 79901 EHRET HIGH SCHOOL 79903 HIGGINS L.W. HIGH 79905 RUPPEL ACADEMY FOR ADVANCED STUDIES 79907 HARRY S TRUMAN SCHOOL 79911 ALLEN ELLENDER SCHOOL 79913 ESTELLE SCHOOL 79955 CHERBONNIER-RILLIEUX SCHOOL (LUCILLE CHERBONNIER SCHOOL) 79958 STREHLE COMMUNITY SCHOOL (Catherine Strehle Elem) 79959 Emmett C. Gilbert School of Excellence at Ford (FORD HENRY MIDDLE) 79960 HARRIS MILDRED S. ELEMENTARY 79963 MYRTLE C. THIBODEAUX ELEMENTARY SCHOOL 79964 BUTLER, JOSHUA ELEMENTARY SCHOOL 79965 WORLEY STELLA MIDDLE 79966 PITRE VIC A. ELEMENTARY 80103 JEFFERSON ELEMENTARY SCHOOL 80109 RIVERDALE HIGH SCHOOL 80110 RIVERDALE MIDDLE SCHOOL 80138 HAZEL PARKHILDA KNOFF ELEMENTARY SCHOOL 80142 HARAHAN ELEMENTARY SCHOOL 80275 GRAND ISLE SCHOOL 203410 CONGETTA TRIPPE JANET ELEMENTARY 227000 WESTBANK COMMUNITY SCHOOL 16038033 JEFFERSON THOMAS HIGH SCHOOL FOR ADVANCED STUDIES 16056479 PATRICK F TAYLOR SCIENCE AND TECHNOLOGY REGIONAL ACADEMY 16056742 RAY ST. PIERRE ACADEMY FOR ADVANCED STUDIES (MARRERO ACADEMY FOR ADVANCED STUDIES) 16073043 ADMINISTRATION BUILDING ANNEX 16066444 ADMINISTRATION BUILDING 16066436 PAUL E EMENES SPECIAL SERVICES BUILDING 17004445 Bonella A. St. Ville Elementary 17004446 Frederick Douglass Elementary 79898 CUILLIER JOSEPH A. SR. CAREER CENTER 17012534 Ralph J Bunche Elementary 17016628 Woodmere School 17022883 RUPPEL ACADEMIE FRANCAISE

Page 11 Line Item # 2099013717.002

Product and Service Details Data Connection between two or more sites entirely within the applicant’s network Purpose

Function Fiber

Type of Connection Switched Multimegabit Data Service Bandwidth Speed Upload Speed 10.0 Gbps Download Speed 10.0 Gbps

Connection Information Does this include firewall services? No Is this a connection between eligible schools, Yes libraries and NIFs (i.e., a connection that provides a “Wide area network”)?

Is this a direct connection to a single school, No library or a NIF for Internet access?

Cost Calculation for FRN Line Item # 2099013717.002

Monthly Cost One-Time Cost Monthly Recurring Unit Cost $1,000.00 One-time Unit Cost $0.00 Monthly Recurring Unit Ineligible - $0.00 One-time Ineligible Unit Costs - $0.00 Costs One-time Eligible Unit Cost = $0.00 Monthly Recurring Unit Eligible = $1,000.00 One-time Quantity x 0 Costs Monthly Quantity x 82 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $82,000.00 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $984,000.00 Total Eligible Recurring Costs = $984,000.00 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $984,000.00 Line Item Cost

Page 12 Recipients of Services BEN Name 79715 HEARST PHOEBE SCHOOL 79719 EAST JEFFERSON HIGH SCHOOL 79720 BRIDGEDALE ELEMENTARY SCHOOL 79723 DOLHONDE ELLA ELEMENTARY 79728 GRACE KING HIGH SCHOOL 79731 MEISLER J.D. MIDDLE 79733 ADAMS MIDDLE SCHOOL 79734 KELLER HAROLD ELEMENTARY 79739 BISSONET PLAZA SCHOOL 79741 AIRLINE PARK ACADEMY FOR ADVANCED STUDIES 79742 HARRIS T.H. MIDDLE 79743 MATAS RUDOLPH SCHOOL 79751 GREEN PARK ELEMENTARY SCHOOL 79755 RIVIERE MARIE ELEMENTARY 79757 ELLIS, J.C. SCHOOL 79758 HAYNES ACADEMY FOR ADVANCED STUDIES 79764 METAIRIE ACADEMY FOR ADVANCED STUDIES 79767 BIRNEY ELEMENTARY SCHOOL 79820 MCDONOGH 26-HOMEDALE ELEMENTARY SCHOOL 79821 HART WILLIAM ELEMENTARY 79825 GRETNA NO 2 ACADEMY FOR ADVANCED STUDIES 79827 GRETNA MIDDLE SCHOOL 79828 JOHNSON SHIRLEY T.-GRETNA PARK ELEMENTARY 79833 TERRYTOWN ELEMENTARY SCHOOL 79834 BOUDREAUX, GERALDINE ELEMENTARY SCHOOL 79835 LIVAUDAIS MIDDLE SCHOOL 79838 COX GEORGE A. ELEMENTARY 79839 SOLIS PAUL J. ELEMENTARY 79846 PITTMAN ELLA C. ELEMENTARY 79849 WOODLAND WEST ELEM SCHOOL 79850 HELEN COX HIGH SCHOOL 79852 WEST JEFFERSON HIGH SCHOOL 79856 CLANCY-MAGGIORE ELEMENTARY SCHOOL FOR THE ARTS 79859 WASHINGTON MONTESSORI SCHOOL 79862 CHATEAU ESTATES SCHOOL 79864 A.C. ALEXANDER SCHOOL 79865 GREENLAWN TERRACE ELEM SCHOOL 79866 SCHNECKENBURGER WALTER ELEMENTARY 79868 TOM BENSON SCHOOL (ROOSEVELT THEODORE MIDDLE) 79869 AUDUBON, JOHN JAMES SCHOOL 79870 WOODS GRANVILLE T. ELEMENTARY 79871 BONNABEL MAGNET ACADEMY HIGH SCHOOL 79873 LEO E. KERNER JR. ELEMENTARY 79874 FISHER MIDDLE-HIGH SCHOOL

Page 13 BEN Name 79891 JUDGE LIONEL COLLINS ELEMENTARY SCHOOL 79894 MARRERO L.H. MIDDLE 79897 LINCOLN SCHOOL FOR THE ARTS 79901 EHRET HIGH SCHOOL 79903 HIGGINS L.W. HIGH 79905 RUPPEL ACADEMY FOR ADVANCED STUDIES 79907 HARRY S TRUMAN SCHOOL 79911 ALLEN ELLENDER SCHOOL 79913 ESTELLE SCHOOL 79955 CHERBONNIER-RILLIEUX SCHOOL (LUCILLE CHERBONNIER SCHOOL) 79958 STREHLE COMMUNITY SCHOOL (Catherine Strehle Elem) 79959 Emmett C. Gilbert School of Excellence at Ford (FORD HENRY MIDDLE) 79960 HARRIS MILDRED S. ELEMENTARY 79963 MYRTLE C. THIBODEAUX ELEMENTARY SCHOOL 79964 BUTLER, JOSHUA ELEMENTARY SCHOOL 79965 WORLEY STELLA MIDDLE 79966 PITRE VIC A. ELEMENTARY 80103 JEFFERSON ELEMENTARY SCHOOL 80109 RIVERDALE HIGH SCHOOL 80110 RIVERDALE MIDDLE SCHOOL 80138 HAZEL PARKHILDA KNOFF ELEMENTARY SCHOOL 80142 HARAHAN ELEMENTARY SCHOOL 80275 GRAND ISLE SCHOOL 203410 CONGETTA TRIPPE JANET ELEMENTARY 227000 WESTBANK COMMUNITY SCHOOL 16038033 JEFFERSON THOMAS HIGH SCHOOL FOR ADVANCED STUDIES 16056479 PATRICK F TAYLOR SCIENCE AND TECHNOLOGY REGIONAL ACADEMY 16056742 RAY ST. PIERRE ACADEMY FOR ADVANCED STUDIES (MARRERO ACADEMY FOR ADVANCED STUDIES) 16073043 ADMINISTRATION BUILDING ANNEX 16066444 ADMINISTRATION BUILDING 16066436 PAUL E EMENES SPECIAL SERVICES BUILDING 17004445 Bonella A. St. Ville Elementary 17004446 Frederick Douglass Elementary 79898 CUILLIER JOSEPH A. SR. CAREER CENTER 17012534 Ralph J Bunche Elementary 17016628 Woodmere School 17022883 RUPPEL ACADEMIE FRANCAISE

Page 14 Line Item # 2099013717.003

Product and Service Details Data Connection between two or more sites entirely within the applicant’s network Purpose

Function Fiber

Type of Connection Switched Multimegabit Data Service Bandwidth Speed Upload Speed 8.0 Gbps Download Speed 8.0 Gbps

Connection Information Does this include firewall services? No Is this a connection between eligible schools, Yes libraries and NIFs (i.e., a connection that provides a “Wide area network”)?

Is this a direct connection to a single school, No library or a NIF for Internet access?

Cost Calculation for FRN Line Item # 2099013717.003

Monthly Cost One-Time Cost Monthly Recurring Unit Cost $1,570.00 One-time Unit Cost $0.00 Monthly Recurring Unit Ineligible - $0.00 One-time Ineligible Unit Costs - $0.00 Costs One-time Eligible Unit Cost = $0.00 Monthly Recurring Unit Eligible = $1,570.00 One-time Quantity x 0 Costs Monthly Quantity x 2 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $3,140.00 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $37,680.00 Total Eligible Recurring Costs = $37,680.00 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $37,680.00 Line Item Cost

Page 15 Recipients of Services BEN Name 79715 HEARST PHOEBE SCHOOL 79719 EAST JEFFERSON HIGH SCHOOL 79720 BRIDGEDALE ELEMENTARY SCHOOL 79723 DOLHONDE ELLA ELEMENTARY 79728 GRACE KING HIGH SCHOOL 79731 MEISLER J.D. MIDDLE 79733 ADAMS MIDDLE SCHOOL 79734 KELLER HAROLD ELEMENTARY 79739 BISSONET PLAZA SCHOOL 79741 AIRLINE PARK ACADEMY FOR ADVANCED STUDIES 79742 HARRIS T.H. MIDDLE 79743 MATAS RUDOLPH SCHOOL 79751 GREEN PARK ELEMENTARY SCHOOL 79755 RIVIERE MARIE ELEMENTARY 79757 ELLIS, J.C. SCHOOL 79758 HAYNES ACADEMY FOR ADVANCED STUDIES 79764 METAIRIE ACADEMY FOR ADVANCED STUDIES 79767 BIRNEY ELEMENTARY SCHOOL 79820 MCDONOGH 26-HOMEDALE ELEMENTARY SCHOOL 79821 HART WILLIAM ELEMENTARY 79825 GRETNA NO 2 ACADEMY FOR ADVANCED STUDIES 79827 GRETNA MIDDLE SCHOOL 79828 JOHNSON SHIRLEY T.-GRETNA PARK ELEMENTARY 79833 TERRYTOWN ELEMENTARY SCHOOL 79834 BOUDREAUX, GERALDINE ELEMENTARY SCHOOL 79835 LIVAUDAIS MIDDLE SCHOOL 79838 COX GEORGE A. ELEMENTARY 79839 SOLIS PAUL J. ELEMENTARY 79846 PITTMAN ELLA C. ELEMENTARY 79849 WOODLAND WEST ELEM SCHOOL 79850 HELEN COX HIGH SCHOOL 79852 WEST JEFFERSON HIGH SCHOOL 79856 CLANCY-MAGGIORE ELEMENTARY SCHOOL FOR THE ARTS 79859 WASHINGTON MONTESSORI SCHOOL 79862 CHATEAU ESTATES SCHOOL 79864 A.C. ALEXANDER SCHOOL 79865 GREENLAWN TERRACE ELEM SCHOOL 79866 SCHNECKENBURGER WALTER ELEMENTARY 79868 TOM BENSON SCHOOL (ROOSEVELT THEODORE MIDDLE) 79869 AUDUBON, JOHN JAMES SCHOOL 79870 WOODS GRANVILLE T. ELEMENTARY 79871 BONNABEL MAGNET ACADEMY HIGH SCHOOL 79873 LEO E. KERNER JR. ELEMENTARY 79874 FISHER MIDDLE-HIGH SCHOOL

Page 16 BEN Name 79891 JUDGE LIONEL COLLINS ELEMENTARY SCHOOL 79894 MARRERO L.H. MIDDLE 79897 LINCOLN SCHOOL FOR THE ARTS 79901 EHRET HIGH SCHOOL 79903 HIGGINS L.W. HIGH 79905 RUPPEL ACADEMY FOR ADVANCED STUDIES 79907 HARRY S TRUMAN SCHOOL 79911 ALLEN ELLENDER SCHOOL 79913 ESTELLE SCHOOL 79955 CHERBONNIER-RILLIEUX SCHOOL (LUCILLE CHERBONNIER SCHOOL) 79958 STREHLE COMMUNITY SCHOOL (Catherine Strehle Elem) 79959 Emmett C. Gilbert School of Excellence at Ford (FORD HENRY MIDDLE) 79960 HARRIS MILDRED S. ELEMENTARY 79963 MYRTLE C. THIBODEAUX ELEMENTARY SCHOOL 79964 BUTLER, JOSHUA ELEMENTARY SCHOOL 79965 WORLEY STELLA MIDDLE 79966 PITRE VIC A. ELEMENTARY 80103 JEFFERSON ELEMENTARY SCHOOL 80109 RIVERDALE HIGH SCHOOL 80110 RIVERDALE MIDDLE SCHOOL 80138 HAZEL PARKHILDA KNOFF ELEMENTARY SCHOOL 80142 HARAHAN ELEMENTARY SCHOOL 80275 GRAND ISLE SCHOOL 203410 CONGETTA TRIPPE JANET ELEMENTARY 227000 WESTBANK COMMUNITY SCHOOL 16038033 JEFFERSON THOMAS HIGH SCHOOL FOR ADVANCED STUDIES 16056479 PATRICK F TAYLOR SCIENCE AND TECHNOLOGY REGIONAL ACADEMY 16056742 RAY ST. PIERRE ACADEMY FOR ADVANCED STUDIES (MARRERO ACADEMY FOR ADVANCED STUDIES) 16073043 ADMINISTRATION BUILDING ANNEX 16066444 ADMINISTRATION BUILDING 16066436 PAUL E EMENES SPECIAL SERVICES BUILDING 17004445 Bonella A. St. Ville Elementary 17004446 Frederick Douglass Elementary 79898 CUILLIER JOSEPH A. SR. CAREER CENTER 17012534 Ralph J Bunche Elementary 17016628 Woodmere School 17022883 RUPPEL ACADEMIE FRANCAISE

Page 17 Line Item # 2099013717.004

Product and Service Details Data Connection between two or more sites entirely within the applicant’s network Purpose

Function Fiber

Type of Connection Switched Multimegabit Data Service Bandwidth Speed Upload Speed 10.0 Gbps Download Speed 10.0 Gbps

Connection Information Does this include firewall services? No Is this a connection between eligible schools, Yes libraries and NIFs (i.e., a connection that provides a “Wide area network”)?

Is this a direct connection to a single school, No library or a NIF for Internet access?

Cost Calculation for FRN Line Item # 2099013717.004

Monthly Cost One-Time Cost Monthly Recurring Unit Cost $2,500.00 One-time Unit Cost $0.00 Monthly Recurring Unit Ineligible - $0.00 One-time Ineligible Unit Costs - $0.00 Costs One-time Eligible Unit Cost = $0.00 Monthly Recurring Unit Eligible = $2,500.00 One-time Quantity x 0 Costs Monthly Quantity x 2 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $5,000.00 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $60,000.00 Total Eligible Recurring Costs = $60,000.00 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $60,000.00 Line Item Cost

Page 18 Recipients of Services BEN Name 79715 HEARST PHOEBE SCHOOL 79719 EAST JEFFERSON HIGH SCHOOL 79720 BRIDGEDALE ELEMENTARY SCHOOL 79723 DOLHONDE ELLA ELEMENTARY 79728 GRACE KING HIGH SCHOOL 79731 MEISLER J.D. MIDDLE 79733 ADAMS MIDDLE SCHOOL 79734 KELLER HAROLD ELEMENTARY 79739 BISSONET PLAZA SCHOOL 79741 AIRLINE PARK ACADEMY FOR ADVANCED STUDIES 79742 HARRIS T.H. MIDDLE 79743 MATAS RUDOLPH SCHOOL 79751 GREEN PARK ELEMENTARY SCHOOL 79755 RIVIERE MARIE ELEMENTARY 79757 ELLIS, J.C. SCHOOL 79758 HAYNES ACADEMY FOR ADVANCED STUDIES 79764 METAIRIE ACADEMY FOR ADVANCED STUDIES 79767 BIRNEY ELEMENTARY SCHOOL 79820 MCDONOGH 26-HOMEDALE ELEMENTARY SCHOOL 79821 HART WILLIAM ELEMENTARY 79825 GRETNA NO 2 ACADEMY FOR ADVANCED STUDIES 79827 GRETNA MIDDLE SCHOOL 79828 JOHNSON SHIRLEY T.-GRETNA PARK ELEMENTARY 79833 TERRYTOWN ELEMENTARY SCHOOL 79834 BOUDREAUX, GERALDINE ELEMENTARY SCHOOL 79835 LIVAUDAIS MIDDLE SCHOOL 79838 COX GEORGE A. ELEMENTARY 79839 SOLIS PAUL J. ELEMENTARY 79846 PITTMAN ELLA C. ELEMENTARY 79849 WOODLAND WEST ELEM SCHOOL 79850 HELEN COX HIGH SCHOOL 79852 WEST JEFFERSON HIGH SCHOOL 79856 CLANCY-MAGGIORE ELEMENTARY SCHOOL FOR THE ARTS 79859 WASHINGTON MONTESSORI SCHOOL 79862 CHATEAU ESTATES SCHOOL 79864 A.C. ALEXANDER SCHOOL 79865 GREENLAWN TERRACE ELEM SCHOOL 79866 SCHNECKENBURGER WALTER ELEMENTARY 79868 TOM BENSON SCHOOL (ROOSEVELT THEODORE MIDDLE) 79869 AUDUBON, JOHN JAMES SCHOOL 79870 WOODS GRANVILLE T. ELEMENTARY 79871 BONNABEL MAGNET ACADEMY HIGH SCHOOL 79873 LEO E. KERNER JR. ELEMENTARY 79874 FISHER MIDDLE-HIGH SCHOOL

Page 19 BEN Name 79891 JUDGE LIONEL COLLINS ELEMENTARY SCHOOL 79894 MARRERO L.H. MIDDLE 79897 LINCOLN SCHOOL FOR THE ARTS 79901 EHRET HIGH SCHOOL 79903 HIGGINS L.W. HIGH 79905 RUPPEL ACADEMY FOR ADVANCED STUDIES 79907 HARRY S TRUMAN SCHOOL 79911 ALLEN ELLENDER SCHOOL 79913 ESTELLE SCHOOL 79955 CHERBONNIER-RILLIEUX SCHOOL (LUCILLE CHERBONNIER SCHOOL) 79958 STREHLE COMMUNITY SCHOOL (Catherine Strehle Elem) 79959 Emmett C. Gilbert School of Excellence at Ford (FORD HENRY MIDDLE) 79960 HARRIS MILDRED S. ELEMENTARY 79963 MYRTLE C. THIBODEAUX ELEMENTARY SCHOOL 79964 BUTLER, JOSHUA ELEMENTARY SCHOOL 79965 WORLEY STELLA MIDDLE 79966 PITRE VIC A. ELEMENTARY 80103 JEFFERSON ELEMENTARY SCHOOL 80109 RIVERDALE HIGH SCHOOL 80110 RIVERDALE MIDDLE SCHOOL 80138 HAZEL PARKHILDA KNOFF ELEMENTARY SCHOOL 80142 HARAHAN ELEMENTARY SCHOOL 80275 GRAND ISLE SCHOOL 203410 CONGETTA TRIPPE JANET ELEMENTARY 227000 WESTBANK COMMUNITY SCHOOL 16038033 JEFFERSON THOMAS HIGH SCHOOL FOR ADVANCED STUDIES 16056479 PATRICK F TAYLOR SCIENCE AND TECHNOLOGY REGIONAL ACADEMY 16056742 RAY ST. PIERRE ACADEMY FOR ADVANCED STUDIES (MARRERO ACADEMY FOR ADVANCED STUDIES) 16073043 ADMINISTRATION BUILDING ANNEX 16066444 ADMINISTRATION BUILDING 16066436 PAUL E EMENES SPECIAL SERVICES BUILDING 17004445 Bonella A. St. Ville Elementary 17004446 Frederick Douglass Elementary 79898 CUILLIER JOSEPH A. SR. CAREER CENTER 17012534 Ralph J Bunche Elementary 17016628 Woodmere School 17022883 RUPPEL ACADEMIE FRANCAISE

Page 20 FRN Calculation for FRN #2099013717

Monthly Charges Total Requested Amount Total Monthly Recurring Charges $99,140.00 Total Eligible Pre-Discount $1,189,680.00 Total Monthly Ineligible Charges - $0.00 Recurring Charges Total Eligible Pre-Discount One- + $0.00 Total Monthly Eligible Charges = $99,140.00 Time Charges Total Number of Months of x 12 Total Pre-Discount Charges = $1,189,680.00 Service Discount Rate 90% Total Eligible Pre-Discount = $1,189,680.00 Recurring Charges Funding Commitment Request = $1,070,712.00

One-Time Charges Total One-Time Charges $0.00 Total Ineligible One-Time - $0.00 Charges Total Eligible Pre-Discount = $0.00 One-Time Charges

Page 21 Certifications I certify that the entities listed in this application are eligible for support because they are schools under the statutory definitions of elementary and secondary schools found in the No Child Left Behind Act of 2001, 20 U.S.C. §§ 7801(18) and (38), that do not operate as for-profit businesses and do not have endowments exceeding $50 million. I certify that the entity I represent or the entities listed on this application have secured access, separately or through this program, to all of the resources, including computers, training, software, internal connections, maintenance, and electrical capacity, necessary to use the services purchased effectively. I recognize that some of the aforementioned resources are not eligible for support. I certify that the entities I represent or the entities listed on this application have secured access to all of the resources to pay the discounted charges for eligible services from funds to which access has been secured in the current funding year. I certify that the Billed Entity will pay the non-discount portion of the cost of the goods and services to the service provider(s). Total Funding Summary

Below is a summary of the total line item costs on this FCC Form 471:

Summary Total funding year pre-discount eligible amount on this FCC Form $1,189,680.00 471 Total funding commitment request amount on this FCC Form 471 $1,070,712.00 Total applicant non-discount share of the eligible amount $118,968.00 Total budgeted amount allocated to resources not eligible for E-rate $160,000.00 support Total amount necessary for the applicant to pay the non-discount $278,968.00 share of eligible and any ineligible amounts Are you receiving any of the funds directly from a service provider No listed on any of the FCC Forms 471 filed by this Billed Entity for this funding year? Has a service provider listed on any of the FCC Forms 471 filed by No this Billed Entity for this funding year assited you in locating funds needed to pay your non-discounted share?

I certify an FCC Form 470 was posted and that any related RFP was made available for at least 28 days before considering all bids received and selecting a service provider. I certify that all bids submitted were carefully considered and the most cost-effective service offering was selected, with price being the primary factor considered, and is the most cost-effective means of meeting educational needs and technology goals. I certify that the entity responsible for selecting the service provider(s) has reviewed all applicable FCC, state, and local procurement/competitive bidding requirements and that the entity or entities listed on this application have complied with them. I certify that the services the applicant purchases at discounts provided by 47 U.S.C. § 254 will be used primarily for educational purposes, see 47 C.F.R. § 54.500 and will not be sold, resold or transferred in consideration for money or any other thing of value, except as permitted by the Commission’s rules at 47 C.F.R. § 54.513. Additionally, I certify that the entity or entities listed on this application have not received anything of value or a promise of anything of value, as prohibited by the Commission’s rules at 47 C.F.R. § 54.503(d), other than services and equipment sought by means of this form, from the service provider, or any representative or agent thereof or any consultant in connection with this request for services. I certify that I and the entity(ies) I represent have complied with all program rules and I acknowledge that failure to do so may result in denial of discount funding and/or cancellation of funding commitments. There are signed contracts or other 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. I acknowledge that failure to comply with program rules could result in civil or criminal prosecution by the appropriate law enforcement authorities. I acknowledge 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 service, receive an appropriate share of benefits from those services. I certify that I will retain required documents 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 later of the last day of the applicable funding year or the service delivery deadline for the associated funding request. I acknowledge that I may be audited pursuant to participation in the schools and libraries program. I certify that I will retain all documents necessary to demonstrate compliance with the statute and Commission rules regarding the application for, receipt of, and delivery of services receiving schools and libraries discounts, and that if audited, I will make such records available to USAC. I certify that I am authorized to order telecommunications and other supported services for the eligible entity(ies) listed on this application. I certify that I am authorized to submit this request on behalf of the eligible entity(ies) listed on this application, that I have examined this request, that all of the information on this form is true and correct to the best of my knowledge, that the entities that are receiving discounts pursuant to this application have complied with the terms, conditions and purposes of the program, that no kickbacks were paid to anyone and that false statements on this form can be punished by fine or forfeiture under the Communications Act, 47 U.S.C. §§ 502, 503(b), or fine or imprisonment under Title 18 of the United States Code, 18 U.S.C. § 1001 and civil violations of the False Claims Act. I 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. I will institute reasonable measures to be informed, and will notify USAC should I be informed or become aware that I or any of the entities listed on this application, or any person associated in any way with my entity and/or the entities listed on this application, is convicted of a criminal violation or held civilly liable for acts arising from their participation in the schools and libraries support mechanism. I certify that if any of the Funding Requests on this FCC Form 471 are for discounts for products or services that contain both eligible and ineligible components, that I have allocated the eligible and ineligible components as required by the Commission's rules at 47 C.F.R. § 54.504. Notice

Page 22 Section 54.504 of the Federal Communications Commission's rules requires all schools and libraries ordering services that are eligible for and seeking universal service discounts to submit an application for such discounts by filing this Services Ordered and Certification Form (FCC Form 471) with the Universal Service Administrator. 47 C.F.R. § 54.504. The collection of information stems from the Commission's authority under Section 254 of the Communications Act of 1934, as amended. 47 U.S.C. § 254. The data in the report will be used to ensure that schools and libraries comply with the application requirements for universal service discounts contained in 47 C.F.R. § 54.504. Schools and libraries must file this form themselves or as part of a consortium. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The FCC is authorized under the Communications Act of 1934, as amended, to collect the information we request in this form. We will use the information you provide to determine whether approving your application for universal service discounts is in the public interest. If we believe there may be a violation or a potential violation of any applicable statute, regulation, rule or order, your application may be referred to the Federal, state, or local agency responsible for investigating, prosecuting, enforcing, or implementing the statute, rule, regulation or order. In certain cases, the information in your application for universal service discounts may be disclosed to the Department of Justice or a court or adjudicative body when (a) the FCC; or (b) any employee of the FCC; or (c) the United States Government is a party of a proceeding before the body or has an interest in the proceeding. In addition, consistent with the Communications Act of 1934, FCC regulations and orders, the Freedom of Information Act, 5 U.S.C. § 552, or other applicable law, information provided in or submitted with this form or in response to subsequent inquiries may be disclosed to the public. If you owe a past due debt to the Federal government, the information you provide may also be disclosed to the Department of the Treasury Financial Management Service, other Federal agencies and/or your employer to offset your salary, IRS tax refund or other payments to collect that debt. The FCC may also provide the information to these agencies through the matching of computer records when authorized. If you do not provide the information we request on the form, the FCC or the Universal Service Administrator may delay processing of your application for universal service discounts or may return your application without action. The foregoing Notice is required by the Paperwork Reduction Act of 1995, Pub. L. No. 104-13, 44 U.S.C. § 3501, et seq. Public reporting burden for this collection of information is estimated to average 4.5 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, completing, and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the reporting burden to the Federal Communications Commission, Performance Evaluation and Records Management, Washington, DC 20554. We also will accept your comments via the email if you send them to [email protected]. DO NOT SEND COMPLETED WORKSHEETS TO THESE ADDRESSES. Authorized Person Title: Consultant Name: Teri Lawrence

Phone: 225-224-2786 Email: [email protected]

Address: P.O. Box 728 Pine Grove LA 70453 Employer: Educational Professional Services

15-Feb-2020 10:29:42 EST Certified Timestamp

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