OMB 3060-0806 Approval by OMB FCC Form 471 November 2015 Description of Services Ordered and Certification Form 471
FCC Form 471 Application Information Nickname Loudoun C1 Application Number 191034809 Funding Year 2019 Category of Service Category 1
Billed Entity Contact Information LOUDOUN COUNTY SCHOOL DISTRICT Gregory W Weisiger 43711 PARTLOW ROAD ASHBURN VA 20147 516-801-7840 571-252-2105 [email protected]
Billed Entity Number 126347 FCC Registration Number 0006072011 Applicant Type School District
Melissa Zaruba: [email protected] Holiday/Summer Contact Information
Consulting Firms Name Consultant City State Zip Phone Email Registration Code Number Number E-Rate Central 16060891 Westbury NY 11590 516-801-7800 [email protected]
Entity Information
School District Entity - Details BEN Name Urban/ State State NCES School District Endowment Rural LEA ID School Code Attributes ID 126347 LOUDOUN COUNTY SCHOOL Urban Public School District None DISTRICT
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 21781 ALDIE ELEMENTARY Rural None Pre-K; Public School None SCHOOL
Page 1 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 21835 BANNEKER Rural None Pre-K; Public School None ELEMENTARY SCHOOL 21837 MIDDLEBURG Rural None Pre-K; Public School None ELEMENTARY SCHOOL 21856 HILLSBORO Rural None Public School None ELEMENTARY SCHOOL 21857 LOUDOUN VALLEY HIGH Rural None Public School None SCHOOL 21858 EMERICK ELEMENTARY Rural None Pre-K; Public School None SCHOOL 21859 BLUE RIDGE MIDDLE Rural None Public School None SCHOOL 21860 LINCOLN ELEMENTARY Rural None Public School None SCHOOL 21863 ROUND HILL Rural None Pre-K; Public School None ELEMENTARY SCHOOL 21864 FARMWELL STATION Urban None Public School None MIDDLE SCHOOL 21865 ASHBURN ELEMENTARY Urban None Pre-K; Public School None SCHOOL 21866 SANDERS CORNER Urban None Pre-K; Public School None ELEMENTARY SCH 21867 BROAD RUN HIGH Urban None Public School None SCHOOL 21868 DOMINION TRAIL Urban None Pre-K; Public School None ELEMENTARY SCH 21880 HAMILTON Rural None Pre-K; Public School None ELEMENTARY SCHOOL 21881 MEADOWLAND Urban None Pre-K; Public School None ELEMENTARY SCHOOL 21882 SENECA RIDGE MIDDLE Urban None Public School None SCHOOL 21883 SUGARLAND Urban None Pre-K; Public School None ELEMENTARY SCHOOL 21884 ROLLING RIDGE ELEM Urban None Pre-K; Public School None SCHOOL 21886 SULLY ELEMENTARY Urban None Pre-K; Public School None SCHOOL 21888 PARK VIEW HIGH Urban None Public School None SCHOOL 21889 STERLING ELEMENTARY Urban None Public School None SCHOOL 21890 STERLING MIDDLE Urban None Public School None SCHOOL 21892 GUILFORD Urban None Pre-K; Public School None ELEMENTARY SCHOOL 21893 LOWES ISLAND Urban None Public School None ELEMENTARY SCHOOL 21894 ALGONKIAN Urban None Pre-K; Public School None ELEMENTARY SCHOOL 21895 POTOMAC FALLS HIGH Urban None Public School None SCHOOL 21897 POTOWMACK Urban None Pre-K; Public School None ELEMENTARY SCHOOL 21919 MONROE VOC-TECH Urban None Public School None CENTER 21920 LOUDOUN COUNTY Urban None Public School None HIGH SCHOOL Page 2 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 21921 CATOCTIN ELEMENTARY Urban None Pre-K; Public School None SCHOOL 21923 JL SIMPSON MIDDLE Urban None Public School None SCHOOL 21924 COOL SPRING Urban None Pre-K; Public School None ELEMENTARY SCHOOL 21929 LEESBURG Urban None Public School None ELEMENTARY SCHOOL 21931 DOUGLASS SCHOOL Urban None Public School None 21932 BALL'S BLUFF Urban None Pre-K; Public School None ELEMENTARY 21933 LUCKETTS Rural None Pre-K; Public School None ELEMENTARY SCHOOL 21936 LOVETTSVILLE Rural None Pre-K; Public School None ELEMENTARY SCHOOL 21970 WATERFORD Rural None Public School None ELEMENTARY SCHOOL 167065 HORIZON ELEMENTARY Urban None Pre-K; Public School None SCHOOL 189283 HILLSIDE ELEMENTARY Urban None Pre-K; Public School None 191740 EVERGREEN MILL Rural None Pre-K; Public School None ELEMENTARY 205428 CEDAR LANE Urban None Pre-K; Public School None ELEMENTARY 205429 HARPER PARK MIDDLE Urban None Public School None SCHOOL 229699 EAGLE RIDGE MIDDLE Urban None Public School None SCHOOL 229701 LITTLE RIVER Urban None Pre-K; Public School None ELEMENTARY SCHOOL 229702 MILL RUN ELEMENTARY Urban None Pre-K; Public School None SCHOOL 229703 SELDENS LANDING Urban None Pre-K; Public School None ELEMENTARY SCHOOL 229704 STONE BRIDGE HIGH Urban None Public School None SCHOOL 229708 TOLBERT ELEMENTARY Urban None Public School None SCHOOL. 235129 HERITAGE HIGH Rural None Public School None SCHOOL 235130 RIVER BEND MIDDLE Urban None Public School None SCHOOL 235131 HARMONY MIDDLE Rural None Public School None SCHOOL 235132 FOREST GROVE Urban None Public School None ELEMENTARY SCHOOL 235133 HUTCHISON FARM Urban None Public School None ELEMENTARY SCHOOL 235196 DOMINION HIGH Urban None Public School None SCHOOL 235197 BELMONT RIDGE Urban None Public School None MIDDLE SCHOOL 235198 COUNTRYSIDE Urban None Public School None ELEMENTARY SCHOOL 235199 FRANCES HAZEL REID Urban None Public School None ELEMENTARY SCHOOL
Page 3 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 235200 MOUNTAIN VIEW Rural None Public School None ELEMENTARY 16021589 BELMONT STATION Urban None Public School None ELEMENTARY SCHOOL 16021590 MERCER MIDDLE Urban None Public School None SCHOOL 16021591 SMART'S MILL MIDDLE Urban None Public School None SCHOOL 16028063 BRIAR WOODS HIGH Urban None Public School None SCHOOL 16028064 FREEDOM HIGH Urban None Public School None SCHOOL 16028065 LEGACY ELEMENTARY Urban None Public School None SCHOOL 16028067 NEWTON-LEE Urban None Public School None ELEMENTARY SCHOOL 16028068 PINEBROOK Rural None Public School None ELEMENTARY 16042743 SYCOLIN CREEK Rural None Public School None ELEMENTARY SCHOOL 16042744 ROSA LEE CARTER Rural None Public School None ELEMENTARY SCHOOL 16042745 ARCOLA ELEMENTARY Urban None Public School None SCHOOL 16042746 STONE HILL MIDDLE Rural None Public School None SCHOOL 16060152 CREIGHTON'S CORNER Rural None Public School None ELEMENTARY 16060156 KENNETH CULBERT Rural None Public School None ELEMENTARY 16060157 LIBERTY ELEMENTARY Urban None Public School None 16060158 STEUART W WELLER Urban None Public School None ELEMENTARY 16065992 WOODGROVE HIGH Rural None Public School None SCHOOL 16066077 TUSCARORA HIGH Rural None Public School None SCHOOL 16066078 BUFFALO TRAIL Rural None Public School None ELEMENTARY 16066079 JM LUNSFORD MIDDLE Rural None Public School None SCHOOL 16070690 JOHN CHAMPE HIGH Urban None Public School None SCHOOL 16070691 FREDERICK DOUGLASS Urban None Public School None ELEMENTARY SCHOOL 16074384 DISCOVERY Urban None Public School None ELEMENTARY 16074385 MOOREFIELD STATION Urban None Public School None ELEMENTARY 16080363 CARDINAL RIDGE Rural None Public School None ELEMENTARY 16084324 RIVERSIDE HIGH Urban None New Construction None SCHOOL School; Public School 16080365 ROCK RIDGE HIGH Rural None Public School None 16080364 TRAILSIDE MIDDLE Urban None Public School None 17010306 Madisons Trust ES Rural None Public School None
Page 4 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 17016868 BRAMBLETON MIDDLE Urban None Public School None SCHOOL 17018956 Willard Intermediate Urban None Public School None School 17018954 Waxpool El School Urban None Public School None 17018953 Lightridge High School Urban None Public School None 17018952 Independence HS Urban None Public School None 17018951 Goshen Post Elementary Urban None Public School None School 17018950 Academies of Loudon Urban None Public School None
Related Child School Entity - Discount Rate Calculation Details BEN Name Urban/ Number of Students CEP Rural Students Count Based Percentage on Estimate 21781 ALDIE ELEMENTARY SCHOOL Rural 129 N/A 21835 BANNEKER ELEMENTARY SCHOOL Rural 162 N/A 21837 MIDDLEBURG ELEMENTARY SCHOOL Rural 0 N/A 21856 HILLSBORO ELEMENTARY SCHOOL Rural 0 N/A 21857 LOUDOUN VALLEY HIGH SCHOOL Rural 1347 N/A 21858 EMERICK ELEMENTARY SCHOOL Rural 489 N/A 21859 BLUE RIDGE MIDDLE SCHOOL Rural 934 N/A 21860 LINCOLN ELEMENTARY SCHOOL Rural 93 N/A 21863 ROUND HILL ELEMENTARY SCHOOL Rural 532 N/A 21864 FARMWELL STATION MIDDLE SCHOOL Urban 1144 N/A 21865 ASHBURN ELEMENTARY SCHOOL Urban 601 N/A 21866 SANDERS CORNER ELEMENTARY SCH Urban 532 N/A 21867 BROAD RUN HIGH SCHOOL Urban 1605 N/A 21868 DOMINION TRAIL ELEMENTARY SCH Urban 720 N/A 21880 HAMILTON ELEMENTARY SCHOOL Rural 186 N/A 21881 MEADOWLAND ELEMENTARY SCHOOL Urban 441 N/A 21882 SENECA RIDGE MIDDLE SCHOOL Urban 1027 N/A 21883 SUGARLAND ELEMENTARY SCHOOL Urban 612 N/A 21884 ROLLING RIDGE ELEM SCHOOL Urban 658 N/A 21886 SULLY ELEMENTARY SCHOOL Urban 444 N/A 21888 PARK VIEW HIGH SCHOOL Urban 1395 N/A 21889 STERLING ELEMENTARY SCHOOL Urban 450 N/A 21890 STERLING MIDDLE SCHOOL Urban 1037 N/A 21892 GUILFORD ELEMENTARY SCHOOL Urban 549 N/A 21893 LOWES ISLAND ELEMENTARY SCHOOL Urban 604 N/A 21894 ALGONKIAN ELEMENTARY SCHOOL Urban 466 N/A 21895 POTOMAC FALLS HIGH SCHOOL Urban 1633 N/A 21897 POTOWMACK ELEMENTARY SCHOOL Urban 567 N/A 21919 MONROE VOC-TECH CENTER Urban 0 N/A 21920 LOUDOUN COUNTY HIGH SCHOOL Urban 1469 N/A 21921 CATOCTIN ELEMENTARY SCHOOL Urban 668 N/A 21923 JL SIMPSON MIDDLE SCHOOL Urban 1076 N/A Page 5 BEN Name Urban/ Number of Students CEP Rural Students Count Based Percentage on Estimate 21924 COOL SPRING ELEMENTARY SCHOOL Urban 629 N/A 21929 LEESBURG ELEMENTARY SCHOOL Urban 489 N/A 21931 DOUGLASS SCHOOL Urban 169 N/A 21932 BALL'S BLUFF ELEMENTARY Urban 581 N/A 21933 LUCKETTS ELEMENTARY SCHOOL Rural 296 N/A 21936 LOVETTSVILLE ELEMENTARY SCHOOL Rural 518 N/A 21970 WATERFORD ELEMENTARY SCHOOL Rural 183 N/A 167065 HORIZON ELEMENTARY SCHOOL Urban 662 N/A 189283 HILLSIDE ELEMENTARY Urban 773 N/A 191740 EVERGREEN MILL ELEMENTARY Rural 532 N/A 205428 CEDAR LANE ELEMENTARY Urban 808 N/A 205429 HARPER PARK MIDDLE SCHOOL Urban 1060 N/A 229699 EAGLE RIDGE MIDDLE SCHOOL Urban 1223 N/A 229701 LITTLE RIVER ELEMENTARY SCHOOL Urban 775 N/A 229702 MILL RUN ELEMENTARY SCHOOL Urban 907 N/A 229703 SELDENS LANDING ELEMENTARY SCHOOL Urban 726 N/A 229704 STONE BRIDGE HIGH SCHOOL Urban 1722 N/A 229708 TOLBERT ELEMENTARY SCHOOL. Urban 701 N/A 235129 HERITAGE HIGH SCHOOL Rural 1484 N/A 235130 RIVER BEND MIDDLE SCHOOL Urban 1203 N/A 235131 HARMONY MIDDLE SCHOOL Rural 1097 N/A 235132 FOREST GROVE ELEMENTARY SCHOOL Urban 576 N/A 235133 HUTCHISON FARM ELEMENTARY SCHOOL Urban 815 N/A 235196 DOMINION HIGH SCHOOL Urban 1599 N/A 235197 BELMONT RIDGE MIDDLE SCHOOL Urban 1278 N/A 235198 COUNTRYSIDE ELEMENTARY SCHOOL Urban 741 N/A 235199 FRANCES HAZEL REID ELEMENTARY SCHOOL Urban 671 N/A 235200 MOUNTAIN VIEW ELEMENTARY Rural 694 N/A 16021589 BELMONT STATION ELEMENTARY SCHOOL Urban 715 N/A 16021590 MERCER MIDDLE SCHOOL Urban 1474 N/A 16021591 SMART'S MILL MIDDLE SCHOOL Urban 1074 N/A 16028063 BRIAR WOODS HIGH SCHOOL Urban 1865 N/A 16028064 FREEDOM HIGH SCHOOL Urban 2072 N/A 16028065 LEGACY ELEMENTARY SCHOOL Urban 1006 N/A 16028067 NEWTON-LEE ELEMENTARY SCHOOL Urban 694 N/A 16028068 PINEBROOK ELEMENTARY Rural 903 N/A 16042743 SYCOLIN CREEK ELEMENTARY SCHOOL Rural 708 N/A 16042744 ROSA LEE CARTER ELEMENTARY SCHOOL Rural 913 N/A 16042745 ARCOLA ELEMENTARY SCHOOL Urban 942 N/A 16042746 STONE HILL MIDDLE SCHOOL Rural 1022 N/A 16060152 CREIGHTON'S CORNER ELEMENTARY Rural 1135 N/A 16060156 KENNETH CULBERT ELEMENTARY Rural 508 N/A 16060157 LIBERTY ELEMENTARY Urban 1039 N/A 16060158 STEUART W WELLER ELEMENTARY Urban 812 N/A 16065992 WOODGROVE HIGH SCHOOL Rural 1620 N/A Page 6 BEN Name Urban/ Number of Students CEP Rural Students Count Based Percentage on Estimate 16066077 TUSCARORA HIGH SCHOOL Rural 1515 N/A 16066078 BUFFALO TRAIL ELEMENTARY Rural 968 N/A 16066079 JM LUNSFORD MIDDLE SCHOOL Rural 1650 N/A 16070690 JOHN CHAMPE HIGH SCHOOL Urban 1656 N/A 16070691 FREDERICK DOUGLASS ELEMENTARY SCHOOL Urban 732 N/A 16074384 DISCOVERY ELEMENTARY Urban 841 N/A 16074385 MOOREFIELD STATION ELEMENTARY Urban 974 N/A 16080363 CARDINAL RIDGE ELEMENTARY Rural 862 N/A 16084324 RIVERSIDE HIGH SCHOOL Urban 1807 N/A 16080365 ROCK RIDGE HIGH Rural 2222 N/A 16080364 TRAILSIDE MIDDLE Urban 1254 N/A 17010306 Madisons Trust ES Rural 1230 N/A 17016868 BRAMBLETON MIDDLE SCHOOL Urban 1327 N/A 17018956 Willard Intermediate School Urban 1334 N/A 17018954 Waxpool El School Urban 0 N/A 17018953 Lightridge High School Urban 0 N/A 17018952 Independence HS Urban 0 N/A 17018951 Goshen Post Elementary School Urban 1148 N/A 17018950 Academies of Loudon Urban 0 N/A
Related School District NIFs School School District Name NIF BEN NIF Name District BEN 126347 LOUDOUN COUNTY SCHOOL DISTRICT 16052562 TRANSPORTATION OFFICE 126347 LOUDOUN COUNTY SCHOOL DISTRICT 16052563 DOUGLASS SUPPORT FACILITY 126347 LOUDOUN COUNTY SCHOOL DISTRICT 16052564 SCHOOL BOARD OFFICE 126347 LOUDOUN COUNTY SCHOOL DISTRICT 16064273 FACILITY SERVICES 126347 LOUDOUN COUNTY SCHOOL DISTRICT 16067887 STAFF TRAINING CENTER 126347 LOUDOUN COUNTY SCHOOL DISTRICT 16067888 PARENT RESOURCE CENTER 126347 LOUDOUN COUNTY SCHOOL DISTRICT 17019008 Round Hill Center 126347 LOUDOUN COUNTY SCHOOL DISTRICT 17019009 Valley Service Center
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 82504 14560 18.0% Urban 40% 40%
Page 7 Funding Request for FRN #1999062662 Funding Request Nickname: ENA
Service Type: Data Transmission and/or Internet Access
What is the FRN number from the previous 1899073980 year ?
Agreement Information - Contract Contract Number Account Number
Establishing FCC Form 470 170078887 Service Provider ENA Services, LLC (SPN: 143030857) Was an FCC Form 470 posted Yes for the product and/or services Based on State Master No you are requesting? Contract?
Award Date May 09, 2017 Based on a multiple award No schedule? How many bids were received 2 Includes Voluntary Extensions? No for this contract?
What is the service start date? July 01, 2019 Remaining Voluntary Extensions
Total Remaining Contract Length
What is the date your contract June 30, 2022 expires for the current term of the contract?
Pricing Confidentiality Is there a statute, rule, or other restriction which prohibits No publication of the specific pricing information for this contract?
Internet Access and transport Narrative
Page 8 Line Item # 1999062662.001
Product and Service Details Data Connection between two or more sites entirely within the applicant’s network Purpose
Function Fiber
Type of Connection Ethernet 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, No libraries and NIFs (i.e., a connection that provides a “Wide area network”)?
Is this a direct connection to a single school, Yes library or a NIF for Internet access?
Cost Calculation for FRN Line Item # 1999062662.001
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $6,525.00 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 = $6,525.00 One-time Quantity x 0 Costs Monthly Quantity x 1 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $6,525.00 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $78,300.00 Total Eligible Recurring Costs = $78,300.00 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $78,300.00 Line Item Cost
Page 9 Recipients of Services BEN Name Quantity 235196 DOMINION HIGH SCHOOL 1.000000
Page 10 Line Item # 1999062662.002
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 Ethernet 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 # 1999062662.002
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $10,950.00 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 = $10,950.00 One-time Quantity x 0 Costs Monthly Quantity x 1 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $10,950.00 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $131,400.00 Total Eligible Recurring Costs = $131,400.00 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $131,400.00 Line Item Cost
Page 11 Recipients of Services BEN Name 16052564 SCHOOL BOARD OFFICE
Page 12 FRN Calculation for FRN #1999062662
Monthly Charges Total Requested Amount Total Monthly Recurring Charges $17,475.00 Total Eligible Pre-Discount $209,700.00 Total Monthly Ineligible Charges - $0.00 Recurring Charges Total Eligible Pre-Discount One- + $0.00 Total Monthly Eligible Charges = $17,475.00 Time Charges Total Number of Months of x 12 Total Pre-Discount Charges = $209,700.00 Service Discount Rate 40% Total Eligible Pre-Discount = $209,700.00 Recurring Charges Funding Commitment Request = $83,880.00
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 13 Funding Request for FRN #1999062686 Funding Request Nickname: Allied
Service Type: Data Transmission and/or Internet Access
What is the FRN number from the previous 1899075308 year ?
Agreement Information - Contract Contract Number Account Number
Establishing FCC Form 470 180026973 Service Provider Allied Telecom Group, LLC (SPN: 143022365) Was an FCC Form 470 posted Yes for the product and/or services Based on State Master No you are requesting? Contract?
Award Date March 21, 2018 Based on a multiple award No schedule? How many bids were received 2 Includes Voluntary Extensions? No for this contract?
What is the service start date? July 01, 2019 Remaining Voluntary Extensions
Total Remaining Contract Length
What is the date your contract June 30, 2020 expires for the current term of the contract?
Pricing Confidentiality Is there a statute, rule, or other restriction which prohibits No publication of the specific pricing information for this contract?
Internet Access for School Division Narrative
Page 14 Line Item # 1999062686.001
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 Ethernet 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, No libraries and NIFs (i.e., a connection that provides a “Wide area network”)?
Is this a direct connection to a single school, Yes library or a NIF for Internet access?
Cost Calculation for FRN Line Item # 1999062686.001
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $7,450.00 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 = $7,450.00 One-time Quantity x 0 Costs Monthly Quantity x 1 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $7,450.00 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $89,400.00 Total Eligible Recurring Costs = $89,400.00 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $89,400.00 Line Item Cost
Page 15 Recipients of Services BEN Name 16052564 SCHOOL BOARD OFFICE
Page 16 FRN Calculation for FRN #1999062686
Monthly Charges Total Requested Amount Total Monthly Recurring Charges $7,450.00 Total Eligible Pre-Discount $89,400.00 Total Monthly Ineligible Charges - $0.00 Recurring Charges Total Eligible Pre-Discount One- + $0.00 Total Monthly Eligible Charges = $7,450.00 Time Charges Total Number of Months of x 12 Total Pre-Discount Charges = $89,400.00 Service Discount Rate 40% Total Eligible Pre-Discount = $89,400.00 Recurring Charges Funding Commitment Request = $35,760.00
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 17 Funding Request for FRN #1999062734 Funding Request Nickname: Verizon
Service Type: Data Transmission and/or Internet Access
Agreement Information - Month-to-Month Establishing FCC Form 470 190015073 Account Number
Was an FCC Form 470 posted Yes Service Provider Verizon Virginia LLC (SPN: for the product and/or services 143001422) you are requesting? When will the services end? June 30, 2020 How many bids were received 1 for this contract?
What is the service start date? July 01, 2019
Pricing Confidentiality Is there a statute, rule, or other restriction which prohibits No publication of the specific pricing information for this contract?
WAN service to all schools and administrative offices Narrative
Page 18 Line Item # 1999062734.001
Product and Service Details Data Connection between two or more sites entirely within the applicant’s network Purpose
Function Fiber
Type of Connection Ethernet Bandwidth Speed Upload Speed 100.0 Mbps Download Speed 100.0 Mbps
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 # 1999062734.001
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $712.50 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 = $712.50 One-time Quantity x 0 Costs Monthly Quantity x 21 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $14,962.50 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $179,550.00 Total Eligible Recurring Costs = $179,550.00 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $179,550.00 Line Item Cost
Page 19 Recipients of Services BEN Name 21781 ALDIE ELEMENTARY SCHOOL 21835 BANNEKER ELEMENTARY SCHOOL 21860 LINCOLN ELEMENTARY SCHOOL 21866 SANDERS CORNER ELEMENTARY SCH 21868 DOMINION TRAIL ELEMENTARY SCH 21880 HAMILTON ELEMENTARY SCHOOL 21883 SUGARLAND ELEMENTARY SCHOOL 21884 ROLLING RIDGE ELEM SCHOOL 21886 SULLY ELEMENTARY SCHOOL 21889 STERLING ELEMENTARY SCHOOL 21892 GUILFORD ELEMENTARY SCHOOL 21893 LOWES ISLAND ELEMENTARY SCHOOL 21932 BALL'S BLUFF ELEMENTARY 21933 LUCKETTS ELEMENTARY SCHOOL 21970 WATERFORD ELEMENTARY SCHOOL 191740 EVERGREEN MILL ELEMENTARY 229708 TOLBERT ELEMENTARY SCHOOL. 235132 FOREST GROVE ELEMENTARY SCHOOL 16028067 NEWTON-LEE ELEMENTARY SCHOOL 16042743 SYCOLIN CREEK ELEMENTARY SCHOOL 16070691 FREDERICK DOUGLASS ELEMENTARY SCHOOL
Page 20 Line Item # 1999062734.002
Product and Service Details Data Connection between two or more sites entirely within the applicant’s network Purpose
Function Fiber
Type of Connection Ethernet Bandwidth Speed Upload Speed 1.0 Gbps Download Speed 1.0 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 # 1999062734.002
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $1,282.50 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 = $1,282.50 One-time Quantity x 0 Costs Monthly Quantity x 67 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $85,927.50 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $1,031,130.00 Total Eligible Recurring Costs = $1,031,130.00 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $1,031,130.00 Line Item Cost
Page 21 Recipients of Services BEN Name 21858 EMERICK ELEMENTARY SCHOOL 21859 BLUE RIDGE MIDDLE SCHOOL 21864 FARMWELL STATION MIDDLE SCHOOL 21865 ASHBURN ELEMENTARY SCHOOL 21867 BROAD RUN HIGH SCHOOL 21894 ALGONKIAN ELEMENTARY SCHOOL 21921 CATOCTIN ELEMENTARY SCHOOL 21923 JL SIMPSON MIDDLE SCHOOL 21924 COOL SPRING ELEMENTARY SCHOOL 21929 LEESBURG ELEMENTARY SCHOOL 21931 DOUGLASS SCHOOL 167065 HORIZON ELEMENTARY SCHOOL 189283 HILLSIDE ELEMENTARY 205428 CEDAR LANE ELEMENTARY 205429 HARPER PARK MIDDLE SCHOOL 229699 EAGLE RIDGE MIDDLE SCHOOL 235129 HERITAGE HIGH SCHOOL 235131 HARMONY MIDDLE SCHOOL 235133 HUTCHISON FARM ELEMENTARY SCHOOL 235197 BELMONT RIDGE MIDDLE SCHOOL 235198 COUNTRYSIDE ELEMENTARY SCHOOL 235199 FRANCES HAZEL REID ELEMENTARY SCHOOL 16028064 FREEDOM HIGH SCHOOL 16042745 ARCOLA ELEMENTARY SCHOOL 16060152 CREIGHTON'S CORNER ELEMENTARY 16060156 KENNETH CULBERT ELEMENTARY 16066078 BUFFALO TRAIL ELEMENTARY 16066079 JM LUNSFORD MIDDLE SCHOOL 16070690 JOHN CHAMPE HIGH SCHOOL 16074384 DISCOVERY ELEMENTARY 16080363 CARDINAL RIDGE ELEMENTARY 17016868 BRAMBLETON MIDDLE SCHOOL 17018951 Goshen Post Elementary School 21857 LOUDOUN VALLEY HIGH SCHOOL 21863 ROUND HILL ELEMENTARY SCHOOL 21881 MEADOWLAND ELEMENTARY SCHOOL 21882 SENECA RIDGE MIDDLE SCHOOL 21888 PARK VIEW HIGH SCHOOL 21890 STERLING MIDDLE SCHOOL 21895 POTOMAC FALLS HIGH SCHOOL 21897 POTOWMACK ELEMENTARY SCHOOL 21919 MONROE VOC-TECH CENTER 21920 LOUDOUN COUNTY HIGH SCHOOL 21936 LOVETTSVILLE ELEMENTARY SCHOOL
Page 22 BEN Name 229701 LITTLE RIVER ELEMENTARY SCHOOL 229702 MILL RUN ELEMENTARY SCHOOL 229703 SELDENS LANDING ELEMENTARY SCHOOL 229704 STONE BRIDGE HIGH SCHOOL 235130 RIVER BEND MIDDLE SCHOOL 235200 MOUNTAIN VIEW ELEMENTARY 16021590 MERCER MIDDLE SCHOOL 16021591 SMART'S MILL MIDDLE SCHOOL 16028065 LEGACY ELEMENTARY SCHOOL 16028068 PINEBROOK ELEMENTARY 16042744 ROSA LEE CARTER ELEMENTARY SCHOOL 16042746 STONE HILL MIDDLE SCHOOL 16060157 LIBERTY ELEMENTARY 16060158 STEUART W WELLER ELEMENTARY 16065992 WOODGROVE HIGH SCHOOL 16066077 TUSCARORA HIGH SCHOOL 16074385 MOOREFIELD STATION ELEMENTARY 16084324 RIVERSIDE HIGH SCHOOL 16080365 ROCK RIDGE HIGH 16080364 TRAILSIDE MIDDLE 17010306 Madisons Trust ES 17018956 Willard Intermediate School 17019008 Round Hill Center
Page 23 Line Item # 1999062734.003
Product and Service Details Data Connection between two or more sites entirely within the applicant’s network Purpose
Function Fiber
Type of Connection Ethernet 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 # 1999062734.003
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $4,750.00 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 = $4,750.00 One-time Quantity x 0 Costs Monthly Quantity x 3 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $14,250.00 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $171,000.00 Total Eligible Recurring Costs = $171,000.00 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $171,000.00 Line Item Cost
Page 24 Recipients of Services BEN Name 235196 DOMINION HIGH SCHOOL 16028063 BRIAR WOODS HIGH SCHOOL 17018950 Academies of Loudon
Page 25 Line Item # 1999062734.004
Product and Service Details Data Connection between two or more sites entirely within the applicant’s network Purpose
Function Fiber
Type of Connection Ethernet Bandwidth Speed Upload Speed 1.0 Gbps Download Speed 1.0 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 # 1999062734.004
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $1,282.50 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 = $1,282.50 One-time Quantity x 0 Costs Monthly Quantity x 2 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $2,565.00 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $30,780.00 Total Eligible Recurring Costs = $30,780.00 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $30,780.00 Line Item Cost
Page 26 Recipients of Services BEN Name 17018954 Waxpool El School 17018952 Independence HS
Page 27 FRN Calculation for FRN #1999062734
Monthly Charges Total Requested Amount Total Monthly Recurring Charges $117,705.00 Total Eligible Pre-Discount $1,412,460.00 Total Monthly Ineligible Charges - $0.00 Recurring Charges Total Eligible Pre-Discount One- + $0.00 Total Monthly Eligible Charges = $117,705.00 Time Charges Total Number of Months of x 12 Total Pre-Discount Charges = $1,412,460.00 Service Discount Rate 40% Total Eligible Pre-Discount = $1,412,460.00 Recurring Charges Funding Commitment Request = $564,984.00
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 28 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 $1,711,560.00 471 Total funding commitment request amount on this FCC Form 471 $684,624.00 Total applicant non-discount share of the eligible amount $1,026,936.00 Total budgeted amount allocated to resources not eligible for E-rate $0.00 support Total amount necessary for the applicant to pay the non-discount $1,026,936.00 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 29 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: Director Name: Aaron Smith
Phone: 571-252-1387 Email: [email protected]
Address: 21000 Education Court ASHBURN VA Employer: LOUDOUN COUNTY SCHOOL 20148 DISTRICT
26-Mar-2019 10:21:57 EDT Certified Timestamp
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