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 FY 20-21 Cox Application Number 201027093 Funding Year 2020 Category of Service Category 1
Billed Entity Contact Information VIRGINIA BEACH CITY SCH DIST Michael Combs 2512 GEORGE MASON DRIVE VIRGINIA BEACH 757-263-6800 VA 23452 [email protected] 757-263-6800
Billed Entity Number 126526 FCC Registration Number 0011821147 Applicant Type School District
Entity Information
School District Entity - Details BEN Name Urban/ State State NCES School District Endowment Rural LEA ID School Code Attributes ID 126526 VIRGINIA BEACH CITY SCH DIST Urban Public School District None
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 25383 VIRGINIA BEACH MIDDLE Urban 128 0140 None Public School None SCHOOL 25384 COOKE ELEMENTARY Urban 128 0130 None Public School None SCHOOL 25385 BIRDNECK Urban 128 0060 None Public School None ELEMENTARY SCHOOL 25387 SEATACK ELEMENTARY Urban 128 0290 Public School None SCHOOL 25388 LINKHORN PARK Urban 128 0330 None Public School None ELEMENTARY SCH 25392 THALIA ELEMENTARY Urban 128 0350 None Public School None SCHOOL 25393 WINDSOR OAKS Urban 128 0670 None Public School None ELEMENTARY SCHOOL
Page 1 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 25395 WINDSOR WOODS Urban 128 0560 None Public School None ELEMENTARY SCH 25396 MALIBU ELEMENTARY Urban 128 0500 None Public School None SCHOOL 25398 KINGSTON Urban 128 0580 None Public School None ELEMENTARY SCHOOL 25399 HOLLAND ELEMENTARY Urban 128 0600 Public School None SCHOOL 25402 KING'S GRANT ELEM Urban 128 0420 None Public School None SCHOOL 25404 BROOKWOOD Urban 128 0630 None Public School None ELEMENTARY SCHOOL 25405 LYNNHAVEN Urban 128 0520 None Public School None ELEMENTARY SCHOOL 25406 PLAZA MIDDLE SCHOOL Urban 128 0640 None Public School None 25407 GREAT NECK MIDDLE Urban 128 0430 None Public School None SCHOOL 25408 DEY ELEMENTARY Urban 128 0360 None Public School None SCHOOL 25410 ALANTON ELEMENTARY Urban 128 0590 None Public School None SCHOOL 25411 COX HIGH SCHOOL Urban 128 0030 None Public School None 25412 TRANTWOOD Urban 128 0510 None Public School None ELEMENTARY SCHOOL 25414 FIRST COLONIAL HIGH Urban 128 0610 None Public School None SCHOOL 25416 LYNNHAVEN MIDDLE Urban 128 0730 None Public School None SCHOOL 25419 CORPORATE LANDING Urban 128 1041 None Public School None ELEM SCHOOL 25420 CORPORATE LANDING Urban 128 0980 None Public School None MIDDLE SCH 25421 OCEAN LAKES Urban 128 0880 None Public School None ELEMENTARY SCHOOL 25423 OCEAN LAKES HIGH Urban 128 0960 None Public School None SCHOOL 25425 SHELTON PARK Urban 128 0300 None Public School None ELEMENTARY SCHOOL 25426 BAYSIDE ELEMENTARY Urban 128 0280 None Public School None SCHOOL 25427 HERMITAGE Urban 128 0540 None Public School None ELEMENTARY SCHOOL 25428 THOROUGHGOOD Urban 128 0400 None Public School None ELEMENTARY SCHOOL 25430 INDEPENDENCE MIDDLE Urban 128 0740 None Public School None SCHOOL 25431 BAYSIDE HIGH SCHOOL Urban 128 0530 None Public School None 25432 LUXFORD ELEMENTARY Urban 128 0460 None Public School None SCHOOL 25438 PEMBROKE MEADOWS Urban 128 0660 None Public School None ELEM SCHOOL 25440 PARKWAY ELEMENTARY Urban 128 0820 Public School None SCHOOL 25441 ROSEMONT Urban 128 0810 None Public School None ELEMENTARY SCHOOL 25442 GREEN RUN HIGH Urban 128 0010 None Public School None SCHOOL Page 2 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 25444 NORTH LANDING Urban 128 0760 None Public School None ELEMENTARY SCH 25445 Technical and Career Urban None Public School None Education Center 25446 GREEN RUN Urban 128 0770 None Public School None ELEMENTARY SCHOOL 25447 PRINCESS ANNE Urban 128 0750 None Public School None MIDDLE SCHOOL 25448 Floyd Kellam High School Urban 128 0440 None Public School None 25449 PRINCESS ANNE Urban 128 0340 None Public School None ELEMENTARY SCH 25450 STRAWBRIDGE Urban 128 0940 None Public School None ELEMENTARY SCHOOL 25451 RED MILL ELEMENTARY Urban 128 0900 None Public School None SCHOOL 25452 SALEM ELEMENTARY Urban 128 0830 None Public School None SCHOOL 25453 ROSEMONT FOREST Urban 128 0840 None Public School None ELEM SCHOOL 25454 LANDSTOWN Urban 128 0932 None Public School None ELEMENTARY SCHOOL 25455 LANDSTOWN MIDDLE Urban 128 0931 None Public School None SCHOOL 25456 CHRISTOPHER FARMS Urban 128 0990 None Public School None ELEMENTARY 25457 CREEDS ELEMENTARY Urban 128 0230 None Public School None SCHOOL 25460 WILLIAMS ELEMENTARY Urban 128 0470 Public School None SCHOOL 25461 NEWTOWN Urban 128 0710 Public School None ELEMENTARY 25462 BAYSIDE MIDDLE Urban 128 0700 None Public School None SCHOOL 25465 PEMBROKE Urban 128 0490 None Public School None ELEMENTARY SCHOOL 25466 BAYSIDE SIXTH GRADE Urban 128 0115 None Public School None CAMPUS 25468 PRINCESS ANNE HIGH Urban 128 0321 None Public School None SCHOOL 25469 POINT O'VIEW Urban 128 0680 None Public School None ELEMENTARY SCHOOL 25470 ARROWHEAD Urban 128 0550 None Public School None ELEMENTARY SCHOOL 25471 WHITE OAKS Urban 128 0020 None Public School None ELEMENTARY SCHOOL 25472 KEMPSVILLE MEADOWS Urban 128 0410 None Public School None ELEM SCHOOL 25473 LARKSPUR MIDDLE Urban 128 0970 None Public School None SCHOOL 25479 KEMPSVILLE Urban 128 0450 None Public School None ELEMENTARY SCHOOL 25481 KEMPSVILLE HIGH Urban 128 0620 None Public School None SCHOOL 25484 KEMPSVILLE MIDDLE Urban 128 0690 None Public School None SCHOOL 25485 COLLEGE PARK Urban 128 0720 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 25486 WOODSTOCK Urban 128 0390 None Public School None ELEMENTARY SCHOOL 25487 FAIRFIELD ELEMENTARY Urban 128 0780 None Public School None SCHOOL 25489 PROVIDENCE Urban 128 0692 None Public School None ELEMENTARY SCHOOL 25490 INDIAN LAKES Urban 128 0800 None Public School None ELEMENTARY SCHOOL 25491 BRANDON MIDDLE Urban 128 0790 None Public School None SCHOOL 25493 TALLWOOD Urban 128 0910 None Public School None ELEMENTARY SCHOOL 25494 CENTERVILLE Urban 128 0040 None Public School None ELEMENTARY SCHOOL 25495 TALLWOOD HIGH Urban 128 0920 None Public School None SCHOOL 25496 SALEM MIDDLE SCHOOL Urban 128 0050 None Public School None 25497 GLENWOOD Urban 128 0870 None Public School None ELEMENTARY SCHOOL 25498 SALEM HIGH SCHOOL Urban 128 0850 None Public School None 211528 NEW CASTLE Urban 128 1020 None Public School None ELEMENTARY SCHOOL 230094 LANDSTOWN HIGH Urban 128 1030 None Public School None SCHOOL 16026689 THREE OAKS Urban 128 0100 None Public School None ELEMENTARY 16035785 JUVENILE DETENTION Urban Juvenile Justice None HOME 16040591 DIAMOND SPRINGS Urban 128 0106 Public School None ELEMENTARY 16052291 RENAISSANCE Urban 128 1049 None Public School None ACADEMY 16082325 OLD DONATION SCHOOL Urban 128 0080 None Public School None 16078709 GREEN RUN Urban 128 1050 None Charter School; None COLLEGIATE Public School
Related Child School Entity - Discount Rate Calculation Details BEN Name Urban/ Number of Students CEP Rural Students Count Based Percentage on Estimate 25383 VIRGINIA BEACH MIDDLE SCHOOL Urban 805 N/A 25384 COOKE ELEMENTARY SCHOOL Urban 538 N/A 25385 BIRDNECK ELEMENTARY SCHOOL Urban 649 N/A 25387 SEATACK ELEMENTARY SCHOOL Urban 363 N/A 100.00% 25388 LINKHORN PARK ELEMENTARY SCH Urban 556 N/A 25392 THALIA ELEMENTARY SCHOOL Urban 593 N/A 25393 WINDSOR OAKS ELEMENTARY SCHOOL Urban 578 N/A 25395 WINDSOR WOODS ELEMENTARY SCH Urban 426 N/A 25396 MALIBU ELEMENTARY SCHOOL Urban 423 N/A 25398 KINGSTON ELEMENTARY SCHOOL Urban 540 N/A 25399 HOLLAND ELEMENTARY SCHOOL Urban 599 N/A 84.47% 25402 KING'S GRANT ELEM SCHOOL Urban 558 N/A
Page 4 BEN Name Urban/ Number of Students CEP Rural Students Count Based Percentage on Estimate 25404 BROOKWOOD ELEMENTARY SCHOOL Urban 624 N/A 25405 LYNNHAVEN ELEMENTARY SCHOOL Urban 423 N/A 25406 PLAZA MIDDLE SCHOOL Urban 1087 N/A 25407 GREAT NECK MIDDLE SCHOOL Urban 1141 N/A 25408 DEY ELEMENTARY SCHOOL Urban 794 N/A 25410 ALANTON ELEMENTARY SCHOOL Urban 632 N/A 25411 COX HIGH SCHOOL Urban 1774 N/A 25412 TRANTWOOD ELEMENTARY SCHOOL Urban 532 N/A 25414 FIRST COLONIAL HIGH SCHOOL Urban 1815 N/A 25416 LYNNHAVEN MIDDLE SCHOOL Urban 894 N/A 25419 CORPORATE LANDING ELEM SCHOOL Urban 471 N/A 25420 CORPORATE LANDING MIDDLE SCH Urban 1213 N/A 25421 OCEAN LAKES ELEMENTARY SCHOOL Urban 586 N/A 25423 OCEAN LAKES HIGH SCHOOL Urban 2030 N/A 25425 SHELTON PARK ELEMENTARY SCHOOL Urban 426 N/A 25426 BAYSIDE ELEMENTARY SCHOOL Urban 517 N/A 25427 HERMITAGE ELEMENTARY SCHOOL Urban 649 N/A 25428 THOROUGHGOOD ELEMENTARY SCHOOL Urban 620 N/A 25430 INDEPENDENCE MIDDLE SCHOOL Urban 1277 N/A 25431 BAYSIDE HIGH SCHOOL Urban 1817 N/A 25432 LUXFORD ELEMENTARY SCHOOL Urban 519 N/A 25438 PEMBROKE MEADOWS ELEM SCHOOL Urban 536 N/A 25440 PARKWAY ELEMENTARY SCHOOL Urban 470 N/A 100.00% 25441 ROSEMONT ELEMENTARY SCHOOL Urban 445 N/A 25442 GREEN RUN HIGH SCHOOL Urban 1313 N/A 25444 NORTH LANDING ELEMENTARY SCH Urban 446 N/A 25445 Technical and Career Education Center Urban 0 N/A 25446 GREEN RUN ELEMENTARY SCHOOL Urban 376 N/A 25447 PRINCESS ANNE MIDDLE SCHOOL Urban 1443 N/A 25448 Floyd Kellam High School Urban 1959 N/A 25449 PRINCESS ANNE ELEMENTARY SCH Urban 644 N/A 25450 STRAWBRIDGE ELEMENTARY SCHOOL Urban 655 N/A 25451 RED MILL ELEMENTARY SCHOOL Urban 652 N/A 25452 SALEM ELEMENTARY SCHOOL Urban 508 N/A 25453 ROSEMONT FOREST ELEM SCHOOL Urban 531 N/A 25454 LANDSTOWN ELEMENTARY SCHOOL Urban 794 N/A 25455 LANDSTOWN MIDDLE SCHOOL Urban 1417 N/A 25456 CHRISTOPHER FARMS ELEMENTARY Urban 684 N/A 25457 CREEDS ELEMENTARY SCHOOL Urban 332 N/A 25460 WILLIAMS ELEMENTARY SCHOOL Urban 548 N/A 84.49% 25461 NEWTOWN ELEMENTARY Urban 517 N/A 84.33% 25462 BAYSIDE MIDDLE SCHOOL Urban 720 N/A 25465 PEMBROKE ELEMENTARY SCHOOL Urban 563 N/A 25466 BAYSIDE SIXTH GRADE CAMPUS Urban 394 N/A 25468 PRINCESS ANNE HIGH SCHOOL Urban 1747 N/A Page 5 BEN Name Urban/ Number of Students CEP Rural Students Count Based Percentage on Estimate 25469 POINT O'VIEW ELEMENTARY SCHOOL Urban 718 N/A 25470 ARROWHEAD ELEMENTARY SCHOOL Urban 533 N/A 25471 WHITE OAKS ELEMENTARY SCHOOL Urban 635 N/A 25472 KEMPSVILLE MEADOWS ELEM SCHOOL Urban 459 N/A 25473 LARKSPUR MIDDLE SCHOOL Urban 1554 N/A 25479 KEMPSVILLE ELEMENTARY SCHOOL Urban 505 N/A 25481 KEMPSVILLE HIGH SCHOOL Urban 1679 N/A 25484 KEMPSVILLE MIDDLE SCHOOL Urban 768 N/A 25485 COLLEGE PARK ELEMENTARY SCHOOL Urban 541 N/A 25486 WOODSTOCK ELEMENTARY SCHOOL Urban 713 N/A 25487 FAIRFIELD ELEMENTARY SCHOOL Urban 545 N/A 25489 PROVIDENCE ELEMENTARY SCHOOL Urban 558 N/A 25490 INDIAN LAKES ELEMENTARY SCHOOL Urban 635 N/A 25491 BRANDON MIDDLE SCHOOL Urban 1242 N/A 25493 TALLWOOD ELEMENTARY SCHOOL Urban 596 N/A 25494 CENTERVILLE ELEMENTARY SCHOOL Urban 686 N/A 25495 TALLWOOD HIGH SCHOOL Urban 1834 N/A 25496 SALEM MIDDLE SCHOOL Urban 1066 N/A 25497 GLENWOOD ELEMENTARY SCHOOL Urban 1028 N/A 25498 SALEM HIGH SCHOOL Urban 1704 N/A 211528 NEW CASTLE ELEMENTARY SCHOOL Urban 744 N/A 230094 LANDSTOWN HIGH SCHOOL Urban 2182 N/A 16026689 THREE OAKS ELEMENTARY Urban 758 N/A 16035785 JUVENILE DETENTION HOME Urban 0 N/A 16040591 DIAMOND SPRINGS ELEMENTARY Urban 584 N/A 84.42% 16052291 RENAISSANCE ACADEMY Urban 490 N/A 16082325 OLD DONATION SCHOOL Urban 1252 N/A 16078709 GREEN RUN COLLEGIATE Urban 360 N/A
Related School District NIFs School School District Name NIF BEN NIF Name District BEN 126526 VIRGINIA BEACH CITY SCH DIST 16021260 DEPARTMENT OF ADMINISTRATIVE SUPPORT SERVICES CITY PBX BLDG. 16 MUN. CTR 126526 VIRGINIA BEACH CITY SCH DIST 16021271 LASKIN ROAD ANNEX 126526 VIRGINIA BEACH CITY SCH DIST 16057190 VIRGINIA BEACH CITY PUBLIC SCHOOLS TRANSPORTATION 126526 VIRGINIA BEACH CITY SCH DIST 17008733 Virginia Beach School Administration Building 126526 VIRGINIA BEACH CITY SCH DIST 17008736 Glennwood Bus Garage 126526 VIRGINIA BEACH CITY SCH DIST 17008764 Plaza Annex 126526 VIRGINIA BEACH CITY SCH DIST 17008765 Corporate Landing Annex
Discount Rate
Page 6 School District School District School District School District Category One Category Two Enrollment NSLP Count NSLP Percentage Urban/Rural Status Discount Rate Discount Rate 68723 27683 40.0% Urban 60% 60%
Page 7 Funding Request for FRN #2099044272 Funding Request Nickname: COX FY 20-21
Service Type: Data Transmission and/or Internet Access
Agreement Information - Contract Contract Number 4638-1 Account Number 001-5410-123368101
User-entered Establishing FCC 620550000865626 Service Provider Cox Virginia Telcom, LLC (SPN: Form 470# 143000013)
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 Yes Award Date March 17, 2011 schedule?
How many bids were received 7 Includes Voluntary Extensions? Yes for this contract? Remaining Voluntary 5 What is the service start date? July 01, 2020 Extensions
Total Remaining Contract 63 Length
What is the date your contract June 30, 2021 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 bandwidth to support 16 gbps Narrative
Page 8 Line Item # 2099044272.001
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 OC-192 Bandwidth Speed Upload Speed 9.953 Gbps Download Speed 9.953 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, No library or a NIF for Internet access?
Cost Calculation for FRN Line Item # 2099044272.001
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $8,400.00 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 = $8,400.00 One-time Quantity x 0 Costs Monthly Quantity x 1 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $8,400.00 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $100,800.00 Total Eligible Recurring Costs = $100,800.00 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $100,800.00 Line Item Cost
Page 9 Recipients of Services BEN Name 25383 VIRGINIA BEACH MIDDLE SCHOOL 25384 COOKE ELEMENTARY SCHOOL 25385 BIRDNECK ELEMENTARY SCHOOL 25387 SEATACK ELEMENTARY SCHOOL 25388 LINKHORN PARK ELEMENTARY SCH 25392 THALIA ELEMENTARY SCHOOL 25393 WINDSOR OAKS ELEMENTARY SCHOOL 25395 WINDSOR WOODS ELEMENTARY SCH 25396 MALIBU ELEMENTARY SCHOOL 25398 KINGSTON ELEMENTARY SCHOOL 25399 HOLLAND ELEMENTARY SCHOOL 25402 KING'S GRANT ELEM SCHOOL 25404 BROOKWOOD ELEMENTARY SCHOOL 25405 LYNNHAVEN ELEMENTARY SCHOOL 25406 PLAZA MIDDLE SCHOOL 25407 GREAT NECK MIDDLE SCHOOL 25408 DEY ELEMENTARY SCHOOL 25410 ALANTON ELEMENTARY SCHOOL 25411 COX HIGH SCHOOL 25412 TRANTWOOD ELEMENTARY SCHOOL 25414 FIRST COLONIAL HIGH SCHOOL 25416 LYNNHAVEN MIDDLE SCHOOL 25419 CORPORATE LANDING ELEM SCHOOL 25420 CORPORATE LANDING MIDDLE SCH 25421 OCEAN LAKES ELEMENTARY SCHOOL 25423 OCEAN LAKES HIGH SCHOOL 25425 SHELTON PARK ELEMENTARY SCHOOL 25426 BAYSIDE ELEMENTARY SCHOOL 25427 HERMITAGE ELEMENTARY SCHOOL 25428 THOROUGHGOOD ELEMENTARY SCHOOL 25430 INDEPENDENCE MIDDLE SCHOOL 25431 BAYSIDE HIGH SCHOOL 25432 LUXFORD ELEMENTARY SCHOOL 25438 PEMBROKE MEADOWS ELEM SCHOOL 25440 PARKWAY ELEMENTARY SCHOOL 25441 ROSEMONT ELEMENTARY SCHOOL 25442 GREEN RUN HIGH SCHOOL 25444 NORTH LANDING ELEMENTARY SCH 25445 Technical and Career Education Center 25446 GREEN RUN ELEMENTARY SCHOOL 25447 PRINCESS ANNE MIDDLE SCHOOL 25448 Floyd Kellam High School 25449 PRINCESS ANNE ELEMENTARY SCH 25450 STRAWBRIDGE ELEMENTARY SCHOOL
Page 10 BEN Name 25451 RED MILL ELEMENTARY SCHOOL 25452 SALEM ELEMENTARY SCHOOL 25453 ROSEMONT FOREST ELEM SCHOOL 25454 LANDSTOWN ELEMENTARY SCHOOL 25455 LANDSTOWN MIDDLE SCHOOL 25456 CHRISTOPHER FARMS ELEMENTARY 25457 CREEDS ELEMENTARY SCHOOL 25460 WILLIAMS ELEMENTARY SCHOOL 25461 NEWTOWN ELEMENTARY 25462 BAYSIDE MIDDLE SCHOOL 25465 PEMBROKE ELEMENTARY SCHOOL 25466 BAYSIDE SIXTH GRADE CAMPUS 25468 PRINCESS ANNE HIGH SCHOOL 25469 POINT O'VIEW ELEMENTARY SCHOOL 25470 ARROWHEAD ELEMENTARY SCHOOL 25471 WHITE OAKS ELEMENTARY SCHOOL 25472 KEMPSVILLE MEADOWS ELEM SCHOOL 25473 LARKSPUR MIDDLE SCHOOL 25479 KEMPSVILLE ELEMENTARY SCHOOL 25481 KEMPSVILLE HIGH SCHOOL 25484 KEMPSVILLE MIDDLE SCHOOL 25485 COLLEGE PARK ELEMENTARY SCHOOL 25486 WOODSTOCK ELEMENTARY SCHOOL 25487 FAIRFIELD ELEMENTARY SCHOOL 25489 PROVIDENCE ELEMENTARY SCHOOL 25490 INDIAN LAKES ELEMENTARY SCHOOL 25491 BRANDON MIDDLE SCHOOL 25493 TALLWOOD ELEMENTARY SCHOOL 25494 CENTERVILLE ELEMENTARY SCHOOL 25495 TALLWOOD HIGH SCHOOL 25496 SALEM MIDDLE SCHOOL 25497 GLENWOOD ELEMENTARY SCHOOL 25498 SALEM HIGH SCHOOL 211528 NEW CASTLE ELEMENTARY SCHOOL 230094 LANDSTOWN HIGH SCHOOL 16026689 THREE OAKS ELEMENTARY 16035785 JUVENILE DETENTION HOME 16040591 DIAMOND SPRINGS ELEMENTARY 16052291 RENAISSANCE ACADEMY 16082325 OLD DONATION SCHOOL 16078709 GREEN RUN COLLEGIATE 16057190 VIRGINIA BEACH CITY PUBLIC SCHOOLS TRANSPORTATION 17008764 Plaza Annex 16021271 LASKIN ROAD ANNEX 17008765 Corporate Landing Annex 16021260 DEPARTMENT OF ADMINISTRATIVE SUPPORT SERVICES CITY PBX BLDG. 16 MUN. CTR
Page 11 BEN Name 17008736 Glennwood Bus Garage 17008733 Virginia Beach School Administration Building
Page 12 FRN Calculation for FRN #2099044272
Monthly Charges Total Requested Amount Total Monthly Recurring Charges $8,400.00 Total Eligible Pre-Discount $100,800.00 Total Monthly Ineligible Charges - $0.00 Recurring Charges Total Eligible Pre-Discount One- + $0.00 Total Monthly Eligible Charges = $8,400.00 Time Charges Total Number of Months of x 12 Total Pre-Discount Charges = $100,800.00 Service Discount Rate 60% Total Eligible Pre-Discount = $100,800.00 Recurring Charges Funding Commitment Request = $60,480.00
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 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 $100,800.00 471 Total funding commitment request amount on this FCC Form 471 $60,480.00 Total applicant non-discount share of the eligible amount $40,320.00 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 $40,320.00 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 14 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: Coordinator of Telecommunications Name: Michael Combs
Phone: 757-263-6800 Email: [email protected]
Address: 2512 GEORGE MASON DRIVE Employer: VIRGINIA BEACH CITY SCH DIST VIRGINIA BEACH VA 23452
24-Mar-2020 11:52:59 EDT Certified Timestamp
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