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Description of Services Ordered and Certification Form 471 FCC Form

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Description of Services Ordered and Certification Form 471 FCC Form 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 Hornbeck-1G-ASE30HGL5 Application Number 161052485 Funding Year 2016 Category of Service Category 1 Billed Entity Contact Information VERNON PARISH SCHOOL BOARD Don S Gallemore 201 BELVIEW RD LEESVILLE LA 71446 - 2904 337-239-1663 337-239-1663 [email protected] [email protected] Billed Entity Number 139347 FCC Registration Number 0011542172 Applicant Type School District [email protected] Holiday/Summer Contact Information Entity Information School District Entity - Details BEN Name Urban/ State State NCES School District Endowment Rural LEA ID School Code Attributes ID 139347 VERNON PARISH SCHOOL Rural 058 058 Public School District None BOARD 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 80938 EVANS HIGH SCHOOL Rural 058 058003 None Public School; Pre-K None 80961 PITKIN HIGH SCHOOL Rural 058 058010 None Public School; None Pre-K; Head Start 80963 ROSEPINE HIGH Rural 058 058012 None Public School None SCHOOL 80964 ROSEPINE Rural 058 058016 None Public School; None ELEMENTARY SCHOOL Pre-K; Head Start 81876 ANACOCO HIGH Rural 058 058001 None Public School None SCHOOL 81877 ANACOCO ELEMENTARY Rural 058 058018 None Public School; None SCHOOL Pre-K; Head Start Page 1 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 81913 HORNBECK HIGH Rural 058 058005 None Public School; None SCHOOL Pre-K; Head Start 81916 HICKS HIGH SCHOOL Rural 058 058004 None Public School; None Pre-K; Head Start 81917 VERNON MIDDLE Rural 058 058014 None Public School None SCHOOL 81918 EAST LEESVILLE ELEM Rural 058 058002 None Public School; None SCHOOL Pre-K; Head Start 81919 LEESVILLE HIGH Rural 058 058006 None Public School None SCHOOL 81920 LEESVILLE JR HIGH Rural 058 058007 None Public School None SCHOOL 81921 WEST LEESVILLE ELEM Rural 058 058015 None Public School None SCHOOL 81923 PICKERING Rural 058 058008 None Public School; None ELEMENTARY SCHOOL Pre-K; Head Start 81924 PICKERING HIGH Rural 058 058009 None Public School None SCHOOL 81947 NORTH POLK Rural 058 058019 None Public School; None ELEMENTARY SCHOOL Pre-K; Head Start 81948 Parkway Elementary Rural 058 058011 None Public School; New None School Construction School 81962 SIMPSON HIGH SCHOOL Rural 058 058013 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 80938 EVANS HIGH SCHOOL Rural 382 N/A 80961 PITKIN HIGH SCHOOL Rural 512 N/A 80963 ROSEPINE HIGH SCHOOL Rural 516 N/A 80964 ROSEPINE ELEMENTARY SCHOOL Rural 768 N/A 81876 ANACOCO HIGH SCHOOL Rural 364 N/A 81877 ANACOCO ELEMENTARY SCHOOL Rural 550 N/A 81913 HORNBECK HIGH SCHOOL Rural 402 N/A 81916 HICKS HIGH SCHOOL Rural 352 N/A 81917 VERNON MIDDLE SCHOOL Rural 407 N/A 81918 EAST LEESVILLE ELEM SCHOOL Rural 478 N/A 81919 LEESVILLE HIGH SCHOOL Rural 787 N/A 81920 LEESVILLE JR HIGH SCHOOL Rural 392 N/A 81921 WEST LEESVILLE ELEM SCHOOL Rural 436 N/A 81923 PICKERING ELEMENTARY SCHOOL Rural 898 N/A 81924 PICKERING HIGH SCHOOL Rural 617 N/A 81947 NORTH POLK ELEMENTARY SCHOOL Rural 639 N/A 81948 Parkway Elementary School Rural 456 N/A 81962 SIMPSON HIGH SCHOOL Rural 283 N/A Related School District NIFs Page 2 School School District Name NIF BEN NIF Name District BEN 139347 VERNON PARISH SCHOOL BOARD 16022508 VPSB HEADSTART 139347 VERNON PARISH SCHOOL BOARD 16020242 VERNON PARISH SCHOOL BOARD ADMIN Discount Rate School District School District School District School District Category One Category Two Voice Enrollment NSLP Count NSLP Percentage Urban/ Discount Rate Discount Rate Discount Rate Rural Status 9239 5569 61.0% Rural 80% 80% 40% Funding Request for FRN #1699120800 Funding Request Nickname: Hornbeck -1G-ASEE0HGL5 Service Type: Data Transmission and/or Internet Access Agreement Information - Contract Contract Number ASE30HGL5-1g-HORNBECK Account Number 337-M31-9907 Establishing FCC Form 470 160009696 Service Provider BellSouth Telecommunications, LLC (SPN: 143004824) Was an FCC Form 470 posted Yes for the product and/or services Based on State Master Yes you are requesting? Contract? Award Date April 22, 2016 Based on a multiple award Yes schedule? How many bids were received 1 Includes Voluntary Extensions? No for this contract? What is the service start date? July 01, 2016 Remaining Voluntary Extensions Total Remaining Contract Length What is the date your contract July 01, 2019 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? One gig data circuit from Hornbeck High School, located on Stillwell Ave, Hornbeck, LA to Narrative Vernon Parish School Sytems Central Office - WAN access for this remote school site. Line Item # 1699120800.001 Product and Service Details Data Connection between two or more sites entirely within the applicant’s network Purpose Page 3 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 Connection Used by One building/ library or a NIF for Internet access? site listed Cost Calculation for FRN Line Item # 1699120800.001 Monthly Cost One-Time Cost Monthly Recurring Unit Cost $838.83 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 = $838.83 One-time Quantity x 0 Costs Monthly Quantity x 1 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $838.83 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $10,065.96 Total Eligible Recurring Costs = $10,065.96 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $10,065.96 Line Item Cost Recipients of Services BEN Name 81913 HORNBECK HIGH SCHOOL FRN Calculation for FRN #1699120800 Monthly Charges Total Requested Amount Total Monthly Recurring Charges $838.83 Total Eligible Pre-Discount $10,065.96 Total Monthly Ineligible Charges - $0.00 Recurring Charges Total Eligible Pre-Discount One- + $0.00 Total Monthly Eligible Charges = $838.83 Time Charges Total Number of Months of x 12 Total Pre-Discount Charges = $10,065.96 Service Discount Rate 80% Total Eligible Pre-Discount = $10,065.96 Recurring Charges Funding Commitment Request = $8,052.77 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 4 Connectivity Questions District/System-wide Internet Access Questions Does your school district currently aggregate Internet access for the entire district(as opposed to buying Yes Internet access on a building-by-building basis)? Download Speed 2.50 Download Speed Units Gbps Upload Speed 2.50 Upload Speed Units Gbps Per Entity Basis Questions Entity Name VERNON PARISH SCHOOL BOARD Entity Number 139347 BEN Entity Name Download Units Upload Units Connection Wifi Barriers Sufficient to Robust Network 80938 EVANS HIGH SCHOOL 1.00 Gbps 1.00 Gbps Fiber Mostly Outdated equipment 80961 PITKIN HIGH SCHOOL 1.00 Gbps 1.00 Gbps Fiber Mostly Outdated equipment 80963 ROSEPINE HIGH SCHOOL 1.00 Gbps 1.00 Gbps Fiber Mostly Outdated equipment 80964 ROSEPINE ELEMENTARY SCHOOL 1.00 Gbps 1.00 Gbps Fiber Mostly Outdated equipment 81876 ANACOCO HIGH SCHOOL 1.00 Gbps 1.00 Gbps Fiber Mostly Outdated equipment 81877 ANACOCO ELEMENTARY SCHOOL 1.00 Gbps 1.00 Gbps Fiber Mostly Outdated equipment 81913 HORNBECK HIGH SCHOOL 1.00 Gbps 1.00 Gbps Copper Mostly Outdated equipment 81916 HICKS HIGH SCHOOL 1.00 Gbps 1.00 Gbps Fiber Mostly Outdated equipment 81917 VERNON MIDDLE SCHOOL 1.00 Gbps 1.00 Gbps Fiber Mostly Outdated equipment 81918 EAST LEESVILLE ELEM SCHOOL 1.00 Gbps 1.00 Gbps Fiber Mostly Outdated equipment 81919 LEESVILLE HIGH SCHOOL 1.00 Gbps 1.00 Gbps Fiber Mostly Outdated equipment 81920 LEESVILLE JR HIGH SCHOOL 1.00 Gbps 1.00 Gbps Fiber Mostly Outdated equipment 81921 WEST LEESVILLE ELEM SCHOOL 1.00 Gbps 1.00 Gbps Fiber Mostly Outdated equipment 81923 PICKERING ELEMENTARY SCHOOL 1.00 Gbps 1.00 Gbps Fiber Mostly Outdated equipment 81924 PICKERING HIGH SCHOOL 1.00 Gbps 1.00 Gbps Fiber Mostly Outdated equipment 81947 NORTH POLK ELEMENTARY SCHOOL 1.00 Gbps 1.00 Gbps Fiber Mostly Outdated equipment 81948 Parkway Elementary School 1.00 Gbps 1.00 Gbps Fiber Mostly Outdated equipment 81962 SIMPSON HIGH SCHOOL 1.00 Gbps 1.00 Gbps Fiber Mostly Outdated equipment 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.
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