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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 December 2018 Description of Services Ordered and Certification Form 471 FCC Form 471 Application Information Nickname 2021_139347_Vernon Parish School Boa Application Number 211033802 rd_C2 Funding Year 2021 Category of Service Category 2 Billed Entity Contact Information VERNON PARISH SCHOOL BOARD Tiffany Bullion 201 BELVIEW RD LEESVILLE LA 71446 - 2904 315-422-7608 337-239-1663 [email protected] [email protected] Billed Entity Number 139347 FCC Registration Number 0011542172 Applicant Type School District Consulting Firms Name Consultant City State Zip Phone Email Registration Code Number Number e2e Exchange, LLC 16043595 Syracuse NY 13206 315-422-7608 [email protected] m Entity Information School District Entity - Details BEN Name Urban/ State State NCES School District How does Total Endowment Rural LEA ID School Code Attributes the district Student ID report its Count for student count Category for Category Two Budget Two budget? 139347 VERNON PARISH Rural 058 058 Public Sch A number for 9239 None SCHOOL BOARD ool District each school in the district Related Entity Information Related Child School Entity - Details Page 1 BEN Name Urban/ State State NCES Alternative School Attributes Total Endowment Rural LEA ID School ID Code Discount Students for C2 Budget 80938 EVANS HIGH SCHOOL Rural 058 058003 None Pre-K; Public School 382 None 80961 PITKIN HIGH SCHOOL Rural 058 058010 None Head Start; Pre- 512 None K; Public School 80963 ROSEPINE HIGH SCH Rural 058 058012 None Public School 516 None OOL 80964 ROSEPINE ELEMENTA Rural 058 058016 None Head Start; Pre- 768 None RY SCHOOL K; Public School 81876 ANACOCO HIGH SCH Rural 058 058001 None Public School 364 None OOL 81877 ANACOCO ELEMENTA Rural 058 058018 None Head Start; Pre- 550 None RY SCHOOL K; Public School 81913 HORNBECK HIGH SCH Rural 058 058005 None Head Start; Pre- 402 None OOL K; Public School 81916 HICKS HIGH SCHOOL Rural 058 058004 None Head Start; Pre- 352 None K; Public School 81917 VERNON MIDDLE SCH Rural 058 058014 None Public School 407 None OOL 81918 EAST LEESVILLE ELE Rural 058 058002 None Head Start; Pre- 478 None M SCHOOL K; Public School 81919 LEESVILLE HIGH SCH Rural 058 058006 None Public School 787 None OOL 81920 LEESVILLE JR HIGH S Rural 058 058007 None Public School 392 None CHOOL 81921 WEST LEESVILLE ELE Rural 058 058015 None Public School 436 None M SCHOOL 81923 PICKERING ELEMENT Rural 058 058008 None Head Start; Pre- 898 None ARY SCHOOL K; Public School 81924 PICKERING HIGH SCH Rural 058 058009 None Public School 617 None OOL 81947 NORTH POLK ELEMEN Rural 058 058019 None Head Start; Pre- 639 None TARY SCHOOL K; Public School 81948 Parkway Elementary Sc Rural 058 058011 None New Construction 456 None hool School; Public School 81962 SIMPSON HIGH SCHO Rural 058 058013 None Public School 283 None OL Related Child School Entity - Discount Rate Calculation Details BEN Name Urban/ Number of Students CEP CEP Base Rural Students Count Based Percentage Year 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 Page 2 BEN Name Urban/ Number of Students CEP CEP Base Rural Students Count Based Percentage Year on Estimate 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 No 81962 SIMPSON HIGH SCHOOL Rural 283 N/A Related School District NIFs 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 Enrollment NSLP Count NSLP Percentage Urban/Rural Status Discount Rate Discount Rate 9239 5569 60.0% Rural 80% 80% Page 3 Funding Request for FRN #2199051617 Funding Request Nickname: Transformyx_IC Service Type: Internal Connections Agreement Information - Contract Contract Number Account Number Establishing FCC Form 470 210020727 Service Provider Transformyx, LLC (SPN: 143026008) 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 24, 2021 Based on a multiple award No schedule? How many bids were received 9 Includes Voluntary Extensions? No for this contract? What is the service start date? July 01, 2021 Remaining Voluntary Extensions Total Remaining Contract Length What is the date your contract June 30, 2022 expires for the current term of the contract? Document Name Document Description 2021_Transformyx_VernonParish_SignedQuote.pdf Pricing Confidentiality Is there a statute, rule, or other restriction which prohibits No publication of the specific pricing information for this contract? Internal Connections Narrative Page 4 Line Item # 2199051617.003 Product and Service Details Type of Internal Connection Data Distribution Type of Product Switch Make Cisco Systems Model MS225-48FP-HW Is installation included in Price?No Is the hardware for this FRN lineNo item leased? Cost Calculation for FRN Line Item # 2199051617.003 Monthly Cost One-Time Cost Monthly Recurring Unit Cost $0.00 One-time Unit Cost $3,664.68 Monthly Recurring Unit Ineligible - $0.00 One-time Ineligible Unit Costs - $0.00 Costs One-time Eligible Unit Cost = $3,664.68 Monthly Recurring Unit Eligible = $0.00 One-time Quantity x 125 Costs Monthly Quantity x 0 Total Eligible One-time Costs = $458,085.00 Units 0 Total Monthly Eligible Recurring = $0.00 Summary Costs Total Eligible Recurring Costs $0.00 Months of Service x 12 Total Eligible One-time Costs + $458,085.00 Total Eligible Recurring Costs = $0.00 Pre-Discount Extended Eligible = $458,085.00 Line Item Cost Page 5 Recipients of Services Entity # Entity Name 80938 EVANS HIGH SCHOOL 80961 PITKIN HIGH SCHOOL 80963 ROSEPINE HIGH SCHOOL 80964 ROSEPINE ELEMENTARY SCHOOL 81876 ANACOCO HIGH SCHOOL 81877 ANACOCO ELEMENTARY SCHOOL 81913 HORNBECK HIGH SCHOOL 81916 HICKS HIGH SCHOOL 81917 VERNON MIDDLE SCHOOL 81918 EAST LEESVILLE ELEM SCHOOL 81919 LEESVILLE HIGH SCHOOL 81920 LEESVILLE JR HIGH SCHOOL 81921 WEST LEESVILLE ELEM SCHOOL 81923 PICKERING ELEMENTARY SCHOOL 81924 PICKERING HIGH SCHOOL 81947 NORTH POLK ELEMENTARY SCHOOL 81948 Parkway Elementary School 81962 SIMPSON HIGH SCHOOL Page 6 Line Item # 2199051617.004 Product and Service Details Type of Internal Connection License Type of Product License Make Cisco Systems Model LIC-MS225-48FP-5YR Is installation included in Price?No Is the hardware for this FRN lineNo item leased? Cost Calculation for FRN Line Item # 2199051617.004 Monthly Cost One-Time Cost Monthly Recurring Unit Cost $0.00 One-time Unit Cost $556.34 Monthly Recurring Unit Ineligible - $0.00 One-time Ineligible Unit Costs - $0.00 Costs One-time Eligible Unit Cost = $556.34 Monthly Recurring Unit Eligible = $0.00 One-time Quantity x 125 Costs Monthly Quantity x 0 Total Eligible One-time Costs = $69,542.50 Units 0 Total Monthly Eligible Recurring = $0.00 Summary Costs Total Eligible Recurring Costs $0.00 Months of Service x 12 Total Eligible One-time Costs + $69,542.50 Total Eligible Recurring Costs = $0.00 Pre-Discount Extended Eligible = $69,542.50 Line Item Cost Page 7 Recipients of Services Entity # Entity Name 80938 EVANS HIGH SCHOOL 80961 PITKIN HIGH SCHOOL 80963 ROSEPINE HIGH SCHOOL 80964 ROSEPINE ELEMENTARY SCHOOL 81876 ANACOCO HIGH SCHOOL 81877 ANACOCO ELEMENTARY SCHOOL 81913 HORNBECK HIGH SCHOOL 81916 HICKS HIGH SCHOOL 81917 VERNON MIDDLE SCHOOL 81918 EAST LEESVILLE ELEM SCHOOL 81919 LEESVILLE HIGH SCHOOL 81920 LEESVILLE JR HIGH SCHOOL 81921 WEST LEESVILLE ELEM SCHOOL 81923 PICKERING ELEMENTARY SCHOOL 81924 PICKERING HIGH SCHOOL 81947 NORTH POLK ELEMENTARY SCHOOL 81948 Parkway Elementary School 81962 SIMPSON HIGH SCHOOL Page 8 Line Item # 2199051617.005 Product and Service Details Type of Internal Connection Data Distribution Type of Product Switch Make Cisco Systems Model MS120-8P-HW Is installation included in Price?No Is the hardware for this FRN lineNo item leased? Cost Calculation for FRN Line Item # 2199051617.005 Monthly Cost One-Time Cost Monthly Recurring Unit Cost $0.00 One-time Unit Cost $623.47 Monthly Recurring Unit Ineligible - $0.00 One-time Ineligible Unit Costs - $0.00 Costs One-time Eligible Unit Cost = $623.47 Monthly Recurring Unit Eligible = $0.00 One-time Quantity x 30 Costs Monthly Quantity x 0 Total Eligible One-time Costs = $18,704.10 Units 0 Total Monthly Eligible Recurring = $0.00 Summary Costs Total Eligible Recurring Costs $0.00 Months of Service x 12 Total Eligible One-time Costs + $18,704.10 Total Eligible Recurring Costs = $0.00 Pre-Discount Extended Eligible = $18,704.10 Line Item Cost Page 9 Recipients of Services Entity # Entity Name 80938 EVANS HIGH SCHOOL 80961 PITKIN HIGH SCHOOL 80963 ROSEPINE HIGH SCHOOL 80964 ROSEPINE ELEMENTARY SCHOOL 81876 ANACOCO HIGH SCHOOL 81877 ANACOCO ELEMENTARY SCHOOL 81913 HORNBECK HIGH SCHOOL 81916 HICKS HIGH SCHOOL 81917 VERNON MIDDLE SCHOOL 81918 EAST LEESVILLE
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