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 2020 RWAN 471 Application Number 201020958 Funding Year 2020 Category of Service Category 1
Billed Entity Contact Information Diocese of Harrisburg Daniel Breen 4800 Union Deposit Rd Harrisburg PA 17111 717-657-4804 717-657-4808 [email protected] [email protected]
Billed Entity Number 17005340 FCC Registration Number 0020262820 Applicant Type Consortium
Consulting Firms Name Consultant City State Zip Phone Email Registration Code Number Number James R. Beeghley, Ed.D. 16079485 Mechanicsburg PA 17055 717-467-1863 [email protected]
Entity Information Consortium Entities
School Entity - Details BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 18033 GOOD SHEPHERD Urban Survey Public School None SCHOOL 18040 TRINITY HIGH SCHOOL Urban Survey Public School None 18059 ST PATRICK ELEM SCH- Urban Survey Public School None CARLISLE 18108 ST JOAN OF ARC Urban Survey Private School None ELEMENTARY SCH 18121 LEBANON CATHOLIC Urban 2.1522 Survey Private School None SCHOOL 1513E8 18143 SACRED HEART ELEM Rural 2.1522 Survey Private School None SCH-LEWISTOWN 1513E8 18186 ST JOSEPH SCHOOL- Urban 2.1522 Survey Private School None MECHANICSBURG 1513E8 18193 SEVEN SORROWS OF Urban 2.1522 Survey Pre-K; Private School None BVM SCHOOL 1513E8
Page 1 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 18235 ST THERESA Urban 2.1522 Survey Private School None ELEMENTARY SCHOOL 1513E8 18259 HARRISBURG CATHOLIC Urban 2.1522 Survey Pre-K; Private School None ELEMENTARY 1513E8 CATHEDRAL CAMPUS 18268 ST MARGARET MARY Urban 2.1522 Survey Private School None SCHOOL 1513E8 18271 BISHOP MCDEVITT HIGH Urban 2.1522 Survey Private School None SCHOOL 1513E8 18312 HOLY NAME OF JESUS Urban 2.1522 Survey Private School None SCHOOL 1513E8 18441 ST FRANCIS XAVIER Urban 2.1522 Survey Private School None SCHOOL 1513E8 18456 ST JOSEPH ELEM Urban 2.1522 Survey Private School None SCHOOL-HANOVER 1513E8 18462 St. Teresa of Calcutta - Urban 2.1522 None Private School None Conewago Campus 1513E8 18476 St. Teresa of Calcutta - Urban 2.1522 Survey Private School None McSherrystown Campus 1513E8 18477 DELONE CATHOLIC Urban 2.1522 Survey Private School None HIGH SCHOOL 1513E8 18527 ST JOSEPH Urban 2.1522 Survey Private School None ELEMENTARY SCH- 1513E8 YORK 18540 YORK CATHOLIC HIGH Urban 2.1522 Survey Private School None SCHOOL 1513E8 18547 ST PATRICK Urban 2.1522 Survey Private School None ELEMENTARY SCH- 1513E8 YORK 18605 OUR MOTHER Urban Survey Private School None PERPETUAL HELP SCH 18740 ST LEO THE GREAT Urban 2.1522 Survey Private School None SCHOOL 1513E8 18744 LANCASTER CATHOLIC Urban 2.1522 Survey Private School None HIGH SCHOOL 1513E8 18776 SACRED HEART ELEM- Urban 2.1522 Survey Private School None LANCASTER 1513E8 18778 RESURRECTION Urban 2.1522 Survey Private School None ELEMENTARY SCHOOL 1513E8 18880 ST COLUMBA SCHOOL Urban Survey Public School None 18895 ST JOSEPH ELEM SCH- Urban 2.1522 Survey Private School None DANVILLE 1513E8 18951 OUR LADY OF LOURDES Urban 2.1522 Survey Private School None REGIONAL SCHOOL 1513E8 19459 HOLY FAMILY Urban Survey Public School None CONSOLIDATED SCH 229337 OUR LADY OF THE Urban 2.1522 Survey Private School None ANGELS 1513E8 14461012 SAINT ROSA OF LIMA Urban 2.1522 Survey Private School None ELEMENTARY SCHOOL 1513E8 16060975 SAINT JOHN THE Rural 2.1522 Survey Private School None BAPTIST 1513E8 153799 St. Catherine Laboure Urban None Private School None
School Entity - Discount Rate Calculation Details
Page 2 BEN Name Urban/ Number of Students CEP Rural Students Count Based Percentage on Estimate 18033 GOOD SHEPHERD SCHOOL Urban 251 N/A 18040 TRINITY HIGH SCHOOL Urban 517 N/A 18059 ST PATRICK ELEM SCH-CARLISLE Urban 276 N/A 18108 ST JOAN OF ARC ELEMENTARY SCH Urban 350 N/A 18121 LEBANON CATHOLIC SCHOOL Urban 352 N/A 18143 SACRED HEART ELEM SCH-LEWISTOWN Rural 81 N/A 18186 ST JOSEPH SCHOOL-MECHANICSBURG Urban 367 N/A 18193 SEVEN SORROWS OF BVM SCHOOL Urban 208 N/A 18235 ST THERESA ELEMENTARY SCHOOL Urban 462 N/A 18259 HARRISBURG CATHOLIC ELEMENTARY CATHEDRAL CAMPUS Urban 211 N/A 18268 ST MARGARET MARY SCHOOL Urban 333 N/A 18271 BISHOP MCDEVITT HIGH SCHOOL Urban 746 N/A 18312 HOLY NAME OF JESUS SCHOOL Urban 362 N/A 18441 ST FRANCIS XAVIER SCHOOL Urban 202 N/A 18456 ST JOSEPH ELEM SCHOOL-HANOVER Urban 152 N/A 18462 St. Teresa of Calcutta - Conewago Campus Urban 204 N/A 18476 St. Teresa of Calcutta - McSherrystown Campus Urban 427 N/A 18477 DELONE CATHOLIC HIGH SCHOOL Urban 412 N/A 18527 ST JOSEPH ELEMENTARY SCH-YORK Urban 279 N/A 18540 YORK CATHOLIC HIGH SCHOOL Urban 601 N/A 18547 ST PATRICK ELEMENTARY SCH-YORK Urban 113 N/A 18605 OUR MOTHER PERPETUAL HELP SCH Urban 153 N/A 18740 ST LEO THE GREAT SCHOOL Urban 365 N/A 18744 LANCASTER CATHOLIC HIGH SCHOOL Urban 630 N/A 18776 SACRED HEART ELEM-LANCASTER Urban 156 N/A 18778 RESURRECTION ELEMENTARY SCHOOL Urban 125 N/A 18880 ST COLUMBA SCHOOL Urban 98 N/A 18895 ST JOSEPH ELEM SCH-DANVILLE Urban 82 N/A 18951 OUR LADY OF LOURDES REGIONAL SCHOOL Urban 510 N/A 19459 HOLY FAMILY CONSOLIDATED SCH Urban 93 N/A 229337 OUR LADY OF THE ANGELS Urban 169 N/A 14461012 SAINT ROSA OF LIMA ELEMENTARY SCHOOL Urban 85 N/A 16060975 SAINT JOHN THE BAPTIST Rural 85 N/A 153799 St. Catherine Laboure Urban 353 N/A
Related Entity Information Consortium Related Entities
Related School NIFs School BEN School Name NIF BEN NIF Name
18121 LEBANON CATHOLIC SCHOOL 16060452 DIOCESE OF HARRISBURG OFFICE
Discount Rate
Page 3 Category One Discount Rate Category Two Discount Rate 47% 47%
School Discount Rate School Enrollment School NSLP Count School NSLP School Urban/ Category One Category Two Percentage Rural Status Discount Rate Discount Rate 251 27 11.0% Urban 40% 40% 517 61 12.0% Urban 40% 40% 276 36 13.0% Urban 40% 40% 350 35 10.0% Urban 40% 40% 352 30 9.0% Urban 40% 40% 81 26 32.0% Rural 60% 60% 367 26 7.0% Urban 40% 40% 208 52 25.0% Urban 50% 50% 397 39 10.0% Urban 40% 40% 211 155 73.0% Urban 80% 80% 333 75 23.0% Urban 50% 50% 746 193 26.0% Urban 50% 50% 362 35 10.0% Urban 40% 40% 202 52 26.0% Urban 50% 50% 152 44 29.0% Urban 50% 50% 204 21 10.0% Urban 40% 40% 427 65 15.0% Urban 40% 40% 412 62 15.0% Urban 40% 40% 279 42 15.0% Urban 40% 40% 601 57 9.0% Urban 40% 40% 113 46 41.0% Urban 60% 60% 153 30 20.0% Urban 50% 50% 365 50 14.0% Urban 40% 40% 620 116 19.0% Urban 40% 40% 156 58 37.0% Urban 60% 60% 125 41 33.0% Urban 50% 50% 98 18 18.0% Urban 40% 40% 82 28 34.0% Urban 50% 50% 510 75 15.0% Urban 40% 40% 93 19 20.0% Urban 50% 50% 155 65 42.0% Urban 60% 60% 85 13 15.0% Urban 40% 40% 85 14 16.0% Rural 50% 50% 353 76 22.0% Urban 50% 50%
Page 4 Funding Request for FRN #2099029916 Funding Request Nickname: Comcast
Service Type: Data Transmission and/or Internet Access
Agreement Information - Contract Contract Number PA-SVaro-121219-KA02/FY20 Account Number
Establishing FCC Form 470 200001120 Service Provider Comcast Business Communications (SPN: Was an FCC Form 470 posted Yes 143003990) for the product and/or services you are requesting? Based on State Master No Contract? Award Date January 28, 2020 Based on a multiple award No How many bids were received 3 schedule? for this contract? Includes Voluntary Extensions? No What is the service start date? July 01, 2020 Remaining Voluntary Extensions
Total Remaining Contract Length
What is the date your contract June 30, 2025 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?
Wide area network connectivity to 37 schools and the Diocese of Harrisburg. Note Due to Narrative the limitations in EPC, the Diocese NIF has been added to the Lebanon Catholic School. It is a fully eligible NIF, but the system does not permit it to be its own consortium member.
Page 5 Line Item # 2099029916.001
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 1000.0 Mbps Download Speed 1000.0 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 # 2099029916.001
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $3,276.64 One-time Unit Cost $1,000.00 Monthly Recurring Unit Ineligible - $0.00 One-time Ineligible Unit Costs - $0.00 Costs One-time Eligible Unit Cost = $1,000.00 Monthly Recurring Unit Eligible = $3,276.64 One-time Quantity x 1 Costs Monthly Quantity x 1 Total Eligible One-time Costs = $1,000.00 Total Monthly Eligible Recurring = $3,276.64 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $39,319.68 Total Eligible Recurring Costs = $39,319.68 Total Eligible One-time Costs + $1,000.00 Pre-Discount Extended Eligible = $40,319.68 Line Item Cost
Page 6 Recipients of Services BEN Name 16060452 DIOCESE OF HARRISBURG OFFICE
Page 7 FRN Calculation for FRN #2099029916
Monthly Charges Total Requested Amount Total Monthly Recurring Charges $3,276.64 Total Eligible Pre-Discount $39,319.68 Total Monthly Ineligible Charges - $0.00 Recurring Charges Total Eligible Pre-Discount One- + $1,000.00 Total Monthly Eligible Charges = $3,276.64 Time Charges Total Number of Months of x 12 Total Pre-Discount Charges = $40,319.68 Service Discount Rate 47% Total Eligible Pre-Discount = $39,319.68 Recurring Charges Funding Commitment Request = $18,950.25
One-Time Charges Total One-Time Charges $1,000.00 Total Ineligible One-Time - $0.00 Charges Total Eligible Pre-Discount = $1,000.00 One-Time Charges
Page 8 Funding Request for FRN #2099029983 Funding Request Nickname: Comcast 2
Service Type: Data Transmission and/or Internet Access
Agreement Information - Contract Contract Number PA-SVaro-121119-KA01/FY20 Account Number
Establishing FCC Form 470 200001120 Service Provider Comcast Business Communications (SPN: Was an FCC Form 470 posted Yes 143003990) for the product and/or services you are requesting? Based on State Master No Contract? Award Date January 28, 2020 Based on a multiple award No How many bids were received 3 schedule? for this contract? Includes Voluntary Extensions? No What is the service start date? July 01, 2020 Remaining Voluntary Extensions
Total Remaining Contract Length
What is the date your contract June 30, 2025 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?
Wide area network connectivity to 35 schools and the Diocese of Harrisburg. Note Due to Narrative the limitations in EPC, the Diocese NIF has been added to the Lebanon Catholic School. It is a fully eligible NIF, but the system does not permit it to be its own consortium member.
Page 9 Line Item # 2099029983.001
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 Mbps Download Speed 10.0 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 # 2099029983.001
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $253.86 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 = $253.86 One-time Quantity x 0 Costs Monthly Quantity x 6 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $1,523.16 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $18,277.92 Total Eligible Recurring Costs = $18,277.92 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $18,277.92 Line Item Cost
Page 10 Recipients of Services BEN Name 18259 HARRISBURG CATHOLIC ELEMENTARY CATHEDRAL CAMPUS 18462 St. Teresa of Calcutta - Conewago Campus 18778 RESURRECTION ELEMENTARY SCHOOL 18143 SACRED HEART ELEM SCH-LEWISTOWN 18547 ST PATRICK ELEMENTARY SCH-YORK
Page 11 Line Item # 2099029983.002
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 50.0 Mbps Download Speed 50.0 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 # 2099029983.002
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $367.53 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 = $367.53 One-time Quantity x 0 Costs Monthly Quantity x 18 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $6,615.54 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $79,386.48 Total Eligible Recurring Costs = $79,386.48 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $79,386.48 Line Item Cost
Page 12 Recipients of Services BEN Name 18033 GOOD SHEPHERD SCHOOL 18059 ST PATRICK ELEM SCH-CARLISLE 229337 OUR LADY OF THE ANGELS 18441 ST FRANCIS XAVIER SCHOOL 18456 ST JOSEPH ELEM SCHOOL-HANOVER 18312 HOLY NAME OF JESUS SCHOOL 18268 ST MARGARET MARY SCHOOL 153799 St. Catherine Laboure 18108 ST JOAN OF ARC ELEMENTARY SCH 18776 SACRED HEART ELEM-LANCASTER 18740 ST LEO THE GREAT SCHOOL 18476 St. Teresa of Calcutta - McSherrystown Campus 18186 ST JOSEPH SCHOOL-MECHANICSBURG 18193 SEVEN SORROWS OF BVM SCHOOL 18235 ST THERESA ELEMENTARY SCHOOL 16060975 SAINT JOHN THE BAPTIST 14461012 SAINT ROSA OF LIMA ELEMENTARY SCHOOL 18527 ST JOSEPH ELEMENTARY SCH-YORK
Page 13 Line Item # 2099029983.003
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 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 # 2099029983.003
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $511.52 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 = $511.52 One-time Quantity x 0 Costs Monthly Quantity x 3 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $1,534.56 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $18,414.72 Total Eligible Recurring Costs = $18,414.72 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $18,414.72 Line Item Cost
Page 14 Recipients of Services BEN Name 18040 TRINITY HIGH SCHOOL 18121 LEBANON CATHOLIC SCHOOL 18540 YORK CATHOLIC HIGH SCHOOL
Page 15 Line Item # 2099029983.004
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 300.0 Mbps Download Speed 300.0 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 # 2099029983.004
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $769.17 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 = $769.17 One-time Quantity x 0 Costs Monthly Quantity x 3 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $2,307.51 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $27,690.12 Total Eligible Recurring Costs = $27,690.12 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $27,690.12 Line Item Cost
Page 16 Recipients of Services BEN Name 18271 BISHOP MCDEVITT HIGH SCHOOL 18744 LANCASTER CATHOLIC HIGH SCHOOL 18477 DELONE CATHOLIC HIGH SCHOOL
Page 17 Line Item # 2099029983.005
Product and Service Details Internet access service that includes a connection from any applicant site directly to the Internet Service Purpose Provider
Function Copper
Type of Connection Cable Modem Bandwidth Speed Upload Speed 10.0 Mbps Download Speed 10.0 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 # 2099029983.005
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $443.00 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 = $443.00 One-time Quantity x 0 Costs Monthly Quantity x 1 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $443.00 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $5,316.00 Total Eligible Recurring Costs = $5,316.00 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $5,316.00 Line Item Cost
Page 18 Recipients of Services BEN Name 19459 HOLY FAMILY CONSOLIDATED SCH
Page 19 Line Item # 2099029983.006
Product and Service Details Internet access service that includes a connection from any applicant site directly to the Internet Service Purpose Provider
Function Copper
Type of Connection Cable Modem Bandwidth Speed Upload Speed 50.0 Mbps Download Speed 50.0 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 # 2099029983.006
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $614.66 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 = $614.66 One-time Quantity x 0 Costs Monthly Quantity x 4 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $2,458.64 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $29,503.68 Total Eligible Recurring Costs = $29,503.68 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $29,503.68 Line Item Cost
Page 20 Recipients of Services BEN Name 18880 ST COLUMBA SCHOOL 18951 OUR LADY OF LOURDES REGIONAL SCHOOL 18605 OUR MOTHER PERPETUAL HELP SCH 18895 ST JOSEPH ELEM SCH-DANVILLE
Page 21 Line Item # 2099029983.007
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 2000.0 Mbps Download Speed 2000.0 Mbps
Connection Information Does this include firewall services? Yes 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 # 2099029983.007
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $1,701.26 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 = $1,701.26 One-time Quantity x 0 Costs Monthly Quantity x 1 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $1,701.26 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $20,415.12 Total Eligible Recurring Costs = $20,415.12 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $20,415.12 Line Item Cost
Page 22 Recipients of Services BEN Name 16060452 DIOCESE OF HARRISBURG OFFICE
Page 23 FRN Calculation for FRN #2099029983
Monthly Charges Total Requested Amount Total Monthly Recurring Charges $16,583.67 Total Eligible Pre-Discount $199,004.04 Total Monthly Ineligible Charges - $0.00 Recurring Charges Total Eligible Pre-Discount One- + $0.00 Total Monthly Eligible Charges = $16,583.67 Time Charges Total Number of Months of x 12 Total Pre-Discount Charges = $199,004.04 Service Discount Rate 47% Total Eligible Pre-Discount = $199,004.04 Recurring Charges Funding Commitment Request = $93,531.90
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 24 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 $239,323.72 471 Total funding commitment request amount on this FCC Form 471 $112,482.15 Total applicant non-discount share of the eligible amount $126,841.57 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 $126,841.57 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 25 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: Superintendent Name: Daniel Breen
Phone: 717-657-4804 Email: [email protected]
Address: 4800 Union Deposit Rd Harrisburg PA Employer: Diocese of Harrisburg 17111
18-Apr-2020 06:50:32 EDT Certified Timestamp
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