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 FY17 471 Transfer to LVA Application Number 171048445 Funding Year 2017 Category of Service Category 1

Billed Entity Contact Information Colonial Intermediate Unit 20 Consortium Jamespeter Hinkle 6 Danforth Drive Easton PA 18045 610-515-6599 610-515-6599 [email protected] [email protected]

Billed Entity Number 17002701 FCC Registration Number 0025148024 Applicant Type Consortium

Entity Information Consortium Entities

Related School District Entity - Details BEN Name Urban/ State State NCES School District Endowment Rural LEA ID School Code Attributes ID 125917 INTERMEDIATE UNIT 20 Urban Public School District; None ESA School District 16051282 ACADEMY Urban Charter School District; None REGIONAL CHARTER SCHOOL Public School District

Related Entity Information Consortium Related Entities

Related Child School Entity - Details BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 16033692 COLONIAL ACADEMY Rural Public School None 16052322 IU 20 CLASSROOMS Rural None Public School None AT FIVE POINTS ELEMENTARY SCHOOL 16052323 IU 20 CLASSROOMS AT Rural None Public School None BANGOR AREA MIDDLE SCHOOL 16052324 IU 20 CLASSROOMS Urban None Public School None AT WASHINGTON ELEMENTARY SCHOOL

Page 1 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 16052342 IU 20 CLASSROOMS Urban None Public School None AT ASA PACKER ELEMENTARY SCHOOL 16052345 IU 20 CLASSROOMS AT Urban None Public School None BETHLEHEM ARE VO- TECH SCHOOL 16052346 IU 20 CLASSROOMS Urban None Public School None AT EAST HILLS MIDDLE SCHOOL 16052348 IU 20 CLASSROOMS Urban None Public School None AT FREEDOM HIGH SCHOOL 16052349 IU 20 CLASSROOMS Urban None Public School None AT FREEMANSBURG ELEMENTARY SCHOOL 16052352 IU 20 CLASSROOMS Urban None Public School None AT GOVERNOR WOLF ELEMENTARY SCHOOL 16052354 IU 20 CLASSROOMS AT Urban None Public School None HANOVER ELEMENTARY SCHOOL 16052357 IU 20 CLASSROOMS AT Urban None Public School None MARVINE ELEMENTARY SCHOOL 16052361 IU 20 CLASSROOMS Urban None Public School None AT CLEARVIEW ELEMENTARY SCHOOL 16052363 IU 20 CLASSROOMS AT Urban None Public School None LIBERTY HIGH SCHOOL 16052365 IU 20 CLASSROOMS Urban None Public School None AT FARMERSVILLE ELEMENTARY SCHOOL 16052367 IU 20 CLASSROOMS AT Urban None Public School None NORTHEAST MIDDLE SCHOOL 16052368 IU 20 CLASSROOMS AT Urban None Public School None EAST STROUDSBURG HIGH SCHOOL-NORTH 16052371 IU 20 CLASSROOMS AT Rural None Public School None RESICA SCHOOL 16052375 IU 20 CLASSROOMS AT Urban None Public School None CHESTON ELEMENTARY SCHOOL 16052377 IU 20 CLASSROOMS AT Urban None Public School None 16052378 IU 20 CLASSROOMS AT Urban None Public School None FORKS ELEMENTARY SCHOOL 16052379 IU 20 CLASSROOMS AT Urban None Public School None PALMER ELEMENTARY SCHOOL 16052380 IU 20 CLASSROOMS AT Urban None Public School None PAXINOSA ELEMENTARY SCHOOL 16052399 IU 20 CLASSROOMS AT Rural None BUSHKILL ELEMENTARY SCHOOL

Page 2 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 16052401 IU 20 CLASSROOMS Urban None Public School None AT NAZARETH AREA INTERMEDIATE SCHOOL 16052408 IU 20 CLASSROOMS AT Urban None Public School None LEHIGH ELEMENTARY SCHOOL 16052409 IU 20 CLASSROOMS AT Rural None Public School None MOORE ELEMENTARY SCHOOL 16052410 IU 20 CLASSROOMS AT Urban None Public School None NORTHAMPTON AREA MIDDLE SCHOOL 16052412 IU 20 CLASSROOMS Rural None Public School None AT WIND GAP MIDDLE SCHOOL 16052416 IU 20 CLASSROOMS Rural None Public School None AT PLEASANT VALLEY ELEMENTARY SCHOOL 16052417 IU 20 CLASSROOMS Rural None Public School None AT PLEASANT VALLEY INTERMEDIATE SCHOOL 16052418 IU 20 CLASSROOMS Rural None Public School None AT PLEASANT VALLEY MIDDLE SCHOOL 16052419 IU 20 CLASSROOMS AT Urban None Public School None PLEASANT VALLEY HIGH SCHOOL 16052422 IU 20 CLASSROOMS AT Rural None Public School None POCONO MOUNTAIN EAST JUNIOR HIGH SCHOOL 16052426 IU 20 CLASSROOMS AT Rural None Public School $0.00 POCONO MOUNTAIN WEST JUNIOR HIGH SCHOOL 16052428 IU 20 CLASSROOMS AT Rural None Public School None POCONO MOUNTAIN WEST HIGH SCHOOL 16052429 IU 20 CLASSROOMS Rural None Public School None AT SWIFTWATER ELEMENTARY SCHOOL 16052430 IU 20 CLASSROOMS Rural None Public School None AT SWIFTWATER INTERMEDIATE SCHOOL 16052433 IU 20 CLASSROOMS Urban None Public School None AT SAUCON VALLEY ELEMENTARY SCHOOL 16052435 IU 20 CLASSROOMS Urban None Public School None AT SAUCON VALLEY MIDDLE SCHOOL 16052445 IU 20 CLASSROOMS Urban None Public School None AT CHIPPERFIELD ELEMENTARY SCHOOL 16052447 IU 20 CLASSROOMS AT Urban None Public School None STROUDSBURG JUNIOR HIGH SCHOOL 16052449 IU 20 CLASSROOMS AT Urban None Public School None STROUDSBURG MIDDLE SCHOOL Page 3 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 16052451 IU 20 CLASSROOMS AT Urban None Public School None STROUDSBURG HIGH SCHOOL 16052454 IU 20 CLASSROOMS Urban None Public School None AT FAITH LUTHERAN CHURCH 16052459 IU 20 CLASSROOMS AT Rural None Public School None WILLIAMS TOWNSHIP ELEMENTARY SCHOOL 16052460 IU 20 CLASSROOMS Urban None Public School None AT 16059165 IU 20 CLASSROOMS AT Urban None Public School None SHAWNEE ELEMENTARY SCHOOL 16059173 IU 20 CLASSROOMS Urban None Public School None AT GEORGE WOLF ELEMENTARY SCHOOL 16059174 IU 20 CLASSROOMS Urban None Juvenile Justice; None AT NORTHAMPTON Private School COUNTY JUVENILE JUSTICE CENTER 16059177 IU 20 CLASSROOMS AT Urban None Public School None EASTON AREA MIDDLE SCHOOL 16059178 IU 20 CLASSROOMS AT Urban None Public School None MOREY ELEMENTARY SCHOOL 16059618 IU 20 CLASSROOMS Urban None Public School None AT NAZARETH MIDDLE SCHOOL 16059638 IU 20 CLASSROOMS Urban None Public School None AT BROUGHAL MIDDLE SCHOOL 16059641 IU 20 CLASSROOMS AT Urban None Public School None EAST STROUDSBURG HIGH SCHOOL - SOUTH 16059644 IU 20 CLASSROOMS AT Urban None Public School None J.M. HILL ELEMENTARY SCHOOL 16059651 IU 20 CLASSROOMS Rural None Public School None AT J.T. LAMBERT INTERMEDIATE SCHOOL 16059654 IU 20 CLASSROOMS AT Rural None Public School None MIDDLE SMITHFIELD SCHOOL 16064437 IU 20 CLASSROOMS AT Urban None Public School None EAST STROUDSBURG ELEMENTARY SCHOOL 16064438 IU 20 CLASSROOMS Urban None Public School None AT PEN ARGYL HIGH SCHOOL 16064441 IU 20 CLASSROOMS AT Urban None Public School None THOMAS JEFFERSON ELEMENTARY SCHOOL 16068340 IU 20 CLASSROOMS AT Urban None Public School None AVONA ELEMENTARY SCHOOL

Page 4 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 16068341 IU 20 CLASSROOMS Rural None Public School None AT CLEAR RUN INTERMEDIATE SCHOOL 16068344 IU 20 CLASSROOMS AT Urban None Public School None MARCH ELEMENTARY SCHOOL 16074918 COLONIAL LEARNING Urban Survey Pre-K; Public School None CENTER 17008079 IU 20 CLASSROOMS Rural None Public School None AT CLEAR RUN ELEMENTARY CENTER 17008090 IU 20 CLASSROOMS Rural None Public School None AT 17008091 IU 20 CLASSROOMS Urban None Public School None AT NORTHAMPTON AREA HIGH SCHOOL 17008093 IU 20 CLASSROOMS Rural None Public School None AT POCONO MOUNTAIN EAST HIGH SCHOOL 17008094 IU 20 CLASSROOMS Urban None Public School None AT SAUCON VALLEY SENIOR HIGH SCHOOL 17008097 IU 20 CLASSROOMS Urban None Public School None AT COLONEL JOHN SIEGFRIED ELEMENTARY SCHOOL 17010662 IU 20 CLASSROOMS Urban None Private School None AT NOTRE DAME OF BETHLEHEM SCHOOL 17010663 IU 20 CLASSROOMS Urban None Private School None AT SACRED HEART SCHOOLS 17010664 IU 20 CLASSROOMS AT Urban None Private School None ST JANES FRANCES DE CHANTAL SCHOOL 17010665 IU 20 CLASSROOMS Urban None Private School None AT GOOD SHEPARD SCHOOL 17010666 IU 20 CLASSROOMS AT Urban None Private School None ST THERESA SCHOOL 16084997 IU 20 CLASSROOMS Urban None Private School None AT NOTRE DAME ELEMENTARY SCHOOL 16050578 LEHIGH VALLEY Urban 1204 120480002 None Private School None ACADEMY REGIONAL 80002 CHARTER SCHOOL JR HIGH SCHOOL 16050856 LEHIGH VALLEY Urban None Private School None ACADEMY REGIONAL CHARTER SCHOOL ELEMENTARY SCHOOL K TO 3 16051320 LEHIGH VALLEY Urban None Private School None ACADEMY REGIONAL CHARTER SCHOOL HIGH SCHOOL 16052135 LEHIGH VALLEY Urban None Private School None ACADEMY REGIONAL Page 5 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount CHARTER SCHOOL ELEMENTARY SCHOOL 4 6

Related Child School Entity - Discount Rate Calculation Details BEN Name Urban/ Number of Students CEP Rural Students Count Based Percentage on Estimate 16033692 COLONIAL ACADEMY Rural 265 N/A 65.83% 16052322 IU 20 CLASSROOMS AT FIVE POINTS ELEMENTARY SCHOOL Rural 6 N/A 16052323 IU 20 CLASSROOMS AT BANGOR AREA MIDDLE SCHOOL Rural 20 N/A 16052324 IU 20 CLASSROOMS AT WASHINGTON ELEMENTARY SCHOOL Urban 7 N/A 16052342 IU 20 CLASSROOMS AT ASA PACKER ELEMENTARY SCHOOL Urban 18 N/A 16052345 IU 20 CLASSROOMS AT BETHLEHEM ARE VO-TECH SCHOOL Urban 17 N/A 16052346 IU 20 CLASSROOMS AT EAST HILLS MIDDLE SCHOOL Urban 11 N/A 16052348 IU 20 CLASSROOMS AT FREEDOM HIGH SCHOOL Urban 26 N/A 16052349 IU 20 CLASSROOMS AT FREEMANSBURG ELEMENTARY SCHO Urban 19 N/A OL 16052352 IU 20 CLASSROOMS AT GOVERNOR WOLF ELEMENTARY SCH Urban 8 N/A OOL 16052354 IU 20 CLASSROOMS AT HANOVER ELEMENTARY SCHOOL Urban 8 N/A 16052357 IU 20 CLASSROOMS AT MARVINE ELEMENTARY SCHOOL Urban 8 N/A 16052361 IU 20 CLASSROOMS AT CLEARVIEW ELEMENTARY SCHOOL Urban 17 N/A 16052363 IU 20 CLASSROOMS AT LIBERTY HIGH SCHOOL Urban 33 N/A 16052365 IU 20 CLASSROOMS AT FARMERSVILLE ELEMENTARY SCHOO Urban 32 N/A L 16052367 IU 20 CLASSROOMS AT NORTHEAST MIDDLE SCHOOL Urban 13 N/A 16052368 IU 20 CLASSROOMS AT EAST STROUDSBURG HIGH SCHOOL-N Urban 8 N/A ORTH 16052371 IU 20 CLASSROOMS AT RESICA SCHOOL Rural 8 N/A 16052375 IU 20 CLASSROOMS AT CHESTON ELEMENTARY SCHOOL Urban 6 N/A 16052377 IU 20 CLASSROOMS AT EASTON AREA HIGH SCHOOL Urban 91 N/A 16052378 IU 20 CLASSROOMS AT FORKS ELEMENTARY SCHOOL Urban 14 N/A 16052379 IU 20 CLASSROOMS AT PALMER ELEMENTARY SCHOOL Urban 29 N/A 16052380 IU 20 CLASSROOMS AT PAXINOSA ELEMENTARY SCHOOL Urban 29 N/A 16052399 IU 20 CLASSROOMS AT BUSHKILL ELEMENTARY SCHOOL Rural 0 N/A 16052401 IU 20 CLASSROOMS AT NAZARETH AREA INTERMEDIATE SCH Urban 7 N/A OOL 16052408 IU 20 CLASSROOMS AT LEHIGH ELEMENTARY SCHOOL Urban 25 N/A 16052409 IU 20 CLASSROOMS AT MOORE ELEMENTARY SCHOOL Rural 30 N/A 16052410 IU 20 CLASSROOMS AT NORTHAMPTON AREA MIDDLE SCHOO Urban 20 N/A L 16052412 IU 20 CLASSROOMS AT WIND GAP MIDDLE SCHOOL Rural 11 N/A 16052416 IU 20 CLASSROOMS AT PLEASANT VALLEY ELEMENTARY SCH Rural 9 N/A OOL 16052417 IU 20 CLASSROOMS AT PLEASANT VALLEY INTERMEDIATE SC Rural 23 N/A HOOL 16052418 IU 20 CLASSROOMS AT PLEASANT VALLEY MIDDLE SCHOOL Rural 16 N/A 16052419 IU 20 CLASSROOMS AT PLEASANT VALLEY HIGH SCHOOL Urban 52 N/A

Page 6 BEN Name Urban/ Number of Students CEP Rural Students Count Based Percentage on Estimate 16052422 IU 20 CLASSROOMS AT POCONO MOUNTAIN EAST JUNIOR HIG Rural 23 N/A H SCHOOL 16052426 IU 20 CLASSROOMS AT POCONO MOUNTAIN WEST JUNIOR HI Rural 14 N/A GH SCHOOL 16052428 IU 20 CLASSROOMS AT POCONO MOUNTAIN WEST HIGH SCH Rural 16 N/A OOL 16052429 IU 20 CLASSROOMS AT SWIFTWATER ELEMENTARY SCHOOL Rural 25 N/A 16052430 IU 20 CLASSROOMS AT SWIFTWATER INTERMEDIATE SCHOOL Rural 31 N/A 16052433 IU 20 CLASSROOMS AT SAUCON VALLEY ELEMENTARY SCHO Urban 15 N/A OL 16052435 IU 20 CLASSROOMS AT SAUCON VALLEY MIDDLE SCHOOL Urban 5 N/A 16052445 IU 20 CLASSROOMS AT CHIPPERFIELD ELEMENTARY SCHOOL Urban 7 N/A 16052447 IU 20 CLASSROOMS AT STROUDSBURG JUNIOR HIGH SCHOO Urban 11 N/A L 16052449 IU 20 CLASSROOMS AT STROUDSBURG MIDDLE SCHOOL Urban 12 N/A 16052451 IU 20 CLASSROOMS AT STROUDSBURG HIGH SCHOOL Urban 45 N/A 16052454 IU 20 CLASSROOMS AT FAITH LUTHERAN CHURCH Urban 0 N/A 16052459 IU 20 CLASSROOMS AT WILLIAMS TOWNSHIP ELEMENTARY S Rural 14 N/A CHOOL 16052460 IU 20 CLASSROOMS AT WILSON AREA HIGH SCHOOL Urban 11 N/A 16059165 IU 20 CLASSROOMS AT SHAWNEE ELEMENTARY SCHOOL Urban 7 N/A 16059173 IU 20 CLASSROOMS AT GEORGE WOLF ELEMENTARY SCHOO Urban 23 N/A L 16059174 IU 20 CLASSROOMS AT NORTHAMPTON COUNTY JUVENILE JU Urban 183 N/A STICE CENTER 16059177 IU 20 CLASSROOMS AT EASTON AREA MIDDLE SCHOOL Urban 42 N/A 16059178 IU 20 CLASSROOMS AT MOREY ELEMENTARY SCHOOL Urban 9 N/A 16059618 IU 20 CLASSROOMS AT NAZARETH MIDDLE SCHOOL Urban 38 N/A 16059638 IU 20 CLASSROOMS AT BROUGHAL MIDDLE SCHOOL Urban 26 N/A 16059641 IU 20 CLASSROOMS AT EAST STROUDSBURG HIGH SCHOOL - Urban 8 N/A SOUTH 16059644 IU 20 CLASSROOMS AT J.M. HILL ELEMENTARY SCHOOL Urban 14 N/A 16059651 IU 20 CLASSROOMS AT J.T. LAMBERT INTERMEDIATE SCHOOL Rural 36 N/A 16059654 IU 20 CLASSROOMS AT MIDDLE SMITHFIELD SCHOOL Rural 5 N/A 16064437 IU 20 CLASSROOMS AT EAST STROUDSBURG ELEMENTARY S Urban 30 N/A CHOOL 16064438 IU 20 CLASSROOMS AT PEN ARGYL HIGH SCHOOL Urban 6 N/A 16064441 IU 20 CLASSROOMS AT THOMAS JEFFERSON ELEMENTARY S Urban 9 N/A CHOOL 16068340 IU 20 CLASSROOMS AT AVONA ELEMENTARY SCHOOL Urban 12 N/A 16068341 IU 20 CLASSROOMS AT CLEAR RUN INTERMEDIATE SCHOOL Rural 24 N/A 16068344 IU 20 CLASSROOMS AT MARCH ELEMENTARY SCHOOL Urban 1 N/A 16074918 COLONIAL LEARNING CENTER Urban 77 N/A 17008079 IU 20 CLASSROOMS AT CLEAR RUN ELEMENTARY CENTER Rural 8 N/A 17008090 IU 20 CLASSROOMS AT BANGOR AREA HIGH SCHOOL Rural 5 N/A 17008091 IU 20 CLASSROOMS AT NORTHAMPTON AREA HIGH SCHOOL Urban 21 N/A 17008093 IU 20 CLASSROOMS AT POCONO MOUNTAIN EAST HIGH SCHO Rural 1 N/A OL 17008094 IU 20 CLASSROOMS AT SAUCON VALLEY SENIOR HIGH SCHO Urban 3 N/A OL

Page 7 BEN Name Urban/ Number of Students CEP Rural Students Count Based Percentage on Estimate 17008097 IU 20 CLASSROOMS AT COLONEL JOHN SIEGFRIED ELEMENT Urban 9 N/A ARY SCHOOL 17010662 IU 20 CLASSROOMS AT NOTRE DAME OF BETHLEHEM SCHOO Urban 38 N/A L 17010663 IU 20 CLASSROOMS AT SACRED HEART SCHOOLS Urban 15 N/A 17010664 IU 20 CLASSROOMS AT ST JANES FRANCES DE CHANTAL SCH Urban 39 N/A OOL 17010665 IU 20 CLASSROOMS AT GOOD SHEPARD SCHOOL Urban 38 N/A 17010666 IU 20 CLASSROOMS AT ST THERESA SCHOOL Urban 14 N/A 16084997 IU 20 CLASSROOMS AT NOTRE DAME ELEMENTARY SCHOOL Urban 22 N/A 16050578 LEHIGH VALLEY ACADEMY REGIONAL CHARTER SCHOOL JR H Urban 291 N/A IGH SCHOOL 16050856 LEHIGH VALLEY ACADEMY REGIONAL CHARTER SCHOOL ELE Urban 598 N/A MENTARY SCHOOL K TO 3 16051320 LEHIGH VALLEY ACADEMY REGIONAL CHARTER SCHOOL HIG Urban 301 N/A H SCHOOL 16052135 LEHIGH VALLEY ACADEMY REGIONAL CHARTER SCHOOL ELE Urban 450 N/A MENTARY SCHOOL 4 6

Related School District NIFs School School District Name NIF BEN NIF Name District BEN 125917 INTERMEDIATE UNIT 20 16046797 COLONIAL IU 20 ADMINISTRATIVE BUILDING

Discount Rate Category One Discount Rate Category Two Discount Rate Voice Discount Rate 75% 73% 15%

School District 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 1661 1283 78.0% Urban 90% 85% 30% 1640 670 41.0% Urban 60% 60% 0%

Page 8 Funding Request for FRN #1799110682 Funding Request Nickname: FY17 FRN Transfer to LVA

Service Type: Data Transmission and/or Internet Access

What is the FRN number from the previous 1699142796 year ?

Agreement Information - Contract Contract Number Account Number

User-entered Establishing FCC 570010001319000 Service Provider PenTeleData Limited Partnership I Form 470# (SPN: 143004441)

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 No Award Date March 25, 2015 schedule?

How many bids were received 3 Includes Voluntary Extensions? No for this contract? Remaining Voluntary What is the service start date? July 01, 2017 Extensions

Total Remaining Contract Length

What is the date your contract June 30, 2020 expires for the current term of the contract?

Document Name Document Description

CIU 20 LVA Final Contract 2015 (1).pdf

Pricing Confidentiality Is there a statute, rule, or other restriction which prohibits No publication of the specific pricing information for this contract?

I contacted the USAC CSB and I was told to include a note to let the reviewer know that Narrative this was submitted as a request type of Consortium. Please call me if there are any further questions at 610-515-6599. This a point to point connection between 6 Danforth Drive, Easton, PA and 1560 Valley Center Pkwy, Bethlehem, PA.

Page 9 Line Item # 1799110682.001

Product and Service Details Data Connection between two or more sites entirely within the applicant’s network Purpose

Function Copper

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 # 1799110682.001

Monthly Cost One-Time Cost Monthly Recurring Unit Cost $1,720.00 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 = $1,720.00 One-time Quantity x 0 Costs Monthly Quantity x 1 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $1,720.00 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $20,640.00 Total Eligible Recurring Costs = $20,640.00 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $20,640.00 Line Item Cost

Page 10 Recipients of Services BEN Name 16046797 COLONIAL IU 20 ADMINISTRATIVE BUILDING 16050578 LEHIGH VALLEY ACADEMY REGIONAL CHARTER SCHOOL JR HIGH SCHOOL 16050856 LEHIGH VALLEY ACADEMY REGIONAL CHARTER SCHOOL ELEMENTARY SCHOOL K TO 3 16051320 LEHIGH VALLEY ACADEMY REGIONAL CHARTER SCHOOL HIGH SCHOOL 16052135 LEHIGH VALLEY ACADEMY REGIONAL CHARTER SCHOOL ELEMENTARY SCHOOL 4 6

Page 11 FRN Calculation for FRN #1799110682

Monthly Charges Total Requested Amount Total Monthly Recurring Charges $1,720.00 Total Eligible Pre-Discount $20,640.00 Total Monthly Ineligible Charges - $0.00 Recurring Charges Total Eligible Pre-Discount One- + $0.00 Total Monthly Eligible Charges = $1,720.00 Time Charges Total Number of Months of x 12 Total Pre-Discount Charges = $20,640.00 Service Discount Rate 75% Total Eligible Pre-Discount = $20,640.00 Recurring Charges Funding Commitment Request = $15,480.00

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 12 Certifications 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). 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. 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 $20,640.00 471 Total funding commitment request amount on this FCC Form 471 $15,480.00 Total applicant non-discount share of the eligible amount $5,160.00 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 $5,160.00 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 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 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 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

Page 13 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: Technology Management Assistant Name: Jamespeter Hinkle

Phone: 610-515-6599 Email: [email protected]

Address: 6 Danforth Drive Easton PA 18332 Employer: Jamespeter Hinkle

11-May-2017 21:37:58 EDT Certified Timestamp

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