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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 Internet - Segra Application Number 201034846 Funding Year 2020 Category of Service Category 1 Billed Entity Contact Information CHESTERFIELD COUNTY PUBLIC SCHOOLS Brian D Jones 9900 KRAUSE ROAD CHESTERFIELD VA 23832 804-639-8930 804-639-8931 [email protected] [email protected] Billed Entity Number 126544 FCC Registration Number 0011810835 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 126544 CHESTERFIELD COUNTY PUBLIC Urban Public School District None SCHOOLS 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 25001 ALBERTA SMITH Urban 021 0620 51 - None Pre-K; Public School None ELEMENTARY SCH 00840- 462 25002 BAILEY BRIDGE MIDDLE Urban 021 0631 51 - None Public School None SCHOOL 00840- 53 25003 MANCHESTER HIGH Urban 021 0632 51 - None Public School None SCHOOL 00840- 338 25004 CLOVER HILL HIGH Urban 021 0740 51 - None Public School None SCHOOL 00840- 324 25005 CLOVER HILL Urban 021 0150 51 - 00840- None Pre-K; Public School None ELEMENTARY SCHOOL 2055 Page 1 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 25006 CRENSHAW Urban 021 0410 51 - 00840- None Pre-K; Public School None ELEMENTARY SCHOOL 2099 25007 SWIFT CREEK Urban 021 0340 51 - 00840- None Pre-K; Public School None ELEMENTARY SCHOOL 1990 25008 SWIFT CREEK MIDDLE Urban 021 0270 51 - 00840- None Public School None SCHOOL 1834 25009 WOOLRIDGE Urban 021 0440 51 - 00840- None Pre-K; Public School None ELEMENTARY SCHOOL 2176 25010 ROBIOUS MIDDLE Urban 021 0760 51 - None Public School None SCHOOL 00840- 347 25011 ROBIOUS ELEMENTARY Urban 021 0730 51 - None Pre-K; Public School None SCHOOL 00840- 346 25012 EVERGREEN Urban 026 0300 51 - 00840- None Pre-K; Public School None ELEMENTARY SCHOOL 2097 25013 JAMES RIVER HIGH Urban 021 0770 51 - None Public School None SCHOOL 00840- 766 25014 BETTIE WEAVER Urban 021 0510 51 - None Pre-K; Public School None ELEMENTARY SCHOOL 00840- 762 25015 MIDLOTHIAN MIDDLE Urban 021 0040 51 - None Public School None SCHOOL 00840- 343 25016 MIDLOTHIAN HIGH Urban 021 0320 51 - 00840- None Public School None SCHOOL 2006 25018 WATKINS ELEMENTARY Urban 021 0650 51 - None Pre-K; Public School None SCHOOL 00840- 335 25030 GRANGE HALL Rural 021 0180 51 - None Pre-K; Public School None ELEMENTARY SCHOOL 00840- 330 25147 CRESTWOOD Urban 021 0560 51 - None Pre-K; Public School None ELEMENTARY SCHOOL 00840- 325 25235 FALLING CREEK MIDDLE Urban 021 0670 51 - Public School None SCHOOL 00840- 329 25236 FALLING CREEK ELEM Urban 021 0670 51 - Head Start; Pre- None SCHOOL 00840- 328 K; Public School 25237 HENING ELEMENTARY Urban 021 0500 51 - None Head Start; Pre- None SCHOOL 00840- 336 K; Public School 25238 MEADOWBROOK HIGH Urban 021 0580 51 - None Public School None SCHOOL 00840- 342 25239 HOPKINS ROAD Urban 021 0060 51 - None Head Start; Pre- None ELEMENTARY SCHOOL 00840- 333 K; Public School 25248 BON AIR ELEMENTARY Urban 021 0020 51 - None Pre-K; Public School None SCHOOL 00840- 318 25249 GREENFIELD Urban 021 0070 51 - None Public School None ELEMENTARY SCHOOL 00840- 33 25250 PROVIDENCE MIDDLE Urban 021 0700 51 - None Public School None SCHOOL 00840- 344 25252 MANCHESTER MIDDLE Urban 021 0600 51 - None Public School None SCHOOL 00840- 338 25253 GORDON ELEMENTARY Urban 021 0290 51 - 00840- None Pre-K; Public School None SCHOOL 1835 25254 MONACAN HIGH Urban 021 0280 51 - 00840- None Public School None SCHOOL 1833 25255 REAMS ROAD Urban 021 0700 51 - None Pre-K; Public School None ELEMENTARY SCHOOL 00840- 345 25256 DAVIS ELEMENTARY Urban 021 0620 51 - None Head Start; Pre- None SCHOOL 00840- 323 K; Public School 25257 PROVIDENCE Urban 021 0380 51 - 00840- None Pre-K; Public School None ELEMENTARY SCHOOL 2056 25258 BENSLEY ELEMENTARY Urban 021 0430 51 - Head Start; Pre- None SCHOOL 00840- 316 K; Public School Page 2 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 25259 BEULAH ELEMENTARY Urban 021 0130 51 - None Pre-K; Public School None SCHOOL 00840- 317 25261 SALEM CHURCH MIDDLE Urban 021 0722 51 - None Public School None SCHOOL 00840- 349 25262 SALEM CHURCH Urban 021 0720 51 - None Pre-K; Public School None ELEMENTARY SCHOOL 00840- 348 25263 BELLWOOD Urban 021 0660 51 - Head Start; Pre- None ELEMENTARY SCHOOL 00840- 315 K; Public School 25797 MATOACA HIGH Rural 021 0530 51 - None Public School None SCHOOL 00840- 340 25799 ETTRICK ELEMENTARY Urban 021 0350 51 - Head Start; Pre- None SCHOOL 00840- 327 K; Public School 25808 MATOACA MIDDLE Rural 021 0110 51 - None Public School None SCHOOL 00840- 341 25810 MATOACA ELEMENTARY Urban 021 0370 51 - None Pre-K; Public School None SCHOOL 00840- 339 25827 ECOFF ELEMENTARY Urban 021 0480 51 - 00840- None Pre-K; Public School None SCHOOL 2177 25828 CE CURTIS Urban 021 0492 51 - None Pre-K; Public School None ELEMENTARY SCHOOL 00840- 325 25829 THOMAS DALE HIGH Urban 021 0610 51 - None Public School None SCHOOL 00840- 350 25832 CC WELLS ELEMENTARY Urban 021 0050 51 - None Pre-K; Public School None SCHOOL 00840- 319 25833 CARVER MIDDLE Rural 021 0420 51 - None Public School None SCHOOL 00840- 321 25834 HARROWGATE Rural 021 0460 51 - Head Start; Pre- None ELEMENTARY SCHOOL 00840- 332 K; Public School 25836 CHESTERFIELD Urban 021 0089 51 - None Public School None TECHNICAL CENTER AT 00840- 323 COURTHOUSE 25837 BIRD HIGH SCHOOL Urban 021 0010 51 - None Public School None 00840- 337 25838 GATES ELEMENTARY Urban 021 0360 51 - 00840- None Pre-K; Public School None SCHOOL 1989 25839 JACOBS ROAD Urban 021 0400 51 - 00840- None Pre-K; Public School None ELEMENTARY SCHOOL 2098 25841 CHALKLEY Urban 021 0550 51 - Head Start; Pre- None ELEMENTARY SCHOOL 00840- 334 K; Public School 25848 MARGUERITE Urban 021 0780 51 - 00840- None Head Start; Pre- None CHRISTIAN ELEM SCH 1086 K; Public School 25850 ENON ELEMENTARY Urban 021 0390 51 - None New Construction None SCHOOL 00840- 326 School; Public School 215194 SPRING RUN ES Urban 021 0800 51 - 00840- None Pre-K; Public School None 1903 234046 CARVER COLLEGE AND Urban 021 0030 51 - 00840- None Public School None CAREER ACADEMY 1605 16034166 COSBY HIGH SCHOOL Urban 021 0840 51 - 00840- None Public School None 2661 16042050 ELIZABETH SCOTT Urban 021 0850 51 - 00860- None Head Start; Pre- None ELEMENTARY SCHOOL 2779 K; Public School 16042051 WINTERPOCK Rural 021 0860 51 - 00840- None Pre-K; Public School None ELEMENTARY SCHOOL 2780 16046472 TOMAHAWK CREEK Urban 021 0880 51 - 00840- None Public School None MIDDLE SCHOOL 2754 16046473 ELIZABETH DAVIS Urban 021 0870 51 - 00840- None Public School None MIDDLE SCHOOL 2767 Page 3 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 16081142 CHESTERFIELD Urban 021 0089 51 - 00840- None Public School None CAREER & TECHNICAL 2972 EDUCATION CENTER AT HULL 16081145 ACADEMY 360 Urban 021 0930 51 - 00840- None Public School None 2983 17020265 Old Hundred Elementary Rural None New Construction None School School; Public School Related Child School Entity - Discount Rate Calculation Details BEN Name Urban/ Number of Students CEP Rural Students Count Based Percentage on Estimate 25001 ALBERTA SMITH ELEMENTARY SCH Urban 631 N/A 25002 BAILEY BRIDGE MIDDLE SCHOOL Urban 1570 N/A 25003 MANCHESTER HIGH SCHOOL Urban 2114 N/A 25004 CLOVER HILL HIGH SCHOOL Urban 1752 N/A 25005 CLOVER HILL ELEMENTARY SCHOOL Urban 772 N/A 25006 CRENSHAW ELEMENTARY SCHOOL Urban 659 N/A 25007 SWIFT CREEK ELEMENTARY SCHOOL Urban 677 N/A 25008 SWIFT CREEK MIDDLE SCHOOL Urban 1120 N/A 25009 WOOLRIDGE ELEMENTARY SCHOOL Urban 781 N/A 25010 ROBIOUS MIDDLE SCHOOL Urban 1242 N/A 25011 ROBIOUS ELEMENTARY SCHOOL Urban 744 N/A 25012 EVERGREEN ELEMENTARY SCHOOL Urban 980 N/A 25013 JAMES RIVER HIGH SCHOOL Urban 1909 N/A 25014 BETTIE WEAVER ELEMENTARY SCHOOL Urban 681 N/A 25015 MIDLOTHIAN MIDDLE SCHOOL Urban 1369 N/A 25016 MIDLOTHIAN HIGH SCHOOL Urban 1833 N/A 25018 WATKINS ELEMENTARY SCHOOL Urban 822 N/A 25030 GRANGE HALL ELEMENTARY SCHOOL Rural 867 N/A 25147 CRESTWOOD ELEMENTARY SCHOOL Urban 592 N/A 25235 FALLING CREEK MIDDLE SCHOOL Urban 1478 N/A 49.73% 25236 FALLING CREEK ELEM SCHOOL Urban 763 N/A 53.70% 25237 HENING ELEMENTARY SCHOOL Urban 921 N/A 25238 MEADOWBROOK HIGH SCHOOL Urban 1902 N/A 25239 HOPKINS ROAD ELEMENTARY SCHOOL Urban 735 N/A 25248 BON AIR ELEMENTARY SCHOOL Urban 640 N/A 25249 GREENFIELD ELEMENTARY SCHOOL Urban 640 N/A 25250 PROVIDENCE MIDDLE SCHOOL Urban 1100 N/A 25252 MANCHESTER MIDDLE SCHOOL Urban 1144 N/A 25253 GORDON ELEMENTARY SCHOOL Urban 629 N/A 25254 MONACAN HIGH SCHOOL Urban 1554 N/A 25255 REAMS ROAD ELEMENTARY SCHOOL Urban 495 N/A 25256 DAVIS ELEMENTARY SCHOOL Urban 728 N/A 25257 PROVIDENCE ELEMENTARY SCHOOL Urban 656 N/A 25258 BENSLEY ELEMENTARY SCHOOL Urban 655 N/A 48.90% Page 4 BEN Name Urban/ Number of Students CEP Rural Students Count Based Percentage on Estimate 25259 BEULAH ELEMENTARY SCHOOL Urban 933 N/A 25261 SALEM CHURCH MIDDLE SCHOOL Urban 908 N/A 25262 SALEM CHURCH ELEMENTARY SCHOOL Urban 617 N/A 25263 BELLWOOD ELEMENTARY SCHOOL Urban 562 N/A 55.70% 25797 MATOACA HIGH SCHOOL Rural 1561 N/A 25799
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