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 American Samoa Yr20-Tel Application Number 171025640 Funding Year 2017 Category of Service Category 1
Billed Entity Contact Information AMERICAN SAMOA SEA Brittany Mosqueda P. O. BOX DOE PAGO PAGO AS 96799 661-716-1840 684-633-7924 [email protected] [email protected]
Billed Entity Number 150224 FCC Registration Number 0011750395 Applicant Type School District
Corrina Rodriguez - [email protected] Holiday/Summer Contact Information
Consulting Firms Name Consultant City State Zip Phone Email Registration Code Number Number Infinity Communications & Consultin 16043605 Bakersfield CA 93312 661-716-1840 fred.brakeman@infinityco g mm.com
Entity Information
School District Entity - Details BEN Name Urban/ State State NCES School District Endowment Rural LEA ID School Code Attributes ID 150224 AMERICAN SAMOA SEA Urban Public School District None
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 199075 AFONO ELEM Urban Survey Public School None 199107 ALATAUA LUA/ Urban Survey Public School None TAPUTAPU ELEM
Page 1 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 199108 TUATOO TAUTALATASI Rural Survey Public School None ELEM 199109 AUA ELEM Urban Survey Public School None 199110 MATATULA ECE Urban Survey Public School None 199112 FAGA'ITUA HIGH Urban Survey Public School None SCHOOL 199113 FALEASAO ELEM Urban Survey Public School None 199116 FITIUTA ELEM Urban Survey Public School None 199117 A.P. LUTALI ELEM Rural Survey Public School None 199118 LE'ATELE ELEM Urban Survey Public School None 199121 LEONE MIDKIFF ELEM Urban Survey Public School None 199122 LUPELELE ELEM Urban Survey Public School None 199123 MANU'A HIGH SCHOOL Urban Survey Public School None 199124 MANULELE ELEM Urban Survey Public School None 199125 MATAFAO ELEM Urban Survey Public School None 199126 MATATULA ELEM Urban Survey Public School None 199127 MAUGA O ALAVA ELEM Urban Survey Public School None 199128 OLOMOANA ELEM Urban Survey Public School None 199129 OLOSEGA ECE Urban Survey Pre-K; Public School None 199130 COLEMAN ELEM (Pago Urban Survey Public School None Pago) 199131 PAVA'IA'I ELEM Urban Survey Public School None 199134 SAMOANA HIGH Urban Survey Public School None SCHOOL 199135 SILIAGA ELEM Urban Survey Public School None 199136 TAFUNA HIGH SCHOOL Urban Survey Public School None 199138 NU'UULI VOCATIONAL Urban Survey Public School None TECHNICAL HIGH SCHOOL 199139 MASEFAU ELEM Urban Survey Public School None 199140 MARY THE MOTHER Urban Survey Public School None 199141 MARIST ST. FRANCIS Urban Survey Public School None 199142 SPICC Urban Survey Public School None 199143 MANUMALO BAPTIST Urban Survey Public School None ACADEMY 199145 ST. THERESA ELEM Urban Survey Public School None 199148 IAKINA ADVENTIST Urban Survey Public School None ACADEMY (SDA) 199149 NAZARETH MONTESORY Urban Survey Public School None 199150 PACIFIC HORIZONS Urban Survey Public School None 199151 KANANAFOU ELEM Urban Survey Public School None 199152 SOUTH PACIFIC Urban Survey Public School None ACADEMY (SPA) 199155 FA'ASAO MARIST HIGH Urban Survey Public School None 199156 TAFUNA ELEM Urban Survey Public School None 199157 SAMOA BAPTIST Urban Survey Public School None ACADEMY (HAPPY VALLEY) 224617 JUVENILE DETENTION Urban Survey Juvenile Justice; None CENTER Public School
Page 2 BEN Name Urban/ State State NCES Code Alternative School Attributes Endowment Rural LEA ID School ID Discount 16044866 PETELI ACADEMY Urban Survey Public School None 16058187 COLEMAN ECE (Pago Urban Survey Pre-K; Public School None Pago) 16058189 MASEFAU ECE Urban Survey Pre-K; Public School None 16058191 MAUGA O ALAVA ECE Urban Survey Pre-K; Public School None 16058192 OLOSEGA ELEM Urban Survey Public School None 16058212 A.P. LUTALI ECE Rural Survey Pre-K; Public School None 16058214 AFONO ECE Urban Survey Pre-K; Public School None 16058217 AUA ECE Urban Survey Pre-K; Public School None 16058218 LE'ATELE ECE Urban Survey Pre-K; Public School None 16058220 MATAFAO ECE Urban Survey Pre-K; Public School None 16058465 LAULI'I ECE Urban Survey Pre-K; Public School None 16062601 ALATAUA LUA ECE Urban Survey Pre-K; Public School None 16062602 FAGA'ITUA ECE Urban Survey Pre-K; Public School None 16062603 LAULI'I ELEM Urban Survey Public School None 16062604 LUPELELE ECE Urban Survey Pre-K; Public School None 16062606 OLOMOANA ECE Urban Survey Pre-K; Public School None 16062607 SILIAGA ECE Urban Survey Pre-K; Public School None 16055290 LEONE ECE Urban Survey Pre-K; Public School None 16055291 TAU ECE Rural Survey Pre-K; Public School None 17010302 TAFUNA ECE Urban Survey Public School None 16055289 KANANAFOU HIGH Urban Survey Public School None SCHOOL 199119 LEONE HIGH SCHOOL Urban Survey Public School None 17010594 PAVAIAI ECE Urban Survey 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 199075 AFONO ELEM Urban 63 N/A 199107 ALATAUA LUA/TAPUTAPU ELEM Urban 262 N/A 199108 TUATOO TAUTALATASI ELEM Rural 153 N/A 199109 AUA ELEM Urban 420 N/A 199110 MATATULA ECE Urban 22 N/A 199112 FAGA'ITUA HIGH SCHOOL Urban 557 N/A 199113 FALEASAO ELEM Urban 70 N/A 199116 FITIUTA ELEM Urban 36 N/A 199117 A.P. LUTALI ELEM Rural 79 N/A 199118 LE'ATELE ELEM Urban 79 N/A 199121 LEONE MIDKIFF ELEM Urban 859 N/A 199122 LUPELELE ELEM Urban 740 N/A 199123 MANU'A HIGH SCHOOL Urban 53 N/A 199124 MANULELE ELEM Urban 1030 N/A 199125 MATAFAO ELEM Urban 584 N/A 199126 MATATULA ELEM Urban 175 N/A
Page 3 BEN Name Urban/ Number of Students CEP Rural Students Count Based Percentage on Estimate 199127 MAUGA O ALAVA ELEM Urban 61 N/A 199128 OLOMOANA ELEM Urban 100 N/A 199129 OLOSEGA ECE Urban 12 N/A 199130 COLEMAN ELEM (Pago Pago) Urban 555 N/A 199131 PAVA'IA'I ELEM Urban 1169 N/A 199134 SAMOANA HIGH SCHOOL Urban 946 N/A 199135 SILIAGA ELEM Urban 182 N/A 199136 TAFUNA HIGH SCHOOL Urban 1208 N/A 199138 NU'UULI VOCATIONAL TECHNICAL HIGH SCHOOL Urban 352 N/A 199139 MASEFAU ELEM Urban 91 N/A 199140 MARY THE MOTHER Urban 40 N/A 199141 MARIST ST. FRANCIS Urban 132 N/A 199142 SPICC Urban 297 N/A 199143 MANUMALO BAPTIST ACADEMY Urban 689 N/A 199145 ST. THERESA ELEM Urban 167 N/A 199148 IAKINA ADVENTIST ACADEMY (SDA) Urban 225 N/A 199149 NAZARETH MONTESORY Urban 70 N/A 199150 PACIFIC HORIZONS Urban 144 N/A 199151 KANANAFOU ELEM Urban 522 N/A 199152 SOUTH PACIFIC ACADEMY (SPA) Urban 227 N/A 199155 FA'ASAO MARIST HIGH Urban 290 N/A 199156 TAFUNA ELEM Urban 961 N/A 199157 SAMOA BAPTIST ACADEMY (HAPPY VALLEY) Urban 209 N/A 224617 JUVENILE DETENTION CENTER Urban 6 N/A 16044866 PETELI ACADEMY Urban 131 N/A 16058187 COLEMAN ECE (Pago Pago) Urban 125 N/A 16058189 MASEFAU ECE Urban 28 N/A 16058191 MAUGA O ALAVA ECE Urban 28 N/A 16058192 OLOSEGA ELEM Urban 43 N/A 16058212 A.P. LUTALI ECE Rural 10 N/A 16058214 AFONO ECE Urban 9 N/A 16058217 AUA ECE Urban 50 N/A 16058218 LE'ATELE ECE Urban 14 N/A 16058220 MATAFAO ECE Urban 58 N/A 16058465 LAULI'I ECE Urban 28 N/A 16062601 ALATAUA LUA ECE Urban 12 N/A 16062602 FAGA'ITUA ECE Urban 12 N/A 16062603 LAULI'I ELEM Urban 190 N/A 16062604 LUPELELE ECE Urban 110 N/A 16062606 OLOMOANA ECE Urban 10 N/A 16062607 SILIAGA ECE Urban 25 N/A 16055290 LEONE ECE Urban 115 N/A 16055291 TAU ECE Rural 15 N/A 17010302 TAFUNA ECE Urban 125 N/A 16055289 KANANAFOU HIGH SCHOOL Urban 136 N/A Page 4 BEN Name Urban/ Number of Students CEP Rural Students Count Based Percentage on Estimate 199119 LEONE HIGH SCHOOL Urban 848 N/A 17010594 PAVAIAI ECE Urban 55 N/A
Related School District NIFs School School District Name NIF BEN NIF Name District BEN 150224 AMERICAN SAMOA SEA 199154 FELETI BARSTOW PUBLIC LIBRARY 150224 AMERICAN SAMOA SEA 16063464 TESTING OFFICE 150224 AMERICAN SAMOA SEA 199137 SPECIAL EDUCATION 150224 AMERICAN SAMOA SEA 199153 DEPARTMENT OF EDUCATION 150224 AMERICAN SAMOA SEA 16037790 E-RATE OFFICE 150224 AMERICAN SAMOA SEA 16044865 SCHOOL LUNCH 150224 AMERICAN SAMOA SEA 16062608 WAREHOUSE 150224 AMERICAN SAMOA SEA 16055284 CHANCERY OFFICE 150224 AMERICAN SAMOA SEA 16055285 TEACHER QUALITY OFFICE 150224 AMERICAN SAMOA SEA 16055286 DOE LIBRARY 150224 AMERICAN SAMOA SEA 16055287 OFFICE OF CURRICULUM AND INSTRUCTION 150224 AMERICAN SAMOA SEA 16055288 TRANSPORTATION 150224 AMERICAN SAMOA SEA 16085198 JROTC 150224 AMERICAN SAMOA SEA 16085199 ATHLETICS OFFICE 150224 AMERICAN SAMOA SEA 16085202 ELEMENTARY OFFICE 150224 AMERICAN SAMOA SEA 16085204 DUAL LANGUAGE OFFICE 150224 AMERICAN SAMOA SEA 17010303 EARLY CHILDHOOD EDUCATION 150224 AMERICAN SAMOA SEA 17010592 ATHLETICS OFFICE #2 150224 AMERICAN SAMOA SEA 17010593 TEACHER QUALITY OFFICE #2
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 16014 12171 77.0% Urban 90% 85% 30%
Page 5 Funding Request for FRN #1799054427 Funding Request Nickname: Local Lines
Service Type: Voice
What is the FRN number from the previous 1699121953 year ?
Agreement Information - Contract Contract Number Account Number
User-entered Establishing FCC 190310001124783 Service Provider American Samoa Form 470# Telecommunications Authority IXC Division (SPN: 143002923) 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 14, 2013 Based on a multiple award No schedule? How many bids were received 2 for this contract? Includes Voluntary Extensions? No
What is the service start date? July 01, 2017 Remaining Voluntary Extensions
Total Remaining Contract Length
What is the date your contract June 30, 2018 expires for the current term of the contract?
Document Name Document Description
7 Local Contract.pdf
Pricing Confidentiality Is there a statute, rule, or other restriction which prohibits No publication of the specific pricing information for this contract?
263 local lines - please link child entity 17014866 to parent entity 150224 Narrative
Page 6 Line Item # 1799054427.001
Product and Service Details Function Voice
Type of Connection Local Phone Service Only
Cost Calculation for FRN Line Item # 1799054427.001
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $50.66 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 = $50.66 One-time Quantity x 0 Costs Monthly Quantity x 263 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $13,323.58 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $159,882.96 Total Eligible Recurring Costs = $159,882.96 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $159,882.96 Line Item Cost
Page 7 Recipients of Services BEN Name 199075 AFONO ELEM 199107 ALATAUA LUA/TAPUTAPU ELEM 199108 TUATOO TAUTALATASI ELEM 199109 AUA ELEM 199110 MATATULA ECE 199112 FAGA'ITUA HIGH SCHOOL 199113 FALEASAO ELEM 199116 FITIUTA ELEM 199117 A.P. LUTALI ELEM 199118 LE'ATELE ELEM 199121 LEONE MIDKIFF ELEM 199122 LUPELELE ELEM 199123 MANU'A HIGH SCHOOL 199124 MANULELE ELEM 199125 MATAFAO ELEM 199126 MATATULA ELEM 199127 MAUGA O ALAVA ELEM 199128 OLOMOANA ELEM 199129 OLOSEGA ECE 199130 COLEMAN ELEM (Pago Pago) 199131 PAVA'IA'I ELEM 199134 SAMOANA HIGH SCHOOL 199135 SILIAGA ELEM 199136 TAFUNA HIGH SCHOOL 199138 NU'UULI VOCATIONAL TECHNICAL HIGH SCHOOL 199139 MASEFAU ELEM 199140 MARY THE MOTHER 199141 MARIST ST. FRANCIS 199142 SPICC 199143 MANUMALO BAPTIST ACADEMY 199145 ST. THERESA ELEM 199148 IAKINA ADVENTIST ACADEMY (SDA) 199149 NAZARETH MONTESORY 199150 PACIFIC HORIZONS 199151 KANANAFOU ELEM 199152 SOUTH PACIFIC ACADEMY (SPA) 199155 FA'ASAO MARIST HIGH 199156 TAFUNA ELEM 199157 SAMOA BAPTIST ACADEMY (HAPPY VALLEY) 224617 JUVENILE DETENTION CENTER 16044866 PETELI ACADEMY 16058187 COLEMAN ECE (Pago Pago) 16058189 MASEFAU ECE 16058191 MAUGA O ALAVA ECE
Page 8 BEN Name 16058192 OLOSEGA ELEM 16058212 A.P. LUTALI ECE 16058214 AFONO ECE 16058217 AUA ECE 16058218 LE'ATELE ECE 16058220 MATAFAO ECE 16058465 LAULI'I ECE 16062601 ALATAUA LUA ECE 16062602 FAGA'ITUA ECE 16062603 LAULI'I ELEM 16062604 LUPELELE ECE 16062606 OLOMOANA ECE 16062607 SILIAGA ECE 16055290 LEONE ECE 16055291 TAU ECE 17010302 TAFUNA ECE 16055289 KANANAFOU HIGH SCHOOL 199119 LEONE HIGH SCHOOL 17010594 PAVAIAI ECE 16062608 WAREHOUSE 16055288 TRANSPORTATION 16063464 TESTING OFFICE 16055285 TEACHER QUALITY OFFICE 16055287 OFFICE OF CURRICULUM AND INSTRUCTION 16037790 E-RATE OFFICE 199137 SPECIAL EDUCATION 199153 DEPARTMENT OF EDUCATION 16044865 SCHOOL LUNCH 16055284 CHANCERY OFFICE 16055286 DOE LIBRARY 17010303 EARLY CHILDHOOD EDUCATION 16085198 JROTC 16085199 ATHLETICS OFFICE 16085202 ELEMENTARY OFFICE 16085204 DUAL LANGUAGE OFFICE 199154 FELETI BARSTOW PUBLIC LIBRARY 17010592 ATHLETICS OFFICE #2 17010593 TEACHER QUALITY OFFICE #2
Page 9 FRN Calculation for FRN #1799054427
Monthly Charges Total Requested Amount Total Monthly Recurring Charges $13,323.58 Total Eligible Pre-Discount $159,882.96 Total Monthly Ineligible Charges - $0.00 Recurring Charges Total Eligible Pre-Discount One- + $0.00 Total Monthly Eligible Charges = $13,323.58 Time Charges Total Number of Months of x 12 Total Pre-Discount Charges = $159,882.96 Service Discount Rate 30% Total Eligible Pre-Discount = $159,882.96 Recurring Charges Funding Commitment Request = $47,964.89
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 10 Funding Request for FRN #1799054437 Funding Request Nickname: Long Distance Lines
Service Type: Voice
What is the FRN number from the previous 1699121968 year ?
Agreement Information - Contract Contract Number Account Number
User-entered Establishing FCC 791690000948375 Service Provider AST Telecom LLC (SPN: Form 470# 143029520)
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 20, 2012 schedule?
How many bids were received 2 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, 2019 expires for the current term of the contract?
Document Name Document Description
7 Long Distance Contract.pdf
Pricing Confidentiality Is there a statute, rule, or other restriction which prohibits No publication of the specific pricing information for this contract?
341 long distance lines - please link child entity 17014866 to parent entity 150224 Narrative
Page 11 Line Item # 1799054437.001
Product and Service Details Function Voice
Type of Connection Long Distance Phone Service Only
Cost Calculation for FRN Line Item # 1799054437.001
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $8.13 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 = $8.13 One-time Quantity x 0 Costs Monthly Quantity x 341 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $2,772.33 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $33,267.96 Total Eligible Recurring Costs = $33,267.96 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $33,267.96 Line Item Cost
Page 12 Recipients of Services BEN Name 199075 AFONO ELEM 199107 ALATAUA LUA/TAPUTAPU ELEM 199108 TUATOO TAUTALATASI ELEM 199109 AUA ELEM 199110 MATATULA ECE 199112 FAGA'ITUA HIGH SCHOOL 199113 FALEASAO ELEM 199116 FITIUTA ELEM 199117 A.P. LUTALI ELEM 199118 LE'ATELE ELEM 199121 LEONE MIDKIFF ELEM 199122 LUPELELE ELEM 199123 MANU'A HIGH SCHOOL 199124 MANULELE ELEM 199125 MATAFAO ELEM 199126 MATATULA ELEM 199127 MAUGA O ALAVA ELEM 199128 OLOMOANA ELEM 199129 OLOSEGA ECE 199130 COLEMAN ELEM (Pago Pago) 199131 PAVA'IA'I ELEM 199134 SAMOANA HIGH SCHOOL 199135 SILIAGA ELEM 199136 TAFUNA HIGH SCHOOL 199138 NU'UULI VOCATIONAL TECHNICAL HIGH SCHOOL 199139 MASEFAU ELEM 199140 MARY THE MOTHER 199141 MARIST ST. FRANCIS 199142 SPICC 199143 MANUMALO BAPTIST ACADEMY 199145 ST. THERESA ELEM 199148 IAKINA ADVENTIST ACADEMY (SDA) 199149 NAZARETH MONTESORY 199150 PACIFIC HORIZONS 199151 KANANAFOU ELEM 199152 SOUTH PACIFIC ACADEMY (SPA) 199155 FA'ASAO MARIST HIGH 199156 TAFUNA ELEM 199157 SAMOA BAPTIST ACADEMY (HAPPY VALLEY) 224617 JUVENILE DETENTION CENTER 16044866 PETELI ACADEMY 16058187 COLEMAN ECE (Pago Pago) 16058189 MASEFAU ECE 16058191 MAUGA O ALAVA ECE
Page 13 BEN Name 16058192 OLOSEGA ELEM 16058212 A.P. LUTALI ECE 16058214 AFONO ECE 16058217 AUA ECE 16058218 LE'ATELE ECE 16058220 MATAFAO ECE 16058465 LAULI'I ECE 16062601 ALATAUA LUA ECE 16062602 FAGA'ITUA ECE 16062603 LAULI'I ELEM 16062604 LUPELELE ECE 16062606 OLOMOANA ECE 16062607 SILIAGA ECE 16055290 LEONE ECE 16055291 TAU ECE 17010302 TAFUNA ECE 16055289 KANANAFOU HIGH SCHOOL 199119 LEONE HIGH SCHOOL 17010594 PAVAIAI ECE 16062608 WAREHOUSE 16055288 TRANSPORTATION 16063464 TESTING OFFICE 16055285 TEACHER QUALITY OFFICE 16055287 OFFICE OF CURRICULUM AND INSTRUCTION 16037790 E-RATE OFFICE 199137 SPECIAL EDUCATION 199153 DEPARTMENT OF EDUCATION 16044865 SCHOOL LUNCH 16055284 CHANCERY OFFICE 16055286 DOE LIBRARY 17010303 EARLY CHILDHOOD EDUCATION 16085198 JROTC 16085199 ATHLETICS OFFICE 16085202 ELEMENTARY OFFICE 16085204 DUAL LANGUAGE OFFICE 199154 FELETI BARSTOW PUBLIC LIBRARY 17010592 ATHLETICS OFFICE #2 17010593 TEACHER QUALITY OFFICE #2
Page 14 FRN Calculation for FRN #1799054437
Monthly Charges Total Requested Amount Total Monthly Recurring Charges $2,772.33 Total Eligible Pre-Discount $33,267.96 Total Monthly Ineligible Charges - $0.00 Recurring Charges Total Eligible Pre-Discount One- + $0.00 Total Monthly Eligible Charges = $2,772.33 Time Charges Total Number of Months of x 12 Total Pre-Discount Charges = $33,267.96 Service Discount Rate 30% Total Eligible Pre-Discount = $33,267.96 Recurring Charges Funding Commitment Request = $9,980.39
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 15 Funding Request for FRN #1799054441 Funding Request Nickname: Cellular Voice Services
Service Type: Voice
What is the FRN number from the previous 1699121981 year ?
Agreement Information - Contract Contract Number Account Number
User-entered Establishing FCC 791690000948375 Service Provider AST Telecom LLC (SPN: Form 470# 143029520)
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 20, 2012 schedule?
How many bids were received 2 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, 2019 expires for the current term of the contract?
Document Name Document Description
7 Cellular Serv Contract.pdf
Pricing Confidentiality Is there a statute, rule, or other restriction which prohibits No publication of the specific pricing information for this contract?
75 cellular lines - please link child entity 17014866 to parent entity 150224 Narrative
Page 16 Line Item # 1799054441.001
Product and Service Details Function Voice
Type of Connection Cellular Voice with no Data and/or Text Messaging
Cost Calculation for FRN Line Item # 1799054441.001
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $163.52 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 = $163.52 One-time Quantity x 0 Costs Monthly Quantity x 75 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $12,264.00 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $147,168.00 Total Eligible Recurring Costs = $147,168.00 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $147,168.00 Line Item Cost
Page 17 Recipients of Services BEN Name 199075 AFONO ELEM 199107 ALATAUA LUA/TAPUTAPU ELEM 199108 TUATOO TAUTALATASI ELEM 199109 AUA ELEM 199110 MATATULA ECE 199112 FAGA'ITUA HIGH SCHOOL 199113 FALEASAO ELEM 199116 FITIUTA ELEM 199117 A.P. LUTALI ELEM 199118 LE'ATELE ELEM 199121 LEONE MIDKIFF ELEM 199122 LUPELELE ELEM 199123 MANU'A HIGH SCHOOL 199124 MANULELE ELEM 199125 MATAFAO ELEM 199126 MATATULA ELEM 199127 MAUGA O ALAVA ELEM 199128 OLOMOANA ELEM 199129 OLOSEGA ECE 199130 COLEMAN ELEM (Pago Pago) 199131 PAVA'IA'I ELEM 199134 SAMOANA HIGH SCHOOL 199135 SILIAGA ELEM 199136 TAFUNA HIGH SCHOOL 199138 NU'UULI VOCATIONAL TECHNICAL HIGH SCHOOL 199139 MASEFAU ELEM 199140 MARY THE MOTHER 199141 MARIST ST. FRANCIS 199142 SPICC 199143 MANUMALO BAPTIST ACADEMY 199145 ST. THERESA ELEM 199148 IAKINA ADVENTIST ACADEMY (SDA) 199149 NAZARETH MONTESORY 199150 PACIFIC HORIZONS 199151 KANANAFOU ELEM 199152 SOUTH PACIFIC ACADEMY (SPA) 199155 FA'ASAO MARIST HIGH 199156 TAFUNA ELEM 199157 SAMOA BAPTIST ACADEMY (HAPPY VALLEY) 224617 JUVENILE DETENTION CENTER 16044866 PETELI ACADEMY 16058187 COLEMAN ECE (Pago Pago) 16058189 MASEFAU ECE 16058191 MAUGA O ALAVA ECE
Page 18 BEN Name 16058192 OLOSEGA ELEM 16058212 A.P. LUTALI ECE 16058214 AFONO ECE 16058217 AUA ECE 16058218 LE'ATELE ECE 16058220 MATAFAO ECE 16058465 LAULI'I ECE 16062601 ALATAUA LUA ECE 16062602 FAGA'ITUA ECE 16062603 LAULI'I ELEM 16062604 LUPELELE ECE 16062606 OLOMOANA ECE 16062607 SILIAGA ECE 16055290 LEONE ECE 16055291 TAU ECE 17010302 TAFUNA ECE 16055289 KANANAFOU HIGH SCHOOL 199119 LEONE HIGH SCHOOL 17010594 PAVAIAI ECE 16062608 WAREHOUSE 16055288 TRANSPORTATION 16063464 TESTING OFFICE 16055285 TEACHER QUALITY OFFICE 16055287 OFFICE OF CURRICULUM AND INSTRUCTION 16037790 E-RATE OFFICE 199137 SPECIAL EDUCATION 199153 DEPARTMENT OF EDUCATION 16044865 SCHOOL LUNCH 16055284 CHANCERY OFFICE 16055286 DOE LIBRARY 17010303 EARLY CHILDHOOD EDUCATION 16085198 JROTC 16085199 ATHLETICS OFFICE 16085202 ELEMENTARY OFFICE 16085204 DUAL LANGUAGE OFFICE 199154 FELETI BARSTOW PUBLIC LIBRARY 17010592 ATHLETICS OFFICE #2 17010593 TEACHER QUALITY OFFICE #2
Page 19 FRN Calculation for FRN #1799054441
Monthly Charges Total Requested Amount Total Monthly Recurring Charges $12,264.00 Total Eligible Pre-Discount $147,168.00 Total Monthly Ineligible Charges - $0.00 Recurring Charges Total Eligible Pre-Discount One- + $0.00 Total Monthly Eligible Charges = $12,264.00 Time Charges Total Number of Months of x 12 Total Pre-Discount Charges = $147,168.00 Service Discount Rate 30% Total Eligible Pre-Discount = $147,168.00 Recurring Charges Funding Commitment Request = $44,150.40
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 20 Funding Request for FRN #1799054447 Funding Request Nickname: Fiber Circuits
Service Type: Data Transmission and/or Internet Access
What is the FRN number from the previous 1699122016 year ?
Agreement Information - Contract Contract Number Account Number
User-entered Establishing FCC 631700001321365 Service Provider American Samoa Form 470# Telecommunications Authority IXC Division (SPN: 143002923) Was an FCC Form 470 posted Yes for the product and/or services Based on State Master No you are requesting? Contract?
Award Date April 16, 2015 Based on a multiple award No schedule? How many bids were received 1 for this contract? Includes Voluntary Extensions? No
What is the service start date? July 01, 2017 Remaining Voluntary Extensions
Total Remaining Contract Length
What is the date your contract June 30, 2019 expires for the current term of the contract?
Document Name Document Description
7 WAN Contract.pdf
Pricing Confidentiality Is there a statute, rule, or other restriction which prohibits No publication of the specific pricing information for this contract?
78 circuits @1Gb - please link child entity 17014866 to parent entity 150224 Narrative
Page 21 Line Item # 1799054447.001
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 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 # 1799054447.001
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $775.24 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 = $775.24 One-time Quantity x 0 Costs Monthly Quantity x 78 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $60,468.72 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $725,624.64 Total Eligible Recurring Costs = $725,624.64 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $725,624.64 Line Item Cost
Page 22 Recipients of Services BEN Name 199075 AFONO ELEM 199107 ALATAUA LUA/TAPUTAPU ELEM 199108 TUATOO TAUTALATASI ELEM 199109 AUA ELEM 199110 MATATULA ECE 199112 FAGA'ITUA HIGH SCHOOL 199113 FALEASAO ELEM 199116 FITIUTA ELEM 199117 A.P. LUTALI ELEM 199118 LE'ATELE ELEM 199121 LEONE MIDKIFF ELEM 199122 LUPELELE ELEM 199123 MANU'A HIGH SCHOOL 199124 MANULELE ELEM 199125 MATAFAO ELEM 199126 MATATULA ELEM 199127 MAUGA O ALAVA ELEM 199128 OLOMOANA ELEM 199129 OLOSEGA ECE 199130 COLEMAN ELEM (Pago Pago) 199131 PAVA'IA'I ELEM 199134 SAMOANA HIGH SCHOOL 199135 SILIAGA ELEM 199136 TAFUNA HIGH SCHOOL 199138 NU'UULI VOCATIONAL TECHNICAL HIGH SCHOOL 199139 MASEFAU ELEM 199140 MARY THE MOTHER 199141 MARIST ST. FRANCIS 199142 SPICC 199143 MANUMALO BAPTIST ACADEMY 199145 ST. THERESA ELEM 199148 IAKINA ADVENTIST ACADEMY (SDA) 199149 NAZARETH MONTESORY 199150 PACIFIC HORIZONS 199151 KANANAFOU ELEM 199152 SOUTH PACIFIC ACADEMY (SPA) 199155 FA'ASAO MARIST HIGH 199156 TAFUNA ELEM 199157 SAMOA BAPTIST ACADEMY (HAPPY VALLEY) 224617 JUVENILE DETENTION CENTER 16044866 PETELI ACADEMY 16058187 COLEMAN ECE (Pago Pago) 16058189 MASEFAU ECE 16058191 MAUGA O ALAVA ECE
Page 23 BEN Name 16058192 OLOSEGA ELEM 16058212 A.P. LUTALI ECE 16058214 AFONO ECE 16058217 AUA ECE 16058218 LE'ATELE ECE 16058220 MATAFAO ECE 16058465 LAULI'I ECE 16062601 ALATAUA LUA ECE 16062602 FAGA'ITUA ECE 16062603 LAULI'I ELEM 16062604 LUPELELE ECE 16062606 OLOMOANA ECE 16062607 SILIAGA ECE 16055290 LEONE ECE 16055291 TAU ECE 17010302 TAFUNA ECE 16055289 KANANAFOU HIGH SCHOOL 199119 LEONE HIGH SCHOOL 17010594 PAVAIAI ECE 16062608 WAREHOUSE 16055288 TRANSPORTATION 16063464 TESTING OFFICE 16055285 TEACHER QUALITY OFFICE 16055287 OFFICE OF CURRICULUM AND INSTRUCTION 16037790 E-RATE OFFICE 199137 SPECIAL EDUCATION 199153 DEPARTMENT OF EDUCATION 16044865 SCHOOL LUNCH 16055284 CHANCERY OFFICE 16055286 DOE LIBRARY 17010303 EARLY CHILDHOOD EDUCATION 16085198 JROTC 16085199 ATHLETICS OFFICE 16085202 ELEMENTARY OFFICE 16085204 DUAL LANGUAGE OFFICE 199154 FELETI BARSTOW PUBLIC LIBRARY 17010592 ATHLETICS OFFICE #2 17010593 TEACHER QUALITY OFFICE #2
Page 24 FRN Calculation for FRN #1799054447
Monthly Charges Total Requested Amount Total Monthly Recurring Charges $60,468.72 Total Eligible Pre-Discount $725,624.64 Total Monthly Ineligible Charges - $0.00 Recurring Charges Total Eligible Pre-Discount One- + $0.00 Total Monthly Eligible Charges = $60,468.72 Time Charges Total Number of Months of x 12 Total Pre-Discount Charges = $725,624.64 Service Discount Rate 90% Total Eligible Pre-Discount = $725,624.64 Recurring Charges Funding Commitment Request = $653,062.18
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 25 Funding Request for FRN #1799054450 Funding Request Nickname: IA @50Mb
Service Type: Data Transmission and/or Internet Access
What is the FRN number from the previous 1699122030 year ?
Agreement Information - Contract Contract Number Account Number
User-entered Establishing FCC 791690000948375 Service Provider American Samoa Form 470# Telecommunications Authority IXC Division (SPN: 143002923) 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 20, 2012 Based on a multiple award No schedule? How many bids were received 2 for this contract? Includes Voluntary Extensions? No
What is the service start date? July 01, 2017 Remaining Voluntary Extensions
Total Remaining Contract Length
What is the date your contract June 30, 2019 expires for the current term of the contract?
Document Name Document Description
7 ISP 50Mbps Contract.pdf
Pricing Confidentiality Is there a statute, rule, or other restriction which prohibits No publication of the specific pricing information for this contract?
IA @50Mb - please link child entity 17014866 to parent entity 150224 Narrative
Page 26 Line Item # 1799054450.001
Product and Service Details Internet access service with no circuit (data circuit to ISP state/regional network is billed Purpose separately)
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, No libraries and NIFs (i.e., a connection that provides a “Wide area network”)?
Is this a direct connection to a single school, Yes library or a NIF for Internet access?
Cost Calculation for FRN Line Item # 1799054450.001
Monthly Cost One-Time Cost Monthly Recurring Unit Cost $61,500.00 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 = $61,500.00 One-time Quantity x 0 Costs Monthly Quantity x 1 Total Eligible One-time Costs = $0.00 Total Monthly Eligible Recurring = $61,500.00 Costs Summary Months of Service x 12 Total Eligible Recurring Costs $738,000.00 Total Eligible Recurring Costs = $738,000.00 Total Eligible One-time Costs + $0.00 Pre-Discount Extended Eligible = $738,000.00 Line Item Cost
Page 27 Recipients of Services BEN Name 199075 AFONO ELEM 199107 ALATAUA LUA/TAPUTAPU ELEM 199108 TUATOO TAUTALATASI ELEM 199109 AUA ELEM 199110 MATATULA ECE 199112 FAGA'ITUA HIGH SCHOOL 199113 FALEASAO ELEM 199116 FITIUTA ELEM 199117 A.P. LUTALI ELEM 199118 LE'ATELE ELEM 199121 LEONE MIDKIFF ELEM 199122 LUPELELE ELEM 199123 MANU'A HIGH SCHOOL 199124 MANULELE ELEM 199125 MATAFAO ELEM 199126 MATATULA ELEM 199127 MAUGA O ALAVA ELEM 199128 OLOMOANA ELEM 199129 OLOSEGA ECE 199130 COLEMAN ELEM (Pago Pago) 199131 PAVA'IA'I ELEM 199134 SAMOANA HIGH SCHOOL 199135 SILIAGA ELEM 199136 TAFUNA HIGH SCHOOL 199138 NU'UULI VOCATIONAL TECHNICAL HIGH SCHOOL 199139 MASEFAU ELEM 199140 MARY THE MOTHER 199141 MARIST ST. FRANCIS 199142 SPICC 199143 MANUMALO BAPTIST ACADEMY 199145 ST. THERESA ELEM 199148 IAKINA ADVENTIST ACADEMY (SDA) 199149 NAZARETH MONTESORY 199150 PACIFIC HORIZONS 199151 KANANAFOU ELEM 199152 SOUTH PACIFIC ACADEMY (SPA) 199155 FA'ASAO MARIST HIGH 199156 TAFUNA ELEM 199157 SAMOA BAPTIST ACADEMY (HAPPY VALLEY) 224617 JUVENILE DETENTION CENTER 16044866 PETELI ACADEMY 16058187 COLEMAN ECE (Pago Pago) 16058189 MASEFAU ECE 16058191 MAUGA O ALAVA ECE
Page 28 BEN Name 16058192 OLOSEGA ELEM 16058212 A.P. LUTALI ECE 16058214 AFONO ECE 16058217 AUA ECE 16058218 LE'ATELE ECE 16058220 MATAFAO ECE 16058465 LAULI'I ECE 16062601 ALATAUA LUA ECE 16062602 FAGA'ITUA ECE 16062603 LAULI'I ELEM 16062604 LUPELELE ECE 16062606 OLOMOANA ECE 16062607 SILIAGA ECE 16055290 LEONE ECE 16055291 TAU ECE 17010302 TAFUNA ECE 16055289 KANANAFOU HIGH SCHOOL 199119 LEONE HIGH SCHOOL 17010594 PAVAIAI ECE 16062608 WAREHOUSE 16055288 TRANSPORTATION 16063464 TESTING OFFICE 16055285 TEACHER QUALITY OFFICE 16055287 OFFICE OF CURRICULUM AND INSTRUCTION 16037790 E-RATE OFFICE 199137 SPECIAL EDUCATION 199153 DEPARTMENT OF EDUCATION 16044865 SCHOOL LUNCH 16055284 CHANCERY OFFICE 16055286 DOE LIBRARY 17010303 EARLY CHILDHOOD EDUCATION 16085198 JROTC 16085199 ATHLETICS OFFICE 16085202 ELEMENTARY OFFICE 16085204 DUAL LANGUAGE OFFICE 199154 FELETI BARSTOW PUBLIC LIBRARY 17010592 ATHLETICS OFFICE #2 17010593 TEACHER QUALITY OFFICE #2
Page 29 FRN Calculation for FRN #1799054450
Monthly Charges Total Requested Amount Total Monthly Recurring Charges $61,500.00 Total Eligible Pre-Discount $738,000.00 Total Monthly Ineligible Charges - $0.00 Recurring Charges Total Eligible Pre-Discount One- + $0.00 Total Monthly Eligible Charges = $61,500.00 Time Charges Total Number of Months of x 12 Total Pre-Discount Charges = $738,000.00 Service Discount Rate 90% Total Eligible Pre-Discount = $738,000.00 Recurring Charges Funding Commitment Request = $664,200.00
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 30 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 1.00 Download Speed Units Gbps
Upload Speed 1.00 Upload Speed Units Gbps
Per Entity Basis Questions Entity Name AMERICAN SAMOA SEA Entity Number 150224 BEN Entity Name Download Units Upload Units Connection Wifi Barriers Sufficient to Robust Network 199075 AFONO ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199107 ALATAUA LUA/TAPUTAPU ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199108 TUATOO TAUTALATASI ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199109 AUA ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199110 MATATULA ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199112 FAGA'ITUA HIGH SCHOOL 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199113 FALEASAO ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199116 FITIUTA ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199117 A.P. LUTALI ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199118 LE'ATELE ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199121 LEONE MIDKIFF ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199122 LUPELELE ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199123 MANU'A HIGH SCHOOL 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199124 MANULELE ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199125 MATAFAO ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199126 MATATULA ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199127 MAUGA O ALAVA ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199128 OLOMOANA ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199129 OLOSEGA ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199130 COLEMAN ELEM (Pago Pago) 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199131 PAVA'IA'I ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199134 SAMOANA HIGH SCHOOL 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199135 SILIAGA ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199136 TAFUNA HIGH SCHOOL 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199138 NU'UULI VOCATIONAL TECHNICAL HIGH 1.00 Gbps 1.00 Gbps Fiber Sometimes Other SCHOOL 199139 MASEFAU ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199140 MARY THE MOTHER 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199141 MARIST ST. FRANCIS 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199142 SPICC 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199143 MANUMALO BAPTIST ACADEMY 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199145 ST. THERESA ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199148 IAKINA ADVENTIST ACADEMY (SDA) 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199149 NAZARETH MONTESORY 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199150 PACIFIC HORIZONS 1.00 Gbps 1.00 Gbps Fiber Sometimes Other Page 31 BEN Entity Name Download Units Upload Units Connection Wifi Barriers Sufficient to Robust Network 199151 KANANAFOU ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199152 SOUTH PACIFIC ACADEMY (SPA) 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199155 FA'ASAO MARIST HIGH 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199156 TAFUNA ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199157 SAMOA BAPTIST ACADEMY (HAPPY VAL 1.00 Gbps 1.00 Gbps Fiber Sometimes Other LEY) 224617 JUVENILE DETENTION CENTER 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16044866 PETELI ACADEMY 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16058187 COLEMAN ECE (Pago Pago) 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16058189 MASEFAU ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16058191 MAUGA O ALAVA ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16058192 OLOSEGA ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16058212 A.P. LUTALI ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16058214 AFONO ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16058217 AUA ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16058218 LE'ATELE ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16058220 MATAFAO ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16058465 LAULI'I ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16062601 ALATAUA LUA ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16062602 FAGA'ITUA ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16062603 LAULI'I ELEM 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16062604 LUPELELE ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16062606 OLOMOANA ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16062607 SILIAGA ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16055290 LEONE ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16055291 TAU ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 17010302 TAFUNA ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 16055289 KANANAFOU HIGH SCHOOL 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 199119 LEONE HIGH SCHOOL 1.00 Gbps 1.00 Gbps Fiber Sometimes Other 17010594 PAVAIAI ECE 1.00 Gbps 1.00 Gbps Fiber Sometimes Other
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 $1,803,943.56 471 Total funding commitment request amount on this FCC Form 471 $1,419,357.86 Total applicant non-discount share of the eligible amount $384,585.70
Page 32 Total budgeted amount allocated to resources not eligible for E-rate $775,075.00 support Total amount necessary for the applicant to pay the non-discount $1,159,660.70 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 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.
Page 33 Authorized Person Title: State E-rate Coordinator Name: Lydia Amisone
Phone: 684-633-7924 Email: [email protected]
Address: P. O. BOX DOE PAGO PAGO AS 96799 Employer: Lydia Amisone
28-Apr-2017 17:41:11 EDT Certified Timestamp
Page 34