Comprehensive Community Infrastructure Application

BROADBAND TECHNOLOGY OPPORTUNITIES PROGRAM

OMB Control No. 0660-0031

Comprehensive Community Infrastructure Application

Purpose: The following document outlines the current draft of Round 2 Comprehensive Community Infrastructure Application. This document sequentially outlines each question in the application as indicated in the Easygrants system.

Comprehensive Community Infrastructure Application

PRA Notice and Disclosure Statement prior to Acknowledgement Page

Section One: Acknowledgement

Before applying, applicants should fully read the Notice of Funds Availability (“NOFA”) and Grant Guidelines for Round 2 of BTOP funding. Among other things, applicants should be familiar with the following rules and requirements:

• Applicants who are current RUS loan or grant or whose project will include one or more last mile service areas that are 75% or more rural are strongly advised to apply to the Rural Utility Service’s Broadband Initiatives Program instead of BTOP.

• If an applicant fails to submit a fully complete application, including all required supplemental materials, or fails to provide at a 20% cost share or request a waiver, the application will not be reviewed or considered for an award.

• Applicants must commit to substantially completing their project within two years after the issuance of the grant, and to finishing the project within three years.

• Applicants must successfully demonstrate that the project could not be implemented without federal grant assistance.

• All Comprehensive Community Infrastructure applicants must propose to offer service meeting the definition of broadband established in the NOFA.

• All Comprehensive Community Infrastructure applicants must comply with the nondiscrimination and interconnection requirements established in the NOFA.

• All Comprehensive Community Infrastructure applicants whose project will include a last mile service area must provide service to the entire service area, unless they have requested a waiver of this requirement.

• All Comprehensive Community Infrastructure applicants must have at least one last mile or middle mile service area which is unserved or underserved as defined in the NOFA. Also, every last mile service area must be unserved or underserved as defined in the NOFA.

• Applicants may receive funding only for costs established in the NOFA as eligible costs for the appropriate project category.

• Applicants receiving awards will be subject to quarterly federal reporting requirements and other post-award regulations as specified in the NOFA.

• IMPORTANT NOTICE: Some of the elements in this application will be made publicly accessible through the application database available at http://www.broadbandusa.gov per Section VI. D. of the NOFA. As stated in the NOFA, those elements of the application that will be publicly displayed are: 1) the identity of the applicant and general applicant and project information; 2) an executive summary of the project; 3) information regarding the proposed funded service area; and 4) the federal grant request and cost match. Thus, NTIA will make the following information in the application publicly available: 1) the name and location of the applicant organization; 2) the name, phone number, and email address of the primary point of contact; 3) the project title and description; 4) the executive summary; 5) the total federal grant request and total match amount; and 6) the states in which the project will provide service.

• Please check the box below to acknowledge that you have read the above notices as well as the applicable rules in the NOFA governing this program.

Section Two: Contact Information

Applicant is required to provide the name and contact Information of the person to be contacted on matters involving this application.

Contact

• Name

• Prefix

• First

• Middle

• Last

• Suffix

• Title

• Phone/Fax

  • (Select if) Primary

  • Type

  • Phone Number

  • Extension

• Email

  • (Select if) Primary

  • Type

  • Email Address

Section Three: Additional Contacts

Applicant is required to add information for an additional person of contact.

Other Grant Projects Contact

• Name

  • Prefix

  • First

  • Middle

  • Last

  • Suffix

• Project Role

Applicant is required to select:

• Secondary POC

• Other Contact

• Phone

  • Extension

• Email (Business)

Section Four: Organization Information

Applicant is required to enter the DUNS number for the organization applying for the grant.

Organization Information

• DUNS Number (Lookup function)

• CCR Lookup Status

• DUNS Cage Number

• DUNS and CCR Lookup Status will populate the following:

  • Legal Business Name

  • Point of Contact (POC)

  • Alternate POC

  • Electronic Business POC

  • Alternate Electronic Business POC

*Applicant is required to confirm the information provided above*

Environmental Point of Contact

• Checklist for “Primary”

• Name

• Prefix

• First

• Middle

• Last

• Suffix

• Title

• Phone

  • Extension

Additional Organization Information

• Type of organization: (Drop down menu of different types of organizations. Applicant is required to select)

  • State or State Agency

  • County Government

  • City or Township Government

  • District of Columbia

  • US Territory

  • Indian Tribe

  • Non-profit Corporation

  • Non-profit Foundation

  • Non-profit Institution

  • Non-profit Association

• Is the organization a small business? (Drop Down Yes/No)

• Does the organization meet the definition of a socially and economically disadvantaged small business concern? (Drop Down Yes/No)

• National American Industry Classification System (NAICS) Code

Section Five: Authorization

Applicant is required to input the following information.

Authorized Organizational Representative

• AOR list

• First Lame

• Last Name

• Email

*Applicant is required to confirm the information listed above*

Section Six: Project Information Section

Applicant is required to identify the following:

Project Description

Applicant is required to provide the following:

• Project Title

• Project Description

CCI Priority Checklist

Applicant is required to check all that apply

• This project will deploy Middle Mile broadband infrastructure to community anchor institutions.

• The project will deploy Middle Mile broadband infrastructure and has incorporated a public-private partnership among government, non-profit and for-profits entities, and other key community stakeholders.

• This project will deploy Middle Mile broadband infrastructure in economically distressed areas.

• This project will deploy Middle Mile broadband infrastructure to community colleges.

• This project will deploy Middle Mile broadband infrastructure to public safety entities.

• This project will deploy Middle Mile broadband infrastructure and either includes a Last Mile infrastructure component in unserved or underserved areas or has received commitments from one or more Last Mile broadband service providers to utilize the Middle Mile components. Any Last Mile components in rural areas do not exceed 20% of the total eligible costs of the project.

• This project will deploy Middle Mile broadband infrastructure and Applicant has proposed to contribute 30% or more in non-federal cost match.

(Essay) Fit with BTOP CCI Priorities: With respect to each box on the BTOP CCI Priority Checklist that you checked, please describe how and to what extent the project meets or exceeds the objectives of that priority.

Comprehensive Community Infrastructure Components

Applicant is required to check if the project includes at least one of the following components. Applicants are given the option to check as many as apply.

• Middle Mile

• Last Mile Rural

• Last Mile Non-Rural

BIP Applicants

Applicant is required to identify the following:

• Have you also applied to BIP for funding in the same proposed funded service area?

• If yes, please provide the project title and Easygrants ID number:

• Title of BIP application

• Easygrants ID

Other Applications

• Is this application being submitted in coordination with any other application being submitted during this round of funding, or with an application that received an award in the previous round of funding? (Yes/No)

Applicant is required to enter the EasyGrant ID and Project Title of any other applications that are being submitted in coordination with this one during this round of funding.

• Easygrants ID

• Project Title

• If YES, please explain any synergies and/or dependencies between this project and any other applications.

  • (Essay) Describe how the projects are related, and detail any synergies created by the projects. Also note and dependencies this application may have on other applications and explain what contingency plans, if any, you have in the event the other project does not receive an award.

Individual Background Screening

Applicant is required to identify the following:

• Is Applicant exempt from the Department of Commerce requirements regarding individual background screening in connection with any award resulting from this application? (Select One)

• Yes, Applicant is exempt because it is an accredited college or university

• Yes, Applicant is exempt because it is a unit of a state or local government

• Yes, Applicant is exempt because it is an Economic Development District (EDD) designated by the Department of Commerce Economic Development Administration, has an EDD designation pending, or is a council of governments

• No, Applicant is subject to these requirements

• If the answer to the above question is “No,” please identify each key individual associated with Applicant who would be required to complete Form CD-346, “Applicant for Funding Assistance,” in connection with any award resulting from this Application:

• Name

• Title

• Employer

Executive Summary, Project Purpose, and Benefits

Applicant is required to answer the following:

• (Essay) Executive Summary of the proposed project: Please provide an Executive Summary of the Proposed Project. The Executive Summary should be a brief description of the Project, and address the following topics:

1. Opportunity the proposed system seeks to address

2. A general description of the proposed funded service areas (location, number of communities, etc.)

3. Number of households and businesses passed

4. Number of community anchor institutions, public safety entities, and critical community organizations passed and/or involved with project (e.g., health care, education, libraries, etc.)

5. Proposed services and applications for the proposed funded service areas and users

6. Approach to addressing the non-discrimination and interconnection obligations

7. Type of broadband system that will be deployed (network type and technology standard)

8. Qualifications of Applicant that demonstrate the ability to implement and operate a broadband infrastructure, and/or be a sustainable broadband service provider

9. Overall infrastructure cost of the broadband system

10. Overall expected subscriber projections for the project

11. Number of jobs estimated to be created or saved as a result of this project

• (Essay) Description of BTOP Project Purpose: Describe the purpose of the project and how it supports the statutory objectives of the BTOP program (as set forth above). Please include information to support your assumptions relative to the following. [Two Page Limit]
  1. Project addresses compelling problem or presents an opportunity consistent with the BTOP statutory goals
  2. Project offers an effective solution to that problem or addresses the opportunity
  3. Proposed solution demonstrates broad significance and includes developments that can be replicated to improve future projects
  4. The extent to which the project would produce synergies with a BTOP project funded in Round 1, or an application for Round 2 in another project category (PCC or SBA)
  5. The extent to which the project addresses multiple statutory purposes

• (Essay) Recovery Act and Other Governmental Collaboration: Describe how your project will leverage Recovery Act or other state or federal development programs such as Department of Energy, Department of Transportation and Department of Housing and Urban Development Recovery Act programs. Please identify the programs themselves and the dollar value of those programs. In addition, specify how collaboration can lead to greater project efficiencies.

• Is Applicant seeking a waiver of the Buy American provision pursuant to section X.Q of the NOFA? (Yes/No)

  • (Essay) If YES, Applicant is required to add additional information in the waiver document located in the “Uploads” section of the application, that will ask the following:

    • Specify the broadband equipment, facilities, or goods for which you are seeking a waiver. Also, provide statutory exemption upon which waiver request relies and rationale for receiving a waiver.

• Are you seeking a waiver of any requirement set forth in the NOFA that is not mandated by statute or applicable law? (Yes/No)

  • If YES, Applicant is required to add additional information in the waiver document located in the “Uploads” section of the application that will ask the following:

    • Explain the requirement and section of the NOFA that you are seeking relief from, the extraordinary circumstances presented, and why it is in the best interest of the federal government to grant your requested relief.

• Is Applicant delinquent on any federal debt? (Yes/No)

  • (Essay) If YES, please provide your justification for delinquency.

• Is Applicant a current or past RUS Title II borrower? (Yes/No)

• If Applicant and any proposed award subrecipients have an FCC Universal Service Fund Service Provider (SPIN), please provide such numbers.

Section Seven: Partners

Partners

• Are you partnering with any other key institutions, organizations, or other entities for this project? (Yes/No)

• If YES, a letter of commitment from all key partner(s) will be required. Upload all letters of commitment in the “Uploads” section of the application. If YES, please add your key partners below and provide the requested information.

  • Prefix

  • First

  • Middle

  • Last

  • Suffix

  • Title

  • Organization

  • Project Role

    • Contractor

    • Sub-recipient

    • Third party in-kind contributor

    • Other

  • Address 1

  • Address 2

  • Address 3

  • City

  • State/Province

  • Zip/Postal Code

  • Region

  • Country

  • Phone (Business)

  • Extension

  • E-mail (Business)

• Applicant is required to identify the type of organization for their partner: (Drop down menu of different types of organizations Applicant is required to select)

  • State or State Agency

  • County Government

  • City or Township Government

  • District of Columbia

  • US Territory

  • Indian Tribe

  • Non-profit Corporation

  • Non-profit Foundation

• Applicant is required to identify if their partner is:

  • Whether key partner(s)is a small business (Drop Down Yes/No)

  • Whether key partner(s) meets the definition of a socially and economically disadvantaged small business concern (Drop Down Yes/No)

Partners Description

• Please provide a description of the involvement of the partners listed above in the project.

(Essay) Project Partnerships: If applicable, describe the roles of the project partners, including any contributions to funding, planning, implementing, managing, or operating the proposed network. Please clarify any potential benefits that the partners will receive from the project (e.g. free or discounted access to dark fiber). Also discuss the project’s general approach to involving local communities in the project area. You will be asked to provide letters of commitment or support from key partners in the upload section.

Section Eight: Congressional Districts

Applicant is required to identify the following:

Congressional Districts

• Applicant Headquarters

• Project Service States (All 50 states available for selection)

• Project Service Areas (Pre-populated with Congressional Districts from states selected above)

• Will any portion of your proposed project serve federally recognized tribal entities? (Yes/No)

• Indicate each federally recognized tribal entity your proposed project will serve (List of Tribal Entities based on Project service areas selected above)

• Have you consulted with each of the federally recognized tribal entities identified above? (Yes/No)

Section Nine: Service Area Details

Applicant is required to identify the following:

Project Information

• Is Applicant is seeking a waiver for providing less than 100% coverage of a last mile service area pursuant to section V.D.3 of the NOFA?. (Yes/No). If YES, you will be required to provide supporting documentation.

Applicant will be required to fill out this question in the waiver document located in the “Uploads” section of the application, that will ask Applicant the following: Explain why providing service or coverage for the entire last mile service area is extremely burdensome, including whether there are any legal, technical, or financial impediments.

Applicant is required to add the following information for each service details.

Project Details

Project Details

• Service Area Type

• Last Mile

• Middle Mile

• Service Area Name

• Community Name

• Rural Classification of the Last Mile Service Area

• Rural

• Non-Rural

• Service Status of the Last Mile Service Area

• Unserved

• Underserved

• If Service Status is “Underserved” please select at least one applicable option from this list.

• No more than 50% of the households in the proposed funded service area have access to facilities-based, terrestrial broadband service at greater than the minimum broadband transmission speed;

• No fixed or mobile broadband service provider advertises broadband transmission speeds of at least 3 mbps downstream in the proposed funded service area;

• The rate of broadband subscribership for the proposed funded service area is 40% of households or less.

• Applicant is required to identify: Estimated Percentage of Households with Access to Broadband

• Applicant is required to identify: Estimated Percentage of Households Subscribing to Broadband

• Applicant is required to identify: Total Square Miles in Service Area

• Applicant is required to identify: Total Population in Proposed Service Area

• Applicant is required to identify: Total Number of Households in Service Area

• Applicant is required to identify: Total Number of Businesses in Service Area

• Applicant is required to identify: Total Number of Community Anchor Institutions and Public Safety Entities in Proposed Funded Service Area

• Applicant is required to identify: Unemployment Rate in the Service Area

• Applicant is required to identify: Median Income in the Service Area

Section Ten: Community Anchor Summary

Applicant is required to identify the number of Community Anchor Institutions for the following:

Community Anchor Institution

• Schools (k-12)

• Libraries

• Medical and Healthcare Providers

• Public Safety Entities

• Community Colleges

• Other Institutions of Higher Education

• Other Community Support Organization

• Public Housing

• Other Government Facilities

• Historically Black Colleges and Universities

• Tribal Colleges and Universities

• Alaska Native Serving Institutions

• Hispanic Serving Institutions

• Native Hawaiian Serving Institutions

Total Community Anchor Institutions

Minority Serving Institutions

• Historically Black Colleges and Universities

• Tribal Colleges and Universities

• Alaska Native Serving Institutions

• Hispanic Serving Institutions

• Native Hawaiian Serving Institutions

Total Minority Serving Institutions

Section Eleven: Project Benefits

Applicant is required to provide the following information.

Demographics

Please provide estimates of the number of job-years created by this program. Refer to the Council of Economic Advisor’s guide to job creation estimates http://www.whitehouse.gov/administration/eop/cea/Estimate-of-job-creation for definitions and background. You may deviate from the guidance for job creation estimates provided therein if you have sound reason to believe that you can provide a more accurate estimate of job creation by another methodology.

• How many direct job-years will be created from this project?

• How many indirect jobs will be created from this project?

• How many jobs will be induced from this project?

• (Essay) Methodology: Please describe the methodology employed to produce the job-years estimates provided above. If you utilized the methodology suggested by the Council of Economic Advisors, please note that.

• (Essay)Project Impact/Middle Mile Benefits: Identify the last mile service areas for which your middle mile project will provide service. List the service providers with whom the proposed network proposes to interconnect with as well as the critical community facilities, community anchor institutions and public safety entities that the network will target as direct customers. Please provide the projected end-users that will be served by these proposed connections and the basis for these end-user projections. If applicable, describe the level of need or vulnerability and how such connections will enhance services to the community beyond providing broadband service.

• (Essay) Level of Need: Please discuss the degree of need for the proposed network in the proposed funded service area. Include discussion of the competitive landscape in the area for comparable services to those to be offered by the proposed network, as well as any pertinent details regarding the current broadband infrastructure in the area. Describe variations among service areas if there are any. If there are existing service providers already present in all or part of the area, explain what needs the existing services are failing to meet that the proposed project will address (i.e. what value-add the proposed network will provide). Applicants may also wish to discuss the proportion of the proposed funded service area that qualifies as unserved or underserved, as well as the general economic conditions in the proposed funded service area.

Section Twelve: Technology Detail

Applicant is required to provide the following information.

Technology Feasibility

• Indicate the technology that will be used to deliver last mile services (check all that apply).

• Wireline – xDSL

• Wireline – Coaxial Cable

• Wireline – Fiber-optic Cable

• Wireline – Broadband Over Power Line

• Wireline – Hybrid System

• Wireless – Terrestrial Fixed

• Wireless – Terrestrial Mobile

• Wireless – Satellite

• Other

• If Other or Hybrid System, enter text

Technology Questions

• (Essay) Methodology for Area Status: Methodology for Area Status: Describe the methodology, source of data, and analytical approaches used to determine whether the proposed funded service areas are classified as “unserved” or “underserved” [Limit One page]

• (Essay) Description of Network Openness: Please explain how the proposed project will be consistent with the NOFA’s non-discrimination and network interconnection obligations. If Applicant will not be solely responsible for operating the network, please clarify which entity or entities will be responsible for upholding the nondiscrimination and interconnection obligations. In addition, describe the interconnection, nondiscrimination, and network management practices that would be adopted if you are awarded BTOP funds. If any responsible entity is not a commercial service provider, briefly describe that entity’s operational ability to meet BTOP’s interconnection obligations.

• (Essay) System Design: Provide a description of the system design used to deliver the broadband service. Please address and provide sufficient detail for a reviewer to evaluate the soundness of the design:

• Discuss the key network components, from end-users to the network’s primary Internet Point(s) of Presence (POP)—noting which network components already exist and which would be added by the proposed project.

• Describe the proposed network’s centralized facilities and points of interconnection.

• For wireless access, state the frequency, how much spectrum is available, technology used, morphology of the area, topology of the area, power levels at the user devices, whether or not mobile

• Specific advantages for using this particular technology strategy, taking into account service offering capacity, speed, reliability, and cost effectiveness

• Paths to upgrade the system and add additional capabilities in the future

• Is Applicant seeking a waiver pursuant to the Section IX.C of the NOFA so as to sell or lease portions of the award-funded broadband facilities during their life? (YES/NO)

• IF YES, Applicant is required to answer the following question in the waiver document located in the “Uploads” section of the application: Explain whether the transaction would be for adequate consideration and why the transaction would be in the best interests of those served by the project.

Section Thirteen: Project Budget

Applicant is required to provide the following information.

Project Budget (Two columns: Federal Grant Request and Match)

• Last Mile

• Middle Mile

• Total

• Project Budget Total (Autocalculated by entries above)

• Match Percent (Autocalculated by entries above)

• (Essay) Projects Outside the Recommended Funding Range: If this total project budget is above or below the project size range recommended in the NOFA ($5 million - $150 million), please provide a reasoned explanation for this variance from the recommended range.

Outside Leverage

• Applicant is providing matching funds of at least 20% or more towards the total eligible project costs. (Yes/No, applying for a waiver)

  • If NO, Applicant will be required to supply additional information in the waiver document located in the “Uploads” section of the application, that will ask the following:

    • (Essay) Explain inability, based on financial need, to provide the required 20% share of the cost of the proposed project (see section V.C of the NOFA).

• (Essay) Matching Cost Detail: Please provide a detailed account of all matching costs for this project. For cash matches provide: a) the name of the party providing the match, b) the funding amount (and percentage of the total budget it represents), c) the type of funding (e.g. grant match, equity, debt, internal, other), d) the use of the funding (e.g. infrastructure, working capital, operating losses, and e) any key financing terms and conditions. For in-kind matches, provide: a) the name of the party providing the match, b) the match value (and percentage of the total budget it represents), c) the nature of the in-kind contribution, d) an explanation of how the contribution qualifies as an eligible cost under BTOP eligible cost rules, and e) if the contributor is not the applicant, a description of any benefits the contributor will derive from the project (e.g. free or discounted access to the network).

• (Essay) Unjust Enrichment: Please state whether this project is receiving or if you have applied for any Federal support for non-recurring costs in the area for which you are seeking an award. If so, please state how much and from which federal program.

• (Essay) Disclosure of Federal and/or State Funding Sources: Disclose the source and amount of other federal or state funding including, but not limited to all Universal Service funds, Applicant has received or has requested for activities or projects to which the application relates.

• (Essay) Reasonableness: Concisely and convincingly explain why the unit price and total number of units required for this project are reasonable to deliver your proposed services in the designated proposed funded service areas. Provide any relevant data and summaries of your analysis (e.g., industry benchmarks around units required per household or institutions served, etc.). If your project includes a last mile component, and the cost per household for this component is $10,000 per household or greater, your response to this question MUST include a justification for this per household cost.

• (Essay) Demonstration of Need: Please explain the reasons why the project would not have been implemented without federal assistance, and why the particular level of federal assistance requested is appropriate. The response should incorporate the data provided in the Net Present Value Analysis upload, and should include discussion of what discount rate is most appropriate to evaluate this project.

Funds to States/Territories

• Applicant is required to fill in the Amount of Federal Grant Request per state/territory Applicant proposes to serve.

Section Fourteen: Historical Financials

Applicant is required to identify Historical Financials for 2007, 2008, and 2009 for the following categories:

• Revenue

• Expenditures

• Net Assets

• Change in Net Assets from Prior Year

• Bond Rating (if applicable)

Section Fifteen: Project Readiness

Applicant is required to identify the following:

Project Readiness

• (Essay) Licenses, Regulatory Approvals and Agreements: Please list all of the licenses and regulatory approvals required to implement and operate the proposed project, and indicate the status of each. Please address the following if relevant; [sic] Tower Leases, Equipment Leases, Building Leases, Land Leases, FCC Authorizations, State Authorizations, Video Franchise Agreements, Leasing of Local Loops, etc.

• (Essay) Construction and Vendor Contracts: Identify the extent to which you intend to rely on contractors and/or vendors to deploy the network facilities. Please provide any evidence that contractors and/or vendors are ready to enter into agreements with Applicant, should the application be approved. Signed contracts or other signed agreements would carry the most weight will[sic] respect to evidence, but are not necessary.

• (Essay) Organizational Readiness: Describe key factors to indicate how your organization will be prepared to implement, manage and operate a broadband services network. Describe the organizational governance and management. Address how your organization will ensure that the necessary sales, operational, and billing support systems are in place to provide the proposed services (e.g., network management, provisioning, billing and customer care, etc.)

• (Essay) Customer Base: Please describe the existing customer base including industry, residential, business, anchor institutions, and service providers.

Section Sixteen: Environmental Questions

Applicant is required to answer the following essay questions:

• (Essay) Project Description: Describe all project-related construction activities, including, but not limited to building construction related to installing prefabricated buildings; internal modifications, or equipment additions to buildings or other structures (e.g., relocating interior walls or adding computer facilities); the construction and installation of buried cable; or installation of telecommunications transmission facilities including construction of new monopole towers, satellite dishes. Complete descriptions and locations must be provided for each site affected by project-related construction activities.

• (Essay) Property Changes: Describe and indicate the amount of property to be cleared, excavated, fended, or otherwise disturbed by the project. Describe the current land use and zoning for each project site affected by construction. Document whether the proposed project is located on public land owned or managed by the federal government. For information related to federal lands see the following website – http://www.geocommunicator.gov. This website provides cadastral survey and land management information and data from the National Integrated Land System, specifically the distribution of the Public Land Survey System (PLSS), other survey-based data, and federal land boundaries.

• (Essay) Buildings: Describe buildings or other structure (i.e., transmission facilities), including dimensions, to be constructed or modified. For linear projects, state whether the project is to be located on or within previously disturbed public rights-of-way.

• (Essay) Wetlands: Describe and indicate whether wetlands are present on or near the project site(s) affected by construction (maps of wetlands may be obtained from the U.S. Fish and Wildlife Service’s National Wetland Inventory website: http://www.fws.gov/wetlands/ or from soil maps obtained from the USDA, Natural Resource Conservation Service’s website: http://websoilsurvey.nrcs.usda.gov/app/HomePage.htm).

• (Essay) Threatened and Endangered Species: Describe and indicate whether any project site(s) will directly or indirectly affect any threatened, endangered or candidate species or is within or near critical habitats. To document the analysis, applicants must provide species lists and appropriate specie accounts obtained from the U.S. Fish and Wildlife Service’s website: http://ecos.fws.gov/tess_public/ for each county affected by construction of the project.

• (Essay) Floodplains: Describe whether or not any facility(ies) or site(s) are located within a 100 or 500-year floodplain. Information related to floodplains and National Flood Insurance Maps may be obtained from the Federal Emergency Management Agency’s (FEMA) website: http://msc.fema.gov/webapp/wcs/stores/servlet/FemaWelcomeView?storeId=10001&catalogId=10001&langId=-1. If any project-related construction activities are within floodplains, a copy of the FEMA, “FIRMette” with construction activities depicted on the map must be included. For obtaining FIRMettes review the tutorial provided by FEMA.

• (Essay) Historic Properties and Cultural Resources: Describe any cultural resources, including historic properties, i.e., properties listed in or eligible for listing in the National Register of Historic Places, which are located in or within a one-mile radius of the project area and how they may be impacted by the project. Information related to historic properties can be obtained from the State Historic Preservation Office (SHPO) in your respective State – see the website of the National Conference of SHPO: http://www.ncshpo.org/find/index.htm. Applicants must indicate if any portion of the project is located on tribal lands, meaning lands within the exterior boundaries of any Indian reservation and all dependent Indian communities. Information regarding historic properties located on tribal lands may be obtained from the Tribal Historic Preservation Officer (THPO) or the tribe’s official representative for historic preservation. If provided, applicants should provide any information gathered about historic properties on tribal lands, including any correspondence with an Indian tribe. Applicants must gather information about the nature and location of historic properties from the SHPO. SHPOs should be asked the following questions: 1. Is the proposed project located on, within or adjacent to any properties listed in or eligible for listing in the National Register of Historic Places? Is the proposed project located on, within or adjacent to a National Historic Landmark? If the answer is yes, describe and indicate the geographic relationship between the project and property with maps. 2. Will the proposed project impact, use or alter a building or structure that was constructed more than 50 years ago? If so, describe the building/structure with a statement of its condition, including photographs, and document its age. 3. If provided, applicants should provide SHPO responses/information to these questions including any correspondence with the SHPO.

• (Essay) Coastal Areas: Determine whether or not the project is within the boundaries of a coastal zone management area (CZMA). For boundary related and contact information related to CZMA, see National Oceanic and Atmospheric Administration, Office of Ocean and Coastal Resource Management’s website: http://coastal management.noaa.gov/consistency/welcome.html

• (Essay) Brownfields: Determine whether the project is located within a brownfield site. Per 42 U.S.C. 9601, the term “brownfield site “ means real property, the expansion, redevelopment, or reuse of which may be complicated by the presence or potential presence of a hazardous substance, pollutant, or contaminant. Maps and locations of sites, facilities and properties that have been contaminated by hazardous materials and are being, or have been, cleaned up under EPA’s Superfund, RCRA and/or brownfields cleanup programs can be found at the following website: http://iaspub.epa.gov/Cleanups/.

Section Seventeen: Uploads

Upload Checklist

• Last Mile Offerings/Middle Mile Offerings/Competitor Tables (Required)

• Network Diagram (Required)

• Provide network diagrams for your project. Examples are provided in the Grant Guidelines. The diagrams must show:

• All of the network elements and the capacity, facilities, and mileage between each element. The diagram must clearly denote which of the network elements already exist.

• The types of facilities used in connecting all the network elements (fibers, copper, microwave, etc.).

• Internet peering points, access to local exchange carriers and central offices.

• The proposed aggregation node facilities that will provide the egress point(s) from the broadband backbone to the networks of the selected service provider(s) and the selected Internet Service Provider(s) and any other value-added services that may be provided in the new infrastructure.

• The points of interconnection and collocation facilities.

• Wireless Systems: Provide the antennae height, cell site radius, and approximate coverage area for each access point.

• Build Out Timeline (Required)

• List of Community Anchor Institutions and Points of Interest (Required)

• Management Team Resumes and Organizational Chart (Required)

• Provide the resumes of the senior management team and project team members significant to the project's success. Please identify their years of experience and relevant expertise with projects of similar size, scope, and complexity. Please identify specific prior (or current) projects, dates, and outcomes that showcase the management team's track record as relevant to executing the project. In addition, provide an organizational chart that details the structure of your organization, including any parent, subsidiary, affiliate, or partner organizations.

• Government and Key Partnerships (Optional)

• Please submit documentation, such as letters of support or commitment, from each of the key partners in the project. The documentation should clearly describe the specific details of the partner’s participation. For example, if the partner is providing part of the project's cost matching contribution, the documentation should state the exact amount of the cash contribution, or describe, in detail, the nature of the in-kind contribution. If the partner is an Indian tribe or a socially and economically disadvantaged small business, as defined by Section 8(a) of the Small Business Act, 15 U.S.C. 637, the documentation should make note of this, and explain the basis for this claim.

• Historical Financial Statements (Required)

• Provide detailed organizational financial statements for the last two years: a) Income Statement; b) Balance Sheet; c) Statement of Cash Flows. If your organization was established less than two years ago, provide all available information. Note that, this response requires financial data for the organization as a whole—in contrast to the pro forma financial projections, which require project-specific financial information. A standard annual Income Statement, Balance Sheet, and Cash Flows based on generally accepted accounting principles (GAAP) are preferable. If your organization cannot readily produce this data in a standard format, you should explain why not, and provide comparable data, such as your most recent IRS Form 990 or annual audit, that provides as detailed a picture as possible of your financial history for a minimum of one year prior to your submission of this application. If appropriate, you may include Notes on Financial Statements that explain costs and revenues by major categories, and you may make note of any abnormal or one-time charges, large liabilities or asset transactions, legal actions, or other financial events you feel require explanation. If key partners are involved in delivering programmatic benefits (e.g., operating a proposed broadband network), it is recommended that historical financial statements for the key partners be provided as well.

• Detailed Budget (Required)

• Subscriber Estimates (Required)

• Pro-forma Forecast (Required)

• Dashboard Metrics (Required)

• Service Area Data (Required)

• SPIN (Optional)

• Waivers – (Optional)

• Map Uploads (Required)

• Provide maps illustrating the following. The maps should delineate between network and facilities that: a) are part of Applicant's/key partners' existing network, b) proposed as part of this project, c) leased from a third party, or d) utilized under some alterative arrangement. Applicants may include additional details they deem relevant. Note that GIS-format source files for these maps may be requested in due diligence.

• The Proposed Funded Service Area (should show and label all Last Mile and Middle Mile service areas and illustrate which are unserved/underserved/served). To the extent that Applicant or key partners already provide service within the Proposed Funded Service Area, the area(s) of this existing service should be indicated.

• The path of the network.

• Centralized facilities (e.g., central offices, primary node facilities, major points of aggregation)

• Points of interconnection (unpowered, non-environmentally controlled points of interconnection, e.g., splice points, need not be displayed) and collocation facilities.

• Internet peering point(s).

• Wireless towers, if applicable, and coverage areas.

• Anchor institutions to be directly connected as part of the proposed project.

• BTOP Certifications (Required)

• SF 424C Budget (Required)

• SF 424 D Assurances – Construction (Required)

• Supplemental Information (Optional)

Uploads Editor Section

• Download Template if Available

• Upload Requirements

• Upload Document

• Upload Details

• Original File/Document Name

• Converted File/Document Name

• Uploaded By

• Uploaded Date

• Status

Section Eighteen: Review and Submit

Applicant is required to review and submit the application

View Full Submission

• Applicant can review the PDF

Validation Status

• Will indicate to Applicant whether each section is “complete” or “incomplete” in the application

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