Sustainable Broadband Adoption Application

BROADBAND TECHNOLOGY OPPORTUNITIES PROGRAM

OMB Control No. 0660-0031

Sustainable Broadband Adoption Application

Purpose: The following document outlines the current draft of Round 2 Public Sustainable Broadband Adoption Application. This document sequentially outlines each question in the application as indicated in the Easygrants system.

Sustainable Broadband Adoption 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:

• 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.

• 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; and 3) 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 identify the name and contact Information of 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 of 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 (NAISC) 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

Applicant is required to identify the following:

Project Description

• Project Title

• Project Description

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)

Please 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 the 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 the 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 questions:

• (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:

• Opportunity the proposed system seeks to address

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

• Number of households and businesses passed

• 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.)

• Proposed services and applications for the proposed funded service areas and users

• Approach to addressing the non-discrimination and interconnection obligations

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

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

• Overall infrastructure cost of the broadband system

• Overall expected subscriber projections for the project

• 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]
  a) Project addresses compelling problem or presents an opportunity consistent with the BTOP statutory goals
  b) Project offers an effective solution to that problem or addresses the opportunity
  c) Proposed solution demonstrates broad significance and includes developments that can be replicated to improve future projects
  d) 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)
  e) 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.

• (Essay) Innovative Approach to Sustainable Broadband Adoption. Describe your approach to increasing broadband adoption rates. (Requirement for all applicants) Please describe how your approach to the problem of increasing broadband adoption rates is innovative, and explain why it improves upon conventional approaches to encouraging adoption. Programs may provide broadband education, awareness, training, access, equipment and/or support. Explain how your innovative solution(s) would be feasible in other situations.

• (Essay) Technology Strategy. Explain the proposed technical and operational solutions. (Requirement for all applicants) Explain the mechanics and operational details of your project and how your approach is an effective and appropriate means of creating sustainable adoption in your target population.

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

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

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)

• 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: Community Anchor Summary

Applicant is required to identify whether their proposed project serves Community Anchor Institutions.

Community Anchor Institution

Schools (k-12)

Libraries

Medical and Healthcare Providers

Public Safety Entities

Community Colleges

Public Housing

Other Institutions of Higher Education

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 Ten: Demographics

Applicant is required to identify the following:

Demographics

• Will your proposed project be specifically directed to serve vulnerable population groups? (Yes/No)

• If "Yes" which vulnerable population groups will your proposed project serve? Check as many as apply:

• Hispanic

• Black/African-American

• Asian

• Native American or Native Alaskan

• Native Hawaiian or Pacific Islander

• English as a Second Language (ESL)

• Disabled

• Low Income

• Unemployed

• Senior Citizen (55 and over)

• Youth

• Other- Applicant is required to explain “Other”

Applicant is required to answer the following essay questions, depending on their answers above:

• (Essay) Vulnerable Populations: Please describe the specific affirmative steps that your program will take to engage and serve each specified vulnerable population checked above.

• (Essay) Accessibility: Please describe the ways in which your center(s) will be accessible and welcoming to people with disabilities and which technologies will be used (I.e., software, adaptive technologies).

• (Essay) Other Languages: Please describe the multilingual training and outreach being offered and which languages it will be in.

Section Eleven: Project Budget

Project Budget: Applicant is required to provide the following information

1. Federal Grant Request

2. Total Match Amount

3. Total Budget

• Match Percentage

• (Essay) Projects Outside the Recommended Funding Range: If this total project budget is above or below the project size range recommended in the NOFA ($500,000-$15 million), please provide a reasoned explanation for this variance from the recommended range.

• (Essay) Sustainability. Demonstrate the sustainability of your project. (Requirement for all applicants) Please indicate whether and how the project will be sustained beyond the funding period. Also discuss how the projected increases in broadband adoption rates will be sustained beyond the grant period.

Matching Funds

Applicant is required to answer the following questions:

• 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) Describe Matching Contributions: 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, 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: Please disclose the source and amount of other federal or state funding received or requested for activities or projects to which this project relates. Please specify all Universal Service Fund (USF) funding delineated by specific program.

• (Essay) Project Outside the Recommended Funding Range: If this total project budget is above or below the project size range recommended in the NOFA ($500,000-$15 million), please provide a reasoned explanation for this variance from the recommended range.

Budget Narrative

Applicant is required to answer the following questions:

• (Essay) Budget Narrative: Please provide a narrative that explains the project budget (as proposed on SF-424 A and/or SF-424 C) and spending plan (timeline) in sufficient detail for reviewers to determine whether the expenditures are necessary and appropriate to the solution you are proposing.

• (Essay) Budget 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.)

• (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

• Total U.S. Dollars

Section Twelve: 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 Thirteen: Project Benefits

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.

Adoption Metrics

Applicant is required to identify the following:

• How many total new home subscribers (household accounts) to broadband do you expect to generate through use of BTOP funds over the entire life of the program funded?

• How many total new business and/or institutional subscribers to broadband do you expect to generate through use of BTOP funds over the entire life of the program funded?

• How many total users of broadband in public computer centers or users of broadband outside the home (e.g., in a community college) do you expect to generate through use of BTOP funds over the entire life of the program funded?

• What is the total cost of your project per new subscriber (household, individual, or institutional) or new end-user? Total in Dollars.

• (Essay) Measuring Adoption Impact: Please describe how you intend to effectively track and measure the benefits generated by this project.

Broadband Training Programs

Applicant is required to identify the following:

• If you intend to provide training or education, how many people in total will your program(s) reach?

• How many hours of training do you expect to provide per person on average for each participant in your training program(s), through completion of training for that individual?

• How many Full Time Employee (FTEs) instructors or facilitators will you employ for broadband and digital literacy training purposes?

• (Essay) Qualifications (training and experience) of Full Time Employees: Applicant is required to identify their qualifications and training experiences.

Equipment Affordability Programs

Applicant is required to identify the following:

• What is the total up-front cost of this equipment? Total in Dollars.

• If you are providing an equipment purchase or loan program, for how many households, businesses and/or institutions do you expect to provide equipment or computers?

• Households

• Businesses

• Institutions

• If you are employing a loan program for purchases of service or equipment, what will be the total cost to the typical customer you assist over the life of the loan, including all interest and fees? Total in Dollars

• How many broadband-related equipment units (e.g. computers, wireless devices) do you intend to purchase overall?

Broadband Awareness Campaigns

Applicant is required to identify the following:

• If you are conducting an awareness campaign, how many people do you expect your campaign will reach?

• (Essay) Awareness Campaign Methods: Briefly describe the targeting, media, and messaging strategies your awareness campaign will employ.

• (Essay) Measuring Campaign Impact: Describe how you will measure the impact of the awareness campaign.

Section Fourteen: Project Readiness

Applicant is required to answer the following essay questions:

Text Areas

• (Essay) Organizational Readiness. Describe your organization's readiness to implement the project. (Requirement for all applicants) Please describe key factors that demonstrate your organization will be prepared to implement, operate, and sustain your project using federal funds. Include past experience in managing projects of comparable size and complexity.

• (Essay) Project Timeline and Challenges. Provide a detailed implementation plan. (Requirement for all applicants) Please provide a detailed implementation plan on a quarterly basis that shows the phases of the project and establishes key milestones. Include such activities as construction, staffing and hiring, resource development, staff training, equipment purchases, and installation. Also, include a description of key challenges or risks to the timely completion of the project, including any mitigation plans to address the risks.

• (Essay) Licenses and Regulatory Approvals. List any licenses or regulatory approvals required to complete your project and indicate the status of each. (Requirement for all applicants) If applicable, please list any local, state, or federal licenses and regulatory approvals required to complete your project, and indicate the status of each.

Section Fifteen: Environmental Questionnaire

Applicant is required to answer the following questions:

• Does the proposed action involve the procurement of materials? (Yes/No)

• (Essay) If so, will the materials be installed, stored or operated in an existing building or structure? Include the list of equipment and peripherals to be procured.

• Does the proposed action involve procurement of electronic equipment? (Yes/No)

• (Essay) If yes, will the equipment be disposed of in an environmentally sound manner at the end of its useful life?

• Does the proposed action involve construction, remodeling, or renovation? (Yes/No)

• (Essay) If so, will these activities be limited to only minor interior renovations to a structure, facility, or installation? Include a description of the proposed renovations with your project summary.

• Does the proposed action involve the production and/or distribution of informational materials, brochures, or newsletter? (Yes/No)

• Does the proposed action involve training, teaching, or meeting facilitation at an existing facility or structure? (Yes/No)

• (Essay) If yes, explain.

• Does the proposed action involve ground or surface disturbance to accommodate new fiber optic cable? (Yes/No)

• (Essay) If yes, include a description of the extent of service upgrade, a list of the permits required, and linear footage of underground fiber optic cabling required.

• Does the proposed action involve an upgrade of broadband service to an existing facility or structure?

• (Essay) If yes, include a description of the extent of service upgrade, a list of the permits required, and linear footage of underground fiber optic cabling required?

Section Sixteen: Uploads

Applicant is required to provide the following uploads if applicable.

Upload Checklist

• 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)

• SPIN (Optional)

• Waivers – (Optional)

• Community Anchor Institution Detail (Required)

• BTOP Certifications (Required)

• SF 424C Budget (Required)

• SF 424 B Assurances – Non-Construction (Required)

• Supplemental Information (Optional)

Uploads

• Applicant is required to pick “Upload” type and “Upload” the document

Section Seventeen: Review and Submit

Applicant is required to review and submit the application

View Full Submission

• Applicant can review their application in PDF.

Validation Status

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

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