OMB Control No. 0660-XXX
Expiration Date: TBD
Applicant Info:
Type of entity: “(A) a State, political subdivision of a State, Tribal government, technology company, electric utility, utility cooperative, public utility district, telecommunications company, telecommunications cooperative, nonprofit foundation, nonprofit corporation, nonprofit institution, nonprofit association, regional planning council, Native entity, or economic development authority; or (B) a partnership of two (2) or more entities described in (A).”
Identify “Primary Applicant”
If individual entity, default as primary
If partnership, specify which entity is primary
Check Y/N: “Add new collaborators to application”
Open text fields in Salesforce to enter “Name, Email and Role of Collaborator”
Check Y/N: “NTIA strongly encourages prospective non-state applicants to coordinate and consult with the State Broadband Office or other coordinating body located in the jurisdiction in which the eligible entity proposes to deploy middle mile infrastructure to ensure that the proposal is consistent with the state’s broadband plan and priorities. Please confirm collaboration and consultation.”
“Government and Community Involvement”
Open field 500-word narrative:
“Please provide information on the applicant’s coordination with applicable State, Territory, Tribal, and local governments, including their awareness of the proposed project and any potential impact to respective service areas; and
Information regarding the applicant’s involvement and coordination with community organizations or other relevant partners in the proposed service area.”
Template form built in by Salesforce SF 424
“Managerial Capability”: “Applicants shall submit to the Assistant Secretary one-page resumes for (a) all key management personnel and (b) all key personnel of subcontractors or other entities that will play substantial roles in building, managing, or operating the middle mile network built using Middle Mile Grant (MMG) Program funding.
Open text fields in Salesforce to enter “Key Personnel. Name, Email and Role of Key Personnel”
“Upload one-page resume”
“Each applicant shall submit any necessary organizational chart(s) detailing all of its parent companies, subsidiaries, and affiliates.”
“Upload organizational chart(s)”
Open field 500-word narrative: “Each applicant must also provide a narrative describing the applicant’s readiness to manage a middle mile broadband network. This narrative should describe the experience and qualifications of key management set to undertake this project, the applicant’s experience undertaking projects of similar size and scope, recent and upcoming organizational changes including mergers and acquisitions, and relevant organizational policies.”
“This narrative shall denote who will own the assets at the end of award period.”
Check Y/N: “Is parent/owner of applicant a foreign entity? If yes, please identify country.”
Upload CD511
Upload Standard Form LLL, if applicable
Upload Negotiated Indirect Cost Rate Agreement, as applicable
Template form built in by Salesforce “Template Table of Funded Part. and Unfunded Collaborators”
“List all funded and unfunded project collaborators, including partners, subrecipients, match providers, major contractors/supplies, details on role/scope of work for project.”
Upload “Certificate of Operational Capability”:
“Each applicant must supply a certification from an officer-level employee (or individual of comparable rank) attesting to the applicant’s operational capability to complete and operate the proposed project.”
“If the applicant has provided a voice and/or broadband internet access service, it must supply a certification from an officer-level employee (or individual of comparable rank) attesting that it has filed FCC Form 477s and the Broadband DATA Act submission, if applicable, to the extent required during this time period and otherwise complied with the Commission’s rules and regulations. Alternatively, the applicant must explain any pending or completed enforcement action, civil litigation, or other matter in which it was alleged to have failed to comply with Commission rules or regulations.”
“If the applicant has operated only an electric transmission or distribution service, it must submit qualified operating or financial reports that it has filed with the relevant financial institution for the relevant time period along with a certification that the submission is a true and accurate copy of the reports that were provided to the relevant financial institution.”
Upload “Certificate of Experience”: “If applicable, the applicant must submit a certification from an officer-level employee (or individual of comparable rank) that it has operated a middle mile broadband network for at least two years or that it is a wholly owned subsidiary of such an entity and must specify the number of years the applicant or its parent company has been operating.”
Upload “Certification of Technical Capability”: “Each applicant must supply a certification from an officer-level employee (or individual of comparable rank) attesting that it is technically qualified to complete and operate the proposed project.”
Open field “1,000-word Executive Summary to describe:”
“Please describe how the applicant’s proposal will advance the objectives of the MMG Program, as well as the specific objectives of outlined in the Notice of Funding Opportunity (NOFO);
An overview of the proposed route or service area(s), including information regarding rurality and socio-economic indicators in the area to be served by the proposed project; and
A description of need in the proposed service area(s), including communities considered unserved and/or underserved in the proposed service area(s).”
Open field “1,000-word Level of Need Narrative to explain:”
A description of the level of need in the proposed service area(s), including communities considered unserved and/or underserved in the proposed service area(s) 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.
The Applicant should provide the most complete picture it can of the existing state of broadband infrastructure in the proposed area, the reasons why the existing infrastructure is insufficient to meet the needs of the communities in that area, and, particularly in cases where the project will not leverage existing infrastructure, why the proposed network is the most efficient means to address the unmet needs of the area.
Discuss the extent to which the proposed project will comprehensively meet, whether directly or indirectly, all of the broadband needs of the communities within the project area. Ideally this should include consideration of residential and business services, support for community anchor institutions in the area, and access, transport, and wholesale services for other broadband service providers.
The Applicant should note any specific service providers that have expressed an interest in utilizing the network to provide last mile service (specifying the level of interest, e.g., letter of commitment, agreements, or contracts). The Applicant should provide an estimated number of expected users of the proposed middle mile facilities and the basis for these end-user projections (e.g., letters of intent, agreements or contracts.)
Open field 500-word narrative to describe:
“Please describe targeted last mile service objectives, including last mile service provider letters of commitment, agreements, or contracts; and
Letters of intent, agreements, or contracts pertaining to other expected users of the proposed middle mile facilities.”
Open field 500-word narrative to describe:
“Please provide information on existing middle mile offerings in the area, if any, including competitor data if applicable; and
A description of the proposed service offerings, including the pricing of the services to be offered over the proposed facility.”
Open field 500-word narrative to describe:
“Please provide a description of the applicant’s nondiscrimination, interconnection, and network management plans, which will be made available upon request by NTIA; and
Include the URL to publicly available interconnection policy and verify that such policy is to be offered in perpetuity.”
Drop down “Type of technology to be used in proposal: Fiber Optic Technology, Wireless, Other”; add ability to select more than one per project, and open field to explain “Other”
If fiber, check Y/N: “Each applicant of an award to build middle mile infrastructure using fiber optic technology shall certify that the proposed project, upon completion, will include direct interconnection facilities that will facilitate the provision of lit broadband service, at speeds not less than 1 Gigabit per second for downloads and 1 Gigabit per second for uploads to anchor institutions located within 1,000 feet of the middle mile infrastructure.
If fiber, upload template “Template CAI”
Check Y/N: “An eligible entity applying for a middle mile grant may seek, and the Assistant Secretary may grant, a waiver of the requirements set out in the previous paragraph, in full or in part, to the extent the eligible entity demonstrates that the requirement is not technically or economically feasible.”
If wireless or other, allow capability to respond to CAI options but not mandatory to complete.
“Special Rules for Tribal Governments and Native Entities”
“The Infrastructure Investment and Jobs Act permits the Assistant Secretary, in consultation with Tribal governments and Native entities, to waive, or specify alternative requirements, in connection with most directives governing the MMG Program if the Assistant Secretary finds that waiver or modification of the requirement is necessary for (a) the effective delivery and administration of middle mile grants to Tribal governments or (b) the construction, improvement, or acquisition of middle mile infrastructure on trust land.”
“Check Y/N if waiver or alternative requirements are requested.”
“A Tribal Government may certify whether an area within its own Tribal Land is unserved or underserved based on criteria of its choosing. Any such Tribal Government must certify that the areas where middle mile service is proposed (including any such areas where a provider offers, or has proposed to offer, last-mile service) are unserved or underserved and provide a statement on Tribal Letterhead explaining how the determination that the area is unserved or underserved was made and additional supporting information if available.”
Upload certification, as applicable.
“Fair Labor Practices”
Open field 500-word description: “Applicants must have a demonstrated record of and plans to be in compliance with federal labor and employment laws. This will help ensure that projects are carried out in accordance with the law, assist NTIA in ensuring that a prospective awardee is capable of carrying out activities funded by an award in a competent manner in compliance with all applicable federal, state, and local laws; and promote the effective and efficient completion of high-quality middle mile broadband infrastructure projects by ensuring a reliable supply of skilled workers and minimizing disruptive and costly delays. In order for NTIA to evaluate an applicant’s demonstrated record of and plans to be in compliance with federal labor and employment laws, each applicant must provide examples of items described in III.G in the NOFO.”
“Advancing Workforce Development Objectives”
Open field 500-word description: “A skilled workforce is critical to meeting infrastructure buildout timelines under the Infrastructure Act and connecting households across the country to reliable, affordable, high-speed broadband. A well-trained workforce will also allow for the safe deployment of sustainable networks. To meet the workforce needs of the MMG Program, applicants must make appropriate investments to develop a skilled, diverse workforce. Each applicant must provide as part of its application examples of items described in III.H in the NOFO.”
“Climate Resiliency”
Open field 500-word description: “Please demonstrate that the applicant has sufficiently accounted for current and future weather- and climate-related risks to new MMG Program infrastructure projects. In particular, each applicant should clearly demonstrate how it is conducting the items listed in III.I in the NOFO.”
“Civil Rights and Nondiscrimination Law Compliance”
Check Y/N: “Prior to distributing any MMG Program funding to a prospective awardee, NTIA will require the prospective awardee to agree, by contract or other binding commitment, to abide by the non-discrimination requirements set forth in III.J in the NOFO.”
“Network Route Maps”
“Applicant shall upload network route maps in a Shapefile format.”
“Upload Template Data Submission Specification”
“Applicants must submit a table with information for all interconnection points proposed for the network. This table has three required fields: Point Name, Latitude and Longitude.”
“Upload network logical diagram”
“Environmental Narrative”
Open field 200-word description: “Please provide a service-area environmental description that describes the physical project area and its surroundings (e.g., disturbed or developed land vs. open space; adjacent natural resources, such as rivers, wetlands, or forestlands; and any protected lands or resources in or near the project area), including site photographs and aerial photographs (e.g., Google Earth or Google Maps images), if the project includes construction and/or ground disturbing activities.”
“Project Timeline”
Drop down “Number of Years” (1, 2, 3, 4, 5)
Open field 500-word narrative:
“Please provide a timeline for the build-out/implementation of the project with critical path, including key milestones for implementation of the project, preparations, and risk factors; and
A capital investment schedule evidencing that the applicant will complete build-out and the initiation of service within five years of the date on which the entity receives the grant and will meet interim buildout requirements set forth herein and in any other binding document.”
Check Y/N: “Is the project able to accelerate project completion?”
if Y, 200 word open field “Please describe.”
Check Y/N: “Is the project connecting non-contiguous trust lands?”
If Y, 200 word “Please describe.”
Check Y/N: “Is the project benefitting national security interests of the US and US DOD?”
If Y, 200 word “Please describe.”
Budget Info
Upload “Certification of Financial Capability”:
“Each applicant must supply a certification from an officer-level employee (or individual of comparable rank) attesting that it is financially qualified to meet the obligations associated with a project, that they will have available funds for all project costs that exceed the amount of the grant, and that they will comply with all MMG Program requirements, including service milestones.”
Upload “Letter of Credit”:
“Each applicant must submit a letter from a bank meeting eligibility requirements consistent with those set forth in 47 C.F.R. § 54.804(c)(2) committing to issue an irrevocable stand-by letter of credit, in the required form, to the applicant. The letter shall at a minimum provide the dollar amount of credit offered and the issuing bank’s agreement to follow the terms and conditions of NTIA’s model letter of credit. NTIA will ensure, prior to issuing a middle mile grant award, that each eligible entity obtains an acceptable, irrevocable standby letter of credit in a value of no less than 25 percent of the award amount.
Each eligible entity shall provide with its letter of credit an opinion letter from its legal counsel clearly stating, subject only to customary assumptions, limitations, and qualifications, that in a proceeding under Title 11 of the United States Code, 11 U.S.C. § 101 et seq. (the “Bankruptcy Code”), the bankruptcy court would not treat the letter of credit or proceeds of the letter of credit as property of the winning bidder's bankruptcy estate under section 541 of the Bankruptcy Code.”
Upload “Audited Financial Statements (3 years)”
“Each applicant shall submit financial statements from the three prior fiscal years that are audited by an independent certified public accountant. If the applicant is not audited in the ordinary course of business, in lieu of submitting audited financial statements it must submit unaudited financial statements from the three prior fiscal years and certify that it will provide financial statements from the three prior fiscal years that are audited by an independent certified public accountant by an NTIA specified deadline.”
Upload “Historical Financial Statements (previous 3 years)”
Salesforce built in template SF 424C
Upload “Template Pro Forma”
“Pro forma financial projection and analysis related to the project’s sustainability, inclusive of subscriber (e.g., last mile network connections, other wholesale services), across an eight-year forecast period.”
Open field 500-word Template Budget Narrative. “The Budget Narrative must explain the necessity and basis for all costs, clearly correspond to the information included in a Detailed Budget Justification, in the form of a spreadsheet, and reflect only allowable costs that are consistent with the project scope.”
Salesforce built in Template Detailed Budget Justification: “The Detailed Budget Justification spreadsheet must reflect the cost categories that appear on the SF-424 and SF-424C and include itemized calculations for each cost placed under those categories.”
Check YN: “Any other funding provided for this project?”
If Y, 200 word narrative “Please describe.”
Extension
Check Y/N: “Is an extension being requested? An eligible entity may submit a request for an extension, which must include the justification for such an extension and all relevant circumstances. At the request of an eligible entity, the Assistant Secretary may extend the buildout deadline by not more than one (1) year if the eligible entity certifies that:
(i) the eligible entity has a plan for use of the grant funds;
(ii) the project to build out middle mile infrastructure is underway; or
(iii) extenuating circumstances require an extension of time to allow completion of the project to build out middle mile infrastructure.”
If Y, open field 200-word explanation “Please describe.”
Agency Disclosure Notice: This information collection is authorized by [OMB control #0660-XXXX]. Public reporting burden for this collection of information is estimated to average five (5) hours or 300 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and 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 this burden, to U.S. Department of Commerce, (National Telecommunications and Information Administration, 1401 Constitution Ave. NW, Washington, DC 20230). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Bleau, Sarah |
| File Modified | 0000-00-00 |
| File Created | 2022-05-16 |