Document
TAB D - BIP Annual Progress Report
ICR 202206-0660-002 · OMB 0660-0049 · Object 122085401.
Document Viewer [xlsx]
Document Metadata
| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
|---|---|
| File Title | TAB D - BIP Annual Progress Report |
| Author | Toriola, Olabode |
| Last Modified By | Calc |
| File Modified | 2022-06-08 |
| File Created | 2026-09-01 |
| Conversion State | complete |
Extracted Text
Broadband Infrastructure Program Data Report Form This Broadband Infrastructure Program (BIP) report form will serve as a tool to capture indicators highlighting broadband infrastructure from the award's inception to the award's closeout. The form contains three separate reports: Baseline Report, Performance (Technical) Report, and Annual Report. Baseline Report: The Baseline Report is submitted once at the beginning of your project and is based on anticipated figures and schedules. You will use the Baseline Report to provide your projected goals and planned activities from the award start date to closeout. Some metrics will also ask you to provide data on the current state of your program before expending BIP grant funds. The Baseline Report is due 45 calendar days after NEPA approval. Performance (Technical) Report: The Performance (Technical) Report is submitted semi-annually for periods ending March 31 and September 30 and captures project performance and outcomes. You will use the Performance (Technical) Report to provide your actual completed goals and planned activities from award inception to the current reporting period. You will submit the semi-annual report twice a year until you expend all BIP grant funds, as well as upon closeout of the award. The Performance Report is due 30 calendar days after the closing period. The final closeout report is due 120 calendar days after the last Performance Technical Report. Annual Report: The Annual Report captures narrative data on your project. You will use the Annual Report to provide necessary information on BIP grant-funded project activities from award inception to the current reporting period. You will submit the annual report once a year until you expend all BIP grant funds. The Annual Report is due 30 calendar days after the closing period. Click on the links below to view the report forms. Baseline Report Performance (Technical) Report Annual Report BROADBAND INFRASTRUCTURE PROGRAM BASELINE REPORT OMB Control No. XXX-XXXX Expiration Date: TBD BROADBAND INFRASTRUCTURE PROGRAM BASELINE REPORT GENERAL GENERAL INFORMATION Recipient Organization Recipient Street Address City, State, Zip Code Performance Period Start Date (MM/DD/YYYY) Award Identification Number Report Date (MM/DD/YYYY) DUNS/UEI Number Performance Period End Date (MM/DD/YYYY) INFRASTRUCTURE MILESTONE CATEGORIES 7. Network Build (all components - owned, leased, Indefeasible Rights of Use, etc.) 8. Equipment Deployment 9. Network Testing 10. Other (please specify): Please use the table provided to indicate your anticipated percentage of completion on a semi-annual basis for each year of the milestone category. Year One begins with your award start date. The percentage of completion should be based primarily on the expenditure of your project budget and should be reported cumulatively from award inception through the end of each semi-annual reporting period. For example, if you expect to complete a particular milestone within the first three periods of your project, Year Two Period One and all subsequent Year and Period should state 100%. Year 1 MILESTONES Period 1 Projected Period 2 Projected Year 2 Period 1 Projected Year 3 Period 2 Projected Period 1 Projected Period 2 Projected Year N Period 1 Projected Period 2 Projected 1. Overall Project 1b 2. Environmental Assessment 3. Network Design 4. Rights Of Way 5. Construction Permits And Other Approvals 6. Site Preparation 7. Equipment Procurement 8. Network Build (all components - owned, leased, Indefeasible Rights of Use, etc.) 9. Equipment Deployment 10. Network Testing 11. Other (please specify): NETWORK BUILD PROGRESS Please use the following table to provide anticipated key indicators and progress of your infrastructure project. Please select the appropriate drop-down option to indicate if the network build progress item is either middle-mile, last-mile, both, or not applicable. Information should be reported cumulatively from award inception through the end of the semi-annual period. Please write “N/A” if your project does not include this indicator. NETWORK BUILD PROGRESS a. Number of new fiber miles (aerial or underground) Middle Mile or Last Mile Year 1 Period 1 - Period 2 Projected Projected Year 2 Period 1 - Period 2 Projected Projected Year 3 Period 1 - Period 2 Projected Projected Year N Period 1 - Period 2 Projected Projected Middle Mile b. Number of fiber miles leased c. Number of existing fiber miles upgraded 2 d. Number of new wireless links e. Number of new towers f. Number of new interconnection points g. Number of signed agreements with broadband wholesalers or last mile providers h. Number of potential agreements (i.e., agreements currently being negotiated) with broadband wholesalers or last-mile providers (This number should NOT be reported cumulatively) i. Number of wireless licenses obtained j. Other (please specify): BROADBAND ACCESS KEY INDICATORS Please use the following table to provide anticipated key indicators with the projected totals for each beneficiary and access type for your infrastructure service or project. Information should be reported cumulatively from award inception through the end of the semi-annual period. Please write “N/A” if your project does not include this indicator. PROJECTED NUMBER OF SUBSCRIBERS AND SPEED Year 1 Year 2 Year 3 2 Year N March-25 February-25 January-25 December-24 November-24 October-24 September-24 August-24 July-24 June-24 May-24 April-24 March-24 February-24 January-24 December-23 November-23 October-23 September-23 August-23 July-23 June-23 May-23 April-23 March-23 February-23 January-23 December-22 November-22 October-22 September-22 August-22 July-22 June-22 May-22 END DATE (MM/DD/YYYY) April-22 START DATE (MM/DD/YYYY) MILESTONE CATEGORIES 1. Environmental Assessment 2. Network Design 1a 3. Rights Of Way 4. Construction Permits And Other Approvals 5. Site Preparation 6. Equipment Procurement March-22 Please use the chart below to provide the start dates and end dates for each milestone category of your project. If necessary, please add an additional milestone category at the bottom of the chart and specify. BROADBAND INFRASTRUCTURE PROGRAM BASELINE REPORT BENEFICIARY TYPE ACCESS TYPE Period 1 Projected Period 2 Projected Period 1 Projected Period 2 Projected Period 1 Projected Period 2 Projected Period 1 Projected Period 2 Projected 0 0 0 0 0 0 0 0 1. Number of Households passed/serviceable 2. Households with new access 3a. Unserved Households 3. Households with improved access Total number of Households served 4. Number of Households served with speeds of at least 25/3 5. Number of Households served with speeds of at least 100/20 Using the Excel spreadsheet template titled "BIP Reports Addendum A", please provide an updated count of Households within each of the eligible census block groups along with their Location ID that you plan to connect to your network in column titled '# of Units'. The locations should match and conform to the Federal Communications Commission (FCC) Broadband Serviceable Location Fabric, which is a unique identifier the geographic coordinates, and where available, the address(es) associated with each location. Please be sure to select 'Baseline Report' checkbox when completing the addendum. 3b. Businesses 1. Number of Businesses passed/serviceable 2. Businesses with new access 3. Businesses with improved access Total number of Businesses served 4. Number of Businesses served with speeds of at least 25/3 5. Number of Businesses served with speeds of at least 100/20 0 0 0 0 0 0 0 0 Using the Excel spreadsheet template titled "BIP Reports Addendum B", please provide an updated count of Businesses within each of the eligible census block groups along with their Location ID that you plan to connect to your network in column titled '# of Units'. The locations should match and conform to the Federal Communications Commission (FCC) Broadband Serviceable Location Fabric, which is a unique identifier the geographic coordinates, and where available, the address(es) associated with each location. Please be sure to select 'Baseline Report' checkbox when completing the addendum. 3 3c. Community Anchor Institutions (CAIs) 1. Number of CAIs passed/serviceable 2. CAIs with new access 3. CAIs with improved access Total number of CAIs served 4. Number of CAIs served with speeds of at least 25/3 5. Number of CAIs served with speeds of at least 100/20 0 0 0 0 0 0 0 0 Using the Excel spreadsheet template titled "BIP Reports Addendum C", please provide an updated count of Community Anchor Institutions (CAIs) within each of the census block groups along with their Location ID that you plan to connect to your network in column titled '# of Units'. The locations should match and conform to the Federal Communications Commission (FCC) Broadband Serviceable Location Fabric, which is a unique identifier the geographic coordinates, and where available, the address(es) associated with each location. Please be sure to select 'Baseline Report' checkbox when completing the addendum. 1. Number of Broadband wholesalers or last-mile providers passed/serv 2. Broadband wholesalers or last-mile providers with new access 3. Broadband wholesalers or last-mile providers with improved access 3d. Broadband Wholesalers or Last-Mile Providers Total number of Broadband wholesalers or last-mile providers served 4. Number of Broadband wholesalers or last-mile providers served with speeds of at least 25/3 0 0 0 0 0 0 0 0 5. Number of Broadband wholesalers or last-mile providers served with speeds of at least 100/20 OTHER INDICATORS Please use the following table to provide the total for each workforce indicator. List the projected total for each period. The projected totals should be cumulative from the award inception. Please write "N/A" if your project does not include this indicator. Workforce Indicator 4 Outcome 4a. New positions available and funded through BIP grant Questions Year 1 Period 1 - Period 2 Projected Projected Year 2 Period 1 - Period 2 Projected Projected Year 3 Period 1 - Period 2 Projected Projected 1. Number of new positions created 2. Number of new positions filled CERTIFICATION CERTIFICATION I certify to the best of knowledge and belief that this report is correct and complete for performance of activities for the purposes set forth in the award documents. Telephone (area code, number Typed or printed name and title of Authorized Certifying Official: and extension): Email Address: Signature of Certifying Official: Date: 3 Year N Period 1 - Period 2 Projected Projected BROADBAND INFRASTRUCTURE PROGRAM PERFROMANCE (TECHNICAL) REPORT OMB Control No. XXX-XXXX Expiration Date: TBD BROADBAND INFRASTRUCTURE PROGRAM PERFORMANCE (TECHNICAL) REPORT GENERAL GENERAL INFORMATION Recipient Organization Recipient Street Address City, State, Zip Code DUNS/UEI Number Performance Period Start Date (MM/DD/YYYY) Report Period Start Date (MM/DD/YYYY) Award Identification Number Report Date (MM/DD/YYYY) Yes Final Report No Performance Period End Date (MM/DD/YYYY) Report Period End Date (MM/DD/YYYY) INFRASTRUCTURE MILESTONE CATEGORIES Please provide the percent complete for the following key milestones of your project. Write “0” in the Percent Complete column and "N/A" in the Narrative column if your project does not include this activity. If you provided additional milestones in your baseline plan, please include them at the bottom of the table and specify. Unless otherwise indicated in the instructions, figures should be reported cumulatively from award inception to the end of the most recent reporting period. Please provide a narrative description if the percent complete is 5% more or less from the target provided in your baseline plan. (300 words or less) MILESTONES Percent Complete Narrative (Describe reasons for variances of 5% or more from the baseline plan) 1. Overall Project 2. Environmental Assessment 1a 3. Network Design 4. Rights Of Way 5. Construction Permits And Other Approvals 6. Site Preparation 7. Equipment Procurement 8. Network Build (all components - owned, leased, Indefeasible Rights of Use, etc.) 9. Equipment Deployment 10. Network Testing 11. Other (please specify): Please describe significant project accomplishments during this reporting period funded through BIP grant. (600 words or less) 1b Please describe any challenges to achieving project accomplishments during this reporting period funded through BIP grant. (600 words or less) 1c NETWORK BUILD PROGRESS Please report the following information regarding network build progress. Write “0” in the Total column and "N/A" in the Narrative column if your project does not include this activity. Please select the appropriate drop-down option to indicate if the network build progress item is either middle-mile, last-mile, both, or not applicable. Unless otherwise indicated in the instructions, figures should be reported cumulatively from award inception to the end of the most recent reporting semi-annual period. Please provide a narrative description if the total is 5% more or less from the target provided in your baseline plan. (300 words or less) NETWORK BUILD PROGRESS 2 Middle Mile or Last Mile Total Narrative (Describe reasons for variances of 5% or more from the baseline plan) 2a. Number of new fiber miles (aerial or underground) 2b. Number of fiber miles leased 2c. Number of existing fiber miles upgraded 2d. Number of new wireless links 2e. Number of new towers 2f. Number of new interconnection points 2g. Number of signed agreements with broadband wholesalers or last-mile providers (include names of broadband wholesalers or last-mile providers in the narrative column) 2h. Number of potential agreements (i.e., agreements currently being negotiated) with broadband wholesalers or last-mile providers (This number should NOT be reported cumulatively) 2i. Number of wireless licenses obtained 2j. Other (please specify): BROADBAND ACCESS KEY INDICATORS Please use the following table to provide anticipated key indicators with the cumulative totals for each beneficiary category and access type for your infrastructure service or project. Information should be reported cumulatively from award inception through the end of the semi-annual period. Please write “N/A” if your project does not include this indicator. Please provide a narrative description if the total is 5% more or less from the target provided in your baseline plan. (300 words or less) PROJECTED NUMBER OF SUBSCRIBERS AND SPEED ACCESS TYPE 1. Number of Households passed/serviceable 2. Households with new access 3. Households with improved access 3a. Unserved Households Total number of Households served 4. Number of Households served with speeds of at least 25/3 5. Number of Households served with speeds of at least 100/20 BENEFICIARY TYPE 3b. Businesses 3 1. Number of Businesses passed/serviceable 2. Businesses with new access 3. Businesses with improved access Total number of Businesses served 4. Number of Businesses served with speeds of at least 25/3 5. Number of Businesses served with speeds of at least 100/20 1. Number of CAIs passed/serviceable 2. CAIs with new access 3c. Community Anchor Institutions (CAIs) 4 Total Narrative (Describe reasons for variances of 5% or more from the baseline plan) 3 BROADBAND INFRASTRUCTURE PROGRAM PERFROMANCE (TECHNICAL) REPORT 3c. Community Anchor Institutions (CAIs) 3. CAIs with improved access Total number of CAIs served 4. Number of CAIs served with speeds of at least 25/3 5. Number of CAIs served with speeds of at least 100/20 1. Number of Broadband wholesalers or last-mile providers passed/servicea 2. Broadband wholesalers or last-mile providers with new access 3. Broadband wholesalers or last-mile providers with improved access 3d. Broadband Wholesalers or Last Mile Providers Total number of Broadband wholesalers or last-mile providers served 4. Number of Broadband wholesalers or last-mile providers served with speeds of at least 25/3 5. Number of Broadband wholesalers or last-mile providers served with speeds of at least 100/20 INFRASTRUCTURE BUDGET EXECUTION DETAILS Please provide details below on your total budget and total fund expended to date for each budget element, including detailed disbursements of both matching funds approved and federal funds obligated from project inception through end of this reporting period. Figures should be reported cumulatively from award inception to the end of the applicable reporting period. Projected Budget Element 4 Federal Funds 4a. Administrative and legal expenses 4b. Land, structures, rights-of-way, appraisals, etc. 4c. Relocation expenses and payments 4d. Architectural and engineering fees 4e. Other architectural and engineering fees 4f. Project inspection fees 4g. Site work 4h. Demolition and removal 4i. Construction 4j. Equipment 4k. Miscellaneous 4l. Subtotal 4m. Contingencies 4n. Totals $ $ $ $ $ $ $ $ $ $ $ $ $ $ Total Budget (Federal plus Non Federal) Non Federal Funds -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ -$ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ Federal Funds Expended to Date - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ Non Federal Funds Expended to Date - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ Total Funds Expended - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - $ - OTHER INDICATORS Please use the following table to provide the total for each question. List the projected total for the number of new position created and or filled this reporting period. Information should be reported cumulatively from award inception through the end of the semi-annual period. Please write "N/A" if your project does not include this indicator. Workforce Indicator 5 Outcome 5a. New positions available and funded through BIP grant Total Questions 1. Number of new positions created 2. Number of new positions filled Narrative (Describe reasons for variances of 5% or more from the baseline plan) Please use the following table to provide the maximum upload and download speed for each question. Information should be reported as of the report date. Please write "N/A" if your project does not include this indicator. Broadband Speed 6 Outcome 6a. Maximum available speed upon project completion Upload Questions 1. What is the maximum available speeds for HH in your eligible area 2. What is the maximum available speeds for Businesses in your eligible area 3. What is the maximum available speeds for CAIs in your eligible area CERTIFICATION CERTIFICATION I certify to the best of knowledge and belief that this report is correct and complete for performance of activities for the purposes set forth in the award documents. Telephone (area code, number and extension): Typed or printed name and title of Authorized Certifying Official: Email Address: Signature of Certifying Official: Date: 5 Download BROADBAND INFRASTRUCTURE PROGRAM ANNUAL REPORT OMB Control No. XXX-XXXX Expiration Date: TBD BROADBAND INFRASTRUCTURE PROGRAM ANNUAL REPORT GENERAL GENERAL INFORMATION Recipient Organization Recipient Street Address City, State, Zip Code Performance Period Start Date (MM/DD/YYYY) Report Period Start Date (MM/DD/YYYY) Please describe significant project accomplishments during this period. (600 words or less) Award Identification Number Report Date (MM/DD/YYYY) DUNS/UEI Number Performance Period End Date (MM/DD/YYYY) Report Period End Date (MM/DD/YYYY) 1 Please describe each service provided with BIP grant funds. (600 words or less) 2 Provide the number of locations or geographic areas at which broadband service was provided using the grant funds. (Please attach associated shapefiles of geographic areas) (600 words or less) 3a Using the Excel spreadsheet template titled "BIP Reports Addendum A", please provide an updated count of Households within each of the eligible census block groups along with their Location ID that you connected to your network in column 3b titled '# of Units'. The locations should match and conform to the Federal Communications Commission (FCC) Broadband Serviceable Location Fabric, which is a unique identifier the geographic coordinates, and where available, the address(es) associated with each location. Please be sure to select 'Annual Report' checkbox when completing the addendum. Using the Excel spreadsheet template titled "BIP Reports Addendum B", please provide an updated count of Businesses within each of the eligible census block groups along with their Location ID that you connected your network in column titled 3c '# of Units'. The locations should match and conform to the Federal Communications Commission (FCC) Broadband Serviceable Location Fabric, which is a unique identifier the geographic coordinates, and where available, the address(es) associated with each location. Please be sure to select 'Annual Report' checkbox when completing the addendum. Using the Excel spreadsheet template titled "BIP Reports Addendum C", please provide an updated count of Community Anchor Institutions (CAIs) within each of the eligible census block groups along with their Location ID that you connected to 3d your network in column titled '# of Units'. The locations should match and conform to the Federal Communications Commission (FCC) Broadband Serviceable Location Fabric, which is a unique identifier the geographic coordinates, and where available, the address(es) associated with each location. Please be sure to select 'Annual Report' checkbox when completing the addendum. If applicable, please list each subrecipient that received a subgrant from the covered partnership and a description of the specific project for which the grant funds were provided. (600 words or less) 4 CERTIFICATION I certify to the best of knowledge and belief that this report is correct and complete for performance of activities for the purposes set forth in the award documents. Typed or printed name and title of Authorized Certifying Official: Telephone (area code, number and extension): Email Address: Signature of Certifying Official: Date: 6 BROADBAND INFRASTRUCTURE PROGRAM REPORTS ADDENDUM A OMB Control No. XXX-XXXX Expiration Date: TBD BROADBAND INFRASTRUCTURE PROGRAM ANNUAL REPORT ADDENDUM A Recipient Organization Recipient Street Address City, State, Zip Code Performance Period Start Date (MM/DD/YYYY) Performance Period End Date (MM/DD/YYYY) Award Identification Number Report Date (MM/DD/YYYY) DUNS/UEI Number Report Type Baseline Report Annual Report Household Locations in the Service Area The Location ID is the Fabric ID associated with the Federal Communications Commission maps required by the Broadband Deployment Broadband Deployment Accuracy and Technology Availability (DATA) Act, Pub. L. No. 116-130, 134 Stat. 228 (2020) (codified at 47 U.S.C. §§ 641-646) (Broadband DATA Maps). The “location_id” data element is a unique identifier for the location served. A Location ID should be included for each location in the Broadband Serviceable Location Fabric when the Fabric is made available to filers. Number of units refers to one location that has multiple units within that one location. Please insert rows at the bottom of the table to report additional location data if needed. Location ID Street Address City State ZIP Latitude Longitude Census Block # of Units 7 BROADBAND INFRASTRUCTURE PROGRAM REPORTS ADDENDUM A CERTIFICATION I certify to the best of knowledge and belief that this report is correct and complete for performance of activities for the purposes set forth in the award documents. Typed or printed name and title of Authorized Certifying Official: Telephone (area code, number and extension): Email Address: Signature of Certifying Official: Date: 8 BROADBAND INFRASTRUCTURE PROGRAM REPORTS ADDENDUM B OMB Control No. XXX-XXXX Expiration Date: TBD BROADBAND INFRASTRUCTURE PROGRAM ANNUAL REPORT ADDENDUM B Recipient Organization Recipient Street Address City, State, Zip Code Performance Period Start Date (MM/DD/YYYY) Performance Period End Date (MM/DD/YYYY) Award Identification Number Report Date (MM/DD/YYYY) DUNS/UEI Number Report Type Baseline Report Annual Report Business Locations in the Service Area The Location ID is the Fabric ID associated with the Federal Communications Commission maps required by the Broadband Deployment Broadband Deployment Accuracy and Technology Availability (DATA) Act, Pub. L. No. 116-130, 134 Stat. 228 (2020) (codified at 47 U.S.C. §§ 641-646) (Broadband DATA Maps). The “location_id” data element is a unique identifier for the location served. A Location ID should be included for each location in the Broadband Serviceable Location Fabric when the Fabric is made available to filers. Number of units refers to one location that has multiple units within that one location. Please insert rows at the bottom of the table to report additional location data if needed. Location ID Street Address City State ZIP Latitude Longitude Census Block # of Units 9 BROADBAND INFRASTRUCTURE PROGRAM REPORTS ADDENDUM B CERTIFICATION I certify to the best of knowledge and belief that this report is correct and complete for performance of activities for the purposes set forth in the award documents. Typed or printed name and title of Authorized Certifying Official: Telephone (area code, number and extension): Email Address: Signature of Certifying Official: Date: 10 BROADBAND INFRASTRUCTURE PROGRAM REPORTS ADDENDUM C OMB Control No. XXX-XXXX Expiration Date: TBD BROADBAND INFRASTRUCTURE PROGRAM ANNUAL REPORT ADDENDUM C Recipient Organization Recipient Street Address City, State, Zip Code Performance Period Start Date (MM/DD/YYYY) Performance Period End Date (MM/DD/YYYY) Award Identification Number Report Date (MM/DD/YYYY) DUNS/UEI Number Report Type Baseline Report Annual Report Community Anchor Institutions (CAIs) Locations in the Service Area The Location ID is the Fabric ID associated with the Federal Communications Commission maps required by the Broadband Deployment Broadband Deployment Accuracy and Technology Availability (DATA) Act, Pub. L. No. 116-130, 134 Stat. 228 (2020) (codified at 47 U.S.C. §§ 641-646) (Broadband DATA Maps). The “location_id” data element is a unique identifier for the location served. A Location ID should be included for each location in the Broadband Serviceable Location Fabric when the Fabric is made available to filers. Number of units refers to one location that has multiple units within that one location. Please insert rows at the bottom of the table to report additional location data if needed. Location ID Street Address City State ZIP Latitude Longitude Census Block # of Units 11 BROADBAND INFRASTRUCTURE PROGRAM REPORTS ADDENDUM C CERTIFICATION I certify to the best of knowledge and belief that this report is correct and complete for performance of activities for the purposes set forth in the award documents. Typed or printed name and title of Authorized Certifying Official: Telephone (area code, number and extension): Email Address: Signature of Certifying Official: Date: 12