2016 Border-to-Border Broadband Development …€¦ · Web viewYou can use this tool to determine if areas of a proposed broadband development project might be grant eligible under

Please read through this entire application package BEFORE you begin to respond to the application questions and before you fill out the checklist. This will help ensure you understand the full scope of the application, as well as the details you will need to provide to complete the application.

State of Indiana

Office of the GovernorEric J. Holcomb

Office of the Lieutenant GovernorSuzanne Crouch

Indiana Office of Community and Rural Affairs

Indiana Department of Transportation

Maximum grant amount: $5 millionApplication period opens: 2/21/2019

Deadline for submission: May 3, 2019 4 p.m. (ET)

Broadband Grant ProgramPhase 1 - Unserved Areas

Next Level Connections Grant Program2019 APPLICATION COVERSHEETS/CHECKLIST (5 PAGES)

The Coversheets/Checklist must be answered & checked to have your full application considered for review. We recommend you do this AFTER you fill out the full application section starting on Page 4. However, please read the coversheets (i-iv) and the application introduction (Pages 1-3) before you begin filling out the details that start on Page 4.

☐ Project Title: _______________________________________________________________

☐ Name of Applicant Organization: _______________________________________________

Grant request amount: How much funding are you seeking from the Next Level Connections Broadband Grant Program for this project? How much are you committing as match to the state grant funds? The maximum broadband grant is $5 million for eligible broadband development infrastructure costs. Please round to the nearest dollar.

☐ State Grant Requests $____________________________, which is _____ % of the entire total eligible project cost. (State grant request must be 80% or less of total eligible project costs listed below.)

☐ Total Applicant Match you are providing is $______________________ which is _____ % of the entire total eligible project cost below. (It must be 20% or more of the total eligible project costs.)

☐ Total Eligible Costs are $________________________ (This is the combination of state grant request & applicant match, shown above.)

☐ Total Ineligible Costs are $________________________ (These are costs that the applicant will incur as part of the project, but are not eligible under the grant.)

☐ Total Project Costs are $________________________ (This is the total cost of the project including both eligible and ineligible costs.)

☐ Applicant Eligibility:

Applicant must be an established entity able to deliver broadband service to a residence/end user (last mile).

The established entity will be the lead applicant, but partnering with other entities is permitted in order to deliver the entire solution.

The applicant must demonstrate financial, technical and operational capacity in building and operating a broadband network.

☐ Applicant Primary Contact Person: ____________________________________________

Organization: _______________________________________________________________

Applicant Address: ____________________________________________________________________________

City: ___________________________________________ Zip Code: _________________

22019 Next Level Connections Broadband Grant Application (Phase 1 – Unserved) – Due May 3, 2019

Phone Number: _________________ Email Address: _______________________________

☐ State of Indiana Bidder Number: __________________________________________ If you do not have a State of Indiana Bidder number, you can register for a bidder number. State Bidder registration instructions and information may be found at: http://www.in.gov/idoa/2464.htm

☐ Application Partners: If the application proposes a multi-partner or multi-sector initiative of any kind, please provide the identity and contact information for the primary contact of each application partner. NOTE: all funding partners contributing to the applicant match, including the primary applicant, must provide a letter stating they have reviewed the application, confirm their commitment, and must provide proof the match is available at the time of application.

List application partners and contact information here:

(Attach additional sheets if needed for more partners than this space allows.)

☐ Project Manager for this project (If different from above Applicant Primary Contact Person), in the event of an award: Name: ________________________________________________________

Phone & E-mail: _________________________________________________________

☐ Application Author: __________________________________________________

Author’s Phone & E-mail: _______________________________________________________________________

Author’s organization & relationship (ex. Contractor) to Applicant organization: _______________________________________________________________________

☐ General Time Frame of Grant Project:

Starting Month_____/ ______Year Ending Month_____/ ______YearProject must be completed within 24 months. Please provide a timeline of major milestones for

the project.

☐ ONE PARAGRAPH DESCRIPTION OF PROJECT

(This may be used in promotional materials for the grant program in the event your application is accepted).


http://www.in.gov/idoa/2464.htm

Please state the location, the type of project (fixed wireless, wireline, etc.), the number of passings/locations (households, businesses, anchor institutions) to be connected, the project partners, the speed goals to be met/exceeded, and the community/economic development rationale for the project. We have provided a template summary paragraph below, but please use details from your project to craft an original statement that will be shared with the public.

SAMPLE Paragraph:

☐ EXECUTIVE SUMMARY (up to two pages long) – Please check the box at right to show that you have included an Executive Summary as the last page(s) of your application document. Specific topics to include in the Executive Summary are located at the end of the application. Information included in this section will be posted publically for challenge purposes.

☐ General Location(s) of your project: (you must also provide detailed location information in the body of the application, but please also note the general location here):

☐ Does your project also involve middle mile deployment? :

Middle mile infrastructure is broadband infrastructure that links a broadband service provider’s core


YOUR COMPANY/ORGANIZATION NAME

This Next Level Connections project will serve XXX unserved households and XXX unserved businesses in the _ (specific area) in City/Townships/County/area. In a funding partnership with the State of Indiana and (project partners), (name of applicant) will improve unserved levels to XXX megabits per second up and XXX megabits per second down by (Date). (Community & Economic Development rationale example -please do not copy – write your own unique statement here): “Building a fiber-to-the-premise network that provides advanced broadband services to farms and residences in the proposed grant area improves access to applications and tools to make operations more efficient and enhances crop production. It will also improve access to health care and education, all factors supporting a robust local economy that is globally competitive, too”. Total eligible project cost is $_________. Applicant match is $_________.

network infrastructure to last-mile infrastructure.

Total Number of Passings. VERY IMPORTANT to INCLUDE

Please list in the box below the total number of passings/location counts proposed in your project by type of location:

PASSINGS TALLY SHEET* Households Businesses Anchor InstitutionsCurrently UNSERVED Number of passings expected to improve to actual 10/1, or higher, as a result of the project.

*Note: These estimates should match the totals of your responses in a more detailed chart in the full application.

Business definitions: all business types; includes farms & home-based businesses, and work-at-home/telecommuter use of broadband.

Anchor Institutions definitions: includes facilities such as libraries, township halls, fire and police stations, city halls, county buildings, state facilities, public safety locations, hospitals and nursing homes, and educational institutions.

END OF COVERSHEETS/CHECKLIST

The Table of Contents, Introduction, and Application Section begin on the next page.

We recommend that you read all pages of the entire application package, including coversheets/checklist, introduction, application section, and all appendices before you begin to fill out the application.


NEXT LEVEL CONNECTIONS BROADBAND GRANT2019 APPLICATION

Phase 1 – Unserved AreasGRANT APPLICATION TABLE OF CONTENTS

Coversheets/Checklist - Pages i-v

Please use the preceding five pages (i–iv) of this document as the coversheets/checklist to your grant application. Please be sure to check-off each item on the checklist to verify you have seen and completed it.

Introduction Section Purpose/Background - Page 1 Funding Availability - Page 1 Deadlines/Requirements – Page 2 Eligible Project Areas – Page 2 Eligible Applicants – Page 2 Eligible Program Costs – Page 2 Applicant Match Requirement – Page 3 Authorizing Affidavit – Page 3 Broadband Ready Community Resolution– Page 3 Executive Summary & Grant Rationale – Pages 3

Questions - Page 3

Application Section Section I - Project Details - Page 4 Section II - Documentation to Support Project – Page 6 Section III - Cost Analysis – Page 8 Section IV - Project Schedule – Page 10 Section V - Financials – Pages 10-11 Section VI - Payment Information – Page 11 Sample Affidavit Authorizing Application - Page 12 Executive Summary & Grant Rationale - Page 13

Awarding Grants Selection Criteria and Weights – Page 14-15

Appendices Appendix I - Anticipated Improvements Scoring Table – Page 16 Appendix II - Grant Request Amount Scoring Table – Page 16


NEXT LEVEL CONNECTIONS BROADBAND GRANT PROGRAM2019 APPLICATION

Phase 1 – Unserved Areas

***YOU MUST READ THE FOLLOWING NARRATIVETO FULLY UNDERSTAND THE APPLICATION PROCESS***

INTRODUCTION

PURPOSE/BACKGROUND: The Next Level Connections Broadband Grant Program is designed to promote access to broadband service to all areas of the state, which is necessary for a highly functioning 21st Century economy. Significant investment for the deployment of broadband has been made through industry funds, as well as prior and ongoing grant programs. Yet, there are still areas of Indiana that are deemed unserved for a range of economic and topographical reasons. At the same time, advancements in technology have heightened consumer and business expectations where certain areas are now considered underserved.

FUNDING AVAILABILITY: As previously announced, $100 million has been made available as funding for the Next Level Connections Broadband Grant Program. Priority will be given to projects that leverage greater amounts of funding from other private sources. The maximum grant amount is $5 million. All grant project work must be completed within 24 months of grant award.


The application deadline is May 3, 2019 4:00 PM (ET).

Maximum grant amount: $5 million

The application should consist of three files (Application, Executive Summary, Maps). Narrative files should be submitted in pdf format while map files can be submitted in any of the following formats: (.shp, .kml, .kmz). Information that contains trade secrets should be marked “Confidential” and saved in a separate file. Pursuant to IC 5-14-3-4(a)(4) these records may not be disclosed by a public agency. Files should be electronically submitted by email (if under 20 MB in size) to [email protected], OR by mail on a USB thumb drive to:

OCRANext Level Connections1 North Capitol, Suite 600Indianapolis, IN 46204

Files over 20 MB in aggregate must be mailed, or hand-delivered on a thumb drive. Digital signatures will be accepted. No paper copies will be accepted.

The application MUST be received in the OCRA office by 4:00 PM ET on Friday, May 3 , 2019. Failure to comply with submission requirements could render an application ineligible. Late submissions will not be accepted.

mailto:[email protected]

DEADLINES/REQUIREMENTS: The Next Level Connections Broadband Grant Program is a competitive grant cycle for the year 2019. The application deadline is May 3, 2019. Completed applications and supporting documentation (one electronic copy in PDF format) must be received by the Office of Community & Rural Affairs (OCRA) by 4:00 p.m. on the due date to be considered for funding. An applicant may apply for more than one project, but an individual (separate) application must be completed for each project. Please fill out the entire application and clearly label any attachments with the question/statement number from the application form. Information that contains trade secrets should be marked “Confidential” and saved in a separate file. Pursuant to IC 5-14-3-4(a)(4) these records may not be disclosed by a public agency. Award decisions are estimated to be made in late July 2019.

ELIGIBLE PROJECT AREAS: Broadband development projects located in unserved areas are eligible. An unserved area is an area of Indiana in which the census block does not have at least one broadband provider offering actual speeds of at least 10Mbps down and 1Mbps up, or a potential provider for which the census block has been designated through a federal funding program to deploy that minimum level of service by a specified date. Determination of the available broadband service is based on the following: The most recent available data from the FCC Form 477 (December 2017) will be used to

determine existing service levels. Because this data is collected on a census block level and can overstate the availability of

services, an applicant is permitted to provide additional information to demonstrate that the proposed service area is unserved.

Additional information must be sufficient to conclude that an area is eligible and may include but is not limited to: o Statistically significant survey data for the designated area, or o Documentation of the location of existing infrastructure within a given census block.

ELIGIBLE APPLICANTS: Eligible applicants for this grant program must be able to provide broadband service to residential/end user consumers. The qualified applicant has to demonstrate financial, technical, and operational capacity in building and operating a broadband network.

ELIGIBLE PROGRAM COSTS: The Next Level Connections Broadband Grant Program can pay up to 80 percent of the eligible costs for a qualifying project up to $5 million. A “qualified broadband project” is a project for the deployment of broadband infrastructure for the provision of qualified broadband service, regardless of the delivery technology, in unserved areas in Indiana. “Qualified broadband project expenses” are terrestrial capital expenses directly related to a qualified broadband project, including design, construction, engineering, and permitting expenses. Maintenance or operating expenses related to the project do not qualify as an eligible expense.

Last mile infrastructure is broadband infrastructure that serves as the final leg connecting a broadband service provider’s network to the end-user customer’s on premise telecommunications equipment. Middle mile infrastructure is broadband infrastructure that links a broadband service provider’s core network infrastructure to last-mile infrastructure.

Construction of broadband infrastructure may include any of the following: project planning;


obtaining construction permits; construction of facilities, including construction of “last mile” infrastructure; equipment; and installation.

APPLICANT MATCH REQUIREMENT: To obtain a broadband grant, the applicant must provide for the funding not covered by the grant, as well as to provide at least 20% of the eligible costs to deploy the proposed broadband infrastructure as an applicant match. The match can come from any private and public sources available to the applicant, but cannot include any other state or federal funds applied to the same unserved area. An application will receive additional points if the applicant match is greater than 20% of the total eligible project costs.

Documentation to support the match is required as part of the application. Some examples include: a letter of credit, letter from a bank, board resolution committing funding, or loan documentation. If you have additional financial partners for the applicant match, please also provide documentation for their applicant match.

Any eligible project expenses incurred between the grant award date and the end of the project (whichever is earlier), can be counted as part of the applicant match. The state grant funding period begins after the grant application is received, evaluated, and officially approved with an award letter.

AUTHORIZING AFFIDAVIT: The applicant must complete an affidavit or other documentation authorizing this application and guaranteeing the applicant match. A sample affidavit is provided at the end of this application.

BROADBAND READY CERTIFICATION: If the applicant is serving areas with Broadband Ready Certified communities, please include a copy of the certification.

EXECUTIVE SUMMARY & GRANT RATIONALE: After you’ve completed the application, please reflect on your application responses and provide a brief executive summary and grant rationale (up to two pages) using the guidelines provided. These should be the last pages of your application.

ANY QUESTIONS? If you have questions after reviewing the application and supporting documentation, please see the Frequently Asked Questions document available on our grant website at https://www.in.gov/ocra/nlc.htm . The FAQ will be updated throughout the application process.


https://www.in.gov/ocra/nlc.htm

GRANT APPLICATION - PROJECT DETAILSSECTION I: PROJECT INFORMATION AND LOCATION

1.1 Name of Project: _____________________________________________

1.2 Primary Applicant: _____________________________________________

1.3 Does Your Project Also Have Middle Mile Components: Yes☐ No☐

1.4 Written location information and map of project area. Please include geographical boundaries and list of census blocks and road segments if census block is over 2 square miles where broadband will be provided. In addition include a map of the service area boundaries and also include place names, boundaries, buildings, road/street names, street addresses, or other features that clearly identify the project coverage area. Applicants may provide information regarding additional infrastructure deployments that are not eligible for grant funding to provide context for the proposed project area.

Please be clear and concise as this information will be posted to inform the challenge process. For more information on the challenge process, see the Frequently Asked Questions (FAQs) document on our website at https://www.in.gov/ocra/nlc.htm. The FAQ will be updated throughout the application process.

1.5 Please identify the County or Counties and IN Legislative district(s) in which your project resides.

County/Counties/Townships: _________________________________Indiana Legislative District # _________Rep __________Sen (Note: The Indiana Legislature has a tool to look up legislative district numbers. You must have a precise address and know the zip code of the site. Go to: http://iga.in.gov)


In the Application question and answer sections that follow, please be as brief as possible, but include enough information to

fully articulate your broadband project.

http://iga.in.gov/

BROADBAND INFRASTRUCTURE TO BE PROVIDED (Please label each attachment with the corresponding numbers listed below.)

1.6 Please attach a list or schedule of all grant eligible elements (labor, materials, equipment, design services, etc.) to be purchased for the project.

Below is a list of commonly used and recommended grant eligible elements and budget categories. Please use these recommended categories. If a category is not listed here, please add it into your list of all grant eligible elements and also in your project budget (on Page 9).

NEXT LEVEL CONNECTIONS BROADBAND GRANT PROJECT – USE OF FUNDS LISTRECOMMENDED GRANT ELIGIBLE ELEMENTS & PROJECT BUDGET CATEGORIES

Please use these common “Use of Funds” budget categories as appropriate for your proposed project list and in your project budget table. Please add other categories as needed.

Buildings and Land Construction – Labor – Last Mile Construction – Labor – Middle Mile Construction - Material Customer Premise Equipment Customer Premise Installation Electronics Permits Professional Services, to include design, and engineering

1.7 Please attach budgetary engineering designs, diagrams and maps that show the proposed project. Design documents must clearly demonstrate applicant’s complete understanding of the project and ability to provide the proposed solution. The information must be certified by a Professional Engineer registered in Indiana.

1.8 Demonstration that the installed infrastructure is a connection to the Internet that provides capacity for transmission at the actual speed proposed by the applicant. The information must be certified by the manufacturer or a Professional Engineer registered in Indiana.

1.9 Provide a narrative on how the design was developed and selected. Outline factors, such as geography and topography that were taken into consideration. Discuss how the design meets the needs of the service area. Also, discuss the expected useable life of the project for the service area.


SECTION II. GRANT APPLICATION - DOCUMENTATION TO SUPPORT PROJECT

2.1 UNSERVED EVIDENCE

Provide evidence to demonstrate that the proposed project is for an unserved area.

Maps showing unserved areas in the state eligible for the grant program are available through the website. You can use this tool to determine if areas of a proposed broadband development project might be grant eligible under the criteria of the 2019 Next Level Connections Broadband Grant Program.

Existing broadband providers will be able to challenge proposed service areas being considered for public funding immediately following the close of the grant application window. The supplemental Challenge document for the challenge process will be posted on the OCRA website: https://www.in.gov/ocra/nlc.htm

2.2 ANTICIPATED IMPROVEMENTS

Using the “Anticipated Improvements” table below, please provide the number of households or businesses that will be able to receive broadband services as a result of the proposed project. If services are being improved as part of this project, please identify the speeds currently available for each type of location, using the ranges provided on the table, and the speeds that will be offered if the project is awarded grant funding.

To the extent possible, please identify location types by household, business (including home-based business or telecommuter, farm, etc.). See definitions below the chart box.

Anticipated Improvements in Broadband Service Based on the Broadband Project Investments

# of PassingsSpeed Now: 0/0 ≤10/1 0/0 ≤10/1 0/0 ≤10/1 0/0 ≤10/1

Speed After Build: 10/1

10/1 25/3

25/3 100/5 100/5 1G/1G 1G/1G

HouseholdsBusinessesTOTAL

Business definitions: all business types; includes farms & home-based businesses, and work-at-home/telecommuter use of broadband.

2.3 COMMUNITY & ECONOMIC IMPACT

Community & economic development impact, useful usage of broadband: Demonstration of


the economic & community development potential of the project including how the project will provide opportunities for existing business retention and expansion, new business attraction, increased jobs and/or other expanded business and community opportunities, including:

2.3a How will businesses or economic development efforts be impacted by the project? Will the project help address the needs of rural entrepreneurs and teleworkers?

2.3b Specific evidence of how health or public safety will benefit from the project, including how the use of telemedicine and electronic health records is facilitated/improved.

2.3c Specific evidence of how educational access (for all ages) will benefit from the project, including how the use of e-learning opportunities would be improved.

2.3d General description of how quality of life would improve as a result of the grant project.

2.3e Examples of proposed pricing stability and affordability to local residents. Include information on any discounted pricing available for special groups, such as, but not limited to, low-to-moderate income households, senior-citizens, non-profit organizations, etc.

2.3f Provide the speed tiers (download and upload) and pricing structure that will be offered over the initial five years of the project.

2.3g Please include with your proposed pricing information the specific un-discounted/rack rate pricing of unbundled internet-only service of actual 10 Mbps down and 1 Mbps upload and if offered, for service of average 10- 25 Mbps down and 3 Mbps upload and all higher speeds.

2.4 COMMUNITY ENGAGEMENT & SUPPORT

Provide evidence of community support for the project. Examples include letters endorsing the project from residents, businesses, legislators, congressional representatives, and local government resolutions

2.4a Provide a listing of any significant community anchor institutions that will benefit from the proposed project. Please be specific listing the institutions and how they benefit. Include any demonstrations of how the broadband deployment will be incorporated into specific community programs. Please be sure to include specific information on any school, library, public safety, or general communications tower that will receive a fiber connection as part of this project.

2.4b Provide documentation of a commitment that applicant will offer service for a minimum of five years.

2.4c Provide letter(s) of support from any local units of government of the communities or counties within the project’s service area.


SECTION III. PROJECT COST ANALYSIS

3.1 What are the total eligible project costs? $ _______________________

(Qualified broadband project costs may include project planning; obtaining construction permits; construction of facilities, equipment; and installation of the broadband service.

Please also remember to figure in both time and expense for the required local and state environmental reviews and permits. See 3.7 – 3.10 below for more information

Note: These review and permitting tasks must also be reflected on the Project Schedule.

3.2 How much grant money are you seeking from the Next Level Connections Broadband Grant Program for this project? $______________________

(Note: Up to 80% of the total broadband development cost is eligible to be reimbursed by a state broadband grant, to a maximum of $5 million. Points will be awarded to projects that leverage greater applicant match funding.)

3.3 Please fill out the PROJECT BUDGET TABLE below indicating the sources, uses, and amounts of all funds that will be used for qualified broadband project costs as defined on Page 2. Please use the recommended Use of Funds categories where possible, creating other categories where anticipated expenses do not fall within one of the recommended categories.

Sources and Uses of Broadband Grant Funds1 and Applicant Match for the Project

PROJECT BUDGETUse of Funds (Activity-Category)

Amount Source of Funds (Applicant portion/state grant)

1 Please note that Next Level Connections Broadband grant funds are disbursed to grantees on a reimbursement basis.


EXPLANATION OF BUDGET TABLE ITEMS:

Use of Funds (Activity-Category) – See Page 5 for a list of commonly used budget categories. Please use the recommended categories where possible, creating other categories where anticipated expenses do not fall within one of the recommended categories. You can also add additional rows as necessary.

Amount – Total cost of the budget line item. Source of Funds – Who is paying for this activity? Please note if it will be included in an invoice for

reimbursement from the Next Level Connections Broadband Grant program.

3.4 Please attach all written funding commitments from all project funding partners, including public, private, and non-profit or philanthropic sources.

3.5 If the grant request is approved for this project, is the remainder of the financing in place for building this project?

☐ NO, the applicant match funds are not yet in place. If funds are not secured yet, what is the process to secure the funds and what is the timeline in which they will be obtained? Please explain briefly but completely.

☐ YES, all of the applicant match is in place. If yes, you must attach evidence that applicant match funds are secured.

3.6 Are there additional costs related to this project that are not eligible costs that will be incurred as part of the overall project costs for deploying broadband to this area?____________ If yes, what are those costs?_________________________

3.7 Have all of the required local/city/county/state approvals necessary for this project to proceed been obtained (planning commission, zoning, route and road authorities, railroad crossing, etc.) ________ If not, what remains to be done and what is required for completing the process of obtaining approvals? Include this information in the project timeline/schedule.

3.8 Have state environmental review requirements been met, if applicable? _____ If not, what remains to be done and what is required for completing the process of obtaining approvals? Please include this information in the project timeline/schedule.

3.9 Does the project affect/is the project located in or near local, state or federal historic or potentially historic, architectural or archeological resources? If yes, what remains to be done and what is required for completing the process of obtaining approvals? Include this information in the project timeline/schedule (Section 4.1). (Questions regarding historic resources should be directed to Indiana Department of Natural Resources – Division of Historic Preservation & Archaeology (DHPA) at 317-232-1646).

3.10 Please provide a Five Year stand-alone financial plan/forecast for this project, including a description of how the costs and anticipated revenues will result in the financial viability of the project over time.


IV. PROJECT SCHEDULE

4.1 Provide a project schedule outlining the major milestones and their timing for the overall project, you may use the form below or provide an alternative format to indicate the milestones involved in the project and the expected completion date (month and year) of the activity. The last task on the project schedule should indicate the date upon which service to the last location will be turned on.

PROJECT MILESTONES BY YEAR AND MONTH

Project YEAR 2019 YEAR 2020 YEAR 2021M J A S O N D J F M A M J J A S O N D J F M A J J A S O N D

Broadband Development Activities Completion date __________/__________/__________

4.2 Please list any factors which would change or delay this schedule.

V. FINANCIALS

5.1 Please describe the need for funding from the Next Level Connections Broadband Grant fund and why the project could not proceed without this funding. Please refer to your five year standalone financial plan/forecast that you’ve completed and demonstrate the financial model with and without grant funding. Be as specific as possible.

5.2 Please provide an organizational chart, and information on key officers or personnel that will be overseeing the project.

5.3 Please include the applicant’s financial statements, including an income statement and balance sheet, for the most recently completed fiscal year. The financial statements must demonstrate the applicant’s financial stability. If the financial statements being provided by the applicant are those of a parent or holding company, additional financial information should be provided for the entity/organization. Please attach as a separate file if necessary. Information that contains trade secrets should be marked “Confidential” and saved in a separate file. Pursuant to IC 5-14-3-4(a)(4) these records may not be disclosed by a public agency.

SECTION VI. PAYMENT INFORMATION

6.1 Most grant payments take place through electronic funds transfer (EFT). To ensure proper payment, a Bidder Number assigned by Indiana Department of Administration (IDOA) is required.


Your Financial Contact Person:_________________________________________________

Telephone Number or e-mail:___________________________________________________

Please also provide:

State of Indiana Tax Identification Number: _____________________

(This is NOT your State of Indiana Vendor Number.)

Federal Employer Identification Number:__________________________

(An Employer Identification Number (EIN) is also known as a federal tax identification number, and is used to identify a business entity.)

Certificate of Territorial Authority__________________________

(Actual order including notice of change or the cause number.)


APPLICANT AFFIDAVIT

I, , certify that I am duly authorized by the governing body of the lead applicant to submit this application and included materials; that the applicant has the capacity to carry out the proposed project; that the proposed project is designed to meet the identified needs of the project area; that all the information submitted as part of this application is true and correct to the best of my knowledge; and that I am an authorized agent of the applicant.

Signature

Print Name:

Title:

Email:


Executive Summary & Grant Rationale Your response to the outline below should be no longer than two pages.

This information may be made public.

After you’ve completed the preceding application and reviewed the AWARDING GRANTS – Selection Criteria & Weights pages that follow this page, please reflect on your application responses and provide a brief executive summary and grant rationale that includes:

Brief project description/summary (less than 150 words)

A general geographic location of the project (not census blocks) and total number of passings estimated to be made as a result of the grant project

A brief description of the applicant’s involvement in the project to date and how the applicant (and/or partners) intends to manage and sustain the project

A statement on how broadband improvements will advance the quality of life and strengthen economic development opportunities in the communities in the project area


Awarding Next Level Connections Broadband Grant2019 Selection Criteria & Weights

The State of Indiana will award grants to projects that provide the highest return in providing access to the unserved for the public costs incurred, and meet all of the grant requirements.

To fulfill this requirement of reviewing applications in an objective and fair manner, applications will be reviewed and evaluated by a team of state agency officials. They will use the following criteria and point values to assist in systematically awarding grants. These criteria reflect information sought via the grant application questions. To ensure that your application receives its maximum point total, please be sure to provide complete responses to the information requested in the application.

250 points possible

Households/Businesses Served: 0 to 75 points Total number of possible passings at project completion. (SEE Appendix I to see how anticipated improvements are scored)

Applicant Match Amount: 0 to 25 points Percent of match being provided compared to eligible project costs. (A higher Applicant match

percentage will result in a higher application score in this category.)

(SEE Appendix II table to see how Applicant match percentages are scored)

Project Description & Readiness: 0 to 35 points Demonstration of project readiness. Examples include a solid engineering and design plan,

financing secured, other approvals secured or in process, project schedule thorough and complete, and evidence of readiness to build, manage and operate the project.

Comprehensive proposal: partners in place, application complete and well prepared, budget table complete.

Initial five-year service (speed tiers and pricing) offers service at or above the speed stated in the application at affordable prices including unbundled broadband service; financial plan described.

Capacity/Sustainability/Scalability: 0 to 70 points Financial soundness and efficiencies. Examples include identification of eligible costs,

leveraging existing broadband, financing is secured, additional costs identified, need for funding clearly identified, financial plan, financial strength demonstrated, and a resolution/applicant affidavit.

Organizational capability. Examples include quality/experience of partners and project manager, organizational charts, company history and resumes.

Technical demonstration. Examples include a clear and concise project description, commitment to offering service for a minimum of five years, rationalization of type of technology chosen, a realistic project schedule that syncs with broadband infrastructure to be provided and the budget table, a clear documentation of areas to be served, and provision of IN vendor ID number and IN identification number and federal employer identification number.

Community Support & Engagement/Partnership: 0 to 25 points


Evidence of community support, including project partners and demonstration of community engagement, such as letters of support, lists of events/meetings demonstrating community engagement at-large and take-rate estimates.

Community Impact & Economic Development Review: 0 to 20 points Does the project demonstrate economic development impacts and, if so, how? This might

include documenting via specific impact statements from businesses as to business retention, expansion, and attraction impact, including home-based businesses and telecommuting. Also evidence of education, health and public safety benefits and general quality of life improvement.

APPENDIX I: Anticipated Improvements Scoring Table


Households and businesses passed: 0 to 75 points Number of locations (passings) served

Speed After Build# of Passings 10/1 25/3 100/5 1 Gig/1 Gig

0-50 10 25 40 60

51-250 15 30 45 70

251+ 20 35 50 75

APPENDIX II - Applicant Match as Percent of Eligible Costs

Grant Request Amount: 0 to 25 points Percent of match compared to eligible project costs. A higher Applicant match percentage will

result in a higher application score in this category.

Match Percent of eligible project costs Points20% 0

21-50% 1051-75% 20>75% 25


END OF APPLICATION PACKAGE

Applications are due on May 3, 2019 by 4 p.m.

Maximum grant amount: $5 million

The application should consist of three files (Application, Executive Summary, Maps). Narrative files should be submitted in pdf format while map files should be submitted in any of the following formats: (.shp, .kml, .kmz). Information that contains trade secrets should be marked “Confidential” and saved in a separate file. Pursuant to IC 5-14-3-4(a)(4) these records may not be disclosed by a public agency. Files should be electronically submitted by email (if under 20 MB in aggregate size) to [email protected], OR by mail on a USB thumb drive to:

OCRANext Level Connections1 North Capitol, Suite 600Indianapolis, IN 46204

Files over 20 MB in aggregate must be mailed, or hand-delivered on a thumb drive. Digital signatures will be accepted. No paper copies will be accepted.

The application MUST be received in the OCRA office by 4:00 PM ET on Friday, May 3 , 2019. Failure to comply with submission requirements could render an application ineligible. Late submissions will not be accepted.


mailto:[email protected]

Documents

2016 Border-to-Border Broadband Development …€¦ · Web viewYou can use this tool to determine if areas of a proposed broadband development project might be grant eligible under