Application for Texas Classroom Connectivity Special Construction State Match CCI.B

Acceptance of Texas Classroom Connectivity Special Construction State Match (CCI.B)
County District Number*
CDN
NCES Number:
School District or Consortium Name:*
Form 471 Application Number:*
471 Application Number
District Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Funding Request Number(s):*
FRN
FRN Number:
List additional FRN if needed.
FRN Number:
List additional FRN if needed.
Billed Entity Number (BEN):*
District Billed Entity Number (BEN).
Total Pre-Discount Charges:*
Total Pre-Discount Charges. From your Funded FCDL.
Special Construction State/Tribal Match Percentage:*
From your Funded FCDL.
Special Construction State/Tribal Match Discount Rate:*
From your Funded FCDL.
Funding Commitment Request:
Calculated. Should equal value from your FCDL.
Texas CCI State Match Percentage:
Calculated.
Texas CCI State Match Dollars:
Calculated.
Applicant Funding Amount (Local funded amount, may be zero):
Calculated. Must be greater than or equal to zero (0).
Superintendent's Name*

First NameLast Name
Superintendent's Email (Enter and confirms email address)*

Confirmation Emailexample@example.com
The undersigned below hereby certifies that the Texas Classroom Connectivity Special Construction State Match award to for the special construction E-rate project(s) requested on E-rate Funding Year 2019 Form 471, Funding Request Number(s) (FRN) is accepted by the applicant and all project specific contingencies are understood and accepted.
- The applicant has attached a copy of the USAC Funding Commitment Decision Letter (FCDL).
- The project(s) will be completed within twelve months of receipt of the FCDL and completion notification will be sent to TEA.
- All work to be completed, inclusive of project management and oversight, materials, labor or other, specifically related to the project(s) are the responsibility of the Applicant without any TEA participation.
- All awarded funds will be expended in a timely manner, meeting all USAC rules and requirements.
- The applicant recognizes that under current E-rate rules and regulations, special construction fiber projects must be lit by June 30th of 2022. If the applicant will not meet this goal, the applicant must formally request an extension from USAC. Failing to do so may result in USAC seeking a commitment adjustment and the return of any awarded funds.
- Applicant certifies it has in current funds, amounts sufficient to meet the Applicant share as of or on July 1, 2022.
- In the event that USAC seeks a commitment adjustment, or COMAD, from the applicant for special construction charges because of violations of rules and regulations of the E-rate program, the Commissioner, or his or her designee, at his or her sole discretion, may seek to recover any state funds granted to Texas applicants for special construction charges.
Certification:*
Date:*

MonthDayYear
Date
Superintendent's Signature

Clear
The Superintendent's Signature is required. It is not required on this form to allow the form to be submitted but must be edited to include the superintendent's signature. Some districts may be able to gather the superintendent's signature in a single submittal. Other districts may submit the form and then edit the form at a later time to include the superintendent's signature.

The form cannot be processed until the superintendent's signature is included!
Applicant Notes:
Upload District's most recent FCDL/RFCDL:*

Browse Files
Please upload your district's most recent FCDL/RFCDL. Cancelof
Upload District's Form FCC Form 471 spreadsheet:*

Browse Files
Please upload your district's FCC Form 471 spreadsheet.. Cancelof
Contact Name.*

First NameLast Name
Contact Email (Enter and Confirm email address)*

Confirmation Emailexample@example.com
E-rate Consultant Name.

First NameLast Name
E-rate Consultant (Enter and Confirm email address)

Confirmation Emailexample@example.com
Should be Empty:

Acceptance of Texas Classroom Connectivity Special Construction State Match (CCI.B)