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OMB Control No.: 0660-0031*Expiration Date: 07-31-2010

Broadband Technology Opportunities Program

Comprehensive Community Infrastructure Paper Application

February 16, 2010

Version 1.0

National Telecommunications and Information Administration

Broadband Technology Opportunities Program1401 Constitution Avenue, NWWashington, DC 20230

* Notwithstanding any other provision of law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with a collection of information subject to the Paperwork Reduction Act unless that collection displays a currently valid OMB Control Number.

Made Possible by the Broadband Technology Opportunities Program

Funded by the American Recovery and Reinvestment Act of 2009


1 IntroductionPursuant to section X.N. of the Notice of Funds Availability (NOFA), an Applicant may seek a waiver of the electronic filing requirement set forth in section VI.E. of the NOFA and request that the National Telecommunications and Information Administration (NTIA) accept its application in another format (e.g., paper). As stated in section X.N., it is the general intent of NTIA not to waive any of the provisions set forth in the NOFA. However, under extraordinary circumstances and when it is in the best interest of the federal government, NTIA may grant relief. Thus, Applicants seeking a waiver of the electronic filing requirement must specifically set forth in writing the extraordinary circumstances they face, why they cannot file electronically, and why it is in the best interest of the federal government to grant relief. To the extent that an Applicant petitions for relief of the electronic filing requirement and intends to submit a paper application, the written waiver requests must be submitted along with the paper application by the deadline set forth below.

Waiver requests and accompanying paper applications must be received by NTIA no later than 5:00 p.m. EDT on March 15, 2010. When seeking to apply in a paper format, the Applicant assumes all risk of not meeting this deadline. As stated in the Round 2 Grant Guidance, the submitted paper application must comply with all of the following guidelines. An applicant’s failure to comply with the character limits, page limits, and formatting requirements as set forth in the application, or the failure to submit all required attachments may result in the applicant’s waiver request not being considered.

The application must be typed, single-sided, single-spaced, on 8 ½” x 11” paper, excluding maps, diagrams, and charts. To the extent applicable, the font must be no less than 12 points with margins no less than one inch. Applicants must also submit a copy of their application on an appropriate electronic medium, such as a DVD, CD-ROM, or flash drive. Each submission must also be clearly labeled with the name of the Applicant, a description of each submission (e.g., Attachment M), and the electronic format used (e.g., Word 2007 or Adobe Acrobat 7.0). Please note that NTIA will not accept paper applications via facsimile machine transmission or via electronic mail.

Applicants filing in a paper format must submit an application signed by an authorized representative of the Applicant certifying that he or she is authorized to submit the application on behalf of the Applicant and that all of the contents of the application are true and correct to the best of his or her knowledge, information, and belief.

Waiver requests and paper applications must be mailed, shipped, or sent overnight express to:

Broadband Technology Opportunities Program National Telecommunications and Information Administration U.S. Department of Commerce 1401 Constitution Avenue, NW HCHB, Room 4887 Washington, DC 20230

Or hand-delivered to:

Broadband Technology Opportunities Program National Telecommunications and Information Administration U.S. Department of Commerce 1401 Constitution Avenue, NW

Round 2 Comprehensive Community Infrastructure Application 1




HCHB, Room 1874 Washington, DC 20230

Room 1874 is located at entrance #10 on 15th Street NW, between Pennsylvania and Constitution Avenues. United States Postal Service Priority Mail, First Class Mail, and Parcel Post packages delivered to the DOC are irradiated. Irradiation could result in damage to the contents, or delay the delivery of an application to the BTOP Office. Thus, Applicants are encouraged to consider the impact of these procedures in selecting their chosen method for application delivery.





2 Acknowledgement of Notices

Acknowledge

Before applying, applicants should fully read the Notice of Funds Availability (“NOFA”) and Grant Guidance for Round 2 of BTOP funding. Among other things, applicants should be familiar with the following rules and requirements:

Applicants who are current RUS loan or grant recipients or whose project will include one or more last mile service areas that are 75% or more rural are strongly advised to apply to the Rural Utility Service’s Broadband Initiatives Program instead of BTOP.

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.

All Comprehensive Community Infrastructure applicants must propose to offer service meeting the definition of broadband established in the NOFA.

All Comprehensive Community Infrastructure applicants must comply with the nondiscrimination and interconnection requirements established in the NOFA.

All Comprehensive Community Infrastructure applicants whose project will include a last mile service area must provide service to the entire service area, unless they have requested a waiver of this requirement.

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.

Applicants that are not exempt from taxation should consult with their tax advisors regarding the potential tax consequences of BTOP grants. For an example of the analysis that the Internal Revenue Service may apply to BTOP grants, please see www.irs.gov/pub/irs-drop/n-03-18.pdf. Federal taxes are not an eligible cost under Federal grant programs such as BTOP.

In advance of accepting a BTOP award from NTIA, Applicants should review the Department of Commerce's grant award document, the CD-450 "Financial Assistance Award." Applicants should also familiarize themselves with the Department of Commerce’s standard terms and conditions for grants. See “Financial Assistance Standard terms and Conditions.”

IMPORTANT NOTICE: Some of the elements in this application will be made publicly





accessible through the application database available at 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; 3) information regarding the proposed funded service area; and 4) 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 place an X below to acknowledge that you have read the above notices as well as the applicable rules in the NOFA governing this program.

____ I Acknowledge the above statement.





3 Contact Information

Contact InformationProvide the name and contact information of person to be contacted on matters involving this application. ALL INFORMATION ON THIS PAGE WILL BE MADE PUBLICLY AVAILABLE.

Prefix:

First Name:

Middle Name:

Last Name:

Suffix:

Title:

Telephone: Extension:

Fax Number:

Email:





4 Additional Contacts

Other Grant Project Contact Information Enter the contact information for each additional point of contact.

Prefix:

First Name:

Middle Name:

Last Name:

Suffix:

Title:

Project Role:

Seconary POC

Other Contact

Telephone Number:

Extension:

Email (Business):





5 Organization Information

Organization Information Please enter the DUNs Number for the organization applying for this grant.

DUNS Number:

CCR:

CAGE Number:

Legal Business Name:

Point of Contact (POC):

Alternate POC:

Electronic Business POC:

Alternate Electronic Business POC:

Environmental Point of ContactEnter the contact information for environmental point of contact.

Prefix:

First Name:

Middle Name:

Last Name:

Suffix:

Title:

Phone:





Additional Organization Information Please enter the following information.

Type of Organization: Please select the appropriate classification for your organization from the choices indicated below. (Note: If there are multiple sponsoring organizations, designate the lead applicant that would enter into a grant agreement with the Agency and assumes operational and financial responsibility should an award be made).

____ 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

____ Cooperative or Mutual

____ Native Hawaiian Organization

____ For-profit Entity

____ Other

Is the organization a small business?

____ Yes

____ No

Does the organization meet the definition of a socially and economically disadvantaged small business concern?

____ Yes

____ No





6 Authorization

Authorization Please indicate the Applicant’s Authorized Organization Representative.

First Name:

Last Name:

Email:





7 Project Information

Project Title Provide a title for the project that is descriptive and illustrates the purpose of the project.

[Insert Text Here]

Project Description Provide a few short sentences to describe the project. Because this brief description of the project will appear on publicly accessible Web sites, the Applicant should ensure that it describes the project fairly and in the light the Applicant wants the public to see its proposal. This response is limited to 400 characters.

[Insert Text Here]

CCI Priority Checklist Please place an X next to all that apply:

____ 1. This project will deploy Middle Mile broadband infrastructure to community anchor institutions.

____ 2. This project will deploy Middle Mile broadband infrastructure and has incorporated a public-private partnership among government, non-profit and for-profit entities, and other key community stakeholders.

____ 3. This project will deploy Middle Mile broadband infrastructure in economically distressed areas.

____ 4. This project will deploy Middle Mile broadband infrastructure to community colleges.

____ 5. This project will deploy Middle Mile broadband infrastructure to public safety





entities.

____ 6. This project will deploy Middle Mile broadband infrastructure and either includes a Last Mile infrastructure component in unserved or underserved areas or has received commitments from one or more Last Mile broadband service providers to utilize the Middle Mile components. Any Last Mile components in rural areas do not exceed 20 percent of the total eligible costs of the project.

____ 7. This project will deploy Middle Mile broadband infrastructure and the applicant has proposed to contribute 30 percent or more in non-federal cost match.

Comprehensive Community Infrastructure Components

Please check if the project includes at least one of the following components (check as many as apply):

____ Middle Mile

____ Last Mile Rural

____ Last Mile Non-Rural

BIP ApplicantsHave you also applied to BIP for funding in the same proposed funded service area?

____ Yes

____ No

If YES, please provide the project title and Easygrants ID number.

Title of BIP Application:

Easygrants ID:

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

If YES, the Applicant has submitted, or plans to submit, any other related applications for BTOP





funds in this round of funding, please indicate the Easygrants ID and Project Title for those applications.

Easygrants ID:

Project Title:

If YES, please explain any synergies and/or dependencies between this project and any other applications. Describe how the projects are related, and detail any synergies created by the projects. Also the Applicant should note any 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. This response is limited to 3,000 characters.

[Insert Text Here]

Individual Background Screening 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:

Essay Question: Executive Summary, Project Purpose, and BenefitsExecutive Summary of the Proposed Project: The Executive Summary should be a brief description of the Project, and may address the following topics:

a. Opportunity the proposed system seeks to address;b. A general description of the proposed funded service areas (location, number of communities, etc.);c. Number of households and businesses passed;d. Number of community anchor institutions passed and/or involved with project (e.g., health care, education, libraries, etc.);e. Proposed services and applications for the proposed funded service areas and users;f. Approach to addressing the nondiscrimination and interconnection obligations;g. Type of broadband system that will be deployed (network type and technology standard);h. Qualifications of the Applicant that demonstrate the ability to implement and operate a broadband infrastructure, and/or be a sustainable broadband service provider;i. Overall infrastructure cost of the broadband system; j. Overall expected subscriber projections for the project; and k. Number of jobs estimated to be created or saved as a result of this project.This response is limited to 9,000 characters.

[Insert Text Here]

Project Purpose: Describe the purpose of the project and how it supports the statutory objectives of the BTOP program (refer to Grant Guidance). Please include information to support your assumptions relative to the following:

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. Whether the proposed funded service area is in an unserved or underserved area; ande. The extent to which the project addresses more than one statutory purpose.This response is limited to 6,000 characters.

[Insert Text Here]

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. This response is limited to 3,000 characters.

[Insert Text Here]

Fit With BTOP CCI Priorities: With respect to each box on the BTOP CCI Priority Checklist that you checked, please describe how and to what extent the project meets or exceeds the objectives of that priority. This response is limited to 6,000 characters.

[Insert Text Here]





Additional QuestionsIs the Applicant seeking a waiver of the Buy American provision pursuant to section X.Q. of the NOFA?

____ Yes

____ No

If YES is selected, you are required to submit additional documentation.

Is the Applicant delinquent on any federal debt? ____ Yes

____ No

If YES is selected, please provide your justification for delinquency. This response is limited to 1,500 characters.

[Insert Text Here]

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 is selected, you are required to submit additional documentation.

Is the applicant a current recipient of a grant or loan from RUS?____ Yes

____ No





8 Partners

Partners Please indicate the following information.

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. Attach all letters of commitment to this application and insert a label for each letter indicating it is a key partner letter of commitment.

If YES, the Applicant must fill in the requested following information for each of its key partner(s) on the following pages.

Partner Information: Please provide a description of the involvement of the partners listed above in the project. 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 attachments section. This response is limited to 6,000 characters.

[Insert Text Here]





Partners The Applicant must provide information on each partner, including contact information.

Prefix:

First Name:

Middle Name:

Last Name:

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):





Organization:

____ 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

____ Cooperative or Mutual

____ Native Hawaiian Organization

____ For-profit Entity

____ Other

Is your key partner(s) a small business?

____ Yes

____ No

Does the organization(s) meet the definition of a socially and economically disadvantaged small business concern?

____ Yes

____ No





9 Congressional Districts

Congressional Districts The Applicant is required to provide the Congressional District of the location of its headquarters. Then, the Applicant should list the appropriate states or territories of its Project Service areas. Finally, the Applicant should indicate the relevant Congressional District(s) in which the project will provide service. Additional guidance on Congressional Districts can be found at http://www.nationalatlas.gov/printable/congress.html with maps of each Congressional District.

Applicant Headquarters:

Project Service State(s):

Project Service Area(s) Congressional District(s):

Will any portion of your proposed project serve federally recognized tribal entities? Please answer Yes or No.

____ Yes

____ No

If YES, indicate each federally recognized tribal entity your proposed project would serve. Please refer to the list of Tribal Entities in Section 19: Additional Information, of this application to determine the name of each federally recognized tribal entity your proposed project would serve. Please indicate which state the tribal entity is located in.

Tribal Entity:

State:

Have you consulted with each of the federally recognized tribal entities listed above?

____ Yes

____ No


http://www.nationalatlas.gov/printable/congress.html




10 Service Area Details

Project Information Please provide the following information for the proposed funded service area.

Is the applicant seeking a waiver for providing less than 100% coverage of a last mile service area pursuant to section V.D.3 of the NOFA?

____ Yes

____ No

If YES, you will be required to provide supporting documentation.

Service Details

*Service Area Type (Select One)

____ Last Mile

____ Middle Mile

*Service Area Name:

*Rural Classification of the Service Area

____ Rural

____ Non-Rural

*Service Area Status of the Service Area

____ Unserved

____ Underserved

____ Served

If Service Status is “Underserved” please select at least one applicable option from this list.

____ No more than 50% of the households in the proposed funded service area have access to facilities-based, terrestrial broadband service at greater than the minimum broadband transmission speed;





____ No fixed or mobile broadband service provider advertises broadband transmission speeds of at least 3 Mbps downstream in the proposed funded service area;

____ The rate of broadband subscribership for the proposed funded service area is 40% of households or less.

Total Square Miles in the Service Area

Total Population in the Proposed Service Area

Total Number of Households in the Service Area

Total Number of Businesses in the Service Area

Total Number of Community Anchor Institutions and Public Safety Entities in the Proposed Funded Service Area

Unemployment Rate in the Service Area

Median Income in the Service Area

Estimated Percentage of Households with Access to Broadband

Estimated Percentage of Households Subscribing to Broadband





11 Community Anchor Summary

Community Anchor Institution Enter the number of Community Anchor Institutions for each category. Please sum up the total amount of community anchor institutions covered by the proposed project. Update the information as needed.

Proposed Number of Community Anchor Institutions

Schools (K-12)

Libraries

Medical and Healthcare Providers

Public Safety Entities

Community Colleges

Public Housing

Other Institutions of Higher Education

Other Community Support Organization

Other Government Facilities

Total Community Anchor Institutions

Minority Serving Institutions Please indicate the number of minority serving institutions in each category that the proposed project intends to include.

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





12 Project Benefits

Demographics 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?

Methodology Used to Estimate Jobs: 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. This response is limited to 1,500 characters.

[Insert Text Here]


http://www.whitehouse.gov/administration/eop/cea/Estimate-of-job-creation




Project Impact: 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 proposed funded service 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. This response is limited to 9,000 characters.

[Insert Text Here]

Vulnerable Populations: If any vulnerable population groups are overrepresented in the project's Proposed Funded Service Area, please note them, and provide supporting data. This response is limited to 3,000 characters.

[Insert Text Here]

Level of Need: Please discuss the degree of need for the proposed network in the proposed funded





service area. 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. This response is limited to 12,000 characters.

[Insert Text Here]





13 Technology Type

Technology Type Indicate the technology that will be used to deliver broadband services (check all that apply).

____ Wireline – xDSL

____ Wireline – Coaxial Cable

____ Wireline – Fiber-optic Cable

____ Wireline – Broadband Over Power Line

____ Wireline – Hybrid System

____ Wireless – Terrestrial Fixed

____ Wireless – Terrestrial Mobile

____ Wireless – Satellite

____ Other

If Other or Hybrid, please specify: _____________________________

Technology Questions Methodology for Area Status: Describe the methodology, source of data, and analytical approaches used to determine whether the Last Mile or Middle Mile Service Areas are classified as "unserved" or "underserved." This response is limited to 3,000 characters.

[Insert Text Here]





Description of Network Openness: Please explain how the proposed project will be consistent with the NOFA's nondiscrimination and network interconnection obligations. If the applicant will not be solely responsible for operating the network, please clarify which entity or entities will be responsible for upholding the nondiscrimination and interconnection obligations. In addition, describe the interconnection, nondiscrimination, and network management practices that would be adopted if you were awarded BTOP funds. If any responsible entity is not a commercial service provider, briefly describe that entity's operational ability to meet BTOP's interconnection obligations. This response is limited to 3,000 characters.

[Insert Text Here]

System Design: Provide a description of the system design used to deliver the broadband service. Please address and provide sufficient detail for a reviewer to evaluate the soundness of the design.

Discuss the key network components, from end-users to the network’s primary Internet Point(s) of Presence (POP)—noting which network components already exist and which would be added by the proposed project.

For wireless access, state the frequency, how much spectrum is available, technology used, morphology of the area, topology of the area, power levels at the user devices, whether or not mobile.

Specific advantages for using this particular technology strategy, taking into account service offering capacity, speed, reliability, and cost effectiveness.

Paths to upgrade the system and add additional capabilities in the future. Describe the proposed network’s centralized facilities and points of interconnection.

This response is limited to 6,000 characters.

[Insert Text Here]





Is the applicant seeking a waiver pursuant to section IX.C of the NOFA so as to sell or lease portions of the award-funded broadband facilities during their life?

____ Yes

____ No

If YES, you will be required to provide supporting documentation.





14 Project Budget

Project Budget Please complete estimated funding information for the project according to the following categories:

Federal Grant Request Total

Last Mile

Middle Mile

Total

Project Budget Total $

Match %

Projects Outside Recommended Funding Range: If this total project budget is above or below the project size range recommended in the NOFA ($5 million - $150 million), please provide a reasoned explanation for this variance from the recommended range. This response is limited to 3,000 characters.

[Insert Text Here]

Outside Leverage Applicant is providing matching funds of at least 20% towards the total eligible project costs.

____ Yes

____ No, applying for a waiver

If NO is selected, you are required to submit additional documentation.





Matching Cost Detail: 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 (e.g., infrastructure, working capital, operating losses, 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).This response is limited to 6,000 characters.

[Insert Text Here]

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. This response is limited to 3,000 characters.

[Insert Text Here]





Disclosure of Federal and/or State Funding Sources: Disclose the source and amount of other federal or state funding including, but not limited to, all Universal Service Funds the applicant has received or has requested for activities or projects to which the application relates. This response is limited to 3,000 characters.

[Insert Text Here]

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.). NOTE: If the project includes a last mile component, and the cost per household for this component is $10,000 per household or greater, your response to this question MUST include a justification for this per household cost. This response is limited to 3,000 characters.

[Insert Text Here]

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 attachment, and should include discussion of what discount rate is most appropriate to evaluate this project. This response is limited to 3,000 characters.

[Insert Text Here]

Funds to States/Territories Please provide a breakdown of the federal funding request for each state or territory included in the proposed project service area. The total across all states and territories should equal the total federal grant request.

STATE Funds

TOTAL $





15 Historical Financials

Historical Financials Applicants are required to identify Historical Financials for 2007, 2008, and 2009 for the following categories:

2007 2008 2009

Revenues

Expenditures

Net Assets

Change in Net Assets from Prior Year

Bond Rating (if applicable)





16 Project Readiness

Project Readiness BTOP Organizational Readiness: Describe key factors to indicate how your organization will be prepared to implement, manage, and operate a broadband services network. Describe the organizational governance and management. Address how your organization will ensure that the necessary sales, operational, and billing support systems are in place to provide the proposed services (e.g., network management, provisioning, billing, customer care, etc.).This response is limited to 3,000 characters.

[Insert Text Here]

Construction and Vendor Contracts: Identify the extent to which you intend to rely on contractors and/or vendors to deploy the network facilities. Please provide any evidence that contractors and/or vendors are ready to enter into agreements with the applicant, should the application be approved. Signed contracts or other signed agreements would carry the most weight with respect to evidence, but are not necessary. This response is limited to 1,500 characters.

[Insert Text Here]

Customer Base: Please describe the applicant’s (and, if the proposed network will be primarily managed by a partner, the partner’s) existing customer base, if any, in the Proposed Funded Service Area. Include data on residential, business, community anchor institution, and third party service provider customers. This response is limited to 1,500 characters.

[Insert Text Here]





Licenses, Regulatory Approvals and Agreements: Please list all of the licenses and regulatory approvals required to implement and operate the proposed project, and indicate the status of each. Please address the following if relevant; Tower Leases, Equipment Leases, Building Leases, Land Leases, FCC Authorizations, State Authorizations, Video Franchise Agreements, Leasing of Local Loops, etc. This response is limited to 1,500 characters.

[Insert Text Here]

SPIN Number: If the applicant and any proposed award sub-recipients have an FCC Universal Service Fund Service Provider Identification Number (SPIN), please provide the following information: Name of Entity and SPIN. This response is limited to 1,500 characters.

[Insert Text Here]





17 Environmental Questionnaire

Environmental Questionnaire The Environmental Questionnaire must be completed for all Infrastructure projects. Any project-related activity that may adversely affect the environment must not be undertaken prior to the completion of Rural Utilities Service/National Telecommunication and Information Administration environmental review process. Doing so may jeopardize consideration of your application. All of the following questions must be completed or the application will be considered incomplete. Additional guidance related to BTOP/BIP environmental requirements can be found at http://www.broadbandusa.gov/compliance.htm.

Project Description: Describe all project-related construction activities, including, but not limited to building construction related to installing prefabricated buildings; internal modifications, or equipment additions to buildings or other structures (e.g., relocating interior walls or adding computer facilities); the construction and installation of buried cable; or installation of telecommunications transmission facilities including construction of new monopole towers, satellite dishes. Complete descriptions and locations must be provided for each site affected by project-related construction activities. This response is limited to 1,500 characters.

[Insert Text Here]

Property Changes: Describe and indicate the amount of property to be cleared, excavated, fenced, or otherwise disturbed by the project. Describe the current land use and zoning for each project site affected by construction. Document whether the proposed project is located on public land owned or managed by the federal government. For information related to federal lands see the following website – http://www.geocommunicator.gov. This website provides cadastral survey and land management information and data from the National Integrated Land System specifically the distribution of the Public Land Survey System (PLSS), other survey-based data, and federal land boundaries. This response is limited to 1,500 characters.

[Insert Text Here]


http://www.geocommunicator.gov/

http://www.broadbandusa.gov/compliance.htm




Buildings: Describe buildings or other structures (i.e., transmission facilities), including dimensions, to be constructed or modified. For linear projects, state whether the project is to be located on or within previously disturbed public rights-of-way. This response is limited to 1,500 characters.

[Insert Text Here]

Wetlands: Describe and indicate whether wetlands are present on or near the project site(s) affected by construction (maps of wetlands may be obtained from the U.S. Fish and Wildlife Service's National Wetland Inventory website: http://www.fws.gov/wetlands/ or from soil maps obtained from the USDA, Natural Resource Conservation Service's website: http://websoilsurvey.nrcs.usda.gov/app/ HomePage.htm ). This response is limited to 1,500 characters.

[Insert Text Here]

Critical Habitats: Describe and indicate whether any project site(s) will directly or indirectly affect any threatened, endangered or candidate species or is within or near critical habitats. To document the analysis, applicants must provide species lists and appropriate specie accounts obtained from the U.S. Fish and Wildlife Service's website: http://ecos.fws.gov/tess_public/ for each county affected by construction of the project. This response is limited to 3,000 characters.

[Insert Text Here]


http://ecos.fws.gov/tess_public/

http://websoilsurvey.nrcs.usda.gov/app/HomePage.htm

http://www.fws.gov/wetlands/




Floodplains: Describe whether or not any facility(ies) or site(s) is located within a 100 or 500-year floodplain. Information related to floodplains and National Flood Insurance Maps may be obtained from the Federal Emergency Management Agency's (FEMA) website: http://msc.fema.gov/webapp/wcs/stores/servlet/FemaWelcomeView?storeId=10001&catalogId=10001&langId=-1.

If any project-related construction activities are within floodplains, a copy of the FEMA, ''FIRMette'' with construction activities depicted on the map must be included. For obtaining FIRMettes, review the tutorial provided by FEMA. This response is limited to 1,500 characters.

[Insert Text Here]

Protected Land: Describe any cultural resources, including historic properties, i.e., properties listed in or eligible for listing in the National Register of Historic Places, which are located in or within a one-mile radius of the project area and how they may be impacted by the project. Information related to historic properties can be obtained from the State Historic Preservation Office (SHPO) in your respective State - see the website of the National Conference of SHPO: http://www.ncshpo.org/find/index.htm.

Applicants must indicate if any portion of the project is located on tribal lands, meaning lands within the exterior boundaries of any Indian reservation and all dependent Indian communities. Information regarding historic properties located on tribal lands may be obtained from the Tribal Historic Preservation Officer (THPO) or the tribe’s official representative for historic preservation. If provided, applicants should provide any information gathered about historic properties on tribal lands, including any correspondence with an Indian tribe.

Applicants must gather information about the nature and location of historic properties from the SHPO. SHPOs should be asked the following questions:1.Is the proposed project located on, within or adjacent to any properties listed in or eligible for listing in the National Register of Historic Places? Is the proposed project located on, within or adjacent to a National Historic Landmark? If the answer is yes, describe and indicate the geographic relationship between the project and property with maps. 2.Will the proposed project impact, use or alter a building or structure that was constructed more than 50 years ago? If so, describe the building/structure with a statement of its condition, including photographs, and document its age.


http://www.ncshpo.org/find/index.htm

http://msc.fema.gov/webapp/wcs/stores/servlet/FemaWelcomeView?storeId=10001&catalogId=10001&langId=-1

http://msc.fema.gov/webapp/wcs/stores/servlet/FemaWelcomeView?storeId=10001&catalogId=10001&langId=-1




3.If provided, applicants should provide SHPO responses/information to these questions including any correspondence with the SHPO.This response is limited to 1,500 characters.

[Insert Text Here]

Coastal Area: Determine whether or not the project is within the boundaries of a coastal zone management area (CZMA). For boundary related and contact information related to CZMA, see National Oceanic and Atmospheric Administration, Office of Ocean and Coastal Resource Management's website: http://coastalmanagement.noaa.gov/consistency/welcome.html.This response is limited to 1,500 characters.

[Insert Text Here]

Brownfield: Determine whether the project is located within a brownfield site. Per 42 U.S.C. 9601, the term ''brownfield site'' means real property, the expansion, redevelopment, or reuse of which may be complicated by the presence or potential presence of a hazardous substance, pollutant, or contaminant. Maps and locations of sites, facilities and properties that have been contaminated by hazardous materials and are being, or have been, cleaned up under EPA's Superfund, RCRA and/or brownfields cleanup programs can be found at the following website: http://iaspub.epa.gov/Cleanups/. This response is limited to 1,500 characters.

[Insert Text Here]


http://iaspub.epa.gov/Cleanups/

http://coastalmanagement.noaa.gov/consistency/welcome.html




18 Attachments

Attachments

Applicants can find all attachments at www.broadbandusa.gov. Clearly title each attachment when submitting a copy of your application on an appropriate electronic medium, such as a DVD, CD-ROM, or flash drive. The required attachments listed below must be submitted with the application. Note that while the Government and Key Partnerships and the Waiver attachments are not listed as required attachments, they are considered conditional rather than optional. For example, if the Applicant lists key partners in the application or is receiving matching contributions from a third party, it must provide documentation in the Government and Key Partnerships attachment. If the Applicant is requesting a waiver in the application, it must provide documentation in the Waivers attachment.

Applicants are REQUIRED to complete the following attachments: Service Offerings and Competitor Data Network Diagram Build Out Timeline List of Community Anchor Institutions and Points of Interest Management Team Resumes and Organization Chart Historical Financial Statements Budget Narrative Detailed Budget Pro Forma Forecast Subscriber Estimates Dashboard Metrics Service Area Data Network Maps BTOP Certifications SF 424 C and D

The following attachments are NOT REQUIRED for all Applicants: Government and Key Partnerships Waivers Supplemental Information

Service Offerings and Competitor Data

Complete the Last Mile Service Offering, Middle Mile Service Offerings, and Competitor Data worksheets in the Service Offerings and Competitor Data attachment. Either of the Last Mile or Middle Mile Service Offerings worksheets may be omitted if the Applicant is not proposing to provide services of that type.


http://www.broadbandusa.gov/




For both Last Mile and Middle Mile Service Offerings worksheets, the service offerings should include all relevant tiers and markets (e.g., residential, business, wholesale). Applicants should be sure to include details on any services that would be offered at discounted rates to particular classes of customers (e.g., community anchor institutions or third party providers).

In the Last Mile Service Offerings worksheet, Applicants are required to provide estimated average end user speed. Average speeds should be the average sustained actual, non-burst speeds that an end user would receive during a peak hour. For purposes of calculating these speeds, Applicants should utilize their subscriber projections for year eight of the project, and develop subscriber utilization projections that are consistent with any additional services Applicants plans to offer. For wireless broadband services, this speed should be an average of the speeds available across an entire cell. Beyond these general guidelines, due to multiplicity of technical solutions that may be proposed, Applicants may use discretion to determine the most reasonable manner in which to estimate actual speed on their network. Applicants should explain the underlying assumptions used to calculate the average speeds in the space provided.

In the Competitor Data worksheet, Applicants are required to provide data on both Last Mile and Middle Mile service providers, regardless of whether the Applicant proposes to offer both last mile and middle mile services. In the column titled Service Areas Where Service Offered, Applicants should list all of the Last Mile and Middle Mile Service Areas within their Proposed Funded Service areas in which the listed services are available. Please ensure that the Service Area names are consistent with those provided within the application and the Service Areas attachment. If the actual availability of the listed services is limited (e.g., the service is only available within part of the Last Mile or Middle Mile Service Area), not this in the Other Comments column.

In contrast to several other attachment templates in this application, the data provided via this template will NOT be subject to automated processing. These templates worksheets are provided to demonstrate the level of data required and to provide a suggested format. Applicants are free to modify the template layouts in order to provide the most effective presentation of the data for their specific project. Applicants should, however, ensure that they provide at least as much detail as these templates require. To the extent that you modify these templates please ensure that the print layouts are adjusted so that rows do not break across pages in a manner that will be difficult to understand. It is recommended that you provide these documents in PDF format when submitting a copy of your application on an appropriate electronic medium, such as a DVD, CD-ROM, or flash drive.

Network Diagram

Provide network diagrams for your project. Include all of the network elements and the capacity, facilities, and mileage between each element. The diagram must clearly denote which of the network elements already exist. Examples are provided in the Grant Guidance. The diagrams must explicitly show:





The links between the network nodes. The types of facilities used in connecting all the network elements (fibers, copper, microwave, etc.).

Internet peering points, access to local exchange carriers, and central offices and cable head ends.

The proposed aggregation node facilities that will provide the egress point(s) from the broadband backbone to the networks of the selected service provider(s), Last Mile service providers, and the selected Internet Service Provider(s) and any other value-added services that may be provided in the new infrastructure.

The points of interconnection and collocation facilities. Wireless Systems: Provide the antennae height, cell site radius, proposed frequencies, and

approximate coverage area for each access point.

It is recommended that you provide these documents in PDF format when submitting a copy of your application on an appropriate electronic medium, such as a DVD, CD-ROM, or flash drive.

Build Out Timeline

Please complete the Project Plan and Build Out Timeline attachment. Note that these templates may be modified by Applicants in order to provide the most effective presentation of the data for their specific project. Applicants should ensure, however, that they provide at least as much detail as the provided templates require.


Project Plan Use the table in the template to list the major network build-out phases and milestones that

can demonstrate that your entire project will be substantially complete by the end of Year 2 and fully complete by the end of Year 3. This is to be done at the aggregate level (combining all proposed funded service areas).

Indicated how the milestones listed below will demonstrate these completion objectives. The Applicant should consider such project areas as: a) network design; b) securing all relevant licenses and agreements; c) site preparation; d) inside plant deployment; e) outside plant deployment; f) deployment of business & operational support systems; g) network testing; and f) network operational. The Applicant may provide any other milestones that it believes showcase progress.

Project inception (Year 0) starts at the date when the Applicant receives notice that the project has been approved for funding.

In the table, provide any information (e.g., facts, analysis) to: a) demonstrate the reasonableness of these milestones and b) substantiate the ability to reach the milestones by the quarters indicated.





Build Out TimelineComplete the schedule for each Last Mile or Middle Mile Service Area to note the degree of build-out, based on: a) infrastructure funds awarded and b) entities passed (households, businesses, and community anchor institutions). In addition, please complete a schedule that aggregates the build-out timeline across all of the Proposed Funded Service Area.

List of Community Anchors and Points of Interest

Please complete the Anchor Institution Details worksheet by providing information on all Community Anchor Institutions that will be directly connected by the proposed network. Add rows as necessary. All Community Anchor Institutions should be given a type from the specified list. A Community Anchor Institution is considered a minority-serving institution if it is a post-secondary educational institution with enrollment of minority students exceeding 50 percent of its total enrollment. The “Project Role” column only requires a word or two, or a short phrase, not a detailed explanation. A detailed explanation of the role of project partners and community anchor institutions should be provided in the essay portions of the application.

Please complete the Points of Interest worksheet by providing information on all points of interconnection (passive, non-environmentally controlled points of interest, e.g., splice points, may be excluded), collocation facilities, central offices, head ends, and other centralized facilities, network access points to Last Mile service providers, Internet peering points, and towers. For each point of interest you may provide either a street address or geocoordinates or both. You must provide detail on what the point of interest is, whether it is already existing or would be created by the proposed project. Where more than one facility type applies, select the larger facility type. For example, if a central office houses a point of interconnection, select central office as the facility type, or if a cell site is located on a tower, select tower as the facility type. The Interconnection Availability at the Facility field should be Yes if interconnection to the proposed network is available at that location, otherwise No. The brief description field is optional, but may be used to convey a better understanding of what the facility is. You may use the space provided at the bottom of the table to provide additional notes, if desired.

The data provided via this template will be subjected to automated processing. Applicants are therefore required to provide this attachment as an Excel file, and not to convert it to a PDF when submitting a copy of your application on an appropriate electronic medium, such as a DVD, CD-ROM, or flash drive.

Management Team and Organization Chart





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

Please submit documentation, such as letters of support or commitment, from each of the key partners in the project. At a minimum you should provide letters of commitment from each party contributing to the cost match or that will carry out some part of 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 and source of the cash contribution, or describe, in detail, the nature of the in-kind contribution (e.g., specific goods or services, including number of hours). If the partner is carrying out part of the project (beyond providing goods and services within normal business operations), the documentation should provide detail as to the specific responsibilities of the partner. 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

Provide detailed organizational financial statements for the last two years. 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.


Budget Narrative

Please complete the Budget Narrative attachment.

Detailed Budget

Please complete the General Budget Overview and the Detailed Project Costs worksheets in the Detailed Budget attachment.

Refer to the Comprehensive Community Infrastructure Grant Guidance for detailed instructions on completing this attachment.

Applicants are required to provide this attachment as an Excel file, and not to convert it to PDF when submitting a copy of their application on an appropriate electronic medium, such as a DVD, CD-ROM, or flash drive. Applicants should not alter the layout of the provided templates, except to insert additional line-items as needed in the Detailed Project Costs worksheet.

Pro Forma Forecast

Please complete the Income Statement, Balance Sheet, Cash Flows, and NPV-IRR Table worksheets in the Pro Forma Forecast attachment. Key assumptions used to formulate these financial projections should be listed in the Key Assumptions worksheet. Please note that these are project-specific projections, in contrast to the historical financial information which is provided at the organizational level.





Please refer to the Comprehensive Community Infrastructure Grant Guidance for detailed instructions on completing this attachment.

Applicants are required to provide this attachment as an Excel file, and not to convert it to a PDF when submitting a copy of their application on an appropriate electronic medium, such as a DVD, CD-ROM, or flash drive. Applicants may make adjustments to the format of the templates as necessary to provide the most effective presentation of the data for their specific project, but should not remove major headings (e.g. Revenues and Expenses on the Income Statement) or provide less detailed information than would be required to complete the provided templates.

Subscriber Estimates

Please complete the Subscriber Estimates attachment. All Applicants should indicate their 8-year subscriber forecasts with a breakdown by type of subscriber (residential/individual, businesses, community anchor institutions, third-party service providers) and service offerings. The names of the service offerings should match those provided in the Service Offerings and Competitor Data attachment, enabling reviewers to easily cross-reference between the two documents. The Year 0 column should be used to denote any existing customers within the Proposed Funded Service Area. In addition, Applicants that project that they will have third party service provider customers should include a line for parties “Served by Third Party Service Providers,” showing an estimate of how many resident/individual, community anchor institution, and business customers will be served by those service providers, as demonstrated in the example below. At the bottom of the table, Applicants should provide customer totals across all service offerings, with and without customers indirectly served through a third party service provider (if applicable). Applicants should also include a brief discussion of their methodology for deriving these estimates.

In contrast to several other attachment templates in this application, the data provided via this template will NOT be subject to automated processing. Applicants are permitted to modify the template layout in order to provide the most effective presentation of the date for their specific project, but such modifications are generally discourages. Applicants should, in any case, ensure that they provide at least as much detail as the provided templates requires. To the extent that you modify these templates, please ensure that the print layouts are adjusted so that rows do not break across pages in a manner that will be difficult to understand. It is recommended that you provide these documents in PDF format when submitting a copy of your application on an appropriate electronic medium, such as a DVD, CD-ROM, or flash drive.





Qtr 1 Qtr 2 Qtr 3 Qtr 4 Qtr 1 Qtr 2 Qtr 3 Qtr 4Cumulative 0 0 0 0 5 10 17 26

Net Add 0 0 0 0 5 5 7 9Cumulative 0 0 0 0 12 27 52 82





Net Add 0 0 0 0 0 2 1 2

Cumulative/Net Add

Year 1 Year 2

Community Anchor Inst. 0

Business 0

Name of Service Offering Customer Type Year 0

Mega-Metro E - 100 Mbps

Served by Third Party Service Providers Indirect - Business 0

Indirect - Com. Anchor Inst. 0

Third Party Service Provider 0

Indirect - Res./Ind. 0

Dashboard Metrics

Please complete the Dashboard Key Metrics attachment.

Service Area Data

Please complete the CCI Service Area attachment. In each line of the worksheet you will provide the name of a service area and one of the contiguous Census tracts or block groups that make up that service area. Please provide full 11-digit Census tract numbers, including the 2-digit Stat FIPS code, the 3-digit county code, followed by a unique 6-digit tract number. For Census block groups, please provide the full tract number, plus the 1-digit block group number (12 digits total). If there is more than one Census tract or block group in a service area, there will be multiple lines in the table for that service area, see example below. It is critical that the service area names provided in this table match with the service area names provided in the Service Area Details page of the application. Please review this document and Service Area Details page for consistency before submitting your application.

Important Note: Excel truncates leading zeros from numbers. Consequently, the tract/block group column on the worksheet has been formatted as text. This formatting should not be altered, or the validity of your data may be compromised.

The data provided via this template will be subject to automated processing. Applicants are therefore required to provide this attachment as an Excel file, and not to convert it to a PDF when submitting a copy of your application on an appropriate electronic medium, such as a DVD, CD-ROM, or flash drive. Additionally, Applicants should not modify the format of this file (e.g., by adding or removing worksheets). Do not leave blank lines in the table between service areas.





EXAMPLE

Service Area Name Tract or Block Group #Big BB Project South 01001020100Big BB Project South 01001020100Big BB Project South 010010202001Big BB Project West 01001020400Big BB Project North 01001020800Big BB Project North 010010209002

Waivers

Applicant must use the Waiver attachment for any waiver request, and must complete and submit a separate form for each waiver request sought.

Network Maps

Please provide a physical network map that includes the following (if applicable):

The Proposed Funded Service Area (should show and label all Last Mile and Middle Mile service areas and illustrate which are unserved/underserved/served).

The pre-existing service area of the Applicant demonstrating current service levels. The physical path of the network’s transmission medium (e.g., backbone and lateral cable

routes, microwave links), Transmission type, technology, operating bandwidth, capacity (e.g., dark vs. lit strand count), and cable placement (e.g., aerial, burial) should be displayed.

Points of interconnection (purely passive and non-environmentally controlled nodes, e.g., splice points are NOT required).

o Central Offices and associated coverage areaso Headends and associated coverage areaso Collocation Facilitieso Internet Exchange Points/Network Access Pointso Carrier Hotelso Private Interconnection Points with partnering service provider/private network





o Remote Terminals (e.g., Remote DSLAMs, Smart Cabinets, Controlled Environmental Vaults, Regeneration Huts)

Wireless towers and associated coverage areas. Anchor institutions to be directly connected as part of the proposed project.

The maps should delineate between network and facilities that are:

a) part of the Applicant's/key partners' existing network; b) proposed as part of this project; c) leased from a third party; d) utilized under some alterative arrangement; or e) relevant to interconnection with either Last Mile or Middle Mile service providers.

Applicants may also include additional details they deem relevant (and may include more than one map in the attachment).

PLEASE NOTE: Geospational Information System formatted source files (e.g., ESRI Shapefiles, Google Earth KMLs) used to develop these maps may be requested during the application due diligence process.

For system performance reasons, it is recommended that you provide these documents in PDF format when submitting a copy of your application on an appropriate electronic medium, such as a DVD, CD-ROM, or flash drive.

BTOP Certification

Complete the BTOP Certification attachment.

SF 424 C and D

Please complete the SF-424C and SF-424D forms. Please refer to the instructions provided with the forms.

Supplemental Information

Applicant may provide any supplemental information. It is recommended that Applicant provide such data in a PDF format when submitting a copy of their application on an appropriate electronic medium, such as a DVD, CD-ROM, or flash drive.





19 Additional Information

Applicants please use the following table to select the federally recognized tribe(s) your proposed project will serve.

AlabamaPoarch Band of Creek Indians of Alabama

AlaskaAgdaagux Tribe of King CoveAkiachak Native CommunityAkiak Native CommunityAlatna VillageAlgaaciq Native Village (St. Mary’s)Allakaket VillageAngoon Community AssociationAnvik VillageArctic Village (See Native Village of Venetie Government)Asa’carsarmiut TribeAtqasuk Village (Atkasook)Beaver VillageBirch Creek TribeCentral Council of the Tlingit & Haida Indian TribesChalkyitsik VillageCheesh-Na Tribe (formerly the Native Village of Chistochina)Chevak Native VillageChickaloon Native VillageChignik Bay Tribal Council (formerly the Native Village of Chignik)Chignik Lake VillageChilkat Indian Village (Klukwan)Chilkoot Indian Association (Haines)Chinik Eskimo Community (Golovin)Chuloonawick Native VillageCircle Native CommunityCraig Community AssociationCuryung Tribal CouncilDouglas Indian AssociationEgegik Village





Eklutna Native VillageEkwok VillageEmmonak VillageEvansville Village (aka Bettles Field)Galena Village (aka Louden Village)Gulkana VillageHealy Lake VillageHoly Cross VillageHoonah Indian AssociationHughes VillageHuslia VillageHydaburg Cooperative AssociationIgiugig VillageInupiat Community of the Arctic SlopeIqurmuit Traditional CouncilIvanoff Bay VillageKaguyak VillageKaktovik Village (aka Barter Island)Kasigluk Traditional Elders CouncilKenaitze Indian TribeKetchikan Indian CorporationKing Island Native CommunityKing Salmon TribeKlawock Cooperative AssociationKnik TribeKokhanok VillageKoyukuk Native VillageLesnoi Village (aka Woody Island)Levelock VillageLime VillageManley Hot Springs VillageManokotak VillageMcGrath Native VillageMentasta Traditional CouncilMetlakatla Indian Community, Annette Island ReserveNaknek Native VillageNative Village of AfognakNative Village of AkhiokNative Village of AkutanNative Village of Aleknagik





Native Village of AmblerNative Village of AtkaNative Village of Barrow Inupiat Traditional Government Native Village of BelkofskiNative Village of Brevig MissionNative Village of BucklandNative Village of CantwellNative Village of Chenega (aka Chanega)Native Village of Chignik LagoonNative Village of ChitinaNative Village of Chuathbaluk (Russian Mission, Kuskokwim)Native Village of CouncilNative Village of DeeringNative Village of Diomede (aka Inalik)Native Village of EagleNative Village of EekNative Village of EkukNative Village of ElimNative Village of Eyak (Cordova)Native Village of False PassNative Village of Fort YukonNative Village of GakonaNative Village of GambellNative Village of GeorgetownNative Village of Goodnews BayNative Village of HamiltonNative Village of Hooper BayNative Village of KanatakNative Village of KarlukNative Village of KianaNative Village of KipnukNative Village of KivalinaNative Village of Kluti Kaah (aka Copper Center)Native Village of KobukNative Village of KongiganakNative Village of KotzebueNative Village of KoyukNative Village of KwigillingokNative Village of Kwinhagak (aka Quinhagak)Native Village of Larsen Bay





Native Village of Marshall (aka Fortuna Ledge)Native Village of Mary’s IglooNative Village of MekoryukNative Village of MintoNative Village of Nanwalek (aka English BayNative Village of NapaimuteNative Village of NapakiakNative Village of NapaskiakNative Village of Nelson LagoonNative Village of NightmuteNative Village of NikolskiNative Village of NoatakNative Village of Nuiqsut (aka Nooiksut)Native Village of Nunam Iqua (formerly the Native Village of Sheldon’s Point)Native Village of NunapitchukNative Village of OuzinkieNative Village of PaimiutNative Village of PerryvilleNative Village of Pilot PointNative Village of Pitka’s PointNative Village of Point HopeNative Village of Point LayNative Village of Port GrahamNative Village of Port HeidenNative Village of Port LionsNative Village of RubyNative Village of Saint MichaelNative Village of SavoongaNative Village of Scammon BayNative Village of SelawikNative Village of ShaktoolikNative Village of ShishmarefNative Village of ShungnakNative Village of StevensNative Village of TanacrossNative Village of TananaNative Village of TatitlekNative Village of TazlinaNative Village of TellerNative Village of Tetlin





Native Village of TuntutuliakNative Village of TununakNative Village of TyonekNative Village of UnalakleetNative Village of UngaNative Village of Venetie Tribal Government (Arctic Village and Village of Venetie)Native Village of WalesNative Village of White MountainNenana Native AssociationNew Koliganek Village CouncilNew Stuyahok VillageNewhalen VillageNewtok VillageNikolai VillageNinilchik VillageNome Eskimo CommunityNondalton VillageNoorvik Native CommunityNorthway VillageNulato VillageNunakauyarmiut TribeOrganized Village of Grayling (aka Holikachuk)Organized Village of KakeOrganized Village of KasaanOrganized Village of KwethlukOrganized Village of SaxmanOrutsararmuit Native Village (aka Bethel)Oscarville Traditional VillagePauloff Harbor VillagePedro Bay VillagePetersburg Indian AssociationPilot Station Traditional VillagePlatinum Traditional VillagePortage Creek Village (aka Ohgsenakale)Pribilof Islands Aleut Communities of St. Paul & St. George IslandsQagan Tayagungin Tribe of Sand Point VillageQawalangin Tribe of UnalaskaRampart VillageSaint George Island (See Pribilof Islands Aleut Communities of St. Paul & St. George Islands)Saint Paul Island (See Pribilof Islands Aleut Communities of St. Paul & St. George Islands)





Seldovia Village TribeShageluk Native VillageSitka Tribe of AlaskaSkagway VillageSouth Naknek VillageStebbins Community AssociationSun’aq Tribe of Kodiak (formerly the Shoonaq’ Tribe of Kodiak)Takotna VillageTelida VillageTraditional Village of TogiakTuluksak Native CommunityTwin Hills VillageUgashik VillageUmkumiute Native VillageVillage of AlakanukVillage of Anaktuvuk PassVillage of AniakVillage of AtmautluakVillage of Bill Moore’s SloughVillage of ChefornakVillage of Clarks PointVillage of Crooked CreekVillage of Dot LakeVillage of IliamnaVillage of KalskagVillage of KaltagVillage of KotlikVillage of Lower KalskagVillage of OhogamiutVillage of Old HarborVillage of Red DevilVillage of SalamatoffVillage of SleetmuteVillage of SolomonVillage of Stony RiverVillage of Venetie (See Native Village of Venetie Tribal Government)Village of WainwrightWrangell Cooperative AssociationYakutat Tlingit TribeYupiit of Andreafski





ArizonaAk Chin Indian Community of the Maricopa (Ak Chin) Indian Reservation, ArizonaCocopah Tribe of ArizonaColorado River Indian Tribes of the Colorado River Indian Reservation, Arizona and CaliforniaFort McDowell Yavapai Nation, ArizonaFort Mojave Indian Tribe of Arizona, California & NevadaGila River Indian Community of the Gila River Indian Reservation, ArizonaHavasupai Tribe of the Havasupai Reservation, ArizonaHopi Tribe of ArizonaHualapai Indian Tribe of the Hualapai Indian Reservation, ArizonaKaibab Band of Paiute Indians of the Kaibab Indian Reservation, ArizonaPascua Yaqui Tribe of ArizonaQuechan Tribe of the Fort Yuma Indian Reservation, California & Arizona Salt River Pima-Maricopa Indian Community of the Salt River Reservation, Arizona San Carlos Apache Tribe of the San Carlos Reservation, Arizona San Juan Southern Paiute Tribe of Arizona Tohono O’odham Nation of ArizonaTonto Apache Tribe of ArizonaWhite Mountain Apache Tribe of the Fort Apache Reservation, Arizona Yavapai-Apache Nation of the Camp Verde Indian Reservation, Arizona Yavapai-Prescott Tribe of the Yavapai Reservation, Arizona Zuni Tribe of the Zuni Reservation, New Mexico Navajo Nation, Arizona, New Mexico & Utah

CaliforniaAgua Caliente Band of Cahuilla Indians of the Agua Caliente Indian Reservation, CaliforniaAlturas Indian Rancheria, CaliforniaAugustine Band of Cahuilla Indians,California Bear River Band of the Rohnerville Rancheria, CaliforniaBerry Creek Rancheria of Maidu Indians of CaliforniaBig Lagoon Rancheria, CaliforniaBig Pine Band of Owens Valley Paiute Shoshone Indians of the Big Pine Reservation, CaliforniaBig Sandy Rancheria of Mono Indians of CaliforniaBig Valley Band of Pomo Indians of the Big Valley Rancheria, CaliforniaBlue Lake Rancheria, CaliforniaBridgeport Paiute Indian Colony of CaliforniaBuena Vista Rancheria of Me-Wuk Indians of CaliforniaCabazon Band of Mission Indians,CaliforniaCachil DeHe Band of Wintun Indians of the Colusa Indian Community of the Colusa Rancheria, CaliforniaCahto Indian Tribe of the Laytonville Rancheria, California





Cahuilla Band of Mission Indians of the Cahuilla Reservation, CaliforniaCalifornia Valley Miwok Tribe,CaliforniaCampo Band of Diegueno Mission Indians of the Campo Indian Reservation, CaliforniaCapitan Grande Band of Diegueno Mission Indians of California: Barona Group of Capitan Grande Band of Mission Indians of the Barona Reservation, California Viejas (Baron Long) Group of Capitan Grande Band of Mission Indians of the Viejas Reservation, CaliforniaCedarville Rancheria, CaliforniaChemehuevi Indian Tribe of the Chemehuevi Reservation, CaliforniaCher-Ae Heights Indian Community of the Trinidad Rancheria, CaliforniaChicken Ranch Rancheria of Me-Wuk Indians of CaliforniaCloverdale Rancheria of Pomo Indians of CaliforniaCold Springs Rancheria of Mono Indians of CaliforniaColorado River Indian Tribes of the Colorado River Indian Reservation, Arizona and CaliforniaCortina Indian Rancheria of Wintun Indians of CaliforniaCoyote Valley Band of Pomo Indians of CaliforniaDeath Valley Timbi-Sha Shoshone Band of CaliforniaDry Creek Rancheria of Pomo Indians of CaliforniaElem Indian Colony of Pomo Indians of the Sulphur Bank Rancheria,CaliforniaElk Valley Rancheria, CaliforniaEnterprise Rancheria of Maidu Indians of CaliforniaEwiiaapaayp Band of Kumeyaay Indians, CaliforniaFederated Indians of Graton Rancheria,CaliforniaFort Bidwell Indian Community of the Fort Bidwell Reservation of CaliforniaFort Independence Indian Community of Paiute Indians of the Fort Independence Reservation, CaliforniaGreenville Rancheria of Maidu Indians of CaliforniaGrindstone Indian Rancheria of Wintun-Wailaki Indians of CaliforniaGuidiville Rancheria of California Habematolel Pomo of Upper Lake,CaliforniaHoopa Valley Tribe, CaliforniaHopland Band of Pomo Indians of the Hopland Rancheria, CaliforniaIipay Nation of Santa Ysabel, California (formerly the Santa Ysabel Band of Diegueno Mission Indians of the Santa Ysabel Reservation)Inaja Band of Diegueno Mission Indians of the Inaja and Cosmit Reservation,CaliforniaIone Band of Miwok Indians of CaliforniaJackson Rancheria of Me-Wuk Indians of CaliforniaJamul Indian Village of CaliforniaKaruk Tribe of CaliforniaKashia Band of Pomo Indians of the Stewarts Point Rancheria, CaliforniaLa Jolla Band of Luiseno Mission Indians of the La Jolla Reservation, California La Posta Band of Diegueno Mission Indians of the La Posta Indian Reservation, California





Los Coyotes Band of Cahuilla and Cupeno Indians, California (formerly the Los Coyotes Band of Cahuilla & Cupeno Indians of the Los Coyotes Reservation) Lower Lake Rancheria, California Lytton Rancheria of California Manchester Band of Pomo Indians of the Manchester-Point Arena Rancheria, California Manzanita Band of Diegueno Mission Indians of the Manzanita Reservation, California Mechoopda Indian Tribe of Chico Rancheria, California Mesa Grande Band of Diegueno Mission Indians of the Mesa Grande Reservation, California Middletown Rancheria of Pomo Indians of CaliforniaMooretown Rancheria of Maidu Indians of CaliforniaMorongo Band of Mission Indians, California (formerly the Morongo Band of Cahuilla Mission Indians of the Morongo Reservation)Northfork Rancheria of Mono Indians of CaliforniaPaiute-Shoshone Indians of the Bishop Community of the Bishop Colony, CaliforniaPaiute-Shoshone Indians of the Lone Pine Community of the Lone Pine Reservation, CaliforniaPala Band of Luiseno Mission Indians of the Pala Reservation, CaliforniaPaskenta Band of Nomlaki Indians of CaliforniaPauma Band of Luiseno Mission Indians of the Pauma & Yuima Reservation, CaliforniaPechanga Band of Luiseno Mission Indians of the Pechanga Reservation, CaliforniaPicayune Rancheria of Chukchansi Indians of CaliforniaPinoleville Pomo Nation, California (formerly the Pinoleville Rancheria of Pomo Indians of California)Pit River Tribe, California (includes XL Ranch, Big Bend, Likely, Lookout, Montgomery Creek and Roaring Creek Rancherias)Potter Valley Tribe, California Quartz Valley Indian Community of the Quartz Valley Reservation of California Ramona Band or Village of Cahuilla Mission Indians of California Redding Rancheria, California Redwood Valley Rancheria of Pomo Indians of California Resighini Rancheria, California Rincon Band of Luiseno Mission Indians of the Rincon Reservation, California Robinson Rancheria of Pomo Indians of CaliforniaRound Valley Indian Tribes of the Round Valley Reservation, California Rumsey Indian Rancheria of Wintun Indians of California San Manuel Band of Mission Indians, California San Pasqual Band of Diegueno Mission Indians of California Santa Rosa Band of Cahuilla Indians, California (formerly the Santa Rosa Band of Cahuilla Mission Indians of the Santa Rosa Reservation)Santa Rosa Indian Community of the Santa Rosa Rancheria, California Santa Ynez Band of Chumash Mission Indians of the Santa Ynez Reservation, CaliforniaScotts Valley Band of Pomo Indians of California





Sherwood Valley Rancheria of Pomo Indians of CaliforniaShingle Springs Band of Miwok Indians, Shingle Springs Rancheria (Verona Tract), CaliforniaSmith River Rancheria, CaliforniaSoboba Band of Luiseno Indians, CaliforniaSusanville Indian Rancheria, CaliforniaSycuan Band of the Kumeyaay NationTable Mountain Rancheria of CaliforniaTorres Martinez Desert Cahuilla Indians, California (formerly the Torres-Martinez Band of Cahuilla Mission Indians of California)Tule River Indian Tribe of the Tule River Reservation, California Tuolumne Band of Me-Wuk Indians of the Tuolumne Rancheria of California Twenty-Nine Palms Band of Mission Indians of California United Auburn Indian Community of the Auburn Rancheria of California Utu Utu Gwaitu Paiute Tribe of the Benton Paiute Reservation, California Wilton Rancheria, California Wiyot Tribe, California (formerly the Table Bluff Reservation—Wiyot Tribe) Yurok Tribe of the Yurok Reservation, California Fort Mojave Indian Tribe of Arizona, California & NevadaQuechan Tribe of the Fort Yuma Indian Reservation, California & Arizona Washoe Tribe of Nevada & California (Carson Colony, Dresslerville Colony, Woodfords Community, Stewart Community, & Washoe Ranches)

ColoradoSouthern Ute Indian Tribe of the Southern Ute Reservation, ColoradoUte Mountain Tribe of the Ute Mountain Reservation, Colorado, New Mexico & Utah

ConnecticutMashantucket Pequot Tribe of Connecticut Mohegan Indian Tribe of Connecticut

FloridaMiccosukee Tribe of Indians of FloridaSeminole Tribe of Florida (Dania, Big Cypress, Brighton, Hollywood & Tampa Reservations)

IndianaPokagon Band of Potawatomi Indians, Michigan and Indiana

IowaSac & Fox Tribe of the Mississippi in Iowa





IdahoCoeur D’Alene Tribe of the Coeur D’Alene Reservation, IdahoKootenai Tribe of Idaho Nez Perce Tribe, Idaho (previously listed as Nez Perce Tribe of Idaho)Shoshone-Bannock Tribes of the Fort Hall Reservation of IdahoShoshone-Paiute Tribes of the Duck Valley Reservation, Nevada

KansasIowa Tribe of Kansas and NebraskaKickapoo Tribe of Indians of the Kickapoo Reservation in Kansas Prairie Band of Potawatomi Nation, Kansas Sac & Fox Nation of Missouri in Kansas and Nebraska

Louisiana Chitimacha Tribe of LouisianaCoushatta Tribe of LouisianaJena Band of Choctaw Indians,LouisianaTunica-Biloxi Indian Tribe of Louisiana

Massachusetts Mashpee Wampanoag Tribe, Massachusetts Wampanoag Tribe of Gay Head (Aquinnah) of Massachusetts

MaineAroostook Band of Micmac Indians of MaineHoulton Band of Maliseet Indians of MainePassamaquoddy Tribe of MainePenobscot Tribe of Maine

MichiganBay Mills Indian Community, Michigan Grand Traverse Band of Ottawa and Chippewa Indians, MichiganHannahville Indian Community,MichiganKeweenaw Bay Indian Community,MichiganLac Vieux Desert Band of Lake Superior Chippewa Indians, Michigan Little River Band of Ottawa Indians, Michigan Little Traverse Bay Bands of Odawa Indians, Michigan Match-e-be-nash-she-wish Band of Pottawatomi Indians of Michigan Nottawaseppi Huron Band of the Potawatomi, Michigan (formerly the Huron Potawatomi, Inc.)Pokagon Band of Potawatomi Indians, Michigan and Indiana





Saginaw Chippewa Indian Tribe of Michigan Sault Ste. Marie Tribe of Chippewa Indians of Michigan

Minnesota Lower Sioux Indian Community in the State of Minnesota Minnesota Chippewa Tribe, Minnesota (Six component reservations: Bois Forte Band (Nett Lake); Fond du Lac Band; Grand Portage Band; Leech Lake Band; Mille Lacs Band; White Earth Band)Prairie Island Indian Community in the State of Minnesota Red Lake Band of Chippewa Indians, Minnesota Shakopee Mdewakanton Sioux Community of MinnesotaUpper Sioux Community, Minnesota

MississippiMississippi Band of Choctaw Indians, Mississippi

MontanaAssiniboine and Sioux Tribes of the Fort Peck Indian Reservation, MontanaBlackfeet Tribe of the Blackfeet Indian Reservation of MontanaChippewa-Cree Indians of the Rocky Boy’s Reservation, MontanaConfederated Salish & Kootenai Tribes of the Flathead Reservation, MontanaCrow Tribe of MontanaFort Belknap Indian Community of the Fort Belknap Reservation of MontanaNorthern Cheyenne Tribe of the Northern Cheyenne Indian Reservation, Montana

North Carolina Eastern Band of Cherokee Indians of North Carolina

North DakotaSpirit Lake Tribe, North DakotaStanding Rock Sioux Tribe of North & South DakotaThree Affiliated Tribes of the Fort Berthold Reservation, North DakotaTurtle Mountain Band of Chippewa Indians of North Dakota

NebraskaOmaha Tribe of NebraskaPonca Tribe of Nebraska Santee Sioux Nation, Nebraska Winnebago Tribe of Nebraska Iowa Tribe of Kansas and NebraskaSac & Fox Nation of Missouri in Kansas and Nebraska





New MexicoJicarilla Apache Nation, New MexicoMescalero Apache Tribe of the Mescalero Reservation, New Mexico Navajo Nation, Arizona, New Mexico & UtahOhkay Owingeh, New Mexico (formerly the Pueblo of San Juan)Pueblo of Acoma, New Mexico Pueblo of Cochiti, New Mexico Pueblo of Isleta, New Mexico Pueblo of Jemez, New Mexico Pueblo of Laguna, New Mexico Pueblo of Nambe, New Mexico Pueblo of Picuris, New Mexico Pueblo of Pojoaque, New Mexico Pueblo of San Felipe, New Mexico Pueblo of San Ildefonso, New Mexico Pueblo of Sandia, New Mexico Pueblo of Santa Ana, New Mexico Pueblo of Santa Clara, New Mexico Pueblo of Santo Domingo, New Mexico Pueblo of Taos, New Mexico Pueblo of Tesuque, New Mexico Pueblo of Zia, New Mexico Zuni Tribe of the Zuni Reservation, New Mexico Ute Mountain Tribe of the Ute Mountain Reservation, Colorado, New Mexico & Utah

NevadaConfederated Tribes of the Goshute Reservation, Nevada and UtahDuckwater Shoshone Tribe of the Duckwater Reservation, NevadaEly Shoshone Tribe of NevadaFort McDermitt Paiute and Shoshone Tribes of the Fort McDermitt Indian Reservation, Nevada and OregonLas Vegas Tribe of Paiute Indians of the Las Vegas Indian Colony, Nevada Lovelock Paiute Tribe of the Lovelock Indian Colony, Nevada Moapa Band of Paiute Indians of the Moapa River Indian Reservation,Nevada Paiute-Shoshone Tribe of the Fallon Reservation and Colony, NevadaPyramid Lake Paiute Tribe of the Pyramid Lake Reservation, Nevada Reno-Sparks Indian Colony, Nevada Summit Lake Paiute Tribe of NevadaTe-Moak Tribe of Western Shoshone Indians of Nevada (Four constituent bands: Battle Mountain Band; Elko Band; South Fork Band and Wells Band)





Walker River Paiute Tribe of the Walker River Reservation, Nevada Washoe Tribe of Nevada & California (Carson Colony, Dresslerville Colony, Woodfords Community, Stewart Community, & Washoe Ranches)Winnemucca Indian Colony of NevadaYerington Paiute Tribe of the Yerington Colony & Campbell Ranch, Nevada Yomba Shoshone Tribe of the Yomba Reservation, Nevada Shoshone-Paiute Tribes of the Duck Valley Reservation, Nevada

New YorkCayuga Nation of New YorkOneida Nation of New YorkOnondaga Nation of New YorkSaint Regis Mohawk Tribe, New York (formerly the St. Regis Band of Mohawk Indians of New York) Seneca Nation of New YorkTonawanda Band of Seneca Indians of New YorkTuscarora Nation of New York

OklahomaAlabama-Quassarte Tribal Town, OklahomaApache Tribe of OklahomaCaddo Nation of OklahomaCherokee Nation, OklahomaCheyenne and Arapaho Tribes,Oklahoma (formerly the Cheyenne-Arapaho Tribes of Oklahoma)Chickasaw Nation, OklahomaChoctaw Nation of OklahomaCitizen Potawatomi Nation, OklahomaComanche Nation, OklahomaDelaware Nation, OklahomaDelaware Tribe of Indians, OklahomaEastern Shawnee Tribe of OklahomaFort Sill Apache Tribe of OklahomaIowa Tribe of OklahomaKaw Nation, OklahomaKialegee Tribal Town, Oklahoma Kickapoo Tribe of Oklahoma Kiowa Indian Tribe of Oklahoma Miami Tribe of Oklahoma Modoc Tribe of OklahomaMuscogee (Creek) Nation, OklahomaOsage Nation, Oklahoma (formerly the Osage Tribe)





Otoe-Missouria Tribe of Indians, OklahomaOttawa Tribe of OklahomaPawnee Nation of OklahomaPeoria Tribe of Indians of Oklahoma Ponca Tribe of Indians of Oklahoma Quapaw Tribe of Indians, Oklahoma Sac & Fox Nation, Oklahoma Seminole Nation of OklahomaSeneca-Cayuga Tribe of OklahomaShawnee Tribe, OklahomaThlopthlocco Tribal Town, OklahomaTonkawa Tribe of Indians of OklahomaUnited Keetoowah Band of Cherokee Indians in Oklahoma Wichita and Affiliated Tribes (Wichita, Keechi, Waco & Tawakonie), Oklahoma Wyandotte Nation, Oklahoma

OregonBurns Paiute Tribe of the Burns Paiute Indian Colony of OregonConfederated Tribes of Siletz Indians of Oregon (previously listed as the Confederated Tribes of the Siletz Reservation) Confederated Tribes of the Coos, Lower Umpqua and Siuslaw Indians of OregonConfederated Tribes of the Grand Ronde Community of OregonConfederated Tribes of the Umatilla Reservation, OregonConfederated Tribes of the Warm Springs Reservation of OregonCoquille Tribe of OregonCow Creek Band of Umpqua Indians of OregonKlamath Tribes, Oregon Fort McDermitt Paiute and Shoshone Tribes of the Fort McDermitt Indian Reservation, Nevada and Oregon

Rhode IslandNarragansett Indian Tribe of Rhode Island

South CarolinaCatawba Indian Nation (aka Catawba Tribe of South Carolina)

South DakotaCheyenne River Sioux Tribe of the Cheyenne River Reservation, South DakotaCrow Creek Sioux Tribe of the Crow Creek Reservation, South DakotaFlandreau Santee Sioux Tribe of South DakotaLower Brule Sioux Tribe of the Lower Brule Reservation, South Dakota





Rosebud Sioux Tribe of the Rosebud Indian Reservation, South Dakota Sisseton-Wahpeton Oyate of the Lake Valley Reservation, NevadaYankton Sioux Tribe of South Dakota Standing Rock Sioux Tribe of North & South DakotaOglala Sioux Tribe of the Pine Ridge Reservation, South Dakota

TexasAlabama-Coushatta Tribes of TexasKickapoo Traditional Tribe of Texas Ysleta Del Sur Pueblo of Texas

UtahNorthwestern Band of Shoshoni Nation of Utah (Washakie)Paiute Indian Tribe of Utah (Cedar Band of Paiutes, Kanosh Band of Paiutes, Koosharem Band of Paiutes, Indian Peaks Band of Paiutes, and Shivwits Band of Paiutes) (formerly Paiute Indian Tribe of Utah (Cedar City Band of Paiutes, Kanosh Band of Paiutes, Koosharem Band of Paiutes, Indian Peaks Band of Paiutes, and Shivwits Band of Paiutes)

Skull Valley Band of Goshute Indians of UtahUte Indian Tribe of the Uintah & Ouray Reservation, Utah Ute Mountain Tribe of the Ute Mountain Reservation, Colorado, New Mexico & Utah Navajo Nation, Arizona, New Mexico & UtahConfederated Tribes of the Goshute Reservation, Nevada and Utah

Washington Confederated Tribes and Bands of the Yakama Nation, WashingtonConfederated Tribes of the Chehalis Reservation, WashingtonConfederated Tribes of the Colville Reservation, WashingtonCowlitz Indian Tribe, WashingtonHoh Indian Tribe of the Hoh Indian Reservation, WashingtonJamestown S’Klallam Tribe of WashingtonKalispel Indian Community of the Kalispel Reservation, WashingtonLower Elwha Tribal Community of the Lower Elwha Reservation, Washington Lummi Tribe of the Lummi Reservation, Washington Makah Indian Tribe of the Makah Indian Reservation, Washington Muckleshoot Indian Tribe of the Muckleshoot Reservation, WashingtonNisqually Indian Tribe of the Nisqually Reservation, WashingtonNooksack Indian Tribe of WashingtonPort Gamble Indian Community of the Port Gamble Reservation, Washington Puyallup Tribe of the Puyallup Reservation, Washington Quileute Tribe of the Quileute Reservation, Washington





Quinault Tribe of the Quinault Reservation, Washington Samish Indian Tribe, Washington Sauk-Suiattle Indian Tribe of WashingtonShoalwater Bay Tribe of the Shoalwater Bay Indian Reservation, WashingtonSkokomish Indian Tribe of the Skokomish Reservation, WashingtonSnoqualmie Tribe, WashingtonSpokane Tribe of the Spokane Reservation, Washington Squaxin Island Tribe of the Squaxin Island Reservation, WashingtonStillaguamish Tribe of WashingtonSuquamish Indian Tribe of the Port Madison Reservation, WashingtonSwinomish Indians of the Swinomish Reservation, WashingtonTulalip Tribes of the Tulalip Reservation, Washington Upper Skagit Indian Tribe of Washington

WisconsinBad River Band of the Lake Superior Tribe of Chippewa Indians of the Bad River Reservation, WisconsinForest County Potawatomi Community,WisconsinHo-Chunk Nation of WisconsinLac Courte Oreilles Band of Lake Superior Chippewa Indians of Wisconsin Lac du Flambeau Band of Lake Superior Chippewa Indians of the Lac du Flambeau Reservation of Wisconsin Menominee Indian Tribe of Wisconsin Oneida Tribe of Indians of WisconsinRed Cliff Band of Lake Superior Chippewa Indians of Wisconsin Sokaogon Chippewa Community, WisconsinSt. Croix Chippewa Indians of Wisconsin Stockbridge Munsee Community, Wisconsin

WyomingArapahoe Tribe of the Wind River Reservation, WyomingShoshone Tribe of the Wind River Reservation, Wyoming


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