cmic 2.0 grant application...2.0 connecting michigan communities 2.0 grant application – page 11...

GRETCHEN WHITMER GOVERNOR

STATE OF MICHIGANDEPARTMENT OF TECHNOLOGY, MANAGEMENT & BUDGET

LANSING

BROM STIBITZ DIRECTOR

Connecting Michigan Communities 2.0 Grant Application

Please read through the entire Grant Information and Application package before you begin to respond to the application questions. This will help ensure you understand the full scope of the application as well as the details you will need to provide to complete the application.

Application Deadline: All grant applications are due by 4:00 p.m. EST, on Monday, January 4, 2021.

Submission Guidelines: Applicants must email their applications and all attachments to: [email protected]. Applications must be complete, and attachments clearly labeled with the question or statement number from the application form. Completed application, attachments, and supporting documentation must be received by the Department of Technology, Management, and Budget (DTMB), Center for Shared Solutions by 4:00 p.m. EST on Monday, January 4, 2021, to be considered for funding. Applicants will receive an email confirmation in receipt of their submission. It is the applicant’s responsibility to ensure the application is received by DTMB prior to the submission deadline. Applications submitted to the wrong email address or received after the deadline will be rejected. Official application submission date and time will be determined by the time stamp accompanying the application email. Applications dated and time stamped in any other way will be rejected. If a confirmation receipt is not received within two business days, applicants must contact the CMIC Grant Program Office at (517) 335-3727.

Questions and Contact: If you have questions after reviewing the application and supporting documentation, please see the Frequently Asked Questions (FAQ) document available on the grant website: www.michigan.gov/CMICGrant. The FAQ will be updated throughout the application process. Questions and comments can also be submitted via email to: [email protected].

GEORGE W. ROMNEY BUILDING ● 111 SOUTH CAPITOL AVENUE ● LANSING, MICHIGAN 48933 www.michigan.gov/CMICGrant ● 517-335-3727

mailto:[email protected]://www.michigan.gov/CMICGrantmailto:[email protected]

Application Checklist

This checklist is part of your application and should be returned along with your completed application and attachments.

Application Submission Checklist: ☐

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Public application is complete and file name meets the designated namingstructure.Non-Public application is complete and file name meets the designated namingstructure.Confidential Treatment Form is complete.Attachments have been gathered and file names meet the designated namingstructure.

Attachment 1: Map of proposed service area in .pdf format (including bothlast mile coverage and middle mile routes)

Attachment 2: Map of proposed service area in a GIS-compatible file format(including both last mile coverage and middle mile routes)

Attachment 3: Spreadsheet of street addresses that are part of the proposedservice area in .xlsx format

Attachment 4: Match commitment letters or evidenceAttachment 5: Applicant organizational chartAttachment 6: Resumes of key officers, management personnel, andproposed project management team

Attachment 7: Three years of audited financial statements.Attachment 8: Affidavit of commitment to offer the proposed service and costin the proposed service area for a minimum of three years after projectcompletion

Attachment 9: Budgetary engineering designs, diagrams, and maps thatshow the proposed project

Attachment 10: Evidence of network scalabilityAttachment 11: Additional evidence of project readinessAttachment 12: Demonstration of customer interest in the proposed projectAttachment 13: Demonstration of interest/impact/support from businessesAttachment 14: Demonstration of interest/impact/support from the agriculturalcommunity

Attachment 15: Demonstration of interest/impact/support from CAIsAttachment 16: Evidence of application for a SPINAttachment 17: Demonstration of interest/impact/support from communities

File naming structure: Applicants are to use the name of their organization followed by public application, non-public application, or the attachment number and file type (e.g. ABCTelecom_Attachment_1.pdf).

2.0 Connecting Michigan Communities 2.0 Grant Application – page 2

Applicant and Project Information, Contact Information, and Summary

1. Project Name:

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2. Applicant Name:

DBA (if applicable):

Mailing Address:

3. Primary Grant Contact:

Primary Contact Phone Number:

Primary Contact Email Address:

Primary Contact Organization (if not part of the applicant’s organization):

4. Application Author Name:

Application Author Email:

5. Eligibility Status: Select the means by which the applicant is eligible to apply forthe grant:

Licensed under the Michigan Telecommunications Act (1991 PA 179, MCL484.2101 to 484.2603)Franchise holder under the Uniform Video Services Local Franchise Act(2006 PA 480, MCL 484.3301 to 484.3315)Broadband service provider currently providing service in Michigan

6. Are you registered with the Michigan Public Service Commission’s IntrastateTelecommunications Service Providers Registry (ITSP)?

Yes No Unsure


https://mae.force.com/itsp

7. Have you provided broadband coverage data to Connect Michigan in the lastfive years?

☐ ☐ ☐ Yes No Unsure

8. Applicant Identification Numbers: Please provide the following identificationnumbers for the applicant (if available):

Federal Employer Identification Number (EIN):

Michigan Tax Identification Number:

Michigan Vendor Identification Number:

Federal Communications Commission Registration Number (FRN):

Service Provider Identification Number (SPIN):

9. Project Summary (250 words max.):


Locations Passed and Proposed Service:

Attachment 1: Map of proposed service area in .pdf format (including both last mile coverage and middle mile routes) Name of Attachment 1:

Attachment 2: Map of proposed service area in GIS-compatible file format (including both last mile coverage and middle mile routes) Name of Attachment 2:

10. Please provide a brief description of the proposed service area (250 wordsmax.):


Attachment 3: Spreadsheet of street addresses that are part of the proposed service area in .xlsx format. Name of Attachment 3:

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11. Use the following format to complete Attachment 3

Number Street Address City State Zip Code

123 Main St 123 Main St Anytown MI 48823

12. Does the project include a middle mile component? Yes No

13. Locations Passed: Please indicate the total number of locations by type that willbe able to receive improved broadband services as a result of the proposedproject:

Households Businesses Community Anchor Institutions Total Locations Passed

14. Are any vacant lots included in the total number of locations passed listedabove?

Yes No

If yes, these vacant lots should be anticipated for growth in the next five years according to a local, county, or regional master plan or economic development plan. Please list the name of the relevant plan and the jurisdiction implementing the plan.

Plan Name:

Jurisdiction:


15. Please list the jurisdictions impacted by the proposed service area:

City(ies)/Village(s):

Township(s):

County(ies):

State House District(s):

State Senate District(s):

16. Please provide a brief description of the broadband service to be providedincluding, but not limited to, the technology to be used, will bandwidth bededicated or shared, etc. (250 words max.):


Project Costs and Budget

17. Total Project Cost: Please complete the table below

Total Project Cost

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Total Grant Request Total Match Amount Total Match Percentage

Attachment 4: Match commitment letters or evidence Name of Attachment 4:

18. Total matching funds: Please complete the table below summarizing the source,amount, and type of matching funds contributed to the project. Applicants shouldalso indicate if the match is secured or not. Attach additional sheets if necessary.

Source Amount Type Secured? Cash In-Kind Yes NoCash In-Kind Yes NoCash In-Kind Yes NoCash n-Kind Yes NoCash In-Kind Yes NoCash In-Kind Yes No

19. If matching funds or in-kind contributions listed above are not yet secured,please describe the process remaining to secure the funds and the anticipatedtimeline to do so, (250 words max.):


20. Project Budget: Please use the following table to provide a budget for theproposed project.

Category Match Amount Grant Amount Total Buildings and Labor Last Mile Construction Labor Middle Mile Construction Labor Construction Material Customer Premise Equipment Customer Premise Installation Electronics Permits Professional Services and Engineering Other:

Total

21. Please briefly describe why this project needs funding from the CMIC Grantprogram and why the project could not proceed without this funding (250 wordsmax.):

Experience and Financial Wherewithal

Attachment 5: Applicant organizational chart Name of Attachment 5:

Attachment 6: Resumes of key officers, management personnel, and proposed project management team Name of Attachment 6:


22. Please provide a brief history of your organization including experience relevantto the proposed project, (250 words max.):

Attachment 7: Three years of audited financial statements Name of Attachment 7:

23. Please provide a brief statement to accompany your attached audited financialstatements and documentation (250 words max.):


Long-Term Viability

24. Use the template below to complete a five-year stand-alone project financialplan/forecast.

Five-Year Stand-Alone Project Financial Plan Project Name: Year 1 Year 2 Year 3 Year 4 Year 5 Revenue Expenses Anticipated Grant Funds Cash Flow Cumulative Cash Flow

25. Please provide a brief narrative to accompany your five-year stand-alone projectfinancial plan/forecast (400 words max.):


Attachment 8: Affidavit of commitment to offer the proposed service and cost in thproposed service area for a minimum of three years after project completion.

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Name of Attachment 8:

Readiness and Scalability Attachment 9: Budgetary engineering designs, diagrams, and maps that show the proposed project. Design documents must clearly demonstrate the applicant’s complete understanding of the project and ability to provide the proposed solution. This information must be certified by a Professional Engineer registered in Michigan. Name of Attachment 9:

26. Please provide a brief statement to accompany your attached engineeringdesigns, diagrams, and maps indicating your readiness to build, manage, andoperate the proposed network, (400 words max.):


Attachment 10: Evidence of network scalability Name of Attachment 10:

27. Please provide a description and evidence that the proposed infrastructure isscalable to meet the anticipated future connectivity demands of the proposedservice area. Please indicate the end- user connection speed to which theproposed network is designed to scale. This information must be certified by theequipment manufacturer or a professional engineer, (250 words max.):


28. Please use the table below to complete a project schedule outlining individualtasks and their timing by quarter and year. Attach additional pages if necessary.All projects must be complete by September 30, 2025.

Task 2021 2022 2023 2024 2025 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐

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29. Please indicate the anticipated date upon which service to the last location in theproposed project area will be turned on:

30. Please list any factors that would change or delay the proposed schedule:

31. Have all the required local/city/county/state approvals necessary for this projectto proceed been obtained?

Yes NoIf not, what remains to be done and what is required for completing the processof obtaining approvals? Include this information in the project schedule.

32. Have state environmental review requirements been met, if applicable?Yes No

If not, what remains to be done and what is required for completing the processof obtaining approvals? Also Include this information in the project schedule.


33. Does this project affect/is the project located in or near local, state, or federal historic or potentially historic, architectural, or archeological resources?☐ ☐Yes No

If not, what remains to be done and what is required for completing the process of obtaining approvals? Include this information in the project schedule.

34. Please briefly describe how the proposed project will leverage existing broadbandnetworks, where practical, or be built in conjunction with other broadbandinfrastructure project(s), (250 words max.):

Attachment 11: Additional evidence of project readiness Name of Attachment 11:


35. Please provide any additional evidence of your project’s readiness. This evidencecan include, but is not limited to, letters of intent, memorandums of understanding,land/tower lease agreements, right-of-way agreements, permits, etc. Provide ashort narrative to accompany this additional evidence, (250 words max.):

Community and Economic Development

Attachment 12: Demonstration of customer interest in the proposed project Name of Attachment 12:

36. Please provide a brief statement to accompany the demonstration of customerinterest you have attached to this application. This description should include themethod used for gauging customer interest and the results, (250 words max.):


Attachment 13: Demonstration of interest/impact/support from businesses Name of Attachment 13:

37. Please provide a brief description of the businesses needing improvedbroadband service in the proposed project area and the level of improvementneeded. Attach statements or evidence regarding the benefits from the proposedconnectivity solution and how it will impact those businesses (250 words max.):


Attachment 14: Demonstration of interest/impact/support from the agricultural community Name of Attachment 14:

38. If the proposed service area has a significant agricultural presence, pleasebriefly describe how the proposed service will impact farmers and theagricultural community. Attach statements or evidence regarding the benefitsfrom the proposed connectivity solution and how it will impact the agriculturalcommunity (250 words max.):

Attachment 15: Demonstration of interest/impact/support from CAIs Name of Attachment 15:


39. Please provide a brief description of the community anchor institutions (CAIs)needing improved broadband service in the proposed project area and the levelof improvement needed. Attach statements or evidence regarding the benefitsfrom the proposed connectivity solution and how it will impact those CAIs (250words max).

40. In the table below, please list the specific community anchor institutions (CAIs)to be served by the proposed project. Attach additional sheets if necessary.

CAI Name Address Type (healthcare, library, school, etc.)

Attachment 16: Evidence of application for a SPIN (if applicable) Name of Attachment 16:


41. If the proposed project includes connections to schools or libraries, pleaseprovide your SPIN or evidence of application for a SPIN from the FCC UniversalService Administrative Company (USAC) and demonstration of your knowledgeof E-rate and working with the FCC/USAC, (250 words max.):

Attachment 17: Demonstration of interest/impact/support from communities Name of Attachment 17:

42. Please provide a brief description of the communities needing improvedbroadband service in the proposed project area and the level of improvementneeded. Attach statements or evidence regarding the benefits from the proposedconnectivity solution and how it will impact those communities (250 words max).


43. Is broadband included in a local, county, or regional economic developmentplan, master plan, or similar up-to-date planning document, or does thecommunity in which the proposed service is to be deployed have a specificbroadband/technology plan in place?☐ ☐

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No

If yes, please list the name of the relevant plan and the jurisdictionimplementing the plan.

Plan Name:

Jurisdiction:

Affordability and Service Limitations

44. Using the table below, please indicate the download and upload speeds of theservices to be offered in the proposed service area offered over the initial fiveyears of the project (attach additional sheets if necessary). The non-discountedor rack rate monthly pricing of unbundled internet-only service should beincluded for each service offered, as well as the monthly data allowance forcustomers (if applicable):

Download Speed (Mbps)

Upload Speed (Mbps)

Monthly Cost Monthly Data Allowance (GB)

45. Do you participate in the federal Lifeline program?Yes No

46. Do you plan to offer a lower-cost monthly subscription plan for low-incomehouseholds in the proposed service area?

Yes No


If yes, please briefly describe the program including the type of service to be offered, the monthly cost for qualifying household, and how you plan to determine household eligibility for such a program, (400 words max.):

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47. Does any of the proposed service area include (wholly or partially) an eligibledistressed area (a list of eligible distressed areas can be found here: https://www.michigan.gov/mshda/0,4641,7- 141-48987_75951-181277--,00.html)?

Yes ☐ No


https://www.michigan.gov/mshda/0,4641,7- 141-48987_75951-181277--,00.html

If yes, please list the distressed community(ies) impacted by the proposed service area:

Adoption Strategy

48. Please describe any proposed digital literacy training events, materials, and/orresources that will be provided to residents or businesses impacted by theproposed connectivity. Include the number and type of events, includingcommitments from any partners included in the digital literacy training and theanticipated outcomes from related activities. The description must provide cleardetail and contain measurable metrics (400 words max.):


49. Please describe the materials and method(s) to be used for providing residentsand businesses with information promoting the use of an internet connection forimproving quality of life, access to resources, economic opportunity, etc., in theproposed service area. Partnerships with local CAIs that build awareness forenriching online opportunities for residents and businesses are highlyencouraged. Examples of these opportunities include, but are not limited to,telehealth applications, access to government services, e-learning, job andcareer readiness programs, public safety information, cybersecurity training, etc.This description must provide clear detail and contain measurable metrics (400words max.):


Please read through the entire Grant Information and Application package before you begin to respond to the application questions. This will help ensure you understand the full scope of the application as well as the details you will need to provide t...Application ChecklistApplicant and Project Information, Contact Information, and SummaryLocations Passed and Proposed Service:Project Costs and BudgetExperience and Financial WherewithalLong-Term ViabilityReadiness and ScalabilityCommunity and Economic DevelopmentAffordability and Service Limitations

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PublicApplication: OffNon-PublicApplication: OffConfidentialTreatmentForm: OffAttachmentsGathered: OffAttachment1: OffAttachment2: OffAttachment3: OffAttachment4: OffAttachment5: OffAttachment6: OffAttachment7: OffAttachment9: OffAttachment8: OffAttachment10: OffAttachment11: OffAttachment12: OffAttachment13: OffAttachment14: OffAttachment15: OffAttachment16: OffAttachment17: OffPrimary Contact Phone Number: Households: Businesses: Community Anchor Institutions: Total Locations Passed: equipment manufacturer or a professional engineer 250 words max: ApplicantName: DBA: MailingAddress: PrimaryContact: PrimaryOrg: PrimaryEmail: AppAuthor: AppEmail: ProjSummary: FederalNumber: MichiganTaxNum: MichiganVendorNum: FederalCommNum: ServiceNumber: NameAttach3: CityVillage: Township: County: StateHouseDistrict: StateSenateDistrict: DescBroadband: TotalProjectCost: TotalGrantRequest: TotalMatchAmount: TotalMatchPercentage: NameAttach4: FirstSouce: SecondSource: ThirdSource: FourthSource: 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cmic 2.0 grant application...2.0 connecting michigan communities 2.0 grant application – page 11...

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