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August 1, 2009 – July 31, 2010
E-Rate Support Services Agreement
THIS AGREEMENT is made this No. in the County of day of , known as the 200 , by and between School District in the State of
Nebraska, and Educational Service Unit 10, Kearney, Nebraska. Whereas, the School District and ESU 10 desire to enter into an agreement for delivery of Erate support/management services from August 1, 2009 to July 31, 2010, hereinafter detailed, and it is the purpose of this Agreement to evidence this support and understanding of the parties. Therefore, in consideration of the mutual agreements hereinafter set forth, the parties agree as follows: ESU 10 agrees to provide resources and management to the member school to assist in the completion of the Universal Service Fund E-rate applications between the above stated dates.* 1. ESU 10 will assist with or provide the following services: a. Preparation of applicant forms. (PLEASE NOTE: ESU 10 requires the school district to review the applications once prepared and certify that they are an accurate depiction of the school districts needs prior to submission and certification on the USAC website with a written or electronic signature.) b. Any training needed pertaining to the E-rate program c. Regular updates/news releases pertaining to E-rate d. Delivery of documents to school for submission/certification. e. Consultation/training for records retention and establishing a standard filing system f. Guidance on where to locate information for site visits/audits * Any services or support provided to the School District for E-rate support services prior to the E-rate funding year between the above stated dates will be billed at an hourly rate of $75.00. 2. The school district will need to provide ESU 10 with documentation such as student counts, copies of bills and any additional information as it relates to E-rate in a timely manner. School District will be solely responsible for retention of all documentation relating to the Erate program including but not limited to the following: a. Signed contracts with service providers b. E-rate form signatures and/or certifications c. Completion and submission of all Item 21 attachments d. Vendor & Service Provider Invoices e. CIPA & Filtering compliance f. Tech Plan Certification confirmation. g. Fall Membership Reports h. Bids/Quotes/Justification of vendor selection i. Billed entity numbers/FCC Registration Numbers/NCES Codes j. Letters of Agency k. All communications to/from USAC l. Internet Safety Policy & Reviews ESU 10 will not be responsible for, or held liable for: a. E-rate form signatures or certifications (electronic or written) b. Completion or submission of Item 21 attachments c. Denial of funding d. Service Provider negotiations or selections e. Network design or consultation f. Missed form completion/filing due to lack of documentation from School District g. Failure to submit/mail forms within the required time frame. h. Documentation retention relating to the Erate program School District must provide ESU 10 with a point of contact. (POC)
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POC or authorized person must obtain a PIN number for Erate form signatures School District will be responsible for filing and updating all tech plan information on file with the Nebraska Department of Education. School District must meet the deadline for submission of information to allow for timely filing of all forms. School District will be responsible for choosing vendors or service providers.
10. School District agrees to pay ESU 10 for the service used (select one option) and to budget for payment of: 11. E-rate Support Agreement Yearly Fees (based on a per district cost.) a. Telephone Company Service only...................................................................... $ 300.00 b. Telephone Company and Internet Access Service ............................................. $ 1500.00 c. Telephone Company/Internet Access-Distance Learning .................................. $ 2500.00 12. School district will be billed the total amount for the Erate consortium fees within 30 days of signing the consortium agreement. 13. This Agreement shall be binding upon the parties hereto and their successors. The persons executing this Agreement on behalf of the respective parties specifically acknowledge and represent that they have valid authority to bind the party for whose benefit this Agreement has been executed.
Signatures: Date__________________ District Representative District Address: Date__________________ ESU 10 Representative
Distribution of Copies: School District ESU 10 – PO Box 850 – Kearney, NE 68848-0850
in the County of
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AUTHORIZED POINT OF CONTACT INFORMATION (POC) Primary POC
_______________________________ Name
_____________________________________ Address
_____________________________ City, St. Zip
_______________________________ Work Phone
_____________________________________ Cell Phone
_____________________________ FAX Number
_______________________________ E-mail Address
Bookkeeper Information: Please provide us with the contact information of your school/district bookkeeper or person who handles the invoices for your Erate service providers.
_______________________________ Name
_____________________________________ Address
_____________________________ City, St. Zip
_______________________________ Work Phone
_____________________________________ Cell Phone
_____________________________ FAX Number
_______________________________ E-mail Address
Billed Entity Numbers: Building/District Name Entity Number (please use additional sheet if needed) _____________________________________ _____________________________________ _____________________________________
FCC Registration Numbers Building/District Name FCC Registration Number (please use additional sheet if needed) _____________________________________ _____________________________________ _____________________________________
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