TBCP2ProjInfoForm.xlsx
XLSX spreadsheet 28 KB Posted
- Attached to
- Tribal Broadband Connectivity Program
- Opportunity number
- NTIA-ICG-TBCPO-2023-2008098
- Issued by
-
Department of Commerce
About this file
This document contains a project information form template for applicants to the Tribal Broadband Connectivity Program federal grant opportunity. The form requests information on applicant details, project descriptions, service area metrics, and funding details. Applicants must provide organizational identifiers, points of contact, physical addresses, and UEI. They must also specify project titles, types as infrastructure, adoption or both, technology choices, proposed budgets, and service commitments. Metrics include numbers of households, businesses, anchor institutions, and those unserved in the target areas. Applicants disclose involvement in prior broadband grants and applications to NTIA, USDA and other agencies. The related federal grant program is the 11.029 Tribal Broadband Connectivity Program under the Department of Commerce. Successful applicants will receive funding to support broadband infrastructure deployment, adoption programs or both to serve Native American, Native Alaskan and Native Hawaiian communities.
TBCP2 Project Info( Required)
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TBCP2Form
| Field Name | Response | Instructions |
| Applicant Information | ||
| Applicant Name | Provide the name of your Eligible Entity | |
| Applicant Type (Eligible Entities drop down) | Tribal Government; Tribal College or University; the Department of Hawaiian Home Lands on behalf of the Native Hawaiian Community, including Native Hawaiian Education Programs; Tribal organization; or Native Corporation. | |
| Consortium Applicant (Y/N) | Are you applying on behalf of a consortium of federally recognized tribes? |
Please note that the application requests that the consortium application submission should contain authorized Tribal Resolutions attesting to participation in the Consortium project.
| Applicant Tribe(s) | Please list the participating tribes as provided in the Listing of Entities Recognized by and Eligible To Receive Services From the United States Bureau of Indian Affairs (87 FR 4636-4641) |
| UEI | Enter the organization’s UEI received from SAM. The UEI is a unique 12 character organization identifier. Information on registering with System for Award Management (SAM.gov) may be obtained by visiting the SAM.gov home page. https://sam.gov/content/home |
| Authorized Organization Representative (AOR) Name | Name of the authorized representative of the applicant organization. Enter the first and last name (required); prefix, middle name, and suffix. A copy of the governing body's authorization recognizing the official representative must be on file in the applicant's office. (NTIA also requires that this authorization be submitted as part of the application.) |
| AOR Email | Email of the AOR for the applicant organization |
| AOR Title | Title of the AOR for the applicant organization |
| AOR Telephone | Telephone number of the AOR for the applicant organization (e.g. 123-555-4567) |
| Point Of Contact (POC) Name | Name of the point of contact for questions concerning this application. Enter the first and last name (required); prefix, middle name, and suffix. |
| POC Email | Email address of the Point of Contact for this submission |
| POC Title (if applicable) | Title of the POC if applicable |
| POC Telephone | Telephone number of the POC (e.g. 123-555-4567) |
| Lead Applicant Address (Street) | Enter Street Address with leading number (e.g. 1600 Pennsylvania Ave) |
| Lead Applicant Address (City) | Enter City |
| Lead Applicant Address (State drop down) | Enter State/Territory |
| Lead Applicant Address (Zip Code) | Enter Zip Code |
| Basic Project Information | |
| Project Title | Enter a brief descriptive title of the project. |
This is not a description but the simple brief title/name of the project.
Project Type (Drop down) Please select the Project Type from among Infrastructure Deployment (ID), Use & Adoption (UA), or Dual ID/UA
Stand-alone Planning Projects are not eligible under TBCP2.
| Proposed Budget (Total) | Provide the total amount of Federal funding being requested (In whole dollars and no need to enter commas) |
| Proposed Use & Adoption Budget (UA) | Provide the total amount of Federal funding being requested for the Use & Adoption project proposed. If you are not submitting a Use & Adoption project, leave blank. |
| Proposed Broadband Infrastructure Deployment Budget (ID) | Provide the total amount of Federal funding being requested for the Broadband Infrastructure Deployment project proposed. If not submitting an Infrastructure Deployment project, leave blank. |
| ID Deployment Technology(s) (drop down) | Please indicate the broadband technology(ies) proposed to complete the Infrastructure Deployment project. |
| Service Area Information | |
| Total # of NA/AN/NH Households | What is the total number of Native American, Alaskan Native, or Native Hawaiian households contained in the proposed service area of the project? |
| # of NA/AN/NH Households Unserved | What is the total number of Unserved Native American, Alaskan Native, or Native Hawaiian households contained in the proposed service area of the project? |
(Please refer to the definition for Unserved in the TBCP2 NOFO Section A.3.t) # of NA/AN/NH Households Below 150% of the Poverty Line What is the total number of Native American/Alaska Native/Native Hawaiian households that are below 150% of the poverty line applicable to the average family size represented on the particular Tribal Land in the lower 48 states, Alaska, and Hawaii (utilizing U.S. Department of Health and Human Services (HHS) Poverty Guidelines) as provided by the TBCP2 NOFO.
https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines
| Total # of NA/AN/NH Businesses | What is the total number of Native American, Alaskan Native, or Native Hawaiian Businesses contained in the proposed service area of the project? |
| # of NA/AN/NH Businesses Unserved | What is the total number of Native American, Alaskan Native, or Native Hawaiian Businesses that are Unserved within in the proposed service area of the project? |
(Please refer to the definition for Unserved in the TBCP2 NOFO Section A.3.t)
| Total # of NA/AN/NH CAIs | What is the total number of Native American, Alaskan Native, or Native Hawaiian Community Anchor Institutions contained in the proposed service area of the project? |
| # of NA/AN/NH CAIs Unserved | What is the total number of Native American, Alaskan Native, or Native Hawaiian Community Anchor Institutions that are Unserved within in the proposed service area of the project? |
(Please refer to the definition for Unserved in the TBCP2 NOFO Section A.3.t) Enforceable Buildout Commitments (EBC) and associated Broadband Service Providers Please list the Broadband Service Providers with which the Tribal Government has an Enforceable Buildout Commitment within the proposed service area. Refer to TBCP2 NOFO Sec. A.3.k for definition of EBC.
Please write "NA" if your project does not include a particular indicator.
| Project Service Information | |
| Total # of NA/AN/NH Households to be connected to qualifying service | What is the total number of Native American, Alaskan Native, or Native Hawaiian households contained in the proposed service area of the project that will be connected by completing the proposed project? |
| # of NA/AN/NH Unserved Households to be connected to qualifying service | What is the total number of Currently Unserved Native American, Alaskan Native, or Native Hawaiian households contained in the proposed service area of the project that will be connected by completing the proposed project? |
(Please refer to the definition for Unserved in the TBCP2 NOFO Section A.3.t)
| Total # of NA/AN/NH Businesses to be connected to qualifying service | What is the total number of Native American, Alaskan Native, or Native Hawaiian Businesses contained in the proposed service area of the project that will be connected by completing the proposed project? |
| # of NA/AN/NH Unserved Businesses to be connected to qualifying service | What is the total number of Native American, Alaskan Native, or Native Hawaiian Businesses that are Currently Unserved within in the proposed service area of the project that will be connected by completing the proposed project? |
The number entered should refer to the number of unserved Tribal Businesses that will be connected within the proposed service area of the submitted application. (Please refer to the definition for Unserved in the TBCP2 NOFO Section A.3.t)
| Total # of NA/AN/NH CAIs to be connected to qualifying service | What is the total number of Native American, Alaskan Native, or Native Hawaiian Community Anchor Institutions that are within in the proposed service area of the project that will be connected by completing the proposed project? |
| # of NA/AN/NH CAIs Unserved to be connected to qualifying service | What is the total number of Native American, Alaskan Native, or Native Hawaiian Community Anchor Institutions that are Currently Unserved within in the proposed service area of the project that will be connected by completing the proposed project? |
The number entered should refer to the number of unserved Tribal CAIs that will be connected within the proposed service area of the submitted application. (Please refer to the definition for Unserved in the TBCP2 NOFO Section A.3.t)
| Proposed Minimum Household Speed in Mbps | What is the proposed minimum connection speed for all households that will be connected within the proposed service area? |
| Proposed Maximum Household Speed in Mbps | What is the proposed maximum connection speed for all households that will be connected within the proposed service area? |
| Federal Funding Information | |
| Are you a sponsoring tribal government previously applied for TBCP funds (Yes/No)? |
| If yes, provide further information below. | Please indicate whether or not you applied for TBCP funding in 2021. Please answer regardless of having received an award. If you received award, additional information is requested below. | ||
| Further information regarding previous TBCP application submitted in 2021. | Please list the Title and the Grants.Gov Grant Tracking Number (GRANT1345XXXX) of the application submitted in 2021. (Title, GRANTID) | ||
| Are you a sponsoring tribal government that has been awarded TBCP funding (Y/N)? |
| If yes, provide further information below. | Were you awarded funding through TBCP? | ||
| Further information regarding your TBCP award. | Enter the Grants Online Award Number as assigned for the prior TBCP award. This is a unique 14 character award identifier that begins will resemble NT22TBC029XXXX. Entry is limited to 14 characters | ||
| Are you a sponsoring tribal government that has been awarded NTIA Digital Equity Program funding (Y/N)? |
| If yes, provide further information below. | Were you awarded funding through the Digital Equity Program? | ||
| Further information regarding your Digital Equity Program award. | Enter the Digital Equity Program Award Number as assigned in the NIST Grants Management Information System (GMIS). This is a unique 14 character award identifier that begins will resemble NT22TBC029XXXX. Entry is limited to 14 characters | ||
| Are you a sponsoring tribal government that has received a federal award that provides funding for broadband infrastructure deployment, planning, or use & adoption (Y/N)? |
| If yes, provide further information below. | Have you been awarded any other Federal funding, either through a competitive award/grant or formula funding, that provided funding for broadband infrastructure deployment, planning, or use & adoption? | ||
| List the Awarding Agency and Program that provided funding for broadband planning, deployment, or adoption. | List the awarding agency(ies) followed by the Program and year separated by a comma. |
(e.g. USDA, ReConnect Loan and Grant Program) Are you a sponsoring tribal government that has previously applied for federal funds supporting broadband planning, deployment, or adoption, but did not receive an award (Y/N)?
| If yes, provide further information below. | Have you applied for other Federal funding, either through a competitive award/grant or formula funding, that provided funding for broadband infrastructure deployment, planning, or use & adoption? | ||
| List the Awarding Agency and Program that you applied for funding to support broadband planning, deployment, or adoption. | List the awarding agency(ies) followed by the Program separated by a comma. |
(e.g. USDA, ReConnect Loan and Grant Program)
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&"-,Bold"&P of &N https://sam.gov/content/homehttps://www.federalregister.gov/documents/2022/01/28/2022-01789/indian-entities-recognized-by-and-eligible-to-receive-services-from-the-united-states-bureau-ofhttps://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines Validations
| Tribal Government | Yes | Infrastructure Deployment | AL | Cable |
| Tribal College or University | No | Use and Adoption | AK | Fiber |
| Tribal Organization | Dual ID/UA | AZ | Wireless | |
| Dept of Hawaiian Home Lands | AR | Fixed Wireless | ||
| Native Corporation | CA | Licensed Spectrum | ||
| CZ | Satellite | |||
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