Receiving E-rate Funding: Discounted Bills

Transcription

1 Receiving E-rate Funding: Discounted Bills E-rate rules require all vendors to provide applicants with the choice of receiving discounted bills or paying their bills in full each month and then obtaining reimbursement. Applicants may choose a different discount/reimbursement method for each funding request (FRN), but once the choice has been made and an invoice has been submitted to USAC for payment (either a service provider invoice or an applicant BEAR invoice), that method of discounting must be continued for the remainder of the funding year. If you choose to receive discounted bills, the service provider provides discounted bills to the applicant and then submits the Form 474 to USAC for reimbursement. Using this method, the applicant is not required to submit any reimbursement forms to USAC because E-rate funding has been provided to the applicant via a discounted bill. It is important to remember that service providers will not begin issuing discounted bills until the 486 has been submitted to the SLD and your service provider has received a copy of the 486 Approval Letter from the SLD. Therefore, it is in your best interest to submit the Form 486 as quickly as possible after receiving the funding commitment decision letter. How to Request Discounted Bills: This decision should be conveyed to your service provider upon contract signing and immediately after your Funding Commitment Letter is received. There is no formal USAC mechanism to tell your service provider which invoicing option you choose, however each company has different requirements for requesting discounted bills. Some companies just require an e- mail or phone call. Other companies require applicants to complete an online form or paper form specifying which account numbers should be discounted. In order to make that process as easy as possible, below is a list of the most-used vendors in PA and the method to request discounted bills for that company. Vendor AT&T AT&T Mobility Broadview Networks Century Link (Embarq) Comcast Consolidated Communications Earthlink Business (formerly One Communications) Discounted Bills Process Upon receipt of your Funding Commitment Decision Letter, AT&T will send an that includes a hyperlink to submit a GRID that you will complete and return to erate.legt@att.com. Company will send after you have been funded with a form to be completed if you would like discounted bills. You also may contact them directly for a copy of the form at (866) or NECOEMobility@att.com. Samson Wong at SWong@BroadViewNet.com. Company will send after you've been funded with a form to be completed if you would like discounted bills. You also may contact them directly for a copy of the form at erate@centurylink.com. Pam Ervin at Pamela_Ervin@cable.comcast.com to request a copy of the Comcast E-rate Request Form. Pam can be reached at: (215) Stephanie Sapp at Stephanie.Sapp@consolidated.com. Call Susan Walters at (616) or swalters@onecommunications.com to request discounted billing.

2 Vendor Frontier (Commonwealth and CTSI) Ironton Telephone Company Level 3 One Communications PenTeleData Service Electric Telephone Company Sprint/Nextel Sting (Last Mile) Sunesys Verizon Verizon Wireless Verizon Business/Verizon Select Services Windstream XO Communications Discounted Bills Process Complete the online form at: An will be sent to you requesting copies of the corresponding Item 21 attachments to complete the process. Patricia Stewart at pstewart@ironton.com. Contact Amy Ban at /amy.ban@level3.com. Contact Susan Walters at swalters@onecommunications.com. edusales@corp.ptd.net. Patricia Stewart at pstewart@ironton.com. Christina Halley at Christina.Halley@sprint.com. Jen Tobias at jent@stingcom.com. Walt Tustin at WTustin@sunesys.com. Contact Verizon's E-rate Office at You will be required to complete a Grid to complete the discounting process. Return Grid to Nicole.L.Lynch@verizon.com. Company should have sent an containing a personalized PIN number to be used on the website If no was received, contact VW at ERATE@VERIZONWIRELESS.COM or Jeannine Tabb at Jeannine.tabb@verizon.com to request their 1-page Discount Request Form. Company will send asking if you would like discounted bills. You also may contact them directly at e-rate@windstream.com or Call Jamie E. Sontany at to request discounted bills. Below is a short Q & A regarding the discounted billing process. Q1. How does my service provider know how much to discount my bill? Once the SLD receives your Form 486 identifying the actual Service Start Date, your service provider is notified by the SLD to begin billing the discount. If you will receive your discount directly on your bill, your service provider will begin to apply the percentage discount that was approved by the SLD to the services eligible for discount on your bill. In order to apply discounts accurately (discounting the right account, only for eligible services, only at eligible facilities) your service provider may need additional information from you. In either event it is a good idea to discuss discounted bills with your service provider, so that you know when and how your bills will be discounted. Q2. What if the discount on my bill is not the same discount percentage for which I was approved on my Funding Commitment Decision Letter? Your service provider is instructed by the SLD to apply the discount to eligible services used by eligible entities. In many cases eligible services are bundled with ineligible services and/or services are being received jointly by eligible and ineligible entities. Your service provider, therefore, will likely determine a "composite" or "effective" discount for the accounts upon which you were committed discounts. For

3 this reason, the actual discount that you receive on your monthly bill may differ from the approved discount percentage on your Funding Commitment Decision Letter. Q3. What if I have filed my Form 486 and still have not received a discounted bill from my service provider? Contact your service provider to verify that you have provided all necessary information to the service provider and that the service provider intends to apply your percentage discount to your bill. Q4. What if the discount appeared on previous bills but now has stopped? Have you received the entire amount of your funding commitment in the form of discounts on your bills? If the answer is yes, this is why your discounts have stopped. To verify the amount of your funding commitment, you should refer to your Funding Commitment Decision Letter, and find the dollar amount of your "Funding Commitment Decision" for the Funding Request Number (FRN) associated with this service provider. If you have received more than one Funding Commitment Decision Letter relating to this FRN, refer to the most recent letter. Have you filed a Form 500 to cancel or reduce the FRN or to change the Contract Expiration Date? If the answer is yes, this may be why your discounts have stopped. If the answer to both questions is NO, contact your service provider to find out why you hav stopped receiving discounts on your bills.

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5 Receiving E-rate Funding: Obtaining Reimbursements E-rate rules require all vendors to provide applicants with the choice of receiving discounted bills or paying their bills in full each month and then obtaining reimbursement. Applicants may choose a different discount/reimbursement method for each funding request (FRN), but once the choice has been made and an invoice has been submitted to USAC for payment (either a service provider invoice or an applicant BEAR invoice), that method of discounting must be continued for the remainder of the funding year. If you choose to NOT receive discounted bills and instead opt for the reimbursement process, the applicant pays the full amount of the invoice and then submits the Form 472 BEAR Invoice to USAC for reimbursement. USAC will then review and process the BEAR for payment. Upon approval, USAC will disburse funding to the service provider within 20 calendar days. The service provider then has 20 business days to remit the reimbursement amount to the applicant from their own account. Some vendors will try to issue invoice credits instead of sending a reimbursement check. This is up to the applicant whether they will permit invoice credits in lieu of reimbursement checks. Deadlines to Submit Form 472 BEAR: The deadline to submit BEAR Invoice to USAC is 120 days from the last date to receive service in the funding year, which is October 28 for recurring services and January 28 for non-recurring services (such as equipment purchases). Beginning in October 2015, all invoices extension requests must be submitted on or before the invoice deadline in which case USAC is permitted to grant a single, 120-day invoice deadline extension. USAC is not permitted to grant a second invoice deadline extension, nor are they permitted to grant extension requests that are submitted after the original invoice deadline. Such requests are required to be submitted to the FCC as a request for a waiver of the invoice deadline rule, and must include compelling evidence that a late invoice submission serves the public interest. Important FAQs: 1) Can I complete the BEAR online? Yes! The BEAR Form can be submitted electronically to the SLD -- if your service provider is accepting Online BEARs and if you have an E-rate PIN. If you cannot file online or choose not to, you can complete the Form 472 online using the PDF format, print it, and then mail it to the SLD (after getting the service provider to counter-sign, of course). The paper BEAR is located at: under Form 472. The Online BEAR can be filed at 2) Can I put all of my reimbursement requests on a single BEAR? No, a separate BEAR must be completed for each separate SPIN. For example, if you have 2 FRNs that list Comcast, and one FRN that is for AT&T, you can submit both Comcast FRN reimbursement requests on a single BEAR (as long as they have the same SPIN), and submit the AT&T reimbursement request on a separate BEAR. 3) Am I required to have the provider sign the BEAR? Yes and No. You need the service provider's signature on the PAPER BEAR Form before you submit it to the SLD. For the Online BEAR, the completed form will automatically be transmitted to the service

6 provider for their electronic signature and then automatically filed with USAC. No separate signature is needed. To find the fax number of your service provider to have them sign the PAPER BEAR, use the SLD's SPIN search database ( and call the number listed. Also, make sure the service provider signs the last page of the paper BEAR -- the Service Provider Certification Page -- and not the Applicant Certification Page which looks very similar. Also make certain that the provider includes the date beside their signature; dates are considered a minimum processing standard. 4) I was committed more funding than I actually spent. Can I request reimbursement for the full amount that was originally committed? No. Applicants may only seek reimbursement for the exact amount paid for the service instead of just listing the full funding cap (for example, if you were committed $10,000, but then only spent $6,000, you can only request E-rate reimbursements based on the $6000). Please know that the SLD has increasingly been requesting copies of invoices when they review the BEARs as proof that you are requesting the accurate amount. Don't send the invoices with the BEAR, but know they might be requested. 5) I spent more than what was committed on my funding commitment letter (my cap). What should I list on my BEAR -- the cap or the actual amount spent? The SLD would like you to complete the BEAR with the actual figures of what you spent for the service, and not just list your funding cap amount. For example, if you spent $10,000, and had a 50% discount, you would list $10,000 in Column 14 and $5,000 in Column 15, even if you were only committed $4,000. The reason is that the SLD would like to show how much applicants are actually spending on services and also so they know that you are not just listing the funding commitment amount (the cap), but have actually added up how much was actually spent in each of the 12 months using the actual vendor bills. Unfortunately, they will only reimburse you up to the amount that you were committed. 6) When will I receive my BEAR reimbursement check? After the SLD has reviewed and approved your BEAR, they will mail to you a BEAR Notification Letter, listing the amount of your check. Your check is mailed to your service provider within 20 calendar days of the date of the approval letter. Service providers are required to mail you a check for the same amount within 20 business days of receiving the check from the SLD. And if the past is any indication, the BEAR Approval Letters are mostly being issued within days of their receipt at the SLD. 7) What if I receive my BEAR Notification Letter and it lists that $0 was approved? This typically means that there was an error made on the BEAR Form and the applicant must correct the error and resubmit to the SLD. Many years ago, the SLD reached out to the applicant to correct the mistakes found on the Form 472s completed by applicants but this is no longer the case. Now the SLD will "pass zero" the BEAR (meaning they will not authorize any funding), but it does not mean the E-rate funding is gone. It simply means that the applicant must resubmit the BEAR with corrected information and typically there is an explanation on the BEAR explaining what was incorrect to help identify the error. If the explanation is inadequate, contact the Client Service Bureau at for more information.

7 8) What if I actually received a slightly different service than what was originally listed on my Item 21 attachments? The SLD has increased scrutiny of the BEARs to make sure that reimbursement requests are for exactly what services were approved for on the FCDLs and Item 21 attachments. If you changed services during the funding year from what you originally listed on your Item 21 attachments, you should first seek a "correcting service substitution request" from the SLD. The instructions for submitting a service substitution can be found at: 9) What should I do if I did not use the service or funding? File a Form 500 and cancel the FRN. The easiest version to use is available at:

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9 Submitting an Online BEAR Important: To submit a BEAR Form online, applicants will need their PIN, AND their service provider must be accepting Online BEARs. If a vendor is not accepting Online BEARs, the applicant must file a paper BEAR (Hint: If you re unsure, call your vendor to find out before you begin this process. There is no website or list to show which vendors accept Online BEARs, unfortunately). 1) Log-in to the Online BEAR System at: using your Billed Entity Number (BEN), PIN, address, and the last name of the PIN user. (If the system says it's an invalid address, try typing it in CAPs, or try using the last name of the contact person.) Unlike all other SLD forms, the Online BEAR requires you to log-in using your PIN instead of certifying the form after it's been submitted. 2) Click on New BEAR Form at the top of the page to start a new BEAR. (If you ever want to track a BEAR that's been submitted (even previously submitted paper-submitted BEARs) or is pending, instead click on "Track Form" and enter the query information.)

10 3) When the blank BEAR Form appears: Enter an Applicant Form Identifier. This is a name/label that you make up such as 2014AT&T # 3: Enter the SPIN for this BEAR (remember a BEAR can only be associated with 1 SPIN) # 7: Enter the Form 471 Number # 8: Enter the FRN Number # 10 (Use for recurring services and skip # 11): The date for # 10 should be the date of the first bill that you received from the service provider for the reimbursements being requested on this BEAR. For example, if you are filing for 12 months worth of bills, your first bill likely was 7/1/2014 or some date in July If you are only filing for reimbursement on bills from January June 2015, your bill date would likely be 1/1/2015 or some date in January # 11: (Use for non-recurring services and skip # 10): The date in # 11 should be the date that the products were shipped, the last date that the service provider performed its work, or the vendor bill date. # 12: Enter the eligible pre-discount amount spent for this FRN. The online system will then automatically multiply the amount in # 14 by your approved discount and that product will then be entered in # 15. If you incurred more charges that the pre-discount amount cap, you should enter the pre-discount amount cap in the online system. Note: If you have more than 1 FRN for this SPIN, you may click "Add Line Item" at the bottom of Block 2 to enter the new FRN information on the same BEAR.

11 4) Block 3 Certifications: A, B, C, D, E: Check the box to the left of each certification. # 15: Check the signature box. # 18-20: Enter the authorized person s contact information. 5) Block 4, Item 27 Remittance Information. The applicant should write in the name and title of the person to whom the reimbursement check should be mailed and the contact person s address. This person should be an employee of the applicant and not a third party such as a consultant. 6) When you have reviewed and verified all of the information on the form, click the Certify and Submit button at the bottom of the form. Your service provider will automatically receive an notification that your form is available to be reviewed and certified. USAC also will send you a copy of that notification. It is also be a good idea to your service provider to let them know you have

12 submitted a BEAR that needs to be certified (just in case the USAC does not reach the service provider). 7) If.. your service provider certifies your BEAR, you will receive an that the form has been vendorcertified and has been electronically sent to USAC for payment. your service provider does not certify your form within 15 days, USAC will cancel your BEAR Form and send a notice of cancellation by to both you and the service provider....your service provider denies your BEAR, you should contact them to find out the reason, and then resubmit a new BEAR. you entered more than one line item, and if your service provider does not certify all of them, you must file a new BEAR Form for the line(s) that were not certified. (Your service provider has the option of certifying the entire BEAR Form or just certifying certain lines on that form.) Unfortunately, it's not possible to amend a submitted BEAR, or open a previously submitted or pending BEAR, and make revisions. You must file a new BEAR Form to request reimbursement. 8) After the service provider certifies the BEAR, it typically will take USAC 1-2 weeks to process it, and if it's approved, you'll receive a Form 472 Approval Letter and USAC will remit electronic payment to the service provider within 20 calendar days. The service provider then must mail you a check within 20 business days.

13 FCC Form 472 DO NOT STAPLE THIS FORM Do not write in this space Approved by OMB OMB Control No Estimated time per response: 1.0 h Please read instructions before completing. U'" _. r _. niyic:i~cu "';'IC:I YI\.o1C: IVI "';'\.oilvvi~ ClIlY I..IUranes BILLED ENTITY APPLICANT REIMBURSEMENT FORM For reimbursement of discounts on approved services already paid for by the Billed Entity Applicant. Only one Service Provider Identification Number (SPIN) per form. Must be completed and signed by the Billed Entity Applicant and signed by the relevant service provider. (To be completed by schools, libraries, or consortia.) Persons willfully making false statements on this form can be punished by fine or forfeiture, under the Communications Act, 47 U.S.C. Secs. 502, 503(b), or fine or imprisonment under Title 18 of the United States Code, 18 U.S.C. Sec FCC NOTICE FOR individuals REQUIRED BY THE PRIVACY ACT AND THE PAPERWORK REDUCTION ACT Part 54 of the Commission's Rules authorizes the FCC to collect the information on this form. Failure to provide all requested information will delay the processing of the application or result in the application being returned without action. Information requested by this form will be available for public Inspection. Your response is required to obtain the requested authorization. The public reporting for this collection of information is estimated to range from 1 to 2 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the required data, and completing and reviewing the collection of information. If you have any comments on this burden estimate, or how we can improve the collection and reduce the burden it causes you, please write to the Federal Communications Commission, AMD-PERM, Paperwork Reduction Act Project ( ), Washington, DC We will also accept your comments regarding the Paperwork Reduction Act aspects of this collection via the Internet if you send them to PRA@fcc,gov, PLEASE DO NOT SEND YOUR RESPONSE TO THIS FORM TO THIS ADDRESS, Remember - You are not required to respond to a collection of information sponsored by the Federal government, and the government may not conduct or sponsor this collection, unless it displays a currently valid OMS control number or if we fail to provide you with this notice. This collection has been assigned an OMS control number of THE FOREGOING NOTICE IS REQUIRED BY THE PRIVACY ACT OF 1974, PUBLIC law , DECEMBER 31,1974,5 U.S.C. 552a(e)(3) AND THE PAPERWORK REDUCTION ACT OF 1995, PUBLIC law , OCTOBER 1,1995, 44 U.S.C. SECTION Applicant Form Identifier (Create an identifier for your own reference) IFCC Form 472 Invoice # (To be inserted by administrator) BLOCK 1: HEADER INFORMATION 1. Billed Entity Name 2. Billed Entity Number 3. Service Provider Identification Number (SPIN) 4. Contact Name 5. Contact Telephone Number 6. Total Reimbursement Amount (total from Block 2, Column 14) $0.00 Page 1 of 5 FCC Form

14 Billed Entity Applicant Reimbursement Form For reimbursement of discounts on approved services already paid for by the Billed Entity Applicant. Approved by OMB OMB Control No Estimated time per response: 1.0 hour Billed Entity Name Contact Name Billed Entity Number Contact Telephone Number Appl icant Form Identifier I BLOCK 2: LINE ITEM INFORMATION PER FUNDING REQUEST NUMBER (7) (8) (9) (10) (11 ) (12) (13) (14) FCC Form 471 Application Number (from Funding Commitment Decision Letter) Funding Request Number (FRN) (from Funding Commitment Decision Letter) Bill Frequency Customer Billed Date (mm/yyyy) Shipping Date to Customer or Last Day of Work Performed (mm/dd/yyyy) Total (Undiscounted) Amount for Service Discount Rate DO NOT WRITE IN For each FRN, complete either Column (10) THIS COLUMN. or Column (11), but not both Columns 1 $ $ $ $ $ $ $ $ $ $ $ $ $ $0.00 TOTAL REIMBURSEMENT AMOUNT TO BE ENTERED INTO ITEM (6) $0.00 Amount Billed to USAC (Column 12 multiplied by Column 13) Page 2 of 5 FCC Form 472 July 2013

15 BILLED ENTITY APPLICANT Reimbursement Form Approved by OMB OMB Control No Ef s Imae tdf Ime per response: 10hour Billed Entity Name Billed Entity Number Contact Name Applicant Form Identifier Block 3: Billed Entity Certification I declare under penalty of perjury that the foregoing is true and correct and that I am authorized to submit this Billed Entity Applicant Reimbursement Form on behalf of the eligible schools, libraries, or consortia of those entities represented on this Form, and I certify to the best of my knowledge, information and belief, as follows: A. The discount amounts listed in Column (14) of this Billed Entity Applicant Reimbursement Form represent charges for eligible services delivered to and used by eligible schools, libraries, or consortia of those entities for educational purposes, on or after the service start date reported on the associated FCC Form 486. B. The discount amounts listed in Column (14) of this Billed Entity Applicant Reimbursement Form were already billed by the service provider and paid by the Billed Entity Applicant on behalf of eligible schools, libraries, and consortia of those entities. C. The discount amounts listed in Column (14) of this Billed Entity Applicant Reimbursement Form are for eligible services approved by the fund administrator pursuant to a Funding Commitment Decision Letter. D. I recognize that I may be audited pursuant to this application and will retain for at least five years (or whatever retention period is required by the rules in effect at the time of this certification), after the last day of service delivered in this funding year any and all records that I rely upon to fill in this form. E. I certify that, in addition to the foregoing, this Billed Entity Applicant is in compliance with the rules and orders governing the schools and libraries universal service support program, and I acknowledge that failure to be in compliance and remain in compliance with those rules and orders may result in the denial of discount funding and/or cancellation of funding commitments. I acknowledge that failure to comply with the rules and orders governing the schools and libraries universal service support program could result in civil or criminal prosecution by law enforcement authorities. 15. Signature of authorized person 16. Date 17. Printed name of authorized person 18. Title or position of authorized person 19. Telephone number of authorized person 20. Address of authorized person Page 3 of 5 FCC Form 472 July 2013

16 BILLED ENTITY APPLICANT Reimbursement Form Approved by OMB OMB Control No Ef s Imae tdf Ime per response: 10hour Billed Entity Name Billed Entity Number Contact Name Applicant Form Identifier Block 4: Service Provider Acknowledgment I declare under penalty of perjury that the foregoing is true and correct and that I am authorized to submit this Service Provider Acknowledgment for this Billed Entity Applicant Reimbursement Form, and acknowledge to the best of my knowledge, information and belief, as follows: A. The service provider must remit the discount amount authorized by the fund administrator to the Billed Entity Applicant who prepared and submitted this Billed Entity Applicant Reimbursement Form as soon as possible after the fund administrator's notification to the service provider of the amount of the approved discounts on this Billed Entity Applicant Reimbursement Form, but in no event later than 20 business days after receipt of the reimbursement payment from the fund administrator, subject to the restriction set forth in B. below. B. The service provider must remit payment of the approved discount amount to the Billed Entity Applicant prior to tendering or making use of the payment issued by the Universal Service Administrative Company to the service provider of the approved discounts for the Billed Entity Applicant Reimbursement Form. C. I certify that. in addition to the foregoing. this Service Provider is in compliance with the rules and orders governing the schools and libraries universal service support program, and I acknowledge that failure to be in compliance and remain in compliance with those rules and orders may result in the denial of discount funding and/or cancellation of funding commitments. I acknowledge that failure to comply with the rules and orders governing the schools and libraries universal service support program could result in civil or criminal prosecution by law enforcement authorities. 21. Signature of authorized person (fax, copy or original signature) 22. Date 23. Printed name of authorized person 24. Title or position of authorized person 25. Telephone number of authorized person 26. Address of authorized person 27. Applicant Remittance Information Name Title Street Address Page 4 of 5 FCC Form 472 July 2013

17 Approved by OMB OMB Control No Estimated time per response: 1.0 hour A paper copy of this Form (pages 1-4) should be mailed to: SLD BEAR FCC Form 472 P. O. Box 7026 Lawrence, KS If sent by express delivery services or U.S. Postal Service, Return Receipt Requested, the form (pages 1-4) should be mailed to: SLD Forms ATTN: SLD BEAR FCC Form Greenway Drive Lawrence, KS Phone: Page 5 of 5 FCC Form 472 July 2013

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19 FCC Form 472 Universal Service for Schools and Libraries BILLED ENTITY APPLICANT REIMBURSEMENT FORM Instructions for Completing the Universal Service for Schools and Libraries Billed Entity Applicant Reimbursement (BEAR) Form Approved by OMB OMB Control No Estimated time per response: 1.0 hour FCC NOTICE FOR INDIVIDUALS REQUIRED BY THE PRIVACY ACT AND THE PAPERWORK REDUCTION ACT Part 54 of the Commission s Rules authorizes the FCC to collect the information on this form. Failure to provide all requested information will delay the processing of the application or result in the application being returned without action. Information requested by this form will be available for public inspection. Your response is required to obtain the requested authorization. The public reporting for this collection of information is estimated to range from 1 to 2 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the required data, and completing and reviewing the collection of information. If you have any comments on this burden estimate, or how we can improve the collection and reduce the burden it causes you, please write to the Federal Communications Commission, AMD-PERM, Paperwork Reduction Act Project ( ), Washington, DC We will also accept your comments regarding the Paperwork Reduction Act aspects of this collection via the Internet if you send them to PRA@fcc.gov. PLEASE DO NOT SEND YOUR RESPONSE TO THIS FORM TO THIS ADDRESS. Remember You are not required to respond to a collection of information sponsored by the Federal government, and the government may not conduct or sponsor this collection, unless it displays a currently valid OMB control number or if we fail to provide you with this notice. This collection has been assigned an OMB control number of THE FOREGOING NOTICE IS REQUIRED BY THE PRIVACY ACT OF 1974, PUBLIC LAW , DECEMBER 31, 1974, 5 U.S.C. 552a(e)(3) AND THE PAPERWORK REDUCTION ACT OF 1995, PUBLIC LAW , OCTOBER 1, 1995, 44 U.S.C. SECTION PURPOSE OF FORM The FCC Form 472, Billed Entity Applicant Reimbursement (BEAR) Form is used by the Billed Entity that received a Funding Commitment Decision Letter (FCDL) from the fund administrator, the Schools and Libraries Division (SLD) of the Universal Service Administrative Company (USAC), and filed an FCC Form 486, Receipt of Service Confirmation Form, indicating that the Billed Entity intended to submit to USAC an invoice for reimbursement of discounts on eligible services received on or after the effective date of discounts and already paid for by the applicant. Completion of the BEAR Form is mandatory unless the Billed Entity and service provider have made their own, mutually agreed-upon arrangements for reimbursement or implementation of the discounts. If such an arrangement has been mutually agreed upon, reimbursement of the discounts can be achieved by submission of an FCC Form 474, Service Provider Invoice Form to the fund administrator, following the implementation of the discounts. The applicant should prepare and submit a BEAR Form to the fund administrator when ALL of the following conditions occur: 1. The applicant receives a FCDL from the fund administrator which approves discounts for services; AND 2. The applicant is already receiving or has received these services, and has already paid for the services, including the price of the discounts; AND 3. The applicant has filed an FCC Form 486; AND 4. The service provider has filed an FCC Form 473. FCC Form 472 Instructions Page 1 of 7 July 2013

20 Approved by OMB OMB Control No A Billed Entity will prepare a BEAR Form for the amount of the discounts associated with the services set forth in a specific Funding Request Number (FRN from the associated FCC Form 471 which the applicant has already received and paid for. If the applicant will be seeking reimbursement for services provided by more than one service provider, as designated by a Service Provider Identification Number (SPIN) in the applicant s FCC Form 486, the applicant will prepare a separate BEAR for each SPIN. The reimbursement period for each FRN will begin with the Funding Year Service Start Date reported by USAC in your FCC Form 486 Notification Letter. On the BEAR Form, the service provider must sign an Acknowledgment that: (1) The service provider must remit the discount amount authorized by the fund administrator to the Billed Entity who prepared and submitted this BEAR as soon as possible after the fund administrator s notification to the service provider of the amount of the approved discounts on this BEAR, but in no event later than 20 business days after receipt of the reimbursement payment from the fund administrator, subject to the restriction set forth in (2) below (2) The service provider must remit payment of the approved discount amount to the Billed Entity prior to tendering or making use of the payment issued by the Universal Service Administrative Company to the service provider of the approved discounts for the BEAR. Important Note: This Acknowledgment, which is Block 4 of the BEAR Form, must be submitted by the Billed Entity as part of the completed, entire BEAR Form to the fund administrator. If the BEAR Form is submitted without the signature of your service provider on the Acknowledgment, the BEAR will not be processed and it may be returned to you. FILING REQUIREMENTS AND GENERAL INSTRUCTIONS Who Must File? The Billed Entity representing a school, library, library consortium, or consortium of multiple entities (hereinafter referred to as school or library ) who: (1) completed and submitted the FCC Form 471; and (2) filed the FCC Form 486; and (3) seeks to receive reimbursement for the discounts for services already received and paid for since the actual service start date must submit this BEAR Form to the fund administrator. The Billed Entity must complete the BEAR Form and obtain the signature of the relevant service provider on the Service Provider Acknowledgment before sending the BEAR Form to the fund administrator. Throughout these Instructions, the Billed Entity Applicant will be referred to as applicant or you, the relevant service provider will be referred to as your service provider, and the BEAR Form will be referred to as BEAR or Form. How Many BEARs to File at One Time? You must submit a separate BEAR for each service provider with a separate Service Provider Identification Number (SPIN) whose services you have already received and paid for since your actual service start date. For each SPIN, your BEAR should contain information for each and every one of the multiple FRNs for services delivered by that service provider AND for which you have received your FCDL. Please be sure that each BEAR that you complete contains only one SPIN. Examples You receive one FCDL (based on one FCC Form 471) that has five FRNS approved for discounts: SPIN # is associated with three FRNs SPIN # is associated with one FRN SPIN # is associated with one FRN. You can submit three BEARs: one listing all the FRNs associated with SPIN # , and one each for SPIN FCC Form 472 Instructions Page 2 of 7 July 2013

21 # and SPIN # Approved by OMB OMB Control No You receive two FCDLs on the same date, based on two FCC Forms 471. One letter approves discounts for two FRNs associated with SPIN # The other letter approves discounts for three FRNs also associated with SPIN # You can file just one BEAR listing all the FRNs associated with SPIN # When to File? The BEAR should be filed after you have received and paid for eligible services covered by your FCC Form(s) 471 and you have filed an FCC Form 486 for the pertinent FRNs approved in your FCDL. You may submit the BEAR once a year for reimbursement of the discounts for non-recurring services for the entire year, or you may file more frequently (e.g., quarterly, bimonthly, monthly) if that is more convenient. NOTE: If USAC has adjusted your Funding Year Service Start Date, as reflected on your FCC Form 486 Notification Letter, USAC will not honor BEARs with recurring services dates in Column 12 or non-recurring services dates in Column 13 prior to that adjusted Funding Year Service Start Date. Service Provider Annual Certification Form The FCC Form 473 is used by the service provider to confirm that invoice forms submitted or approved by the service provider are completed in compliance with FCC rules governing the schools and libraries universal service support mechanism. The FCC Form 473 must be completed and submitted by the service provider prior to the applicant submitting its first invoice form to USAC. No invoices will be paid without an FCC Form 473 filed for the pertinent funding year. If your service provider has not done so already, please be sure to ask your service provider to complete and submit the FCC Form 473. Where to File? The BEAR can be filed either online or on paper. If you are filing online: You may complete, submit and certify the BEAR in the Apply Online section of our website. The system is designed so that once you make the appropriate certifications, the service provider featured is notified that the BEAR is available for their review and online certification or response to you. If you file a BEAR online, do not also mail a printed copy to USAC. OR If you are filing on paper: Do not staple the BEAR Form, You may complete and submit the BEAR by filing a paper copy of the completed BEAR, including BOTH the completed and signed Block 3 AND Block 4 certification pages, with USAC. The signed BEAR must be filed with USAC at the address listed at the bottom of the BEAR: SLD BEAR FCC Form 472, P.O. Box 7026, Lawrence, KS For those applicants using express delivery services or U.S. Postal Service Return Receipt Requested, send to: SLD Forms, ATTN: SLD BEAR FCC Form 472, 3833 Greenway Drive, Lawrence, KS 66046, phone DO NOT FILE THIS OR ANY OTHER UNIVERSAL SERVICE FORM WITH THE FCC. In addition, if you are filing on paper, you may want to work directly with your service provider in filling out this BEAR; at minimum, you must provide the completed BEAR when you contact your service provider to obtain a signature on the Block 4 Service Provider Acknowledgment. Contact your service provider to find out who on its staff should be your contact person for these purposes. Compliance. Anyone filing false information is subject to penalties for false statements, including fine or forfeiture, under the Communications Act, 47 U.S.C. 502, 503(b), or fine or imprisonment under Title 18 of the United States Code, 18 U.S.C. FCC Form 472 Instructions Page 3 of 7 July 2013

22 1001. Approved by OMB OMB Control No All of the information required in the BEAR must be completed, in order for this BEAR to be accepted by the fund administrator for entry into our data system. A valid entry must be submitted by the Billed Entity for each component of information required. These instructions set forth the requirements for a valid entry. If you have any questions about completing this BEAR or any Program form, please contact the SLD Client Service Bureau at , or visit the USAC website, before submitting the BEAR. If the BEAR is not properly completed, it may be rejected and returned to you. Where to Get More Information? You may call the SLD Client Service Bureau at , send an from the USAC website using Submit a Question or a fax to for more information on how to complete this or other universal service forms. Information is also available on the USAC website. SPECIFIC INSTRUCTIONS Type or clearly print in the spaces provided. Applicants may attach additional pages if necessary. Applicant Form Identifier (Create an identifier for your own reference) Please assign a unique number to identify this BEAR for your own records. This number (which can include both numerals and letters) could be generated by your usual billing system, or created specifically for this purpose. For example, if you have an accounting system which assigns an invoice number to bills and receivables, you may use the identification number assigned by your billing system. We will refer to this number to identify this particular invoice should we need to contact you concerning this BEAR. Reminder: Complete the Applicant Remittance Information on Page 5, under the Block 4: Service Provider Acknowledgement. Block 1 Header Information Item (1) - Billed Entity Name. Provide your name as indicated on the corresponding FCDL. Item (2) - Billed Entity Number. Provide the Billed Entity Number as it appears on your FCDL. Please be sure to obtain this information from your FCDL, as the information may have been reported differently in your original FCC Form 471. Item (3) - Service Provider Identification Number (SPIN). Provide the number assigned to the service provider who is delivering the services for which you are submitting this BEAR. Remember, only one SPIN is permitted per BEAR. Please be sure to obtain this information from your FCDL for the FRNs for which you are seeking reimbursement. Item (4) - Contact Name. Provide the name of the person who should be contacted if the fund administrator has questions about this BEAR. The contact person must be able to answer questions in a timely manner regarding the information included in this BEAR and the eligible services that have been or are being provided. Item (5) - Contact Telephone Number. Provide the telephone number with area code for contacting the person identified in Item (4). You may also include an extension of up to four (4) digits for a total of 14 digits. Item (6) - Total Reimbursement Amount. Provide the total amount associated with this BEAR. This amount should be the sum of the entries in Column (14). Block 2 Line Item Information per Funding Request Number Columns (7) through (14) The information requested in the following Columns should be completed for each FRN when: (1) you are already receiving or have received the service(s); FCC Form 472 Instructions Page 4 of 7 July 2013

23 Approved by OMB OMB Control No (2) the service was delivered to you on or after the start date of discounts reported on your FCC Form 486 Notification Letter; (3) you already paid for the services you are receiving or have received; and (4) your service provider has filed an FCC Form 473 for the funding year. Please remember that all FRNs included on this BEAR must be associated with the same service provider whose SPIN is listed in Item (3) of Block 1. Column (7) - FCC Form 471 Application Number. This is the number USAC assigned to the FCC Form 471 with which this line of the BEAR is associated. This number must be obtained from your FCDL. Column (8) - Funding Request Number (FRN). This is the number USAC assigned to each FRN on your FCC Form 471. Each FRN is set forth in your FCDL. Column (9) - Bill Frequency. Please do not complete this Column, as this Column will be completed by the fund administrator. Please note that only Column 10 OR Column 11 should be completed for each FRN (i.e., each line on the form). Please do NOT complete BOTH Columns 10 and 11 for the same FRN. Also, the date featured in this column cannot be earlier than the Service Start Date featured in the FCC Form 486 Notification Letter. Only paid services received in the applicable Funding Year for each FRN are eligible for discounts. Column (10) - Customer Billed Date. Use this Column for reimbursement of bills for recurring services and for multiple installments for non-recurring services. The month and year you enter in this column should be for the first month you received services represented by the amount in Column (14). The date must be in month and 4-digit year (mm/yyyy) format and must be within the funding year. For example: If you receive a monthly bill dated June 15, 2012 for recurring services from July 1 to July 31, you should enter 07/2012. If you receive a quarterly bill dated November 1, 2012 for recurring services from October 1 to December 31, you should enter 10/2012. If you receive a bimonthly installment bill dated September 10, 2012 for non-recurring services from September 1 to October 31, you should enter 09/2012. Column (11) - Shipping Date or Last Day of Work Performed. Use this Column for reimbursement for non-recurring services billed one time only such as Internal Connections. The date in Column (13) should be either the date that the products were shipped or the last date that the service provider performed its work. This date should be in month/day/fourdigit year (mm/dd/yyyy) format. Column (12) - Total (Undiscounted) Amount for Service per FRN. The total undiscounted amount represents the total amount paid per FRN for which you are seeking reimbursement of the discount on this BEAR. This total undiscounted amount should reflect the charges for services actually received and should not be an estimated amount. The total undiscounted amount should also not be the total annual amount for the FRN, unless you are making an annual filing or are contractually obligated to pay the entire cost of services. You must deduct charges for any ineligible services, or for eligible services delivered for ineligible recipients or used for ineligible purposes. You should gather your customer bills and any other documentation you need to support your calculations. Column (13) Discount Rate. Use this column to list the applicant s approved discount percentage. You can find this discount percentage for each FRN in the FCDL. Column (14) Amount Billed to USAC. This column is calculated by multiplying the amount in Column (12) by the applicant s Discount Rate in Column (13). FCC Form 472 Instructions Page 5 of 7 July 2013

24 Approved by OMB OMB Control No Block 3 Billed Entity Certification The Billed Entity must sign the Certification and declare under penalty of perjury that: (A) The discount amounts listed in Column (14) of this Billed Entity Applicant Reimbursement Form represent charges for eligible services delivered to and used by eligible schools, libraries, or consortia of those entities for educational purposes, on or after the service start date reported on the associated FCC Form 486. (B) The discount amounts listed in Column (14) of this Billed Entity Applicant Reimbursement Form were already billed by the service provider and paid by the Billed Entity Applicant on behalf of eligible schools, libraries, and consortia of those entities. (C) The discount amounts listed in Column (14) of this Billed Entity Applicant Reimbursement Form are for eligible services approved by the fund administrator pursuant to a Funding Commitment Decision Letter. (D) I recognize that I may be audited pursuant to this application and will retain for at least five years (or whatever retention period is required by the rules in effect at the time of this certification), after the last day of service delivered in this funding year any and all records that I rely upon to fill in this form. (E) I certify that, in addition to the foregoing, this Billed Entity is in compliance with the other rules and orders governing the schools and libraries universal service support program and I acknowledge that failure to be in compliance and remain in compliance with those rules and orders may result in the denial of discount funding and/or cancellation of funding commitments. I acknowledge that failure to comply with the rules and orders governing the schools and libraries universal service support program could result in civil or criminal prosecution by law enforcement authorities. Item (15) - Signature. Provide the signature of the authorized person. Item (16) - Date. Provide the date that the Billed Entity signed the BEAR. Item (17) - Printed name of authorized person. Provide the printed name of the authorized person. Item (18) - Title or position of authorized person. Provide the title or position of the authorized person. Item (19) - Telephone number of the authorized person. Provide the telephone number of the authorized person, should the fund administrator need to contact this person. Item (20) - Address of authorized person. Provide the address of the authorized person. Block 4 Service Provider Acknowledgment After completing the top of page 4 (Billed Entity Name, Billed Entity Number, Contact Name, and Contact Telephone Number), provide a copy of all four pages of the BEAR to your service provider. Your service provider must complete and sign Block 4: Service Provider Acknowledgment, and return it to you via fax, mail, or in person. An original ink signature is NOT required on Block 4. The service provider whose SPIN is listed in Item 3 of Block 1 must sign the Acknowledgment that confirms the following: (A) The service provider must remit the discount amount authorized by the fund administrator to the Billed Entity Applicant who prepared and submitted this Billed Entity Applicant Reimbursement Form as soon as possible after the fund administrator s notification to the service provider of the amount of the approved discounts on this Billed Entity Applicant Reimbursement Form, but in no event later than 20 business days after receipt of the reimbursement payment from the fund administrator, subject to the restriction set forth in B. below. (B) The service provider must remit payment of the approved discount amount to the Billed Entity Applicant prior to tendering or making use of the payment issued by the Universal Service Administrative Company to the service provider of the approved discounts for the Billed Entity Applicant Reimbursement Form. FCC Form 472 Instructions Page 6 of 7 July 2013