20160701Mud Lake Telephone Cooperative Form 481.pdf

RICEIVED
" r I: .,'1"- - I i1i{ lc: 2 t+
GVNW CONSULTING, INC.
2270IA MONTANAWAY*2OO
COLORADO SPRINGS, CO 80918
TEL. [phone]
FAX [phone]
rvww.gvnw.@mll-lrj,-','1-riArr. rf,ilIt,lI'r
June 30, 2016
Jean Jewell
ldaho Public Utilities Commission
472W. Washington
Boise, lD 83702
Via UPS
RE: Case No. GNR-T-1&01 - 2016 Eligible Telecommunications Carrier (ETC) Annual
Reporting Requirements with the IPUC and Informational Filing of Federal
Communications Commission (FCC) Form 481 - Carrier Annual Report for Mud Lake
Telephone Cooperative Association
Dear Ms. Jewell
Pursuant to Case No. GNR-T-16-01 Mud Lake Telephone Cooperative Association (Mud Lake)
hereby submits to the ldaho Public Utilities Commission (IPUC) copies of the filing to the Federal
Communications Commission (FCC) and the Universal Service Administrative Corporation
(USAC) for designation as an Eligible Telecommunications Canier, in accordance with 47 U.S.C.
54.313 and 54.422. Also included is the signed Affidavit pursuant to IPUC Order 29U1. Mud
Lake Telephone Cooperative (SAC 472227) is a rural incumbent local exchange canier as
designated by the FCC, and is eligible to receive federal universal service high-cost support
pursuant to the Code of Federal Regulations (CFR), Title 47, Sections 54.301, 54.305, and Part
36, sub-part F. Please review the attached filing data and include Mud Lake in your Annual Use
Certification Letter to USAC and the FCC.
The enclosed filing contains documents that contain certain confidential trade secret information
that relates to its financial position and is exempt from public disclosure pursuant to Section 9-
340 D(1), ldaho Code. Pursuant to Rule 67 of the Rules of Procedure of the IPUC, the enclosed
trade secret information has been submitted on yellow paper and placed in a sealed envelope,
stamped confidential.
Please direct any questions to Andy Schein at 719.594.5820 or by email at [e-mail].
Sincerely,4)J;
Andy Schein
cc: Randy Mead, Mud Lake
sw"or fuaho I
counry o1 Sa$ur-sonltt
CERTIFICATION BY ELIGIBLE TELECOMMI.JNICATIONS CARRIER
OF COMPLIANCE WITH SERVICE QUALITY AND CUSTOMER
PROTECTION, ABILITY TO REMAIN FUNCTIONAL IN EMERGENCIES,
AND USE OF FEDERAL HIGH-COST SUPPORT
AFFIDAVIT OT BUSINESS OR CORPORATE OFFICER
The ldaho Public Utilities Commission Order No. 29841 requires that Eligible Telecommunications Carriers certift
that it is compliant with applicable service quality standards and consumer protection rules; and ETCs must
demonstrate the ability to remain functional in emergencies. In addition, the Commission must file an annual
certification with the USAC and the FCC that all federal high-cost support provided to ETCs within the State of
Idaho will be used only for $e provision, maintenance, and upgrading of facilities and services for which the
support is intended. Accordingly, the undersigned states and verifies under oath the following:
I . I am an of{icer of Mud Lake Telephone Cooperative Association, an eligible telecommunications carrier
for receiving federal universal service support under section 2 l4(e) of the Telecommunications Act of 1996
in the state of ldaho.
2. I am familiar with the Company's day-to-day operations in the state of ldaho and with the State's service
quality standards and consumer protection rules as set forth in Commission Order No. 29841.
3. Mud Lake Telephone Cooperative Association is complying rvith applicable service quality standards and
consumer protection rules ofthe Federal Communications Commission and the ldaho Public Utilities
Commission.
4. I certiS to the Commission that the company is able to remain functional in emergencies as set forth in
Commission Order No. 29841 and in 47 C.F.R. 54.201 (a\2).
5. I also certiff that all federal universal service support funds received by Mud Lake Telephone Cooperative
Association during the current calendar year will be used in a manner consistent with section 254(e); that
is, for the provision, maintenance, and upgrading of facilities and services for which the support is
intended. The company will continue to comply for the period of January 1,2017, through December 31,
2017,lo be eligible for federal univerual service fund support.
6. This verification and alfidavit is provided to the Idaho Public Utilities Commission to enable the IPUC to
certiry to the FCC that federal universal service support received by the eligible carriers in the state will be
used in a manner consistent with Section 254(e) ofthe Telecommunications Act.
SUBSCRIBED AND SWORN to bsfore me this 21
=.. :p,?",
=*: -.- i*Ezr\Punltc ,j S
"rrrrrrrfifiHp,N
Notary Public f8r f,4qho , residing at T*sre-{zn , T,D
My Commission expires ? -4- etr I
aayor Tua'** , )bll
Page 1
<010> StudyAreaCode
<015> StudvArea Name M Nre TEL COOP
<020> Proeram Year
<030> Contact Name: Person USAC should contact
with questions about this data Judi Ushio
<035> Contact Telephone Number: 71es94s814 ext.
Number of the Derson identitied in data line <030>
<039> Contact Email Address:juahio@qmx. comEmail ot the identitied in data line <030>
FormType s4.313 and s4.422
Page 1
No@6c
coE
=ooEot
o
oo
E6z
rc
.9
Eoo
Eo
=sio;>o=.l-->Ed co=ofo,^HItao or$+
.=@6
!do9 ,-i iohLi IFNO
6;9qiCP'UgEts'<loo
o=q>Eo;:
io b -o
=ENO6:o=dEf ;gE.9 B>6O>oooii6 L s 6ih 3r EgabEd6+ o> ].Y P
.J TE;E.9 E :",, .=
>6=-J
H E iE U
N
I
"lol
PI
!l
I
Ilo>oloc= | >os I EleE I 6*3H I t'R.g: I *s:tr | -o6E I B*ci I $:;!; I h5I
e I +eai I sEfq I qit
.9 ^. I .. b =AUI ta2ouldf'u
=:l =Ee,v il v b iie:l 3-Eg
=!l :Pio Bl o P-Erl E;=B tEl B E o
3=. I E6=
cEI c;i
rl
=l"l
o
c
oc
o:
()(Juos
Eo
co,ao
=tso
(,)FU
2!o
o
o
goo
Eo
ao
@-
o
@ETE9EE8Soos3gE EfrH
E ll H B eh:E E=E;:l E=€:hb q96o;.=l/i.ia
=Eto2.^-tge ;gEu-L.=i6-oE€":-=E--
3 e ; E : E + E;6;oS 4 gi + a A e
;*;F#rEEEggEST E-;EBEE
E:EiEEEagE;EgEEggggF5;:: H,gBg;riEs r; t t tEe9-'t Eg sEEEP E E g I fr E " Ei.
eEEu giEEEEiy; =: 3; g s g Ht^ ^ f'o;; E r: E F A b q X.p+EE;EB?3;I:Es[!:!EEEEi
# E E : s. E E E E E:
NN AiisHiiVVVVVV
@ o o o o
o!6.9
o
oz
Eo!3
o@o
oo
,E
o
o
.EEoEc
@p
o
@o
o
o
!t
o
E
o
!!
E
c
oo
"
oo
o
G
!
=oE
co:o
ot
aIE
z
o!
E
=zoco-og
@F
o
o
o
D
Ea
!.9E
E
o
E
o
=fot
U
l
o
o
Ez
co
oo
G@
EG
do
ao
ooUj
F
x
oIE
o
Ezoo
!,
o
oEo0
o
E
o
oz
E
oU
co
o(o
@oroo@om
c,2
6O$tsCEtoo(Jrco(J<H5
aos
oetuE
c.,
Eo
oc
.E
.EEEedEgE>o38Fo-9Vt!gcr
NoMoc
a
o
o@Gaoo-
o
o,9o
o!6to
o
coooE
oo;
oo
o!co
G
.o
aoE
ou
o
N
oq
3C
b@o
o
o
o
G
!
=oG
ao
=o
oo
o
oEE
o
E
oE
6
E
co
o
o
o
o
o!
;
Eco
=o
@o
o
Elz
-Ezo
o
g
F
G
c
U
o
o
D
ga
E
.9E
E
o
a
ao
E
oE
la
d
@
Ez
o
o
a
E
oC
o
o
ooU
F
s
a
E
Ez
o
!
o
o!oU
@
!,
o
o
o
@oIo
dz
Ecouo
=
@ooo6@o
oz
6()sbE Eoovor6Nos>EO:
6oo
EE
Eoo.oEOEu=E8icI€ro
3E
a
o
ot*
EeE
=o6EoG
G
ooE62
,lS lol;ll6l IEll'!
Eo0Etto
a
E
EEo=E
5
o
$
o
Egc-q.EE
o?iE-gE
=oEE5o
$$
EcoIEo0!
e
Eo
6co
Eoo
o
ootc>g
6
)
omo
o.s
o
6E
E!@lE
Eop
go
oq
o
q
!!
=6Er
a
EE
=6EutdcoU
Ao
Im?o
.E
o
G!E
!0
Eop
ao
oo
o
o,Etz
o!
Efz0coEo
oFtoco(J
h
?
ooo
oo
EoUo4
Ao
ooUpE
CT
E
J
aD
=
oEG2oo
!
6o
r
r
o!oUoo
!
oo
(a@od
<01D Study Area Code
<015> StudyArea Name
<020>Pro8ram Year
<030> Contact Name - Person USAC ahould contact regarding this data Jud hEo
<035> ContaEt Telephone Numbe, - Number of pe6on ideotified in data line
<039> contact Email Address - Email Address of pe6on identified in data line ru.Hryv..6
<400>
<410>
<420>
<430>
<440>
<450>
Select from the drop-down list to indicate how you would like to report
voice complaints (zero o. $eater) for voice telephony service in the ptior offered only fixed voice
calendar year for each service area in which you are designated an ETC for
any facilities you own, operate, lease, or otherwise utilize.
Complaints per lo(x) customers for fixed voice O - 0
Complaints per 1000 customers for mobile voice
select from the drop-down list to indicate how you would like to report
end-user customer complaints (zero or greater) for broadband service in offered only fixed broadband
the prior calendar year for each seNice area in which you are designated
an ETC for any facilities you ourn, operate, lease, or othe.wise utilize.
Complaints per 1000 customers for fixed broadband
Complaints per 10fi) customers for mobile broadband
0.0
@ c.nlfy @mpllfie with .Fpll<!bl! sfllc. qu.llty !t ndarda fid @nlumd pDtacuon rul.s yes
4722211d51o.Edf
610, DBcdft doEurcdtu &il|@ ou.lli $.ndddr & &nrumq Prddld Rul6 cmpll.ne
<010> SiudvAr.r Cod.
<):l{D Cml.d x.m. - pGffi tlslc should ffi
<,3$ cd.ct Em.il AddG. - En.ilAddB of pelu iddifi.d in d# line <o3o> JuH@'-cd
<6q> C.nifv @mFli.ne caardinf .bility to fundio in cmcE.n<y siMions
<Eto> Dcsiptlrr. dcm.m ior tundlon lity ln E.n.r8lrry shu*i6i
o;
.>t
s-9
eE
.9!
3&.
-oGE
_9?
.96c6$oa99
G6
orooNT
EoI3
o@o
a
omo
oc
o
,EEoE
Cop
go
oo
o
oE!
@
EU
@
!E
o
Er
6
coU
o
o
omo
o.g
o
o
.EEo
,F
Eo
=co
oo
o
o!
Elz
@!
EfzocoEoooF
6
co(J
4oo
o
€
6
rc!
,!E
u
.=!oUo
6
Co
I
=oE
(J
f,
Co
oc
o
Eoz
o
Co(J
omo
Go
Eouoo
oNo
oo
I
ts
J
o
E
o
Ezoo
El
oo
oEo(J
6o
!l
oo
o6(3ooo
c,z
E
oU
6
ob'cotnoooo(n
dz
6OstEF 6Touor coN(JS>H5E
t!
lgoo
GGo.go
00
,Et,
E
.E
0aiCO'=rAteE6o'iis-u
aE
f;lc
-eE8
@
d
o
@
oq
3
oIo
)
o
o
o
,EEo5co
=o
e
o
o
!o
E
!E
E
co
o
o
o
@c
6
o;oEcop
co
o
o
@!
Efz
o!
E
z
o
o
og
@F
o
o
D
!
!
.2
,E
co
t
lco
d
Ez
E
o
o
o
o
E
o
d
o
o
oo
j
F
3
oD:
Ez
o
!
a
!o
!j
o
o
o
6I6@om
dzo
coL'6
=o
@oooo@om
o
co:rio
b Em: oH3:R
H 5=
p
o
Eo!c
=rieg€ooo=6E
o
o@od
o
oCu
ooE
o
.0
o
coe
EoU
o
6UEoo
coo
E
Uuc
o
N
@
!
oa
oz
c
q
EoU
@
,E!o-
@
o
o
oo
o
F
J
!
E
.q
oUucEoooG
o
@
Eo
;
o@o
oo
o.=
o!
.=!.9
Cap
co
oo
o
o!!
6
Eu
o!!
6EU
coU
oo
o
o
a.E
GoE
.E!@
Fco
=co
oo
o
o!
E
z
o!
EazocotqgoF
6
coU
o
o
D
6
o
oE
.9E
@,=E
GMo
G
co
=foE
U
fco
od
o
Eoz
oc
oo
o
E
@o
d
oNo
ccc
ts
c
o
Ezoo
!l
o
o!oUoo
!f
o
o
@eo@ofi
Ciz6
oU(o
o
66o6oo
ddz$EtcgoOU1o
u1so
.9too.EE8Eu-
i! +ibEll=ou
o
o@od
oooGco@oo
co
Ef
oo
!ot
6
ooEz
o
U6o.9aZ-dXLovo4_e6;uroio>z
9Eo+JfF
@Xq
=^'9ePXqc€i,i = oHe" E gE
E;; (E L- s li'i=6E E P E Hig=eE 1 E E giE,oE 3 P Ez.Y- '= , 'i P'g'EI:E E ,iUg iss;.HE o inEilpSg.E;+ix E EiE:EEgEHSEf E,!.E;EgEHE!-EE e'EE€:rIE,HE-io":..oel4oqEcO9-iE=;66J,=oI-E;E E€.E;=sEEEaE.33 FbE9.t!--=-j.=EEttEEiI'E, hEEEEEE===
H 3 € q H E} E'E E g E E g
HH6=c==t6o@G66
-q-l.=;iF=:o-oocLo-oEPyTa.EENhEEEEEEE:E= 283>888838ts!;o
=c:mnAnAAAnnnxo:jdNmsio\or6(nYUtr)1 NNNNNNNNN.io oll o) o)o)o)oooo)(nVVVVVVVVV
c
.9
Gg
.cIo
Eo
EqJ
bo@ooCU
o
Ec
o
o(9
E.ct
F
oNo
2
=
oo.;
o
!cG6 o@>n oiqLLIOEtsirO3
E}Oga00E^
=q E'ocEGIJ
oo6€6 F
A T6
Eo
9
3
Fo@o
t
o
o
o
!;@
!
o
=o
@q
o
o
!!
E
o
E-
E
o
a
o
t
D
!
A
o
o.=
6
6
=o.Eco
=co
oo
o
DEz
o4Ezococoo'6F
tro
o
.2
co
=o
f
o
@o
oEz
co
oo
E
o
d
oNo
ooU
ts
J
I
E
@
Ez
!j
a
o
U
o
!I
ao
N
o,uoGo-
p
ooU
ao
d
J1l{de
U
o
-a
oi.ad
il
A{d
{Jtro)o
IUtl
co
E
Ioott(ucIG
o
lu
EGzu6*o
o
dd
rNNNr
]JooI
EooSE ]J'
d coro qH.l s7E lgl9 ocE b9t E!)
; o!o trg9 olE -do2ouC tl)-iCo'il'ddt1 (up.K-trB
oo0') .c>'rJ
!tE€!:o6olt
o
troo
FEgEotrE6E9o>
SE€t€3-6qt8
c.9
GI
Eo,I
E5g
GCL
EoIE'EE4'!,Go
co
og
o.9atu
oI'6
o
ooE9'=.e3EoF116!9o>:P6=-'=€t€8GEi8
tr.9
GI
EI
.ts
-cI6
Go
EoIo
6
tuU
Eo
oI'6
qd
+ododt-drNNNr
oo),
omod
oNod
oooH
odoH
oo
'd
b@o
)
o(no
o
.E
o
ET'
.cT'(u
.Eco
=co
oo
o
o
E'E
G
EU
oEE
G
EU
o6
coLJ
o)(no
xo
omo
0,E
GE1l
.=t,o
eEo
=co
0,
CL
o
oltE
=z.
otE
=zoEo
CLooFt6
coU
u)mo
o
to
6
G
E!,
.9
OI
.E1'
Goto
o6coI
=5o
(J
rtt
=Eo
(ue
0,
EGz
oG
co(J
omo
G!u
EG
o!o
o-
oNo
ooU
dqH
s
oc
=
0,
E6z
Go
E'f
VI
UIdo
F
oT'o(J
E0,
E'
o
o
Nd
Q'o0Er
mdob06C
ano-.ofa
@eR-!,qcEoEE8E96^tr@iECoa-:.
=ooo= o5i;9;t;3-zae
avF-0ro6-8aO'==oca.tro*o6(ocL- oEE!s€E60E
BE EEpAS€ e
(,)"P
= 0r.=thESi,eE€E3 8Ed95
o(Y)Hd
z
xo
c
.9
o,o
=oEvIGlt
o'=
o
0,
oEos
=EtoU
ooHH
oUii
oeo.iEo
ooo
oc
ooE'
.gE'o
EEop
tro
oo
o
o
E'!
6
EU
o!E
o
EU
66co(J
O!(no
x
r
or)o
0,
.E
GoE
.Et,o
EEop
tro
oo
o
o-clEfz
o-clE
=zo
o-co
-g0,F
IGcoU
u)(Y)o
o
t
@
na
(!
(oE'
.2
o!
.EE'oo!o
I6coI
=o
IJ
fEo
oCL
o
Eoz
Ioco|J
omo
oo
Et!
o!o
.L
oNo
ooU
j
F
s
oDE
o
EEzo(u
t,
tn
6do
oE'o(J
6o
E'f
odo
mdou06G
<tdoooGo-
@
E
oo
!oE
6
ooEGz
E EE
E
OE
colY6c..Y=c
=L^qG46Y-.!ecLa r' i"i ! EE E 6b b 3.g = =!
qEil EE E E.EE :E; 3 grF 5.E e ;iE ;E E fi
P PP h; EL Ec.i qE E Et g SE E aE g EE .E ='6 -q orltr E U
=9 -cOEb Ee E E3,E E3 E EN:i '-6 E -d.= !i. r o9 E U'' C E.: X E: o 6c P cq t no:o>-p.E EE b EEE,, Ef+ # :Efi*E Ei E EgN'; A A N8;E N N Nb;E V V V
o
N
o€
Eo
co
E5
o!Eos
o
ooE
GE
Eitrqo
o
3oo!
o
o!oo
ao
o
GgL
o'6,tto3
.9o5ro
Jc
J
oNa\td
csCL
@c,
o
J
tro
CLooFoI'6
o
tro
Eco(J
od
EoF
odNH
Ec(
3a)EG
C
a
od)o
o
E
E
6E
.sEo
a3cop
co
@o
o
o
E'!,
o
EU
o
E'E'
o
EU
Io
oU
(t)(no
xo
o(no
q)c
G
6E'
.E
E'o
'Ftrop
co
oEL
o
(uII
E5z
(l,3
E
=z
(uco-co(uoF
I6co(J
6(no
c
EtrE
!
E
G
6!,
E
o(EE
6ha(u
I@
EoII:'oE
U
f
co
(Uo.
@
E6z
U6
c,oU
ofno
G(l,
E6
o!o
G
oNo
ccU
F
4
c:
o
Eoz
6(U
E,
6
utHo
r
oEoLJ
Go
!,
=q
oHo
<ldoEOoL
od
boc
=c
OJ
EfUOco.9-o:OJ):-cCOLco
PC
+-oooJ
0J'=
Eoi(ooJzd
boc
=Co)
E:,UOco.oPT
TEOLGOPC
siOoo(U'=
Loi(UoJzd
!!!!
vic
.9
ofT'U
obo
GOEPOG
oH3;8.96ts
q;o
-l)o_
!ool5o.o
fc
U:
.sD dIO.EtorotoPoc
6-APCooo-UE
UEE.e
-cOP
;oFEgP
9o:o+9
eccoo'.='=6
E"E
GCH.;of
GO
o- .-:c!o.-ia.:,
0Ji
cm9Eof,9a3a
o. (J
oo5
b.czE
:E
39--3:
:osB6=Oo
c-ooQO6G0r<LO
0ats.9loro-' Eh<oi6EiUC!otuo-ogE
Eo
tE
o
o
o
o
!
.=
!
E
o
=co
et
o
EE
o
E
o
!!
E
coU
o
o
; i =H r :!€ ;€ ;ge Eeii i Es str9 f,y b;r ;-r ;5EE= EieE -E e; 3.Eg EE g'E.EE; 6,Q;h 3. :c ;i
Es E: ESE$E,E:Hiq r it ;
=iE iE +i!E$EEEEi g.FEi g
gf:gEifE*s{;3;EaaEi*EEiiE
$fr: fr; e!EEEqEg=asn es:ssn E-n Eig:i=*iE;gE EE; E;; eE;= :l rcntag:Eec=E i=x €E: E
Efis #E tiEt;lEgIE;* i=E t** ;tJuts Jts :U.o5€Est-o=E r:rno Pqo =
ei:s;f;sgggFH$IBiIHE i:; gEfr H
Ucnnnn
ori(\(a1 sf<tt,)|nrnF.l r-l c\l N c\ (\ c.,l 6l r-.tR R R R R RR R RVVVVVVVVV
o
c
6
!
,E
!o
Ftro
=tr
oo
o
o
E-z
@!
Ez
o
eo
F
ts
c
co
E
c
I
fco
o
Ez
E
o
d
o
tf
o
o
o
@oo@o
dz6
oI
@
=o
@6oo6(oo
c;z60+!t xoouiiL6N
H6=
ceo
EoEI
oofco
t,E
-gtsE8bo.t8-E
"sEo.E
=9EgE8
@
o
6eo6o
d26
co(J
d
o
@m6odoo
d2:1 6<EE 5nE:R8=i
E6)5EcoU
c.e6et,E:'ooa.
Ego
tt3
.cTE8Eo, 18"8
"sEe.E:9EeE8
!!!!!b!c.F
=c
0.)
EloOco.9'o=OJ:
-EuLEOPC
+!o 0,)0).=LU(t,oJzE
bo
r=
=co
EfL)oco.9-oHOJ:-ccUL6OPC
+!O 0.)
0J'=troi(ooJzd
!!
E i =gE ,*s iE iE iE i':E=J EBE ;:s ag ag ag aE_E;€ -.E ??EE::€ E: P: E: .glgIS €ufi EtiiE:E rH aH rfl rHH;i ;EH E.trE;EEE e+ e+ e3 :a
i$f =sEI fEgtl;+fE$uE5*Es*Es*
iII flIiE EEiEHEBgIiffEIIEIIEIsHs iIFi EiEr*f;*E*EECSEtBE#r
Egf; ii!E IfiIIE:EF5gEIgEIgEIgEEEF q=!H 5gH9f;Ts*ESFEgFEgFEgFE:E iiEE ;;E;;:TtH;iE;iE;;E;iEe** IeEE g!eEEUE{g.E:E€:E.E:E,E:
Annnnnn5=3RiHNRRRRRRRVVVVVVV
g
aYl
m+l.na
0cullhfl1sl F{
EEfi+! p Euto-o-ua; EgEE;.-"Cqd9p PEa b E
r:& 5oL-co-(!cqo.9AgOLUTgP L.E.;3
F,(Eii'=YL).tr o =o-E E.qSsXv0J(J/\uO2
L . L No- ./). E :iX8 RXV
@
o
od
{Xt Sltx.Otleh C.nhrAdrrnftiE!DoqtrE4doh
h C.ldbn Foril
'i FCf6a81 : l:l'.a l' '
' . Oillconblilo ,06oo$r'OrrBcffitta4 r0eo0et9
rir2Oa
Study Area Code
<015> Study Area Name MUD LA.KE TEL COOP
ProSram Year 2017
Contact Name - Person USAC should contact reSarding this data Judi Ushio
ContactTelephoneNumber-Numberofpersonidentifiedindataline<030> 7195945814 eXE.
<039> Cohtact Emait Address - Ema it Address of person identified in data tihe <o3o> j u s hi oogvnw ' c om
Complete the items below to note compliance with five year service quality plan (pursuant to 47 CFR 5 54.202(a)) and, for privately held carriers, ensuring
compliance with the financial reporting requirements set forth in 47 CFR 5 54.313(f)(2). I further certify that the information reported on this form and in
the documents attached below is accurate.
Progress Report on 5 Year Plan
(3009) carrier certifies to 54.313(fXlXiii)
(3010A) Milestone certification {47 cFR 5 54.313(fX1)(i)}
(30108) Please Provide Attachment
(3012A) Community Anchor lnstitutions {47 CFR 5
s4.313(fXlXii))
(30128) Please Provide Attachment
(3013) ls your company a Privately Held ROR carrier {47 cFR
5 s4.313(f)(2))
(3014) lf yes, does your company file the RUs annual report
Please check these boxes to confirm that the
attached PDF, on line 3017, contains the required
information pursuant to 5 54.313(f)(2) compliance
requires:(3015) Electronic copy of their annual RUS reports
(Operating Report for Telecommunications
Borrowers)(3016) Document(s) with Balance Sheet, lncome statement
and Statement of cash Flows
(3017)lf the response is yes on line 3014, attach your
company's RUS annual report and all required
documentation
(3018) lf the response is no on line 3014, is your company
audited?
lf the response is yes on line 3018, please check the
boxes below to confirm your submission on line
3026 pursuant to 5 54.313(f)(2), contains:
(3019) Either a copy of their audited financial statement; or
(2) a financial report in a format comparable to RUs
Operating Report for Telecommunications Borrowers(3020) Document(s) for Balance sheet, lncome Statement
and Statement of cash Flows
(3021) Management letter and/or audit opinion issued by
the independent certified public accountant that
performed the company's financial audit.
lf the response is no on line 3018, please check the
boxes below to confirm your submission on line
3026 pursuant to 5 54.313(fX2), contains:
(30221 Copy of their financial statement which has been
subject to review by an independent certified public
accountant; or 2) a financial report in a format
comparable to RUS Operating Report for
Telecommunications Eorrowers(3023) Underlying information subjeded to a review by an
independent certified public accountant
(3024)Underlying information subjected to an officer
certification.
Document{s) for Balance sheet, lncome Statement
and Statement of cash Flows
Attach the worksheet listing required information
{302s)
Yes - Atlach Certifica!ioE
Name of Attached Document Listing Required
lnformation
Yes - Attach New Community hchors
Name of Attached Document Listing Required'"t?'Ji:T O O
(Yes/Nol O O
fl
E
Name of Attached Document Listing Required
lnformation
(Yes/No)oo
E
E
E
E
E
E
E
Name of Attached Document Listing Required
lnformation
(3026)
page 17
Page 20
<010> StudvArea Code 47 2221
<015> StudvArea Nam!M ]ffE TEL COOP
<020> Prorram Year 20r?
<030> Contact Namc - Pcren UsAc should contact rcgarding this data Judi- Ushio
<O3S> Cdntad Teleohona Number - Numbcr of ereon idcntifird in data lin! <030> 71959458L4 qt .
<039> contactEmailAddrass-EmailAddrrssofoersonidentifiedindatalin!<030> lushio@ffiw-com
TO BE COMPTETED BYTHE REPORTING CARRIER,IFTHE REPORTING CARRTER IS FIUNG ANNUAT REPORTING ON IT5 OWTT BEHAIF:
Certlfication of Officer as to the Accuracy of th€ Oata Reported for the Annual ReportinS for CAF or Ll Reciplents
ccrtlfy thrt I am ah ofnrcr of the reportlnS cerilar; my rrsponslbllltlB lnchdc ?nsurln3 thG .ccuracy of tha annual raportltr! rcqulrcmrnts for unlvc.sal scrulce support
.clpluts; .nd, to the b.st of my knowlcdt!, th. lnfom.tlon ,.port d on thls io.m and ln any attachmcnts ls accurrtc.
M UKE TEI COOP
iirnatur.of authorized officar: CERTTFTED ol{Lr}rE Datr 06/3O/20L6
trinted namc ofAuthorizcd officlr: Randy Mead
-ltle or position of Authorized otficer: GeDerar Manager
ilephonc number of Authorized officer: 208374s401 exs' 6s1?
itudv Ar.a cod. of Rr6dtin! ca.d.. 472221 Filln! Du! Dateforthis form, o7 / 0L/ 2oL6
Prmnswillfullymaki[f.lsstat€mGntsffthisformenb€punishrdbyfinoqforfoituEmd.rth€CommunicationsAdof 1934 47U.S.C.99502,503(b],orffnGorimprisonmcnt
underTitl. 18 of the Unitld Stat$ de, 18 U.S.C.5 1m1.
Page 20
PaBe 21
-Atent/Carrler FCcForm/Bl
Collection Form OMB Control No. 306GO986/OMB Contrcl No. 3060$19
2073
412221<010> StudV Area Code
<015> Study Area Name MUD BKE TEL COOP
<020> Program Year 2At1
<030> ContactName-PersonUSACshouldcontactregardingthisdata Judi Ushio
<035> contactTelephoneNumber-Numberofpersonidentifiedindataline<o3o> 7r95945814 exc
<039> Contact Emai I Add ress - Emai I Add ress of De rson identified in data li ne <o3o> i ushi o@gvnw . c om
TO BE COMPTETEO BY THE REPORTING CARRIER, IF AN AGENT IS FITING ANNUAT REPORTS ON THE CARRIER'S BEHALF:
TO BE COMPI-ETED BY THE AUTHORIZED AGENT:
Certification of Officer to Authorize an Agent to File Annual Reports for CAF or Ll Recipients on Behalf of Reporting Carrier
cErtify that (Name ol is authorized to submit the information reported on behalf of the reporting carrier.I
gsnt; and, to the best of my knowledgs, the reports and data provided to the authoriz€d agent is accurate.
Jame of Authorized
{ame of Reoortins Carrier
;isnature of Authorized Of{icer Dete'
)rinted name of Authorized Officer
itle or position of Authorized Officerl
'eleohone humber of Authori2ed officerl
;tudv Area Code of ReoortinE Carrier FilinE Due Date for this form:
uhderTille 18 ofthe United States Code, 18 U.S.C. 5 1001.
Certification of Agent Authorized to File Annual Reports for CAF or Ll Recipients on Behalf of ReportinE Carrier
he data reported herein based on data provided by the reporting carrier; and, to the best of my knowledge, the lnformation reported herein is accurate,
,Jame of Reporting Carrier
,iame of Authori2ed AEent Firm:
iiEnature of Authorized Agent or Employee of Agent Date:
,lame of Authorized Asent Emoloveel
itle or position of Authorized Asent or Emplovee of Agent
ele number of Authorized AEent or Emolovee of,
tudv Area Code of Reoortins Carrier Filins Due Date for this form
18 of the United States Code, 18 U.S.C. E 1001.
Page 21
,2;
@i
-EEUE
UE
:o
-oOEol
-o,9;
{o
ooorrN
aoI
3
beo
o
o
E
!;
Ec
=co
o
o
o
!
E
o
!E
E
oco
o
o
jx
o
!
.g!
F
=o
o
o
!
Ez
a!
E
z
o
ogoF
co
o
o
D
o
6o
,9t
,E!
o
co
!
fo
a
fc
o
Ez
coU
a
o
E
a
d
oNo
ooo
j
F
I
oIE
Ez
o
!
o
ooo
o
El
o
o
Ol
6o6@o
dzo
coI6
=o
@6o?o@o
dz
iri I{Et xmo eou6Nus>tso:
6
6Itooco
o
EC!
c
EeCOETgE
eEe8FsE8
o
t
oIo
o
o
o
!
.=
!oEcop
ao
oo
o
o
!!
E
@
!
E
c
o
o
X
o
o
oc
!
.gEoE
cop
o
o
o
o
E
z
o!
EJzo
o
6F
o
D
!
E
o
o
ooU
J
F
F]
3
a
E6z
6o
!)
o
!o
!J
oo
o
@oo@o
d26
coIE
o
@oIo@o
d2
@o{Eq co888EoNu s->U=,
Ec
o
ooAEEO!BccG6€,E60o=n8
472227ID510
Service Quality Standards &
Consumer Protection Rules Compliance:
Consumer Protection
Voice and Broadband
Mud Lake complies with the requirements of 47CFR Part 64 Subpart U, Customer Proprietary Network
lnformation and the Federal Trade Commission Red Flag Rules to prevent identity theft. A manual for
each of those programs is in place and is part of the employees' handbook. Employee training is
conducted annually and new hires are instructed on the programs as required by their job functions.
Service Quality Standards
Voice
Mud Lake complies with the service standards as required by the state regulatory commission. Mud Lake
is committed to providing the highest quality service to its customers.
Broadband
Mud Lake complies with the service standards as established by state regulatory commission. Mud Lake
follows the service standards noted in NECATariff#5 and is committed to provide the highest quality
service to its broadband customers.
472227rD610
Description of Functionality
In Emergency Situations
Back-up Power for Both Voice and Broadband Services
Mud Lake Telephone prides itself on updating and maintaining all its plant and equipment to
prevent outages before they happen. If outages do happen, the Company has 24-hour on call staff
and alarm reporting systems in place that send notifications to the 24 hour personnel monitoring
these systems. The Company certifies that it follows best practices that are designed to allow them
to remain functional in an emergency situation through the use of back-up power to ensure
functionality in the event of a limited commercial power failure.
Mud Lake utilizes battery back-up systems and standby generators in its central offices. This
enables Mud Lake to maintain power during an outage of at least 4 to 8 hours with battery back-
up, and for 48 hours utilizing stored fuel. Mud Lake also uses its portable gas powered generator
to support the remote cabinets in the network in the event of an extended power outage.
The Company performs exercises to test disaster preparedness on each site's back-up power
systems which are tested weekly. Major transport facilities are also tested periodically to ensure
failover reliability.
Abilitv to reroute traffic/data around damaeed facilities
Mud Lake Telephone has a folded ring architecture, so it has some redundancy in rerouting
exchange traffic between its five exchanges in case of damaged CWF facilities. The five year
improvement plan incorporates additional fiber improvements that will make this a full fiber ring
architecture/network with complete redundancy in between its exchanges.
The Company is also a partner of the Idaho Syringa Network, which provides a fiber ring
throughout southem Idaho and Mud Lake's study area. Being on the Syringa ring networkprovides
the Company the capability of re-routing interexchange traffic and providing continuous service in
emergency situations due to damaged facilities.
Capability to manaee traffic/data spikes resulting from emereency situations
Mud Lake's trunk routes are monitored by Central Office equipment for usage utilization and
management. Mud Lake Telephone takes no responsibility for the capabilities of interconnected
networks to manage traffic spikes resulting from emergency situations, but will continue its best
efforts for its networks during such events.
472227IDt0r0
Voice Services Rate Comparability
As evidenced by the data provided in line 700 of this Form 481, Mud Lake's voice service
pricing is no more than2 standard deviations above the national average urban rate ($47.48) as
announced by the Wireline Competition Bureau on April 16,2015 (DA 15-470)
472227idr030
Mud Lake Telephone Cooperative Association
Broadband Services Rate Comparability
Mud Lake's Broadband Services pricing meets the FCC's broadband public interest obligations
because it offers broadband service as shown on Line 710 of its Form 481 filing, at actual
speeds of at least 10 Mbps downstream / I Mbps upstream at no more than the applicable
benchmark for broadband services announced by the Bureau on April L6,2015 (DAl5-470).
4722271Dt210
Mud Lake Telephone Cooperative Association
Lifeline Assistance Program
The Lifeline Telephone Assistance Program provides for a discount of the recurring monthly rate for the
provision of local residential service for certain low-income customers, which service provides an
unlimited number of local calling minutes.
The Lifeline Telephone Assistance Program discount is only available to low-income customers who
meet eligibility requirements established by the Federal Communications Commission. Lifeline
subscribers receive the same residential service as a regular subscriber, but at a reduced monthly recurring
rate. Thus lifeline subscribers have an unlimited number of local calling minutes.
The Federal Communications Commission national eligibility criteria include subscribers with a
household income of 135 percent of the federal poverty level or participation in one of the following
programs: Supplemental Nutrition Assistance Program, Medicaid, Temporary Aid to Needy Families,
Supplemental Security lncome, Low Income Home Energy Assistance Program, National Free Lunch or
Federal Public Housing Assistance.
Eligible Lifeline customers will receive a monthly discount of $9.25 through the Federal Communications
Commission's Lifeline Program and a $2.50 monthly discount through the Idaho Telephone Service
Assistance Program on the regular Company rates for residential service. Only one telephone number per
household is eligible for a Lifeline discount.
A Lifeline customer may not be disconnected from local service solely for non-payment of toll charges,
but the Lifeline customer must continue to pay the local service rates and charges.
As for toll, lifeline subscribers, similar to every Mud Lake Telephone subscriber, are free to choose their
own toll usage plans through IXCs that serve Mud Lake. Toll blocking is available at no charge to
qualifying Lifeline customers. If a qualifying Lifeline customer voluntarily elects toll blocking service
from the Company, where that service is available, the customer will not be required to pay a deposit, if
otherwise applicable, to initiate service.
TO APPLY: Potential Lifeline customers must contact a Community Action Partnership office or an
Idaho Department of Health and Welfare Regional Offrce to determine their eligibility to participate in
the program.
472227id30r0
59 W. Main
POB T]5
f)ulxri.s, ID &3.123 Mud LokefilrPil0tt
208.374.540r
June 21, 2016
Ms. Marlene H. Dortch
Secretary
Federal Com m unications Commission
9300 East Hampton Drive
Capitol Heights, MD 20743
WC Docket No. 1rt-58, 2015 Annual Report, Form 481for High-Cost Recipient
54.313(fX1) "Milestone Certification"
Dear Ms. Dortch:
ln compliance wlth the filing requirements associated with, and attached to Form 481, we wish
to advise the Commlssion that Mud Lake Telephone Cooperative Association provides High
Speed lnternet service to lts customers and:
o Has taken reasonable steps to provide upon reasonable request broadband service at
actual speeds of 10 Mbps downstream / 1 Mbps upstream;
r Provides latency suitable for real-time applications including VolP and usage capacity
which is reasonably comparable to those in urban areas and;
o That reasonable requests for servlce are met within a reasonable timeframe.
lf there are questions, I may be contacted at 208.374.5401
T-208-37 t-51.50
'r-90t|-374^5150
F-208.i}7,L5688
Sincerely,WW
Justin Petersen
Presldent
472227id30t2
Number of New Anchor Institutions: I
Name: Clark County High School
Address: 43 West 2nd South, Dubois, D 83423
Mud Lake Telephone Cooperative Association
AI\CHOR INSTITUTIONS