HomeMy WebLinkAbout20170629Columbine Telephone ETC.pdfSILVER STAR
kCOMMUNICATIONS
June 26, 2017
Diane Holt, Secretary
Idaho Public Utilities Commission
472 W. Washington
PO Box 83720
Boise, ID 83720-0074
Re: 2017 Eligible Telecommunications Carrier (ETC) Annual Report Filing (Program
year 2018); Docket No. GNR-T-17-01
Columbine Telephone Company, Inc. (472295)
Dear Ms. Holt:
Columbine Telephone Company, Inc. ("the Company") hereby files with the Commission
its 2017 ETC Annual Report Filing (Program year 2018), as follows:
A copy of the FCC Form 481 - Carrier Annual Reporting Collection Form filed with the
USAC and FCC, completed pursuant to 47 CFR §§ 54.313 and 54.422, as applicable, and
redacted for public viewing to protect confidential and proprietary financial information,
along with the Officer Affidavit per Commission Order 29841.
The non-redacted, confidential information is submitted to the Commission separately via
express delivery, pursuant to Rule 67 of the Idaho Public Utilities Commission Rules of
Procedure and Idaho Code § 9-340D(1).
Request is hereby made that the Commission notify the Federal Communications
Commission and the Universal Service Administration Company, prior to October 1, 2017, that
the Company is eligible to receive federal high-cost support for the year 2018.
Questions regarding this filing should be directed to my attention as shown below.
Michelle Motzkus
Legal & Regulatory Administrator
ph: 307-883-6690
email: mamotzkus@silverstar.net
Enclosures
SilverStar.com PO Box 226, Freedom, WY 83120 877.883.2411
state of Wyoming
County of Lincoln
)CERTIFICATION BY ELIGIBLE TELECOMMUNICATIONS CARRIER
:ss.OF COMPLIANCE WITH SERVICE QUALITY AND CUSTOMER
)PROTECTION,ABILITY TO REMAIN FUNCTIONAL IN
EMERGENCIES, AND USE OF FEDERAL HIGH-COST SUPPORT.
AFFIDAVIT OF BUSINESS OR CORPORATE OFFICER
The Idaho Public Utilities Commission Order No.29841 requires that EligibleTelecommunications Carriers
(ETC)certify that it is compliant with applicable service quality standards and consumer protection rules; and
ETCs must demonstrate the ability to remain functional in emergencies.Inaddition,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 the provision,maintenance,and upgrading of facilities and services for
which the support is intended.Accordingly,the undersigned states and verifies under oath the following:
1. Iam an officer of Columbine Telephone Company, Inc. (dba Silver Star Communications)("the Company")
an eligible telecommunications carrier receiving federal universal service support under section 214(e) of
the Telecommunications Act of 1996 In the State of Idaho.
2. Iam familiar with the Company's day-to-day operations In the state of Idaho and with the State's service
quality standards and consumer protection rules as set forth in Commission Order No.29841.
3. The Company is complying with applicable service quality standards and consumer protection rules of the
Federal Communications Commission and the Idaho Public Utilities Commission.
4. Icertify 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 certify that all federal universal service support funds received by the Company 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 1,2018,through December 31,2018,to be eligible for federal
universal service fund support.
6. This verification and affidavit is provided to the Idaho Public Utilities Commission to enable the IPUC to
certify 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)of the Telecommunications Act.
BONNIE JACKSON
Wyoming
Notary Public,County of Lincoln
My Commission Expires
September 30,201 7
SUBSCRIBED AND SWORN to before me thisO?^day of June,2017.
£
Barbara Sessions,CFO
Rotary Pubfidfor Wyoming,residing at Lincoln County
My Commi^on expires f
Page 1
Page 1
FCC Form 481 - Carrier Annual Reporting OMB
3060-0986
<010> Study Area Code <015> Study Area Name
<020> Program Year
<030> Contact Name: Person USAC should contact
with questions about this data
<035> Contact Telephone Number:
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<039> Contact Email:
Email of the person identified in data line <030>
Data Collection Form
F Type
54.313 and 54.422
Michelle Motzkus
2018
mamotzkus@silverstar.net
COLUMBINE TELEPHONE CO., INC.
3078836690 ext.
472295
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Page
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(00)
C Form 481
Data Collection Form OMB Control No. 3060-0986
2013
Michelle Motzkus
2018
mamotzkus@silverstar.net
0.0
Offered only fixed broadband
COLUMBINE TELEPHONE CO., INC.
3078836690 ext.
0.218
Offered only fixed voice
472295
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5
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Progress Report on 5 Year Plan
(3009) Carrier certifies to 54.313(f)(1)(iii)
(3010A)
(3010B) Name of Attached Document Listing Required
Information
(3012A)
(3012B) Name of Attached Document Listing Required
Information
(3013) (Yes/No)
(3014) (Yes/No)
(3015)
(3016)
(3017) Name of Attached Document Listing Required
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(3018) (Yes/No)
(3019)
(3020)
(3021)
(3022)
(3023)
(3024)
(3025)
(3026)
Please Provide Attachment
Community Anchor Institutions {47 CFR §
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Please Provide Attachment
Is your company a Privately Held ROR Carrier {47 CFR
§ 54.313(f)(2)}
If 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 § 54.313(f)(2) compliance
requires:
Electronic copy of their annual RUS reports
(Operating Report for Telecommunications
Borrowers)
Document(s) with Balance Sheet, Income Statement
and Statement of Cash Flows
If the response is yes on line 3014, attach your
company's RUS annual report and all required
documentation
If the response is no on line 3014, s your company
audited?
If the response is yes on line 3018, please check the
boxes below to confirm your submission on line
3026 pursuant to § 54.313(f)(2), contains:
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(2) a financial report in a format comparable to RUS
Operating Report for Telecommunications Borrowers
Document(s) for Balance Sheet, Income Statement
and Statement of Cash Flows
Management letter and/or audit opinion issued by
the independent certified public accountant that
performed the company’s financial audit.
If the response is no on line 3018, please check the
boxes below to confirm your submission on line
3026 pursuant to § 54.313(f)(2), contains:
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 Borrowers
Underlying information subjected to a review by an
independent certified public accountant
Underlying information subjected to an officer
certification.
Document(s) %& Balance Sheet, Income Statement
and Statement of Cash Flows
Attach the worksheet listing required information Name of Attached Document Listing Required
Information
page 1;
(>>>> &
/ &
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>>>>>>>>>>>>>>>FCC Form 481
Data Collection Form OMB Control No. 3060-0986
2013
Page 1;
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Michelle Motzkus
2018
mamotzkus@silverstar.net
Yes - Attach Certification
472295id3010b.pdf
COLUMBINE TELEPHONE CO., INC.
472295wy3026.pdf
3078836690 ext.
472295
No - No New Community Anchors
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<010> Study Area Code
<015> Study Area Name
<020> Program Year
<030> Contact Name - Person USAC should contact regarding this data
<035> Contact Telephone Number - Number of person identified in data line <030>
<039> Contact Email Address - Email Address of person identified in data line <030>
4005 Rural Broadband Experiment
Authorized Rural Broadband Experiment (RBE) recipients must address the certification for public interest obligations, provide a list of newly served
community anchor institutions, and provide a list of locations where broadband has been deployed.
Public Interest Obligations – FCC 14-98 (paragraphs 26-29, 78)
Please address Line 4001 regarding compliance with the Commission’s public interest obligations. All RBE participants must provide a response to Line 4001.
4001. Recipient certifies that it is offering broadband to the identified locations meeting the requisite public
interest obligations consistent with the category for which they were selected, including broadband speed,
latency, usage capacity, and rates that are reasonably comparable to rates for comparable offerings in urban
areas?
Community Anchor Institutions – FCC 14-98 (paragraph 79)
4003a. RBE participants must provide the number, names, and addresses of community anchor institutions to
which they newly deployed broadband service in the preceding calendar year. On this line, please respond
(yes – attach new community anchors, no – no new anchors) to indicate whether this list will be provided.
If yes to 4003A, please provide a response for 4003B.
4003b. Provide the number, names and addresses
of community anchor institutions to which the
recipient newly began providing access to
broadband service in the preceding calendar year.
Name of Attached Document Listing Required Information
Broadband Deployment Locations – FCC 14-98 (paragraph 80)
4004a. Attach a list of geocoded locations to
which broadband has been deployed as of the
June 1st immediately preceding the July 1st filing
deadline for the FCC Form 481.
Name of Attached Document Listing Required Information
4004b. Attach evidence demonstrating that the
recipient is meeting the relevant public service
obligations for the identified locations. Materials
must at least detail the pricing, offered broadband
speed and data usage allowances available in the
relevant geographic area.
Name of Attached Document Listing Required Information
FCC Form 481 (4005) Rural Broadband Experiment Additional Documentation
OMB Control No. 3060-0986/OMB Control No. 3060-0819 Data Collection Form
July 2013
page 1K
Page 1K
Michelle Motzkus
2018
mamotzkus@silverstar.net
COLUMBINE TELEPHONE CO., INC.
3078836690 ext.
472295
RE
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Page Q
Page Q
Certification - Reporting Carrier FCC Form 481
Data Collection Form OMB Control No. 3060-0986
2013
<010> Study Area Code
<015> Study Area Name
<020> Program Year
<030> Contact Name - Person USAC should contact regarding this data
<035> Contact Telephone Number - Number of person identified in data line <030>
<039> Contact Email Address - Email Address of person identified in data line <030>
TO BE COMPLETED BY THE REPORTING CARRIER, IF THE REPORTING CARRIER IS FILING ANNUAL REPORTING ON ITS OWN BEHALF:
Printed name of Authorized Officer:
! !" # $ ! # %! !& ' ( # $ !
& ' ) $*+& ' "
Name of Reporting Carrier:
Signature of Authorized Officer:Date
+ #! +!! # ' ) ! , "' " -
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Title or position of Authorized Officer:
Telephone number of Authorized Officer:
Study Area Code of Reporting Carrier: Filing Due Date for this form:
Persons willfully making false statements on this form can be punished by fine or forfeiture under the Communications Act of 1934, 47 U.S.C. §§ 502, 503(b), or fine or imprisonment
under Title 18 of the United States Code, 18 U.S.C. § 1001.
CERTIFIED ONLINE
07/03/2017
3078836672 ext.
Michelle Motzkus
Barbara Sessions
2018
06/23/2017
mamotzkus@silverstar.net
COLUMBINE TELEPHONE CO., INC.
CFO
COLUMBINE TELEPHONE CO., INC.
3078836690 ext.
472295
472295
RE
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Certification - Agent / Carrier FCC Form 481
Data Collection Form OMB Control No. 3060-0986
2013
<010> Study Area Code
<015> Study Area Name
<020> Program Year
<030> Contact Name - Person USAC should contact regarding this data
<035> Contact Telephone Number - Number of person identified in data line <030>
<039> Contact Email Address - Email Address of person identified in data line <030>
! $) $ # 3 (
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TO BE COMPLETED BY THE AUTHORIZED AGENT:
Telephone number of Authorized Agent or Employee of Agent:
Signature of Authorized Agent or Employee of Agent:
Name of Authorized Agent :
I, as agent for the reporting carrier, certify that I am authorized to submit the annual reports for universal service support recipients on behalf of the reporting carrier; I have provided
the data reported herein based on data provided by the reporting carrier; and, to the best of my knowledge, the information reported herein is accurate.
Date:
]ame of Authorized Agent Employee:
Title or position of Authorized Agent or Employee of Agent
Name of Reporting Carrier:
Study Area Code of Reporting Carrier: Filing Due Date for this form:
Printed name of Authorized Officer:
Name of Reporting Carrier:
Study Area Code of Reporting Carrier:
Title or position of Authorized Officer:
Telephone number of Authorized Officer:
Filing Due Date for this form:
TO BE COMPLETED BY THE REPORTING CARRIER, IF AN AGENT IS FILING ANNUAL REPORTS ON THE CARRIER'S BEHALF:
! $ # 3 ! $)
$ !
& ' " $*+& ' " #!
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I certify that (Name of Agent)_______________________________________________________ is authorized to submit the information reported on behalf of the reporting carrier. I
also certify that I am an officer of the reporting carrier; my responsibilities include ensuring the accuracy of the annual data reporting requirements provided to the authorized
agent; and, to the best of my knowledge, the reports and data provided to the authorized agent is accurate.
Date:
Name of Authorized Agent:
Signature of Authorized Officer:
Persons willfully making false statements on this form can be punished by fine or forfeiture under the Communications Act of 1934, 47 U.S.C. §§ 502, 503(b), or fine or imprisonment
under Title 18 of the United States Code, 18 U.S.C. § 1001.
Persons willfully making false statements on this form can be punished by fine or forfeiture under the Communications Act of 1934, 47 U.S.C. §§ 502, 503(b), or fine or imprisonment under Title
18 of the United States Code, 18 U.S.C. § 1001.
Michelle Motzkus
2018
mamotzkus@silverstar.net
COLUMBINE TELEPHONE CO., INC.
3078836690 ext.
472295
RE
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Attachments
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Columbine Telephone Company, Inc.
dba Silver Star Communications (“Silver Star”)
SAC 472295 – Idaho
Service Quality Standards & Consumer Protection Rules
Statement of Compliance
(FCC Form 481 – Line 510)
Silver Star has established operating procedures designed to facilitate compliance with applicable
consumer protection rules; including rules regarding verification of orders for telecommunications
service as required of submitting carriers (i.e., Slamming) {Section 64.1100}, compliance with the FCC’s
Truth-in-Billing Requirements {64.2400}, compliance with the FCC’s customer proprietary network
information (CPNI) Requirements {64.2009}, and all other customer protection rules including employee
training and policy manual development as applicable.
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Columbine Telephone Company, Inc.
dba Silver Star Communications (“Silver Star”)
SAC 472295 – Idaho
Functionality in Emergency Situations
Statement of Compliance
(FCC Form 481 – Line 610)
Silver Star has established operating procedures designed to facilitate compliance with
applicable service quality standards, which may include customer remedies and
improvement plans. Specifically Silver Star complies with Rule 500.01 of the Idaho Public
Utilities Commission rules requiring it to furnish to its customers safe, adequate and
continuous service in accordance with accepted good practice, and to that end,
maintains its entire plant and system in such condition as to enable it to furnish such
service, and inspect its system and facilities in such manner and with such frequency as
may be necessary to obtain knowledge of their current condition and adequacy. Silver
Star is capable of functioning in emergency situations, by maintaining both battery and
generator back-up power, which ensure reasonable functionality of voice services
without an external power source. Additionally, Silver Star can reroute voice and
broadband traffic around damaged facilities and is capable of managing traffic spikes
resulting from emergency situations.
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REDACTED - FOR PUBLIC INSPECTION
Columbine Telephone Company, Inc.
dba Silver Star Communications (“Silver Star”)
SAC 472295 – Idaho
Low-Income Telephone Assistance Program Terms & Conditions
Statement of Compliance
(FCC Form 481 – Line 1210)
Silver Star provides unlimited local calling for lifeline-eligible residential
customers, discounted by the federally authorized amount of $9.25, and
state telephone assistance discounts, where applicable. Silver Star’s
lifeline-discounted monthly telephone service provides access to
emergency, operator, interexchange, and directory assistance services.
The service does not include enhanced calling features such as voice
mail, caller ID, call forwarding, internet or long distance telephone
service. Toll Limitation service is provided at no charge for lifeline
customers, upon customer request and pursuant to FCC guidelines.
RE
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COLUMBINE TELEPHONE COMPANY, INC.
dba Silver Star Communications (“Silver Star”)
SAC 472295 – Idaho
Annual Report of Company Financial Conditions and Operations
Line 3026 (54.313(f)(2) Compliance)
(FCC Form 481)
This section, consisting of seven (7) pages, is redacted in its entirety.
RE
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P
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CONFIDENTIAL INFORMATION –
SUBJECT TO PROTECTIVE ORDER
BEFORE THE FEDERAL
COMMUNICATIONS COMMISSION
and pursuant to 47 CFR § 0.459(a)