20200701Q Link Wireless Form 481 and Affidavit.pdf

Page 1
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State of Florida
County of Broward
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CERTIFICATION BY ELIG]BLE TELECOMMUNICATIONS CARRIER
OF COMPLIANCE WTH 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 ldaho Public Utilities Commission Order No. 29841 requires that an Eligible Telecommunications
Canier certrry that it is compliant with applicable service quality standards and consumer protection rules;
and ETCs must demonstrate the ability to remain functional in emergencies. ln 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 ldaho will be used only br 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. I am an officer of Q Link \Mreless LLC, an eligible telecommunications canier for receMing bderal
universal service support under section 214(e) of the Telecommunications Act of 1996 in the
state of ldaho.
2. I am familiar with the Company's day{oday operations in the state of ldaho and with the State's
service quality standards and consumer protection rules as set furth in Commission Order No.
29841.
3. Q Link Wireless LLC is complying with applicable service quality standards and consumer
protection rules of the FederalCommunications Commission and the ldaho Public Utilities
Commission.
4. I certiff to the Commission that the Company is able to remain functional in emergencies as set
forth in Commission Order No.29&41 and in 47 G.F.R. S 54.201(aX2).
5. I also certiff that all federal universal service support funds received by Q Link \Mreless LLC
during the cunent calendar year will be used in a manner consistent with section 254(e): that is,
for the provision, maintenance, and upgrading of f;acilities and services for which the support is
intended. The company will continue to comply for the period of January 1,2021, through
December 31,2021, to be eligible for federal universal service fund support.
6. This verification and affidavit is provided to be the ldaho Public Utilities Commission to enable the
IPUC to certiff to the FCC that federal universal service support received by the eligible caniers
in the state will be used in a manner consistent with Section 254(e) of the Telecommunications
Act.
lssa Asad, CEO
6.211-20
Date
SUBSCRIBED AND SWORN to before me this L\ a"V ot lunt 2020.
Notary
8otd.d Atlctkutr
VAERGMARRY
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Plcase Prcvide Attachm"nt
Community Anchor lnstitutions {47 CFR I
54.313(fXlXii))
Plcasc Providc Attachmcnt
ls your @mpany a Priwtely Held ROR Carri.r {47 CFR
5 s4.313(fX2))
lf yes, docs your company filc the RUS annual report
Plcasc check thc* box.s to confim that the
attachcd PDF, on line 3012 contains th. requirrd
information pursuant to $ 54.313(f)(2) compliance
rcquircs:
Elcctronic @py of their annual RUS rcports
(operatinS Rcport for Telcommuni€tions
Borrowers)
Dcument(s) with Ba18ne Sheet, lncome Statemant
and statcmnt of c.sh Flows
lfthe r.spon* is ycs on linc 3014, attach your
company's RUS annual rcport and all requircd
d@umcntation
lf the rcspone is no on line 3014 is your company
auditcd?
lfthe respons is Vcs on line 3018, plcasc ch*k the
boxes bclow to confirm your submission on line
3025 pursuant to 5 54.313(f)(2), contains:
Eithera copy of thcir audit dfinancial statcmcnt; or
(2) a financial r.port in a format comparablc to RUS
opcEting Rcpon for Telecommuni6tions Borrowcrs
Dcumcnt(s) for Balanc Shcct, lncomc Statcment
and Statement of cesh Flows
Managcm.nt lett.r and/or audit opinion issued by
thc indcpendent certified public accountant that
performcd the ompany's financial audit.
lf thc respons. is no on line 3018, plcasc ch*k the
boxes below to onfirm your submission on line
3026 pursuant to 5 54.313(fX2), contains:
Copy of thcirfinancial statcmcnt which has becn
subjcct to rwirw by an independcnt artified public
acountant; or 2) a finencial rcport in a format
6mpaEbl. to RUS OpcratinS Rcport for
Tele@mmu nications BorrcweE
UndcrlyinS information subjccted to a rcview by an
independcnt ccrtifi ed public acountant
Name of Auachcd Documcnt Listing Rcquired
lnformation
(Ycs/No) O O
Name of Attached Document Listing Required
lnformation
o o
oo
(301s)
(3016)
(3017)
(3018)
(301e)
(3020)
(3021)
(3026) Attach the workshcct listing required information
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Cdt ct Addrcss - Email Addrcss of pcrson in dat
202!
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t{XE irrral Sroadbmd Erecrlment
Authoriz.d Rural Bro.dband Expcrimmt (RBEI r.cipi.nts must.ddr6s thc ccrtification for Public int.rcst obliSations and Provid! a
list of newly scrwd community anchor institutions.
tub[c lntrr6t Obllatuons - FCC !l-98lp.r.fnpht zcz,,.,lgl
Plc.s! addr.ss Unc 4OO1 rcSardin8 compli.nce with th! Commisslon's public interEt obligatbns. All RBE partkipants must provide a
rBponsr to Linc i1001.
41tr1. Rlciplcnt ccrtifiB that it is off.ri]B broadbend mccunS the requislte publk intlrcst obliSstions consistcnt with th. catrSory for
which th.y w.re sGl.ct.d, including broadb.nd spled, Irtency, usagr capacity, and rat s that arc re.rcnably comparable to ratGs for
comparablG offlrings in urban arcas.
ConrmunttyAndror lnrtltudoni- FiCC 1+98 (p.r.f.ph 791
ruxl3a. RBE partlcipants must provide th. numbcr, nam6, and addrcsscs of community anchor institutlons to
wfrkh thcy ncwly deployed broadband scruicc in the prcceding calendrr ycar. On thB line, phase rapond
(v.3 -.ttach nrw community rnchors, no - no no anchors) to indkEt wheth.r Urls list will b! providcd.
lf yGs to IUBA plar. proylda . rGtgons. for t(Xr3B.
flxIlb. Prorrid. th. numb.r, namGs .nd addrcsscs
ot community .nchor instihrtions to which th.
recipilnt newly b€8.n providinS acc.ss to
broadband scrukc in tha prccrdirf calcndar ycar.
Nam. of Attached Documlnt Lbting Rrquired lnfom.tlon
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5005Alask Phn
(s0111
(s012)
Please indicate whether any terrestrial backhaul or other satellite backhaul bccame
commerclally arnilabl! in the previous calendar ycar in areas prcvlously scnrcd
excluslvely by pcrformance'limitint satellite backhaul.
lf the fflint carrilr identified in its approrcd perfomance plans that lt reli6 exclusivcly on
satelllte backhaul for a ccrtain porlton of the population in lts service area, lndicate whether
any ter.estrial backhaul or other satelllte backhaul becamc conmercially awilable in the
previolus calendar year in areas that wcrc pradoiusly senrcd exclusivcly by satellite backhaul.
(Yes/No)
(Yes/Nol
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Patc 19
<010> StudvArea Code
<015> StudvArca Name O Link wlrele€s LLC
<O2O> Pr@Bm Ycar 2021
<030> Contact Namc - Pcmn USAC should contact rcgarding this data Heather Kirbw
<035> ContactTclcohoneNumbcr-NumbcrofD.rsonid.ntificdindatalinc<030> 110232180s ext
<039> Contact Email Address - Email Address of oerson idcntified in dat. lin. <030> etcetelecomcousel. com
TO BE COMPTEIED 8Y THE REPORTING CARRIER, tF I}IE REPORNNG CARRIER IS FITIITG ANNUAT REPORTING ON ITS OWN EEHALF3
Certmcation of Offlcer as to the Accuracy of the Data Reported for the Annual Reportlnt for CAF or Ll Reclphnts
ccrdfy that I am an officer of thc rcportlnt cerlGr my r.sponslbllltlcs lnduda cmualnt tha ,cauracy of the annual repordng rcqulrlmGnts iot unly?rsal saille suppdt
|?dplcntsi .nd, to thc bcsf of my knowlad$, thr lniomatlon rcportad on thli torm and In .ny rttadrments ls accuratr.
l,lamc of RaDortins Carrier:
sirnature of Authorizcd fficer:Datr
Printed name of Authorized fficer:
Iitle or @sition of Authorizcd Otficer:
Ielcohone numbcr of Authorized Officcr:
itudv Area Code of Remrtinr Carrier:Filin( Duc Date for this form:
PcmnrwilltullymkingfalestatcmentsonthirformenbepunirhcdbyfincoriorfuitucundlrtheCommunietionsActof 1934,47U.S.C.55502,503(b),orflncorlmprlsnment
undcrTitl. 18 ofthr Uhitcd StaGs Codc, 18 U.S.C. 0 1001.
Pag.19
Pate 20
otEcont olxo 30co{96/oit!cmt ol1{o. aEo{filt
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<010> Study Area Code 479018
<015> Study Area Name 0 Link Wireless LLC
<020> Proiram Year 2021
<030> Contact Name - Person USAC should contact regarding this data Heather Kirby
<035> contactTelephoneNumber-Numberofpersonidentifiedindataline<o3o> f102121a05 ext
<039> contact Email Address - Email Address of person identified in data line <030> etc@telecomcounsel com
TO BE COMPTETED BYTHE REPORTING CARRIER, IF AN AGENT IS FITING ANNUAI. REPORTS ON THE CARRIER'S BEHATF
Certification of Officer to Authorire an Agent to File Annual Reports for CAF or Ll Recipients on Behalf of Reporting Carriel
lcert|fythat(NameofAgont}ls8ulhodzedto3ubmltthelnformationreportedonbehalfofthereportingcarrl8r.|
agent; and, to tho bo3t ot my knowledge, the reports and data provlded to the authorlzod agent ls accurato.
NameofAuthorizedAcent: Expelt Telecom Compliance
NameofReDortinrCirrier: O Link Wireless LLC
SirnatureofAuthorizedOfficer: CERTTFTED OMrNE Date: 06 / 26 / 2o2o
Printed name of Authorized Officer: Issa Asad
Iitle or oositloh ofAuthorized Officer: cEo
Ieleohone number of Authoriued Officcr: 8005101540 exE
Studv Area Code of Rercrtins Carrier: 479018 Filing Due Date for th;ts lotni o7 / Oa / 2o2o
Persons willfully making tal* statements on this forh can b€ punished by fine or forfeiture under the Communications Ad of 1934, 47 U.S.C. 95 502, 503(b), or fine or imprisonment
under Title 18 ofthe United States Code, 18 U.S.C. 5 1001.
TO BE COMPTETED BY THE AUTHORIZED AGENT:
Certification of Atent Authotized to File Annual Reports for CAF or Ll Recipients on Behalf of Reporting Carrier
the data reported herein based on data proyided by the reportint carrier; and, to the bcit of my knowledg€, the Infomatlon reported hcrein ls accu.ate.
0 Li.nk wireless LLcName of Reportinf Crrrier:
Name of Authorized Asent Firmi Exper! Telecom Compliance
iiqnatureofAuthorizedArentorEmDloveeof ACent: CERTIFIED ONLINE Date: oG / 25 / 2o2a
vi.cEoria MartinName of Authorized Acent Emplovee:
fitleorDositionofAuthori2edArentorEmoloveeofAsent Requlatorv sDecialist
lelephone number of Authorized Aqent or Emplovee of Agent: 67 a61 22 831 ext
itudv Area Code of Remrtinr Carrier:4?9018 Filing Due Date for this form: a1 / a1 /2.2a
18 oflhe United States Code, 18 U.S.C. 5 1001.
PaSe 20
Attachments
Form 481 section l2l0 Q LINK WIRELESS LIFELINE OFFERING Effective l2lll20l9
LITELINE NON.TRIBAL:
1.000 Minutes & 3 GB Data (O LINK ALWAYS Oltl
1,000 anytime minutes per month
Unlimited text and picture messaging
3 GB data per month
Minutes & data do not rollover
Net cost to Lifeline customer: $0
LIFELINE TRIBAL:
Unlimited Talk & Text & 3 GB Data (O LIItlK ALWAYS ON TRIBAL)
Unlimited anytime voice minutes per month
Unlimited text and picture messaging
3 GB data per month (no rollover)
Net cost to Tribal Lifeline customer: $0
All packages include
o Free data-capable deviceo Free calls to Q LINK Customer Serviceo Free calls to 9l I emergency services
o Free access to Voicemail, Caller-lD, and Call Waiting features
o Voice minutes may be used for Domestic Long Distance at no extra charge
o Data is at 3G speeds or higher
Additional Airtime available for purchase, rates posted on Q LINK's website:
https ://ql inkwireless.com/members/carVq uickpurchase.aspx