20210628Columbine Telephone Form 481 Affidavit.pdf

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SENT VIA EMAIL: [e-mail]
Jan Noriyuki, Commission Secretary
ldaho Public Utilities Commission
11331W. Chinden Blvd. Bldg. 8, Ste. 201-A
Boise, lD 83714
Re:2021 Eligible Telecommunications Carrier (ETC)Annual Report Filing (Program
year 2021); Docket No. GNR-T-19-01
Columbine Telephone Company, lnc. 147 22951
Dear Ms. Noriyuki:
Columbine Telephone Company, Inc. ("the Company") hereby notifies the Commission
that it has filed its FCC Form 481with the Universal Service Administration Company ("USAC")
and files with the Commission its Affidavit and Certification by Eligible Telecommunications
Carrier of Compliance.
Request is hereby made that the Commission notify the Federal Communications
Commission and USAC, prior to October L,IOZL, that the Company is eligible to receive federal
high-cost support for the year 2022.
Questions regarding this filing should be directed to:
Michelle Motzkus
Legal & Regulatory Administrator
phone: [phone]
email : [e-mail]
Kind regards,
Bonnie J
Legal & Regulatory Assistant
Attachment
SilverStar.com I PO Box 225 | Freedom, WY 83120 | 877.883.24LL
State of Wyoming CE RT! FICATION BY ELIGI BLE TE LECOM M U N ICATIONS CARRI ER
OF COMPLIANCE WITH SERVICE QUALITY AND CUSTOMER
PROTECTION, ABILITY TO REMAIN FUNCTIONAL IN EMERGENCIES,
AND USE OF FEDERAL HIGH-COST SUPPORT.
County of Lincoln
AFFIDAVIT OF BUSINESS OR CORPORATE OFFICER
The tdaho Public Utilities Commission Order No. 29841 requires that Eligible Telecommunications Carriers
(ETC) certifu 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 allfederal high-cost support provided to ETCs within
the State of ldaho 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. I am an officer of Columbine Telephone Comoanv. lnc., an eligible telecommunications carrier for
receiving federal universal service support under section 214(e) of the Telecommunications Act of
1995 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. Columbine Teleohone Comoanv. lnc.. is complying with applicable service quality standards and
consumer protection rules of the Federal Communications Commission and the ldaho Public Utilities
Commission.
4. ! certiff to the Commission that the Company is able to remain functional in emergencies as set forth
in Commission Order No. 29841and in 47 C.F.R. S 5a.201(aX2).
5. I also certifo that all federal universalservice support funds received by Columbine Teleohone
Comoanv. lnc., 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 L,2OZ1-, through
December 31,202L, to be eligible for federal universal service fund support.
5. This verification and affidavit is provided to be the ldaho Public Utilities Commission to enable the
IPUC to certifo to the FCC that federa! 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.
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202rCommission
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BONNIE L.
SUBSCRIBED AND SWORN to before me this
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My Commission expires