20210629Viasat Carrier Services Form 481 and Affidavit.pdf

THEcoMMPLIANCE HoME oF THE AccuComplionce Suite oF coMpLtANCE soLUTtoNS
Accut icc.irsr: , AccuReg , AccuTox . Ace(GixFiilFfltcuAgent
;',_, -i';;; Ig f,fi ll: Sl
,:-' r- ' ll,r,i-;C
, ii : i;; l,{i*tiS*lCl{
(ryuT- 2.,-o I
GROUP
lune29,202L
Diane Hanian
Commission Secretary
tdaho Public Utilities Commission
472W. Washington
Boise, ldaho 83720-OO7 4
1430 SPRTNG H|LL ROAD. SU|TE 315 | UclraN, VIRGINIA 22LO2
P [phone] t [e-mail]
t (7031563-6222 W www.CommplianceGroup.com
RE: Viasat Carrier Serices, lnc. - 2O2l FCC Form 481 and Officer Attestation - SAC 479026
Dear Commission Secretary -
Pursuant to FCC requirements under 47 C.F.R. SS 54.313 &54.422, enclosed please find for filing a
copy of Viasat Carrier Services, lnc.'s FCC Form 481 - Annual Eligible Telecommunications Carrier
Certification and executed Affidavit Certifying Use of Federal High-Cost Support for SAC 479026.
As the filing indicates, Viasat has not yet begun providing services to ldaho subscribers.
Ptease do not hesitate to contact the undersigned directly with any questions about this report at
m a p @ co m m p I ia ncegrou p.cq!1.
Respectfully Submitted,
t^ gL\htuQ-,
Marsha A. Pokorny
Managing Consultant on behalf of Viasat Carrier Services, lnc.
;,,
&
+
State of California CERTIFICATION BY ELIGIBLE TELECOMMUNICATIONS CARRIER
OF COMPLIANCE WTH SERVICE QUALITYAND CUSTOMER
PROTECTION, ABILITY TO REMAIN FUNCTIONAL IN EMERGENCIES,
AND USE OF FEDERAL HIGH.COST SUPPORT.
County 6 San Diego
AFFIDAVIT OF BUSINESS ORCORPORATE OFFICER
The ldaho Publlc Utilities Gommiasion Order No. 298/-1 requlres that Ellglble Telecommunications Ganlers
(ETC) cerlily that it is compliant with appllcabls seMce quality standards and consumer protectlon rules; and
ETCe must demonstrate the ability to remaln functlonal ln emergenclee. ln addilion, the Commiselon must file
an annualcertlllcation with the USAC and the FCG that allfederal high*oet eupport provkled to ETCs wlthin
the State of ldaho will be used only for the provislon, maintenance, and upgrading of facllitles and serulces for
which the eupport is intended. Accordingly, the underslgned states and veriliee under oath the followlng:
1.lamanofflcorof@aneligibletelecommunlcatbnscarrierforrecelvlng
federal universal servlce support under gection 214(e) of the Telocommunications Act of 1996 in the
etate of ldaho.
2. I am familiar with the Company's day-today operatione in the state of ldaho and wlth the State's seMce
quality etandards and consumer protectlon rules as setforth ln Commlgsbn Order No. 29841.
3. Vlasat Canter Seruicp,g lnc. ia complying wlth applicable seruice quality standardg and coneumer
protectlon rules of the Federal Communications Commioslon and the ldaho Publb Utilltiee Commlssion.
4. I certiff to the Commlsaion that the Company ie able to remain functlonal in emergencles ae set forth in
Commlssion Order No. 298[.1and in 47 C.F.R. $ 5a.201(a)(2).
5. I afso certiff that allfederal universal service supportfunds received by Viasal Canler Seruies, lnc.
during the current calendar year will be used in a manner conslstent with section 354(e): that ia, for the
provision, malntenance, and upgrading of facilitles and eeMces for whlch the support is intended. The
company will continue to comply for the period of January 1, 2022, through December 31 , 2022, to be
eligible for federal unlversal eervice fund support.
6. This verification and affidavit ls provkled to be the ldaho Public Ulilities Commission to enable the IPUC
to certify to the FCC that federal universal servicE support received by the eligible caniers in the state
will be used in a manner coneistent with Section 2S4(e) of the Telecommunlcations Act.
-Ltv:.-
gt-r
Robert Blalr- Preeident & Secretary
)
)
)
8A
Name/Title
Svnc 6. zoztDate '
JuneSUBSCRIBED AND SWORN to before me this day of
Notary Public for residlng at
My Commission expires
See Attached Notary
vrasat'dt
Callfornla Jurat wlth Afflant
Statement
A notary public or other officer completing this certificate verifies only the
identity of the individua! who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or validity of that document.
State of California
County of San Diego
Subscribed and sworn to (or affirmedl before me on thls 15 day of 5u"'a 2021.
gy Robert Blair proved to me on the basis of satisfactory evidence to be the
person(slwho appeared before me.
ffiB7
rMENA IYNN DOYIE
tlotary Publk' Crfifunlr
Sil Dlclo CountY
Commlrrlon I 228t561 Signature of Notary PublictlyGomm. trPlrer llrr tt' 202!
349 lnverness Driw Soulh, Englewood, Colorado 80112 T. 720.493.6000 F. 720.493.6010 wvnr.viasal.com
roEE^
<O1(D StudvAreaCode 119026
<015> StudvArea Name Viaaat
<)20> ProgramYear 2022
<030> Contact Name: Person USAC should contact
with questions about this data SheLby Strlegel
<035> ContactTelephone Number: 8s5{539333 st
Number ot the person identified in data line <030>
<039> Contact EmailAddress:
Email ot the oeBon identitied in data line <030>VlaaatCarrlerSenlcerovlasat . cm
Form Type 54.313 and 5{.{22
l(zool s"-i." outage Reporting (volce)
lData colleaaon rorm
I
FCC Form /t81
OMB Control IIo. !
DccGmbcr 2020
<010> Studv Area Code 479026
<015> Studv Area Name viaEat
<020> Procram Year 2022
<030> contact Name - Person USAC should contact regarding this data Shelby Striegef
<035> contactTelephone Number - Number of person identified in data line <o3o> 8ss453e333 ext
<039> Contact Email Address - Email Address of person identified in data line <030> viaEatcarlierseryices@viasat . com
<2t0>
<220>
For the prior calendar year, were there any reportable voice service outages?
<a><b1><b2><d><e><f>
Did Outal
Affect Multipl
Study Areas
NORS
Reference
Number
outage staft
Date
outage start
Time
Outage End
Date
Outate End
Time
Number of
Customers Affected Total Number of
Custome13
911 Facilities
Affected
(Yes / l{o)
S€rvice Outage
Desc,iption (Check
all that apply)
l(4001 t{umber of complalnts per 1,000
lData
collectlon Foltn
qlstomclli FrEformtlS,
OiiE Gontrol
Dlqrbcrzot
<010> Study Area Code 479026
<015> Study Area Name viaEa!
<020> Program Year 2022
<030> Contact Name - Person USAC should contact regarding this data shelby strieEel
<035>Contact Telephone Number - Number of person identified in data line
<030>8554519333 ext
<039>Contact Email Address - Email Address of person identified in data line
<030>
ViaaatCarrierSeryicea@viaaat . con
<400>
Select from the drop-down list to indicate how you would like to report
voice complaints (zero or greater) for voice telephony service in the prior
calendar year for each service area in which you are designated an ETC for
any facilities you own, operate, lease, or otherwise utilize.
<410> Complaints per 1000 customers for fixed voice
<42O> Complaints per 1000 customers for mobile voice
<()10> StrdyAreaCodc a79026
<015> S&dyAr.aNams Vlasat
42(b Pror.mYe.r 2,022
<)!X> ConEet Name - Frrson USAC strould contact rqardinsthir d.ta theLb!. 8ttlieg.l
<0!ts> conBctTdcohone ilumber - Hurnber of person ldentfied ln data llne <o:NF 8s5{6!t333 6xt
O39> Contact Enall Addrcgs - Emall Addrrsi of person ldendficd ln data llnc <)!l(> vlxaucarri.rsrh'!.ed.vlrset. cm
€15> Certfi compllanae witft appllcrbh mlnlmum rewlce standards
()1(D StudyAreaCode a79026
<)1$ SMyAreallame v{.il1
20> ProframYear unaa
<)3()> Comact Name - Person l6AC should oontact reprdlng this data 8beIby SEriegel
<Xls> Contact Tehphone ilumber - Number of person ldentlfid in data llne (XX}> 855{53e333 cxt
<)!l9> Contact Emall Address- Email Addressofpenon ldefiified ln data llned)3(Ir vlasatgirrlBrscrvlcerrvlasrt.coo
<6(I)> Certify compllance regarding abllity to function in emergency situations YeE
<61b Desoiptive document br Functionaliry in EmergEncy Situalions 479026 IDNIO (610) Functionallty h Emergencla Si
<010> Studv Area Code 479026
<015> StudyArea Name Viasat
<020> Prorram Year
<030> Contact Name - Person USAC should contact regarding this data shelby strieqel
<035> contactTelephoneNumber-Numberofpersonidentifiedindataline<030> 8ss453e333 ext
<039> Contact Email Address - Email Address of person identified in data line <030> viaaarcarrlerseryiceaeviaaat.con
<810> ReportingCarrier viasat Carrier Seryices, Inc
<811> HoldinsComoanv Viasat, Inc
<812> Operatinlcompany viaeat carrier seryicea, rnc
<813>
Affiilates sAc DoinS Busin$s As Compan
<)1D StudyAreaCode 479026
<)15> StudyArcaName vLasats
<020> Program Year 2022
<)3(> Contact ilame - Person USAC should contact retardlrythls data Shelby stllegel
855{539333 exl<035> Contact Telephone Number - Number of pcrcon ldcntified ln data line <)3D
<)39 Contact Email Address - Emall Address of pcrson idrntif,ed in data linc <)3O,Viasatcarlersewr.cetavlagat . cm
<90D Does the filing entity offer tribal tand services? (Y/N)
<910> Trlbal tand(s) on which ETCServes
<92D Tribal Government Engagement Obligation
lf your company serves Tribal lands, please select (Yes,No, NA) for each these boxes
to confirm the status described on the attached PDF, on line 920,
demonstates coordinatlon with the Tribal government pursuant to
5 54.313(aX5) includes:
<921>Needs assqsment and deploynent planning with a fucrus on Tribal
community sndror instifu tions.
Feasibility and sustainability plannlng;
Marketing services in a culturally sensitive manner;
Compliance with Rights of way processes
Compliance with Land Use permitting requirements
Compliance wlth Facilities Siting rules
Compliance wlth Environmental Review processes
Compliance wlth Cultural Preservation review processes
Compliance with Tribal Business and Ucensing requirements.
Yet
Duck valleyFort ga11
Nez P€rce
{79q2! tu&g lrzq' TrADat WErcBg EngagereBE gpragBEloa.IEr
Name of Attached D,ocument
<922>
<923>
<924>
<925>
<926>
<927>
<928>
<929>
Select
Yes or No or
Not Appllcable
Not AppucableE
Not Appllcable
Not eDplicabl€
t{ot &D11cab1e
l{ot Appllcrbl€
Not lppll,ctbl.
No! .lDpucable
Not ^ppucableNot. Atrplicable
<010> StudyArea Code 179026
<015> StudyArea Name virsat
<02D ProgramYear 2022
<030> Contact Name - Percon USAC should contact regardlng this data sbelby SErleg€I
<035> Contact Telephone Number - Number of person identified in data line <030>85s4639333 qt
<03$ Contact Email Address - Email Address of identifiedindataline<030> vl.alatcarrlersewlceacviasa!.cm
<1fln>Voice services rate comparability certffication Not Applicable
419026 IDAIIO (1010) Voice Serviee Rate Comparability
<1010>Attach detailed description for voice services rate
com parability compliance
Name of Attached Document
Not Applicable - Please ercplain ln the attachment t
<1020>Broadband comparabllity certificatlon
<1030>Attach detailed description for broadband
comparability compliance
479026 fDN{O (1030) Broadband Service Ratse Comparabi
Name of Attached Document
<01D StudyAreaCode t79026
<015> StudyArea Name Vlasat
<020> ProgramYear 2022
<03D Contact Name - Person USACshould contact regardingthis data Shelby Scrieg€],
<035> Contact Telephone Number - Number of person identified in data line <030>85s4639333 st
<039> Contact Email Address - Email Address of person identified in data line <030> viararcarrlerserlceroviasat..ed
<1100> Certify whether terrestrial backhaul options exist (Y/N)
<113D Please selec{ the appropriate response (Yes, No, Not Applicable) to oonfirm the
reporting canieroffers broadband seMce of at least t Mbps dournsteam and 256 ktps
upsfeam wlhin he supported area pursuant to $ 54.313(9).
<1140>Alaska Plan rate-of-retum certification (yes, no, or not applicable) of
compliance with approved performance plan.
YeE
<010> StudyArea Code 479026
<015> StudyArea Name vlrset
<020> ProgramYear
<030> Contact Name- Person USACshould contactregardingthisdata Qhalhv Ai.i.dal
<035> Contact Telephone Number - Number of person identified in data line <030> sss.63 e333 exr .
<039> Contact Email Address - Email Address of person identlffed in data line <03D viasarcarrlerseryiceret iaEae.ffi
<121D Terms & Conditions of Voice Telephony Lifeline Plans
<7220> Link to public Website HTTP
"Please check these boxes below to confirm that the attached document(s), on line 1210,
or the website listed, on line 1220, contains the required information pursuant to
5 54.422(aX2) annual reporting for ETCs receiving louFincome support, canie6 must
annually report:
<722L> lnformation describing the terms and conditions of any voice
telephony servlce plans offered to Lifeline subscribers,
{79025 IDAIIO (1210) Teffi CoDdiEion€ of voice Telephony Lllella,
Name Document
<1222> Details on the number of minutes provided as part of the plan,
<7223> Additional charges for toll calls, and rates for each such plan.
E
E
479026
<015> StudyAreaName vlaaat
<020> ProBfemYear 2oz2
sbalby Strlegel
<035> ContactTelephone Number- Number ofperson ldendffed ln data line<030>
<039> Contact Email Address - Email Addres of person idendffed in data line <)!m> viaaatcurl.ers€wic.s.vl.etrts . ce
Select the appropriate rEsponses below (Yes, No, Not Applicablef to note compliance as a recipient of frozen High Cost s
to offset aocess charge reductions, and Connect Amerlca Phase ll support as set forth in 47 CFR 54.313(c),(d),(e). The inf
form and in the documents attached below is accurate.
<2015> 2016 and future Frozen Support Certification 47 CFR $ 5a.313(cXa) f
Price Cap Carrier Connect America ICC Support {47 CFR 0 54.313(d)}
<2016> Certification support used to build broadband
Connect America Phase ll Reporting t47 CFR $ s4s13(ell
<2OL7 A> Connect America Fund Phase 1l recipient?
<2OL7C> Total amount of Phase ll support, if any, the price cap carrier used for
capital expenditures in 2018.
<2018>Name of Attached Document Listing
Required lnformation
t-
Attach the number, names, and addresses of community anchor
institutions to which the carrier newly began providing access to
broadband service in the preceding calendar year - 54.313(eXfXiiXA)
Connect America Phase ll - FCC Form 470 Postings
<2019> For the filing due July 1 following full implementation of this requirement,
answer yes, no, or not applicable to this certification request
I
<010> StudyArea Code 479026
<015> StudyArea Name Viasat
<020> ProgramYear 2022
<030> Contact Name - Person USAC should contact regarding this data Shelby Striegel
<035> Contact Telephone Number - Number of person identified in data line <030>8554539333 ext
<039> Contact Email Address - Email Address of person identified in data line <030>ViasatCarri.erServi
(3007)Does this filing retain a Cost Consultant and/or Firm, or other Third Party to prepare financial and
operations data disclosures submitted to the National Exchange Carrier Association (NECA), USAC,
or the Administrator?
Name of Gonsultant Name ofGonsuhant
<010> Study Area Code 479026
<015> Study Area Name
<020> Program Year 2022
<030> Contact Name - Person USAC should contact regarding this data Shelby Striecel
<035> Contact Telephone Number - Number of person identified in data line <030> I5 54 6 3 9 3 3 3 ext .
Vi as at Carr i e rS e rvi c e s@<039> Contact Email Address - Email Address of person identified in data line <030>
Select from the drop down menu or check the boxes below to note compliance with 54.313(f)(1). Privately held carrier
financial reporting requirements set forth in 47 CFR 54.313(fX2). I further certify that the information reported on this
attached below is accurate.
Progress Report on 5 Year Plan
carrier certifi es to 54.313(0( lxiii)
(3oos)
(3010A)
(30108)
(3012A)
(3012B)
(3013)
(301s)
(3015)
(3017)
(3014)
Certification of Public lnterest Obligations {47 CFR 5
s4.313(0(1)(i))
Please Provide Attachment
Rate-of-Return Community Anchor lnstitutions
lndicate if the carrier newly deployed broadband
service to community anchor institution(s) in the
previous calendar year.
Please Provide Attachment
Using link, download template and list the number,
name and address for each community anchor
institution. Attach the document which contains the
community anchor institution details as required by
47 C.F.R. 5 s4.313(fXlxii)
ls your company a Privately Held ROR Carrier {47
cFR $ s4.313(fX2))
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 S 54.313(f)(2) compliance
requires:
Electronic copy oftheir annual RUS reports
(Operating Report for Telecommunications
Borrowers)
Document(s) with Balance Sheet, lncome Statement
and Statement of Cash Flows
lfthe response is yes on line 3014, attach your
company's RUS annual report and all required
documentation
Name of Attached Document Listing Required
lnformation
Name of Attached Document Listing
Required lnformation
(Yes/No)
(Yes/No)
Name of Attached Document Listing Required
lnformation
oooo
(3018)lf the response is no on line 3014, is your company
audited?
lf the response is yes on line 3018, please check the
hawac lralarrr la aaniFirm rrarrr crrlrmicciaa nn lina
(Yes/No)oo
<010>
ln drtr llm {30>
Flnalehl DataSumrEry
(3027) Revenue
(3028) OperatinS Expenses
(3029) Net lncome
(3030) Telephone Plant ln ServiceflPlS)
(30311 Total Assets
(3032) Total Debt
(3033) Total Equity
(3034)Dividends
t{.m of Att chcd D$umnt Lktlnt Rrqulnd lniom.tion
<010>Study Area Code 419026
<015>
<020>
Area Name
Program Year
viastts
2022
<030>Contact Name - Person USAC should contact regarding this data sh.lby st"lee_el -----^
<035>ContactTelephone Number - Number of person identified in data line <030>
<039>Contact Email Address - Email Address of person identified in data line <03D via'arcarriersailice'.via'at.cdr
4005 Rural Broadband Experlment
Authorized Rural Broadband Experiment (RBE) recipients must address the certification for public interest
obligations and provide a list of newly served community anchor institutions.
Public Interest Obllgations - FCC 1tl-98 (paragraphs 25-29, 78)
Please address Line 4001 regarding compliance with the Commission's public interest obligations. All RBE
participants must provide a response to Line 4001.
rO01. Recipient certifies that it is offering broadband 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.
RBE C.ommunlty Anchor lnstltutlons
<4003a> lndicate if the carrier newly deployed broadband service to community anchor institution(s) in the
previous calendar year
<4003b> Please Provide Attachment: Using link,
download template and list the number, name
and address for each community anchor
institution. Attach the document which contains
the community anchor institution details as
required by FCC 14-98 (paragraph 79)
Name of Attached Document Listing Required lnformation
(5@51 Alaska Plan Participants Additional Documentation
Data f-ollection Fo]m
<010>Study Area Code
FCC Form 'l81
OMB Control l{o. 306
December 2020
479026
<015>Study Area Name Viasat
<020>
<030>
Year
Contact Name - Person USAC should contact regarding this data
2022
shelby stliege1
<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>ViasatCa!!ie!Services@viasat . com
5005 Alaska Plan
(s011)
(s012)
Please indicate whether any terrestrial backhaul or other satellite backhaul became
commercially available in the previous calendar year in areas previously served
exclusively by performance-limiting satellite backhaul.
lf the filing carrier identified in its approved perfomance plans that it relies exclusively on
satellite backhaulfor a certain poriton of the population in its service area, indicate whether
any terrestrial backhaul or other satellite backhaul became commercially available in the
previoius calendar year in areas that were previoiusly served exclusively by satellite backhaul
<a><b>
Description Of Backhaul Technology
(Yes/Nr
(Yes/Nc
Newly Served Loc
<5013>
Date Backhaul Available
<010>Studv Area Code 479026
<015>Study Area Name Viaaat
<020> Program Year 2022
<030>Contact Name - Person USAC should contact regarding this data Shelby striegel
<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>ViaaatCarrierSeryicea@viasat.. cc
<6010> Enter the total amount of Phase ll Auction Support, if any, the carrier used
for ca pital expenditures
Phase ll Auction and New York Funds Certification
<6011>Certiflt (either yes or no) regarding whether the recipient has available
funds for all project costs that will exceed the amount of support that will
be received for the next calendar year. This certification must be provided
starting the first July 1st after receiving support until the recipient's
penultimate year of support
Phase ll Auction Community Anchor lnstitutions
<5012a> lndicate if the carrier newly deployed broadband service to community
anchor institution(s) in the previous calendar year
<6012b> Please Provide Attachment Using link, download template and list the
number, name and address for each community anchor institution.
Attach the document which contains the community anchor
institution details as required by FCC 14-98 (paragraph 79)
Phase !l Auction FCC Form 470 Postings
<6013>For the filing due July 1 following full implementation of this
requirement answer yes or no to this certification request
Phase ll Auction Post-Fina! Deployment Milestone Performance Certification
Starting the first July lst after meeting the final service milestone, certify
(yes or no) that the Phase ll-funded network that the Phase ll auction
recipient operated in the prior year meets the relevant performance
requirements in 5 54.309
4
(Yes/No)
Name of Attached
Document Listing Required
lnformation
Yr
N
<6014>
Y
<010>Study Area Code 419026
<015>Study Area Name vlasat
<020>Program Year 2022
<030>
<035>
Contact Name - Person USAC should contact this data
Contact Telephone Number - Number of person identified in data line <030>
thelby Strlegel
<039>Contact Email Address - Email Address of person identified in data line <030>ViaaatCalrierseryiceseviasat, . (
<7010> Phase llAuction recipientperformance requirementscertification (Yes/No)
(8fi151 Unledo a Puerto Rico Fixed and Mobile Funds Certlfication
Data Collection Fonn
<010>Study Area Code
FCC Form tl81
OMB Control No. 3060n
December 2020
479026
<015>Study Area Name Viaeat-
<020>Program Year 2022
<030>Contact Name - Person USAC should contact regarding this data Shelby Striegel
<035>Contact Telephone Number - Number of person identified in data line <030>
<039>Contact Email Address - EmailAddress of person identified in data line <030>ViasatCarrierServices@wiasat . com
<8010>
<8011>
<8012a>
<8012b>
<8013>
Uniendo a Puerto Rico Stage 2 Fixed - Capital Expenditures
Enter the total amount of Uniendo a Puerto Rico Stage 2 fixed support, if any, the
carrier used for capital expenditures.
Uniendo a Puerto Rico Stage 2 Fixed - Available Funds Certification
Certify (either yes or no) regarding whether the recipient has available funds for all project
costs that will exceed the amount of support that will be received for the next calendar
year. This certification must be provided starting the first July 1st after receiving support
until the recipient's penultimate year of support.
Uniendo a Puerto Rico Stage 2 Fixed - Community Anchor lnstitutions
lndicate if the carrier newly deployed broadband service to community anchor institution(s)
in the previous calendar year.
Please Provide Attachment
Using link, download template and list the number, name and address for each community
anchor institution. Attach the document which contains the community anchor institution
details as required by 47 C.F.R. 5 5a.313(eX2)(A). Allowable File Types.
Uniendo a Puerto Rico Stage 2 Fixed - FCC Form 470 Postings
For the filing due July 1 following full implementation of this requirement answer yes, no, or
not applicable to this certification request.
Name of Attached
Document Listing R
lnformation
<8014>Uniendo a Puerto Rico Stage 2 Fixed - Post-Final Deployment Milestone Performance Certification
Starting the first July 1st after meeting the final service milestone, certify (yes or no) that the
Uniendo a Puerto Rico Stage 2-funded network that the Stage 2 recipient operated in the prior
year meets the relevant performance requirements in S 54.309.
<8020>Uniendo a Puerto Rico Stage 2 Fixed - Support Reimbursement Certification
54.313(n): Recipients of Uniendo a Puerto Rico Fund Stage 2 fixed support shallcertify that
such support was not used for costs that are (or will be) reimbursed by other sources of
support, including of federal or local government aid or insurance reimbursements; and that
support was not used for other purposes, such as the retirement of company debt unrelated
to eligible expenditures, or other expenses not directly related to network restoration,
hardening, and expansion consistent with the framework of the Uniendo a Puerto Rico Fund.
<8030> I laianr{a - D.16..+^ Diaa C}aaa ? Eival - Flicac}ar Dran:rae{aaac aad Dacaaaca t'laarrmanlafian
<010>Study Area Code 4',19026
<015>Study Area Name via6at
<020>
<030>
Year
Contact Name - Person USAC should contact regarding this data
2022
SheLby Striegel
<035>Contact Telephone Number - Number of person identified in data line <030>8554539333 ext
<039>Contact Email Address - Email Address of person identified in data line <030>ViasaECarrierServices@viasat. com
<9010>
<9011>
<9012a>
<9012b>
<9013>
Connect USVI Stage 2 Fixed - Capita! Expenditures
Enter the total amount of Connect USVI Fund Stage 2 fixed support, if any, the carrier used
for capital expenditu res.
Connect USV! Stage 2 Fixed - Available Funds Certification
Certify (either yes or no) regarding whether the recipient has available funds for all project
costs that will exceed the amount of support that will be received for the next calendar year
This certification must be provided starting the first July 1st after receiving support until the
recipient's penultimate year of support.
Connect USVI Stage 2 Fixed - Community Anchor lnstitutions
lndicate if the carrier newly deployed broadband service to community anchor institution(s)
in the previous calendar year.
Please Provide Attachment
Using link, download template and list the number, name and address for each community
anchor institution. Attach the document which contains the community anchor institution
details as required by 47 C.F.R. 5 5+.313(eX2XiXn).
Connect USV! Stage 2 Fixed - FCC Form 470 Postings
For the filing due July 1 following full implementation of this requirement answer yes, no, or
not applicable to this certification request.
Connect USVI Stage 2 Fixed - Post-Final Deployment Milestone Performance Certification
Starting the first July 1st after meeting the final service milestone, certify (yes or no) that the
Connect USVI Fund Stage 2-funded network that the Stage 2 recipient operated in the prior year
meets the relevant performance requirements in 5 54.309.
Connect USV! Stage 2 Fixed - Support Reimbursement Certification
54.313(n): Recipients of Connect USVI Fund Stage 2 fixed support shall certify that such support was
not used for costs that are (or will be) reimbursed by other sources of support, including of federal
or local government aid or insurance reimbursements; and that support was not used for other
purposes, such as the retirement of company debt unrelated to eligible expenditures, or other
expenses not directly related to network restoration, hardening, and expansion consistent with the
framework ofthe Connect USVI Fund.
Name of Attached
Document Listing
lnformation
<9014>
<9020>
Connect USVI Stage 2 Fixed - Disaster Preparedness and Response Documentation
PaBe 2l
<01D StudyArea Code a7902.6
<015> StudyArea Name vlaEat
<02D ProRramYear 2022
<030> Contact Name - Person USAC should contact rerardinc this data Sh.lhv -qtri.dcl
<035> ContactTelephoneNumber-Numberofpersonidentifiedindataline<03D 8551639333 ext
<039> Contact Email Address - Email Address of person ldentified in data line <030> via8atcarrierseryice8evj.asaE . com
ro BE CoMPTETED BY THE REPORflI|G CARRTE& rF THE REPORmilG CARRIER lS FTLTNG Ailr{UAL REPORmf{G ON lTn OWN BE]r,AtF:
Grtificatlon of Officer as to the Accuracy of the Data Report d for the Annual Reportlng for CAF or Ll Reciplents
GGiplcnG; .n4 to thc bcst of my knowlcdtc, thc lniomalion reported on thls form and ln any attdrmcnts is ec6lr.ta.
[ame of Remrtin! carrier viaaat
iirnatureofAuthorizedofficer: cERTrFrm oNLrI{E Date 06/aa/2o21
Drinted name of Authorized ofiicer: Robert Blair
Iitle or msition of Authori2ed ofilcer: President and secretary
feleohone number of Authorized fficer. 8554539333 4t
itudvArea Code of Reoortins Carrier: 419026 Filinr Due Date fort6itlor^' 01 / 0t/ 2o2L
Percns willfully makini f.l$ stat mcnB on this form 6n bc punished by ffnG or forfeiturc und.r th. Communlotions Act of 1934, 47 U.S.C 9$ 502, 503(bl, or ffne or lmprienmcnt
under Tltl€ 18 of th. Unitcd Stat$ dc, 18 U.S.C. 5 1001.
Page 21
PaEe 22
Certlticatlon - Agent / Cender
Dat Coll€ctbn Fom
FCC Fom /Ol
oMB Conrd trro. 3o6o{r986/OM8 cont ol r{o. 3(t6{Hn1!'
D.c.mbcr 2020
<010> StudyArea Code 41 9026
<015> StudyArea Name Vi.asat
<02D Pro{ram Year 2022
<030> contact Name - Person USAC should contact regarding this data Shelby Striegel
<035> contactTelephoneNumber-Numb€rofpersonidentifiedindataline<030> 8554539333 ext
<039> contactEmailAddress-EmailAddressofpersonidentifiedindataline<030> viasatcarrierservices@viasat com
IO BE COMPLETED BY THE REPORTING CARRIER, IF AN AGENT IS FILING ANNUAT REPORTS ON THE CARRIER'S BEHATF:
TO BE COMPIETED 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
lcgr0fythat(Nameof,qgent)l8author|zedto3ubmitthelnfomat|on]eportedmbehalfofthereporUngcanier.l
atso certtfy that I am ,, om"". or urlIf,iIilllIlflfEf,Illilittue; tnctude snsurtng ths accuracy of the annuat data reportng requtremenb provtded to ttre aut rorized
agent; and, to ths best of my knowlodge, the rqporB and data proylded to the authorlzGd agent ls accurato.
Name of Authorized AIent:
Name of ReDortinc Carrier:
SiEnature of Authorized Officer:Date:
Printed name ot Authorized Officer:
ftle or oosition of Authorized Officer:
Ieleohone number of Authori2ed officer:
Studv Area Code of Rebdftins crrrier:Filins Due Date for this form:
Perronswillfullymakingfalses[e-mail]1934,47U.S.C.59502,503(b),orfineorimprisonment
underTitle 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 Reporting Carrier
the data report€d hereln based on data provided by the reponlnt carrleD and, to th€ best of my knowledte, the lnformatlon r€ported h€r€ln ls accurat€.
Name of ReDortinE Carrier:
Name of Authorized Alent Firm:
Sicnature of Authorized Apent or EmDlovee of Asent:Date:
Name of Authorized Aoent FmDlovee:
ntle or position of Authorized Asent or Emplovee of Agent
lelephone number of Authorized Acent or Employee of Acent:
itudv Area Code of Reoortinq Carrier;Filinc Due Date for this form:
18 of the United States Code, 18 U.S.C. S 1001.
PaEe 22
479026<010> StudyArea Code
<015> StudyArea Name vLa6at
<020> ProgramYear 2022
<030> Contact Name - Penon USAC should contact regarding this data Shel.by striegel
8554539333 €xt<035> Contact Telephone Number - Number of percon identlfled in data line <030>
<039> Contact Email Address - Email Address of person identified in data line <030>vlaaatCarrierSewiceaovlaBa!. cm
I certifo under penalty of perjury that no universal service support has been or will be used to purchase,
obtain, maintain, improvg modifu, or othenvise support any equipment or services produced or provided
by any company designated by the Federal Communications Commission as posing a national security
threat to the integrity of communications networks or the communications supply chain since the
effective date of the designations
Yer
Please Provide Waiver Document
Allowable File Type (pdf only)
Name of Attached Document Listing Required
lnformation
(610) Descriptive document for Functionality in Emergency Situations
Viasat has in place contingency plans for credible emergency situations for each of the major network
facilities that are geographically distributed across the United States. These plans contain activation,
required staffing, escalation, and communication procedures to deal with such
emergencies. Additionally, all of the company's ground-based facilities are equipped with independent
power generators and sufficient fuel to operate for several days so as to mitigate power outages. The
design of these facilities contains multiple levels of redundancy and autonomy that also mitigate the
need for dedicated human interaction.
(920) Trlbal Government Engagement Obligation
Viasat did not prwide supported services in 2020. As Viasat continues to dwelop its service offers for
2O2t and subsequent years, it will comply with all Commission requirements for Tribal Engagement,
including, as applicable, needs assessment and deployment planning with a focus on Tribal community
anchor institutions; (ii) Feasibility and sustainability planning; fiii) Marketing services in a culturally
sensitive manner; (iv) Rights of way processes, land use permitting facilities siting environmenta! and
cultura! preservation review processes; and (v) Compliance with Tribal business and licensing
requirements.
(1010) Detailed Description forVoice Servlces & Broadband Rate Gomparability Compliance
Viasat did not provide the supported services in 2020. As Viasat continues to develop its service offers
for 202! and subsequent years, it will comply with all Commission requirements, including that voice
service rates are no more than two standard deviations above the applicable nationalaverage urban
rate.
(10f 0) Detailed Description for Broadband Rate Comparability Gompliance
Viasat did not provide the supported seruices in 202O. As Viasat continues to develop its service offers
for 2021 and subsequent years, it will comply with all Commission requirements, including that the rates
will be consistent with the FCC's urban rate benchmark for broadband service.
(1210) Terms & Conditions of Voie Telephony Lifeline Plans
This Viasat Lifeline Prcgram only applies to customers who arc qualified to, and are
rcceiving, Viasat Internet or Voie Seruice thrcugh a federal or state Connect America
Fund program, or other similar prcgram as designated by Viasat, and through a state
or federal lifeline program flifeline SeruiceJ. For Lifeline Service, all terms and
conditions of the Customer Agrcement apply, as well as these supplemental terms:
1. As part of your receiving Lifeline Seruice, Viasat will discount your monthly Seruice fee for your
Internet or Voice Seruice the amount of the then current federal or state discount (as
applicable). The Lifeline Seruice discount will appear on your bill as a separate line item labeled
"Lifeline Discount."
Z You understand that Lifeline is a government assistance program, that the seruice is non-
transferrable, that only eligible @nsumers may enroll in the program, and the program is limited
to one discount per household.
3. You are only eligible for Lifeline Service if you (or your dependent or other person in your
household) currently get benefits from the government program(s) listed on the Lifeline Program
Application Form (FCC Form 5629) or your annual household income is 135o/o or less than the
Federal Poverty Guidelines (the amount listed in the Federal Poverty Guidelines table on the Lifeline
Program Application Form (FCC Form 5629)).
4. You understand that your household can only get one Lifeline Service benefit, and, to the best of
your knowledge, your household is not getting more than one Lifeline Service benefit. A
"household" is any individual or group of individuals who are living together at the same address
as one economic unit. A household may include related and unrelated persons. An "economic
unit" consists of all adult individuals contributing to and sharing in the income and expenses of a
household. An adult is any person eighteen years or older. If an adult has no or minimal income,
and lives with someone who provides financial support to him/her, both people sha!! be
considered part of the same household. Children under the age of eighteen living with their
parents or guardians are considered to be paft of the same household as their parents or
guardians.
5. You agree that if you move you will give Viasat your new address within 30 days. You
understand that you must notiff Viasat within 30 days if you do not qualiff for Lifeline Service
anymore, including if:
a. You, or the person in your household that qualified, no longer qualify for any
reason (such as, no longer qualiffing through a government program or
based on household income level).b. Either you or someone in your household gets more than one Lifeline Service
benefit (including, more than one lifeline broadband internet service, more
than one lifeline telephone selice, or both lifeline telephone and lifeline
broadband internet seruices).
6. You agree that Viasat can give the Lifeline Seruice program administrator ('AdministratorJ all of
the information you provided on the Lifeline Program Application Form (FCC Form 5629). You
understand that this information is meant to help run the Lifeline Seruice program and that if
you do not let Viasat give it to the Administrator, you wi!! not be able to receive Lifeline Seruice
benefits. You can also apply for Lifeline Seruice directly with the Administrator through the
National Verifier, available at httos://www.lifelinesuooort.org/national-verifier/ .
7. Security. You agree to take reasonable measures to protect the security of any devices you
connect to the internet through the Service, including, without limitation, maintaining an up-to-
date version of anti-virus and/or firewall software to protect your devices from malicious code,
programs or other internal components (such as a computer virus, computer worm, computer
time bomb or similar component). You expressly agree that if your computer or an internet
connected device becomes infected and causes any of the prohibited activities listed in the
Acceptable Use Policy, Viasat may immediately suspend your Service until such time as your
computer is sufficiently protected to prevent fufther prohibited activities. You will be fully liable
for all monthly fees and other charges under this Agreement during any period of suspension.
Although Viasat has no obligation to monitor the Services or its networlg Viasat and its
authorized suppliers reserve the right to monitor bandwidth, usage, transmissions, and content
from time to time in order to operate the Seruices, identifu violations of this Agreement, or
protect the Viasat network, the Seruices and other users of the Services. In all citset you are
solely responsible for the security of any device you choose to connect to the Seruice, including,
without limitation, the security of any data stored or shared on such device(s). Viasat customer
seruice representatives are available to Lifeline customers who need assistance obtaining access
to free anti-virus software.
8. All the answers and agreements that you provided on Lifeline Program Application Form (FCC
Form 5629) are true and correct to the best of your knowledge. You understand that willingly
giving false or fraudulent information to get Lifeline Seruice program benefits is punishable by
law and can result in fines, jail time, de-enrollment, or being barred from the program.
9. Viasat or the National Verifier may have to check whether you sti!! qualiff at any time. If you
need to receftiff (renew) your Lifeline Seruice benefit you understand that you have to respond
by the applicable deadline communicated to you or you will be removed from the LifelineSeruice
program and your Lifeline Seruice benefit will stop.
10. You may transfer your Lifeline benefit to another Lifeline seruice provider at no charge for the
transfer of benefits to another provider.
11. You were truthfu! about whether or not you are a resident of Tribal lands, as defined in section 2
of the Lifeline Program Application Form (FCC Form 5629).
12 De-enrollment. If you become ineligible for the Lifeline Program, you have an obligation to
contact Viasat directly and de-enroll from the Lifeline-suppofted seruice. There are several other
situations that might result in your being de-enrolled from Lifeline Discounts:
a. If Viasat has a reasonable basis to believe that you are no longer eligible,
Viasat will send you a notice of impending termination of the Lifeline benefit.
You will have 30 days from the date of the impending termination letter to
demonstrate continued eligibility by re<ertifoing your continued eligibility.
Viasat must terminate your Lifeline benefit if you fail to demonstrate
continued eligibility within the 30-day time period.
b. If USAC, the administrator of universal service, provides notification to Viasat
that you have more than one discounted aacount, or that more than one
member of your household is receiving servicg Viasat must de-enroll you
from the Lifeline program within five business days.c You have an obligation to re<eftiff annually that only one member of your
household receives program-supported seruice and that you continue to be
eligible. If you fail to respond to Viasafs or the National Verifie/s request for
ceftification, Viasat or the NationalVerifier will provide you with notification
that you have 60 days from the date of the notification to provide the
requested ceftification. If you fail to provide the requested certification within
the 60-day notification period, Viasat will de-enroll you from the Lifeline
program within five business days from the end of the 60day notification
period.
13. Viasat Voice. Viasat Voice provides unlimited local and long distance calling to destinations in all
50 states, plus Canada. Fees apply for ca!!s outside of these locations. You may contact Viasat
at [number to be provided] to block calls that could result in additional fees. Call blocking, also
known as toll limitation, is offered at no charge to Lifeline customers. Fufther, you may
purchase a battery backup; we offer 8- and 2*hour options for a one-time fee of $-and $-
respectively.
14. EasyCare Plan is optional for Lifeline subscribers. Viasat will provide EasyCare to Lifeline
subscribers who elect the seruice free for the first 90 days. For more detail, see the EasyCare
Plan Addendum.
15 If you are unable to resolve a dispute with Viasat, you may contad the [Agenq NameJb Bureau
of Consumer Seruices (BCS). BCS will address Lifeline-related issues that include (1) eligibility
disputes; (2) program offering issues; and (3) limited equipment-related issues. Contact the
[Agenry name and contact informationJ orsubmita comolaintform. Mail: fAgenry Name and
Conbd InformationJ.