Please Mail signed copy And email To: The CMRS E911 Advisory Committee and the Budget and Control Board, Division of the State Chief Information Officer Attention: Jim Rion, Division of the CIO
|
|
Was there any previous preliminary or final approval for the Phase II solution? |
YES |
NO |
|
|
|
|
|
|
|
If Yes, please provide the following: |
|
|
|
|
Type or category” |
|
|
|
|
Date: |
|
|
|
|
Amount: |
|
|
|
|
Do not include any costs which have already been approved in this application other than above. |
|
|
|
Tier 1. |
Monthly Recurring Costs Maintenance |
Total Amount |
Requested |
|
|
|
|
|
|
A. |
E911 Mapping/GIS |
100% |
100% |
|
|
Hardware and software maintenance @ $ monthly annualized |
|
|
|
|
Requested reimbursement for costs for 5-year service contract |
|
* |
|
|
|
|
|
|
B. |
Computer Aided Dispatch |
|
|
|
|
If reimbursement other than as for pre-approved categories is requested, please attach justification. |
|
Phase II related expenses |
|
|
|
|
Requested |
|
|
|
Total Amount |
15% |
|
|
Hardware and software maintenance @ monthly Annualized |
|
|
|
|
Requested reimbursement for costs for 5-year service contract |
|
* |
|
|
|
|
|
|
|
|
|
|
|
C. |
E911 Controller/CPE |
|
|
|
|
If reimbursement other than as for pre-approved categories is requested, please attach justification. |
|
|
|
|
|
Total Amount |
AnnualizedPhase II related expenses Requested |
|
|
|
100% |
20% |
|
|
Hardware and software @ $monthly annualized |
$ |
$ |
|
|
Requested reimbursement for costs for 5-year service contract |
$ |
$ |
|
|
|
|
|
|
D. |
Other Phase II Related Expenses |
|
|
|
|
Additional trunks required for Phase II times 5 years |
|
|
|
|
Additional Phase II database maintenance charges-5 years. |
|
|
|
|
Interconnection recurring services- 5 yeas. |
|
|
|
|
Specify any other recurring costs times 5 years: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Annualized Monthly Recurring Costs for 5 Years- total |
$ |
$ |
|
Tier 2. |
One-Time Non-Recurring Costs |
Total Amount |
Amount Requested |
|
|
|
|
|
|
A. |
E911 Mapping/GIS |
100% |
100% |
|
|
Phase II related expenses |
|
|
|
|
Hardware and software |
$ |
$ |
|
|
|
|
|
|
B. |
Computer Aided Dispatch |
|
|
|
|
If reimbursement other than as for pre-approved categories is requested, please attach justification. |
|
|
|
|
|
|
|
|
|
Phase II related expenses |
100% |
15% |
|
|
Hardware and software |
$ |
$ |
|
|
|
|
|
|
C. |
E911 Controller/CPE |
|
|
|
|
If reimbursement is requested, please attach justification. |
|
|
|
|
|
|
|
|
|
Phase II related expenses |
100% |
20% |
|
|
Hardware and software |
$ |
$ |
|
|
|
Total Amount |
Amount Requested |
|
D. |
Other Phase II Related Non-recurring Expenses |
|
|
|
|
Additional trunks required for Phase II |
|
|
|
|
Additional Phase II database charges |
|
|
|
|
Interconnection services |
|
|
|
|
Specify any other non-recurring costs: NOTE Extended ALI Format has been pre-approved, but it is not necessary to include it or apply for it here or otherwise. |
|
$
|
|
– |
Total One-Time Non-Recurring Costs
|
|
$ |
|
—————–
|
Total One-Time Non-Recurring Costs (Tier 2 immediately above) |
|
$ |
|
|
5 Years – Annualized Monthly Recurring Costs(Tier 1) |
|
$ |
|
|
|
Total Costs |
Costs Requested |
|
|
GRAND TOTAL including 5 years maintenance |
$ |
$ |
|
I, the undersigned, am an official of the county/city of , who is duly authorized to execute the above application for , and I affirm that the information provided in this application is as accurate and truthful as county personnel and agents can provide, with due diligence and within reason, and that neither I nor anyone providing information of which I have knowledge have submitted information herein with any intent to defraud or have provided any information which we know to be in any way false or misleading.
I so affirm:_________________________________________
(Signing official of Applicant)
_________________________________________
(Title)
_________________________________________
(Local government Name)
_________________________________________
(Date)