No preview available
HomeMy WebLinkAboutC19-118 US Customs and Border Protection[Street Address) [City, State, Zip Code] US. Customs and Border Protection U. S. CUSTOMS AND BORDER PROTECTION (CBP) MEMORANDUM OF AGREEMENT FOR EQUIPMENT UPGRADES This Memorandum of Agreement ("MOA") outlines the agreement between the below named Airport Owner/Operator (Sponsor) and CBP in regards to the Sponsor's responsibility to reimburse CBP for costs related to providing and periodically upgrading the equipment required for the performance of the Federal Inspections Services (FIS) facility at the below named Airport location. The legal authority for CBP to enter into and require such an agreement is found at 19 U.S.C. § 58(b); 19 U.S.C. § 482; 19 U.S.C. § 1433; 19 U.S.C. § 1461; 19 U.S.C. § 1459; 19 U.S.C. § 1499; 19 U.S.C. § 1644a; 19 U.S.C. § 1524; 8 U.S.C. §§ 1222-1225; 8 U.S.C. § 1356 (a); 6 U.S.C. § 231; 8 C.F.R. Part 234; 19 C.F.R. § 122.11; 19 C.F.R. § 122.12; 19 C.F.R. § 122.14. Airport Owner/Operator: Eagle County Regional Airport (EGE) Location: 217 Eldon Wilson Road Gypsum, CO 81637 Eaele Countv Regional Airport (EGE) RESPONSIBILITIES Data and Cabling EGE will be responsible for the procurement and installation of all data cabling and electrical components required for connectivity of the Automated Data Processing (ADP) Local Area Network (LAN), Data, Information Technology (IT), and any Voice and any Tactical Communications (TacComm) Systems and equipment according to CBP Office of Information Technology (OIT) provided specifications for the Eagle County Regional Airport located at 21.9 Eldon Wilson Road Gypsum, CO 81637. However, EGE must give CBP two weeks advance notice of all cable pulls so that CBP can be present and observe their installation. Reimbursement of ADP LAN, Data, IT, Voice, and TacComm Systems and Equipment Costs EGE shall reimburse CBP for all new and upgraded ADP LAN, Data, IT, and any Voice and TacComm Systems equipment and connectivity costs, including ordering equipment, installation, maintenance, and recurring costs required to start-up and maintain continuous CBP operations at the EGE Federal Inspection Services (FIS) facility located at 219 Eldon Wilson Road Gypsum, CO 81637. Estimated new and upgraded ADP LAN, Data, IT, and any Voice and TacComm equipment costs total of $66,083.00. No additional initial or increased recurring Verizon circuit cost is required at this time, due to the sufficiency of the existing circuit already funded by EGE. One time travel cost of $2,500.00 is also required for a Data Engineer, as needed for equipment installations. Attached is CBP OIT's Cost Estimate (GYP005A) that identifies the ADP LAN, Data, IT, and any Voice and TacComm equipment requirements for the CBP FIS for which EGE will reimburse CBP all ADP LAN, Data, IT, and any Voice and TacComm equipment, recurring, and servicing costs. EGE will be billed for the actual costs of the ADP LAN, Data, IT, and any Voice and TacComm equipment and any required replacement equipment. EGE will continue to be billed annually for recurring out -year network charges for the existing Verizon Data Circuit. 04/17/19 C19-118 ADP LAN, Data, IT, and Any Voice and TacComm Equipment Upgrades EGE also agrees to periodically upgrade the ADP LAN, Data, IT, and any Voice and TacComm equipment on a schedule determined by CBP (approximately every 3-5 years, as needed), and reimburse CBP all costs. CBP will provide EGE at minimum 120 days advance notice of any required upgrades. EGE Accounts Payable Information EGE Tax Identification Number: EGE Bill To Representative: EGE Phone Number: EGE Email Address: EGE Address: 84-6000762 Jennifer Farineau 970-328-2682 0ennifer.farineau@ea leg county us P. O. Box 850 Eagle, CO 81631 Payment Process A copy of this signed agreement will be forwarded to the CBP National Finance Center (NFC). Upon receipt and installation of all equipment identified in GYP005A, the NFC will issue EGE a bill for the actual ADP LAN, Data, IT, and any Voice and TacCom equipment costs not to exceed $66,083.00. The CBP NFC will also continue to bill EGE 90 -days prior to the due date for recurring out -year network and connectivity charges owed for the existing network circuit, and sums owed for any future ADP LAN, Data, IT, and Voice and TacComm equipment upgrades and/or replacements not covered by manufacturer warranties when procured. Pursuant to 19 C.F.R. § 24.3a, any amounts due CBP under the terms of this agreement not reimbursed within 30 days of billing will begin accruing interest charges based on current U.S. Treasury borrowing rates and may ultimately be referred for collection against the EGE. Equipment Ownership CBP will retain possessory ownership of all ADP LAN, Data, IT, and Voice and TacComm equipment ordered by CBP and reimbursed by EGE until CBP vacates the premises. CBP will transfer ownership rights of all ADP LAN, Data, IT, Voice and TacComm equipment used in CBP operations and reimbursed by EGE for the CBP FIS when CBP vacates the premises. Within one month (30 -days) following installation and reimbursement, CBP OIT will deliver a list of Serial Numbers and/or other identification and warranty information for the EGE reimbursed ADP LAN, Data, IT, Voice and TacComm equipment to the EGE as instructed below. EGE Equipment Administrator: EGE Email Address: EGE Phone Number: EGE Ship to Address: Andy Solsvia andy.solsvie(@eaglecounty.us (970) 328-2649 P. O. Box 850 Eagle, CO 81631 04/17/19 Page 2 of 3 U.S. CUSTOMS AND BORDER PROTECTION (CBP) RESPONSIBILITIES Equipment Connectivity and Maintenance The CBP OIT retains responsibility for ordering and installing required data equipment and connection(s) from the CBP FIS to the CBP National Data Center, and imaging, maintaining, and controlling all of the ADP LAN, Data, IT, and any Voice and TacComm equipment listed in the attached CBP OIT Cost (GYP005A) for the CBP FIS as required by CBP, the costs of which EGE shall reimburse CBP. EGE will incur no additional costs or CBP OIT charged service fees for any required ADP LAN, Data, IT, and Voice and TacComm equipment maintenance/repair/replacement covered by CBP procured equipment warranties. Data Ownership All data entered and/or stored in any manner on the equipment covered by this MOA shall belong to the United States and is confidential and protected information. It shall be CBP's responsibility to properly remove said data before possession of any equipment is transferred to the EGE. In the event data inadvertently remains on any of the equipment upon transfer, EGE shall keep the information confidential and immediately notify CBP so that CBP can remove the data. AUTHORIZATION (TWO ORIGINALS WITH SIGNATURES ARE REQUIRED) Authorized Representative The EGE signatory to this MOA represents and warrants that he or she is a duly authorized representative of the EGE, with full power and authority to enter into this MOA and to bind the EGE with regard to all matters relating to this agreement. Agreement to these terms is attested by the signatures below. I � I County Manager Eagle County Eagle County Regional Airport ieff.shroll@eaglecounty.us q /7- ao/ Email Address Date a 5'�ay) Aa, "gw -.0pq 4 � j Y�13 Email Addres - e Date Area Port Director Office of Field Operations, San Francisco/Portland Field Office U.S. Customs and Border Protection 0417j'19 Page 3 of 3 a•••l� DEPARTMENT OF HOMELAND SECURITY OMR APPROVAL NO. 1651-4064 g U.S. Customs and Border Protection EXPIRATION DATED&M-2016 `w .4�e ri� CREATEIUPDATE IMPORTER IDENTITY FORM 19 CFR 24.5 As the importer, consignee, or other party listed in block 1, you are responsible for the validity of the information provided in this document. Any Customs Broker or third party who is submitting the information on your behalf is only obligated to convey this information to Customs and Border Protection (CBP). TYPE OF ACTION (Mark all applicable): x❑ Notification of identification number ❑ Change of name" ❑ Change of address` 1. NAME AND IDENTIFICATION NUMBER 1A. Importer/Business/Private Party Name: Eagle County Government 1B, Internal Revenue Service (IRS) number/Social Security Number (SSN): 84-600076 1C. [-]DIV ❑ AKA ❑ DBA 1D. DIVlAKAIDBA Name: Eagle County Regional Airport 1E. ❑x I wish to be assigned a CBP Number. Check here if requesting a CBP-assigned number and indicate reason(s). Check all reasons that apply. ❑ I have a SSN, but wish to use a ❑ I have no Social ❑ 1 have no IRS ❑ I have not applied for ❑ I am not a GBP -Assigned Number on all my Security Number Number an IRS number or SSN U.S. Resident entry documents 1F. CBP-Assigned Number: 1 G. Type of Company: ❑ Corporation ❑ Partnership ❑ LLC [] Sole Proprietorship ❑ Individual ❑ U.S. Government Z State/Local Government ❑ Foreign Government 1H. If you are an importer, how many entries do you plan on filing in a year? Please select from the following: ❑ 1-5 per year ❑ 5-25 per year iX 25 or more per year ❑ infrequent personal shipments, or ❑ I do not intend to import. 11. How will the identification number be utilized? Please select all options that will apply: ❑ Importer of Record [] Consignee/Ultimate Consignee ❑ Drawback Claimant ❑ Refunds/Bills, or ❑ Other 1J. Program Code 1: 1K. Program Code 2; 1L. Program Code 3: 1M. Program Code 4: 2. ADDRESS INFORMATION 2A. MAILING ADDRESS Street Address 1: City: StatelProvince: Street Address 2: Zip Code' Country ISO Code, Is the address in 2A, a ❑ Residence ❑ Corporate Office ❑ Warehouse ❑ Retail Location ❑ Office Building ❑ Business Service Center ❑ Post Office Box or ❑ Other -Explain: 2B. PHYSICAL LOCATION ADDRESS Street Address 1: City: State/Province: Street Address 2: Zip Code: Country ISO Code: Is the address in 2B, a ❑ Residence ❑ Corporate Office ❑ Warehouse ❑ Retail Location (J Office Building or ❑ Other - Explain: 2C. Phone number: Extension: 2D. Fax number: 2E. Email address: 2F. Website: 3. COMPANY INFORMATION 3A. Provide a brief business description: 3B. Provide the 6 -digit North American Industry Classification System (NAICS) code for this business 3C. Provide the D -U -N -S Number for the Importer: 3D. If you are also a brokerlself-filer, supply the filer code that will be used when conducting business with CBP: CBP Form 5106 (611 T) Page 1 of 4 3E. Year established: 3F. List the names and Internal Revenue Service (IRS) employer identification, Social Security or CBP-assigned numbers for current or previous related business entities. Related Business Name of Business Entities IRS/SSN/CBP Assigned Number ❑ Current ❑ Previous ❑ Current ❑ Previous ❑ Current ❑ Previous 3G. Primary Banking Institution: (Name) (Bank Routing Number) (City) (State) (Country ISO Code) 3H. Certificate or Articles of Incorporation - (Locator I.D.) 31. Certificate or Articles of Incorporation — (Reference Number) 3J. Business Structure/Beneficial Owner/Company Officers - The officers listed in this section must have importing and financial business knowledge of the company listed in section 1 of this form and must have legal authority to make decisions on behalf of the company listed in section 1. Elements designated below with an asterisk are optional data fields. Company Position Title: Name (First, Middle, Last): Direct Phone Number: Extension: Direct Email: 'Social Security Number. 'Passport Number. 'Country of Issuance: 'Passport Expiration Date: 'Passport Type: ❑ Regular ❑ Official ❑ Diplomatic ❑ Passport Card Company Position Title: Name (First, Middle, Last): Direct Phone Number Extension: Direct Email: 'Social Security Number. 'Passport Number. 'Country of Issuance: 'Passport Expiration Date: 'Passport Type: ❑ Regular ❑ Official ❑ Diplomatic ❑ Passport Card Company Position Title: Name (First, Middle, Last): Direct Phone Number. Extension: Direct Email: 'Social Security Number: "Passport Number: 'Country of Issuance: "Passport Expiration Date: 'Passport Type: ❑ Regular ❑ Official ❑ Diplomatic ❑ Passport Card Company Position Title: Name (First, Middle, Last): Direct Phone Number. Extension: Direct Email: 'Social Security Number: 'Passport Number. 'Country of Issuance: 'Passport Expiration Date: *Passport Type: ❑ Regular ❑ Official p Diplomatic ❑ Passport Cana 4. CERTIFICATION By my signature below, I certify that, to the best of my knowledge and belief, all of the information included in this document is true, correct, and provided in good faith. I understand that if I make an intentional false statement, or commit deception or fraud in this 5106 document, I may be fined or imprisoned (18 U.S.C. § 1001). Printed or Typed Full Name and Title: Jeff Shroll, County Manager Sig at Telephone Number. 970-328-8604 Date: Broker Name: Telephone Number. CBP Form 6108 (8117) Page 2 of 4 PAPERWORK REDUCTION ACT STATEMENT: An agency may not conduct or sponsor an information collection and a person is not required to respond to this information unless it displays a current valid OMB control number and an expiration date. The control number for this collection is 1651-0064. The estimated average time to complete this application is 45 minutes. The obligation to respond is required to obtain a benefit. If you have any comments regarding the burden estimate you can write to U.S. Customs and Border Protection, Office of International Trade, Regulations and Rulings, 90 K Street NE, Washington DC 20229-1177. PRIVACY ACT STATEMENT: Pursuant to the requirements of Public Law 93-579 (Privacy Act of 1974), notice is hereby given that: 19 CFR 24.5 authorizes the disclosure of Social Security numbers (SSN) on the CBP Farm 5106, and implements CBP's authority to collect the taxpayer identification number and SSN as provided for in 31 U.S.C. 7701; the principal purpose for disclosure of the Social Security number is to identify the individuals conducting business with CBP to assist in regulatory compliance and investigations, and administrative or judicial proceedings; the information collected may be provided to those officers and employees of CBP and any constituent unit of the Department of Homeland Security who have a need to know the information in the performance of their duties; also, the records may be referred to any federal, state, local tribal, territorial, or foreign agency for whom CBP determines may assist In the enforcement of criminal or civil laws, or assist In intelligence or counter -intelligence, or breach notification, or for the compilation of foreign trade statistics and for verifying the existence of the importer and any linkages or affiliations between importers (19 U.S.C. 4320) persuant to the requirements of Public Law 114-125 (Trade Facilitation and Trade Enforcement Act of 2015); and failure to provide the required information will result in the denial of an importer of record number, the requirement to use a separate party for transactions, and may impact or delay the importation of shipments in international trade. TYPE OF ACTION (CBP Form 5106 QR Code can be scanned to link this form to your smartphone or mobile operating device.) Notification of Identification Number - Check this box if this is your first request for services with CBP, or if your current Importer Number Is inactive and you wish to activate this number. Change Name - Check this box if the Importer Number is on file but there is a change in the name. Change of Address - Check this box if the Importer Number is on file but there is a change in the address. BLOCK 7 - NAME AND IDENTIFICATION NUMBER 1A - Importer/Business/Private Name - Please indicate the name of the company or individual who will be importing or seeking service or payment. If you are submitting this document as a consignee to the import transaction, sections 1 and 2 must be filled out completely. 1 B - IRSISSN - Complete this black if you are assigned an Internal Revenue Service (IRS) employer Identification number or Social Security Number (SSN). If neither an IRS employer identification number nor a Social Security Number (SSN) has been assigned, the word 'NONE' shall be written in 1 B. The SSN should belong to the principal or owner of the company. 1C - DIV/AKAIDBA - Complete this block if an importer is a division of another company (DIV), Is also known under another name (AKA), or conducts business under another name (DBA). 1D - Complete this block only if Block 1 C is used. 1E - Request CBP-Assigned Number - Complete this block if you have neither an IRS employer identification number nor a SSN and you require a CBP-assigned number, or, you choose to use a CBP-assigned number in lieu of your SSN. If you have an IRS employer identification number at the time you submit this form that number will automatically become your Importer identification number and no CBP-assigned number will be issued. PLEASE NOTE: A CBP-assigned number is for CBP use only and does not replace listing a SSN or IRS employer identification number on this form. If you have elected to request a CBP Assigned Number in lieu of your SSN, you must provide your SSN in section 3J of this form. In general, a CBP- assigned number will be issued to foreign businesses or individuals, provided no IRS employer identification number or SSN exists for the requester. A requester can choose to keep using the CBP-assigned number even if the individual subsequently acquires a SSN. If block 1 E is completed, CBP will issue an assigned number and inform the requester. This identification number will be used for all future CBP transactions when an identification number is required. If an IRS employer identification number, a Social Security Number, or both, are obtained after an Identification number has been assigned by CBP, a new CBP Form 5106 form shalt not be filed unless requested by CBP. 1 F - CBP-Assigned Number - Complete this block if you have already been assigned a CBP-Assigned Number, and there is a requested change in Block `Type of Action". 1G - Type of Company- Please select the description that accurately describes your company. A Limited Liability Company (LLC) is not a corporation; it is a legal form of company that provides limited liability to its owners. 1 H - Provide an estimate of the number of entries that will be imported into the U.S. in one year, if you are an importer of record. 11- Check the boxes which will indicate how the name and identification number will be utilized. If the role of the party is not listed, you can select "Other" and then list the specific role for the party. (ex., Transportation carrier, Licensed Customs Brokerage Firm. Container Freight Station, Commercial Warehouse/Foreign Trade Zone Operator, Container Examination Station or Deliver to Party). 11.1 thru 1M - If you are currently an active participant in a CBP Partnership Program(s), please provide the program code in Block 1 J thru Block 1 M of the revised CBP Form 5106 and the information that is contained In Section 3 of the revised CBP Form will not be required. (ex., Customs Trade Partnership Against Terrorism - CTPAT, Importer Self -Assessment - ISA) BLOCK 2 - ADDRESS INF 1IRMATION 2A - MAILING ADDRESS (Mailing Address for the named business entity or Individual referenced In section 1) Street Address 1 - This block must always be completed. It may or may not be the physical location. Insert a post office box number or a street number representing the first line of the mailing address. For a U.S. or Canadian mailing address, additional mailing address information may be inserted. If a P.O. Box number is given for the mailing address, a second address (physical location) must be provided in 2B. CBP Form 5106 (6117) Page 3 of 4 Street Address 2 - If applicable, this block must always be completed with the apartment, suite, floor, and/or room number. City - Insert the city name of the importer's mailing address. State/Province - For a U.S. mailing address, insert a valid 2 -position alphabetic U.S, state postal code. For a Canadian mailing address, insert a 2 -character alphabetic code representing the province of the importer's mailing address. Zip Code - For a U.S. mailing address, insert a 5 or 9 -digit numeric ZIP code as established by the U.S. Postal Service. For a Canadian mailing address, insert a Canadian postal routing code. For a Mexican mailing address, leave blank. For all other foreign mailing addresses, a postal routing code may be inserted. Country ISO Code - For a U.S. mailing address, leave blank. For any foreign mailing address, including Canada and Mexico, insert a 2 -character alphabetic International Standards Organization (ISO) Code representing the country. Type of Address - Check the box that describes this address. 29 - PHYSICAL LOCATION ADDRESS - (Please provide the address that is associated with the business or the individual. This address cannot be a P.O. Box, Business Service Center, etc. The address associated with the business can be the principal's home address.) Street Address 1- If the place of business is the same as the mailing address, leave blank. If different from the mailing address, insert the company s business address in this space. A second address representing the company's place of business is to be provided if the mailing address is a post office box or drawer. Street Address 2 - If applicable, this block must always be completed with the apartment, suite, floor, and/or room number. City - Insert the city name for the business address. State/Province - For a U.S. address, insert a 2 -character alphabetic U.S. state postal code. For a Canadian address, insert a 2 - character alphabetic code representing the province of the importer's business address. Zip Code - For a U.S. business address, insert a 5 or 9 -digit numeric ZIP code as established by the U.S. Postal Service. For a Canadian address, insert a Canadian postal routing code. For a Mexican address, leave blank. For all other foreign addresses, a postal routing code may be inserted. Country ISO Code - For a U.S. address, leave blank. For any foreign address, including Canada and Mexico, insert a 2 -character alphabetic ISO code representing the country. Type of Address - Check the box which describes this address. 2C - Phone Number - The phone number and extension 2D - Fax Number - The fax number. 2E - E-mail Address - The e-mail. 2F - Website - The website. BLOCK 3 - COMPANY INFORMATION Company information is the named business entity referenced in section 1 is required. Providing the Personally Identifiable Information in section 3J (i.e. Social Security Number and Passport information) is optional unless in Block 1 E, the filer has checked: "I have a SSN, but wish to use a CBP-Assigned Number on all my entry documents." In this instance a SSN must be provided in 3J, as appropriate.The absence of this information will affect CBP's ability to fully understand the level of risk on subsequent transactions and could result In the delay of cargo release or the processing of a refund. 3A - Provide a brief description of your business. 3B - Complete this field if you know the North American Industry Classification System (NAILS) code as defined by the Department of Commerce. Provide your 6 -digit NAICS code. 3C - If available, provide the Dun & Bradstreet Number for the name that was presented in section 1. 3D - If you are an importer who is a self -filer and are using your own filer code, or a broker who also has maintained an identification number, provide the filer code that you will be using to conduct business with CBP. 3E - Indicate the year in which your company was established. 3F - Related Businesses Information - List the name and IRS employer Identification number, Social Security Number or CBP assigned number for each related business and Indicate if it is a current or previous related business. 3G - Indicate the primary banking information for the company that is listed in section 1. 3H - Certificate or Articles of Incorporation - Provide the 2 -digit State or insert a 2 -character alphabetic ISO Code representing the country in which the articles of incorporation for the business were filed. (as applicable) 31- Certificate or Articles of Incorporation - Provide the file, reference, entity, issuance or unique identifying number for the certificate or articles of incorporation or the foreign articles of incorporation. (as applicable) 3J - Business Structure/Beneficial Owner/Company Officer - The names of each Beneficial Owner/Company Officer of the Corporation or the LLC that is listed in this section are required fields. The Beneficial Owner is any individual or group of individuals that, either directly or indirectly, has the power to vote or influence the transaction decisions regarding a specific security or one who has the benefits of ownership of a Security (finance) or property and yet does not nominally own the asset itself. Beneficial Owner/ Company Officers who have importing and financial business knowledge of the company listed in section 1 and the legal authority to make decisions on behalf of the company listed in section 1 with respect to that knowledge. Please note, however, that the Social Security Number or the Passport Number/Country of Issuance ISO Cade/Passport Expiration Date/Passport Type, in the absence of a SSN, are optional in this section. CBP Form 5106 (6117) Page 4 of 4 U.S. Customs and Border Protection Office of information & Technology Cost Sign -Off Document* (*Actual costs will be derived from actual obligations) This is a Rough Order of Magnitude Estimate. Final Costs will be determined once the network designs are completed Site: GYPODSA - Eagle County Airport Gypsum Date Prepared: 3/5/2019 Preparer: jonathan.d.shifflett@cbp.dhs.gov Data Equipment CostsOCG31 Line Item Description Qty Unit Cost Total 10 APC AP7831 SmartRack PDU, Metered, Zero U, 15A, 100/12OV, (16) 5-15 (BRAND NAME or EQUIVALENT) 1 $500.00 $500.00 20 8 Port KVM System 1 $1,500.00 $1,500.00 30 Dell NetShelter SX42V (BRAND NAME or EQUIVALENT) 1 $3,000.00 $3,000.00 40 APC Smart -UPS XL2200 VA RM (BRAND NAME or EQUIVALENT) 1 $1,100.00 $1,100.00 50 Cables To Go 5' Cats 550MHz Blue Patch Cable; 25 Pack (BRAND NAME or EQUIVALENT) 1 $175.00 $175.00 60 Self Gripping Strap Back -to -Back Polypropylene Hook Nylon Loop Shape Cut to Length Roll Length 25 yd. 1 $30.00 $30.00 70 Cables To Go 7' Cat6 550MHz Blue Patch Cable; 25 Pack (BRAND NAME or EQUIVALENT) 1 $200.00 $200.00 80 2U (3.Sinch) Cable management panel with 5 D -rings (BRAND NAME or EQUIVALENT) 1 $35.00 $35.00 90 Wireless Keyboard & Mouse Combo MK520 2 $75.00 $150.00 100 ViewSonic VG2428WM-LED 24" Monitor w/Sound (BRAND NAME or EQUIVALENT) 2 $350.00 $700.00 110 APC P7V 7 -Outlet 840 Joule Surge Suppressor (BRAND NAME or EQUIVALENT) 3 $30.00 $90.00 120 Mouse Pad 2 $10.00 $20.00 130 Dell 3420 Tower - Slim (SOOGS SSD) (BRAND NAME or EQUIVALENT) 3 $1,450.00 $4,350.00 140 Cisco 4000 Series 16 -Port Ruggedized Switch (BRAND NAME or EQUIVALENT) 1 $5,500.00 $5,500.00 150 Riverbed 5teelhead Appliance CX570L (BRAND NAME or EQUIVALENT) 275 conn / 10 Mbps; No Fiber, VM or Steel Fusion 1 $13,500.00 $13,500.00 160 103 Cost Contingency for Equipment 1 $3,085.00 $3,085.00 Total Equipment Cost: $33,935.00 Voice Equipment Costs (OCC -31): 170 There are no voice costs associated with this request. $0.00 Total Voice Cost: $0.00 BSDP Video Equipment Costs (OCC -31): 180 "There are no BSDP video equipment costs associated with this request_" $D.00 Total BSDP Video Equipment Costs: $0.00 1 BSDP Video Services Costs (OCC -25): i, 190 I "There are no BSDP service costs associated with this request." I I I $0.00 I Total BSDP Video Service Costs: $0.00 Total BSDP Equipment and Services Costs: $0.00 Tactical Communication (TACCOM) Equipment Costs (OCC -31): 200 There are no TacCom equipment costs associated with this request. $0.00 Tactical Communication Equipment: $0.00 TACCOM Services Costs (OCC -25): 210 1 There are noTacCom service costs associated with this request. Total Tactical Communication Services Costs: $0.00 Total TACCOM Equipment and Installation Costs: $0.00 Circuit Costs (OCC -23): 220 Verizon 10M circuit Annual Recurring Costs 1 $12,648.00 $12,648.00 230 Verizon 10M Circuit installation Costs 1 $9,500.00 $9,500.00 240 Verizon Special Construction 1 $7,500.00 $7,500.00 Total Annual Circuit Costs: $29,648.00 Travel/Installation Costs (OCC -21): 250 Travel for Data Engineer 1 $2,500.00 $2,500.00 i Total Travel Costs: $2,500.00 TOTAL ESTIMATED INITIAL EQUIPMENT AND SERVICE COSTS $66,083.00 Out Year Recurring Service Costs: 260 Verizon lom Circuit Annual Recurring Costs 1 $15,000.00 $15,000.00 Total Estimated Annual Service Costs $15,000.00 NOTE: The OIT Cost Sign -Off Document and the associated estimated costs listed above expire 90 days from the above Date Prepared or at the end of the Government's current fiscal year, whichever comes first. After such time, a new OIT Cost Sign - Off Document is required. Acceptance By signing below, I accept any and all costs associated with the purchase and installation of equipment. Authority Signature: Date: - j q_ tet4 017 Reference #: GYPOOSA-OFO-19548C Document Expiration Date: 6/3/2019