[Attachment F] SMC Order Form
Tennessee Educational Broadband Consortium
Multiple Award Schedule
State Master Contract Order Form
This agreement ("Agreement") is entered into between Hickman County School District ("Customer")
and Central Technologies ("Service Provider"), for E-Rate Category 2 purchases. For good and valuable
consideration, including the mutual promises contained herein, Customer orders from the Service
Provider the services identified below and/or in Attachment A to this Agreement ("Service"). Customer
and Service Provider agree that the Service shall be provided pursuant to the rates, charges, terms and
conditions set forth in 33104-00420 Central Technologies.
Service Ordered by Customer:
IDENTIFY REQUESTED SERVICE(S) HEREIN AND/OR IN ATTACHMENT A
The selected Service period is Internal Connections (July 1, 2026 - June 30, 2031). Unless otherwise
agreed upon in writing, the Service period shall commence upon service installation.
Requested Service Commencement Date(s): July 1, 2026
If this Agreement is cancelled or terminated prior to Service Installation, cancellation charges will apply
as set forth in the Master Contract (if applicable).
Customer may seek Universal Service Fund funding pursuant to the rules and regulations associated
with the E-Rate program.
Customer further warrants and represents that Customer is authorized to enter into this Agreement and
to order Service pursuant to the Master Contract. There are no other terms and conditions allowed
pursuant to this agreement other than those present in the underlying State Master Contract. Customer
further warrants and represents that this Agreement complies with all applicable procurement laws
and/or requirements.
This Agreement is effective when executed by Customer. Submission of a quote at the request of the
Customer constitutes the Service Provider's intent to proceed upon acceptance of the Customer. This
Agreement is subject to and controlled by the provisions of the State Master Contract, including any
amendments as may be made from time to time.
Customer Name:
Accepted by [VENDOR NAME]:
Print Name: Belinda Anderson
Print Name:
By: Belhda
By:
Title: Interim Director of Schools
Title:
Date:
MAR 2 4 2026
Date:
Updated: 12/15/2025
This is not a contract. The SMC Order Form is to memoriative that 8 mini-bid was conducted to solect a service provider from the
multiple award State Master Contracts - Tennessee Education Broadband Consortium (TEBC) for specific products/services. No
additional terms and conditions CHN be added to this document, por the BC Master Contracts,
[Attachment F] SMC Order Form
ATTACHMENT A
Quantity
Name of Product or Service
Hickman County School District
E-Rote Funding Year 2026
[Attachment A] TEBC Minl-Bld Service/Equipment List
Company Name:
Centre
impacy SPIN (49810)
131
BIDDER INFORMATION: in
Contect Name:
completed by vendor)
Contect E-mail:
Contact Phone:
047.425.2265
To Be Completed by Applicant
To Be Completed by Vendor
Estended
Preferred
E-Rate
Scheel/Building Name
TEBC Product
Estimated
ELIGIBLE cost
Model Number
Manufacturer Name (or
Price/Unit
Extended Price:svantity THE
Description
supble
-
(optional)
Category
(SKU)
Quantity
price:
Equivalent)
of SKU
DE
Dirtrict
Satware
Aruba
IIPC Areibe Newarking Central AP Foundation5 YEMT Subscription ESTU
CREDIT
249
$180
$58.310
100%
$69 310
Seltware
IIPE Arube Networking Central Switch Class 2F condation 5 year
Arba
22
$550
$12,320
100%
$12,320
Direct
4 Subscription STC
$78,630
$
78,630
Compatibility/Interoperablity Requirements
If vendors nre Inding on "enuivalnet" product line that is different than what is listed in Column C, the products n'ist be enuivalent If GI ntity and
func Fonatity and must by fully interoperable are competible with the applicant's existin Requipment/systems which are as follows
Applicant Ust below what sing equipment/so/twara/sy terms any propos ed equivalent utomen mus be fully compatible with
Term of Service: April 1, 2028 September 30,2027 extended to match Date and
Windwe are my persibled - - him for amount ther ore included than exeginal cotaings in corponse 10 RFO #33101 20000FASS)
"By submitting GLOUB in response TO the Customer's request, and if selected the Service Provider 917898 to stude the Terms and Conditions of the
referenced SMC and proceed with the project accordingly, subject to coordination with the Customer
'Order may be concelled Rate and/or through approval is 500 assured
B&
MAR 2 4 2026
Updated: 12/15/2025
This is not a contract. The SMC Order Form is to memorialize that 8 mini-bid was conducted to select & service provider from the
multiple award State Master Contracts - Tennessee Education Broadband Consortium (TEBC) for specific products/services. No
additional terms and conditions Can be added to this document, per the II BC Master Contracts.

## Table 1

|  | Customer Name: | Accepted by [VENDOR NAME]: |
| --- | --- | --- |
| Print | Name: Belinda Anderson | Print Name: |
| By: | Belhda | By: |
| Title: | Interim Director of Schools | Title: |
| Date: | MAR 2 4 2026 | Date: |

## Table 2

|  | Company Name: | Centre |
| --- | --- | --- |
|  | impacy SPIN (49810) | 131 |
| BIDDER INFORMATION: in completed by vendor) | Contect Name: |  |
|  | Contect E-mail: |  |
|  | Contact Phone: | 047.425.2265 |

## Table 3

|  |  | To | Be Completed by Applicant |  |  |  | To Be Completed by | Vendor |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| Scheel/Building Name (optional) | TEBC Product Category | Preferred Manufacturer Name (or Equivalent) | Description | Model Number (SKU) | Estimated Quantity | Price/Unit | Extended Price:svantity THE price: | E-Rate supble of SKU | Estended ELIGIBLE cost - DE |
| Dirtrict | Satware | Aruba | IIPC Areibe Newarking Central AP Foundation5 YEMT Subscription ESTU | CREDIT | 249 | $180 | $58.310 | 100% | $69 310 |
| Direct | Seltware | Arba | IIPE Arube Networking Central Switch Class 2F condation 5 year 4 Subscription STC |  | 22 | $550 | $12,320 | 100% | $12,320 |
|  |  |  |  |  |  |  |  |  |  |
|  |  |  |  |  |  |  | $78,630 |  | $ 78,630 |