Letter of Agency (LOA)

E-Rate Letter of Agency for Funding Years 2012-2017

Completing this Letter of Agency secures your district or library’s eligibility to purchase from NJPA contracts.  It does not obligate your district or library to undertake such purchases.  Additionally, completing this LOA does not prevent your district from filing additional E-Rate Form 470’s.

This Letter of Agency is executed by the district/library set forth below to confirm participation in the National Joint Powers Alliance’s E-rate Purchasing Consortium. By entering into this LOA, the district/library authorizes NJPA to file an E-rate Form 470 on its behalf. The Form 470 will include E-rate eligible services and equipment in all categories of service, to include telecommunications services, internet access, internal connections and basic maintenance.

 
Submission: This form can be submitted and signed electronically. You may also print the form (click here) and return the completed and signed copy to: National Joint Powers Alliance, 202 12th Street NE, P.O. Box 219, Staples, MN 56479 Phone: 218-894-1930; 888-894-1930 / Fax: 218-894-3045.
 
 
 
By submitting this Letter of Agency, I certify that I am authorized to sign on behalf of the district/library and that NJPA is authorized to file the Form 470 application for E-rate eligible services.
* Name of Entity
 
Billed Entity Number (if known)
 
* Entity Address
 
* Entity City
 
* Entity State
 
* Entity Zip Code
 
* Contact First Name
 
* Contact Last Name
 
* Contact Title
 
* Contact Telephone Number
 
* Contact Email Address
 
* Required Fields