Connectivity Reimbursement Form New Paths ICT Services (Information and Communication Technologies)
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1 General information Activity Report for Payment Request () CHECK ONE ONLY Period ending October 31, 2014 ( ) DEADLINE Period ending March 31, 2015 ( ) DEADLINE Name of the community: Person Responsible for Internet Connectivity: Technician Name (if applicable): Mailing address: Name of the Internet supplier: Telephone: Fax: What is the cost of your monthly access fees? Results SECTION 1 Videoconferencing Connectivity School Name 1
2 D. Total number of computers E. Number of hours (daily) which Internet service is accessible F. Are community members permitted access to use computer facilities at this site after normal G. Describe the results that are being achieved in providing Internet access at this location. H. Videoconferencing Sessions Report on your videoconferencing SECTION 2 Videoconferencing Connectivity School Name 2
3 D. Total number of computers SECTION 3 Videoconferencing Connectivity Other Location 3
4 D. Total number of computers SECTION 4 Videoconferencing Connectivity Other Location 4
5 D. Total number of computers SECTION 5 Videoconferencing Connectivity Other Location 5
6 D. Total number of computers Claim Summary Calculate the total amount being requested for reimbursement for all site locations. (Include this amount in the Invoice for Payment Request (CI ) that you will address to the FNEC.) You must send all corresponding (photocopies) of invoices. NO EXTENSIONS WILL BE ALLOWED PAST THE DEADLINE DATES THANK YOU, Signature Date 6
7 Internet Connectivity Initiative IC Community: Invoice for Payment Request (IC ) Billed to: First Nations Education Council 95, rue de l Ours Wendake, Quebec G0A 4V0 Telephone: (418) Fax: (418) Connectivity Description Cost Total Total Please send a photocopy of all corresponding invoices from your Internet Supplier with your claim. Signature Date Reserved for FNEC s Administration Authorised by Date 2015 Cheque #
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