Current State Assessment

Background Information

Provide your organization’sinformation in the space provided.

Organization Name
Organization Address
Organization Mission
County
Contact Name
Contact Email
Contact Phone Number

Organization Type

Place and ‘X’ to the left of your agency type. Please choose only one.

Law Enforcement / Utilities
Fire / Transportation
Emergency Medical / Hospital
Emergency Management / Health Dept.
Communications / Other (Describe):

Current Device Inventory

Enter applicable information for devices the organization currently provides to employees.

Device Type / Number of Devices / Provider / Notes
Basic phones
Smartphones
Number of Tablets
Number of Aircards/ MiFi’s
Number of Vehicle Routers
Other Devices (Please Name):
Other Devices (Please Name):
Other Devices (Please Name):

Current Service Provide

Complete the following information about your current broadband service provider. If multiple, service providers, please copy and paste the table below.

Current Broadband Provider
Current Plan Cost
Contract Term
Contract Renewal Date (if applicable)
Other Agencies/Departments on Plan
Amount of Data
Number of Minutes
Number of Text Messages
Other Features

Current Software / Applications

Complete the table below with relevant software used today on wireless broadband:

Software Application Name / Description of User / Number of Users

Current Equipment

Complete the table below with relevant equipment used today on wireless broadband:

Equipment Type / Description of Use / Number of Users

Future State Planning Tool

Background Information

Provide your organization’sinformation in the space provided.

Organization Name
Organization Address
Organization Mission
County
Contact Name
Contact Email
Contact Phone Number

Organization Type

Place and ‘X’ to the left of your agency type. Please choose only one.

Law Enforcement / Utilities
Fire / Transportation
Emergency Medical / Hospital
Emergency Management / Health Dept.
Communications / Other (Describe):

FirstNet Transition

Describe your target timing and budget for transition to FirstNet.

Target Implementation Date
Available Budget
Planned Scope (e.g., all devices, etc.)

Desired FirstNet Devices

Enter the total number of expected devices after FirstNet implementation.

Device Type / Number of Devices / Notes
Basic phones
Smartphones
Number of Tablets
Number of Aircards/ MiFi’s
Number of Vehicle Routers
Other Devices (Please Name):
Other Devices (Please Name):
Other Devices (Please Name):

Governance, Policies & Procedures

List the governance documents, policies and/or procedures that may require updating during the transition to FirstNet.

Name of Document / Purpose of Document

New Software / Applications

Complete the table below with anticipated new software to be used on FirstNet:

Software Application Name / Description of User / Number of Users

New Equipment

Complete the table below with anticipated new software to be used on FirstNet:

Equipment Type / Description of Use / Number of Users

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