Current State Assessment
Background Information
Provide your organization’sinformation in the space provided.
Organization NameOrganization 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 / UtilitiesFire / 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 / NotesBasic 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 ProviderCurrent 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 UsersCurrent Equipment
Complete the table below with relevant equipment used today on wireless broadband:
Equipment Type / Description of Use / Number of UsersFuture State Planning Tool
Background Information
Provide your organization’sinformation in the space provided.
Organization NameOrganization 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 / UtilitiesFire / 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 DateAvailable 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 / NotesBasic 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 DocumentNew Software / Applications
Complete the table below with anticipated new software to be used on FirstNet:
Software Application Name / Description of User / Number of UsersNew Equipment
Complete the table below with anticipated new software to be used on FirstNet:
Equipment Type / Description of Use / Number of UsersPage 1 of 4