SSM Health Consortium — Rural Health Care posted service request (HCF)

General Information HCP or Consortium: 35070 - SSM Health Consortium Application Number: RHC46100021889 FCC Registration Number: 0019501519 Address: 430 E DIVISION ST , FOND DU LAC, WI 54935 Application Nickname: FY2026 Funding Year: 2026 Funding Priority: Priority 8 Consortium Participating Sites HCP Number Name LOA Expiry 18426 Agnesian HealthCare - Waupun Clinic 18432 Agnesian HealthCare - Brandon Clinic 18434 Agnesian HealthCare - Beaver Dam Dialysis 18427 Agnesian HealthCare - Markesan Clinic 18438 Agnesian HealthCare - Mayville Clinic 18440 Agnesian HealthCare - Ripon Clinic 18431 Agnesian HealthCare - Campbellsport Clinic 18430 Agnesian HealthCare - Mount Calvary Clinic 18429 Agnesian HealthCare - Fox Lake Clinic 18433 Agnesian HealthCare - Brownsville Clinic 13003 Agnesian Healthcare dba Ripon Medical Center 45857 St. Agnes Hospital 45852 Work & Wellness Waupun 45918 Agnesian Pharmacy Waupun 45853 Waupun Memorial Hospital 45850 Work & Wellness Ripon 45866 Doll & Associates 45851 Waupun Dialysis 38397 Agnesian HealthCare - Fond du Lac Dialysis 54803 Villa Loretto 54805 FDLRC and IT Offices 15463 The Monroe Clinic - Durand 17943 The Monroe Clinic - FastCare 71415 SSM Health St. Clare Meadows Care Center 11183 The Monroe Clinic 96110 SSM Health - Centralia Express Clinic 13161 The Monroe Clinic - Freeport 13158 The Monroe Clinic - Blanchardville 96109 SSM Health - Centralia Primary Care 96107 SSM Health - Nashville Primary Care 98455 SSM Health - Medical Office Building 80761 SSM Health Good Samaritan Hospital - Mt. Vernon 96125 SSM Health - Admin Office ( A ) Page1 96124 SSM Health Medical Group - Surgery Center 96123 SSM Health Medical Group - Cancer Center 96122 SSM Health Medical Group - Infectious Disease 96121 SSM Health - Wayne City Primary Care 96120 SSM Health - Salem Primary Care 96119 SSM Health - Oza Cancer Center 96111 SSM Health - Angela Center 96117 SSM Health - Mt. Vernon Wound Care 96118 SSM Health - Metabolic Center 80775 SSM Health St. Mary's Hospital - Centralia 13160 The Monroe Clinic - New Glarus 96113 SSM Health - Mt. Vernon Primary Care 80796 SSM Health St. Anthony Hospital - Shawnee 96112 SSM Health - Benton Primary Care 80789 SSM Health St. Anthony Hospital - Oklahoma City 119302 SSM Monroe Clinic - Monroe (106 8th Street) 54802 Waupun Christian Home 54804 St. Francis Home Health 13159 The Monroe Clinic - Brodhead 13157 The Monroe Clinic - Albany 50794 Monroe Clinic 13162 The Monroe Clinic - Lena 66208 Agnesian Bone & Joint Health 96114 SSM Health - Mt. Vernon Express Clinic 119303 SSM Monroe Clinic - Monroe (100 8th Street) Requested Services Type of Services Description for Other Min Download Speed Max Download Speed Min Upload Speed Max Upload Speed Speed Unit Allow Bids for Similar Services Data 1 2000 1 2000 Mbps Yes Equipment Installation Network Management S ervices Dates and Timing What is the HCP's desired service contract length?: Up to 5 Year(s) Will the HCP consider bids with contract extension language?: Yes Will the HCP consider bids for month-to-month contracts?: Yes, This is preferred What is the HCP's desired time to publicly post this request for services?: 28 Day(s) What is the HCP's expected bid evaluation period after the public posting?: 5 Day(s) Page2 Bid Evaluation Select the criteria that will be used to evaluate the bids collected. Criteria Description Evaluation Weight (%) Minimum Requirement Price 35 Other Prior Experience, including past per formance 35 If a service provider does not have a similar current or similar former ser vice (within 3 years) with HCP, the s ervice provider must provide 3 refer ences from a healthcare facility in th e same state for like services. Leverage existing resources 25 Utilize existing facilities to minimize disturbance. Other Quality / Clarity / Compliance of RF P Response 5 Adhere to all RFP requirements. Does the HCP have any disqualifying factors that will remove bids or bidders from consideration?: Yes Disqualifying factors: To be considered, please ensure all bids are received before the ACSD and include the specific HCP name, HCP number, funding year, SPIN/498 ID, and posted form number the bid is in response to. HCP may choose not to work with agents, resellers or wholesalers who do not own their own network. Inquiries concerning the bidding process must be made only to the mailing contact listed on the 461. Main Contact Name Organization Title Phone Email Address Timothy Basile SSM Health ConsortiumProject Man ager (973) 581-5238 timothy.basile@s olixinc.com 10 Lanidex Plaza west , Parsi ppany, NJ 07054 RFP and Summary Is the HCP likely to request more than $100 000 in program support from this request for services?: Yes Do state, Tribal, or local procurement rules require the HCP to include an RFP with this request for services application?: No Will the HCP be including an RFP with this application?: Yes RFP Draft FY26.pdf 2531603-RFP Draft FY26.pdf Summary of the HCP's requested services. : Page3 Broadband service(s) to be used for internet connectivity and/or voice/data transmission (Leased/Tariffed Facilities or Services, Network Equipment and Installation) for medical purposes. Page4 Additional Documentation Document Type Description for Other Document Uploaded On Network Plan Agnesian HealthCare Consortium N etwork Plan - HCP 35070.pdf 2/6/2026 12:24 PM EST Declaration of Assistance Name Organization Type Title Employer Nature of Relationship Email Telephone Timothy Basile Consultant Project Man ager Solix, Inc. Consultant timothy.basile@s olixinc.com (973) 581-5238 Page5 Certifications ✓ I certify under penalty of perjury that I am authorized to submit this request on behalf of the healthcare provider or c onsortium. ✓ I certify under penalty of perjury that I have examined this request and all attachments, and to the best of my knowle dge, information, and belief, all statements contained herein and in any attachments are true. ✓ I certify under penalty of perjury that the applicant seeking supported services has complied with any applicable stat e, Tribal, or local procurement rules. ✓ I certify under penalty of perjury that all requested RHC Program support will be used solely for purposes reasonabl y related to the provision of health care service or instruction that the health care provider is legally authorized to pr ovide under the law of the state in which the services are provided. ✓ I certify under penalty of perjury that the applicant seeking supported services satisfies all of the requirements under section 254 of the Communications Act, 47 U.S.C. § 254, and applicable Commission rules. ✓ I certify under penalty of perjury that the applicant seeking support has reviewed and is compliant with all applicable RHC Program requirements. ✓ I understand that all documentation associated with this request, including a copy of the signed Request for Service s (FCC Form 461), any bids/contracts resulting from the FCC Form 461 posting, scoring sheet, and other informatio n that was used in the decision making process, must be retained for a period of at least five years pursuant to 47 C FR § 54.631, or as otherwise prescribed by the Commission's rules. ✓ I certify under penalty of perjury that the applicant seeking supported services is a nonprofit or public entity that falls within one of the seven categories set forth in the definition of health care provider listed in 47 CFR §54.600 of the Commission's rules. ✓ I certify under penalty of perjury that the applicant seeking supported services is physically located in a rural area a s defined in section 47 CFR § 54.600 of the Commission's rules, or is a member of a consortium which satisfies the majority-rural composition requirements set forth in 47 CFR § 54.607 of the Commission's rules. ✓ I certify under penalty of perjury that the services will not be sold, resold, or transferred in consideration for money o r any other thing of value. Signature Name: Timothy Basile Email: timothy.basile@solixinc.com Phone: (973) 581-5238 Employer: Solix, Inc. Title: Project Manager Employer’s FCC RN: 0023913585 Certifier’s Full Name: Timothy Basile Digital Signature: Timothy Basile Date and time: 2/6/2026 12:25 PM EST Page6