| Applicant | Address | Phone | Applicant Type | |
|---|---|---|---|---|
|
George S Flinn , Jr . Doing Business As: GEORGE S. FLINN, JR. |
George S. Flinn, Jr. 6080 MT. MORIAH EXT. MEMPHIS, TN 38115 United States |
+1 (901) 375-9324 | AIRWAVESJD@AOL.COM | Individual |
| Applicant | Address | Phone | |
|---|---|---|---|
|
[Confidential] |
|
|
|
| Applicant | Address | Phone | |
|---|---|---|---|
|
Stephen C Simpson Attorney at Law |
1250 Connecticut Avenue, NW Suite 200 Washington, DC 20036 United States |
+1 (202) 200-1344 | airwavesjd@aol.com |
| Question | Response |
|---|---|
| Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. | No |
| Briefly describe transition plan | Change from channel 48 to 29. Installation of replacement transmitter and new main antenna. Interim antenna, transmitter, and transmission line to maintain operational continuity. Replacement of tower necessary based on structural analysis. |
| Section | Question | Response |
|---|---|---|
| Transmitter Related Expenses | Do you have transmitter related expenses? | Yes |
| Section | Question | Response |
|---|---|---|
| Existing Transmitter Description | Type of change | Retune Existing |
| Use | Primary (Main) | |
| Ownership | Owned | |
| Owner | N/A | |
| Is this transmitter currently shared with another station? | No | |
| Is this transmitter currently in operating condition? | Yes | |
| Existing Transmitter Manufacturer and Type | Manufacturer | Comark |
| Model | DCX-2P | |
| Year | 2005 | |
| Type | Inductive Output Tube | |
| IOT Power Type | Two | |
| Power capacity | 60 kW |
| Section | Question | Response |
|---|---|---|
| New IOT Tubes | Number of Tubes (including accessories) needed | 2 |
| New Mask Filter | ||
| Power | 60 kW | |
| Other Power | N/A | |
| New Exciter | Is a new exciter needed? | Yes |
| Exciter Type | Dual exciter with changeover |
| Section | Question | Response |
|---|---|---|
| Electrical Service | Service Entrance (3 phases 800A 208V) | No |
| Switchgear (industrial 800 amp) | No | |
| Transformer (480V) | No | |
| Power | N/A | |
| Rigid Conduit and Wiring | No | |
| Size | N/A | |
| Length | N/A | |
| Other Electrical Service | No | |
| Description | N/A | |
| HVAC Service | Does the replacement transmitter require HVAC Service? | No |
| Type | N/A | |
| Size | N/A | |
| Other Size | N/A | |
| Transmitter Building Addition/Modification or Leasehold Improvement | Does the Transmitter Building require an addition, modification, other leashold improvement? | No |
| Size | N/A | |
| Channel 14 Costs | Is an RF Consulting Engineer needed? | N/A |
| Is a channel 14 Mask Filer needed? | N/A | |
| Is additional field engineering time needed? | N/A | |
| Number of Days | N/A |
| Section | Question | Response |
|---|---|---|
| New Transmitter | Use | Interim |
| Description of Use | N/A | |
| Change Type | Purchase | |
| Manufacturer | ||
| Model | THU9-4EVO | |
| Transmitter Type | Solid State | |
| Solid State Cooling | Liquid Cooled | |
| Solid State Power capacity | 6.5 kW | |
| Justification for New Transmitter | Interim transmitter necessary during the period when existing main transmitter is re-tuned for new channel. Replacement tower required due to structural analysis. Interim transmitter will be used on new antenna on replacement tower. |
| Section | Question | Response |
|---|---|---|
| Electrical Service | Service Entrance (3 phases 800A 208V) | No |
| Switchgear (industrial 800 amp) | Yes | |
| Transformer (480V) | Yes | |
| Power | 150 kVA | |
| Rigid Conduit and Wiring | Yes | |
| Size | 3 inches | |
| Length | 100.0 feet | |
| Other Electrical Service | No | |
| Description | N/A | |
| HVAC Service | Does the replacement transmitter require HVAC Service? | No |
| Type | N/A | |
| Size | N/A | |
| Other Size | N/A | |
| Transmitter Building Addition/Modification or Leasehold Improvement | Does the Transmitter Building require an addition, modification, other leashold improvement? | No |
| Size | N/A | |
| Channel 14 Costs | Is an RF Consulting Engineer needed? | N/A |
| Is a channel 14 Mask Filer needed? | N/A | |
| Is additional field engineering time needed? | N/A | |
| Number of Days | N/A | |
| Inside RF System | Is an additional interior RF system required to support this interim transmitter? | No |
| Section | Question | Response |
|---|---|---|
| Antenna Related Expenses | Do you have antenna related expenses? | Yes |
| Section | Question | Response |
|---|---|---|
| Existing Antenna Description | Type of change | Purchase New |
| Antenna Use | Primary (Main) | |
| Description of Use | N/A | |
| Ownership | Owned | |
| Owner | N/A | |
| Site | N/A | |
| Is the existing antenna shared with another station or stations? | No | |
| Is the existing antenna directional? | Yes | |
| Is antenna in operating condition? | Yes | |
| Is antenna located on or in close proximity to an antenna farm? | No | |
| Existing Antenna Manufacturer and Type | Class | Full Power |
| Mounting | Side Mount | |
| Antenna position in stack | Not in Stack | |
| Polarization | Horizontal | |
| Type | Slotted Coaxial | |
| Number of Stations Supported | N/A | |
| Number of Panels | N/A | |
| Design power capacity in use | N/A | |
| Lower Limit | N/A | |
| Upper Limit | N/A | |
| Other Antenna Type | N/A | |
| ERP: | 1000.0 kW | |
| Manufacturer | ||
| Model | TFU-28DSC-S200 | |
| Year | 2005 |
| Section | Question | Response |
|---|---|---|
| New Antenna Description | Use | Primary (Main) |
| Description of Use | N/A | |
| Change Type | Purchase New | |
| Is this a request for upgraded equipment? | No | |
| Ownership | Owned | |
| Owner | N/A | |
| Is antenna shared? | No | |
| Is antenna directional? | Yes | |
| Will antenna be located on or in close proximity to an antenna farm? | No | |
| New Antenna Manufacturer and Types | Class | Full Power |
| Mounting | Side Mount | |
| Antenna position in stack | Not in Stack | |
| Polarization | Horizontal | |
| Type | Slotted Coaxial | |
| Number of Stations Supported | N/A | |
| Number of Panels/Bays | N/A | |
| Lower Limit | N/A | |
| Upper Limit | N/A | |
| Design power capacity in use | N/A | |
| Other Antenna Type | N/A | |
| ERP: | 691.0 kW | |
| Manufacturer | ||
| Model | TFU-24DSC-R S200 | |
| Year | 2017 | |
| Justification for New Antenna | Current antenna is coaxial slot design. Channel change not possible. Proposed antenna replicates existing antenna, except in number of bays, which is reduced to maintain approximate physical size. New antenna to be installed on replacement tower. |
| Section | Question | Response |
|---|---|---|
| Combiner for Shared Antenna | Do you need a Combiner for a Shared Antenna? | No |
| Type | ||
| Number of channels supported | N/A | |
| Frequencies of channels supported | N/A | |
| Frequency | N/A | |
| Do you need a combiner output splitter/switcher for dual feed lines? | N/A | |
| Elbow Complex | Do you require the separate purchase of the Elbow Complex? | Yes |
| Broadband or Single Channel? | Single Channel | |
| Feed Line Size | 6 1/8 inches inches | |
| Side Mount Brackets | Do you require the separate purchase of side mount brackets for a high power antenna? | Yes |
| Pattern Scatter Analysis | Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? | No |
| Sweep Test | Do you require the sweep testing of transmission line and antenna? | Yes |
| Section | Question | Response |
|---|---|---|
| Transmission Line Related Expenses | Do you have transmission line related expenses? | Yes |
| Section | Question | Response |
|---|---|---|
| Existing Transmission Line Description | Type of change | Purchase New |
| Use | Primary (Main) | |
| Description of Use | N/A | |
| Ownership | Owned | |
| Owner | N/A | |
| Site | N/A | |
| Is the existing transmission line shared with another station or stations? | No | |
| Is Transmission Line in operating condition? | Yes | |
| Existing Transmission Line Manufacturer and Type | Manufacturer | |
| Type | Rigid | |
| Diameter | 6 1/8 inches | |
| Other Diameter | N/A | |
| Segment Length | 20 inches | |
| Other Segment Length | N/A | |
| Number of parallel runs | 1 | |
| Length | 1200 feet per run |
| Section | Question | Response |
|---|---|---|
| New Transmission Line Costs | Use | Primary (Main) |
| Description of Use | N/A | |
| Change Type | Purchase New | |
| Is this a request for upgraded equipment? | No | |
| Type | Rigid | |
| Diameter | 6 1/8 inches | |
| Other Diameter | N/A | |
| Segment Length | 19 1/2 inches | |
| Other Segment Length | N/A | |
| Number of parallel runs | 1 | |
| Length | 1350 feet per run | |
| Justification for New Transmission Line | Replacement tower required due to structural analysis. New transmission line to be installed on new tower with new antenna. |
| Section | Question | Response |
|---|---|---|
| Tower Equipment or Rigging Costs Changes | Do you have tower equipment or rigging costs changes? | Yes |
| Section | Question | Response |
|---|---|---|
| Existing Tower Description | Type of change | Construct New |
| Tower Use | Primary (Main) | |
| Description of Use | N/A | |
| Ownership | Owned | |
| Is this tower consider Complex? | No | |
| Is this tower currently shared with any other stations? | No | |
| One or more FM, AM or TV radio broadcaster(s) | N/A | |
| Others Types of Users | N/A | |
| Is tower documented for structural analysis? | Yes | |
| Is tower compliant with Rev G? | No | |
| Existing Tower Structure Registration | Do you have a tower registration number? | Yes |
| ASR Number | 1242292 | |
| Coordinates (NAD83) | Latitude (NAD83) | 30° 59' 52.0" N- |
| Longitude (NAD83) | 086° 43' 13.0" W- | |
| Overall Structure Height | 1103.99 feet | |
| Support Structure Height | 1099.07 feet | |
| Ground Elevation Above Mean Sea Level (AMSL) | 145.01 feet | |
| Structure Type | TOWER - Free Standing or Guyed Structure | |
| Tower Owner | Flinn Broadcasting Corp | |
| Date Constructed | 03/01/2004 |
| Section | Question | Response |
|---|---|---|
| Construct New Tower | Use | Primary (Main) |
| Description of Use | N/A | |
| Is this a request for upgraded equipment? | No | |
| Height | 1104.00 feet | |
| Justification for New Tower | Current tower fails TIA-222-G based on completed structural analysis. |
| Section | Question | Response |
|---|---|---|
| Tower Rigging Costs | Complex Tower | N/A |
| Helicopter Services Required | Are helicopter services required? | No |
| Name | Description |
|---|---|
Dismantle and Disposal of Old Tower |
Dismantle and disposal of tower to be replaced. |
| Section | Question | Response |
|---|---|---|
| Outside Project Management Services | Do you require outside project management services? | Yes |
| Number of Hours | 80 | |
| Explanation | External project management provided by Land Communications to assist owner who has insufficient staff resources. | |
| Outside RF consulting Engineering Services | Perform engineering study for new channel assignment and antenna development | Yes |
| Prepare engineering section of Form FCC Construction Permit Application | Yes | |
| For Auxiliary Facility | No | |
| For Main Facility | Yes | |
| Prepare engineering section of Form FCC License to Cover Application | Yes | |
| For Auxiliary Facility | No | |
| For Main Facility | Yes | |
| Prepare request for Special Temporary Authority | Yes | |
| Quantity | 1 | |
| Do you have Distributed Transmission System engineering services? | N/A | |
| Critical Facility | N/A | |
| Terrain-Shielded Facility | N/A | |
| Attorney and Other Outside Consulting Services | Prepare and file Form FCC Construction Permit Application | Yes |
| For Auxiliary Facility | No | |
| For Main Facility | Yes | |
| Prepare and file Form FCC License to Cover Application | Yes | |
| For Auxiliary Facility | No | |
| For Main Facility | Yes | |
| Prepare request for Special Temporary Authority | Yes | |
| Quantity | 1 | |
| NEPA Section 106 environmental review | Yes | |
| Environmental Assessment | Yes | |
| ASR Modification | Yes | |
| FAA Consultation (including preparation of FAA Form 7460) | Yes | |
| Negotiation of Lease and other Matter for Shared Locations | No | |
| Prepare or Review FCC Form 399 for Reimbursement | Yes | |
| Address transition timing and coordination issues w/ other stations and wireless providers | Yes | |
| RF Field Engineering Services | Comprehensive coverage verification via field study | No |
| RF exposure measurements | No | |
| Additional Field Engineering Service | No | |
| Number of Days | N/A | |
| Justification | N/A |
| Section | Question | Response |
|---|---|---|
| AM Pattern Disturbance | Is an Impact Study needed? | No |
| Is Remediation needed? | No | |
| Facility Expenses | Name | N/A |
| Other Distributed Transmission System Expenses Not listed | N/A | |
| Name | N/A | |
| Is Notification of a Medical Facility required as a result of DTV broadcasting? | Yes | |
| Permit and Filing Costs | Local Zoning | Yes |
| Non-zoning permits | Yes | |
| BLM or NFS Coordination | No | |
| FCC Construction Permit Minor Change | Yes | |
| FCC License to Cover Application | Yes | |
| FCC Special Temporary Authority Application | Yes | |
| Other Miscellaneous Expenses | Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? | Yes |
| Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? | Yes | |
| Does this relocation require Equipment Storage? | Yes | |
| Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? | Yes | |
| Does this relocation require MVPD Notification of a Channel Change? | Yes |
| Name | Description |
|---|---|
Building modifications, concrete pad, road repairs |
Required building modifications including concrete pad for interim xmtr heat exchange. Road repairs for material deliveries. |
Tower Removal |
Tower Removal |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $1,090,700.00 | $1,036,500.00 | N/A | $0.00 | N/A |
| Total for all systems | $5,494,220.00 | $5,165,974.25 | N/A | $0.00 | N/A |
| Interim Transmitter THU9-4EVO | $342,450.00 | $325,500.00 | $0.00 | ||
| 3" Rigid Conduit and Wiring (Cost per foot) | $5,200.00 | $4,900.00 | N/A | $0.00 | N/A |
| Switchgear - industrial 800 amp | $38,200.00 | $36,300.00 | N/A | $0.00 | N/A |
| Transformer 3 phase/480v - 150 KVA | $25,550.00 | $24,300.00 | N/A | $0.00 | N/A |
| UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW | $273,500.00 | $260,000.00 | N/A | $0.00 | N/A |
| Primary Transmitter DCX-2P | $748,250.00 | $711,000.00 | $0.00 | ||
| Dual exciter system with change over | $47,350.00 | $45,000.00 | N/A | $0.00 | N/A |
| 60 kW mask filter | $89,400.00 | $85,000.00 | N/A | $0.00 | N/A |
| 2 IOT Tubes | $255,000.00 | $242,000.00 | N/A | $0.00 | N/A |
| Two IOT system (60 kW) | $356,500.00 | $339,000.00 | N/A | $0.00 | N/A |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $197,220.00 | $194,174.00 | N/A | $0.00 | N/A |
| Total for all systems | $5,494,220.00 | $5,165,974.25 | N/A | $0.00 | N/A |
| Primary Antenna TFU-24DSC-R S200 | $197,220.00 | $194,174.00 | $0.00 | ||
| Side mount brackets for high power antennas (if not included in antenna base cost) | $23,150.00 | $21,750.00 | N/A | $0.00 | N/A |
| Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) | $12,300.00 | $10,984.00 | N/A | N/A | N/A |
| Sweep test of existing antenna | $6,730.00 | $6,400.00 | N/A | $0.00 | N/A |
| UHF - High Power, Side Mount, basic slot antenna, 691 kW input, directional,, horizontally polarized | $155,040.00 | $155,040.00 | Quotation from Dielectric attached. | N/A | N/A |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $272,700.00 | $167,465.25 | N/A | $0.00 | N/A |
| Total for all systems | $5,494,220.00 | $5,165,974.25 | N/A | $0.00 | N/A |
| Primary Transmission Line | $272,700.00 | $167,465.25 | $0.00 | ||
| Rigid Transmission Line - copper, 6 1/8" | $272,700.00 | $167,465.25 | N/A | N/A | N/A |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $3,514,020.00 | $3,360,000.00 | N/A | $0.00 | N/A |
| Total for all systems | $5,494,220.00 | $5,165,974.25 | N/A | $0.00 | N/A |
| Primary Tower TOWER | $0.00 | $0.00 | $0.00 | ||
| Primary Tower | $3,514,020.00 | $3,360,000.00 | $0.00 | ||
| Dismantle and Disposal of Old Tower | $400,000.00 | $400,000.00 | N/A | $0.00 | N/A |
| New tower between 1000' and 1500' without elevator, presumptive soil conditions | $2,903,520.00 | $2,760,000.00 | N/A | N/A | N/A |
| Tall Tower (greater than 500') | $210,500.00 | $200,000.00 | N/A | N/A | N/A |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $64,390.00 | $56,250.00 | N/A | $0.00 | N/A |
| Total for all systems | $5,494,220.00 | $5,165,974.25 | N/A | $0.00 | N/A |
| Outside Professional Services | $64,390.00 | $56,250.00 | $0.00 | ||
| Prepare request for Special Temporary Authorization | $2,050.00 | $1,500.00 | N/A | N/A | N/A |
| Prepare engineering section of FCC Form 2100 (main), License to Cover Application | $1,580.00 | $1,500.00 | N/A | N/A | N/A |
| Prepare engineering section of FCC Form 2100 (main), Construction Permit Application | $3,155.00 | $3,000.00 | N/A | N/A | N/A |
| Perform engineering study for new channel assignment and antenna development | $7,360.00 | $3,500.00 | N/A | N/A | N/A |
| Attorney Fees - Prepare and File request for Special Temporary Authorization | $3,680.00 | $3,500.00 | N/A | N/A | N/A |
| Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | $2,365.00 | $2,250.00 | N/A | N/A | N/A |
| Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application | $5,260.00 | $5,000.00 | N/A | N/A | N/A |
| Address transition timing and coordination issues w/ other stations and wireless | $2,630.00 | $2,500.00 | N/A | N/A | N/A |
| Project management of the transition | $12,640.00 | $12,000.00 | N/A | N/A | N/A |
| Prepare and or review reimbursement form | $2,630.00 | $2,500.00 | N/A | N/A | N/A |
| FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase | $2,105.00 | $1,500.00 | N/A | N/A | N/A |
| ASR modification (prepare FCC Form 854) | $2,105.00 | $1,500.00 | N/A | N/A | N/A |
| Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet | $10,520.00 | $10,000.00 | N/A | N/A | N/A |
| NEPA Section 106 environmental review, if needed | $6,310.00 | $6,000.00 | N/A | N/A | N/A |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $355,190.00 | $351,585.00 | N/A | $0.00 | N/A |
| Total for all systems | $5,494,220.00 | $5,165,974.25 | N/A | $0.00 | N/A |
| Other Expenses | $355,190.00 | $351,585.00 | $0.00 | ||
| Tower Removal | $186,500.00 | $186,500.00 | At the request of the FCC staff, a line item entitled “tower removal” has been added into the “Other Expenses Not Listed” section reflecting the attached $186,500.00 quote. Please note that this line item is duplicative of the $400,000 line item “Dismantle and Disposal of Old Tower” in the “Tower Equipment and Rigging Cost Information” section. | N/A | N/A |
| MVPD Notification of Channel Change | $1,000.00 | $1,000.00 | N/A | N/A | N/A |
| Develop and air announcement of upcoming channel change | $1,000.00 | $1,000.00 | N/A | N/A | N/A |
| Equipment Storage | $2,000.00 | $2,000.00 | N/A | N/A | N/A |
| Equipment Delivery and Handling Charges | $50,000.00 | $50,000.00 | N/A | N/A | N/A |
| FCC Filing Fees - Form 2100 minor change CP application | $1,110.00 | $1,070.00 | N/A | N/A | N/A |
| FCC Filing Fees - Form 2100 license to cover application | $335.00 | $325.00 | N/A | N/A | N/A |
| FCC Filing Fees - Special Temporary Authorization request | $195.00 | $190.00 | N/A | N/A | N/A |
| Local Zoning | $500.00 | $500.00 | N/A | N/A | N/A |
| Non-zoning permits | $1,000.00 | $1,000.00 | N/A | N/A | N/A |
| Disposal Costs (for equipment and other waste, net of any salvage value) | $100,000.00 | $100,000.00 | N/A | N/A | N/A |
| DTV Medical Facility Notification | $11,550.00 | $8,000.00 | N/A | N/A | N/A |
| Building modifications, concrete pad, road repairs | $0.00 | $0.00 | N/A | $0.00 | N/A |
| Predetermined Cost Estimate |
Estimated Cost | Actual Cost | |
|---|---|---|---|
| Total for all systems | $5,494,220.00 | $5,165,974.25 | $0.00 |
| Question | Response |
|---|---|
| The facility has ceased operating on its pre-auction channel. | No |
| Construction of final facilities or all necessary modifications are complete. | No |
| All receipts for reimbursement have been submitted no further costs are expected to be incurred. Note this will lock the Form 399 from further editing and begin close-out procedures with the Fund Administrator. | No |
| Section | Question | Response |
|---|---|---|
| Submission of Estimated Expenses Statements | WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT. |
|
| I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above. | George S Flinn , Jr . Individual 08/08/2017 |
| Section | Question | Response |
|---|---|---|
| Submission of Actual Cost Documentation Statements | WILLFUL FALSE, FRAUDULENT, OR FICTITIOUS STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISIONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE AND/OR FRAUDULENT STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT (U.S. CODE, TITLE 31, SECTIONS 3729-3733). |
|
| I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above. | George S Flinn , Jr . Individual 08/08/2017 |
