| Applicant | Address | Phone | Applicant Type | |
|---|---|---|---|---|
|
Campbellsville University |
1 University Drive Campbellsville, KY 42718 United States |
+1 (270) 403-0505 | hkspears@campbellsville.edu | Private Not-for-Profit Educational Institution |
| Applicant | Address | Phone | |
|---|---|---|---|
|
[Confidential] |
|
|
|
| Applicant | Address | Phone | |
|---|---|---|---|
|
Lauren Lynch Flick Esq Pillsbury Winthrop Shaw Pittman LLP |
1200 Seventeenth Street, NW Washington, DC 20036 United States |
+1 (202) 663-8166 | lauren.lynch.flick@pillsburylaw.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 | The WLCU-CD antenna is side mounted on a short guyed tower. The station will flash-cut to the new channel when its antenna is replaced and new transmitter installed in a new building. |
| 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 | Anywave |
| Model | TXR-5X-4-U-C | |
| Year | 2015 | |
| Type | Solid State | |
| Solid State Cooling | Air Cooled | |
| Solid State Power capacity | .56 kW |
| Section | Question | Response |
|---|---|---|
| New IOT Tubes | Number of Tubes (including accessories) needed | N/A |
| New Mask Filter | ||
| Power | 1.5 kW | |
| Other Power | N/A | |
| New Exciter | Is a new exciter needed? | Yes |
| Exciter Type | Single frequency agile |
| 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 | Yes | |
| Description | Increase capacity | |
| HVAC Service | Does the replacement transmitter require HVAC Service? | Yes |
| Type | Heating and Cooling | |
| Size | Other tons | |
| Other Size | 3 tons | |
| Transmitter Building Addition/Modification or Leasehold Improvement | Does the Transmitter Building require an addition, modification, other leashold improvement? | Yes |
| Size | 12.0 square feet | |
| 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 |
| Name | Description |
|---|---|
Retuning |
Required retuning, work, installation, commissioning and proof of performance |
| Section | Question | Response |
|---|---|---|
| Existing Transmitter Description | Type of change | Purchase New |
| Use | Primary (Main) | |
| Description of Use | N/A | |
| Ownership | Owned | |
| Owner | N/A | |
| Site | 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 | |
| Model | TXR-5X-4-U-C | |
| Year | 2015 | |
| Type | Solid State | |
| Solid State Cooling | Air Cooled | |
| Solid State Power Capacity | .56 kW |
| Section | Question | Response |
|---|---|---|
| New Transmitter | Use | Primary (Main) |
| Change Type | Purchase New | |
| Is this a request for upgraded equipment? | No | |
| Manufacturer | ||
| Model | TXR-5X-4-U-C | |
| Transmitter Type | Solid State | |
| Solid State Cooling | Air Cooled | |
| Solid State Power capacity | .56 kW | |
| Justification for New Transmitter | Existing transmitter cannot be re-tuned. |
| 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 | Yes | |
| Description | 400A and backup generator | |
| HVAC Service | Does the replacement transmitter require HVAC Service? | Yes |
| Type | Heating and Cooling | |
| Size | Other | |
| Other Size | 12 tons | |
| Transmitter Building Addition/Modification or Leasehold Improvement | Does the Transmitter Building require an addition, modification, other leashold improvement? | Yes |
| Size | 600.0 square feet | |
| 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 |
| Name | Description |
|---|---|
Mask Filter |
Dielectric UHF Channel 15 Mask Bandpass Filter with Couplers |
Transmitter Project Management |
Labor & expenses associated with transmitter survey, planning, receiving, install & testing |
Exciter |
Anywave 5x plus Exciter |
| 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? | No | |
| 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 | Class A |
| 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: | 3.0 kW | |
| Manufacturer | ||
| Model | SL-8 | |
| Year | 2015 |
| 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? | No | |
| Will antenna be located on or in close proximity to an antenna farm? | No | |
| New Antenna Manufacturer and Types | Class | Class A |
| 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: | 2.48 kW | |
| Manufacturer | ||
| Model | SL-8 | |
| Year | 2018 | |
| Justification for New Antenna | Existing antenna will not function on new channel and cannot be retuned. |
| Section | Question | Response |
|---|---|---|
| Combiner for Shared Antenna | Do you need a Combiner for a Shared Antenna? | |
| 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? | No |
| Broadband or Single Channel? | N/A | |
| Feed Line Size | N/A | |
| Side Mount Brackets | Do you require the separate purchase of side mount brackets for a high power antenna? | No |
| 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? | No |
| Name | Description |
|---|---|
Antenna Data Lines |
Install Antenna Data lines between antenna & building |
| 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 | Flexible Air | |
| Diameter | 7/8 inches | |
| Other Diameter | N/A | |
| Segment Length | N/A | |
| Other Segment Length | N/A | |
| Number of parallel runs | 0 | |
| Length | 114 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 | Flexible Foam | |
| Diameter | 7/8 inches | |
| Other Diameter | N/A | |
| Segment Length | N/A | |
| Other Segment Length | N/A | |
| Number of parallel runs | 0 | |
| Length | 200 feet per run | |
| Justification for New Transmission Line | Old line could not be used, was not long enough |
| 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 | Modify Existing |
| 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? | Yes | |
| One or more FM, AM or TV radio broadcaster(s) | Yes | |
| Others Types of Users | No | |
| Is tower documented for structural analysis? | Unknown | |
| Is tower compliant with Rev G? | Unknown | |
| Existing Tower Structure Registration | Do you have a tower registration number? | No |
| ASR Number | ||
| Coordinates (NAD83) | Latitude (NAD83) | 37° 20' 39.0" N- |
| Longitude (NAD83) | 085° 21' 34.0" W- | |
| Overall Structure Height | 167.00 feet | |
| Support Structure Height | 167.00 feet | |
| Ground Elevation Above Mean Sea Level (AMSL) | 833.00 feet | |
| Structure Type | GTOWER - Guyed Structure Used for Communication Purposes | |
| Tower Owner | Campbellsville University | |
| Date Constructed | 02/01/2011 |
| Facility ID | Call Sign | Service |
|---|---|---|
| 176645 | WLCU | FM |
| Section | Question | Response |
|---|---|---|
| Engineering Study | Please what type of engineering study is required, if any: | No study needed |
| Tower Reinforcements | Please select whether tower reinforcements are needed: | No reinforcements needed |
| Section | Question | Response |
|---|---|---|
| Tower Rigging Costs | Complex Tower | N/A |
| Helicopter Services Required | Are helicopter services required? | No |
| Section | Question | Response |
|---|---|---|
| Outside Project Management Services | Do you require outside project management services? | No |
| Number of Hours | N/A | |
| Explanation | N/A | |
| Outside RF consulting Engineering Services | Perform engineering study for new channel assignment and antenna development | No |
| 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 | No | |
| Quantity | N/A | |
| 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 | No | |
| Quantity | N/A | |
| NEPA Section 106 environmental review | No | |
| Environmental Assessment | No | |
| ASR Modification | No | |
| FAA Consultation (including preparation of FAA Form 7460) | No | |
| 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 |
| Name | Description |
|---|---|
Form 399 Assistance |
Form 399 Assistance |
Legal Fees for Preparation of Transition Progress Reporting |
Legal Fees for Preparation of Transition Progress Reporting |
Technical Services |
David Greenlee |
| 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 | No |
| Non-zoning permits | No | |
| BLM or NFS Coordination | No | |
| FCC Construction Permit Minor Change | No | |
| FCC License to Cover Application | No | |
| FCC Special Temporary Authority Application | No | |
| Other Miscellaneous Expenses | Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? | No |
| Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? | No | |
| Does this relocation require Equipment Storage? | No | |
| 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 |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $186,366.77 | $185,086.77 | N/A | $97,689.49 | N/A |
| Total for all systems | $338,500.04 | $326,672.01 | N/A | $165,004.73 | N/A |
| Primary Transmitter TXR-5X-4-U-C | $24,080.00 | $22,800.00 | $22,800.00 | ||
| 1.5 kW mask filter | $3,030.00 | $2,800.00 | ***System Notice: Estimate adjusted and locked because line has been superseded.***Existing equipment cannot operate on new channel. | $2,800.00 | N/A |
| Single frequency agile exciter | $21,050.00 | $20,000.00 | ***System Notice: Estimate adjusted and locked because line has been superseded.***Existing exciter is at capacity/marginal for station's current operation. Any loss in efficiency due to on-site retuning of transmitter not likely to be withstood. First phase assignment necessitates replacement over repair. | $20,000.00 | N/A |
| Primary Transmitter TXR-5X-4-U-C | $162,286.77 | $162,286.77 | $74,889.49 | ||
| Other Electrical Service: 400A and backup generator | $17,352.20 | $17,352.20 | N/A | N/A | N/A |
| Other -- HVAC Service Type: H Size:12 (Other) | $6,400.00 | $6,400.00 | N/A | N/A | N/A |
| Transmitter Project Management | $14,700.00 | $14,700.00 | N/A | N/A | N/A |
| UHF - Air Cooled Solid State Transmitter .56 kW | $50,800.00 | $50,800.00 | N/A | $50,800.00 | N/A |
| Mask Filter | $2,800.00 | $2,800.00 | N/A | $2,800.00 | N/A |
| Exciter | $20,000.00 | $20,000.00 | Exciter is necessary as it is sold separately than the transmitter. | $20,000.00 | N/A |
| Other -- Building Addition Size: 600.0 | $50,234.57 | $50,234.57 | N/A | $1,289.49 | N/A |
| Actual Information Description | File Name |
|---|---|
| 1.5 kW mask filter | |
| Single frequency agile exciter | |
| Other Electrical Service: 400A and backup generator | Information not provided. |
| Other -- HVAC Service Type: H Size:12 (Other) | Information not provided. |
| Transmitter Project Management | Information not provided. |
| UHF - Air Cooled Solid State Transmitter .56 kW | |
| Mask Filter | |
| Exciter | |
| Other -- Building Addition Size: 600.0 |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $26,626.91 | $7,526.91 | N/A | $7,526.91 | N/A |
| Total for all systems | $338,500.04 | $326,672.01 | N/A | $165,004.73 | N/A |
| Primary Antenna SL-8 | $26,626.91 | $7,526.91 | $7,526.91 | ||
| Antenna Data Lines | $326.91 | $326.91 | N/A | $326.91 | N/A |
| UHF - Lower Power Side Mount, Class A One Station antenna -- basic | $26,300.00 | $7,200.00 | N/A | $7,200.00 | N/A |
| Actual Information Description | File Name |
|---|---|
| Antenna Data Lines | |
| UHF - Lower Power Side Mount, Class A One Station antenna -- basic |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $0.00 | $1,287.00 | N/A | $1,287.00 | N/A |
| Total for all systems | $338,500.04 | $326,672.01 | N/A | $165,004.73 | N/A |
| Primary Transmission Line | $0.00 | $1,287.00 | $1,287.00 | ||
| Flexible Foam Transmission Line - dielectric, 7/8" | $0.00 | $1,287.00 | N/A | $1,287.00 | N/A |
| Actual Information Description | File Name |
|---|---|
| Flexible Foam Transmission Line - dielectric, 7/8" |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $84,200.00 | $80,000.00 | N/A | $18,730.00 | N/A |
| Total for all systems | $338,500.04 | $326,672.01 | N/A | $165,004.73 | N/A |
| Primary Tower GTOWER | $84,200.00 | $80,000.00 | $18,730.00 | ||
| Short Tower (less than 500') | $84,200.00 | $80,000.00 | N/A | $18,730.00 | N/A |
| Actual Information Description | File Name |
|---|---|
| Short Tower (less than 500') |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $24,058.36 | $42,184.33 | N/A | $31,684.33 | N/A |
| Total for all systems | $338,500.04 | $326,672.01 | N/A | $165,004.73 | N/A |
| Outside Professional Services | $24,058.36 | $42,184.33 | $31,684.33 | ||
| Form 399 Assistance | $3,075.00 | $3,075.00 | N/A | $3,075.00 | N/A |
| Prepare and or review reimbursement form | $2,630.00 | $19,492.47 | The rebuild had changed beyond out control, therefore adding more time spent on legal assistance on preparing and reviewing the reimbursement form. | $19,492.47 | Costs exceeded estimate. See entries marked Preparing or reviewing Form 399 on attached invoice. |
| Prepare engineering section of FCC Form 2100 (main), License to Cover Application | $1,580.00 | $1,500.00 | N/A | $1,500.00 | N/A |
| Technical Services | $350.36 | $350.36 | N/A | $350.36 | N/A |
| Legal Fees for Preparation of Transition Progress Reporting | $3,013.00 | $3,013.00 | Costs not included in estimate. See attached invoice entries marked Other-Progress Reporting | $3,013.00 | Costs not included in estimate. See entries on invoice marked Other-Progress Reporting |
| Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | $2,365.00 | $4,253.50 | Costs exceeded estimate. See attached invoice entries labeled Prepare and file license to cover. | $4,253.50 | Costs exceeded estimate. See entries marked Prepare and file license to cover on attached invoice. |
| Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application | $5,260.00 | $5,000.00 | 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 |
| Address transition timing and coordination issues w/ other stations and wireless | $2,630.00 | $2,500.00 | N/A | N/A | N/A |
| Actual Information Description | File Name |
|---|---|
| Form 399 Assistance | |
| Prepare and or review reimbursement form | |
| Prepare engineering section of FCC Form 2100 (main), License to Cover Application | |
| Technical Services | |
| Legal Fees for Preparation of Transition Progress Reporting | |
| Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | |
| Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application | Information not provided. |
| Prepare engineering section of FCC Form 2100 (main), Construction Permit Application | Information not provided. |
| Address transition timing and coordination issues w/ other stations and wireless | Information not provided. |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $17,248.00 | $10,587.00 | N/A | $8,087.00 | N/A |
| Total for all systems | $338,500.04 | $326,672.01 | N/A | $165,004.73 | N/A |
| Other Expenses | $17,248.00 | $10,587.00 | $8,087.00 | ||
| MVPD Notification of Channel Change | $3,198.00 | $3,198.00 | Estimate based on catalogue. Actual cost higher than catalogue. See attached Estimate and comprehensive statement of actual costs incurred attached hereto. | $3,198.00 | Estimate was based on catalogue. Actual costs were higher. See attached Estimate. |
| DTV Medical Facility Notification | $11,550.00 | $4,889.00 | Actual cost as billed. See Attached Estimate. | $4,889.00 | Estimate based on catalogue. Actual cost based on invoice. See attached Estimate. |
| Develop and air announcement of upcoming channel change | $2,500.00 | $2,500.00 | Development and airing of announcement to ensure that over-the-air viewers are properly advised of channel change and requirements for continued service. | N/A | N/A |
| Actual Information Description | File Name |
|---|---|
| MVPD Notification of Channel Change | |
| DTV Medical Facility Notification | |
| Develop and air announcement of upcoming channel change | Information not provided. |
| Predetermined Cost Estimate |
Estimated Cost | Actual Cost | |
|---|---|---|---|
| Total for all systems | $338,500.04 | $326,672.01 | $165,004.73 |
| Question | Response |
|---|---|
| The facility has ceased operating on its pre-auction channel. | Yes |
| Construction of final facilities or all necessary modifications are complete. | Yes |
| 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. | Jeannie S Clark General Manager 10/08/2021 |
| 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. | Jeannie S. Clark General Manager 10/08/2021 |
| Section | Question | Response |
|---|---|---|
| Submission of Final Allocation or Accounting Information 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. | Jeannie S. Clark General Manager 10/08/2021 |
