Applicant | Address | Phone | Applicant Type | |
---|---|---|---|---|
BD. OF TRUSTEES, CAL. STATE UNIV. FOR SAN DIEGO STATE UNIV. Doing Business As: BD. OF TRUSTEES, CAL. STATE UNIV. FOR SAN DIEGO STATE UNIV. |
Leon Messenie 5200 CAMPANILE DRIVE SAN DIEGO, CA 92182 United States |
+1 (619) 594-1515 | lmessenie@kpbs.org | Government Entity |
Applicant | Address | Phone | |
---|---|---|---|
[Confidential] |
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Applicant | Address | Phone | |
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The Preparer is same as the reimbursement contact. |
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Question | Response |
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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 | See Attachment - "KPBS Repack Project Plan ver2" |
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 | ROHDE AND SCHWARZ |
Model | NV8620V | |
Year | 2010 | |
Type | Solid State | |
Solid State Cooling | Liquid Cooled | |
Solid State Power capacity | 20 kW |
Section | Question | Response |
---|---|---|
New IOT Tubes | Number of Tubes (including accessories) needed | N/A |
New Mask Filter | ||
Power | 30 kW | |
Other Power | N/A | |
New Exciter | Is a new exciter needed? | No |
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 |
Name | Description |
---|---|
Proof of Performance - Two Exciters |
Transmitter Manufacturer to perform a Proof of Performance on the primary transmitter with two exciters operation on CH-19. |
Inside RF System - Interconnection |
Inside RF System interconnection components to connect transmitter to mask filter I/O, power monitor, and 4 port switch. Includes 4 port switch with switch controller. |
Section | Question | Response |
---|---|---|
Existing Transmitter Description | Type of change | Retune Existing |
Use | Auxiliary (Backup) | |
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 | ROHDE AND SCHWARZ |
Model | NV8610V | |
Year | 2010 | |
Type | Solid State | |
Solid State Cooling | Liquid Cooled | |
Solid State Power capacity | 10 kW |
Section | Question | Response |
---|---|---|
New IOT Tubes | Number of Tubes (including accessories) needed | N/A |
New Mask Filter | ||
Power | 30 kW | |
Other Power | N/A | |
New Exciter | Is a new exciter needed? | No |
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 |
Name | Description |
---|---|
Inside RF System - Interconnection |
Inside RF System interconnection components to connect transmitter to mask filter I/O, RF Power Monitor, to 4 port switch. |
Proof Of Performance - One Exciter |
Transmitter Manufacturer to perform a Proof of Performance on the auxiliary transmitter with one exciter operating on CH-19. |
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? | Yes | |
Existing Antenna Manufacturer and Type | Class | Full Power |
Mounting | Top 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: | 350.0 kW | |
Manufacturer | ||
Model | TFU-18GTH-R C170SP CH30 | |
Year | 2001 |
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? | Yes | |
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? | Yes | |
New Antenna Manufacturer and Types | Class | Full Power |
Mounting | Top 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: | 285.0 kW | |
Manufacturer | ||
Model | TFU18GTH-R C170SP CH19 | |
Year | 2017 | |
Justification for New Antenna | The current DTV Antenna cannot be re-tuned from CH30 to CH19 |
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? | Broadband | |
Feed Line Size | 3 1/8 inches inches | |
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? | Yes |
Name | Description |
---|---|
Adapter plate to match tower top |
Adapter plate need to mount new antenna to top of tower |
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 | 3 1/8 inches | |
Other Diameter | N/A | |
Segment Length | 19 1/2 inches | |
Other Segment Length | N/A | |
Number of parallel runs | 1 | |
Length | 185 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? | Yes | |
Type | Rigid | |
Diameter | 3 1/8 inches | |
Other Diameter | N/A | |
Segment Length | 20 inches | |
Other Segment Length | N/A | |
Number of parallel runs | 1 | |
Length | 185 feet per run | |
Justification for New Transmission Line | The current transmission line at 19'6" for CH30 is not recommended for use at CH19. 20 foot lengths is recommended |
Name | Description |
---|---|
Dehydrator System |
Dehydrator needed to keep transmission line dry current system is limited in capacity and will not be able to keep new line pressurized. |
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? | Candelabra | |
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? | No | |
Is tower compliant with Rev G? | Unknown | |
Existing Tower Structure Registration | Do you have a tower registration number? | Yes |
ASR Number | 1213483 | |
Coordinates (NAD83) | Latitude (NAD83) | 32° 41' 52.7" N- |
Longitude (NAD83) | 116° 56' 06.3" W- | |
Overall Structure Height | 214.00 feet | |
Support Structure Height | 150.00 feet | |
Ground Elevation Above Mean Sea Level (AMSL) | 2495.00 feet | |
Structure Type | TOWER - Free Standing or Guyed Structure | |
Tower Owner | KPBS | |
Date Constructed | 07/17/2001 |
Section | Question | Response |
---|---|---|
Engineering Study | Please what type of engineering study is required, if any: | Study needed for tower with candelabra |
Tower Reinforcements | Please select whether tower reinforcements are needed: | No reinforcements needed |
Section | Question | Response |
---|---|---|
Tower Rigging Costs | Complex Tower | Candelabra |
Helicopter Services Required | Are helicopter services required? | No |
Section | Question | Response |
---|---|---|
Outside Project Management Services | Do you require outside project management services? | Yes |
Number of Hours | 260 | |
Explanation | See Attachment " KPBS Further Justification for Form 399" | |
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 | 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 | 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 | Yes |
RF exposure measurements | Yes | |
Additional Field Engineering Service | No | |
Number of Days | N/A | |
Justification | N/A |
Name | Description |
---|---|
Additional Legal Expenses |
Additional legal expenses for University-license public TV station |
Quarterly Progress Reports |
FCC-required Quarterly Progress Reports |
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)? | 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 |
---|---|
California Sales Tax |
California Sales Tax at 7.75 percent on all tangible items |
Shipping Freight |
Shipping Antenna, Mask Filters, and other RF Componets to the WIS Storage Yard |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $335,186.25 | $321,586.25 | N/A | $0.00 | N/A |
Total for all systems | $1,363,242.28 | $1,035,586.03 | N/A | $13,362.50 | N/A |
Primary Transmitter NV8620V | $171,400.00 | $164,600.00 | $0.00 | ||
Inside RF System - Interconnection | $25,000.00 | $25,000.00 | N/A | N/A | N/A |
Proof of Performance - Two Exciters | $8,600.00 | $8,600.00 | N/A | N/A | N/A |
30 kW mask filter | $32,600.00 | $31,000.00 | N/A | N/A | N/A |
UHF and VHF - minor banding issues | $105,200.00 | $100,000.00 | N/A | N/A | N/A |
Auxiliary Transmitter NV8610V | $163,786.25 | $156,986.25 | $0.00 | ||
Proof Of Performance - One Exciter | $4,300.00 | $4,300.00 | N/A | N/A | N/A |
Inside RF System - Interconnection | $21,686.25 | $21,686.25 | N/A | N/A | N/A |
UHF and VHF - minor banding issues | $105,200.00 | $100,000.00 | N/A | N/A | N/A |
30 kW mask filter | $32,600.00 | $31,000.00 | N/A | N/A | N/A |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $281,370.00 | $271,018.75 | N/A | $0.00 | N/A |
Total for all systems | $1,363,242.28 | $1,035,586.03 | N/A | $13,362.50 | N/A |
Primary Antenna TFU18GTH-R C170SP CH19 | $281,370.00 | $271,018.75 | $0.00 | ||
Adapter plate to match tower top | $18,300.00 | $18,300.00 | N/A | N/A | N/A |
Elbow complex, broadband, at antenna input, per 3 1/8. feedline (if needed) | $9,340.00 | $8,880.00 | N/A | N/A | N/A |
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized | $247,000.00 | $237,438.75 | see attached quote Line Item 1 from Dielectric for cost justification. | N/A | N/A |
Sweep test of existing antenna | $6,730.00 | $6,400.00 | N/A | N/A | N/A |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $24,054.25 | $26,669.25 | N/A | $0.00 | N/A |
Total for all systems | $1,363,242.28 | $1,035,586.03 | N/A | $13,362.50 | N/A |
Primary Transmission Line | $24,054.25 | $26,669.25 | $0.00 | ||
Dehydrator System | $4,814.25 | $4,814.25 | Required to keep moisture out of inside the new transmission line. | N/A | N/A |
Rigid Transmission Line - copper, 3 1/8" | $19,240.00 | $21,855.00 | Dielectric proposal for 185' of 3-1/8" transmission line with hangers and braces is $21,855.00. FCC Catalog estimate of $99 per foot is based on a 1000' tower. Shorter towers will cost a bit more. | N/A | N/A |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $441,000.00 | $144,000.00 | N/A | $7,000.00 | N/A |
Total for all systems | $1,363,242.28 | $1,035,586.03 | N/A | $13,362.50 | N/A |
Primary Tower TOWER | $441,000.00 | $144,000.00 | $7,000.00 | ||
Structural engineering tower load study for a documented tower with candelabra | $20,000.00 | $19,000.00 | N/A | $7,000.00 | N/A |
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) | $421,000.00 | $125,000.00 | N/A | N/A | N/A |
Actual Information Description | File Name |
---|---|
Structural engineering tower load study for a documented tower with candelabra | |
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) | Information not provided. |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $190,520.00 | $181,750.00 | N/A | $6,362.50 | N/A |
Total for all systems | $1,363,242.28 | $1,035,586.03 | N/A | $13,362.50 | N/A |
Outside Professional Services | $190,520.00 | $181,750.00 | $6,362.50 | ||
Perform engineering study for new channel assignment and antenna development | $7,360.00 | $7,000.00 | N/A | $525.00 | N/A |
Quarterly Progress Reports | $5,000.00 | $5,000.00 | Prepare and file FCC-required progress reports for repacked station throughout transition. | N/A | N/A |
Additional Legal Expenses | $10,000.00 | $10,000.00 | Legal cost for advice and consultation and assistance for University-owned public TV station at complex multi-tenant antenna farm site. | N/A | N/A |
RF Exposure Measurements | $21,050.00 | $20,000.00 | N/A | N/A | N/A |
Comprehensive coverage verification via field study, if needed | $84,200.00 | $80,000.00 | 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 | $2,000.00 | N/A | N/A | N/A |
ASR modification (prepare FCC Form 854) | $2,105.00 | $2,000.00 | 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 |
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 | $1,687.50 | 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 |
Prepare and or review reimbursement form | $2,630.00 | $2,500.00 | N/A | N/A | N/A |
Project management of the transition | $41,080.00 | $39,000.00 | N/A | $4,150.00 | N/A |
Actual Information Description | File Name |
---|---|
Perform engineering study for new channel assignment and antenna development | |
Quarterly Progress Reports | Information not provided. |
Additional Legal Expenses | Information not provided. |
RF Exposure Measurements | Information not provided. |
Comprehensive coverage verification via field study, if needed | Information not provided. |
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase | Information not provided. |
ASR modification (prepare FCC Form 854) | Information not provided. |
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | Information not provided. |
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application | Information not provided. |
Prepare engineering section of FCC Form 2100 (main), License to Cover Application | Information not provided. |
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application | |
Address transition timing and coordination issues w/ other stations and wireless | Information not provided. |
Prepare and or review reimbursement form | Information not provided. |
Project management of the transition |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $91,111.78 | $90,561.78 | N/A | $0.00 | N/A |
Total for all systems | $1,363,242.28 | $1,035,586.03 | N/A | $13,362.50 | N/A |
Other Expenses | $91,111.78 | $90,561.78 | $0.00 | ||
Shipping Freight | $16,000.00 | $16,000.00 | Estimate Freight cost from Dielectric to deliver antenna, mask filters, transmission line and support items to tower rigger storage yard. | N/A | N/A |
California Sales Tax | $33,016.78 | $33,016.78 | N/A | N/A | N/A |
Develop and air announcement of upcoming channel change | $2,545.00 | $2,545.00 | Please see attached KPBS Rate Card, KPBS Production Estimate, and Calculation Document | N/A | N/A |
Equipment Delivery and Handling Charges | $7,500.00 | $7,500.00 | N/A | N/A | N/A |
MVPD Notification of Channel Change | $1,000.00 | $1,000.00 | N/A | N/A | N/A |
Equipment Storage | $7,500.00 | $7,500.00 | N/A | N/A | N/A |
Disposal Costs (for equipment and other waste, net of any salvage value) | $12,000.00 | $12,000.00 | N/A | N/A | N/A |
DTV Medical Facility Notification | $11,550.00 | $11,000.00 | N/A | N/A | N/A |
Predetermined Cost Estimate |
Estimated Cost | Actual Cost | |
---|---|---|---|
Total for all systems | $1,363,242.28 | $1,035,586.03 | $13,362.50 |
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. | Leon Messenie Director of Engineering, KPBS 10/30/2017 |
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. | Leon Messenie Director of Engineering, KPBS 10/30/2017 |