Applicant | Address | Phone | Applicant Type | |
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LILLY BROADCASTING, L.L.C. Doing Business As: LILLY BROADCASTING, L.L.C. |
Kevin Lilly 2 EAST LEIGH LANE NATICK, MA 01760 United States |
+1 (508) 651-4994 | kevin@lillytv.com | Limited Liability Company |
Applicant | Address | Phone | |
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[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. | Yes |
Briefly describe transition plan | WENY-TV operates on the same antenna as WSKA and WYDC, all are being repacked. An interim antenna may be needed to accommodate the stations, because WYDC is in a different phase. The stations have not agreed on use of the antenna(s) or a transition plan. |
Section | Question | Response |
---|---|---|
Transmitter Related Expenses | Do you have transmitter related expenses? | Yes |
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 | HU5000 INNOVATOR HX | |
Year | 2007 | |
Type | Solid State | |
Solid State Cooling | Air Cooled | |
Solid State Power Capacity | 5 kW |
Section | Question | Response |
---|---|---|
New Transmitter | Use | Primary (Main) |
Change Type | Purchase New | |
Is this a request for upgraded equipment? | No | |
Manufacturer | ||
Model | To be determined | |
Transmitter Type | Solid State | |
Solid State Cooling | Air Cooled | |
Solid State Power capacity | 6 kW | |
Justification for New Transmitter | The existing transmitter cannot be retuned to operate on channel 35. The manufacturer is no longer supporting the equipment. |
Section | Question | Response |
---|---|---|
Electrical Service | Service Entrance (3 phases 800A 208V) | Yes |
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? | Yes |
Type | Heating and Cooling | |
Size | 10 tons | |
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 |
---|---|---|
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 this antenna currently shared with any other stations? | Yes | |
Is this 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 | Top Mount | |
Antenna position in stack | Not in Stack | |
Polarization | Horizontal | |
Type | Broadband Panel | |
Number of Stations Supported | 3 | |
Number of Panels | 28 | |
Design power capacity in use | 75.0 % | |
Lower Limit | 535.00 MHz | |
Upper Limit | 700.00 MHz | |
Other Antenna Type | N/A | |
ERP: | 100.0 kW | |
Manufacturer | ||
Model | TUA-C4SP-8 28M-1-T | |
Year | 2006 |
Facility ID | Call Sign |
---|---|
62219 | WYDC |
78908 | WSKA |
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? | Yes | |
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 | Elliptical | |
Type | Broadband Panel | |
Number of Stations Supported | 2 | |
Number of Panels/Bays | 12 | |
Lower Limit | 470.00 MHz | |
Upper Limit | 600.00 MHz | |
Design power capacity in use | 75.0 % | |
Other Antenna Type | N/A | |
ERP: | 100.0 kW | |
Manufacturer | ||
Model | tbd | |
Year | 2017 | |
Justification for New Antenna | Share new antenna with WYDC. Can not reach agreement with WSKG |
Section | Question | Response |
---|---|---|
Combiner for Shared Antenna | Do you need a Combiner for a Shared Antenna? | Yes |
Type | New | |
Number of channels supported | 2 | |
Frequencies of channels supported | RF channel | |
Frequency | N/A | |
Do you need a combiner output splitter/switcher for dual feed lines? | No | |
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? | Yes |
Pattern Scatter Analysis | Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? | Yes |
Sweep Test | Do you require the sweep testing of transmission line and antenna? | Yes |
RF Channel Number |
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30 |
35 |
Section | Question | Response |
---|---|---|
New Antenna Description | Use | Interim |
Description of Use | N/A | |
Change Type | Purchase New | |
Ownership | Owned | |
Owner | N/A | |
Is antenna shared? | Yes | |
Is antenna directional? | Yes | |
Will antenna be located on or in close proximity to an antenna farm? | No | |
New Antenna Manufacturer and Type | Class | Full Power |
Mounting | Side Mount | |
Antenna position in stack | Not in Stack | |
Polarization | Horizontal | |
Type | Broadband Panel | |
Number of Stations Supported | 3 | |
Number of Panels/Bays | 14 | |
Lower Limit | 535.00 MHz | |
Upper Limit | 700.00 MHz | |
Design power capacity in use | 75.0 % | |
Other Antenna Type | N/A | |
ERP: | 100.0 kW | |
Manufacturer | ||
Model | To be determined | |
Year | 2017 | |
Justification for New Antenna | 3 antenna partners must change channels and transition phases are not the same. The existing antenna is directional. A new antenna may be required for seamless operation during the transition. |
Section | Question | Response |
---|---|---|
Combiner for Shared Antenna | Do you need a Combiner for a Shared Antenna? | Yes |
Type | New | |
Number of channels supported | 3 | |
Frequencies of channels supported | Upper and lower frequency | |
Frequency | 535.0 MHz - 698.0 MHz | |
Do you need a combiner output splitter/switcher for dual feed lines? | No | |
Elbow Complex | Do you require the separate purchase of the Elbow Complex? | Yes |
Broadband or Single Channel? | B | |
Feed Line Size | 4 1/16 inches | |
Side Mount Brackets | Do you require the separate purchase of side mount brackets for an 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 |
Section | Question | Response |
---|---|---|
Transmission Line Related Expenses | Do you have transmission line related expenses? | Yes |
Section | Question | Response |
---|---|---|
New Transmission Line Costs | Use | Interim |
Description of Use | N/A | |
Change Type | Purchase New | |
Type | Rigid | |
Diameter | 4 1/16 inches | |
Segment Length | 20' | |
Other Segment Length | ||
Number of parallel runs | 1 | |
Length | 950 feet per run | |
Justification for New Transmission Line | interim line |
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 | Leased | |
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? | Yes | |
Is tower compliant with Rev G? | No | |
Existing Tower Structure Registration | Do you have a tower registration number? | No |
ASR Number | ||
Coordinates (NAD83) | Latitude (NAD83) | 42° 08' 31.2" N- |
Longitude (NAD83) | 077° 04' 38.8" W- | |
Overall Structure Height | 800.52 feet | |
Support Structure Height | 800.52 feet | |
Ground Elevation Above Mean Sea Level (AMSL) | 1679.77 feet | |
Structure Type | TOWER - Free Standing or Guyed Structure | |
Tower Owner | GRI Telecom, Inc | |
Date Constructed | 08/27/2006 |
Facility ID | Call Sign | Service |
---|---|---|
78908 | WSKA | DTV |
62219 | WYDC | DTV |
Section | Question | Response |
---|---|---|
Engineering Study | Please what type of engineering study is required, if any: | Study needed for documented tower |
Tower Reinforcements | Please select whether tower reinforcements are needed: | Minor 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? | Yes |
Number of Hours | 200 | |
Explanation | Tower mods, coordinate shared antenna issues, and attorney project management for accounting and legal issues. | |
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 | Yes | |
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 |
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 | Yes | |
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)? | No |
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? | Yes | |
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 | $311,400.00 | $276,126.00 | N/A | $0.00 | N/A |
Total for all systems | $1,522,620.00 | $1,439,911.00 | N/A | $6,287.50 | N/A |
Primary Transmitter To be determined | $311,400.00 | $276,126.00 | $0.00 | ||
Service entrance 3 phase/800 amp/208 volt | $14,400.00 | $13,700.00 | N/A | N/A | N/A |
UHF - Air Cooled Solid State Transmitter 4 - 6 kW | $236,500.00 | $262,426.00 | quote from Rohde and Schwarz | N/A | N/A |
10 Ton system | $60,500.00 | $0.00 | N/A | N/A | N/A |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $469,220.00 | $458,200.00 | N/A | $0.00 | N/A |
Total for all systems | $1,522,620.00 | $1,439,911.00 | N/A | $6,287.50 | N/A |
Interim Antenna To be determined | $236,880.00 | $231,800.00 | $0.00 | ||
UHF – Broadband Panel, Side Mount Auxiliary/Interim, 100 horizontally polarized | $135,000.00 | $135,000.00 | Estimate based on value for UHF – Broadband Panel, Side Mount Aux/Interim, 45 kW input, low gain, horizontally polarized antenna in the Catalog of Potential Expenses and Estimated Costs. | N/A | N/A |
Sweep test of existing antenna | $6,730.00 | $6,400.00 | N/A | N/A | N/A |
New combiner, cost per channel (without antenna) | $84,200.00 | $80,000.00 | N/A | N/A | N/A |
Elbow complex, broadband, at antenna input, per 4 1/16. feedline (if needed) | $10,950.00 | $10,400.00 | N/A | N/A | N/A |
Primary Antenna tbd | $232,340.00 | $226,400.00 | $0.00 | ||
Side mount brackets for high power antennas (if not included in antenna base cost) | $23,150.00 | $22,000.00 | N/A | N/A | N/A |
UHF - High Power, Side Mount, broadband panel, 12 bay,, 100 kW input, directional,, elliptically or circularly polarized | $113,000.00 | $113,000.00 | N/A | N/A | N/A |
Sweep test of existing antenna | $6,730.00 | $6,400.00 | N/A | N/A | N/A |
New combiner, cost per channel (without antenna) | $84,200.00 | $80,000.00 | N/A | N/A | N/A |
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) | $5,260.00 | $5,000.00 | N/A | N/A | N/A |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $134,900.00 | $128,250.00 | N/A | $0.00 | N/A |
Total for all systems | $1,522,620.00 | $1,439,911.00 | N/A | $6,287.50 | N/A |
Interim Transmission Line | $134,900.00 | $128,250.00 | $0.00 | ||
Rigid Transmission Line - copper, 4 1/16" | $134,900.00 | $128,250.00 | N/A | N/A | N/A |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $381,100.00 | $362,000.00 | N/A | $0.00 | N/A |
Total for all systems | $1,522,620.00 | $1,439,911.00 | N/A | $6,287.50 | N/A |
Primary Tower TOWER | $381,100.00 | $362,000.00 | $0.00 | ||
Tall Tower (greater than 500') | $210,500.00 | $200,000.00 | N/A | N/A | N/A |
Structural engineering tower load study for well documented tower | $12,600.00 | $12,000.00 | N/A | N/A | N/A |
Minor tower reinforcement/modifications | $158,000.00 | $150,000.00 | N/A | N/A | N/A |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $192,810.00 | $182,750.00 | N/A | $6,287.50 | N/A |
Total for all systems | $1,522,620.00 | $1,439,911.00 | N/A | $6,287.50 | N/A |
Outside Professional Services | $192,810.00 | $182,750.00 | $6,287.50 | ||
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 |
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 |
Attorney Fees - Negotiation of lease and other matters for shared locations | $4,210.00 | $4,000.00 | 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 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 | $7,000.00 | 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 |
Prepare and or review reimbursement form | $2,630.00 | $2,500.00 | N/A | N/A | N/A |
Project management of the transition | $31,600.00 | $30,000.00 | N/A | $6,287.50 | N/A |
Attorney Fees - Prepare and File request for Special Temporary Authorization | $3,680.00 | $3,500.00 | 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 |
ASR modification (prepare FCC Form 854) | $2,105.00 | $2,000.00 | N/A | N/A | N/A |
RF Exposure Measurements | $21,050.00 | $20,000.00 | N/A | N/A | N/A |
Actual Information Description | File Name |
---|---|
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. |
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet | Information not provided. |
Attorney Fees - Negotiation of lease and other matters for shared locations | 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 request for Special Temporary Authorization | 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 | Information not provided. |
Perform engineering study for new channel assignment and antenna development | Information not provided. |
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 | |
Attorney Fees - Prepare and File request for Special Temporary Authorization | Information not provided. |
NEPA Section 106 environmental review, if needed | Information not provided. |
ASR modification (prepare FCC Form 854) | Information not provided. |
RF Exposure Measurements | Information not provided. |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $33,190.00 | $32,585.00 | N/A | $0.00 | N/A |
Total for all systems | $1,522,620.00 | $1,439,911.00 | N/A | $6,287.50 | N/A |
Other Expenses | $33,190.00 | $32,585.00 | $0.00 | ||
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 | $0.00 | $0.00 | N/A | N/A | N/A |
Equipment Delivery and Handling Charges | $5,000.00 | $5,000.00 | Estimate based on prior experience. | 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 |
Non-zoning permits | $0.00 | $0.00 | N/A | N/A | N/A |
DTV Medical Facility Notification | $11,550.00 | $11,000.00 | N/A | N/A | N/A |
MVPD Notification of Channel Change | $5,000.00 | $5,000.00 | Estimate based on prior experience. | N/A | N/A |
Develop and air announcement of upcoming channel change | $10,000.00 | $10,000.00 | Estimate based on prior experience. | N/A | N/A |
BLM or NFS Coordination | $0.00 | $0.00 | N/A | N/A | N/A |
Predetermined Cost Estimate |
Estimated Cost | Actual Cost | |
---|---|---|---|
Total for all systems | $1,522,620.00 | $1,439,911.00 | $6,287.50 |
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. | Kevin Lilly Manager of Sole Member 03/29/2018 |
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. | Kevin Lilly Manager of Sole Member 03/29/2018 |