Go to the Federal Communications Commission homepage at www.fcc.gov

FCC Form 399: Reimbursement Request

Approved by OMB 3060-1178
Go to the Federal Communications Commission homepage at www.fcc.gov

(REFERENCE COPY - Not for submission) FCC Form 399: Reimbursement Request

Facility ID:
35512
Service:
DTV
Call Sign:
KTFF-DT
Channel:
23 (UHF)
File Number:
0000028138
FRN:
0008192593
Date Submitted:
06/10/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

UNIMAS FRESNO LLC

Doing Business As: UNIMAS FRESNO LLC

CHRISTOPHER G. WOOD

5999 CENTER DRIVE

LOS ANGELES, CA 90045

United States

+1 (310) 348-3600 CWOOD@UNIVISION.NET Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

Theodore Stoner

VP Distribution Technology

Univision Management Company

Theodore Stoner

9405 NW 41st Street

Miami, FL 33178

United States

+1 (513) 608-0308 tstoner@univision.net

Broadcaster Information and Transition Plan

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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 Install new antenna in ex-analog aperture; install new transmitter & mask filter and modify electrical facilities in existing building; remove channel 48 DTV antenna & transmitter. See attached Implementation Plan document for more information.

Transmitters

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Section Question Response
Transmitter Related Expenses Do you have transmitter related expenses? Yes

Primary Transmitter

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Existing Transmitter Information

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 DHD60P2
Year 2001
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 14 kW

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Manufacturer
Model THU9-8evo
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 13 kW
Justification for New Transmitter Amplifiers of existing transmitter are incapable of operation below channel 40, have been discontinued by the manufacturer, and replacements are not otherwise available. See attached Antenna & Transmitter Analysis document for selection justification.

Primary Transmitter

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Other Transmitter Costs

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 Modification of electrical power distribution system to provide power to new transmitter
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

Primary Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

Antennas

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Section Question Response
Antenna Related Expenses Do you have antenna related expenses? Yes

Primary Antenna

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Existing Antenna Information

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 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: 197.0 kW
Manufacturer
Model TFU-10DSC C170
Year 2000

Primary Antenna

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New Antenna Costs

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 Elliptical
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: 330.0 kW
Manufacturer
Model TFU-20DSB/VP-M-R
Year 2018
Justification for New Antenna Existing (channel 48) antenna not capable of operation on newly assigned channel

Primary Antenna

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Other Antenna Costs

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 4 1/16 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

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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Section Question Response
Transmission Line Related Expenses Do you have transmission line related expenses? Yes

Primary Transmission Line

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Existing Transmission Line

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 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 120 feet per run

Primary Transmission Line

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New Transmission Line

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 Air
Diameter 5 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 150 feet per run
Justification for New Transmission Line KTFF must install second line to support testing and commissioning of post auction antenna using a second aperture on the existing tower. A dormant analog line was intended for this purpose but was corroded and not suitable for reuse per attached report.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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Section Question Response
Tower Equipment or Rigging Costs Changes Do you have tower equipment or rigging costs changes? Yes

Primary Tower

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Existing Tower

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? 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? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1065031
Coordinates (NAD83) Latitude (NAD83) 36° 17' 14.0" N-
Longitude (NAD83) 118° 50' 20.0" W-
Overall Structure Height 128.94 feet
Support Structure Height 75.13 feet
Ground Elevation Above Mean Sea Level (AMSL) 5715.81 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Falcon Cable Systems Company II, LP
Date Constructed 10/27/1998


Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Study needed for undocumented/poorly documented tower
Tower Reinforcements Please select whether tower reinforcements are needed: Minor Reinforcements needed

Primary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower N/A
Helicopter Services Required Are helicopter services required? No

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Post Installation Inspection Fee

Post Installation Inspection Fee

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 1115
Explanation Univision stations are only staffed for daily station operations and minor equipment changes, major projects are contracted out externally. The large volume of work associated with repack schedule requires using external project management 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 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 Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers No
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements Yes
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

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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 Yes
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? No
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? No
Does this relocation require MVPD Notification of a Channel Change? No

Other Expenses

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Other Expenses Not Listed

Name Description

Structural Analysis

Structural Analysis fee

Lease Amendment Application Fee

Lease application fee

Cost Information

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Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $507,400.00 $387,900.00 N/A $272,912.76 N/A
Total for all systems $1,435,113.00 $860,225.54 N/A $409,351.42 N/A
Primary Transmitter THU9-8evo $507,400.00 $387,900.00 $272,912.76
Other Electrical Service: Modification of electrical power distribution system to provide power to new transmitter $12,900.00 $12,900.00 See attached quote for electrical installation of same transmitter at KUVS-DT, Modesto, CA N/A N/A
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW $494,500.00 $375,000.00 N/A $272,912.76 N/A

Components

Actual Information Description File Name
Other Electrical Service: Modification of electrical power distribution system to provide power to new transmitter Information not provided.
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW

Component Description:
DP 35% Factory Acceptance Charge PO# Line 1, 13 kW UHF DTV Transmitter
Amount:
$93,466.89

Component Description:
Transmission installation services
Amount:
$93,466.89

Component Description:
30% of THU9-6 EVO 9.8 kW (ATSC Total Package)
Amount:
$65,871.00

Component Description:
30% Down Payment on Transmitter Installation Services, tax
Amount:
$14,243.48

Component Description:
30% of $32,430 Down payment-KTFF transmitter installation planning & site survey. The other 50% is for KUVI.
Amount:
$4,864.50

Component Description:
30% of $219,570 and $1,000 Downpayment- THU9-6 EVO 9.8 kW
Amount:
$66,871.00

Component Description:
KTFF/KUVI Split Invoice- See cover sheet
Amount:
$4,864.50

Component Description:
N/A
Amount:
N/A

Cost Information

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Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $330,330.00 $74,049.00 N/A $0.00 N/A
Total for all systems $1,435,113.00 $860,225.54 N/A $409,351.42 N/A
Primary Antenna TFU-20DSB/VP-M-R $330,330.00 $74,049.00 $0.00
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $7,500.00 Brackets for "comparable" TFU-8DSB-M-R antenna, per Dielectric quote in attached Antenna & Transmitter Info document. N/A N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $289,500.00 $53,091.00 "Comparable" TFU-8DSB-M-R antenna $33,283, input transformer $4,676, plus 8.25% sales/use tax & $9,300 estimated shipping. See attached Antenna & Transmitter Info document, which includes Dielectric quote. N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Elbow complex, broadband, at antenna input, per 4 1/16. feedline (if needed) $10,950.00 $7,058.00 Please see the attached Dielectric quote 800219CMZ-2 N/A N/A

Components

Information not provided.

Cost Information

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Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $15,750.00 $25,846.04 N/A $5,834.76 N/A
Total for all systems $1,435,113.00 $860,225.54 N/A $409,351.42 N/A
Primary Transmission Line $15,750.00 $25,846.04 $5,834.76
Flexible Air Transmission Line - dielectric, 5" $15,750.00 $25,846.04 Please see attached quote from Dielectric 800219CMZ-2 $5,834.76 N/A

Components

Actual Information Description File Name
Flexible Air Transmission Line - dielectric, 5"

Component Description:
T/L Tuner indoor use 3-50 14-37
Amount:
$1,640.25

Component Description:
MYAT 3 1/8" UNFLANGED 90deg ELBOW
Amount:
$2,888.46

Component Description:
MYAT 3 1_8inx 20ft UNFLANGED LINE SECTION
Amount:
$1,306.05

Cost Information

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Tower Equipment and Rigging Costs

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $270,000.00 $169,900.00 N/A $48,487.50 N/A
Total for all systems $1,435,113.00 $860,225.54 N/A $409,351.42 N/A
Primary Tower TOWER $270,000.00 $169,900.00 $48,487.50
Post Installation Inspection Fee $1,500.00 $1,500.00 Per KGI Invoice CHTR50957 N/A N/A
Short Tower (less than 500') $84,200.00 $98,400.00 See Beckman Tower invoice #181120 N/A N/A
Minor tower reinforcement/modifications $158,000.00 $50,000.00 N/A $48,487.50 N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $20,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Post Installation Inspection Fee Information not provided.
Short Tower (less than 500') Information not provided.
Minor tower reinforcement/modifications

Component Description:
Mast and Tower Reinforcement
Amount:
$48,487.50
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study Information not provided.

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $223,780.00 $122,487.50 N/A $32,398.40 N/A
Total for all systems $1,435,113.00 $860,225.54 N/A $409,351.42 N/A
Outside Professional Services $223,780.00 $122,487.50 $32,398.40
Project management of the transition $176,170.00 $99,675.00 Please see the attached quotes for project management. $32,323.40 N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $1,000.00 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 $2,500.00 N/A $0.00 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 $0.00 N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $0.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $62.50 N/A N/A N/A
RF Exposure Measurements $21,050.00 $10,000.00 N/A $75.00 N/A

Components

Actual Information Description File Name
Project management of the transition

Component Description:
Project Management Services
Amount:
$1,315.50

Component Description:
Project management services
Amount:
$84.00

Component Description:
Project management services
Amount:
$121.50

Component Description:
Project management services
Amount:
$525.00

Component Description:
Project Management
Amount:
$6,275.00

Component Description:
Project Management
Amount:
$2,709.00

Component Description:
Project management services
Amount:
$537.00

Component Description:
Project Management
Amount:
$1,637.35

Component Description:
Project Management
Amount:
$4,355.60

Component Description:
Project Management
Amount:
$1,829.40

Component Description:
Project Management
Amount:
$1,237.30

Component Description:
Project Management
Amount:
$4,017.00

Component Description:
Project Management
Amount:
$2,970.45

Component Description:
Project management services
Amount:
$922.50

Component Description:
Project Management
Amount:
$3,086.30

Component Description:
Project management services
Amount:
$700.50
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 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.
Prepare and or review reimbursement form Information not provided.
Perform engineering study for new channel assignment and antenna development Information not provided.
RF Exposure Measurements

Component Description:
RF exposure measurement scheduling
Amount:
$75.00

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $87,853.00 $80,043.00 N/A $49,718.00 N/A
Total for all systems $1,435,113.00 $860,225.54 N/A $409,351.42 N/A
Other Expenses $87,853.00 $80,043.00 $49,718.00
Lease Amendment Application Fee $2,500.00 $2,500.00 Please see the attached invoice from from KGI Wirless #CHTR50956 N/A N/A
Structural Analysis $2,500.00 $2,500.00 Please see the attached invoice from KGI Wirless and CHTR53737 N/A N/A
Equipment Delivery and Handling Charges $10,732.00 $10,732.00 N/A $10,732.00 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $60,236.00 $60,236.00 GCB Wireless quotes for pre- and post-cutover removal/disposals and Beckman Tower quote #181205 for antenna disposal attached. $35,236.00 N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $3,750.00 RF Notifications invoice 1056 $3,750.00 N/A

Components

Actual Information Description File Name
Lease Amendment Application Fee Information not provided.
Structural Analysis Information not provided.
Equipment Delivery and Handling Charges

Component Description:
Shipment and offload of equipment requiring specialized equipment to reach tower site
Amount:
$10,732.00
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
Bluridge Antenna mast removal
Amount:
$31,800.00

Component Description:
Hazmat Removal
Amount:
$3,436.00
FCC Filing Fees - Form 2100 license to cover application Information not provided.
DTV Medical Facility Notification

Component Description:
Medical Notification Mailing Complete per FCC Repack
Amount:
$3,750.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $1,435,113.00 $860,225.54 $409,351.42

Reimbursement Status

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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

Certification

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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.

  1. The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.

  2. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

  3. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.

  4. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD).

  5. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

  6. The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred.

  7. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.

  8. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.

I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Marcello Enriquez

Senior Finance Analyst


06/10/2019

Attachments

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