Applicant | Address | Phone | Applicant Type | |
---|---|---|---|---|
GRAY TELEVISION LICENSEE, LLC |
Robert Folliard 4370 Peachtree Road Atlanta, GA 30319 United States |
+1 (202) 750-1585 | Robert.Folliard@gray.tv | Limited Liability Company |
Applicant | Address | Phone | |
---|---|---|---|
[Confidential] |
|
|
|
Applicant | Address | Phone | |
---|---|---|---|
Samuel Hariton Widelity |
Samuel Hariton 4031 University Dr Suite 100 Fairfax, VA 22030 United States |
+1 (339) 222-8107 | sam.hariton@widelity.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. | Yes |
Briefly describe transition plan | KYTV proposes to use the existing KYCW-LD channel 19 equipment as its auxiliary during the transition. They will be replacing their transmitter, antenna, and transmission line. |
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 | CD3400P4 | |
Year | 2000 | |
Type | Inductive Output Tube | |
IOT Power Type | Other | |
Other IOT Power Type | 4 | |
Power Capacity | 69.2 kW |
Section | Question | Response |
---|---|---|
New Transmitter | Use | Primary (Main) |
Change Type | Purchase New | |
Is this a request for upgraded equipment? | Yes | |
Manufacturer | ||
Model | ULXTE-150 | |
Transmitter Type | Solid State | |
Solid State Cooling | Liquid Cooled | |
Solid State Power capacity | 87 kW | |
Justification for New Transmitter | Our existing transmitter is a 4 IOT channel 44 that cannot be retuned, see GatesAir memo 1/1/2017. |
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 | The new transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors. | |
HVAC Service | Does the replacement transmitter require HVAC Service? | No |
Type | N/A | |
Size | N/A | |
Other Size | N/A | |
Transmitter Building Addition/Modification or Leasehold Improvement | Does the Transmitter Building require an addition, modification, other leashold improvement? | No |
Size | N/A | |
Channel 14 Costs | Is an RF Consulting Engineer needed? | N/A |
Is a channel 14 Mask Filer needed? | N/A | |
Is additional field engineering time needed? | N/A | |
Number of Days | N/A |
Section | Question | Response |
---|---|---|
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? | Yes | |
Existing Antenna Manufacturer and Type | Class | Full Power |
Mounting | Top Mount | |
Antenna position in stack | Top | |
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: | 967.0 kW | |
Manufacturer | ||
Model | TFU-24GTH-R 04 | |
Year | 2000 |
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? | No | |
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 | Top | |
Polarization | Circular | |
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: | 1000.0 kW | |
Manufacturer | ||
Model | TFU 24JTH/VP-R 04 | |
Year | 2018 | |
Justification for New Antenna | Existing antenna is channel 44 and cannot be retuned to new channel. |
Section | Question | Response |
---|---|---|
Combiner for Shared Antenna | Do you need a Combiner for a Shared Antenna? | No |
Type | ||
Number of channels supported | N/A | |
Frequencies of channels supported | N/A | |
Frequency | N/A | |
Do you need a combiner output splitter/switcher for dual feed lines? | N/A | |
Elbow Complex | Do you require the separate purchase of the Elbow Complex? | Yes |
Broadband or Single Channel? | Single Channel | |
Feed Line Size | 6 1/8 inches inches | |
Side Mount Brackets | Do you require the separate purchase of side mount brackets for a high power antenna? | 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 |
---|---|
Top Plate Adapter |
Top plate adapter to match tower top and antenna bolt pattern. |
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? | No | |
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 | 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: | 1000.0 kW | |
Manufacturer | ||
Model | ATW29HS3-ESO-19H | |
Year | 2008 | |
Justification for New Antenna | Station is utilizing a repurposed antenna and will incur installation costs only for this interim antenna. |
Section | Question | Response |
---|---|---|
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 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 |
---|---|---|
Existing Transmission Line Description | Type of change | Utilize Existing |
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 | Dielectric |
Type | Rigid | |
Diameter | 8 3/16 inches | |
Other Diameter | N/A | |
Segment Length | 20 inches | |
Other Segment Length | N/A | |
Number of parallel runs | 1 | |
Length | 1970 feet per run |
Name | Description |
---|---|
Refurbish Transmission Line |
Cleaning / refurbishment of transmission line due to long term wear and replacement of inner components as recommended by Precision Communications Inc. |
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) | No | |
Others Types of Users | Yes | |
Is tower documented for structural analysis? | Yes | |
Is tower compliant with Rev G? | No | |
Existing Tower Structure Registration | Do you have a tower registration number? | Yes |
ASR Number | 1218324 | |
Coordinates (NAD83) | Latitude (NAD83) | 37° 10' 26.0" N- |
Longitude (NAD83) | 092° 56' 28.1" W- | |
Overall Structure Height | 1999.32 feet | |
Support Structure Height | 1885.15 feet | |
Ground Elevation Above Mean Sea Level (AMSL) | 1546.90 feet | |
Structure Type | TOWER - Free Standing or Guyed Structure | |
Tower Owner | Gray Television Group, Inc. | |
Date Constructed | 11/28/2000 |
Users |
---|
KYCW-LD 11135 |
Wireless ISP |
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: | No reinforcements needed |
Section | Question | Response |
---|---|---|
Tower Rigging Costs | Complex Tower | N/A |
Helicopter Services Required | Are helicopter services required? | No |
Name | Description |
---|---|
Minor Modification |
Modification for new top plate adapter |
Section | Question | Response |
---|---|---|
Outside Project Management Services | Do you require outside project management services? | Yes |
Number of Hours | 900 | |
Explanation | Strategic Support | |
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 | 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 | Yes | |
Number of Days | 3 | |
Justification | We may need additional support because we are forgoing an auxiliary system and will need to guarantee quick on-air since it is being done after our period date. |
Name | Description |
---|---|
Attorney - Other Matters |
Legal Services |
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 | Yes | |
Other Miscellaneous Expenses | Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? | Yes |
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? | Yes | |
Does this relocation require Equipment Storage? | Yes | |
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? | Yes | |
Does this relocation require MVPD Notification of a Channel Change? | Yes |
Name | Description |
---|---|
Floor Mounting Hardware for Mask Filter |
Floor Mounting Hardware for Mask Filter |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $2,737,696.65 | $2,504,187.56 | N/A | $2,496,941.43 | N/A |
Total for all systems | $3,858,302.38 | $3,709,786.89 | N/A | $3,246,840.92 | N/A |
Primary Transmitter ULXTE-150 | $2,737,696.65 | $2,504,187.56 | $2,496,941.43 | ||
UHF - Liquid Cooled Solid State Transmitter 86.8 . 106 kW | $2,630,000.00 | $2,396,490.91 | N/A | $2,389,244.78 | N/A |
Other Electrical Service: The new transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors. | $107,696.65 | $107,696.65 | AC Electrical Systems Inc. Invoice #KTW221-2 & 199712 | $107,696.65 | N/A |
Actual Information Description | File Name |
---|---|
UHF - Liquid Cooled Solid State Transmitter 86.8 . 106 kW | |
Other Electrical Service: The new transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors. |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $396,562.50 | $302,284.10 | N/A | $221,141.53 | N/A |
Total for all systems | $3,858,302.38 | $3,709,786.89 | N/A | $3,246,840.92 | N/A |
Interim Antenna ATW29HS3-ESO-19H | $54,452.50 | $54,122.50 | $47,722.50 | ||
Sweep test of existing antenna | $6,730.00 | $6,400.00 | N/A | N/A | N/A |
UHF - High Power, Side Mount, basic slot antenna, 1000 kW input, directional,, horizontally polarized | $47,722.50 | $47,722.50 | Per Precision Communications Proposal 18380-5 antenna cost only and Addendum to Proposal 18380-5 | $47,722.50 | N/A |
Primary Antenna TFU 24JTH/VP-R 04 | $342,110.00 | $248,161.60 | $173,419.03 | ||
Top Plate Adapter | $18,330.00 | $18,330.00 | N/A | $8,248.50 | N/A |
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) | $12,300.00 | $12,768.00 | Please see the attached DTVPros quote JEHQ1261-06 and invoice # 156-3. | $5,745.60 | N/A |
Sweep test of existing antenna | $6,730.00 | $9,900.00 | Per DTVPros Quote JEHQ1261-06 and Marsand Quote 1928 | $9,900.00 | N/A |
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized | $289,500.00 | $203,971.60 | Per the attached Estimated Cost Justification KYTV-210-New Primary Antenna v0 | $146,332.93 | N/A |
Elbow complex, single channel, at antenna input, per 8 3/16. feedline (if needed) | $15,250.00 | $3,192.00 | ***System Notice: Estimate adjusted and locked because line has been superseded.***DTV pros quote JEHQ1261-01 | $3,192.00 | N/A |
Actual Information Description | File Name |
---|---|
Sweep test of existing antenna | Information not provided. |
UHF - High Power, Side Mount, basic slot antenna, 1000 kW input, directional,, horizontally polarized | |
Top Plate Adapter | |
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) | |
Sweep test of existing antenna | |
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized | |
Elbow complex, single channel, at antenna input, per 8 3/16. feedline (if needed) |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $206,186.85 | $206,186.85 | N/A | ($39,215.60) | N/A |
Total for all systems | $3,858,302.38 | $3,709,786.89 | N/A | $3,246,840.92 | N/A |
Primary Transmission Line | $206,186.85 | $206,186.85 | ($39,215.60) | ||
Refurbish Transmission Line | $206,186.85 | $206,186.85 | N/A | ($39,215.60) | N/A |
Actual Information Description | File Name |
---|---|
Refurbish Transmission Line |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $243,100.00 | $440,552.00 | N/A | $420,552.00 | N/A |
Total for all systems | $3,858,302.38 | $3,709,786.89 | N/A | $3,246,840.92 | N/A |
Primary Tower TOWER | $243,100.00 | $440,552.00 | $420,552.00 | ||
Structural engineering tower load study for well documented tower | $12,600.00 | $28,902.00 | see Estimated Cost Justification KYTV-410-Structural analysis existing tower v0 | $28,902.00 | N/A |
Minor Modification | $20,000.00 | $20,000.00 | original entry of $2,000 was a typo | $0.00 | N/A |
Tall Tower (greater than 500') | $210,500.00 | $391,650.00 | Precision Comm Inc Invoices | $391,650.00 | N/A |
Actual Information Description | File Name |
---|---|
Structural engineering tower load study for well documented tower | |
Minor Modification | Information not provided. |
Tall Tower (greater than 500') |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $178,532.00 | $169,372.00 | N/A | $97,067.95 | N/A |
Total for all systems | $3,858,302.38 | $3,709,786.89 | N/A | $3,246,840.92 | N/A |
Outside Professional Services | $178,532.00 | $169,372.00 | $97,067.95 | ||
Perform engineering study for new channel assignment and antenna development | $7,360.00 | $7,000.00 | N/A | $3,937.50 | N/A |
Attorney - Other Matters | $222.00 | $222.00 | KYTV Justification Outside Professional Services -Attorney - Other Matters | $222.00 | N/A |
Additional Field Engineering Service, 3 Days | $5,400.00 | $5,400.00 | N/A | N/A | N/A |
Attorney Fees - Prepare and File request for Special Temporary Authorization | $3,680.00 | $3,500.00 | N/A | $490.50 | N/A |
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | $2,365.00 | $2,250.00 | N/A | $631.00 | N/A |
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application | $5,260.00 | $5,000.00 | N/A | $432.50 | 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 | $250.00 | 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 |
Prepare and or review reimbursement form | $2,630.00 | $2,500.00 | N/A | N/A | N/A |
Project management of the transition | $142,200.00 | $135,000.00 | N/A | $91,104.45 | N/A |
Actual Information Description | File Name |
---|---|
Perform engineering study for new channel assignment and antenna development | |
Attorney - Other Matters | |
Additional Field Engineering Service, 3 Days | Information not provided. |
Attorney Fees - Prepare and File request for Special Temporary Authorization | |
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 | |
Prepare request for Special Temporary Authorization | Information not provided. |
Prepare engineering section of FCC Form 2100 (main), License to Cover Application | |
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. |
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 | $96,224.38 | $87,204.38 | N/A | $50,353.61 | N/A |
Total for all systems | $3,858,302.38 | $3,709,786.89 | N/A | $3,246,840.92 | N/A |
Other Expenses | $96,224.38 | $87,204.38 | $50,353.61 | ||
Floor Mounting Hardware for Mask Filter | $12,252.12 | $12,252.12 | Please see the attached GatesAir quotes Q-79428 and Q-79477 | N/A | N/A |
MVPD Notification of Channel Change | $1,114.76 | $1,114.76 | N/A | $1,114.76 | N/A |
Develop and air announcement of upcoming channel change | $5,000.00 | $5,000.00 | N/A | $2,362.50 | N/A |
Equipment Storage | $3,000.00 | $3,000.00 | N/A | N/A | N/A |
Disposal Costs (for equipment and other waste, net of any salvage value) | $45,077.50 | $45,077.50 | See attached Sunbelt Environmental Services, Inc. “Waste Disposal Cost Proposal” for $4,795. See attached Comark quote 4034 KYTV Itemization of Existing Transmitter Removal Proposal, for $33,700. | $45,077.50 | a |
FCC Filing Fees - Special Temporary Authorization request | $195.00 | $190.00 | N/A | $190.00 | 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 | $2,545.00 | N/A | N/A | N/A |
Equipment Delivery and Handling Charges | $17,700.00 | $17,700.00 | N/A | $1,608.85 | N/A |
Actual Information Description | File Name |
---|---|
Floor Mounting Hardware for Mask Filter | Information not provided. |
MVPD Notification of Channel Change | |
Develop and air announcement of upcoming channel change | |
Equipment Storage | Information not provided. |
Disposal Costs (for equipment and other waste, net of any salvage value) | |
FCC Filing Fees - Special Temporary Authorization request | |
FCC Filing Fees - Form 2100 license to cover application | Information not provided. |
DTV Medical Facility Notification | Information not provided. |
Equipment Delivery and Handling Charges |
Predetermined Cost Estimate |
Estimated Cost | Actual Cost | |
---|---|---|---|
Total for all systems | $3,858,302.38 | $3,709,786.89 | $3,246,840.92 |
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. | Robert Folliard , III . Assistant Secretary 09/19/2019 |
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. | Robert Folliard , III . Assistant Secretary 09/19/2019 |