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:
24090
Service:
LPD
Call Sign:
WPEM-LD
Channel:
34 (UHF)
File Number:
0000087042
FRN:
0017651043
Eligibility Status:
Not Determined
Date Submitted:
10/22/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

Gerald Locklear

Individual

Doing Business As: GERALD LOCKLEAR

2450 NC HIGHWAY 211 W

LUMBERTON, NC 28360

United States

+1 (910) 739-4477 glministry@netzero.net Individual

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

Tony zumMallen

QCommunications, LLC

705B SE Melody LN #314

Lee's Summit, MO 64063

United States

+1 (816) 729-1177 tony@qcomm.tv

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 Replace the transmitter, line and antenna per the channel reassignment with reasonable and customary engineering and business practices.

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)
Ownership Owned
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model ATJC 1.5 kw
Year 2010
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1.5 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? No
Manufacturer
Model Guanit Series
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2.1 kW
Justification for New Transmitter Transmitter required to match original coverage prior to repack activities.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Other Transmitter Costs
Does the transmitter installation require a Transmitter Building Site Survey/Installation? Yes
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Rigid Conduit and Wiring No
Other Electrical Service No
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Heating and Cooling
Size Other
Other Size 4 tons
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Site Prep

Preparation of site for arrival/installation of new transmitter

Transmitter Taxes

Estimated sales tax collected by vendors as part of the repack. Actual costs to be determined.

Transmitter Shipping fee

Estimated shipping costs for transmitter. Actual costs to be determined.

Transmitter Decommissioning

Disconnect transmitter and components from existing configuration and move within building to make way for new equipment

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)
Ownership Owned
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? No
Existing Antenna Manufacturer and Type
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 1
Number of Panels 4
Design power capacity in use 50.0 %
Lower Limit 590.00 MHz
Upper Limit 596.00 MHz
ERP: 1.0 kW
Manufacturer
Model 4DR/PR-450
Year 2010

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Change Type Purchase New
Ownership Owned
Is antenna shared? No
Is antenna directional? No
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 1
Number of Panels/Bays 4
Lower Limit 590.00 MHz
Upper Limit 596.00 MHz
Design power capacity in use 50.0 %
ERP: 15.0 kW
Manufacturer
Model ATC-BCH512M-34
Year 2019
Justification for New Antenna Replace the antenna per the channel reassignment with reasonable and customary engineering and business practices

Primary Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Single Channel
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? 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
Power Dividers Does the panel antenna require power dividers? Yes
Number of Power Dividers 1
Cable Harness Does the panel antenna require cable harness? Yes
Number of Cable Harnesses 1

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Antenna Taxes

Estimated sales tax collected by vendors as part of the repack. Actual costs to be determined.

Antenna Shipping fees

Estimated shipping costs for antenna. Actual costs to be determined.

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)
Ownership Owned
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Flexible Foam
Diameter 1 5/8 inches
Number of parallel runs 1
Length 500 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Flexible Foam
Diameter Other
Other Diameter 3 inches
Number of parallel runs 1
Length 500 feet per run
Justification for New Transmission Line Line change required due to manufacturer discontinuing 2-1/4" line. 3" line required to match original ERP output.
Interior RF Systems Does the Installation of the Transmission Line require an additional or replacement Inside RF system including switching, patch panels, and dehydrators? No

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Transmission Line Shipping fees

Estimated shipping costs for transmission line. Actual costs to be determined.

Transmission Line Taxes

Estimated sales tax collected by vendors as part of the repack. Actual costs to be determined.

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)
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) No
Others Types of Users Yes
Is tower documented for structural analysis? Unknown
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1007489
Coordinates (NAD83) Latitude (NAD83) 34° 40' 27.0" N-
Longitude (NAD83) 079° 02' 20.1" W-
Overall Structure Height 505.90 feet
Support Structure Height 499.99 feet
Ground Elevation Above Mean Sea Level (AMSL) 144.03 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Pinnacle Towers LLC
Date Constructed 01/01/1995


Other Types of Users

Users
Wireless

Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Tower mapping and report for structural engineer
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

Information not provided.

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 250
Explanation Required to assist in the turnkey management of the channel relocation project in order that the existing internal personnel can maintain and operate the station's daily operational requirements and plans.
Outside RF consulting Engineering Services Perform engineering study for displacement application 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
Prepare Form 601 Yes
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
Negotiation of Lease and other Matter for Shared Locations Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Form 399 assistance or other program management costs Yes
RF Field Engineering Services Comprehensive coverage verification via field study Yes
RF exposure measurements Yes
Additional Field Engineering Service No

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
Permit and Filing Costs FCC Construction Permit Major Change 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)? 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
Point to Point Microwave (STL/ICR) Frequency Coordination for Unidirection System No
Frequency Coordination for Bi-Direction System No
New Point to Point Microwave System No

Other Expenses

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Other Expenses Not Listed

Information not provided.

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 $121,600.00 $136,600.00 N/A $0.00 N/A
Total for all systems $575,452.88 $608,667.88 N/A $0.00 N/A
Primary Transmitter Guanit Series $121,600.00 $136,600.00 $0.00
Site Prep $7,000.00 $7,000.00 Estimate of preparation of site for new transmitter installation. Revised upon Site Survey. N/A N/A
Transmitter Decommissioning $6,000.00 $6,000.00 Estimated costs of harvesting and removal of old transmitter from site. Actual costs to be determined. N/A N/A
Transmitter Shipping fee $1,200.00 $1,200.00 Estimated shipping costs for transmitter. Actual costs to be determined. N/A N/A
Transmitter Taxes $8,400.00 $8,400.00 Estimated sales tax collected by vendors as part of the repack. Actual costs to be determined. N/A N/A
Other -- HVAC Service Type: H Size:4 (Other) $5,000.00 $5,000.00 HVAC costs per attached quote. N/A N/A
Transmitter Building Site Survey/Installation $10,000.00 $25,000.00 Estimated transmitter installation costs. Actual costs to be determined. N/A N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $84,000.00 $84,000.00 N/A N/A N/A

Components

Information not provided.

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 $30,255.00 $43,255.00 N/A $0.00 N/A
Total for all systems $575,452.88 $608,667.88 N/A $0.00 N/A
Primary Antenna ATC-BCH512M-34 $30,255.00 $43,255.00 $0.00
Sweep test of transmission line and antenna $5,730.00 $5,730.00 N/A N/A N/A
Elbow complex, single channel, 3 1/8” input (if needed) $7,600.00 $7,600.00 N/A N/A N/A
Antenna Shipping fees $1,000.00 $1,000.00 Estimated shipping costs for antenna. Actual costs to be determined. N/A N/A
Antenna Taxes $2,000.00 $2,000.00 Estimated antenna sales tax collected by vendors as part of the repack. Actual costs to be determined. N/A N/A
Cable harness (each, for panel antenna system, if not included in antenna cost) $1,000.00 $1,000.00 N/A N/A N/A
Power Dividers (each, for panel antenna system, if not included in antenna cost) $1,300.00 $1,300.00 N/A N/A N/A
Side Mount antenna brackets $4,625.00 $4,625.00 N/A N/A N/A
UHF Broadband panel antenna (per panel), horizontally-polarized $7,000.00 $20,000.00 Estimated antenna costs. Actual cost to be determined. 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 $19,872.88 $19,872.88 N/A $0.00 N/A
Total for all systems $575,452.88 $608,667.88 N/A $0.00 N/A
Primary Transmission Line $19,872.88 $19,872.88 $0.00
Transmission Line Shipping fees $2,149.56 $2,149.56 Estimated shipping costs for transmission line. Actual costs to be determined. N/A N/A
Transmission Line Taxes $1,611.00 $1,611.00 Estimated sales tax collected by vendors as part of the repack. Actual costs to be determined. N/A N/A
Flexible Foam Transmission Line - 3" 1 parallel runs 500 feet $16,112.32 $16,112.32 Transmission line cost per attached quote. N/A N/A

Components

Information not provided.

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 $278,750.00 $278,750.00 N/A $0.00 N/A
Total for all systems $575,452.88 $608,667.88 N/A $0.00 N/A
Primary Tower TOWER $278,750.00 $278,750.00 $0.00
Tower mapping and report for structural engineer $21,000.00 $21,000.00 N/A N/A N/A
Tower Rigging Tall Tower (greater than 500') $157,750.00 $157,750.00 N/A N/A N/A
Minor tower reinforcement/modifications $100,000.00 $100,000.00 Estimated tower modification costs due to possible failing structural analysis. N/A N/A

Components

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 $115,765.00 $120,980.00 N/A $0.00 N/A
Total for all systems $575,452.88 $608,667.88 N/A $0.00 N/A
Outside Professional Services $115,765.00 $120,980.00 $0.00
RF Exposure Measurements $12,100.00 $12,100.00 N/A N/A N/A
Comprehensive coverage verification via field study, if needed $52,600.00 $52,600.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $2,235.00 $2,235.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $3,262.50 $3,262.50 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $1,577.50 $1,577.50 N/A N/A N/A
Prepare Form 601 $755.00 $755.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $3,025.00 $3,025.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,052.50 $1,052.50 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $2,102.50 $2,102.50 N/A N/A N/A
Prepare request for Special Temporary Authorization $1,280.00 $1,280.00 N/A N/A N/A
Perform engineering study for displacement application $1,800.00 $1,800.00 N/A N/A N/A
Form 399 assistance or other Program Management costs $5,890.00 $5,890.00 Per attached QCommunications quote. N/A N/A
Prepare/ Review 399 reimbursement form $1,710.00 $2,500.00 Per attached quote QC-WEPM-1 dated 9/23/19 N/A N/A
Project management of the transition $26,375.00 $30,800.00 Required to assist in the turnkey management of the channel relocation project in order that the existing internal personal can maintain and operate the stations daily operational requirements and plans. N/A N/A

Components

Information not provided.

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 $9,210.00 $9,210.00 N/A $0.00 N/A
Total for all systems $575,452.88 $608,667.88 N/A $0.00 N/A
Other Expenses $9,210.00 $9,210.00 $0.00
Equipment Storage $500.00 $500.00 Expecting multiple staggered equipment deliveries from different vendors and need to store and stage new equipment prior to installation date. N/A N/A
FCC Filing Fees - Special Temporary Authorization request $305.00 $305.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $1,000.00 $1,000.00 4-6 yard disposal bin on site to capture all waste from on site system integration and tower vendors. N/A N/A
Equipment Delivery and Handling Charges $1,000.00 $1,000.00 Transport, forklift rental and handling fees from staging area to transmitter site. N/A N/A
FCC Filing Fees - Form 2100 Major change CP application $4,960.00 $4,960.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $335.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,110.00 N/A N/A N/A

Components

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $575,452.88 $608,667.88 $0.00

Reimbursement Status

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Question Response
The facility has ceased operating on its pre-auction channel.
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.

Gerald Locklear

Owner


10/22/2019

Attachments

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