Applicant | Address | Phone | Applicant Type | |
---|---|---|---|---|
PUGET SOUND EDUCATIONAL TV, INC. |
Arnold Torres 3901 HIGHWAY 121 SOUTH BEDFORD, TX 76021 United States |
+1 (817) 571-1229 | ARNOLD.TORRES@DAYSTAR.COM | Not-for-Profit |
Applicant | Address | Phone | |
---|---|---|---|
[Confidential] |
|
|
|
Applicant | Address | Phone | |
---|---|---|---|
Samuel Hariton Engineer Widelity, Inc. |
Samuel Hariton 4031 University Drive Ste 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. | No |
Briefly describe transition plan | Coordinate with tower owner and other Broadcasters; transition during assigned phase. KWDK will replace antenna and transmitter and remain at same tower site. |
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 | Vissionary | |
Year | 2000 | |
Type | Inductive Output Tube | |
IOT Power Type | Single | |
Power Capacity | 15 kW |
Section | Question | Response |
---|---|---|
New Transmitter | Use | Primary (Main) |
Change Type | Purchase New | |
Is this a request for upgraded equipment? | Yes | |
Manufacturer | ||
Model | TXUD10000ALC | |
Transmitter Type | Solid State | |
Solid State Cooling | Liquid Cooled | |
Solid State Power capacity | 10 kW | |
Justification for New Transmitter | Existing Axcera transmitter is no longer supported by manufacturer as manufacturer is no longer in business. Current transmitter cannot be retuned to new antenna at allotted power level. |
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 | It is estimated that all existing wiring, conduit, and general electrical service will be used. However, in an abundance of caution, we believe that there may be some incidental expenses. | |
HVAC Service | Does the replacement transmitter require HVAC Service? | No |
Type | N/A | |
Size | N/A | |
Other Size | N/A | |
Transmitter Building Addition/Modification or Leasehold Improvement | Does the Transmitter Building require an addition, modification, other leashold improvement? | No |
Size | N/A | |
Channel 14 Costs | Is an RF Consulting Engineer needed? | N/A |
Is a channel 14 Mask Filer needed? | N/A | |
Is additional field engineering time needed? | N/A | |
Number of Days | N/A |
Name | Description |
---|---|
Primary Transmitter - Installation |
Primary Transmitter Installation |
Transmitter Installation - Heat Exchangers |
Mechanical Support for Heat Exchangers Installation |
Primary Transmitter- Other Parts |
Primary Transmitter- Other Parts |
Mask Filter |
Mask Filter |
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 | 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: | 144.0 kW | |
Manufacturer | ||
Model | SWED16OI /42 | |
Year | 2005 |
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 | Side 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: | 123.0 kW | |
Manufacturer | ||
Model | SWEDM12OI/34-EP | |
Year | 2017 | |
Justification for New Antenna | Existing antenna is non-tunable 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? | 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? | 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? | No |
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 | Yes | |
Is tower documented for structural analysis? | Unknown | |
Is tower compliant with Rev G? | Unknown | |
Existing Tower Structure Registration | Do you have a tower registration number? | Yes |
ASR Number | 1056094 | |
Coordinates (NAD83) | Latitude (NAD83) | 47° 30' 16.3" N- |
Longitude (NAD83) | 121° 58' 10.0" W- | |
Overall Structure Height | 310.04 feet | |
Support Structure Height | 270.01 feet | |
Ground Elevation Above Mean Sea Level (AMSL) | 2838.88 feet | |
Structure Type | LTOWER - Lattice Tower | |
Tower Owner | American Tower, LLC | |
Date Constructed | 12/01/1998 |
Facility ID | Call Sign | Service |
---|---|---|
56852 | KWPX-TV | DTV |
66781 | KIRO-TV | DTV |
Users |
---|
KUSE-LD |
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 |
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 | 595 | |
Explanation | KWDK does not have sufficient resource capacity and expertise in house to handle all activities necessary for completion of the station's build by the construction deadline. KWDK will hire an outside firm to facilitate a timely transition. | |
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 | No |
RF exposure measurements | Yes | |
Additional Field Engineering Service | Yes | |
Number of Days | 7 | |
Justification | Installation of transmitter and supervision of antenna installation. |
Name | Description |
---|---|
Site Coordination Meeting |
Site coordination meetings with all broadcasters, contractors and vendors involved with the site project. All involved parties will jointly define a site action plan and cutover approach to allow for construction activities in alignment with stations cont |
Ground and Building A andE Permit Drawing Package |
Generation of permit drawings |
Tower Permit Drawing Package |
Generation of permit drawings. |
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)? | 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 |
---|---|
Nonionizing Electromagnetic Radiation Report |
Report required by local jurisdiction for permitting |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $565,891.68 | $383,367.68 | N/A | $366,065.45 | N/A |
Total for all systems | $1,212,719.39 | $933,235.99 | N/A | $557,357.76 | N/A |
Primary Transmitter TXUD10000ALC | $565,891.68 | $383,367.68 | $366,065.45 | ||
Primary Transmitter- Other Parts | $1,614.68 | $1,614.68 | Please see Graybar quote 0233936006 Rev-1 | $284.70 | N/A |
Transmitter Installation - Heat Exchangers | $695.00 | $695.00 | Please see COMB KWDK Western Sheet Metal Inc Invoice 114347 Justification Letter | N/A | N/A |
Primary Transmitter - Installation | $56,182.00 | $56,182.00 | Please see Estimated Cost Justification KWDK-110-1st Primary Transmitter - Installation V4 | $53,806.75 | N/A |
Other Electrical Service: It is estimated that all existing wiring, conduit, and general electrical service will be used. However, in an abundance of caution, we believe that there may be some incidental expenses. | $5,000.00 | $5,000.00 | N/A | N/A | N/A |
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW | $494,500.00 | $311,976.00 | Please see Estimated Cost Justification KWDK-110-1st Primary Transmitter - UHF Liquid Cooled Solid State, 8.2-13 kW v0 | $311,974.00 | N/A |
Mask Filter | $7,900.00 | $7,900.00 | N/A | N/A | N/A |
Actual Information Description | File Name |
---|---|
Primary Transmitter- Other Parts | |
Transmitter Installation - Heat Exchangers | Information not provided. |
Primary Transmitter - Installation | |
Other Electrical Service: It is estimated that all existing wiring, conduit, and general electrical service will be used. However, in an abundance of caution, we believe that there may be some incidental expenses. | Information not provided. |
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW | |
Mask Filter | Information not provided. |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $132,980.00 | $41,514.60 | N/A | $29,515.00 | N/A |
Total for all systems | $1,212,719.39 | $933,235.99 | N/A | $557,357.76 | N/A |
Primary Antenna SWEDM12OI/34-EP | $132,980.00 | $41,514.60 | $29,515.00 | ||
Side mount brackets for high power antennas (if not included in antenna base cost) | $23,150.00 | $1,124.60 | see Estimated Cost Justification KWDK-210-Primary Antenna - Side Mount Brackets, High Power Antenna v0 | $0.00 | N/A |
Sweep test of existing antenna | $6,730.00 | $6,400.00 | N/A | N/A | N/A |
UHF - Lower Power Side Mount, One Station antenna . medium power (50-200 kW), elliptically or circularly polarized | $103,100.00 | $33,990.00 | N/A | $29,515.00 | N/A |
Actual Information Description | File Name |
---|---|
Side mount brackets for high power antennas (if not included in antenna base cost) | |
Sweep test of existing antenna | Information not provided. |
UHF - Lower Power Side Mount, One Station antenna . medium power (50-200 kW), elliptically or circularly polarized |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $268,500.00 | $261,075.00 | N/A | $38,575.00 | N/A |
Total for all systems | $1,212,719.39 | $933,235.99 | N/A | $557,357.76 | N/A |
Primary Tower LTOWER | $268,500.00 | $261,075.00 | $38,575.00 | ||
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study | $26,300.00 | $31,075.00 | Combined cost of mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study ($20,600) and tower load study ($10475). | $31,075.00 | N/A |
Minor tower reinforcement/modifications | $158,000.00 | $150,000.00 | N/A | N/A | N/A |
Short Tower (less than 500') | $84,200.00 | $80,000.00 | N/A | $7,500.00 | N/A |
Actual Information Description | File Name |
---|---|
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study | |
Minor tower reinforcement/modifications | Information not provided. |
Short Tower (less than 500') |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $197,420.00 | $201,325.00 | N/A | $97,963.60 | N/A |
Total for all systems | $1,212,719.39 | $933,235.99 | N/A | $557,357.76 | N/A |
Outside Professional Services | $197,420.00 | $201,325.00 | $97,963.60 | ||
Project management of the transition | $94,010.00 | $99,675.00 | see Estimated Cost Justification KWDK-510-Project Management v0 | $86,989.10 | N/A |
Tower Permit Drawing Package | $4,700.00 | $4,700.00 | N/A | $4,700.00 | N/A |
Ground and Building A andE Permit Drawing Package | $4,700.00 | $4,700.00 | N/A | N/A | N/A |
Additional Field Engineering Service, 7 Days | $12,000.00 | $12,000.00 | N/A | $0.00 | N/A |
RF Exposure Measurements | $21,050.00 | $20,000.00 | N/A | N/A | N/A |
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase | $2,105.00 | $2,000.00 | N/A | N/A | N/A |
ASR modification (prepare FCC Form 854) | $2,105.00 | $2,000.00 | N/A | N/A | N/A |
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 |
NEPA Section 106 environmental review, if needed | $6,310.00 | $6,000.00 | N/A | N/A | N/A |
Attorney Fees - Prepare and File request for Special Temporary Authorization | $3,680.00 | $3,500.00 | N/A | N/A | N/A |
Attorney Fees - Negotiation of lease and other matters for shared locations | $4,210.00 | $4,000.00 | N/A | $488.50 | 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 | $5,000.00 | The estimated cost has been adjusted to include all invoices submitted for reimbursement at this time. | $5,000.00 | Please see submitted invoices. |
Prepare and or review reimbursement form | $2,630.00 | $2,500.00 | N/A | $786.00 | N/A |
Site Coordination Meeting | $5,000.00 | $5,000.00 | N/A | N/A | N/A |
Actual Information Description | File Name |
---|---|
Project management of the transition | |
Tower Permit Drawing Package | |
Ground and Building A andE Permit Drawing Package | Information not provided. |
Additional Field Engineering Service, 7 Days | |
RF Exposure Measurements | Information not provided. |
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase | Information not provided. |
ASR modification (prepare FCC Form 854) | Information not provided. |
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet | Information not provided. |
NEPA Section 106 environmental review, if needed | Information not provided. |
Attorney Fees - Prepare and File request for Special Temporary Authorization | Information not provided. |
Attorney Fees - Negotiation of lease and other matters for shared locations | |
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 | |
Prepare and or review reimbursement form | |
Site Coordination Meeting | Information not provided. |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $47,927.71 | $45,953.71 | N/A | $25,238.71 | N/A |
Total for all systems | $1,212,719.39 | $933,235.99 | N/A | $557,357.76 | N/A |
Other Expenses | $47,927.71 | $45,953.71 | $25,238.71 | ||
Nonionizing Electromagnetic Radiation Report | $750.00 | $750.00 | Please see KWDK American Tower Customer Project Cost Estimation Nonionizing Electromagnetic Radiation Report | $750.00 | N/A |
MVPD Notification of Channel Change | $4,021.00 | $4,021.00 | see Estimated Cost Justification KWDK-610-MVPD Notifications v0 | $4,021.00 | N/A |
Develop and air announcement of upcoming channel change | $500.00 | $500.00 | N/A | N/A | N/A |
Equipment Delivery and Handling Charges | $10,216.71 | $10,216.71 | see Estimated Cost Justification KWDK-610-Equipment Delivery and Handling v0 | $9,236.71 | N/A |
BLM or NFS Coordination | $5,000.00 | $5,000.00 | N/A | N/A | N/A |
Non-zoning permits | $750.00 | $750.00 | N/A | N/A | N/A |
Local Zoning | $5,000.00 | $5,000.00 | N/A | $1,000.00 | N/A |
FCC Filing Fees - Special Temporary Authorization request | $195.00 | $190.00 | N/A | N/A | N/A |
FCC Filing Fees - Form 2100 license to cover application | $335.00 | $325.00 | N/A | 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 |
DTV Medical Facility Notification | $11,550.00 | $9,631.00 | Estimated Cost Justification KWDK-610-Medical Facility Notifications v0 | $9,631.00 | N/A |
Disposal Costs (for equipment and other waste, net of any salvage value) | $5,000.00 | $5,000.00 | N/A | $600.00 | N/A |
Equipment Storage | $3,500.00 | $3,500.00 | N/A | N/A | N/A |
Actual Information Description | File Name |
---|---|
Nonionizing Electromagnetic Radiation Report | |
MVPD Notification of Channel Change | |
Develop and air announcement of upcoming channel change | Information not provided. |
Equipment Delivery and Handling Charges | |
BLM or NFS Coordination | Information not provided. |
Non-zoning permits | Information not provided. |
Local Zoning | |
FCC Filing Fees - Special Temporary Authorization request | Information not provided. |
FCC Filing Fees - Form 2100 license to cover application | Information not provided. |
FCC Filing Fees - Form 2100 minor change CP application | Information not provided. |
DTV Medical Facility Notification | |
Disposal Costs (for equipment and other waste, net of any salvage value) | |
Equipment Storage | Information not provided. |
Predetermined Cost Estimate |
Estimated Cost | Actual Cost | |
---|---|---|---|
Total for all systems | $1,212,719.39 | $933,235.99 | $557,357.76 |
Question | Response |
---|---|
The facility has ceased operating on its pre-auction channel. | Yes |
Construction of final facilities or all necessary modifications are complete. | Yes |
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. | Arnold Torres Business Administrator 03/05/2021 |
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. | Arnold Torres Business Administrator 03/05/2021 |
Section | Question | Response |
---|---|---|
Submission of Final Allocation or Accounting Information 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. | Arnold Torres Business Administrator 03/05/2021 |