| Applicant | Address | Phone | Applicant Type | |
|---|---|---|---|---|
|
SOUTHERN OREGON CONFERENCE ASSN. OF SEVENTH-DAY ADVENTISTS Doing Business As: SOUTHERN OREGON CONFERENCE ASSN. OF SEVENTH-DAY ADVENTISTS |
Herald Follett 19800 OATFIELD ROAD GLADSTONE, OR 97027 United States |
+1 (503) 850-3500 | Herald.Follett@oc.npuc.org | Not-for-Profit |
| Applicant | Address | Phone | |
|---|---|---|---|
|
[Confidential] |
|
|
|
| Applicant | Address | Phone | |
|---|---|---|---|
|
Tony Zummallen President QCommunications, LLC |
Tony Zummallen 705B SE Melody Lane #314 Lee's Summit, MO 64063 United States |
+1 (816) 729-1177 | tony@Qcomm.tv |
| 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 and the antenna per the channel reassignment project using reasonable and customary engineering and business practices. |
| 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) | |
| 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 | SDT202UB ARK1_ATSC | |
| Year | 2010 | |
| Type | Solid State | |
| Solid State Cooling | Air Cooled | |
| Solid State Power Capacity | .9 kW |
| Section | Question | Response |
|---|---|---|
| New Transmitter | Use | Primary (Main) |
| Change Type | Purchase New | |
| Is this a request for upgraded equipment? | No | |
| Manufacturer | ||
| Model | UAXTE-2-G2 | |
| Transmitter Type | Solid State | |
| Solid State Cooling | Air Cooled | |
| Solid State Power capacity | 1.2 kW | |
| Justification for New Transmitter | New transmitter required for new channel. |
| 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? | No |
| Transmitter Building Addition/Modification or Leasehold Improvement | Does the Transmitter Building require an addition, modification, other leashold improvement? | No |
| Name | Description |
|---|---|
Transmitter Site Prep |
Prep site for installation crew |
Decommission |
De-install and disconnect old transmitter |
Taxes |
Estimated sales tax |
Shipping |
Estimated shipping and freight costs |
| 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) | |
| 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? | Yes | |
| Existing Antenna Manufacturer and Type | ||
| Mounting | Side Mount | |
| Antenna position in stack | Not in Stack | |
| Polarization | Horizontal | |
| Type | Slotted Coaxial | |
| ERP: | 15.0 kW | |
| Manufacturer | ||
| Model | ALP16L2-HSOC | |
| Year | 2010 |
| Section | Question | Response |
|---|---|---|
| New Antenna Description | Use | Primary (Main) |
| Change Type | Purchase New | |
| Ownership | Owned | |
| 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 | ||
| Mounting | Side Mount | |
| Antenna position in stack | Not in Stack | |
| Polarization | Horizontal | |
| Type | Slotted Coaxial | |
| ERP: | 2.0 kW | |
| Manufacturer | ||
| Model | DLP-12H | |
| Year | 2019 | |
| Justification for New Antenna | New antenna required for new channel |
| Section | Question | Response |
|---|---|---|
| Elbow Complex | Do you require the separate purchase of the Elbow Complex? | No |
| 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 |
| Name | Description |
|---|---|
Sales Tax |
Sales tax for new antenna |
Shipping |
Shipping costs of new antenna |
| 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 | 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? | No | |
| Existing Transmission Line Manufacturer and Type | Manufacturer | |
| Type | Rigid | |
| Diameter | 3 1/8 inches | |
| Segment Length | 19 3/4 inches | |
| Number of parallel runs | 1 | |
| Length | 620 feet per run |
| Section | Question | Response |
|---|---|---|
| New Transmission Line Costs | Use | Primary (Main) |
| Change Type | Purchase New | |
| Is this a request for upgraded equipment? | No | |
| Type | Rigid | |
| Diameter | 3 1/8 inches | |
| Segment Length | 20 inches | |
| Number of parallel runs | 1 | |
| Length | 920 feet per run | |
| Justification for New Transmission Line | Repack station KEVE, pre-repack channel 36, required line section lengths of 19 3/4 while the repack channel require 20' sections. | |
| Interior RF Systems | Does the Installation of the Transmission Line require an additional or replacement Inside RF system including switching, patch panels, and dehydrators? | Yes |
| Name | Description |
|---|---|
Sweep |
Sweep per Dielectric quote 1935287 |
| 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) | |
| Ownership | Leased | |
| Is this tower consider Complex? | No | |
| Is this tower currently shared with any other stations? | Yes | |
| One or more FM, AM or TV radio broadcaster(s) | Yes | |
| Others Types of Users | No | |
| Is tower documented for structural analysis? | Yes | |
| Is tower compliant with Rev G? | Yes | |
| Existing Tower Structure Registration | Do you have a tower registration number? | Yes |
| ASR Number | 1035761 | |
| Coordinates (NAD83) | Latitude (NAD83) | 45° 31' 13.0" N- |
| Longitude (NAD83) | 122° 44' 41.0" W- | |
| Overall Structure Height | 918.62 feet | |
| Support Structure Height | 812.00 feet | |
| Ground Elevation Above Mean Sea Level (AMSL) | 954.38 feet | |
| Structure Type | TOWER - Free Standing or Guyed Structure | |
| Tower Owner | Sinclair Portland Licensee, LLC | |
| Date Constructed | 08/15/1973 |
| Facility ID | Call Sign | Service |
|---|---|---|
| 34882 | KUNP-LD | LPD |
| 10192 | KRCW-TV | DTV |
| 35380 | KOIN | DTV |
| 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: | No reinforcements needed |
| Section | Question | Response |
|---|---|---|
| Tower Rigging Costs | Complex Tower | N/A |
| Helicopter Services Required | Are helicopter services required? | No |
| Section | Question | Response |
|---|---|---|
| Outside Project Management Services | Do you require outside project management services? | Yes |
| Number of Hours | 200 | |
| Explanation | 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 | No | |
| Additional Field Engineering Service | Yes | |
| Number of Days | 5 | |
| Justification | Estimated field engineering required during transition activities |
| Name | Description |
|---|---|
Attorney Fees- REPACK Related |
General Attorney fees due to REPACK |
Engineering-General |
Engineering Consultations |
Antenna Pattern Verification |
Antenna Pattern verification via unmanned aerial vehicle (UAV) |
| 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 |
| Name | Description |
|---|---|
Barrel Adapter |
Barrel adapter - QComm |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $126,900.00 | $102,291.00 | N/A | $64,891.00 | N/A |
| Total for all systems | $596,237.32 | $499,217.37 | N/A | $321,835.88 | N/A |
| Primary Transmitter UAXTE-2-G2 | $126,900.00 | $102,291.00 | $64,891.00 | ||
| Shipping | $2,500.00 | $2,500.00 | Estimated shipping and freight costs to ship transmitter from manufacturer to site. Actual costs to be determined. | $2,500.00 | N/A |
| Transmitter Site Prep | $16,000.00 | $16,000.00 | Per QComm quote KEVEInstall - dated 12/8/2020 | $16,000.00 | N/A |
| UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW | $84,000.00 | $44,391.00 | Cost determined by invoices/quotes | $44,391.00 | N/A |
| Taxes | $8,400.00 | $8,400.00 | 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. | N/A | N/A |
| Decommission | $6,000.00 | $6,000.00 | Estimated costs to deinstall, disconnect and decommission old transmitter in preparation for new transmitter. | N/A | N/A |
| Transmitter Building Site Survey/Installation | $10,000.00 | $25,000.00 | 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. | $2,000.00 | N/A |
| Actual Information Description | File Name |
|---|---|
| Shipping | |
| Transmitter Site Prep | |
| UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW | |
| Taxes | Information not provided. |
| Decommission | Information not provided. |
| Transmitter Building Site Survey/Installation |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $23,745.74 | $22,024.74 | N/A | $10,597.00 | N/A |
| Total for all systems | $596,237.32 | $499,217.37 | N/A | $321,835.88 | N/A |
| Primary Antenna DLP-12H | $23,745.74 | $22,024.74 | $10,597.00 | ||
| Sweep test of transmission line and antenna | $5,730.00 | $6,400.00 | Per actual costs | $0.00 | N/A |
| UHF-Low Power, Side Mount, Slotted Coaxial, 2.0kW input, Horizontal | $8,363.00 | $8,363.00 | ***System Notice: Estimate adjusted and locked because line has been superseded.***Cost determined by invoices | $8,363.00 | N/A |
| Side Mount antenna brackets | $4,625.00 | $2,234.00 | Cost determined by invoice. | $2,234.00 | N/A |
| Sales Tax | $2,000.00 | $2,000.00 | Estimated sales tax for new antenna. Actual costs to be determined. | N/A | N/A |
| Shipping | $3,027.74 | $3,027.74 | Actual freight and shipping costs for new antenna. | $0.00 | N/A |
| Actual Information Description | File Name |
|---|---|
| Sweep test of transmission line and antenna | |
| UHF-Low Power, Side Mount, Slotted Coaxial, 2.0kW input, Horizontal | |
| Side Mount antenna brackets | |
| Sales Tax | Information not provided. |
| Shipping |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $97,114.50 | $74,568.75 | N/A | $72,338.25 | N/A |
| Total for all systems | $596,237.32 | $499,217.37 | N/A | $321,835.88 | N/A |
| Primary Transmission Line | $97,114.50 | $74,568.75 | $72,338.25 | ||
| Sweep | $6,400.00 | $6,400.00 | Per Dielectric quote 1935287 | $6,400.00 | N/A |
| Interior RF Systems: Inside RF system including switching, patch panels and dehydrators | $5,614.50 | $5,614.50 | Per Dielectric quote 1935287, Line 11 | $5,614.50 | N/A |
| Rigid Transmission Line - copper, 3 1/8" | $85,100.00 | $62,554.25 | per actual costs from invoices. | $60,323.75 | N/A |
| Actual Information Description | File Name |
|---|---|
| Sweep | |
| Interior RF Systems: Inside RF system including switching, patch panels and dehydrators | |
| Rigid Transmission Line - copper, 3 1/8" |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $178,750.00 | $98,500.00 | N/A | $62,500.00 | N/A |
| Total for all systems | $596,237.32 | $499,217.37 | N/A | $321,835.88 | N/A |
| Primary Tower TOWER | $178,750.00 | $98,500.00 | $62,500.00 | ||
| Tower Rigging Tall Tower (greater than 500') | $157,750.00 | $77,500.00 | Cost based on submitted quote from Rio Steel dated 2/1/2022 plus associated change order per actual costs. Also includes rigging and transmission line install. | $62,500.00 | N/A |
| Tower mapping and report for structural engineer | $21,000.00 | $21,000.00 | 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. | N/A | N/A |
| Actual Information Description | File Name |
|---|---|
| Tower Rigging Tall Tower (greater than 500') | |
| Tower mapping and report for structural engineer | Information not provided. |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $143,221.25 | $175,327.05 | N/A | $95,713.80 | N/A |
| Total for all systems | $596,237.32 | $499,217.37 | N/A | $321,835.88 | N/A |
| Outside Professional Services | $143,221.25 | $175,327.05 | $95,713.80 | ||
| Antenna Pattern Verification | $26,625.00 | $26,625.00 | Per QComm Quote 706P | $26,125.00 | N/A |
| Additional Field Engineering Service, 5 Days | $12,500.00 | $12,500.00 | Estimated costs for field engineering services during transition activities. Actual costs to be determined. | N/A | N/A |
| Comprehensive coverage verification via field study, if needed | $52,600.00 | $43,732.00 | Per-attached quote number 732-R for Coverage Verification ; See also Quote 706P for Pattern Verification ONLY | 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 | 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. | N/A | N/A |
| Prepare request for Special Temporary Authorization | $1,280.00 | $1,280.00 | 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 | $1,950.00 | N/A |
| Prepare engineering section of FCC Form 2100 (main), License to Cover Application | $1,052.50 | $1,052.50 | N/A | $540.00 | 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 Form 601 | $755.00 | $755.00 | 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. | N/A | N/A |
| Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | $1,577.50 | $1,577.50 | 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. | 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 | $8,200.00 | $8,200.00 | Per attached QCommunications quote. | $0.00 | N/A |
| Prepare/ Review 399 reimbursement form | $1,710.00 | $2,500.00 | Per attached QCommunications quote. | $2,500.00 | N/A |
| Project management of the transition | $21,100.00 | $61,283.80 | Cost determined by invoices. | $61,283.80 | Actual equals estimated |
| Attorney Fees- REPACK Related | $1,086.25 | $1,086.25 | Cost determined by Invoices. | $1,005.00 | N/A |
| Engineering-General | $2,310.00 | $2,310.00 | Cost determined by invoices. | $2,310.00 | N/A |
| Actual Information Description | File Name |
|---|---|
| Antenna Pattern Verification | |
| Additional Field Engineering Service, 5 Days | Information not provided. |
| Comprehensive coverage verification via field study, 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 | Information not provided. |
| Prepare request for Special Temporary Authorization | Information not provided. |
| Prepare engineering section of FCC Form 2100 (main), Construction Permit Application | |
| Prepare engineering section of FCC Form 2100 (main), License to Cover Application | |
| Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application | Information not provided. |
| Prepare Form 601 | Information not provided. |
| Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | Information not provided. |
| Perform engineering study for displacement application | Information not provided. |
| Form 399 assistance or other Program Management costs | |
| Prepare/ Review 399 reimbursement form | |
| Project management of the transition | |
| Attorney Fees- REPACK Related | |
| Engineering-General |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $26,505.83 | $26,505.83 | N/A | $15,795.83 | N/A |
| Total for all systems | $596,237.32 | $499,217.37 | N/A | $321,835.88 | N/A |
| Other Expenses | $26,505.83 | $26,505.83 | $15,795.83 | ||
| Equipment Storage | $2,000.00 | $2,000.00 | Expecting multiple staggered equipment deliveries from different vendors and need to store and stage new equipment prior to installation date. Anticipate 6-24 months of storage time. | N/A | N/A |
| Equipment Delivery and Handling Charges | $15,490.18 | $15,490.18 | Actual costs of transport, forklift rental and handling fees from manufacturer to staging area and/or to transmitter site. | $15,490.18 | N/A |
| Disposal Costs (for equipment and other waste, net of any salvage value) | $2,000.00 | $2,000.00 | 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. | N/A | N/A |
| FCC Filing Fees - Special Temporary Authorization request | $305.00 | $305.00 | 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 |
| FCC Filing Fees - Form 2100 Major change CP application | $4,960.00 | $4,960.00 | 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. | N/A | N/A |
| Barrel Adapter | $305.65 | $305.65 | Costs per actual invoices | $305.65 | N/A |
| Actual Information Description | File Name |
|---|---|
| Equipment Storage | Information not provided. |
| Equipment Delivery and Handling Charges | |
| Disposal Costs (for equipment and other waste, net of any salvage value) | Information not provided. |
| 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. |
| FCC Filing Fees - Form 2100 Major change CP application | Information not provided. |
| Barrel Adapter |
| Predetermined Cost Estimate |
Estimated Cost | Actual Cost | |
|---|---|---|---|
| Total for all systems | $596,237.32 | $499,217.37 | $321,835.88 |
| 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. | Yes |
| 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. | Herald Follett Applicant 02/08/2023 |
| 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. | Herald Follett Applicant 02/08/2023 |
| 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. | Herald Follett Applicant 02/08/2023 |
