Applicant | Address | Phone | Applicant Type | |
---|---|---|---|---|
CHRISTIAN TELEVISION NETWORK OF IOWA, INC. Doing Business As: Christian Television Network of Iowa, Inc |
Chris Mavros 744 Main St Dubuque, IA 52001 United States |
+1 (563) 690-1704 | clmavros@yahoo.com | Not-for-Profit |
Applicant | Address | Phone | |
---|---|---|---|
[Confidential] |
|
|
|
Applicant | Address | Phone | |
---|---|---|---|
Joseph C. Chautin III Hardy, Carey, Chautin & Balkin, LLP |
1080 West Causeway Approach Mandeville, LA 70471 United States |
+1 (985) 629-0777 | jchautin@hardycarey.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 | KFXB will install temp low power antenna & line. Then, existing xmtr will feed temp LP antenna thru mask filter. Removal of old antenna. Then, installation of new xmtr, mask filter and antenna to begin. |
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 | Visionary | |
Year | 2004 | |
Type | Inductive Output Tube | |
IOT Power Type | Single | |
Power Capacity | 29 kW |
Section | Question | Response |
---|---|---|
New Transmitter | Use | Primary (Main) |
Change Type | Purchase New | |
Is this a request for upgraded equipment? | Yes | |
Manufacturer | ||
Model | PRLX U16 D14 | |
Transmitter Type | Solid State | |
Solid State Cooling | Liquid Cooled | |
Solid State Power capacity | 27.5 kW | |
Justification for New Transmitter | Manufacturer (Axcera) no longer in business. Existing transmitter not supported. |
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 | additional breakers in panel, EMT or flexible metal conduit, misc wiring | |
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 | 10 |
Name | Description |
---|---|
Factory Training |
Factory training of the new transmitter for the station engineers |
plumbing |
plumbing for heat exchanger |
Equipment Rental |
Heavy equipment rental to off-load the transmitter |
transmission line |
transmitter building interior transmission line components for transmitter interconnects |
Motorized Switch |
4 way motorized switch this is for transferring the output of the transmitter into the station load. |
anti-freeze |
coolant anti-freeze |
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? | Yes | |
Is antenna in operating condition? | Yes | |
Is antenna located on or in close proximity to an antenna farm? | Yes | |
Existing Antenna Manufacturer and Type | Class | Full Power |
Mounting | Top 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: | 1000.0 kW | |
Manufacturer | ||
Model | ATW16H3-HTC4-43S | |
Year | 2009 |
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? | No | |
Ownership | Owned | |
Owner | N/A | |
Is antenna shared? | No | |
Is antenna directional? | Yes | |
Will antenna be located on or in close proximity to an antenna farm? | Yes | |
New Antenna Manufacturer and Types | Class | Full Power |
Mounting | Top Mount | |
Antenna position in stack | Not in Stack | |
Polarization | 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: | 580.0 kW | |
Manufacturer | ||
Model | TFU 12GTH-R C250 | |
Year | 2017 | |
Justification for New Antenna | Existing antenna cannot be re-channeled. |
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? | 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 |
---|---|
temporary antenna |
A temporary low power antenna & line will be needed during the re-channeling process to keep KFXB on the air. |
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 | ERI |
Type | Rigid | |
Diameter | 6 1/8 inches | |
Other Diameter | N/A | |
Segment Length | 20 inches | |
Other Segment Length | N/A | |
Number of parallel runs | 1 | |
Length | 900 feet per run |
Section | Question | Response |
---|---|---|
New Transmission Line Costs | Use | Interim |
Description of Use | N/A | |
Change Type | Purchase New | |
Type | Flexible Air | |
Diameter | 1 5/8 inches | |
Segment Length | N/A | |
Other Segment Length | ||
Number of parallel runs | 1 | |
Length | 750 feet per run | |
Justification for New Transmission Line | to feed interim antenna which will keep KFXB on the air during modification of facility |
Name | Description |
---|---|
misc hardware |
connectors, hanging brackets, etc. |
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? | No | |
One or more FM, AM or TV radio broadcaster(s) | N/A | |
Others Types of Users | N/A | |
Is tower documented for structural analysis? | Yes | |
Is tower compliant with Rev G? | Unknown | |
Existing Tower Structure Registration | Do you have a tower registration number? | Yes |
ASR Number | 1055265 | |
Coordinates (NAD83) | Latitude (NAD83) | 42° 31' 09.0" N- |
Longitude (NAD83) | 090° 37' 11.0" W- | |
Overall Structure Height | 836.93 feet | |
Support Structure Height | 789.03 feet | |
Ground Elevation Above Mean Sea Level (AMSL) | 859.90 feet | |
Structure Type | TOWER - Free Standing or Guyed Structure | |
Tower Owner | Second Generation Realty of Iowa | |
Date Constructed | 01/01/1976 |
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: | Major 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 | KFXB-TV does not have sufficient resource capacity and expertise in-house to handle all of the reimbursement filings by the construction deadline for Phase 1 of Nov 30, 2018. KFXB-TV will hire an outside firm o ensure 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 | Yes |
RF exposure measurements | No | |
Additional Field Engineering Service | Yes | |
Number of Days | 3 | |
Justification | optimization of existing transmission line to operate on new channel |
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? | No | |
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 |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $1,233,925.31 | $1,160,167.07 | N/A | $975,120.36 | N/A |
Total for all systems | $2,460,630.31 | $2,337,830.90 | N/A | $1,373,707.03 | N/A |
Primary Transmitter PRLX U16 D14 | $1,233,925.31 | $1,160,167.07 | $975,120.36 | ||
anti-freeze | $200.00 | $200.00 | N/A | N/A | N/A |
Motorized Switch | $5,100.93 | $5,100.93 | Please see attached cover letter for Hitachi Proposal P#3221 - This estimated cost includes taxes on this item. | $4,590.83 | Please see attached cover letter detailing how taxes have been broken out for each individual item. |
transmission line | $5,000.00 | $5,000.00 | N/A | N/A | N/A |
Equipment Rental | $4,500.00 | $4,500.00 | N/A | $0.00 | N/A |
plumbing | $2,000.00 | $2,000.00 | N/A | N/A | N/A |
Factory Training | $4,747.50 | $4,747.50 | Please see attached cover letter for Hitachi Proposal P#3221 - This estimated cost includes taxes on this item. | $4,272.75 | Please see attached cover letter detailing how taxes have been broken out for each individual item. |
Additional field engineering time, 10-30 days | $63,100.00 | $60,000.00 | N/A | N/A | N/A |
RF Consulting Engineer | $5,260.00 | $5,000.00 | N/A | N/A | N/A |
Other Electrical Service: additional breakers in panel, EMT or flexible metal conduit, misc wiring | $7,516.88 | $7,516.88 | Please see attached cover letter for Hitachi Proposal P#3221 - This estimated cost includes taxes on this item. | $6,765.19 | Please see attached cover letter detailing how taxes have been broken out for each individual item. |
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW | $947,000.00 | $876,201.76 | Please see attached cover letter for Hitachi Proposal P#3221 - This estimated cost includes taxes on this item. | $788,581.59 | Please see attached cover letter detailing how taxes have been broken out for each individual item. |
Channel 14 Mask Filter | $189,500.00 | $189,900.00 | Please see attached cover letter for Hitachi Proposal P#3221 - This estimated cost includes taxes on this item. | $170,910.00 | Please see attached cover letter detailing how taxes have been broken out for each individual item. |
Actual Information Description | File Name |
---|---|
anti-freeze | Information not provided. |
Motorized Switch | |
transmission line | Information not provided. |
Equipment Rental | Information not provided. |
plumbing | Information not provided. |
Factory Training | |
Additional field engineering time, 10-30 days | Information not provided. |
RF Consulting Engineer | Information not provided. |
Other Electrical Service: additional breakers in panel, EMT or flexible metal conduit, misc wiring | |
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW | |
Channel 14 Mask Filter |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $260,705.00 | $248,375.00 | N/A | $170,413.34 | N/A |
Total for all systems | $2,460,630.31 | $2,337,830.90 | N/A | $1,373,707.03 | N/A |
Primary Antenna TFU 12GTH-R C250 | $260,705.00 | $248,375.00 | $170,413.34 | ||
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized | $247,000.00 | $235,000.00 | N/A | $164,587.04 | N/A |
temporary antenna | $6,975.00 | $6,975.00 | to minimize "off air" time while main antenna and transmitter are replaced. | N/A | N/A |
Sweep test of existing antenna | $6,730.00 | $6,400.00 | N/A | $5,826.30 | N/A |
Actual Information Description | File Name |
---|---|
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized | |
temporary antenna | Information not provided. |
Sweep test of existing antenna |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $31,750.00 | $30,250.00 | N/A | $0.00 | N/A |
Total for all systems | $2,460,630.31 | $2,337,830.90 | N/A | $1,373,707.03 | N/A |
Interim Transmission Line | $31,750.00 | $30,250.00 | $0.00 | ||
Flexible Air Transmission Line - dielectric, 1 5/8" | $24,750.00 | $23,250.00 | N/A | N/A | N/A |
misc hardware | $7,000.00 | $7,000.00 | connectors, hanging brackets, etc. needed for installation of temporary transmission line which will feed the temporary antenna | N/A | N/A |
Primary Transmission Line | $0.00 | $0.00 | $0.00 |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $644,100.00 | $621,663.83 | N/A | $221,663.83 | N/A |
Total for all systems | $2,460,630.31 | $2,337,830.90 | N/A | $1,373,707.03 | N/A |
Primary Tower TOWER | $644,100.00 | $621,663.83 | $221,663.83 | ||
Tall Tower (greater than 500') | $210,500.00 | $213,163.83 | Proposal #04051806T from Coast to Coast Tower Service, Inc. | $213,163.83 | Proposal #04051806T from Coast to Coast Tower Service, Inc. |
Major tower reinforcement/modifications | $421,000.00 | $400,000.00 | N/A | N/A | N/A |
Structural engineering tower load study for well documented tower | $12,600.00 | $8,500.00 | N/A | $8,500.00 | N/A |
Actual Information Description | File Name |
---|---|
Tall Tower (greater than 500') | |
Major tower reinforcement/modifications | Information not provided. |
Structural engineering tower load study for well documented tower |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $240,170.00 | $228,285.00 | N/A | $6,509.50 | N/A |
Total for all systems | $2,460,630.31 | $2,337,830.90 | N/A | $1,373,707.03 | N/A |
Outside Professional Services | $240,170.00 | $228,285.00 | $6,509.50 | ||
Attorney Fees - Prepare and File request for Special Temporary Authorization | $3,680.00 | $750.00 | N/A | N/A | N/A |
Attorney Fees - Negotiation of lease and other matters for shared locations | $4,210.00 | $4,095.00 | N/A | N/A | N/A |
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | $2,365.00 | $2,250.00 | N/A | N/A | N/A |
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application | $5,260.00 | $5,000.00 | N/A | N/A | N/A |
Prepare request for Special Temporary Authorization | $2,050.00 | $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 | $2,560.00 | 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 | $94,010.00 | $90,750.00 | Price quote | $6,509.50 | N/A |
NEPA Section 106 environmental review, if needed | $6,310.00 | $6,140.00 | 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 | $10,240.00 | N/A | N/A | N/A |
ASR modification (prepare FCC Form 854) | $2,105.00 | $2,050.00 | 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 | $2,050.00 | N/A | N/A | N/A |
Comprehensive coverage verification via field study, if needed | $84,200.00 | $81,900.00 | N/A | N/A | N/A |
Additional Field Engineering Service, 3 Days | $6,000.00 | $6,000.00 | Work performed by on-site engineering assistant - includes but is not limited to equipment relocation, running control wiring, and assembling connectors. | N/A | N/A |
Actual Information Description | File Name |
---|---|
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. |
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 | Information not provided. |
Prepare and or review reimbursement form | Information not provided. |
Project management of the transition | |
NEPA Section 106 environmental review, if needed | Information not provided. |
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet | Information not provided. |
ASR modification (prepare FCC Form 854) | Information not provided. |
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase | Information not provided. |
Comprehensive coverage verification via field study, if needed | Information not provided. |
Additional Field Engineering Service, 3 Days | Information not provided. |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $49,980.00 | $49,090.00 | N/A | $0.00 | N/A |
Total for all systems | $2,460,630.31 | $2,337,830.90 | N/A | $1,373,707.03 | N/A |
Other Expenses | $49,980.00 | $49,090.00 | $0.00 | ||
Develop and air announcement of upcoming channel change | $400.00 | $400.00 | production time | N/A | N/A |
MVPD Notification of Channel Change | $1,500.00 | $1,500.00 | N/A | N/A | N/A |
DTV Medical Facility Notification | $11,550.00 | $11,000.00 | N/A | N/A | N/A |
FCC Filing Fees - Form 2100 license to cover application | $335.00 | $0.00 | N/A | N/A | N/A |
FCC Filing Fees - Special Temporary Authorization request | $195.00 | $190.00 | N/A | N/A | N/A |
Disposal Costs (for equipment and other waste, net of any salvage value) | $6,000.00 | $6,000.00 | disposal of old transmitter equipent | N/A | N/A |
Equipment Delivery and Handling Charges | $30,000.00 | $30,000.00 | N/A | N/A | N/A |
Predetermined Cost Estimate |
Estimated Cost | Actual Cost | |
---|---|---|---|
Total for all systems | $2,460,630.31 | $2,337,830.90 | $1,373,707.03 |
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. | CHRIS L MAVROS Director of Engineering 12/21/2018 |
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. | CHRIS L MAVROS Director of Engineering 12/21/2018 |