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:
65763
Service:
LPD
Call Sign:
KZKC-LD
Channel:
28 (UHF)
File Number:
0000090023
FRN:
0002710192
Eligibility Status:
Eligible
Date Submitted:
12/22/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

SCRIPPS BROADCASTING HOLDINGS LLC

312 WALNUT STREET

28TH FLOOR

CINCINNATI, OH 45202

United States

+1 (513) 977-3000 DAVE.GILES@SCRIPPS.COM Limited Liability Company

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

Samuel Hariton

Widelity

Samuel Hariton

4031 University Drive

Ste. 100

Fairfax, VA 22030

United States

+1 (339) 222-8107 sam.hariton@widelity.com

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. Yes
Briefly describe transition plan KZKC-LP is sharing new like-for-like facilities with KCBT-LD (61178): new antenna, transmitter and transmission line. KZKC and KCBT will also move to a different tower, owned by American Tower and leased to Scripps and low power broadcaster KDBK.

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 UP-4-SL
Year 1999
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 288 W

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? Yes
Manufacturer
Model UAXTE-3R37
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1.3 kW
Justification for New Transmitter Re-tuning the existing main transmitter is not an option because the pre-displacement transmitter is not capable of being re-tuned to the new channel. KZKC is also entering a channel sharing agreement.

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? No
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

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Transmitter Encoding Equipment

Encoding equipment required for operation with new channel sharing agreement.

Primary Transmitter - Mask Filter

Mask filter required for transmitter operation

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 Leased
Owner Cocola Broadcasting
Is the existing antenna shared with another station or stations? Yes
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 Other
Other Antenna Type Broadband Slot
ERP: 15.0 kW
Manufacturer
Model K723147
Year 1997

Facility ID's and Call Signs of all stations with whom the antenna is shared.

Facility ID Call Sign
61178 KCBT-LD

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? Yes
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 Middle
Polarization Circular
Type Broadband Panel
Number of Stations Supported 2
Number of Panels/Bays 2
Lower Limit 544.00 MHz
Upper Limit 560.00 MHz
Design power capacity in use 65.0 %
ERP: 15.0 kW
Manufacturer
Model TUM-LP-C1-2/2M-1 MBT
Year 2019
Justification for New Antenna The existing antenna cannot be re-tuned to the new frequency.

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? No
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? 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? No
Power Dividers Does the panel antenna require power dividers? No
Cable Harness Does the panel antenna require cable harness? No

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

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 Lease New
Use Primary (Main)
Ownership Leased
Is the existing transmission line shared with another station or stations? Yes
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Flexible Foam
Diameter Other
Other Diameter 3 inches
Number of parallel runs 1
Length 100 feet per run

Facility ID's and Call Signs of all stations with whom the transmission line is shared.

Facility ID Call Sign
61178 KCBT-LD

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Change Type Lease New
Is this a request for upgraded equipment? No
Type Flexible Foam
Diameter 1 5/8 inches
Number of parallel runs 1
Length 100 feet per run
Justification for New Transmission Line The new transmission line is required by the move to a new shared tower location. KZKC will share this equipment as part of its channel sharing arrangement
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

Primary Transmission Line - Reducer

Reducer required for new transmission line

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) Yes
Others Types of Users No
Is tower documented for structural analysis? No
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? No
Coordinates (NAD83) Latitude (NAD83) 35° 27' 13.8" N-
Longitude (NAD83) 118° 35' 40.3" W-
Overall Structure Height 41.00 feet
Support Structure Height 41.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 7525.00 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Cocola Broadcasting
Date Constructed 01/01/1997

FM, AM or TV radio broadcasters. Facility ID's, Call Signs and Services of other broadcast stations with whom the tower is shared

Facility ID Call Sign Service
61178 KCBT-LD LPD

Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: No study needed
Tower Reinforcements Please select whether tower reinforcements are needed: No 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

Name Description

Tower Structural Study

Tower Structural Study

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 254
Explanation KZKC-LP does not have sufficient resources to fulfill the requirements of the repack, and requires the aid of outside project management services to facilitate on-time completion of the station's build.
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 No
Form 399 assistance or other program management costs No
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

Name Description

Transition Timing and Coordination

Transition Timing and Coordination

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 No
FCC Construction Permit Minor Change No
FCC License to Cover Application No
FCC Special Temporary Authority Application No
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
Point to Point Microwave (STL/ICR) Frequency Coordination for Unidirection System Yes
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 $138,807.24 $133,043.11 N/A $111,463.98 N/A
Total for all systems $331,231.63 $338,178.50 N/A $138,534.73 N/A
Primary Transmitter UAXTE-3R37 $138,807.24 $133,043.11 $111,463.98
Primary Transmitter - Mask Filter $10,344.40 $10,344.40 Please see attached GatesAir Quote Q-82310 plus applicable state sales tax $10,344.39 N/A
Transmitter Encoding Equipment $44,462.84 $44,462.84 Please see Heartland Quote #WISQ54742-01 $44,462.84 N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $84,000.00 $78,235.87 Please see Estimated Cost Justification KZKC-LP-110-Primary Transmitter- UHF- Air Cooled Solid State Transmitter 1-2.5 kW V0 $56,656.75 N/A

Components

Actual Information Description File Name
Primary Transmitter - Mask Filter

Component Description:
KZKC-LP-110-Primary Transmitter- Mask Filter
Amount:
$10,344.39
Transmitter Encoding Equipment

Component Description:
ELC-X2S consisting of:
Amount:
$44,462.84
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
Transmitter
Amount:
$56,656.75

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 $12,108.00 $12,108.00 N/A $0.00 N/A
Total for all systems $331,231.63 $338,178.50 N/A $138,534.73 N/A
Primary Antenna TUM-LP-C1-2/2M-1 MBT $12,108.00 $12,108.00 $0.00
UHF-Low Power, Side Mount, Broadband Panel, 2 bay, 15.0kW input, Circular $12,108.00 $12,108.00 Please see Dielectric quote 1733120 $0.00 N/A

Components

Actual Information Description File Name
UHF-Low Power, Side Mount, Broadband Panel, 2 bay, 15.0kW input, Circular

Component Description:
UHF-Low Power Side Mount
Amount:
$12,108.00

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 $3,300.64 $900.64 N/A $0.00 N/A
Total for all systems $331,231.63 $338,178.50 N/A $138,534.73 N/A
Primary Transmission Line $3,300.64 $900.64 $0.00
Primary Transmission Line - Reducer $900.64 $900.64 Please see Estimated Cost Justification KZKC-LP-310-Primary Transmission Line - Reducer V0 N/A N/A
Flexible Foam Transmission Line - dielectric, 1 5/8" $2,400.00 $0.00 KZKC channel sharing agreement includes new shared transmission line 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 $64,740.00 $64,740.00 N/A $8,550.00 N/A
Total for all systems $331,231.63 $338,178.50 N/A $138,534.73 N/A
Primary Tower TOWER $64,740.00 $64,740.00 $8,550.00
Tower Rigging Short Tower (less than 500') $56,190.00 $56,190.00 N/A $0.00 N/A
Tower Structural Study $8,550.00 $8,550.00 Please see SWE Services, LLC proposal 1571 $8,550.00 N/A

Components

Actual Information Description File Name
Tower Rigging Short Tower (less than 500')

Component Description:
Field Services
Amount:
$24,550.00
Tower Structural Study

Component Description:
Field Services
Amount:
$8,550.00

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 $110,612.00 $125,723.00 N/A $17,407.00 N/A
Total for all systems $331,231.63 $338,178.50 N/A $138,534.73 N/A
Outside Professional Services $110,612.00 $125,723.00 $17,407.00
Transition Timing and Coordination $2,025.00 $2,025.00 Please see KZKC-LP Transition Timing and Coordination Budget Revision Justification Letter N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $3,262.50 $3,262.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $1,577.50 $1,577.00 N/A N/A N/A
Project management of the transition $26,797.00 $41,910.00 See Widelity strategic support quote $16,432.00 N/A
Comprehensive coverage verification via field study, if needed $52,600.00 $52,600.00 N/A N/A N/A
RF Exposure Measurements $12,100.00 $12,100.00 N/A $0.00 N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $2,235.00 $2,235.00 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 $1,052.00 N/A $150.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $2,102.50 $2,102.00 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 $825.00 N/A

Components

Actual Information Description File Name
Transition Timing and Coordination 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.
Project management of the transition

Component Description:
Project Management
Amount:
$1,093.75

Component Description:
Project Management
Amount:
$974.70

Component Description:
Project Management
Amount:
$1,350.05

Component Description:
Project Management
Amount:
$292.90

Component Description:
Project Management
Amount:
$278.85

Component Description:
Project Management
Amount:
$373.45

Component Description:
Project Management
Amount:
$733.80

Component Description:
Project Management
Amount:
$416.65

Component Description:
Project management
Amount:
$4,183.75

Component Description:
Project Management
Amount:
$900.00

Component Description:
Project Management
Amount:
$1,013.90

Component Description:
Project Management
Amount:
$1,212.70

Component Description:
Project Management
Amount:
$618.50

Component Description:
Project Management
Amount:
$2,395.00

Component Description:
Project Managemtn
Amount:
$75.00

Component Description:
Project Management
Amount:
$519.00
Comprehensive coverage verification via field study, if needed Information not provided.
RF Exposure Measurements Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Prepare Form 601 Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
Preparation of Application for License to Cover CP
Amount:
$150.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Prepare request for Special Temporary Authorization Information not provided.
Perform engineering study for displacement application

Component Description:
Review of TSID Needed for Transmission.
Amount:
$75.00

Component Description:
Review of Antenna Proposal
Amount:
$150.00

Component Description:
LPTV/Translator Studies
Amount:
$600.00

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 $1,663.75 $1,663.75 N/A $1,113.75 N/A
Total for all systems $331,231.63 $338,178.50 N/A $138,534.73 N/A
Other Expenses $1,663.75 $1,663.75 $1,113.75
Equipment Delivery and Handling Charges $1,113.75 $1,113.75 Please see Dielectric quote 1733120 $1,113.75 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $0.00 $0.00 Disposal required due to displacement. Documents pending at time of certification N/A N/A
Point to Point Microwave (STL/ICR): Frequency Coordination for Unidirection System $550.00 $550.00 N/A N/A N/A

Components

Actual Information Description File Name
Equipment Delivery and Handling Charges

Component Description:
OTHER
Amount:
$1,113.75
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Point to Point Microwave (STL/ICR): Frequency Coordination for Unidirection System Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $331,231.63 $338,178.50 $138,534.73

Reimbursement Status

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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

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.

Sravan V Reddy , Reddy .

Senior Director, General Accounting


12/22/2020

Certification

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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).

  1. The Authorized Person signing below certifies and represents 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 certifies that the statements in this form and attached documentation are true, complete, and correct.

  3. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

  4. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.

  5. 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 (full power and Class A stations) and/or otherwise modify a television station’s facility as a result of the spectrum repack (LPTV/TV Translator stations); or to minimize service disruption resulting from a repacked television station (FM stations); or to continue to carry the signal of a broadcaster that changes channels (MVPD) .

  6. 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.

  7. The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred.

  8. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.

  9. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a prerequisite 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.

Sravan V Reddy , Reddy .

Senior Director, General Accounting


12/22/2020

Attachments

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