| Applicant | Address | Phone | Applicant Type | |
|---|---|---|---|---|
|
HME EQUITY FUND II, LLC Doing Business As: HME EQUITY FUND II, LLC |
Seth Ellis 509 West Colonial Drive Suite 100 ORLANDO, FL 32804 United States |
+1 (407) 906-2484 | sellis@assurancemezz.com | Limited Liability Company |
| Applicant | Address | Phone | |
|---|---|---|---|
|
[Confidential] |
|
|
|
| Applicant | Address | Phone | |
|---|---|---|---|
|
Davina Sashkin Fletcher, Heald & Hildreth, PLC |
Davina Sashkin Fletcher, Heald & Hildreth, PLC 1300 N. 17th Street, Suite 1100 Arlington, VA 22209 United States |
+1 (703) 812-0400 | sashkin@fhhlaw.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 | Build according to FCC transition plan. |
| 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 | TMU9-570 | |
| Year | 2013 | |
| Type | Solid State | |
| Solid State Cooling | Air Cooled | |
| Solid State Power Capacity | .6 kW |
| Section | Question | Response |
|---|---|---|
| New Transmitter | Use | Primary (Main) |
| Change Type | Purchase New | |
| Is this a request for upgraded equipment? | Yes | |
| Manufacturer | ||
| Model | TMU9-4 Evo | |
| Transmitter Type | Solid State | |
| Solid State Cooling | Air Cooled | |
| Solid State Power capacity | 1.5 kW | |
| Justification for New Transmitter | Can't use current Transmitter so need to purchase a new one, need more power per construction permit approved by FCC |
| Section | Question | Response |
|---|---|---|
| Electrical Service | Service Entrance (3 phases 800A 208V) | Yes |
| Switchgear (industrial 800 amp) | No | |
| Transformer (480V) | No | |
| Power | N/A | |
| Rigid Conduit and Wiring | Yes | |
| Size | 3 inches | |
| Length | 100.0 feet | |
| Other Electrical Service | Yes | |
| Description | Will need some electrical work to get it up and running, will submit quote from an electrician. | |
| HVAC Service | Does the replacement transmitter require HVAC Service? | Yes |
| Type | Cooling Only | |
| Size | Other | |
| Other Size | 2 tons | |
| 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 |
|---|---|
Removal |
Cost to just remove the transmitter from building Transmitter Removal Quote # 102 |
Installation |
Cost to Install Transmitter Transmitter Install Quote # 101 |
| 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? | No | |
| Existing Antenna Manufacturer and Type | Class | Class A |
| 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: | 5.0 kW | |
| Manufacturer | ||
| Model | PSILP8BH-39 | |
| Year | 2014 |
| 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? | Yes | |
| Will antenna be located on or in close proximity to an antenna farm? | No | |
| New Antenna Manufacturer and Types | Class | Class A |
| 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: | 15.0 kW | |
| Manufacturer | ||
| Model | TLP-8VP-R P300-SP | |
| Year | 2020 | |
| Justification for New Antenna | Higher power antenna is necessary for modification application parameters (filed in 1st priority window). |
| Section | Question | Response |
|---|---|---|
| Combiner for Shared Antenna | Do you need a Combiner for a Shared Antenna? | |
| 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 |
| Name | Description |
|---|---|
Pipe and Mounting Pieces |
Materials and Labor to fabricate custom tower leg transition mounts. Mounts needed to hold a 3 and a half inch OD pipe off the angle tower leg |
Labor to install Antenna and Disposal Cost |
Labor to install Antenna and then remove the old one. This will include travel. |
| 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) | |
| 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 | |
| Type | Flexible Foam | |
| Diameter | 7/8 inches | |
| Other Diameter | N/A | |
| Segment Length | N/A | |
| Other Segment Length | N/A | |
| Number of parallel runs | 1 | |
| Length | 250 feet per run |
| Section | Question | Response |
|---|---|---|
| New Transmission Line Costs | Use | Primary (Main) |
| Description of Use | N/A | |
| Change Type | Purchase New | |
| Is this a request for upgraded equipment? | Yes | |
| Type | Flexible Foam | |
| Diameter | 7/8 inches | |
| Other Diameter | N/A | |
| Segment Length | N/A | |
| Other Segment Length | N/A | |
| Number of parallel runs | 1 | |
| Length | 250 feet per run | |
| Justification for New Transmission Line | Sweep test results will determine need. |
| 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? | Located on Building | |
| 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? | Yes | |
| Existing Tower Structure Registration | Do you have a tower registration number? | Yes |
| ASR Number | 1037283 | |
| Coordinates (NAD83) | Latitude (NAD83) | 39° 24' 10.4" N- |
| Longitude (NAD83) | 076° 36' 10.9" W- | |
| Overall Structure Height | 279.85 feet | |
| Support Structure Height | 189.96 feet | |
| Ground Elevation Above Mean Sea Level (AMSL) | 477.03 feet | |
| Structure Type | BTWR - Building with Tower | |
| Tower Owner | Towson City Center, LLC | |
| Date Constructed | 06/25/2013 |
| 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: | No reinforcements needed |
| Section | Question | Response |
|---|---|---|
| Tower Rigging Costs | Complex Tower | Located on Building |
| 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 | 600 | |
| Explanation | Applicant has no internal resources capable of overseeing, identifying, purchasing, installing and commissioning this repack project. It will rely solely on outside services to manage all work required. | |
| 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 | No | |
| Quantity | N/A | |
| 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 | No | |
| Quantity | N/A | |
| NEPA Section 106 environmental review | No | |
| Environmental Assessment | No | |
| ASR Modification | No | |
| FAA Consultation (including preparation of FAA Form 7460) | No | |
| 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 | No | |
| RF Field Engineering Services | Comprehensive coverage verification via field study | No |
| RF exposure measurements | No | |
| Additional Field Engineering Service | No | |
| Number of Days | N/A | |
| Justification | N/A |
| Name | Description |
|---|---|
Other Transition- Related Professional Service Costs |
Project Management of the transition. Preparation and review of reimbursement form. |
Quarterly Transition Reports |
Quarterly Transition Reports |
| 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 | 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? | 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 |
|---|---|
Other Miscellaneous Expenses |
Other Miscellaneous Expenses |
Travel to Antenna Site |
Travel to antenna site to walk the site to see if they can get the antenna on the roof without a crane |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $164,180.00 | $94,442.00 | N/A | $72,341.20 | N/A |
| Total for all systems | $829,983.75 | $588,958.75 | N/A | $347,944.74 | N/A |
| Primary Transmitter TMU9-4 Evo | $164,180.00 | $94,442.00 | $72,341.20 | ||
| Other -- HVAC Service Type: C Size:2 (Other) | $2,130.00 | $2,130.00 | No quote yet but Licensee is going with a wall unit instead. Total expenses to date in regards to HVAC service is $2130 | $2,130.00 | N/A |
| Removal | $3,000.00 | $3,000.00 | Removal only of old Transmitter. Transmitter Removal Quote 102 attached. | $1,000.00 | N/A |
| Other Electrical Service: Will need some electrical work to get it up and running, will submit quote from an electrician. | $1,500.00 | $1,500.00 | Waiting on Quotes to submit | N/A | N/A |
| 3" Rigid Conduit and Wiring (Cost per foot) | $5,200.00 | $4,900.00 | N/A | N/A | N/A |
| Service entrance 3 phase/800 amp/208 volt | $14,400.00 | $13,700.00 | N/A | N/A | N/A |
| UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW | $126,000.00 | $57,262.00 | Please see document entitled " Updated #2 Narrative for Transmitter Change WMJF-CD" for the cost justification to increase the transmitter amount to now include the sales tax. | $57,261.20 | N/A |
| Installation | $11,950.00 | $11,950.00 | Cost to install the new transmitter Transmitter Install Quote 101 attached. | $11,950.00 | N/A |
| Actual Information Description | File Name |
|---|---|
| Other -- HVAC Service Type: C Size:2 (Other) | |
| Removal | |
| Other Electrical Service: Will need some electrical work to get it up and running, will submit quote from an electrician. | Information not provided. |
| 3" Rigid Conduit and Wiring (Cost per foot) | Information not provided. |
| Service entrance 3 phase/800 amp/208 volt | Information not provided. |
| UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW | |
| Installation |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $51,080.00 | $72,950.00 | N/A | $72,520.42 | N/A |
| Total for all systems | $829,983.75 | $588,958.75 | N/A | $347,944.74 | N/A |
| Primary Antenna TLP-8VP-R P300-SP | $51,080.00 | $72,950.00 | $72,520.42 | ||
| Pipe and Mounting Pieces | $3,050.00 | $3,050.00 | See Narrative | $3,050.00 | N/A |
| Labor to install Antenna and Disposal Cost | $15,000.00 | $15,000.00 | See attached narrative | $14,800.00 | N/A |
| UHF - Lower Power Side Mount, Class A One Station antenna -- basic | $26,300.00 | $48,500.00 | See document entitled "Narrative for Antenna Estimate Change WMJF-CD" for cost justification and details on corresponding quotes. | $48,270.42 | N/A |
| Sweep test of existing antenna | $6,730.00 | $6,400.00 | Quote for this was originally provided in 2017 and since then prices have gone up and the new standard for a sweep test is $6400 and this is still below the predetermined amount. See line #6 on quote # 900237CMZ-2 from Dielectric | $6,400.00 | N/A |
| Actual Information Description | File Name |
|---|---|
| Pipe and Mounting Pieces | |
| Labor to install Antenna and Disposal Cost | |
| UHF - Lower Power Side Mount, Class A One Station antenna -- basic | |
| Sweep test of existing antenna |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $2,750.00 | $4,000.00 | N/A | $0.00 | N/A |
| Total for all systems | $829,983.75 | $588,958.75 | N/A | $347,944.74 | N/A |
| Primary Transmission Line | $2,750.00 | $4,000.00 | $0.00 | ||
| Flexible Foam Transmission Line - dielectric, 7/8" | $2,750.00 | $4,000.00 | N/A | N/A | N/A |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $433,600.00 | $162,000.00 | N/A | $0.00 | N/A |
| Total for all systems | $829,983.75 | $588,958.75 | N/A | $347,944.74 | N/A |
| Primary Tower BTWR | $433,600.00 | $162,000.00 | $0.00 | ||
| Structural engineering tower load study for well documented tower | $12,600.00 | $12,000.00 | N/A | N/A | N/A |
| Complex Tower (includes, for example, those with candelabras and/or stacked antennas) | $421,000.00 | $150,000.00 | Crane required to install antenna, transmitter and HVAC. Phone quote min $50,000 per day for crane rental and crew, and assuming 2 non-contiguous days (only able to shut down street/building on Sundays). Additional $50,000 sought to cover tower crew. | N/A | N/A |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $132,310.00 | $210,700.00 | N/A | $182,337.99 | N/A |
| Total for all systems | $829,983.75 | $588,958.75 | N/A | $347,944.74 | N/A |
| Outside Professional Services | $132,310.00 | $210,700.00 | $182,337.99 | ||
| Other Transition- Related Professional Service Costs | $2,500.00 | $2,500.00 | Prepare and/or review reimbursement form | $0.00 | N/A |
| Perform engineering study for new channel assignment and antenna development | $7,360.00 | $7,000.00 | N/A | $2,625.00 | The actual hours on the engineering studies came in a little higher than originally estimated. |
| Project management of the transition | $94,800.00 | $159,000.00 | Project management exp- I have attached a narrative and a detailed spreadsheet of the exp that are associated with this cost estimate & why we are requesting more funds. File names are Narrative for Project Management... and Data for Narrative for More... | $154,768.99 | N/A |
| Quarterly Transition Reports | $8,450.00 | $8,450.00 | see attached quote for preparation and filing of reports by counsel and technical consultant | $2,655.00 | N/A |
| Attorney Fees - Negotiation of lease and other matters for shared locations | $4,210.00 | $15,000.00 | Attorneys fees for negotiation of Unable to Construct Channel Resolution Agreement with WETA and MPT, preparation and filing and related CP modification and updated 399. | $11,006.75 | N/A |
| Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | $2,365.00 | $2,250.00 | N/A | $675.00 | N/A |
| Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application | $5,260.00 | $5,000.00 | N/A | $1,610.63 | 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 | $2,000.00 | N/A |
| Prepare and or review reimbursement form | $2,630.00 | $7,000.00 | Originally best estimates were made off the original cost catalog at the time. As they went thru to complete the form there were a lot of revisions for transmitter&antenna costs that got revised. Repack-05A and Repack-08 have $500 more in legal fees | $6,996.62 | N/A |
| Actual Information Description | File Name |
|---|---|
| Other Transition- Related Professional Service Costs | |
| Perform engineering study for new channel assignment and antenna development | |
| Project management of the transition | |
| Quarterly Transition Reports | |
| Attorney Fees - Negotiation of lease and other matters for shared locations | |
| Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | |
| Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application | |
| 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 | |
| Prepare and or review reimbursement form |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $46,063.75 | $44,866.75 | N/A | $20,745.13 | N/A |
| Total for all systems | $829,983.75 | $588,958.75 | N/A | $347,944.74 | N/A |
| Other Expenses | $46,063.75 | $44,866.75 | $20,745.13 | ||
| Local Zoning | $2,000.00 | $2,000.00 | N/A | N/A | N/A |
| DTV Medical Facility Notification | $11,550.00 | $10,353.00 | Adjusting cost to the current market rate for this service, original amount was put in over 2 years ago. Attached is INV-002398 & EST-001750 | $10,353.00 | N/A |
| Travel to Antenna Site | $2,208.75 | $2,208.75 | Legacy EE traveled to Antenna site to meet engineer to walk site to see if they could get the antenna on top of the building without a crane. See attached"Updated Narrative for Antenna Estimate Change WMJF-CD dated 13Oct20" This should be under Antenna | $2,087.13 | N/A |
| MVPD Notification of Channel Change | $5,000.00 | $5,000.00 | N/A | N/A | N/A |
| Equipment Storage | $2,500.00 | $2,500.00 | N/A | N/A | N/A |
| Equipment Delivery and Handling Charges | $8,305.00 | $8,305.00 | Please find attached the document entitled "Narrative for Equipment Delivery and Handling Charges" to request more funds. | $8,305.00 | N/A |
| Disposal Costs (for equipment and other waste, net of any salvage value) | $5,000.00 | $5,000.00 | N/A | N/A | N/A |
| Non-zoning permits | $2,000.00 | $2,000.00 | N/A | N/A | N/A |
| Other Miscellaneous Expenses | $5,000.00 | $5,000.00 | N/A | N/A | N/A |
| Develop and air announcement of upcoming channel change | $2,500.00 | $2,500.00 | N/A | N/A | N/A |
| Actual Information Description | File Name |
|---|---|
| Local Zoning | Information not provided. |
| DTV Medical Facility Notification | |
| Travel to Antenna Site | |
| MVPD Notification of Channel Change | Information not provided. |
| 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. |
| Non-zoning permits | Information not provided. |
| Other Miscellaneous Expenses | Information not provided. |
| Develop and air announcement of upcoming channel change | Information not provided. |
| Predetermined Cost Estimate |
Estimated Cost | Actual Cost | |
|---|---|---|---|
| Total for all systems | $829,983.75 | $588,958.75 | $347,944.74 |
| 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. | Ann Olsen Consultant 03/20/2022 |
| 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. | Ann Olsen Consultant 03/20/2022 |
