| Applicant | Address | Phone | Applicant Type | |
|---|---|---|---|---|
|
ROSS COMMUNICATIONS, LTD. Doing Business As: ROSS COMMUNICATIONS, LTD. |
Glenn N. Ross 708 WEST HILLCREST AVENUE DAYTON, OH 45606 United States |
+1 (937) 275-7677 | skipross3@gmail.com | Limited Liability Company |
| Applicant | Address | Phone | |
|---|---|---|---|
|
[Confidential] |
|
|
|
| Applicant | Address | Phone | |
|---|---|---|---|
|
Tony Zummallen Anywave Communication Technologies |
Tony Zummallen 300 Knightsbridge Parkway Suite 150 Lincolnshire, IL 60069 United States |
+1 (816) 882-5600 | tony.zummallen@anywavecom.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 | Replace the transmitter and antenna per the channel relocation 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 | SBTXU-RFA-2000 | |
| Year | 2015 | |
| Type | Solid State | |
| Solid State Cooling | Air Cooled | |
| Solid State Power Capacity | 2 kW |
| Section | Question | Response |
|---|---|---|
| New Transmitter | Use | Primary (Main) |
| Change Type | Purchase New | |
| Is this a request for upgraded equipment? | No | |
| Manufacturer | ||
| Model | TXVD-2000 | |
| Transmitter Type | Solid State | |
| Solid State Cooling | Air Cooled | |
| Solid State Power capacity | 2 kW | |
| Justification for New Transmitter | Replace the transmitter per the channel relocation project |
| 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 |
|---|---|
Site Prep |
Prepare site for installation of new transmitter |
Emergency Alert System |
Emergency alert system replacement due to Repack |
Encoder |
Encoder |
IP Transport System |
IP Transport system necessary because of Repack |
Taxes |
Estimated sales tax |
Shipping |
Estimated shipping |
Decommission |
Decommission old transmitter |
| 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? | No | |
| Existing Antenna Manufacturer and Type | ||
| Mounting | Side Mount | |
| Antenna position in stack | Top | |
| Polarization | Horizontal | |
| Type | Slotted Coaxial | |
| ERP: | 34.0 kW | |
| Manufacturer | ||
| Model | JA/LS-AB-24 | |
| Year | 2015 |
| 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? | No | |
| New Antenna Manufacturer and Types | ||
| Mounting | Side Mount | |
| Antenna position in stack | Top | |
| Polarization | Horizontal | |
| Type | Slotted Coaxial | |
| ERP: | 3.0 kW | |
| Manufacturer | ||
| Model | PA31-SDP | |
| Year | 2019 | |
| Justification for New Antenna | Replace the antenna per the channel relocation project |
| 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 |
|---|---|
Shipping |
Estimated shipping costs |
Taxes |
Estimated sales tax |
| 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? | Yes | |
| Existing Transmission Line Manufacturer and Type | Manufacturer | |
| Type | Flexible Air | |
| Diameter | Other | |
| Other Diameter | 2 1/4 inches | |
| Number of parallel runs | 1 | |
| Length | 1000 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 | Flexible Foam | |
| Diameter | 1 5/8 inches | |
| Number of parallel runs | 1 | |
| Length | 1000 feet per run | |
| Justification for New Transmission Line | Original line will not be able to mate with new antenna or transmitter due to no connectors nor adapters for existing line available. | |
| 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 |
| Name | Description |
|---|---|
Transmission Line Inspection |
After installation, complete visual/thermal/IR scan of transmission line |
| 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? | Located on Building | |
| Is this tower currently shared with any other stations? | 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 | 1013716 | |
| Coordinates (NAD83) | Latitude (NAD83) | 39° 43' 28.0" N- |
| Longitude (NAD83) | 084° 15' 18.0" W- | |
| Overall Structure Height | 1152.87 feet | |
| Support Structure Height | 1099.07 feet | |
| Ground Elevation Above Mean Sea Level (AMSL) | 895.99 feet | |
| Structure Type | TOWER - Free Standing or Guyed Structure | |
| Tower Owner | WRGT-TV | |
| Date Constructed | 08/15/1984 |
| 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: | Minor Reinforcements needed |
| Section | Question | Response |
|---|---|---|
| Tower Rigging Costs | Complex Tower | Located on Building |
| Helicopter Services Required | Are helicopter services required? | No |
| Name | Description |
|---|---|
Additional Tower Services |
Additional tower work beyond original scope - includes work stoppage due to missing equipment and weather |
| 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 stations 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 | No |
| Name | Description |
|---|---|
Engineering Services |
Engineering Services - Interior equipment installation and testing |
General Consulting Engineering |
General Consulting Engineering services as needed. |
General Legal |
General Legal Services for Repack |
Tower Structural Analysis |
Structural analysis and inspection |
| 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 |
|---|---|
Peripheral equipment |
Peripheral equipment, cables, etc necessary to make transmitter system functional. |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $186,947.54 | $135,772.54 | N/A | $97,710.04 | N/A |
| Total for all systems | $537,462.64 | $480,338.93 | N/A | $267,184.43 | N/A |
| Primary Transmitter TXVD-2000 | $186,947.54 | $135,772.54 | $97,710.04 | ||
| IP Transport System | $14,962.50 | $14,962.50 | IP Transport system necessary to provide signal due to loss of signal due to being off-air from channel displacement | $0.00 | N/A |
| High VHF - Air Cooled Solid State Transmitter 1.1 - 4.4 kW | $101,000.00 | $52,425.00 | N/A | $52,425.00 | N/A |
| Transmitter Building Site Survey/Installation | $10,000.00 | $7,400.00 | Estimated costs for site survey and transmitter installation. Revised upon Site Survey. | $7,400.00 | N/A |
| Decommission | $6,000.00 | $6,000.00 | Estimated costs to deinstall, disconnect and decommission old transmitter in preparation for installation of new transmitter. | $0.00 | N/A |
| Shipping | $5,060.00 | $5,060.00 | Freight for all equipment on Transcom Invoice 11520CH9ttl-2 | $5,060.00 | Freight for all equipment on Transcom invoice including transmitter, mask filter, encoder, antenna, emergency alert system and transmission line/components |
| Taxes | $10,100.00 | $10,100.00 | Estimated sales tax | $0.00 | N/A |
| Encoder | $27,665.84 | $27,665.84 | Per attached Transcom invoice - document submitted 12/3/2020 | $27,665.84 | Per actual invoice and quote from Transcom Corporation. |
| Site Prep | $7,000.00 | $7,000.00 | Estimated costs to prepare site for transmitter installation crew. Includes receiving and inventory of transmitter and all components; pre-assembly of cabinets and subasssemblies; ensuring site has all materials required by installation crew | $0.00 | N/A |
| Emergency Alert System | $5,159.20 | $5,159.20 | Replacement of Emergency Alert System due to repack. See quote attached to WRCX72420-EAS for the additional amounts requested to support the base unit quoted at $3087.50. The peripherals necessary for the system is $2071.70, thus the total of $5159.20. | $5,159.20 | actual costs per vendor invoice from Transcom. INV WRCX72420-EAS |
| Actual Information Description | File Name |
|---|---|
| IP Transport System | |
| High VHF - Air Cooled Solid State Transmitter 1.1 - 4.4 kW | |
| Transmitter Building Site Survey/Installation | |
| Decommission | Information not provided. |
| Shipping | |
| Taxes | Information not provided. |
| Encoder | |
| Site Prep | Information not provided. |
| Emergency Alert System |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $20,910.00 | $20,910.00 | N/A | $6,555.00 | N/A |
| Total for all systems | $537,462.64 | $480,338.93 | N/A | $267,184.43 | N/A |
| Primary Antenna PA31-SDP | $20,910.00 | $20,910.00 | $6,555.00 | ||
| Taxes | $2,000.00 | $2,000.00 | Estimated sales tax | $0.00 | N/A |
| Shipping | $2,000.00 | $2,000.00 | Estimated shipping and freight. Actual costs to be determined. | $0.00 | N/A |
| Side Mount antenna brackets | $4,625.00 | $4,625.00 | N/A | $0.00 | N/A |
| Sweep test of transmission line and antenna | $5,730.00 | $5,730.00 | N/A | $0.00 | N/A |
| High VHF-Low Power, Side Mount, Slotted Coaxial, 3.0kW input, Horizontal | $6,555.00 | $6,555.00 | Per attached Transcom quote. | $6,555.00 | N/A |
| Actual Information Description | File Name |
|---|---|
| Taxes | Information not provided. |
| Shipping | Information not provided. |
| Side Mount antenna brackets | Information not provided. |
| Sweep test of transmission line and antenna | Information not provided. |
| High VHF-Low Power, Side Mount, Slotted Coaxial, 3.0kW input, Horizontal |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $33,424.80 | $26,021.09 | N/A | $16,596.29 | N/A |
| Total for all systems | $537,462.64 | $480,338.93 | N/A | $267,184.43 | N/A |
| Primary Transmission Line | $33,424.80 | $26,021.09 | $16,596.29 | ||
| Flexible Foam Transmission Line - dielectric, 1 5/8" | $24,000.00 | $16,596.29 | N/A | $16,596.29 | N/A |
| Transmission Line Inspection | $9,424.80 | $9,424.80 | Complete visual/thermal/IR scan of transmission line; QComm (QForce) Quote 731T/3002 | N/A | N/A |
| Actual Information Description | File Name |
|---|---|
| Flexible Foam Transmission Line - dielectric, 1 5/8" | |
| Transmission Line Inspection | Information not provided. |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $103,950.00 | $109,215.00 | N/A | $42,450.00 | N/A |
| Total for all systems | $537,462.64 | $480,338.93 | N/A | $267,184.43 | N/A |
| Primary Tower TOWER | $103,950.00 | $109,215.00 | $42,450.00 | ||
| Additional Tower Services | $10,500.00 | $10,500.00 | Additional tower rigging/work per Rio Steel inv 820193-3 | $0.00 | N/A |
| Complex Tower (includes, e.g., towers with candelabras and/or stacked antennas) | $42,450.00 | $42,450.00 | Quoted amount of tower rigging, antenna/line install. Rio Steel and Tower - INV 820193-1 | $42,450.00 | N/A |
| Tower mapping and report for structural engineer | $21,000.00 | $26,265.00 | Structural estimate per quote #20210621-060 from Electronics Research Inc. | $0.00 | N/A |
| Minor tower reinforcement/modifications | $30,000.00 | $30,000.00 | Estimated cost of modifications to tower, if required by study. | $0.00 | N/A |
| Actual Information Description | File Name |
|---|---|
| Additional Tower Services | |
| Complex Tower (includes, e.g., towers with candelabras and/or stacked antennas) | |
| Tower mapping and report for structural engineer | Information not provided. |
| Minor tower reinforcement/modifications | Information not provided. |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $175,550.30 | $171,740.30 | N/A | $103,873.10 | N/A |
| Total for all systems | $537,462.64 | $480,338.93 | N/A | $267,184.43 | N/A |
| Outside Professional Services | $175,550.30 | $171,740.30 | $103,873.10 | ||
| Form 399 assistance or other Program Management costs | $33,910.30 | $33,910.30 | Per Anywave Quote # PR1910-0534 dated 10/16/19, line items 1 & 3 PLUS Additional Hours quote PR2008-0919. | $33,910.30 | Actual same as estimate |
| Prepare engineering section of FCC Form 2100 (main), Construction Permit Application | $2,102.50 | $2,102.50 | N/A | $0.00 | N/A |
| Prepare engineering section of FCC Form 2100 (main), License to Cover Application | $1,052.50 | $1,052.50 | N/A | $0.00 | N/A |
| Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application | $3,025.00 | $12,000.00 | Estimate of attorney fees for preparation of CP. Actual costs to be determined. | $0.00 | N/A |
| Prepare Form 601 | $755.00 | $755.00 | N/A | $0.00 | N/A |
| Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | $1,577.50 | $1,577.50 | N/A | $0.00 | N/A |
| Attorney Fees - Negotiation of lease and other matters for shared locations | $3,262.50 | $3,262.50 | N/A | $0.00 | N/A |
| Attorney Fees - Prepare and File request for Special Temporary Authorization | $2,235.00 | $2,235.00 | N/A | $0.00 | N/A |
| Tower Structural Analysis | $26,265.00 | $26,265.00 | Tower structural analysis and inspection. See ERI quote 20210621-060. | N/A | N/A |
| General Consulting Engineering | $5,000.00 | $5,000.00 | Consulting Engineer services if needed. | $1,290.00 | N/A |
| Engineering Services | $7,400.00 | $7,400.00 | Engineering services (Transcom Corporation) for interior equipment installation and Testing. Transcom invoice 11520CH9ttl-2 and quote | $0.00 | N/A |
| Prepare request for Special Temporary Authorization | $1,280.00 | $1,280.00 | N/A | $0.00 | N/A |
| Perform engineering study for displacement application | $1,800.00 | $5,000.00 | Estimate of engineering fees for displacement application. Actual costs to be determined. | $2,850.00 | N/A |
| General Legal | $10,475.00 | $10,475.00 | General legal expenses due to Repack | $8,600.00 | N/A |
| Prepare/ Review 399 reimbursement form | $1,710.00 | $2,500.00 | Per attached Anywave quote PR1910-0534 dated 10/16/19 | $2,500.00 | N/A |
| Comprehensive coverage verification via field study, if needed | $52,600.00 | $26,125.00 | Per Attached QComm Quote 730C / 3001 attached to INV QC21-721 submission. | $26,125.00 | N/A |
| Project management of the transition | $21,100.00 | $30,800.00 | Estimated 200 hours at $154/hour | $28,597.80 | N/A |
| Actual Information Description | File Name |
|---|---|
| Form 399 assistance or other Program Management costs | |
| Prepare engineering section of FCC Form 2100 (main), Construction Permit Application | Information not provided. |
| Prepare engineering section of 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 Form 601 | Information not provided. |
| Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | Information not provided. |
| Attorney Fees - Negotiation of lease and other matters for shared locations | Information not provided. |
| Attorney Fees - Prepare and File request for Special Temporary Authorization | Information not provided. |
| Tower Structural Analysis | Information not provided. |
| General Consulting Engineering | |
| Engineering Services | |
| Prepare request for Special Temporary Authorization | Information not provided. |
| Perform engineering study for displacement application | |
| General Legal | |
| Prepare/ Review 399 reimbursement form | |
| Comprehensive coverage verification via field study, if needed | |
| Project management of the transition |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $16,680.00 | $16,680.00 | N/A | $0.00 | N/A |
| Total for all systems | $537,462.64 | $480,338.93 | N/A | $267,184.43 | N/A |
| Other Expenses | $16,680.00 | $16,680.00 | $0.00 | ||
| FCC Filing Fees - Form 2100 minor change CP application | $1,110.00 | $1,110.00 | N/A | $0.00 | N/A |
| FCC Filing Fees - Form 2100 license to cover application | $335.00 | $335.00 | N/A | $0.00 | N/A |
| FCC Filing Fees - Form 2100 Major change CP application | $4,960.00 | $4,960.00 | N/A | $0.00 | N/A |
| FCC Filing Fees - Special Temporary Authorization request | $305.00 | $305.00 | N/A | $0.00 | N/A |
| Disposal Costs (for equipment and other waste, net of any salvage value) | $2,000.00 | $2,000.00 | 4-6 yard disposal bin on site to capture all waste from on site system integration and tower vendors | $0.00 | N/A |
| Equipment Delivery and Handling Charges | $2,500.00 | $2,500.00 | Estimated costs to transport, rent forklift and handling fees from staging area to transmitter site | $0.00 | N/A |
| Equipment Storage | $2,500.00 | $2,500.00 | 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. | $0.00 | N/A |
| Peripheral equipment | $2,970.00 | $2,970.00 | The PC's that existed prior to Repack were old pentium processor PC's and were not fast enough to function with the new Repack transmitter. | $0.00 | N/A |
| Actual Information Description | File Name |
|---|---|
| FCC Filing Fees - Form 2100 minor change CP application | Information not provided. |
| FCC Filing Fees - Form 2100 license to cover application | Information not provided. |
| FCC Filing Fees - Form 2100 Major change CP application | Information not provided. |
| FCC Filing Fees - Special Temporary Authorization request | Information not provided. |
| Disposal Costs (for equipment and other waste, net of any salvage value) | Information not provided. |
| Equipment Delivery and Handling Charges | Information not provided. |
| Equipment Storage | Information not provided. |
| Peripheral equipment |
| Predetermined Cost Estimate |
Estimated Cost | Actual Cost | |
|---|---|---|---|
| Total for all systems | $537,462.64 | $480,338.93 | $267,184.43 |
| 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. | Glenn Ross Sole Proprietor 02/03/2023 |
| 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. | Glenn Ross Sole Proprietor 02/03/2023 |
