Attachment Exhibit A

This document pretains to SES-MOD-20160219-00162 for Modification on a Satellite Earth Station filing.

IBFS_SESMOD2016021900162_1126907

Exhibit A 45. Name ofPerson Signing 6. Title of Person Signing m Cynthia J. Grady Regulatory Counsel, Intelsat Corporation WILLFUL FALSE STATEMENTS MADE ON THIS FORM ARE PUNISHABLE BY FINE AND / OR IMPRISONMENT (U.S. Code, Title 18, Section 1001), AND/OR REVOCATION OF ANY STATION AUTHORIZATION (U.S. Code, Title 47, Section 312(a)(1)), AND/OR FORFEITURE (U.S. Code, Title 47, Section 503). SATELLITE EARTH STATION AUTHORIZATIONS FCC Form 312 — Schedule B:(Technical and Operational Description) FOR OFFICIAL USE ONLY Location ofEarth Station Site E1: Site Identifier: Hagerstown Teleport E3. Call Sign: E150002 E2: Contact Name Mr. Eric Lund E6. Phone Number: 2404208990 E3. Street: 17625 TechnologyBlvd E7. City: Hagerstown E8. County: Washington E4. State MD E9. Zip Code 21740 E10. Area of Operation: Hagerstown, MD E11. Latitude: 39 °35‘ 53.9 " N E12. Longitude: 77 ° 45‘ 23.0 " W E13. Lat/Lon Coordinates are: ONAD—27 @NAD—383 ON/A E14. Site Elevation (AMSL): 170.0 meters E15. Ifthe proposed antenna(s) operate in the Fixed Satellite Service (FSS) with geostationary satellites, do(es) the proposed antenna(s) comply with the antenna gain patterns specified in Section 25.209(a) and (b) as demonstrated bythe manufacturer‘s qualification measurement? If NO, provide as a technical ® Yes No ISI)/A lanalysis showing compliance with two—degree spacing policy. E16. If the proposed antenna(s) do not operate in the Fixed Satellite Service (FSS), or ifthey operatein the Fixed Satellite Service (FSS) with non—geostationary satellites, do(es) the proposed antenna(s) oY o No @© comply with the antenna gain patterns specified in Section 23.209(a2) and(b) as demonstrated by the £s No N/A manufacturer‘s qualification measurements? E17. Is the facility operated by remote control? If YES, provide the location and telephone number of O Yes ® No E18. Is frequency coordination required? If YES, attach a frequency coordination ® Yes O No report as E19. Is coordination with another country required? If YES, attach the name of the O Ye @ n country(ies) and plot of coordination contours as €* No E20. FAA Notification — (See 47 CFR Part 17 and 47 CFR part 25.113(c)) Where FAA notification is required, have you attached a copy of a completed FCC Form 854 and/or the FAA‘s study regarding the potential hazard of the structure to O Yes ® No I aviation? FAILURE TO COMPLY WITH 47 CFR PARTS 17 AND 25 WILL RESULT IN THE RETURN OF THIS APPLICATION. POINTS OF COMMUNICATION Satellite Name:INTELSAT 29e ($2913) | INTELSAT 29E | 50.0 W.L. If youselected OTHER, please enter the following: E21. Common Name: ”EZZ. ITU Name: r i 1 httn<{/liconsineo fee cov/ihfeweb/ib.nace.FetchForm?id app num=108083&form=PO15 101... 1/4/2016

I!EZS. Orbit Location: HEZ-t. Country: POINTS OF COMMUNICATION (Dest ination Points) E25. Site Identifier: E26. Common Name: |E27. Country: ANTENNA . £28. 2 E29. E30. E. E32. 2 U E-(l/-t.... 2 Antenna Ga!n i Site ID Antenna GQiumstity Manufacturer Model Antenna Transmint and/or Recieve Id * — Size ( dBi at GHz) figgmstow* Teleport ; 1 Coneial Dynamics ST 16.4]16.4 0.0 dBi at frummememmy n imemmnmmmmmmy ionmoonmooomemmnmmmms onpmanpmsamennnmnprnnmeccsmmmel E37. E35 Building E38. Total E39. E33/34. nal E36. "hllWing Input Maximum [E40. Total E28. % Above Height g Diameter Above Scal L Power at Antenna EIRP for Antenna 5 s Ground Above . & Minor/Major . Level antenna Height Above |al carriers Id Level Ground § . (meters) (meters) . flange Rooftop (dBW) {meters Lievel (Watts) (meters) (meters) — 1 [16.4/16.4 16.4 186.4 ___|o.0 1275.0 0.0 J90.1 FREQUENCY E28. E43/44. E45. E46. Antenna E47. E48. Maximum| E49. Maximum Antenna Frequency T/R Polarization Emission EIRP per ERIP Density per Id Bands(MHz) Mode (H.V,L,R) Designator Carrier(dBW) [Carrier(dBW/4kHz) 1 sarreace [p fEipestas Circular imzorxp |s1.1 56.3 E50. Modulation and Services Command and Ranging 1 sesosss3.s |r [Eieatand Circular IM?oFXD [s1 56.3 E50. Modulation and Services Command and Ranging 1 seso sesas |r |Reftand Sight Circular fesopgpyp 179.¢ 56.3 E50. Modulation and Services Command and Ranging mopom FREQUENCY COORDINATION z £52/53. E54/55. Range > Antenna) (~5C Antenna| C ONXBY® E28. ES1L. , . Station : Station 3 EIRP s Frequency] of Satellite Arc . Elevation| |_, Elevation ¥ee Antennal Satellite $aut M Azimuth Azimuth Density ; Limits |[Eastern/Western Angle Angle e Id Orbit Type Saw$ Angle P Angle o ig toward the (MHz) Limit Eastern |. Western 1 Eastern Limit Western Limit Horizon Limit Limit (dBW/4kHz) 1 (Geostationary|6421 6426 K9.0/51.0 139.2 |35.5 141.6 36.6 —9.41 Geostationary|2e2? . "|[5853.5 [9.0(31.0 1392 |3s.5 1416 |36.6 [941 REMOTE CONTROL POINT LOCATION E61. Call Sign E66. Phone Number NOTE: Please enter the callsign of the controlling station, not the callsign for whichthis inplicationis b filed E62. Street Address I I I http://licensing. fee.gov/ibfsweb/ib.page.FetchForm?id_app_num=108083&form=PO15_101... 1/4/2016

E63. City E68. County E67/68. E64. Zip State/Country Code / _ FCC NOTICE REQUIRED BY THE PAPERWORK REDUCTION ACT The public reporting for this collection of informationis estimated to average 8 2 hours per response, including the time for reviewing instructions, searching existing data sources, gathering ol a and maintaining the required data, and completing and reviewing the collection of information. If you have any comments on this burden estimate, or howwe can improve the collection and reduce the burden it causes you, please write to the Federal Communications Commission, AMD—PERM, Paperwork Reduction Project (3060—0678), Washington, DC 20554. We will also accept your comments regarding the Paperwork Reduction Act aspects ofthis collection via the Internet if you send them to PRA@fee.gov. PLEASE DO NOT SEND COMPLETED FORMS TO THIS ADDRESS. Remember — Youare not required to respond to a collection of information sponsored by the Federal government, and the government maynot conduct or sponsor this collection, unless it displays a currently valid OMB control number or if we fail to provide you with this notice. This collection has been assigned an OMB control number of 3060—0678. THE FOREGOING NOTICE IS REQUIRED BY THE PAPERWORK REDUCTION ACT OF 1995, PUBLIC LAW104—13, OCTOBER 1, 1995, 44 U.S.C. SECTION 3507. Masstfmnractie w oo s ccneutt oc NACAAR iofommeaimArc thi rarmaie


Document Created: 2016-02-17 10:07:50
Document Modified: 2016-02-17 10:07:50
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