Go to the Federal Communications Commission homepage at www.fcc.gov

FCC Form 399: Incentive Auction Relocation Reimbursement Fund System

Approved by OMB 3060-1178
Go to the Federal Communications Commission homepage at www.fcc.gov

(REFERENCE COPY - Not for submission)FCC Form 399: Incentive Auction Relocation Reimbursement Fund System

File Number:
0000028288
FRN:
0002855179
Facility ID:
168662
Repack Channel:
18 (UHF)
Entity:
Broadcaster
Filing Status:
Submitted
Date Submitted:
10/06/2017

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

WEIGEL BROADCASTING CO.

Doing Business As: WEIGEL BROADCASTING CO.

Norman H. Shapiro

26 NORTH HALSTED STREET

CHICAGO, IL 60661

United States

+1 (312) 705-2600 nshapiro@wciu.com Corporation

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

The Preparer is same as the reimbursement contact.

 

 

 

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 WMEU broadcasts from Willis Tower in Chicago, IL. WMEU plans to operate on its current licensed facility until the time of transition. A new antenna and transmitter will be installed due to the channel change.

Question Response
Sharee Station Facility ID 72115
Call Sign WGN-TV
Type Commercial
Licensee Name WGN CONTINENTAL BROADCASTING COMPANY, LLC
Status LICENSED
DTS No
Community of License CHICAGO, IL
Pre-auction RF Channel 19
Post-auction RF Channel 19
Neilsen DMA Chicago
Network Affiliation
Question Response
Sharee Station Facility ID 48772
Call Sign WPWR-TV
Type Commercial
Licensee Name FOX TELEVISION STATIONS, LLC
Status LICENSED
DTS No
Community of License GARY, IN
Pre-auction RF Channel 51
Post-auction RF Channel
Neilsen DMA Chicago
Network Affiliation
Question Response
Sharee Station Facility ID 68043
Call Sign WESV-LD
Type
Licensee Name KRCA LICENSE LLC
Status LICENSED
DTS No
Community of License CHICAGO, IL
Pre-auction RF Channel 40
Post-auction RF Channel
Neilsen DMA
Network Affiliation
Question Response
Sharee Station Facility ID 71428
Call Sign WCIU-TV
Type Commercial
Licensee Name WCIU-TV LIMITED PARTNERSHIP
Status LICENSED
DTS No
Community of License CHICAGO, IL
Pre-auction RF Channel 27
Post-auction RF Channel 23
Neilsen DMA Chicago
Network Affiliation
Question Response
Sharee Station Facility ID 32334
Call Sign WJYS
Type Commercial
Licensee Name OXFORD MEDIA GROUP, INC.
Status LICENSED
DTS No
Community of License HAMMOND, IN
Pre-auction RF Channel 36
Post-auction RF Channel 21
Neilsen DMA Chicago
Network Affiliation
Question Response
Sharee Station Facility ID 68061
Call Sign WRJK-LP
Type
Licensee Name CHICAGO 22, LLC
Status LICENSED
DTS No
Community of License ARLINGTON HEIGHTS, IL
Pre-auction RF Channel 22
Post-auction RF Channel
Neilsen DMA
Network Affiliation
Question Response
Sharee Station Facility ID 71425
Call Sign WWME-CD
Type
Licensee Name CHANNEL 23 LIMITED PARTNERSHIP
Status LICENSED
DTS No
Community of License CHICAGO, IL
Pre-auction RF Channel 39
Post-auction RF Channel 20
Neilsen DMA Chicago
Network Affiliation
Question Response
Sharee Station Facility ID 9617
Call Sign WBBM-TV
Type Commercial
Licensee Name CBS BROADCASTING INC.
Status LICENSED
DTS No
Community of License CHICAGO, IL
Pre-auction RF Channel 12
Post-auction RF Channel 12
Neilsen DMA Chicago
Network Affiliation
Question Response
Sharee Station Facility ID 22211
Call Sign WFLD
Type Commercial
Licensee Name FOX TELEVISION STATIONS, LLC
Status LICENSED
DTS No
Community of License CHICAGO, IL
Pre-auction RF Channel 31
Post-auction RF Channel 24
Neilsen DMA Chicago
Network Affiliation
Question Response
Sharee Station Facility ID 10802
Call Sign WTTW
Type Noncommercial Educational
Licensee Name WINDOW TO THE WORLD COMMUNICATIONS, INC.
Status LICENSED
DTS No
Community of License CHICAGO, IL
Pre-auction RF Channel 47
Post-auction RF Channel 25
Neilsen DMA CHICAGO
Network Affiliation
Question Response
Sharee Station Facility ID 10981
Call Sign WCPX-TV
Type Commercial
Licensee Name ION MEDIA CHICAGO LICENSE, INC.
Status LICENSED
DTS No
Community of License CHICAGO, IL
Pre-auction RF Channel 43
Post-auction RF Channel 34
Neilsen DMA Chicago
Network Affiliation
Question Response
Sharee Station Facility ID 66978
Call Sign WEDE-CD
Type
Licensee Name FIRST UNITED, INC.
Status LICENSED
DTS No
Community of License ARLINGTON HEIGHTS, IL
Pre-auction RF Channel 34
Post-auction RF Channel 28
Neilsen DMA Chicago
Network Affiliation
Question Response
Sharee Station Facility ID 73226
Call Sign WLS-TV
Type Commercial
Licensee Name WLS TELEVISION, INC.
Status LICENSED
DTS No
Community of License CHICAGO, IL
Pre-auction RF Channel 44
Post-auction RF Channel 44
Neilsen DMA Chicago
Network Affiliation
Question Response
Sharee Station Facility ID 47905
Call Sign WMAQ-TV
Type Commercial
Licensee Name NBC TELEMUNDO LICENSE LLC
Status LICENSED
DTS No
Community of License CHICAGO, IL
Pre-auction RF Channel 29
Post-auction RF Channel 33
Neilsen DMA Chicago
Network Affiliation
Question Response
Sharee Station Facility ID 70119
Call Sign WSNS-TV
Type Commercial
Licensee Name NBC TELEMUNDO LICENSE LLC
Status LICENSED
DTS No
Community of License CHICAGO, IL
Pre-auction RF Channel 45
Post-auction RF Channel
Neilsen DMA Chicago
Network Affiliation

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)
Description of Use  
Ownership Owned
Owner  
Site  
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model TDU2 4K00 AV
Year 2011
Type Solid state
IOT Power Type  
Description  
Power capacity  
Solid State Cooling Liquid
Solid State Power Capacity 4 kw
Other Transmitter Type  

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Description of Use  
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model THU9-EVO
Transmitter Type Solid state
IOT Power Type  
Other  
Power capacity  
Solid State Cooling Liquid
Solid State Power Capacity 4.9 kw
Other Transmitter Type  
Justification for New Transmitter The current mask filter is channel-specific and must be replaced. The current transmitter is no longer supported by the manufacturer and as a result, is unable to be retuned.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) Yes
Power 150 kVA
Rigid Conduit and Wiring Yes
Size 2 inches
Length 300.0 feet
Other Electrical Service No
Description  
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 10 tons
Other Size  
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size
Channel 14 Costs Is an RF Consulting Engineer needed?
Is a channel 14 Mask Filer needed?
Is additional field engineering time needed?
Number of Days  

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Structural Analysis

WMEU's transmission facility is located on floor 101 of Willis Tower. Willis Tower requires a detailed analysis of all equipment loads with respect to the structural aspects of the building.

Structural Modifications

As a result of the structural analysis, modifications may be required.

Transmitter Installation

Willis Tower has unique labor requirements. Standard transmitter installation practices are not allowed due to labor agreements. Only building electrical and plumbing contractors may perform any electric or plumbing work related to the installation.

State and City Taxes

Sate and city taxes are required for equipment that is purchased, but not services.

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)
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 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 N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 15.00 kW
Manufacturer
Model TLP-4M/VP
Year 2011

Primary Antenna

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New Antenna Costs

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 Type 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: 11.00 kW
Manufacturer
Model TLP-4M/VP
Year 2019
Justification for New Antenna The current WMEU antenna is a slot antenna designed for channel 32. An equivalent replacement antenna is being proposed for channel 18.

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
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

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

State and City Taxes

State and city taxes are required for equipment that is purchased, but not services.

Transmission Line

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Section Question Response
Transmission Line Related Expenses Do you have transmission line related expenses? No

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)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? Located on Building
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 Yes
Is tower documented for structural analysis? No
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1032959
Coordinates (NAD83) Latitude (NAD83) 41° 52' 44.1" N-
Longitude (NAD83) 087° 38' 10.2" W-
Overall Structure Height 1729.97 feet
Support Structure Height 1435.35 feet
Ground Elevation Above Mean Sea Level (AMSL) 595.14 feet
Structure Type BTWR - Building with Tower
Tower Owner 233 Broadcast, LLC
Date Constructed 01/01/2002

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
9617 WBBM-TV DTV
9613 WBBM-FM FM
71283 WCFS-FM FM
71425 WWME-CD DTV
48772 WPWR-TV DTV
47905 WMAQ-TV DTV
10801 WFMT FM
10802 WTTW DTV
71428 WCIU-TV DTV
22211 WFLD DTV
6377 WTMX FM
73228 WLS-FM FM
70119 WSNS-TV DTV
70042 WLIT-FM FM
66978 WEDE-CD DTV
28621 WJMK FM
72115 WGN-TV DTV

Other Types of Users

Users
LM Land Mobile
FX FM Services
LD TV Services

Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Study needed for undocumented/poorly documented tower
Tower Reinforcements Please select whether tower reinforcements are needed: Minor Reinforcements needed

Primary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower Located on Building
Helicopter Services Required Are helicopter services required? No

Primary Tower

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Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services?
Number of Hours N/A
Explanation N/A
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 N/A
For Main Facility Yes N/A
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 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 Yes
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

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

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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? No
Does this relocation require MVPD Notification of a Channel Change? Yes

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 $390,291.00 $345,985.11 N/A $0.00 N/A
Total for all systems $1,068,518.50 $521,712.61 N/A $0.00 N/A
Primary Transmitter THU9-EVO $390,291.00 $345,985.11 $0.00
State and City Taxes $18,491.00 $18,491.00 State and city taxes are required for equipment that is purchased, but not services. N/A N/A
Transmitter Installation $20,000.00 $20,000.00 Willis Tower requires union labor for all electric and cooling connections. This is a general allowance to cover the additional labor fees for union labor to perform the transmitter installation and building water connections. N/A N/A
Structural Modifications $17,500.00 $17,500.00 Willis Tower requires loading studies for heavy equipment that is installed in the building. As a result, it is anticipated that additional reinforcement will be required. Actual costs to be determined once final equipment selection has been made. N/A N/A
Structural Analysis $5,500.00 $5,500.00 Willis Tower requires loading studies for equipment that exceeds the normal tenant office loads, such as broadcast equipment. Actual costs to be determined once the final equipment selection has been made. N/A N/A
10 Ton system $37,000.00 $37,000.00 N/A N/A N/A
2" Rigid Conduit and Wiring (Cost per foot) $7,500.00 $7,500.00 N/A N/A N/A
Transformer 3 phase/480v - 150 KVA $24,300.00 $24,300.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW $260,000.00 $215,694.11 N/A N/A N/A

Components

Information not provided.

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 $33,962.50 $33,962.50 N/A $0.00 N/A
Total for all systems $1,068,518.50 $521,712.61 N/A $0.00 N/A
Primary Antenna TLP-4M/VP $33,962.50 $33,962.50 $0.00
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $25,000.00 $25,000.00 WMEU currently utilizes an elliptically polarized antenna. The proposed elliptically polarized antenna is slightly more than the FCC estimated amount. N/A N/A
Sweep test of existing antenna $6,400.00 $6,400.00 N/A N/A N/A
State and City Taxes $2,562.50 $2,562.50 State and city taxes are required for equipment that is purchased, but not services. N/A N/A

Components

Information not provided.

Cost Information

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Transmission Line

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 $575,000.00 $72,500.00 N/A $0.00 N/A
Total for all systems $1,068,518.50 $521,712.61 N/A $0.00 N/A
Primary Tower BTWR $575,000.00 $72,500.00 $0.00
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $400,000.00 $35,000.00 N/A N/A N/A
Minor tower reinforcement/modifications $150,000.00 $25,000.00 N/A N/A N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $25,000.00 $12,500.00 N/A N/A N/A

Components

Information not provided.

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 $32,750.00 $32,750.00 N/A $0.00 N/A
Total for all systems $1,068,518.50 $521,712.61 N/A $0.00 N/A
Outside Professional Services $32,750.00 $32,750.00 $0.00
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,500.00 $3,500.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,000.00 $4,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,250.00 $2,250.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,000.00 $5,000.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $1,500.00 $1,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,500.00 $1,500.00 N/A N/A N/A
Prepare and or review reimbursement form $2,500.00 $2,500.00 N/A N/A N/A
Address transition timing and coordination issues w/ other stations and wireless $2,500.00 $2,500.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,000.00 $7,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,000.00 $3,000.00 N/A N/A N/A

Components

Information not provided.

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 $36,515.00 $36,515.00 N/A $0.00 N/A
Total for all systems $1,068,518.50 $521,712.61 N/A $0.00 N/A
Other Expenses $36,515.00 $36,515.00 $0.00
MVPD Notification of Channel Change $2,500.00 $2,500.00 Notification to all MVPD regarding channel changes. N/A N/A
Equipment Delivery and Handling Charges $2,500.00 $2,500.00 Willis Tower loading dock after hours fees. N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $20,000.00 $20,000.00 Removal of WMEU solid state transmitter cabinet, RF system, electrical system, and cooling system. N/A N/A
FCC Filing Fees - Special Temporary Authorization request $190.00 $190.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $325.00 $325.00 N/A N/A N/A
DTV Medical Facility Notification $11,000.00 $11,000.00 N/A N/A N/A

Components

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $1,068,518.50 $521,712.61 $0.00

Construction Status

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Question Response
Is construction complete? 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.

Kyle Walker

VP, Technology


10/06/2017

Attachments

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