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:
0000028465
FRN:
0001732486
Facility ID:
52628
Repack Channel:
18 (UHF)
Entity:
Broadcaster
Filing Status:
Submitted
Date Submitted:
09/21/2018

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

ION MEDIA KNOXVILLE LICENSE, INC.

Doing Business As: ION MEDIA KNOXVILLE LICENSE, INC.

Bianca Frye

601 Clearwater Park Road

West Palm Beach, FL 33401

United States

+1 (561) 682-4110 BiancaFrye@ionmedia.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 Install a broadband interim antenna and operate using current transmitter on pre repack channel. Install a new transmitter, combiner and RF system. Current broadband transmission line and antenna can be used for post repack channels.

Question Response
Sharee Station Facility ID 19200
Call Sign WTNZ
Type Commercial
Licensee Name WTNZ LICENSE SUBSIDIARY, LLC
Status LICENSED
DTS No
Community of License KNOXVILLE, TN
Pre-auction RF Channel 34
Post-auction RF Channel 15
Neilsen DMA Knoxville
Network Affiliation
Question Response
Sharee Station Facility ID 71082
Call Sign WATE-TV
Type Commercial
Licensee Name NEXSTAR BROADCASTING, INC.
Status LICENSED
DTS No
Community of License KNOXVILLE, TN
Pre-auction RF Channel 26
Post-auction RF Channel 26
Neilsen DMA Knoxville
Network Affiliation
Question Response
Sharee Station Facility ID 67926
Call Sign WKXT-LD
Type
Licensee Name DIGITAL NETWORKS-SOUTHEAST, LLC
Status LICENSED
DTS No
Community of License MORRISTOWN, TN
Pre-auction RF Channel 43
Post-auction RF Channel
Neilsen DMA
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 DCX
Year 2000
Type Inductive Output Tube
IOT Power Type Two
Description  
Power capacity 40 kw
Solid State Cooling  
Solid State Power Capacity  
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? Yes
Manufacturer
Model HPTV-PRLX-U30
Transmitter Type Solid state
IOT Power Type  
Other  
Power capacity  
Solid State Cooling Liquid
Solid State Power Capacity 48.5 kw
Other Transmitter Type  
Justification for New Transmitter See attached Transmitter Exhibits. See attached Transmitter Upgrade Disclaimer.

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 500 kVA
Rigid Conduit and Wiring No
Size
Length
Other Electrical Service No
Description  
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 5 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

Removal of Existing Equipment

Removal of existing transmitters and equipment / Site Prep

RF Interconnect

Interconnect between RF system and transmission line

Antennas

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Section Question Response
Antenna Related Expenses Do you have antenna related expenses? Yes

Primary Antenna

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Add Antenna Information

Section Question Response
Existing Antenna Description Type of change Retune Existing
Antenna Use Primary (Main)
Description of Use N/A
Ownership Leased
Owner Amercian Tower
Site N/A
Is this antenna currently shared with any other stations? Yes
Is this antenna directional? No
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 Full Power
Mounting Top-mount single
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 3
Number of Panels 16
Design power capacity in use 75.0 %
Lower Limit 470.00 MHz
Upper Limit 698.00 MHz
Other Antenna Type N/A
ERP: 1000.00 kW
Manufacturer Dielectric
Model TUDO5-16/80H-2-B
Year 2010

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

Facility ID Call Sign
71082 WATE-TV
19200 WTNZ

Primary Antenna

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Adjustment to Existing Antenna

Section Question Response
Sweep Test of Existing Antenna Do you need a sweep test of existing antenna? Yes

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? Yes
Type New
Number of channels supported 3
Frequencies of channels supported RF channel
Frequency N/A

Enter a list of RF channel numbers.

RF Channel Number
26
15
18

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Combiner installation

Combiner installation/reconfiguration and installation material

Interim Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
Ownership Owned
Owner N/A
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 Type Class Full Power
Mounting Side-mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Slot
Number of Stations Supported 3
Number of Panels/Bays 16
Lower Limit 470.00 MHz
Upper Limit 698.00 MHz
Design power capacity in use 75.0 %
Other Antenna Type N/A
ERP: 250.00 kW
Manufacturer
Model TFU-WB-16
Year 2017
Justification for New Antenna Final design of equip isn't complete, ION included estimates based on current understanding of design. 2 repack stations share equip, ION responsible for 50% of the costs assoc with shared equip. See AT and Shared Equipment Exhibits for more information.

Interim 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? Yes
Broadband or Single Channel? Broadband
Feed Line Size 6 1/8 inches
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

Interim 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 Utilize Existing
Use Primary (Main)
Description of Use N/A
Ownership Leased
Owner American Tower
Site N/A
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 Dielectric
Type Rigid
Diameter 8 3/16 inches
Segment Length Broadband
Other Segment Length
Number of parallel runs 2
Length 1514 feet per run

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

Facility ID Call Sign
71082 WATE-TV
19200 WTNZ

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Sweep existing transmission line

Sweep existing 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)
Description of Use N/A
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? Unknown
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1052156
Coordinates (NAD83) Latitude (NAD83) 36° 00' 12.8" N-
Longitude (NAD83) 083° 56' 34.0" W-
Overall Structure Height 1456.02 feet
Support Structure Height 1332.99 feet
Ground Elevation Above Mean Sea Level (AMSL) 1393.03 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner SpectraSite Communications, LLC. through American Towers, LLC.
Date Constructed 01/01/1955

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
19200 WTNZ DTV
71082 WATE-TV DTV
22014 WOFM FM
81317 WYLV FM

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: Major 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

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? Yes
Number of Hours 58
Explanation Required by Landlord, see attached AT Exhibit
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 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 Yes
Environmental Assessment Yes
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 Yes
RF exposure measurements Yes
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 Yes
Non-zoning permits Yes
BLM or NFS Coordination Yes
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? 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

Other Expenses

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Other Expenses Not Listed

Name Description

Obtain building permits from local zoning authorities

Obtain building permits from local zoning authorities (cost of preparation, submission, and prosecution of necessary forms or applications per customer)(See Services agreement)(if needed)

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 $1,550,800.00 $1,106,980.00 N/A $793,384.00 N/A
Total for all systems $2,660,625.00 $1,912,612.00 N/A $819,751.99 N/A
Primary Transmitter HPTV-PRLX-U30 $1,550,800.00 $1,106,980.00 $793,384.00
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW $1,434,000.00 $991,730.00 See attached Hitachi Comark Quote #P3473PRLXU30-011818-R2. $793,384.00 N/A
RF Interconnect $25,000.00 $25,000.00 N/A N/A N/A
Removal of Existing Equipment $25,000.00 $25,000.00 N/A N/A N/A
5 Ton system $19,700.00 $19,250.00 N/A N/A N/A
Transformer 3 phase/480v - 500 KVA $47,100.00 $46,000.00 N/A N/A N/A

Components

Actual Information Description File Name
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW

Component Description:
50% "progress" payment on Comark transmitter. Supporting documentation attached.
Amount:
$495,865.00

Component Description:
30% "deposit" payment for Comark Transmitter. Supporting documentation attached.
Amount:
$297,519.00
RF Interconnect Information not provided.
Removal of Existing Equipment Information not provided.
5 Ton system Information not provided.
Transformer 3 phase/480v - 500 KVA 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 $188,750.00 $144,760.00 N/A $0.00 N/A
Total for all systems $2,660,625.00 $1,912,612.00 N/A $819,751.99 N/A
Interim Antenna TFU-WB-16 $76,100.00 $68,375.00 $0.00
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed) $13,300.00 $8,125.00 N/A N/A N/A
Sweep test of existing antenna $6,550.00 $4,000.00 N/A N/A N/A
UHF - High Power, Side Mount, basic slot antenna, 16 bay,, 250 kW input, directional,, horizontally polarized $56,250.00 $56,250.00 N/A N/A N/A
Primary Antenna TUDO5-16/80H-2-B $112,650.00 $76,385.00 $0.00
Combiner installation $26,100.00 $26,100.00 See AT Exhibits for more information. N/A N/A
New combiner, cost per channel (without antenna) $80,000.00 $46,285.00 See AT Exhibits for more information. N/A N/A
Sweep test of existing antenna $6,550.00 $4,000.00 N/A N/A N/A
UHF - High Power Top Mount Three Station broadband panel antenna horizontally polarized $0.00 $0.00 N/A N/A N/A

Components

Information not provided.

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 $6,400.00 $6,400.00 N/A $0.00 N/A
Total for all systems $2,660,625.00 $1,912,612.00 N/A $819,751.99 N/A
Primary Transmission Line $6,400.00 $6,400.00 $0.00
Sweep existing transmission line $6,400.00 $6,400.00 N/A 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 $640,100.00 $394,422.00 N/A $20,000.00 N/A
Total for all systems $2,660,625.00 $1,912,612.00 N/A $819,751.99 N/A
Primary Tower GTOWER $640,100.00 $394,422.00 $20,000.00
Tall Tower (greater than 500') $205,000.00 $125,000.00 See AT Exhibit for more information. $20,000.00 N/A
Major tower reinforcement/modifications $409,500.00 $250,000.00 See AT Exhibit for more information. N/A N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $25,600.00 $19,422.00 See AT Exhibit for more information. $0.00 N/A

Components

Actual Information Description File Name
Tall Tower (greater than 500')

Component Description:
Down payment associated with securing tower service. Note that amount is not additional to cost of tower rigging and will be deducted from total cost of tower rigging at the time it is quoted. Supporting documentation attached. This invoice has been paid.
Amount:
$20,000.00
Major tower reinforcement/modifications Information not provided.
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study 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 $161,247.00 $155,485.00 N/A $6,367.99 N/A
Total for all systems $2,660,625.00 $1,912,612.00 N/A $819,751.99 N/A
Outside Professional Services $161,247.00 $155,485.00 $6,367.99
RF Exposure Measurements $20,500.00 $20,000.00 N/A N/A N/A
Comprehensive coverage verification via field study, if needed $81,900.00 $80,000.00 N/A N/A N/A
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet $10,240.00 $10,000.00 N/A N/A N/A
NEPA Section 106 environmental review, if needed $6,140.00 $6,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,585.00 $3,500.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,095.00 $4,000.00 N/A N/A N/A
Address transition timing and coordination issues w/ other stations and wireless $2,560.00 $2,500.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,170.00 $5,000.00 See AT Exhibits for more information. $125.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,070.00 $3,000.00 N/A $1,500.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,535.00 $1,500.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $1,535.00 $1,500.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,120.00 $5,000.00 N/A $4,742.99 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,305.00 $2,250.00 N/A N/A N/A
Prepare and or review reimbursement form $2,560.00 $2,500.00 N/A $0.00 N/A
Project management of the transition $8,932.00 $8,735.00 See AT Exhibits for more information. N/A N/A

Components

Actual Information Description File Name
RF Exposure Measurements Information not provided.
Comprehensive coverage verification via field study, if needed Information not provided.
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet Information not provided.
NEPA Section 106 environmental review, if needed Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Perform engineering study for new channel assignment and antenna development

Component Description:
Cost of RF consultant work for new channel assignment and antenna development. Hourly supporting documentation attached. This invoice has been paid.
Amount:
$62.50

Component Description:
Cost of RF consultant work for new channel assignment and antenna development. Hourly supporting documentation attached. This invoice has been paid.
Amount:
$62.50
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Cost of RF consultant preparation of engineering part of FCC Form 2100. Hourly supporting documentation attached. This invoice has been paid.
Amount:
$1,500.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare request for Special Temporary Authorization Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Invoice for station's portion of general repack legal expenses incurred for 42 of the ION repack stations for period 2/1/2017 - 12/15/2017. Payee has corresponded with FCC staff and has provided corrected supporting documentation.
Amount:
$4,837.97

Component Description:
Invoice for WPXK's portion of general repack legal expenses incurred for 42 of the ION repack stations for period 2/1/2017 - 12/15/2017. Payee has corresponded with FCC staff. Hourly supporting documentation and invoice attached.
Amount:
$4,742.99
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare and or review reimbursement form Information not provided.
Project management of the transition 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 $113,328.00 $104,565.00 N/A $0.00 N/A
Total for all systems $2,660,625.00 $1,912,612.00 N/A $819,751.99 N/A
Other Expenses $113,328.00 $104,565.00 $0.00
MVPD Notification of Channel Change $800.00 $800.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $0.00 $0.00 The amount is yet to be determined (TBD) and ION will submit on-air announcement costs when finalized. N/A N/A
Equipment Storage $10,000.00 $10,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $10,000.00 $10,000.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $15,000.00 $15,000.00 N/A N/A N/A
BLM or NFS Coordination $25,000.00 $25,000.00 N/A N/A N/A
Non-zoning permits $15,000.00 $15,000.00 N/A N/A N/A
Local Zoning $25,000.00 $25,000.00 N/A N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $333.00 $325.00 N/A N/A N/A
DTV Medical Facility Notification $11,250.00 $2,500.00 N/A N/A N/A
Obtain building permits from local zoning authorities $750.00 $750.00 See AT Exhibits for more information. 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 $2,660,625.00 $1,912,612.00 $819,751.99

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.

Mario Vasquez

Vice President - Finance, Operations


09/21/2018

Attachments

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