TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
WSKG PUBLIC TELECOMMUNICATIONS COUNCIL Doing Business As: WSKG PUBLIC TELECOMMUNICATIONS COUNCIL	Greg Catlin 601 GATES ROAD, SUITE 4 VESTAL, NY 13850 United States	+1 (607) 729-0100	gcatlin@wskg.org	Not-for-Profit

Applicant

Address

Phone

Applicant Type

WSKG PUBLIC TELECOMMUNICATIONS COUNCIL

Doing Business As: WSKG PUBLIC TELECOMMUNICATIONS COUNCIL

Greg Catlin

601 GATES ROAD, SUITE 4

VESTAL, NY 13850

United States

+1 (607) 729-0100

gcatlin@wskg.org

Not-for-Profit

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant	Address	Phone	Email
[Confidential]

Preparer Contact Information

Preparer Contact Name and Information

Applicant	Address	Phone	Email
The Preparer is same as the reimbursement contact.

Broadcaster Information and Transition Plan

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	Pre-transition: Install transfer switch between existing combiner output and feed to antenna, install new WSKA-DT transmission system into transfer switch. Day-of-transition: switch. Post-transition: tune DigiTline for optimal performance on new channel.

Transmitters

Section	Question	Response
Transmitter Related Expenses	Do you have transmitter related expenses?	Yes

Primary Transmitter

Existing Transmitter Information

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	Ultimate TEU2-2K50LV
	Year	2003
	Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power Capacity	2.5 kW

Primary Transmitter

New Transmitter Costs

Section	Question	Response
New Transmitter	Use	Primary (Main)
	Change Type	Purchase New
	Is this a request for upgraded equipment?	No
	Manufacturer
	Model	MPTV-PRLX-U4
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	6.5 kW
	Justification for New Transmitter	Different manufacturer, price matches already approved Widelity cost. Quote attached as "P2984AR6 WSKA Parallax U4 6.5kW Proposal"

Primary Transmitter

Other Transmitter Costs

Section	Question	Response
Electrical Service	Service Entrance (3 phases 800A 208V)	No
	Switchgear (industrial 800 amp)	No
	Transformer (480V)	No
	Power	N/A
	Rigid Conduit and Wiring	Yes
	Size	2 inches
	Length	60.0 feet
	Other Electrical Service	Yes
	Description	208v 3ph step-down transformer, 30kVA, plus 110v equipment feeds/switchgear was required by prior transmitter vendor. New electrical contractor will review needs for the quoted transm and we believe it should be less.
HVAC Service	Does the replacement transmitter require HVAC Service?	No
	Type	N/A
	Size	N/A
	Other Size	N/A
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

Primary Transmitter

Other Transmitter Cost Not Listed

Name	Description
ATSC Analyzer	Rental of Device to test and ensure complex multiple transmitter system compliance with FCC rules and regulations.

Antennas

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

Primary Antenna

Existing Antenna Information

Section	Question	Response
Existing Antenna Description	Type of change	Retune Existing
	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?	Yes
	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	Full Power
	Mounting	Top Mount
	Antenna position in stack	Not in Stack
	Polarization	Horizontal
	Type	Broadband Panel
	Number of Stations Supported	3
	Number of Panels	28
	Design power capacity in use	31.5 %
	Lower Limit	566.00 MHz
	Upper Limit	722.00 MHz
	Other Antenna Type	N/A
	ERP:	25.0 kW
	Manufacturer	Dielectric
	Model	TUA-C4SP-8/28M-1-T
	Year	2003

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

Facility ID	Call Sign
62219	WYDC
71508	WENY-TV

Primary Antenna

Adjustment to Existing Antenna

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

Primary Antenna

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
35
25
30

Primary Antenna

Other Antenna Cost Not Listed

Name	Description
Transfer switch and Dummy Load	Switch and load to facilitate testing of new transmission system and changeover from old combiner to new combiner.

Transmission Line

Section	Question	Response
Transmission Line Related Expenses	Do you have transmission line related expenses?	Yes

Primary Transmission Line

Add Transmission Line

Section	Question	Response
Existing Transmission Line Description	Type of change	Utilize Existing
	Use	Primary (Main)
	Description of Use	N/A
	Ownership	Owned
	Owner	N/A
	Site	N/A
	Is this transmission currently shared with any other stations?	Yes
	Is Transmission Line in operating condition?	Yes
Existing Transmission Line Manufacturer and Type	Manufacturer	Dielectric
	Type	Rigid
	Diameter	3 1/8 inches
	Other Diameter	N/A
	Segment Length	Broadband
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	795 feet per run

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

Facility ID	Call Sign
62219	WYDC
71508	WENY-TV

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Name	Description
Tune existing Transmission line	Tune Dielectric digit line

Primary Transmission Line

Existing Transmission Line

Section	Question	Response
Existing Transmission Line Description	Type of change	Utilize Existing
	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?	Yes
	Is Transmission Line in operating condition?	Yes
Existing Transmission Line Manufacturer and Type	Manufacturer	Dielectric
	Type	Rigid
	Diameter	3 1/8 inches
	Other Diameter	N/A
	Segment Length	Broadband
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	795 feet per run

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

Facility ID	Call Sign
62219	WYDC
71508	WENY-TV

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Name	Description
Retune	Retune existing Dielectric digiTLine

Tower Equipment And Rigging Costs

Section	Question	Response
Tower Equipment or Rigging Costs Changes	Do you have tower equipment or rigging costs changes?	No

Outside Professional Services Costs

Section	Question	Response
Outside Project Management Services	Do you require outside project management services?	Yes
	Number of Hours	180
	Explanation	Outside consultant has 5 years experience at this facility and 38 years maintaining transmission systems and managing related projects. Staff is limited and contains new staff in key positions.
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	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	Yes
	Number of Days	3
	Justification	Proof of performance, RF exposure level calculations and instalation/proof of combiner performance.

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Name	Description
NETA Financial Management	Support provided to facilitate reimbursement. NETA is currently handling WSKG-TV and WSKA's accounting and bookkeeping services. This is an additional service.
Additional Attorney Fees	Additional attorney fees for advice and consultation on repack matters for small market public TV station

Other Expenses

Section	Question	Response
AM Pattern Disturbance	Is an Impact Study needed?	No
AM Pattern Disturbance	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	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?	No
	Does this relocation require Equipment Storage?	No
	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

Other Expenses Not Listed

Name	Description
Additional Legal Expenses	Additional legal expenses for small market public TV station
Quarterly Progress Reports	Assist with and prepare FCC-required reports
Site Survey	Site survey by transmitter manufacturer to predetermine precise measurements and ensure a smooth installation.
Concrete pad expansion	Expanded concrete pad and roof for outside heat exchanger, will not fit properly on existing pad as-is. Quotation attached as WSKA ACP Concrete and Roof

Cost Information

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	$283,410.00	$269,850.00	N/A	$130,000.00	N/A
Total for all systems	$594,530.00	$489,723.50	N/A	$196,049.00	N/A
Primary Transmitter MPTV-PRLX-U4	$283,410.00	$269,850.00		$130,000.00
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW	$273,500.00	$260,000.00	See Comark Parallax U4 quote, P2984A-R9b Section 1 - 249140 Section 2, items 2.1, 2.2, 2.3 (transport, offload, coolant): 3760+4500+2600 3760+4500+2600+249140 = 260000	$130,000.00	N/A
ATSC Analyzer	$0.00	$0.00	N/A	$0.00	N/A
2" Rigid Conduit and Wiring (Cost per foot)	$1,560.00	$1,500.00	Predetermined cost based on 60' of 2" rigid with wiring.	N/A	N/A
Other Electrical Service: 208v 3ph step-down transformer, 30kVA, plus 110v equipment feeds/switchgear was required by prior transmitter vendor. New electrical contractor will review needs for the quoted transm and we believe it should be less.	$8,350.00	$8,350.00	Transformer was required by prior transmitter vendor. Electrical contractor will review needs for the quoted transmitter and provide a quotation which we believe should be less than this value. New transmitter does require switchgear and feeds.	N/A	N/A

Components

Actual Information Description	File Name
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW	Component Description: Down payment for transmitter, installation, related items. Lines 1-6 of the attached invoice. Amount: $130,000.00
ATSC Analyzer	Information not provided.
2" Rigid Conduit and Wiring (Cost per foot)	Information not provided.
Other Electrical Service: 208v 3ph step-down transformer, 30kVA, plus 110v equipment feeds/switchgear was required by prior transmitter vendor. New electrical contractor will review needs for the quoted transm and we believe it should be less.	Information not provided.

Cost Information

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	$127,190.00	$42,660.00	N/A	$18,130.00	N/A
Total for all systems	$594,530.00	$489,723.50	N/A	$196,049.00	N/A
Primary Antenna TUA-C4SP-8/28M-1-T	$127,190.00	$42,660.00		$18,130.00
Transfer switch and Dummy Load	$36,260.00	$36,260.00	Transfer switch and transmission line to reach switch from new transmitter installation location without new combiner and related items. P2984A-R9b Comark Parallax U4 quote Section 2, items 2.4 and 2.5, 6700+29560 = 36260.	$18,130.00	N/A
Sweep test of existing antenna	$6,730.00	$6,400.00	predetermined cost	$0.00	N/A
UHF - High Power Top Mount Three Station broadband panel antenna horizontally polarized	$0.00	$0.00	Existing antenna will remain in service.	N/A	N/A
New combiner, cost per channel (without antenna)	$84,200.00	$0.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
Transfer switch and Dummy Load	Component Description: Coax interconnect and switch. Lines 7 and 8 of attached invoice. Amount: $18,130.00
Sweep test of existing antenna	Component Description: WSKA -perform RF sweep of existing antenna Amount: $5,300.00
UHF - High Power Top Mount Three Station broadband panel antenna horizontally polarized	Information not provided.
New combiner, cost per channel (without antenna)	Information not provided.

Cost Information

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	$10,000.00	$10,000.00	N/A	$0.00	N/A
Total for all systems	$594,530.00	$489,723.50	N/A	$196,049.00	N/A
Primary Transmission Line	$10,000.00	$10,000.00		$0.00
Tune existing Transmission line	$10,000.00	$10,000.00	Line is Dielectric DigitLine, elbows at the tower base and at the antenna to be tuned post-change. Guess for work on the tower proper. Pending quotation from a contractor as the one we expected would be providing a quote has recently declined the job.	N/A	N/A
Primary Transmission Line	$0.00	$0.00		$0.00
Retune	$0.00	$0.00	N/A	N/A	N/A

Components

Information not provided.

Cost Information

Tower Equipment and Rigging Costs

Information not provided.

Cost Information

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	$83,810.00	$86,408.50	N/A	$10,252.50	N/A
Total for all systems	$594,530.00	$489,723.50	N/A	$196,049.00	N/A
Outside Professional Services	$83,810.00	$86,408.50		$10,252.50
Attorney Fees - Negotiation of lease and other matters for shared locations	$4,210.00	$4,095.00	Cost of negotiations for equipment use given change in plans of other stations using WSKA shared equipment.	$5,248.50	Due to a change in plans by other stations using the multi-party shared combiner at the site, WSKA required additional legal expense.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	$3,155.00	$9,275.00	Actual cost incurred.	$0.00	Billing for MSW's services is based on a rate and actual time spent. This rate multiplied by the time spent resulted in the numbers billed which was higher than the estimate
Additional Attorney Fees	$10,000.00	$10,000.00	Additional attorneys fees for advice and consultation on FCC compliance and on implementation of new repack plan in light of other stations' decision to leave shared equipment arrangement.	$707.00	N/A
NETA Financial Management	$2,500.00	$2,500.00	Half of attached quotation is for WSKG-TV the other half is for WSKA	$2,500.00	N/A
Additional Field Engineering Service, 3 Days	$10,000.00	$10,000.00	N/A	N/A	N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization	$3,680.00	$3,585.00	STA for WSKA interim operations, if needed, due to change in plans for other stations sharing equipment.	N/A	N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	$2,365.00	$2,250.00	Predetermined.	N/A	N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	$5,260.00	$893.50	Actual cost incurred.	$893.50	N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	$1,580.00	$1,500.00	Predetermined.	N/A	N/A
Perform engineering study for new channel assignment and antenna development	$7,360.00	$10,335.00	Actual cost incurred	$0.00	Billing for MSW's services is based on a rate and actual time spent. This rate multiplied by the time spent resulted in the numbers billed which was higher than the estimate.
Address transition timing and coordination issues w/ other stations and wireless	$2,630.00	$2,500.00	Predetermined cost estimate	$353.50	N/A
Project management of the transition	$28,440.00	$22,500.00	Predetermined cost estimate	$550.00	N/A
Prepare and or review reimbursement form	$2,630.00	$6,975.00	Actual cost incurred plus additional for refiling.	$0.00	Billing for MSW's services is based on a rate and actual time spent. This rate multiplied by the time spent resulted in the numbers billed which was higher than the estimate

Components

Actual Information Description	File Name
Attorney Fees - Negotiation of lease and other matters for shared locations	Component Description: Legal work regarding lease negotiations and shared combiner. All lines except line one of the attached invoice. Amount: $4,289.00 Component Description: WSKA legal work regarding repack issues with parties leaving the combiner before Phase deadline. Amount: $151.50 Component Description: WSKA legal work on combiner issues. Amount: $808.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	Component Description: WSKA -MSW perform engineering section of FCC Form 2100 Construction Permit Application Amount: $5,035.00 Component Description: WSKA -MSW prepare engineering section of FCC Form 2100 Construction Permit Application Amount: $4,240.00
Additional Attorney Fees	Component Description: Review updated Form 399 repack in light of change in transition plan. Amount: $353.50 Component Description: WSKA repack legal services, lines 1,2 and 6 of attached invoice. Amount: $353.50
NETA Financial Management	Component Description: WSKA NETA staff support for work related to FCC Spectrum Repack Amount: $1,250.00 Component Description: NETA staff support for works related to FCC Spectrum Auction Amount: $1,250.00 Component Description: WSKA -NETA staff support for work related to FCC Spectrum Repack Amount: $1,250.00
Additional Field Engineering Service, 3 Days	Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization	Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	Component Description: Attorney fees for construction permit application Amount: $893.50
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	Information not provided.
Perform engineering study for new channel assignment and antenna development	Component Description: WKSA -MSW perform engineering study for new channel assignment and antenna development Amount: $10,335.00
Address transition timing and coordination issues w/ other stations and wireless	Component Description: Emails to E. Adler (WSKA repack team) regarding WSKA linked station sets and dependencies; work on issues regarding coordination with other stations and testing. Amount: $202.00 Component Description: Work on WSKA repack issues about coordinating with upstream and downstream stations on new channel launch date and testing. Line 3 of attached invoice. Amount: $151.50
Project management of the transition	Component Description: Dave Fulton project management services for August 2017 Amount: $300.00 Component Description: Project management of the transition for August 2017 Amount: $300.00 Component Description: Project management of transition for September 2017 Amount: $250.00 Component Description: Dave Fulton project management services for September 2017 Amount: $250.00
Prepare and or review reimbursement form	Component Description: WSKA -MSW prepare and/or review reimbursement form Amount: $3,975.00

Cost Information

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	$90,120.00	$80,805.00	N/A	$37,666.50	N/A
Total for all systems	$594,530.00	$489,723.50	N/A	$196,049.00	N/A
Other Expenses	$90,120.00	$80,805.00		$37,666.50
Disposal Costs (for equipment and other waste, net of any salvage value)	$35,265.00	$35,265.00	Removal and disposal of existing combiner system and transmitter post-transition. Quotations attached as P2984ONSITE-R6 and P3635, respectively. $7550+$27715=$35265	$17,632.50	N/A
Concrete pad expansion	$9,840.00	$9,840.00	quotation titled WSKA ACP Concrete and Roof, $9840 Pad and roof over existing heat exchanger does not have enough space for new heat exchanger adjacent per site-survey performed, expansion size recommended by manufacturer.	N/A	N/A
Additional Legal Expenses	$10,000.00	$10,000.00	Additional legal expenses necessary to advise and assist small market public TV station with repack requirements.	$363.00	N/A
Quarterly Progress Reports	$5,000.00	$5,000.00	Assist with and prepare FCC-required quarterly progress reports for station.	$471.00	N/A
DTV Medical Facility Notification	$11,550.00	$2,235.00	Estimate on page 4 of MSW DTVMedicalMVPDEstimates PDF	$2,235.00	N/A
Site Survey	$15,300.00	$15,300.00	Quotation by Comark attached as P3636	$15,300.00	N/A
Develop and air announcement of upcoming channel change	$1,500.00	$1,500.00	Cost of producing a 1 minute spot and producing a informational crawl.	$0.00	N/A
MVPD Notification of Channel Change	$1,665.00	$1,665.00	Estimate on page 3 of MSW DTVMedicalMVPDEstimates PDF	$1,665.00	N/A

Components

Actual Information Description	File Name
Disposal Costs (for equipment and other waste, net of any salvage value)	Component Description: One half deposit for on-site services and removal of existing transmitter. Lines 9 and 10 of attached invoice. Amount: $17,632.50
Concrete pad expansion	Information not provided.
Additional Legal Expenses	Component Description: Attorney fees for additional legal expenses $363.00 Amount: $363.00
Quarterly Progress Reports	Component Description: Attorney fees for quarterly progress report due 4/10/18 Amount: $50.50 Component Description: Attorney fees for quarterly progress report Amount: $50.50 Component Description: Quarterly report portion of this legal invoice. Amount: $50.50 Component Description: Quarterly report portion of this legal invoice. Amount: $151.50 Component Description: Attorney fees for quarterly progress report Amount: $168.00
DTV Medical Facility Notification	Component Description: DTV medical providers notification. Amount: $2,235.00
Site Survey	Component Description: Site survey/system design Amount: $15,300.00
Develop and air announcement of upcoming channel change	Information not provided.
MVPD Notification of Channel Change	Component Description: MVPD notification. Amount: $1,665.00

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$594,530.00	$489,723.50	$196,049.00

Reimbursement Status

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

Certification

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).
The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity certifies that the statements in this form and attached documentation are true, complete, and correct. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. 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 (full power and Class A stations) and/or otherwise modify a television station’s facility as a result of the spectrum repack (LPTV/TV Translator stations); or to minimize service disruption resulting from a repacked television station (FM stations); or to continue to carry the signal of a broadcaster that changes channels (MVPD) . 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. The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a prerequisite 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.	George Walter Senior Controller 04/19/2019

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).

The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.
The above-named entity certifies that the statements in this form and attached documentation are true, complete, and correct.
The above-named entity acknowledges that all certifications and attached documentation are considered material representations.
The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.
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 (full power and Class A stations) and/or otherwise modify a television station’s facility as a result of the spectrum repack (LPTV/TV Translator stations); or to minimize service disruption resulting from a repacked television station (FM stations); or to continue to carry the signal of a broadcaster that changes channels (MVPD) .
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.
The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred.
The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.
The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a prerequisite 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.

George Walter

Senior Controller

04/19/2019

(REFERENCE COPY - Not for submission) FCC Form 399: Reimbursement Request

Applicant Information

Applicant Name, Type, and Contact Information

Reimbursement Contact Information

Reimbursement Contact Name and Information

Preparer Contact Information

Preparer Contact Name and Information

Broadcaster Information and Transition Plan

Transmitters

Primary Transmitter

Existing Transmitter Information

Primary Transmitter

New Transmitter Costs

Primary Transmitter

Other Transmitter Costs

Primary Transmitter

Other Transmitter Cost Not Listed

Antennas

Primary Antenna

Existing Antenna Information

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

Primary Antenna

Adjustment to Existing Antenna

Primary Antenna

Other Antenna Costs

Enter a list of RF channel numbers.

Primary Antenna

Other Antenna Cost Not Listed

Transmission Line

Primary Transmission Line

Add Transmission Line

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

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Primary Transmission Line

Existing Transmission Line

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

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Tower Equipment And Rigging Costs

Outside Professional Services Costs

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Other Expenses

Other Expenses

Other Expenses Not Listed

Cost Information

Transmitters

Components

Cost Information

Antennas

Components

Cost Information

Transmission Line

Components

Cost Information

Tower Equipment and Rigging Costs

Cost Information

Outside Professional Services

Components

Cost Information

Other Expenses

Components

Cost Information

Grand Total

Reimbursement Status

Certification

Attachments