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

FCC Form 399: Reimbursement Request

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

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

Facility ID:
53511
Service:
LPT
Call Sign:
K32OA-D
Channel:
32 (UHF)
File Number:
0000086494
FRN:
0006132047
Eligibility Status:
Eligible
Date Submitted:
10/15/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

PRIEST LAKE TRANSLATOR DISTRICT

Doing Business As: PRIEST LAKE TRANSLATOR DISTRICT

P. O. BOX 53

COOLIN, ID 83821

United States

+1 (208) 443-2492 ayer.larry2@gmail.com Government Entity

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 To replace existing transmitter with new GatesAir 50-watt transmitter, stringent mask filter, Sencore receiver/transcoder, and new panel antennas, in order to vacate repack channel-40 and move to new channel-32.

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)
Ownership Owned
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model TADU-40
Year 2009
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 40.0 W

Primary Transmitter

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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 UAXTE-50
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 50.0 W
Justification for New Transmitter To move from repack channel-40 to newly authorized channel-32, and achieve slightly higher output power plus capability of remote transmitter monitoring.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Other Transmitter Costs
Does the transmitter installation require a Transmitter Building Site Survey/Installation? No
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Rigid Conduit and Wiring No
Other Electrical Service Yes
Description New 100-amp, 120/240 volt electrical service panel, plus additional 20-amp outlets and a 240-volt service for new air conditioner system installed, replacing smaller and aging 50-amp panel.
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Heating and Cooling
Size Other
Other Size 1 tons
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No

Primary Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

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)
Ownership Owned
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type
Mounting Side Mount
Antenna position in stack Top
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 1
Number of Panels 2
Design power capacity in use 10.0 %
Lower Limit 584.00 MHz
Upper Limit 590.00 MHz
ERP: 75.0 W
Manufacturer
Model 4DR-4-2HW
Year 1993

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Change Type Purchase New
Ownership Owned
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types
Mounting Side Mount
Antenna position in stack Top
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 1
Number of Panels/Bays 2
Lower Limit 578.00 MHz
Upper Limit 584.00 MHz
Design power capacity in use 10.0 %
ERP: 100.0 W
Manufacturer
Model 4DR-4-2HW
Year 2019
Justification for New Antenna Mandated repack channel-change from channel-40 to channel-32 demanded new cut-channel antenna and power divider; invoiced total is shared 50/50 by station K33QB-D.

Primary Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? No
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? 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? No
Power Dividers Does the panel antenna require power dividers? Yes
Number of Power Dividers 1
Cable Harness Does the panel antenna require cable harness? Yes
Number of Cable Harnesses 2

Primary 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? 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 Move Equipment
Tower Use Primary (Main)
Ownership Owned
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) No
Others Types of Users Yes
Is tower documented for structural analysis? Unknown
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? No
Coordinates (NAD83) Latitude (NAD83) 48° 31' 52.7" N-
Longitude (NAD83) 116° 49' 01.7" W-
Overall Structure Height 60.00 feet
Support Structure Height 65.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 3158.00 feet
Structure Type UPOLE - Utility POLE/TOWER used to provide service
Tower Owner Applicant
Date Constructed 07/18/1996


Other Types of Users

Users
K33QB-D
K31DS-D

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

Name Description

Replace antennas

Air Pipe, Inc. crew removes existing pair of panel antennas & power divider, and install new Scala-Kathrein channel-32 panel antennas & new power divider.

Access power pole-tower structure for antenna changes

American Tree Service providing crew & rented, self-propelled man-hoist to lift antenna crew up to the proper location.

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? No
Outside RF consulting Engineering Services Perform engineering study for displacement application Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority No
Prepare Form 601 No
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application No
Prepare and file Form FCC License to Cover Application No
Prepare request for Special Temporary Authority No
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement Yes
Form 399 assistance or other program management costs Yes
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements No
Additional Field Engineering Service Yes
Number of Days 1
Justification Field engineering services requested for initial start-up of new transmitter & receiver/transcoder, and to diagnose & correct input channel interference to the new system.

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Barnett Professional Services

Assist with initial set-up of new transmitter, receiver-transcoder, and mask filter, along with programming & testing. Invoiced total is shared 50/50 with K33QB-D.

B.W. St. Clair 2305

Assistance with understanding and navigating reimbursement form-399; review entries and advise corrections needed in all areas of the application.

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Permit and Filing Costs FCC Construction Permit Major Change 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)? No
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? No
Does this relocation require Equipment Storage? No
Point to Point Microwave (STL/ICR) Frequency Coordination for Unidirection System No
Frequency Coordination for Bi-Direction System No
New Point to Point Microwave System No

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 $13,171.20 $17,216.90 N/A $17,216.90 N/A
Total for all systems $85,239.63 $24,613.33 N/A $24,613.33 N/A
Primary Transmitter UAXTE-50 $13,171.20 $17,216.90 $17,216.90
Other Electrical Service: New 100-amp, 120/240 volt electrical service panel, plus additional 20-amp outlets and a 240-volt service for new air conditioner system installed, replacing smaller and aging 50-amp panel. $1,071.20 $1,071.20 N/A $1,071.20 The electrical installation took longer than expected with connection of the air conditioning components, therefore higher than expected labor charges.
UHF - Air Cooled Solid State Transmitter 5 - 50 Watts $10,200.00 $14,245.70 The transmitter vendor also provided the stringent mask filter and Sencore receiver/ transcoder, which increased the GatesAir invoice above the predetermined estimate. $14,245.70 N/A
Other -- HVAC Service Type: H Size:1 (Other) $1,900.00 $1,900.00 N/A $1,900.00 N/A

Components

Actual Information Description File Name
Other Electrical Service: New 100-amp, 120/240 volt electrical service panel, plus additional 20-amp outlets and a 240-volt service for new air conditioner system installed, replacing smaller and aging 50-amp panel.

Component Description:
Eagle Electric contracted to provide materials and labor to install new 100-A electrical panel, new 20-A outlets & a 240-V feed to new air conditioning system.
Amount:
$1,071.20
UHF - Air Cooled Solid State Transmitter 5 - 50 Watts

Component Description:
For GatesAir 50-watt transmitter, stringent mask filter and Sencore receiver/transcoder, plus associated interconnection cables.
Amount:
$14,245.70
Other -- HVAC Service Type: H Size:1 (Other)

Component Description:
No Invoice Number Priest River Heating & Cooling provided materials & labor for installing a ductless heat pump system for climate control in the comm. building.
Amount:
$1,900.00

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 $6,800.00 $2,510.50 N/A $2,510.50 N/A
Total for all systems $85,239.63 $24,613.33 N/A $24,613.33 N/A
Primary Antenna 4DR-4-2HW $6,800.00 $2,510.50 $2,510.50
Cable harness (each, for panel antenna system, if not included in antenna cost) $2,000.00 $388.00 N/A $388.00 N/A
Power Dividers (each, for panel antenna system, if not included in antenna cost) $1,300.00 $332.00 N/A $332.00 N/A
UHF Broadband panel antenna (per panel), horizontally-polarized $3,500.00 $1,790.50 N/A $1,790.50 N/A

Components

Actual Information Description File Name
Cable harness (each, for panel antenna system, if not included in antenna cost)

Component Description:
Broadcasters General Store providing Scala/Kathrein coaxial cable harness for connection of new power divider to new panel antenna. Invoice Total is $2663 plus deposit $2358 equals $5021
Amount:
$388.00
Power Dividers (each, for panel antenna system, if not included in antenna cost)

Component Description:
New Scala/Kathrein 50/50 power divider for new panel antennas. Invoice Total is $2663 plus deposit $2358 equals $5021
Amount:
$332.00
UHF Broadband panel antenna (per panel), horizontally-polarized

Component Description:
New Scala-Kathrein cut-to-channel panel antennas (pair), plus 1/2 freight charges. Costs are shared 50/50 with station K33QB-D. Invoice Total is $2663 plus deposit $2358 equals $5021
Amount:
$1,790.50

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 $56,883.78 $2,768.78 N/A $2,768.78 N/A
Total for all systems $85,239.63 $24,613.33 N/A $24,613.33 N/A
Primary Tower UPOLE $56,883.78 $2,768.78 $2,768.78
Tower Rigging Short Tower (less than 500') $56,190.00 $2,075.00 N/A $2,075.00 N/A
Access power pole-tower structure for antenna changes $693.78 $693.78 N/A $693.78 N/A
Replace antennas $0.00 $0.00 N/A $0.00 N/A

Components

Actual Information Description File Name
Tower Rigging Short Tower (less than 500')

Component Description:
American Tree Service furnished rigging crew, plus rented, self-propelled hydraulic man-lift to access antenna crew
Amount:
$2,075.00
Access power pole-tower structure for antenna changes

Component Description:
Air Pipe tower crew removes old, and installs new cut-to-channel panel antennas and power divider. Air Pipe invoice total is divided 50/50 with station K33QB-D.
Amount:
$693.78
Replace antennas 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 $8,384.65 $2,117.15 N/A $2,117.15 N/A
Total for all systems $85,239.63 $24,613.33 N/A $24,613.33 N/A
Outside Professional Services $8,384.65 $2,117.15 $2,117.15
B.W. St. Clair 2305 $1,000.00 $1,000.00 N/A $1,000.00 N/A
Barnett Professional Services $457.15 $457.15 N/A $457.15 N/A
Additional Field Engineering Service, 1 Days $262.50 $262.50 N/A $262.50 N/A
Prepare/ Review 399 reimbursement form $1,710.00 $0.00 N/A $0.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,052.50 $60.00 N/A $60.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $2,102.50 $337.50 N/A $337.50 N/A
Form 399 assistance or other Program Management costs $0.00 $0.00 N/A $0.00 N/A
Perform engineering study for displacement application $1,800.00 $0.00 N/A $0.00 N/A

Components

Actual Information Description File Name
B.W. St. Clair 2305

Component Description:
Form 399 assistance: guidance, corrections needed, verifying estimated/actual costs.
Amount:
$1,000.00
Barnett Professional Services

Component Description:
Assistance with initial start-up of new transmitter, receiver- transcoder, plus programming of equipment.
Amount:
$457.15
Additional Field Engineering Service, 1 Days

Component Description:
Provide assistance in finding and correcting input channel interference to Sencore receiver plus additional programming of receiver and transmitter.
Amount:
$262.50
Prepare/ Review 399 reimbursement form Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
Electronic filing of Form 347 for License-to-Cover construction permit for K32OA-D (invoiced total cost shared 50/50 with K33QB-D.
Amount:
$60.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Research, prepare and file application for displacement construction permit for station K32OA-D (invoiced total is shared 50/50 with K33QB-D.
Amount:
$337.50
Form 399 assistance or other Program Management costs Information not provided.
Perform engineering study for displacement application 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 $0.00 $0.00 N/A $0.00 N/A
Total for all systems $85,239.63 $24,613.33 N/A $24,613.33 N/A
Other Expenses $0.00 $0.00 $0.00

Components

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $85,239.63 $24,613.33 $24,613.33

Reimbursement Status

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Question Response
The facility has ceased operating on its pre-auction channel. Yes
Construction of final facilities or all necessary modifications are complete. Yes
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. Yes

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.

Larry Ayer

Acting District Chairman


10/15/2019

Certification

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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).

  1. 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.

  2. The above-named entity certifies that the statements in this form and attached documentation are true, complete, and correct.

  3. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

  4. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.

  5. 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) .

  6. 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.

  7. The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred.

  8. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.

  9. 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.

Larry Ayer

Acting District Chairman


10/15/2019

Certification

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Section Question Response
Submission of Final Allocation or Accounting Information 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 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 acknowledges that all certifications and attached documentation are considered material representations.

  2. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.

  3. The above-named entity certifies that all costs identified as "actual costs" herein accurately represent the costs actually paid by the above-named entity, including any discounts, refunds, or rebates.

  4. 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.

  5. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.

  6. 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.

Larry Ayer

Acting District Chairman


10/15/2019

Attachments

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