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:
35464
Service:
DCA
Call Sign:
KFXO-CD
Channel:
15 (UHF)
File Number:
0000025373
FRN:
0006885586
Date Submitted:
10/08/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

NPG OF OREGON, INC.

Doing Business As: NPG OF OREGON, INC.

Jim DeChant

825 EDMOND STREET

ST. JOSEPH, MO 64501

United States

+1 (816) 271-8505 jim.dechant@npgco.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 The existing Transmitter cannot be re-tuned (please see the attached letter from the manufacturer) and a new transmitter will be required

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 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 AT71K2
Year 2010
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1 kW

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? Yes
Manufacturer
Model UAXTE-3R37
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1 kW
Justification for New Transmitter Existing transmitter cannot be re-tuned because it is no longer supported by the manufacturer.

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) No
Power N/A
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service No
Description N/A
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

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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 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 Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Other
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 PARPANEL
ERP: 15.0 kW
Manufacturer KATHREIN
Model K723147
Year 2010

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

Facility ID Call Sign
34879 K45KM-D
35464 KFXO-CD

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 2
Frequencies of channels supported RF channel
Frequency N/A

Enter a list of RF channel numbers.

RF Channel Number
31
15

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? No

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 60
Explanation LOCAL ENGINEERING STAFF IS EXTREMELY LIMITED AND UNABLE TO SUPPORT THIS PROJECT WITHOUT COMPROMISING DAY TO DAY OPERATIONS.
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 No
Quantity N/A
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 No
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

Name Description

Additional Repack Legal Services Not Otherwise Specified in Form 399

NON-CATALOG LEGAL SERVICES SUCH AS REVIEW OF QUARTERLY TRANSITION STATUS REPORTS AND OTHER MISCELLANEOUS NON-CATALOG LEGAL FEES

WIRELESS INFRASTRUCTURE SERVICES

REMOVE OLD COMBINER SYSTEM AND INSTALL NEW COMBINER SYSTEM. MANAGE CUT-OVER. COST INCLUDES TRAVEL AND EXPENSES

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 Yes
FCC License to Cover Application Yes
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? 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

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 $126,000.00 $42,192.06 N/A $0.00 N/A
Total for all systems $304,071.14 $234,180.75 N/A $106,356.63 N/A
Primary Transmitter UAXTE-3R37 $126,000.00 $42,192.06 $0.00
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $42,192.06 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 $90,930.00 $13,413.75 N/A $13,413.75 N/A
Total for all systems $304,071.14 $234,180.75 N/A $106,356.63 N/A
Primary Antenna K723147 $90,930.00 $13,413.75 $13,413.75
Sweep test of existing antenna $6,730.00 $5,000.00 N/A $5,000.00 N/A
New combiner, cost per channel (without antenna) $84,200.00 $8,413.75 Combiner cost is divided between KFXO-CD and K45KM which is a LPTV displaced due to the repack $8,413.75 N/A

Components

Actual Information Description File Name
Sweep test of existing antenna

Component Description:
KFXO-CD-210-Primary Antenna - Sweep Test
Amount:
$2,500.00

Component Description:
KFXO-CD-210-Primary Antenna - Sweep Test
Amount:
$2,500.00
New combiner, cost per channel (without antenna)

Component Description:
RF Channel Combiner ATSC/ATSC3.0
Amount:
$8,413.75

Cost Information

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Transmission Line

Information not provided.

Cost Information

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Tower Equipment and Rigging Costs

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 $68,696.14 $169,729.94 N/A $88,692.88 N/A
Total for all systems $304,071.14 $234,180.75 N/A $106,356.63 N/A
Outside Professional Services $68,696.14 $169,729.94 $88,692.88
WIRELESS INFRASTRUCTURE SERVICES $26,700.00 $26,700.00 COMBINER INTEGRATION SERVICES NECESSARY, STATION STAFF RESOURCES ARE EXTREMELY LIMITED AND CANNOT SUPPORT INSTALLATION WITHOUT COMPROMISING DAY TO DAY OPERATIONS. $26,700.00 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A $516.60 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A $4,132.82 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $500.00 N/A $125.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $1,000.00 N/A $1,000.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $2,000.00 N/A $687.50 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A $125.00 N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $1,319.40 N/A
Project management of the transition $9,480.00 $119,743.80 Widelity invoice NPG-KFXO-LD-017; Widelity Strategic Support Quote $47,381.50 Invoiecs received
Additional Repack Legal Services Not Otherwise Specified in Form 399 $7,536.14 $7,536.14 see Estimated Cost Justification KFXO-CD-550-Attorney - Additional Repack Legal Services v0 $6,705.06 N/A

Components

Actual Information Description File Name
WIRELESS INFRASTRUCTURE SERVICES

Component Description:
New combiner, cost per CH
Amount:
$13,350.00

Component Description:
LABOR
Amount:
$13,350.00
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
KFXO-CD-550-Attorney - License to Cover Application (Main)
Amount:
$391.80

Component Description:
Legal Services
Amount:
$124.80
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Costs for filing and tracking of KFXO C.P. See attached cover memo.
Amount:
$2,291.37

Component Description:
Repack services related to filing and tracking of C.P. Feb. 1 to Jan 31 2017
Amount:
$1,790.45

Component Description:
KFXO-CD-550-Attorney - Construction Permit Application (Main)
Amount:
$51.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
KFXO-CD-Eng. part of application for license
Amount:
$125.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Engineering study work for new channel assignment and antenna development.
Amount:
$1,000.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Engineering study work for new channel assignment and antenna development.
Amount:
$625.00

Component Description:
Engineering study work for new channel assignment and antenna development.
Amount:
$62.50
Address transition timing and coordination issues w/ other stations and wireless

Component Description:
Professional Services - Bend-OR-KFXO-LD/K45KM-TPO calculations for combined system
Amount:
$125.00
Prepare and or review reimbursement form

Component Description:
Repack Legal Services
Amount:
$238.80

Component Description:
Legal Services
Amount:
$153.00

Component Description:
Legal Services
Amount:
$170.40

Component Description:
Repack Legal Services
Amount:
$739.80

Component Description:
Legal Services
Amount:
$153.00

Component Description:
KFXO-CD-590-Prepare and/or Review Reimbursement Form
Amount:
$187.80
Project management of the transition

Component Description:
Cost Reconciliation
Amount:
$4,802.10

Component Description:
Project Management
Amount:
$2,525.30

Component Description:
Project Management
Amount:
$4,552.65

Component Description:
Project Management
Amount:
$6,863.55

Component Description:
Project Management
Amount:
$1,250.80

Component Description:
KFXO-CD-510-Project Management
Amount:
$3,750.00

Component Description:
Project Management
Amount:
$3,115.10

Component Description:
Project Management
Amount:
$2,110.30

Component Description:
KFXO-CD-510-Project Management
Amount:
$3,750.00

Component Description:
Repack Legal Services
Amount:
$92.80

Component Description:
Repack Legal Services
Amount:
$396.60

Component Description:
Project Management
Amount:
$3,808.60

Component Description:
Project Management
Amount:
$2,513.00

Component Description:
Project Management
Amount:
$3,212.15

Component Description:
Project Management
Amount:
$3,534.30

Component Description:
Project Management
Amount:
$2,591.30

Component Description:
Project Management
Amount:
$2,100.65

Component Description:
Project Management
Amount:
$2,047.25
Additional Repack Legal Services Not Otherwise Specified in Form 399

Component Description:
KFXO-CD-550-Attorney - Additional Repack Legal Services
Amount:
$1,020.00

Component Description:
KFXO-CD-550-Attorney - Additional Repack Legal Services
Amount:
$703.20

Component Description:
Repack Legal Services for KFXO-CD
Amount:
$476.70

Component Description:
Repack Legal Services for KFXO-CD
Amount:
$697.80

Component Description:
Repack Legal Services
Amount:
$1,136.40

Component Description:
Legal Repack Services
Amount:
$92.80

Component Description:
Repack Legal Services for KFX0-CD
Amount:
$185.60

Component Description:
legal services
Amount:
$493.80

Component Description:
legal services
Amount:
$323.40

Component Description:
Repack Legal Services
Amount:
$1,065.90

Component Description:
Repack Legal Services
Amount:
$185.60

Component Description:
KFXO-CD-550-Attorney - Additional Repack Legal Services
Amount:
$51.00

Component Description:
Non-Catalog Legal Services such as review of quarterly transition status reports and other miscellaneous non-catalog legal fees.
Amount:
$37.12

Component Description:
Repack Legal Services
Amount:
$27.84

Component Description:
Legal Services
Amount:
$1,285.20

Component Description:
Repack Legal Services
Amount:
$151.90

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 $18,445.00 $8,845.00 N/A $4,250.00 N/A
Total for all systems $304,071.14 $234,180.75 N/A $106,356.63 N/A
Other Expenses $18,445.00 $8,845.00 $4,250.00
DTV Medical Facility Notification $11,550.00 $2,000.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $1,500.00 $1,500.00 N/A $1,500.00 N/A
Equipment Delivery and Handling Charges $1,500.00 $1,500.00 N/A $1,500.00 N/A
Equipment Storage $500.00 $500.00 N/A $500.00 N/A
Develop and air announcement of upcoming channel change $750.00 $750.00 VIDEO PRODUCTION SERVICES N/A N/A
MVPD Notification of Channel Change $1,200.00 $1,200.00 SEE SIGNAL-WIZ QUOTE ATTACHED $750.00 N/A

Components

Actual Information Description File Name
DTV Medical Facility Notification Information not provided.
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
KFXO-CD-610-Disposal Costs
Amount:
$750.00

Component Description:
KFXO-CD-610-Disposal Costs
Amount:
$750.00
Equipment Delivery and Handling Charges

Component Description:
KFXO-CD-610-Equipment Delivery and Handling
Amount:
$750.00

Component Description:
KFXO-CD-610-Equipment Delivery and Handling
Amount:
$750.00
Equipment Storage

Component Description:
KFXO-CD-610-Equipment Storage
Amount:
$250.00

Component Description:
KFXO-CD-610-Equipment Storage
Amount:
$250.00
Develop and air announcement of upcoming channel change Information not provided.
MVPD Notification of Channel Change

Component Description:
Prepare letters to MVPDs.
Amount:
$750.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $304,071.14 $234,180.75 $106,356.63

Reimbursement Status

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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

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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.

James W. DeChant

VP of Technology


10/08/2019

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.

James W. DeChant

VP of Technology


10/08/2019

Attachments

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