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:
9355
Service:
LPD
Call Sign:
K14RB-D
Channel:
14 (UHF)
File Number:
0000088953
FRN:
0018612044
Eligibility Status:
Not Determined
Date Submitted:
11/12/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

St. Michael Broadcasting, Inc.

Doing Business As: St. Michael Broadcasting, Inc.

Michael Bird

PO Box 131202

St. Paul , MN 55113

United States

+1 (612) 724-2265 mrtjabird@netscape.net Not-for-Profit

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

A. Wray Fitch , III .

Attorney

Gammon & Grange, P.C.

8280 Greensboro Drive

Suite 140

McLean, VA 22102

United States

+1 (703) 761-5013 awf@gg-law.com

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. No
Briefly describe transition plan The FCC granted KPXM-TV's request to transition to Channel 16, and St. Michael Broadcasting, Inc. (SMB) was required to cease operations on Channel 16 to protect KPXM. SMB's Displacement Application for Channel 14 was subsequently granted by the FCC.

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 Retune Existing
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 Technalogix
Model TAUD-2000
Year 2018
Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2 kW

Primary Transmitter

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Retuning Transmitter Costs

Section Question Response
New Mask Filter Does the transmitter require a new mask filter? Yes
Mask Filter Type Full Service
Power 3.1-5kW
New Exciter Is a new exciter needed? No

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 No
HVAC Service Does the replacement transmitter require HVAC Service? No
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

Name Description

Uppman Technical Services, Inc.

Airfare cost for Technalogix engineer to travel from Canada to Minneapolis to assess problem with transmitter working on channel 14 after returning from channel 16. Related hotel costs.

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? No
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 Not in Stack
Polarization Horizontal
Type Other
Other Antenna Type Slotted
ERP: 15.0 kW
Manufacturer
Model ALP12L2-HSO-16
Year 2009

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? No
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 Not in Stack
Polarization Horizontal
Type Other
Other Antenna Type Slotted
ERP: 15.0 kW
Manufacturer
Model ALP12L2-HSO-14
Year 2018
Justification for New Antenna The frequency of the previous antenna was 16. The displacement of the station to 14 necessitated the replacement of the previous antenna with one whose frequency is 14.

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

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

ERI Antenna Adapters

1 5/8" to 7/8" adapters for antenna

Uppman Technical Services Inc.

Freight invoice for antenna shipping

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 Leased
Is this tower consider Complex? No
Is this tower currently shared with any other stations? No
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? Yes
ASR Number 1029019
Coordinates (NAD83) Latitude (NAD83) 44° 58' 34.0" N-
Longitude (NAD83) 093° 16' 21.0" W-
Overall Structure Height 886.14 feet
Support Structure Height 774.92 feet
Ground Elevation Above Mean Sea Level (AMSL) 853.99 feet
Structure Type BPOLE - Building with Pole
Tower Owner EIGHTH STREET TOWER CORPORATION _ Please contact Broadcast Services, Inc.
Date Constructed 01/01/1975


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? No
Outside RF consulting Engineering Services Perform engineering study for displacement application Yes
Prepare engineering section of Form FCC Construction Permit Application No
Prepare engineering section of Form FCC License to Cover Application No
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 Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
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 No

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
Permit and Filing Costs FCC Construction Permit Major Change No
FCC Construction Permit Minor Change No
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)? 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

Name Description

Gammon and Grange, P.C.

Legal assistance with Eligibility Certification preparation necessitated by reimbursement process; no line item provided on Outside Professional Services Section of Reimbursement Form for Eligibility Certification preparation

Gammon and Grange, P.C.

Form 1876 preparation necessitated by reimbursement process; no line item provided on Outside Professional Services Section of Reimbursement Form for Form 1876 preparation

Gammon and Grange, P.C.

Legal assistance with Displacement Application and coordination with engineer on application; no line item provided on Outside Professional Services Section of Reimbursement Form for legal assistance with Displacement Application preparation

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 $22,248.99 $8,098.99 N/A $8,098.99 N/A
Total for all systems $216,650.83 $48,433.17 N/A $35,785.03 N/A
Primary Transmitter TAUD-2000 $22,248.99 $8,098.99 $8,098.99
Retune - UHF and VHF - minor re-channel issues $11,000.00 $1,000.00 N/A $1,000.00 N/A
3.1-5kW w mask filter Full Service $9,650.00 $5,500.00 N/A $5,500.00 N/A
Channel 14 -- Additional field engineering time, 1 days $750.00 $750.00 N/A $750.00 N/A
Uppman Technical Services, Inc. $848.99 $848.99 N/A $848.99 N/A

Components

Actual Information Description File Name
Retune - UHF and VHF - minor re-channel issues

Component Description:
UTS Installation and check-out of Mask Filter
Amount:
$1,000.00
3.1-5kW w mask filter Full Service

Component Description:
Com-tech, Model TF8D120C, Full Service Mask Filter, Channel 14, 1 5/8" EIA Connectors, 3.5 kW with fans
Amount:
$5,500.00
Channel 14 -- Additional field engineering time, 1 days

Component Description:
Measurement of transmitter at site; measurement in field for spurious products; report of findings to satisfy the special operating conditions of K14RB-D's Construction Permit, #BLDTL-20100521ACA
Amount:
$750.00
Uppman Technical Services, Inc.

Component Description:
Airfare cost for Technalogix engineer to travel from Canada to Minneapolis to assess problem with transmitter working on channel 14 after returning from channel 16. Related hotel costs.
Amount:
$848.99

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 $19,594.34 $19,594.34 N/A $19,594.34 N/A
Total for all systems $216,650.83 $48,433.17 N/A $35,785.03 N/A
Primary Antenna ALP12L2-HSO-14 $19,594.34 $19,594.34 $19,594.34
UHF-Low Power, Side Mount, Other, 15.0kW input, Horizontal $17,957.00 $17,957.00 N/A $17,957.00 N/A
Uppman Technical Services Inc. $857.34 $857.34 N/A $857.34 N/A
ERI Antenna Adapters $780.00 $780.00 N/A $780.00 N/A

Components

Actual Information Description File Name
UHF-Low Power, Side Mount, Other, 15.0kW input, Horizontal

Component Description:
ERI, Inc. ALP12L2-HSO-14, ALP Series II Low/Medium Power UHF Television Antenna
Amount:
$17,957.00
Uppman Technical Services Inc.

Component Description:
Freight charges for antenna shipment
Amount:
$857.34
ERI Antenna Adapters

Component Description:
ERI 1 5/8" to 7/8" antenna adapters
Amount:
$780.00

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 $157,750.00 $4,804.84 N/A $4,800.00 N/A
Total for all systems $216,650.83 $48,433.17 N/A $35,785.03 N/A
Primary Tower BPOLE $157,750.00 $4,804.84 $4,800.00
Tower Rigging Tall Tower (greater than 500') $157,750.00 $4,804.84 N/A $4,800.00 N/A

Components

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

Component Description:
Sub-contractor Tri-State Communications Services: tower labor to remove channel 16 antenna and install new channel 14 antenna ($4200.00); UTS: provide assistance to its Sub-contractor Tri-State's tower crew with antenna install ($600)
Amount:
$4,800.00

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 $9,422.50 $8,300.00 N/A $3,126.70 N/A
Total for all systems $216,650.83 $48,433.17 N/A $35,785.03 N/A
Outside Professional Services $9,422.50 $8,300.00 $3,126.70
Perform engineering study for displacement application $1,800.00 $1,000.00 N/A $1,000.00 N/A
Form 399 assistance or other Program Management costs $2,100.00 $2,100.00 Includes management of process for collecting information from client and vendors; administrative support for preparing form; and engineering support $0.00 N/A
Prepare/ Review 399 reimbursement form $1,710.00 $2,700.00 Includes review of all FCC documents pertaining to Reimbursement process; briefing client on materials; troubleshooting technical difficulties, such as inaccessibility of LPTV 399 Form after submission of Eligibility Certification; review of application $0.00 The estimated cost
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $1,577.50 $1,500.00 N/A $1,490.40 N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $2,235.00 $1,000.00 N/A $636.30 N/A

Components

Actual Information Description File Name
Perform engineering study for displacement application

Component Description:
Channel search and application for LPTV Displacement
Amount:
$1,000.00
Form 399 assistance or other Program Management costs Information not provided.
Prepare/ Review 399 reimbursement form Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
Legal preparation of License to Cover for K14RB-D following grant of Displacement Application
Amount:
$1,490.40
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
Preparation of Engineering STA seeking permission to broadcast on Ch 14 due to loss of Ch. 16; not filed due to expedited grant of Displacement Application
Amount:
$636.30

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 $7,635.00 $7,635.00 N/A $165.00 N/A
Total for all systems $216,650.83 $48,433.17 N/A $35,785.03 N/A
Other Expenses $7,635.00 $7,635.00 $165.00
FCC Filing Fees - Form 2100 license to cover application $335.00 $335.00 N/A $165.00 N/A
Gammon and Grange, P.C. $7,300.00 $7,300.00 Legal assistance with forms required to be submitted, but for which no line item provided on Outside Professional Services Section: (1) Displacement Application/coordination with engineer: $4500; (2) Form 1876: $600; (3) Eligibility Certification: $2200 N/A N/A

Components

Actual Information Description File Name
FCC Filing Fees - Form 2100 license to cover application

Component Description:
Filing Fee K14RB-D License Application
Amount:
$165.00
Gammon and Grange, P.C. Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $216,650.83 $48,433.17 $35,785.03

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. 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.

Michael Bird

President


11/12/2019

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.

Michael Bird

President


11/12/2019

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.

Michael Bird

President


11/12/2019

Attachments

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