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:
35095
Service:
DTV
Call Sign:
KWBA-TV
Channel:
21 (UHF)
File Number:
0000027262
FRN:
0002710192
Date Submitted:
11/08/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

SCRIPPS BROADCASTING HOLDINGS LLC

Doing Business As: SCRIPPS BROADCASTING LLC

David Giles

312 WALNUT STREET

28TH FLOOR

CINCINNATI, OH 45202

United States

+1 (513) 977-3000 DAVE.GILES@SCRIPPS.COM Limited Liability Company

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

Ray Thurber

Vice President / Engineering

SCRIPPS BROADCASTING HOLDINGS LLC

Ray Thurber

312 Walnut St.

Cincinnati, OH 45202

United States

+1 (248) 827-9202 ray.thurber@scripps.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 KWBA must replace its main antenna and transmitter in order to move it its new channel. See attached narrative for a more detailed explanation.

Transmitters

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

Auxiliary Transmitter

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Add Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Retune Existing
Use Auxiliary (Backup)
Ownership Owned
Owner 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 Rohde Swartz
Model TMU9
Year 2015
Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 3 kW

Auxiliary Transmitter

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Retuning Transmitter Costs

Section Question Response
New IOT Tubes Number of Tubes (including accessories) needed N/A
New Mask Filter
Power 3 kW
Other Power N/A
New Exciter Is a new exciter needed? No

Auxiliary 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

Auxiliary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Arizona Sales Tax

Arizona Sales Tax on Retuning of Existing Aux Transmitter and New Mask Filter.

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 Quantum QEXD1
Year 2005
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 32 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 ULXTE-20
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 12.9 kW
Justification for New Transmitter Current Acrodyne transmitter is orphaned and no longer supported by the manufacturer. Parts are in very limited supply or not available. It cannot be re-tuned. Current transmitter has headroom. Station asking for 1 step-up.

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) Yes
Transformer (480V) Yes
Power 150 kVA
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service Yes
Description Necessary conduit, wiring and fuse disconnects as quoted by electrical contractor.
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

Name Description

Transmitter Headroom Replication Step-up

Cost associated for 1 step from the required transmitter power to account for extra headroom station has in current transmitter.

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)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
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 Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
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 N/A
ERP: 1000.0 kW
Manufacturer
Model SWCD24BFS/44D
Year 2005

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Ownership Owned
Owner N/A
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 Class Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 525.0 kW
Manufacturer
Model TFU-26GTH-R P260
Year 2018
Justification for New Antenna Existing main antenna is a coaxial slot antenna that is channel specific and cannot be reused on the new channel.

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? No
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? N/A
Elbow Complex Do you require the separate purchase of the Elbow Complex? No
Broadband or Single Channel? N/A
Feed Line Size N/A
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? No
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Arizona Sales Tax

Arizona Sales Tax for Antenna

Transmission Line

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

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
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? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Flexible Air
Diameter 5 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 214 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Flexible Air
Diameter 5 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 200 feet per run
Justification for New Transmission Line KWBA will use its current main facility as the interim facility. It will need new transmission line for the new top-mount antenna.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Arizona Sales Tax

Arizona Sales Tax on Transmission Line Expenses

Tower Equipment And Rigging Costs

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Section Question Response
Tower Equipment or Rigging Costs Changes Do you have tower equipment or rigging costs changes? Yes

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Owned
Is this tower consider Complex? Terrain Constrained
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? No
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? No
ASR Number
Coordinates (NAD83) Latitude (NAD83) 31° 45' 32.3" N-
Longitude (NAD83) 110° 48' 05.3" W-
Overall Structure Height 199.00 feet
Support Structure Height 158.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 5869.40 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner SCRIPPS BROADCASTING HOLDINGS LLC
Date Constructed 12/01/1998


Other Types of Users

Users
Microwave Relay
Land Mobile

Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Study needed for undocumented/poorly documented tower
Tower Reinforcements Please select whether tower reinforcements are needed: Major Reinforcements needed

Primary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower Terrain constrained
Helicopter Services Required Are helicopter services required? No

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Arizona Sales Tax

Arizona Sales Tax on Tower Expenses

PE Review of Rigging Plan

Professional Engineering review of proposed rigging plan as required by ANSI/ASEE A10.48 and ANSI/TIA 322 standards.

Road Improvement

The road to the transmitter site must be improved in order for a new antenna and rigging equipment to be delivered. Also investigating helicopter option.

Structural Analysis and Soil Bore

Structural Analysis and Soil Bore for Tower

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 835
Explanation Project manager needed to manage all work at transmitter site required to transition to new channel (both the main and interim facilities). With the size of the current engineering staff, KWBA cannot spare personnel to ensure these tasks are completed.
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
NEPA Section 106 environmental review 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 No
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements Yes
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Arizona Sales Tax

Arizona Sales Tax on Professional Services Expenses

Site Survey

GatesAir performed a site survey to access changes to facility as necessary to transition to new channel including, power and HVAC requirements, available transmitter room space and existing antenna and transmission line RF characteristics at new channel.

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 No
FCC License to Cover Application Yes
FCC Special Temporary Authority Application Yes
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? Yes
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Name Description

Arizona Sales Tax

Arizona Sales Tax on Other Expenses

Employee Time

Time needed by Scripps corporate and KWBA employees to work on the transition to a new channel.

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 $844,739.00 $814,554.78 N/A $0.00 N/A
Total for all systems $2,738,112.77 $2,651,598.55 N/A $8,460.83 N/A
Primary Transmitter ULXTE-20 $714,550.00 $689,770.78 $0.00
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW $494,500.00 $472,870.78 Includes cost to remove old transmitter to make space for new transmitter. $0.00 This is the same as the quoted price per the initial submission (Estimated cost)
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A
Transformer 3 phase/480v - 150 KVA $25,550.00 $24,300.00 N/A N/A N/A
Other Electrical Service: Necessary conduit, wiring and fuse disconnects as quoted by electrical contractor. $12,300.00 $12,300.00 N/A N/A N/A
Transmitter Headroom Replication Step-up $144,000.00 $144,000.00 N/A N/A N/A
Auxiliary Transmitter TMU9 $130,189.00 $124,784.00 $0.00
UHF and VHF - minor banding issues $105,200.00 $100,000.00 N/A N/A N/A
3 kW mask filter $4,155.00 $3,950.00 N/A N/A N/A
Arizona Sales Tax $20,834.00 $20,834.00 N/A N/A N/A

Components

Actual Information Description File Name
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW

Component Description:
Transmitter cost from Gates Air - same as Quoted price
Amount:
$472,870.78
Switchgear - industrial 800 amp Information not provided.
Transformer 3 phase/480v - 150 KVA Information not provided.
Other Electrical Service: Necessary conduit, wiring and fuse disconnects as quoted by electrical contractor. Information not provided.
Transmitter Headroom Replication Step-up Information not provided.
UHF and VHF - minor banding issues Information not provided.
3 kW mask filter Information not provided.
Arizona Sales Tax 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 $274,491.00 $262,161.00 N/A $0.00 N/A
Total for all systems $2,738,112.77 $2,651,598.55 N/A $8,460.83 N/A
Primary Antenna TFU-26GTH-R P260 $274,491.00 $262,161.00 $0.00
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Arizona Sales Tax $20,761.00 $20,761.00 N/A N/A N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized $247,000.00 $235,000.00 N/A $0.00 N/A

Components

Actual Information Description File Name
Sweep test of existing antenna Information not provided.
Arizona Sales Tax Information not provided.
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized

Component Description:
KWBA Antenna
Amount:
$98,853.75

Cost Information

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Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $22,720.00 $21,720.00 N/A $1,124.89 N/A
Total for all systems $2,738,112.77 $2,651,598.55 N/A $8,460.83 N/A
Primary Transmission Line $22,720.00 $21,720.00 $1,124.89
Arizona Sales Tax $1,720.00 $1,720.00 N/A N/A N/A
Flexible Air Transmission Line - dielectric, 5" $21,000.00 $20,000.00 N/A $1,124.89 N/A

Components

Actual Information Description File Name
Arizona Sales Tax Information not provided.
Flexible Air Transmission Line - dielectric, 5"

Component Description:
Other REDUCER 4-50 X 1-50
Amount:
$1,124.89

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 $1,140,332.00 $1,097,032.00 N/A $0.00 N/A
Total for all systems $2,738,112.77 $2,651,598.55 N/A $8,460.83 N/A
Primary Tower TOWER $1,140,332.00 $1,097,032.00 $0.00
Road Improvement $128,216.00 $128,216.00 See attached quote N/A N/A
PE Review of Rigging Plan $7,500.00 $7,500.00 N/A N/A N/A
Arizona Sales Tax $116,316.00 $116,316.00 N/A N/A N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $400,000.00 N/A N/A N/A
Major tower reinforcement/modifications $421,000.00 $400,000.00 N/A N/A N/A
Structural Analysis and Soil Bore $20,000.00 $20,000.00 N/A N/A N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $25,000.00 N/A N/A N/A

Components

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 $206,487.00 $207,352.00 N/A $150.00 N/A
Total for all systems $2,738,112.77 $2,651,598.55 N/A $8,460.83 N/A
Outside Professional Services $206,487.00 $207,352.00 $150.00
Site Survey $16,900.00 $16,900.00 N/A N/A N/A
Arizona Sales Tax $8,527.00 $8,527.00 N/A N/A N/A
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A
Project management of the transition $131,930.00 $135,675.00 Per Widelity Strategic Support Quote and Scripps Engineering Support Quote $150.00 N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $2,050.00 $1,500.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,500.00 N/A N/A N/A

Components

Actual Information Description File Name
Site Survey Information not provided.
Arizona Sales Tax Information not provided.
RF Exposure Measurements Information not provided.
Project management of the transition

Component Description:
Preparation of 387
Amount:
$150.00
Prepare and or review reimbursement form Information not provided.
Perform engineering study for new channel assignment and antenna development Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare request for Special Temporary Authorization Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization 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 $249,343.77 $248,778.77 N/A $7,185.94 N/A
Total for all systems $2,738,112.77 $2,651,598.55 N/A $8,460.83 N/A
Other Expenses $249,343.77 $248,778.77 $7,185.94
Employee Time $123,390.60 $123,390.60 N/A N/A N/A
MVPD Notification of Channel Change $4,528.84 $4,528.84 Per KWBA DTVNotification PO 3003045189 $4,528.84 N/A
Develop and air announcement of upcoming channel change $5,000.00 $5,000.00 N/A N/A N/A
Arizona Sales Tax $21,349.00 $21,349.00 N/A N/A N/A
Equipment Storage $20,000.00 $20,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $46,120.00 $46,120.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $16,875.33 $16,875.33 See attached quote N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A $2,657.10 N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A

Components

Actual Information Description File Name
Employee Time Information not provided.
MVPD Notification of Channel Change

Component Description:
MVPD Notification Services
Amount:
$2,264.42

Component Description:
MVPD Notification Services
Amount:
$2,264.42
Develop and air announcement of upcoming channel change Information not provided.
Arizona Sales Tax Information not provided.
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
DTV Medical Facility Notification

Component Description:
DTV Notification Service
Amount:
$2,657.10
FCC Filing Fees - Form 2100 license to cover application Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $2,738,112.77 $2,651,598.55 $8,460.83

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.

Sravan Reddy , Reddy .

Senior Director, General Accounting


11/08/2019

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.

Sravan Reddy , Reddy .

Senior Director, General Accounting


11/08/2019

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