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:
40758
Service:
DTV
Call Sign:
WSYT
Channel:
14 (UHF)
File Number:
0000028420
FRN:
0022892913
Date Submitted:
11/12/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

BRISTLECONE BROADCASTING LLC

Brian Brady

2111 UNIVERSITY PARK DRIVE

SUITE 650

OKEMOS, MI 48864

United States

+1 (517) 347-4141 BRADY@NORTHWESTBROADCASTING.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

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 Purchase of the transmitter, antenna system and transmission line. Current transmitter manufacturer does not support the retune to the new channel. Installation of interim antenna and transmission line, while main antenna is underway.

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 QXD2-DTV
Year 2002
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 55 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 THU9EVO-30
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 46 kW
Justification for New Transmitter The current TX and the RF output mask filter cannot be re-channeled to meet the new channel assignment.See attached document: "Syracuse Repack WSYT-SS-TX-Upgrade-SEPT2017-rev01"

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) Yes
Power 500 kVA
Rigid Conduit and Wiring Yes
Size 2 inches
Length 100.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Heating and Cooling
Size 15 tons
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? Yes
Size 800.0 square feet
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 15

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

RF Filter and Combiner, Switch and Transmitter Control System

The system will interface directly with the RF switches and TX's control along with other ancillary systems like:tower lights, Dielectric's Scout units, T/L pressure and temp sensors, etc.

Interim Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Interim
Description of Use N/A
Change Type Purchase
Manufacturer
Model THU9-EVO
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 31 kW
Justification for New Transmitter The Interim TX will allow the station operation during the TX replacement period to meet the new channel assignment. See the attached sketch of the WSYT transition plan from CH19 to CH14 : Syracuse Repack WSYT-TransitionPlan-sketch-SEPT2017-rev01

Interim 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) Yes
Power 150 kVA
Rigid Conduit and Wiring Yes
Size 2 inches
Length 150.0 feet
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? Yes
Size 200.0 square feet
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
Inside RF System Is an additional interior RF system required to support this interim transmitter? Yes

Interim 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)
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: 621.0 kW
Manufacturer
Model TFU-16DSB-R S180SP
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? Yes
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 Elliptical
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: 540.0 kW
Manufacturer
Model TFU-20DSC-R T140 DC
Year 2018
Justification for New Antenna The existing slotted antenna is channel specific and must be replaced to meet the channel assignment.

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
Do you need a combiner output splitter/switcher for dual feed lines? No
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Broadband
Feed Line Size 7 3/16 inches inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? Yes
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Enter a list of RF channel numbers.

RF Channel Number
15
14

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Transmission Line 7-75 EIA

T/L 7-75 EIA Length 15'-20' (2pcs) as TBD for connection with existing line

Antnna Monitoring Kit

RF Scout Assembly for antenna monitoring

Beacon Kit

Beacon Kit for support pole

Interim Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
Ownership Owned
Owner N/A
Is antenna shared? Yes
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
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: 540.0 kW
Manufacturer
Model TFU-18DSC-R T140
Year 2018
Justification for New Antenna The Interim antenna will allow operation on the new assigned channel until the new primary antenna is delivered and installed. See the attached WSYT sketch of the transition plan from CH19 to CH14 :Syracuse Repack WSYT-TransitionPlan-sketch-SEPT2017-rev01

Interim 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? Yes
Broadband or Single Channel? S
Feed Line Size 6 1/8 inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for an antenna? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? Yes
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Interim Antenna

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Other Antenna Cost Not Listed

Name Description

Transmission Line 6-50

T/L various fixed lengths (15' to 20') used to connect the Tower T/L with the Inside RF system -

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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Add Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Utilize Existing
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is this transmission currently shared with any other stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer Dielectric
Type Rigid
Diameter 7 3/16 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1200 feet per run

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Dehydrator

Pressurization EQ.

Monitoring System for TL

Continuous monitor real-time, time-domain system measurement at full power

Interim Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Interim
Description of Use N/A
Change Type Purchase New
Type Rigid
Diameter 6 1/8 inches
Segment Length 20'
Other Segment Length
Number of parallel runs 1
Length 1090 feet per run
Justification for New Transmission Line The new TL is required for the Interim Antenna System.

Interim Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Dehydrator

Pressurization Equipment

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 Leased
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) Yes
Others Types of Users No
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1006348
Coordinates (NAD83) Latitude (NAD83) 42° 52' 50.2" N-
Longitude (NAD83) 076° 11' 58.7" W-
Overall Structure Height 1019.02 feet
Support Structure Height 983.91 feet
Ground Elevation Above Mean Sea Level (AMSL) 1629.90 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Sinclair Properties, LLC
Date Constructed 03/20/1987

FM, AM or TV radio broadcasters. Facility ID's, Call Signs and Services of other broadcast stations with whom the tower is shared

Facility ID Call Sign Service
58725 WNYS-TV DTV

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 documented tower
Tower Reinforcements Please select whether tower reinforcements are needed: Serious Reinforcements needed

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? Yes

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
Number of Hours N/A
Explanation N/A
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 Yes
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
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 Yes
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
NEPA Section 106 environmental review Yes
Environmental Assessment No
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study Yes
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

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
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 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

Internal Project Management of Transition

120 h for repack preparations, trips to manufacturers, RF systems engineering planning, schedule 2100, form 399 preparations, CP budgeting, etc.

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 $3,069,687.78 $2,483,830.44 N/A $826,545.22 N/A
Total for all systems $5,476,184.04 $4,585,770.95 N/A $2,196,316.50 N/A
Interim Transmitter THU9-EVO $1,133,950.00 $572,508.14 $409,480.25
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW $947,000.00 $461,000.00 The Interim TX cost is split with WNYS. See attached quote for Interim TX:WSYT Revised Interim THU9evo-20 Sales-Quote_131652_20180928-005347UTC $332,777.36 N/A
Transformer 3 phase/480v - 150 KVA $25,550.00 $29,633.14 The Interim TX cost is split with WNYS. See attached "WSYT - WNYS CH19 & CH44 THU9evo-20 Interim updated Sales_Quote_180801_20190322-175139UTC", and the: "Syracuse Repack WSYT-WNYS-Estimate_Electrical_Service-Interim TX-Jun7-2019-Cover Letter". $29,633.14 The amount is greater than the predetermine cost estimate as the Estimated cost is modified per "Syracuse Repack WSYT-WNYS-Estimate_Electrical_Service-Interim TX-Jun7-2019-Cover_Letter" included.
2" Rigid Conduit and Wiring (Cost per foot) $3,900.00 $1,875.00 The Interim TX cost is split with WNYS N/A N/A
Other -- Building Addition Size: 200.0 $10,000.00 $10,000.00 Estimate for possible costs of building modifications. $2,356.00 N/A
UHF inside RF system including switching $147,500.00 $70,000.00 The Interim TX cost is split with WNYS. See attached quote: WSYT Revised Interim THU9evo-20 Sales-Quote_131652_20180928-005347UTC $44,713.75 N/A
Primary Transmitter THU9EVO-30 $1,935,737.78 $1,911,322.30 $417,064.97
Channel 14 Mask Filter $189,500.00 $180,000.00 N/A $54,699.39 N/A
RF Consulting Engineer $5,260.00 $5,000.00 N/A $4,500.00 N/A
Other -- Building Addition Size: 800.0 $10,000.00 $10,000.00 Estimate for possible costs of building modifications. $1,400.00 N/A
Additional field engineering time, 10-30 days $63,100.00 $60,000.00 N/A N/A N/A
RF Filter and Combiner, Switch and Transmitter Control System $55,477.78 $55,477.78 The documentation is attached to form 399: "WSYT_WNYS Burk Control System Second Revision Sales-Quote_236630_20190805-184606UTC" and "WSYT_WNYS Burk Additional HW and Services Sales-Quote_265011_20191030-162009UTC N/A N/A
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW $1,473,000.00 $1,400,000.00 See attached SS-TX TPO notification:Syracuse Repack WSYT-SS-TX-Upgrade-SEPT2017-rev01,with:authorization-new CP-540K-Jan 22-2018,TPO-ERP CALC-WSYT-TOP_Ant-H-pol-rev01,C-70579-4, THU9evo_bro_en_3607-5860-12_v0100,WSYT CH14 THU9evo-24 AMPs/30 AMPs quotes. $255,177.16 N/A
Transformer 3 phase/480v - 500 KVA $48,400.00 $114,344.52 This new revised estimate includes the cost for the new 480V/400V, 3 Phase Transformer along with all the electrical cost for material and labor. See the attached: "Syracuse Repack WSYT-Estimate_Electrical_Service-Primary_TX-AUG26-2019-Cover_Letter" $101,288.42 N/A
2" Rigid Conduit and Wiring (Cost per foot) $2,600.00 $2,500.00 N/A N/A N/A
15 Ton system $88,400.00 $84,000.00 N/A N/A N/A

Components

Actual Information Description File Name
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW

Component Description:
The attached cover letter is on support of the invoice of the HEX stacking Kit for the Interim TX as of quote#180894 (also attached)
Amount:
$1,714.50

Component Description:
Inv9500099366-APR30-2019, Item#42. The amount represent 60% down payment for WSYT (50%) split cost with WNYS station.
Amount:
$182,249.63

Component Description:
New attachment includes the cover letter requested by the reviewer :"Syracuse Repack WSYT-Inv9500090837-MAR21-2019-Cover_Letter". Item 40 of INV. 9500090837. The amount represent 30% down payment for WSYT (50%) split cost with WNYS
Amount:
$91,124.82

Component Description:
Inv9500099367-APR30-2019, Item#44. The amount represent 10% down payment for WSYT (50%) split cost with WNYS station.
Amount:
$30,374.95

Component Description:
Inv9500099367-APR30-2019, Item#2705. The amount represent tax on portion of Order for WSYT (50%) split cost with WNYS station.
Amount:
$27,313.46
Transformer 3 phase/480v - 150 KVA

Component Description:
The new attachment includes "Syracuse Repack WSYT-Inv9500099367-JUN10-2019-Cover_Letter" as requested by the reviewer. Inv9500099367-APR30-2019, Item#2405. The amount represent 10% down payment for WSYT (50%) split cost with WNYS station.
Amount:
$324.94

Component Description:
New attachment includes the cover letter requested by the reviewer :"Syracuse Repack WSYT-Inv9500090837-MAR21-2019-Cover_Letter". Item 1605 of INV. 9500090837. The amount represent 30% down payment for WSYT (50%) split cost with WNYS
Amount:
$974.81

Component Description:
The new attached Cover Letter requested by the reviewer: "Syracuse Repack WSYT-WNYS-HUEN_Electrical_Service-Interim TX-Jun13-2019-Cover_Letter" represents the INTERIM _TX Electrical Service, amount which is split 50%/50% with WNYS station.
Amount:
$26,383.77

Component Description:
New attachment includes "Syracuse Repack WSYT-Inv9500099366-JUN10-2019-Cover_Letter" as requested by FCC reviewer. Inv9500099366-APR30-2019, Item#2005. The amount represent 60% down payment for WSYT (50%) split cost with WNYS station.
Amount:
$1,949.62
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Other -- Building Addition Size: 200.0

Component Description:
Separation wall of the TR. room. Invoice corrected per reviewer request of MSG2876823
Amount:
$2,356.00
UHF inside RF system including switching

Component Description:
New attachment includes the cover letter requested by the reviewer :"Syracuse Repack WSYT-Inv9500090837-MAR21-2019-Cover_Letter"The amount represent 30% down payment for WSYT (50%) split cost with WNYS
Amount:
$13,414.13

Component Description:
Inv9500099366-APR30-2019, Item#1905. The amount represent 60% down payment for WSYT (50%) split cost with WNYS.
Amount:
$26,828.25

Component Description:
Inv9500099367-APR30-2019, Item#2305. The amount represent 10% down payment for WSYT (50%) split cost with WNYS station.
Amount:
$4,471.37
Channel 14 Mask Filter

Component Description:
Item#1905 of the invoice #9500097811A, representing 25% down payment (DP).
Amount:
$54,699.39
RF Consulting Engineer

Component Description:
Study of CH14 land mobile protection.
Amount:
$4,500.00
Other -- Building Addition Size: 800.0

Component Description:
Building preparations for Tower crew and Interim Antenna Penetration for WSYT_CH14
Amount:
$1,400.00
Additional field engineering time, 10-30 days Information not provided.
RF Filter and Combiner, Switch and Transmitter Control System Information not provided.
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW

Component Description:
The amount represents the additional charge for labor (install) as stated in the cover letter signed by R&S, on May21st, 2019. Invoice revised per reviewer MSG3848174.
Amount:
$19,803.16

Component Description:
The amount represents the additional charge for lifting equipment (install) as stated in the cover letter signed by R&S, on May21st, 2019.
Amount:
$2,168.10

Component Description:
Item#42 of the invoice #9500097811A, representing 25% down payment (DP).
Amount:
$233,205.90
Transformer 3 phase/480v - 500 KVA

Component Description:
Item#2005,TR 3Phases, of the invoice #9500097811A, representing 25% down payment (DP).
Amount:
$2,343.75

Component Description:
Electrical materials and labor cost for the Primary TX_WSYT_CH14.
Amount:
$98,944.67
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
15 Ton system 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 $553,076.00 $380,652.25 N/A $259,518.84 N/A
Total for all systems $5,476,184.04 $4,585,770.95 N/A $2,196,316.50 N/A
Interim Antenna TFU-18DSC-R T140 $112,314.00 $91,092.75 $83,517.98
Transmission Line 6-50 $4,529.00 $4,529.00 N/A $4,076.10 N/A
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $5,000.00 N/A $0.00 N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $8,212.50 The Interim Antenna cost is split with WNYS.Dielectric quote attached: WSYT D14 D15 interim_ANT_ Order. See the attached transition plan:Syracuse Repack WSYT-TransitionPlan-sketch-SEPT2017-rev02. $7,391.26 N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $6,606.25 The Interim Antenna cost is split with WNYS.Dielectric quote attached: WSYT D14 D15 interim_ANT_ Order. See the attached transition plan:Syracuse Repack WSYT-TransitionPlan-sketch-SEPT2017-rev02. $5,945.62 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $5,760.00 N/A
UHF - High Power, Side Mount, basic slot antenna, 540 kW input, directional,, elliptically or circularly polarized $60,345.00 $60,345.00 ***System Notice: Estimate adjusted and locked because line has been superseded.***The interim Antenna cost is split with WNYS. Dielectric quote attached: WSYT D14 D15 interim_ANT_ Order. See attached transition plan:Syracuse Repack WSYT-TransitionPlan-sketch-SEPT2017-rev02. $60,345.00 N/A
Primary Antenna TFU-20DSC-R T140 DC $440,762.00 $289,559.50 $176,000.86
Beacon Kit $4,500.00 $4,500.00 N/A $4,050.00 N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $289,500.00 $145,087.50 The cost for the Master_Top Mount Antenna is split with WNYS. See attached 1696895 Confirmation R5-WSYT-WNYS-Primary_ANT, sum of Item#1, Item#4 and Item#6 as Master_Top Antenna System components description and split equally with WNYS. $130,578.76 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $5,760.00 N/A
New combiner, cost per channel (without antenna) $84,200.00 $80,000.00 N/A N/A N/A
Elbow complex, broadband, at antenna input, per 7 3/16. feedline (if needed) $16,850.00 $16,000.00 N/A $12,879.00 N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $22,000.00 Dielectric quote attached: WSYT D14-WNYS D15 Primary_ANT_ Order $14,782.50 N/A
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $5,000.00 N/A $0.00 N/A
Transmission Line 7-75 EIA $4,172.00 $4,172.00 N/A $3,754.80 N/A
Antnna Monitoring Kit $6,400.00 $6,400.00 N/A $4,195.80 N/A

Components

Actual Information Description File Name
Transmission Line 6-50

Component Description:
Attachment includes the cover letter :"Syracuse Repack WSYT-WNYS-InvMAN01118-APR23-2019-Cover_Letter". Item#9, prior to shipment, down payment of Invoice MAN01118.
Amount:
$2,038.05

Component Description:
New attachment includes the cover letter requested by the reviewer :"Syracuse Repack WSYT-WNYS-InvMAN01043-MAR21-2019-Cover_Letter". Item#9, 45% down payment of Invoice MAN01043
Amount:
$2,038.05
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)

Component Description:
The cost for the scatter study is included in Item#3 of Invoice MAN01043
Amount:
N/A
Side mount brackets for high power antennas (if not included in antenna base cost)

Component Description:
New attachment includes the cover letter requested by the reviewer :"Syracuse Repack WSYT-WNYS-InvMAN01043-MAR21-2019-Cover_Letter". Item#3, includes the scatter study too, and the amount is split equally with WNYS
Amount:
$3,695.63

Component Description:
Attachment includes the cover letter :"Syracuse Repack WSYT-WNYS-InvMAN01118-APR23-2019-Cover_Letter". Item#3, includes the scatter study too, and the amount is split equally with WNYS
Amount:
$3,695.63
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
Attachment includes the cover letter:"Syracuse Repack WSYT-WNYS-InvMAN01118-APR23-2019-Cover_Letter". Item#4 of Inv. MAN01118. The prior to shipment, down payment, is split equally with WNYS station.
Amount:
$2,972.81

Component Description:
New attachment includes the cover letter requested by the reviewer :"Syracuse Repack WSYT-WNYS-InvMAN01043-MAR21-2019-Cover_Letter". Item#4 of Inv. MAN01043. The 45% down payment is split equally with WNYS.
Amount:
$2,972.81
Sweep test of existing antenna

Component Description:
New attachment includes the cover letter requested by the reviewer :"Syracuse Repack WSYT-WNYS-InvMAN01043-MAR21-2019-Cover_Letter". Item#24, of invoice MAN01043, that represent 45% down payment
Amount:
$2,880.00

Component Description:
Attachment includes the cover letter:"Syracuse Repack WSYT-WNYS-InvMAN01118-APR23-2019-Cover_Letter". Item#24, of invoice MAN01118, that represent prior to shipment, down payment.
Amount:
$2,880.00
UHF - High Power, Side Mount, basic slot antenna, 540 kW input, directional,, elliptically or circularly polarized

Component Description:
Attachment includes the cover letter :"Syracuse Repack WSYT-WNYS-InvMAN01118-APR23-2019-Cover_Letter". Item#31, represent prior to shipment, down payment of invoice MAN01118,and is split equally with WNYS station.
Amount:
$30,172.50

Component Description:
New attachment includes the cover letter requested by the reviewer :"Syracuse Repack WSYT-WNYS-InvMAN01043-MAR21-2019-Cover_Letter". Item#1, represent 45% down payment of invoice MAN01043,and is split equally with WNYS
Amount:
$30,172.50
Beacon Kit

Component Description:
New attachment includes the cover letter requested by the reviewer :"Syracuse Repack WSYT-WNYS-InvMAN01041-APR16-2019-Cover_Letter" Represents a down payment of 45%, invoice MAN01041, Item#5
Amount:
$2,025.00

Component Description:
Attachment includes the cover letter :"Syracuse Repack WSYT-WNYS-InvMAN01147-APR18-2019-Cover_Letter" Represents prior to shipment down payment, invoice MAN01147, Item#5
Amount:
$2,025.00
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
Attachment includes a cover letter :"Syracuse Repack WSYT-WNYS-InvMAN01147-APR18-2019-Cover_Letter" The amount represents sum of Item#1, Item#4 and Item#6 of MAN01147, prior to shipment, down payment as components of the Antenna System.
Amount:
$65,289.38

Component Description:
New attachment includes the cover letter requested by the reviewer :"Syracuse Repack WSYT-WNYS-InvMAN01041-APR16-2019-Cover_Letter" The amount represents sum of Item#1, Item#4 and Item#6 of MAN01041 down payment as components of the Antenna System.
Amount:
$65,289.38
Sweep test of existing antenna

Component Description:
Attachment includes the cover letter:"Syracuse Repack WSYT-WNYS-InvMAN01147-APR18-2019-Cover_Letter" Represents prior to shipment, down payment of MAN01147, Item#10
Amount:
$2,880.00

Component Description:
New attachment includes the cover letter requested by the reviewer :"Syracuse Repack WSYT-WNYS-InvMAN01041-APR16-2019-Cover_Letter" Represents 45% down payment of MAN01041, Item#10
Amount:
$2,880.00
New combiner, cost per channel (without antenna) Information not provided.
Elbow complex, broadband, at antenna input, per 7 3/16. feedline (if needed)

Component Description:
Attachment includes the cover letter :"Syracuse Repack WSYT-WNYS-InvMAN01147-APR18-2019-Cover_Letter" Item#7, prior to shipment, down payment, invoice MAN01147
Amount:
$6,439.50

Component Description:
New attachment includes the cover letter requested by the reviewer :"Syracuse Repack WSYT-WNYS-InvMAN01041-APR16-2019-Cover_Letter" Item#7, 45% down payment, invoice MAN01041
Amount:
$6,439.50
Side mount brackets for high power antennas (if not included in antenna base cost)

Component Description:
New attachment includes the cover letter requested by the reviewer :"Syracuse Repack WSYT-WNYS-InvMAN01041-APR16-2019-Cover_Letter" Item#3-Price for mounts includes a scatter study,too.
Amount:
$7,391.25

Component Description:
Attachment includes the cover letter:"Syracuse Repack WSYT-WNYS-InvMAN01147-APR18-2019-Cover_Letter" Item#3-Price for mounts includes a scatter study,too.
Amount:
$7,391.25
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)

Component Description:
The cost for the scatter study is included with Item#3 of the invoice MAN01041
Amount:
N/A
Transmission Line 7-75 EIA

Component Description:
New attachment includes the cover letter requested by the reviewer :"Syracuse Repack WSYT-WNYS-InvMAN01041-APR16-2019-Cover_Letter".T/L different lengths used to connect the existing T/L on the tower with the inside RF System.
Amount:
$1,877.40

Component Description:
Attachment includes the cover letter:"Syracuse Repack WSYT-WNYS-InvMAN01147-APR18-2019-Cover_Letter".T/L different lengths used to connect the existing T/L on the tower with the inside RF System, item#8.
Amount:
$1,877.40
Antnna Monitoring Kit

Component Description:
Attachment includes the cover letter:"Syracuse Repack WSYT-WNYS-InvMAN01147-APR18-2019-Cover_Letter" Monitor and protection unit for Main Master Antenna System, Item#9, prior to shipment, down payment, invoice MAN01147.
Amount:
$2,097.90

Component Description:
New attachment includes the cover letter requested by the reviewer :"Syracuse Repack WSYT-WNYS-InvMAN01041-APR16-2019-Cover_Letter" Monitor and protection unit for Main Master Antenna System, Item#9, 45% down payment, invoice MAN01041
Amount:
$2,097.90

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 $249,832.00 $137,017.00 N/A $78,127.88 N/A
Total for all systems $5,476,184.04 $4,585,770.95 N/A $2,196,316.50 N/A
Interim Transmission Line $222,180.00 $109,365.00 $78,127.88
Rigid Transmission Line - copper, 6 1/8" $220,180.00 $107,365.00 The cost for the Interim TL is split with WNYS. $78,127.88 N/A
Dehydrator $2,000.00 $2,000.00 See the attached quote for the dehydrator:08302017 Order_Quotation M14025 WSYT (002). The cost is split with WNYS. $0.00 N/A
Primary Transmission Line $27,652.00 $27,652.00 $0.00
Dehydrator $4,000.00 $4,000.00 See the attached quote for the dehydrator:08302017 Order_Quotation M14026 WSYT. The cost is split with WNYS. N/A N/A
Monitoring System for TL $23,652.00 $23,652.00 See the attached quote#1929537: "Q1929537" The estimate includes 8% taxes. N/A N/A

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 6 1/8"

Component Description:
New attachment includes the cover letter requested by the reviewer :"Syracuse Repack WSYT-WNYS-InvMAN01043-MAR21-2019-Cover_Letter". Item#27, Inv. MAN01043. The 45% down payment amount invoiced is split equally with WNYS.
Amount:
$39,063.94

Component Description:
Attachment includes the cover letter:"Syracuse Repack WSYT-WNYS-InvMAN01118-APR23-2019-Cover_Letter". Item#27, Inv. MAN01118. The prior to shipment, down payment amount, invoiced is split equally with WNYS station.
Amount:
$39,063.94
Dehydrator

Component Description:
The cost is included into Item#27, T/L Rigid 6-50. The amount is equally split with WNYS.
Amount:
N/A
Dehydrator Information not provided.
Monitoring System for TL 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 $1,323,124.00 $1,303,197.00 N/A $1,008,430.30 N/A
Total for all systems $5,476,184.04 $4,585,770.95 N/A $2,196,316.50 N/A
Primary Tower TOWER $1,323,124.00 $1,303,197.00 $1,008,430.30
Serious tower reinforcement/modifications $1,052,000.00 $1,024,000.00 See the attached acceptance orders signed for tower work: Stainless_Modification_WSYT_WNYS_Syracuse_Sweatte_Feb_20_2019 and Stainless_Service_WSYT_WNYS_Syracuse_Sweatte_Feb_20_2019 $952,872.30 N/A
Tall Tower (greater than 500') $210,500.00 $205,000.00 See the attached acceptance orders signed for tower work: Stainless_Modification_WSYT_WNYS_Syracuse_Sweatte_Feb_20_2019 and Stainless_Service_WSYT_WNYS_Syracuse_Sweatte_Feb_20_2019 $25,885.00 N/A
Structural engineering tower load study for well documented tower $12,600.00 $26,173.00 See the attached cover letter: "Syracuse Repack WSYT-WNYS-Estimate_Structural Engineering Load-Jun6-2019-Cover_Letter". $26,173.00 See the attached "Syracuse Repack WSYT-WNYS-Estimate_Structural Engineering Load-Jun6-2019-Cover_Letter", as requested by reviewer MSG3001902.
Tower Helicopter Lift $48,024.00 $48,024.00 See the attached Cover letter for the change order request net amount for using the Helicopter lift vs gin pole solution: "Helicopter_GinPole Comparison-Change Order Req-CoverLetter"+"Helicopter Site Clearing_Cover_ Letter" cost amount. $3,500.00 N/A

Components

Actual Information Description File Name
Serious tower reinforcement/modifications

Component Description:
Represents 30% per the terms of the contract signed.
Amount:
$317,624.10

Component Description:
Represents 60% per the terms of the contract signed.
Amount:
$635,248.20
Tall Tower (greater than 500')

Component Description:
Represents 50% as per the terms of the contract.
Amount:
$25,885.00
Structural engineering tower load study for well documented tower

Component Description:
Represents 50% upon analysis completion, proposal #P18_T0358_001
Amount:
$6,376.00

Component Description:
Represents 50% upon signed order, proposal #P18_T0358_001
Amount:
$6,376.00

Component Description:
Feb 2019 proposal for tower's structural analyse
Amount:
$13,421.00
Tower Helicopter Lift

Component Description:
Represents the cost amount to clear the site and create a HeliPad for the Helicopter lift of the Main Antenna System
Amount:
$3,500.00

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 $154,375.00 $155,000.00 N/A $0.00 N/A
Total for all systems $5,476,184.04 $4,585,770.95 N/A $2,196,316.50 N/A
Outside Professional Services $154,375.00 $155,000.00 $0.00
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A N/A N/A
NEPA Section 106 environmental review, if needed $6,310.00 $6,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $7,000.00 Attorney Fee Estimates N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $4,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $5,500.00 Attorney Fee Estimates attached: Northwest Repack Cost Estimate Letter to R. Sweatte I (00113549xC33F1) N/A N/A
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application $4,210.00 $6,000.00 Attorney Fee Estimates attached: Northwest Repack Cost Estimate Letter to R. Sweatte I (00113549xC33F1) 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
Prepare request for Special Temporary Authorization $2,050.00 $1,500.00 N/A N/A N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application $1,580.00 $1,500.00 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
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application $2,105.00 $2,000.00 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
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A N/A N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A

Components

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 $126,089.26 $126,074.26 N/A $23,694.26 N/A
Total for all systems $5,476,184.04 $4,585,770.95 N/A $2,196,316.50 N/A
Other Expenses $126,089.26 $126,074.26 $23,694.26
Internal Project Management of Transition $18,000.00 $18,000.00 120h @ $150/h estimate. N/A N/A
MVPD Notification of Channel Change $10,000.00 $10,000.00 See attached FCC Catalog of Potential Expenses and Estimated Costs N/A N/A
Develop and air announcement of upcoming channel change $230.00 $230.00 See attached: Develop-On_Air_Announcement-cost-2017 N/A N/A
Equipment Storage $39,500.00 $39,500.00 See the attached storage fee calculation for 8 months (32 weeks): Syracuse Repack WSYT-Storage calculation-SEPT2017 along with the Dielectric Storage Fees: "Storage Instructions and Rates-Dielectric". N/A N/A
Equipment Delivery and Handling Charges $25,000.00 $25,000.00 See attached FCC Catalog of Potential Expenses and Estimated Costs $3,525.00 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $20,169.26 $20,169.26 New Disposal Cost Estimate is attached :"Syracuse Repack WSYT-Estimate_Disposal Cost-Jun10-2019-Cover_Letter_REV01_Nov1st". $20,169.26 A cover letter was attached for the cost adjustment for the former CH19-RF System disposal invoice vs initial cost estimate: "Syracuse Repack WSYT-Estimate_Disposal Cost-Jun10-2019-Cover_Letter_REV01_Nov1st".
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 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
DTV Medical Facility Notification $11,550.00 $11,550.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,110.00 N/A N/A N/A

Components

Actual Information Description File Name
Internal Project Management of Transition Information not provided.
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges

Component Description:
Unloading and handling of the new WSYT-CH14-Primary TX
Amount:
$1,800.00

Component Description:
Handling and unloading of Interim TX boxes. Invoice reissued per reviewer request of MSG 2876737
Amount:
$1,575.00

Component Description:
Handling the WSYT-CH14, Transformer 3Phases 480V/400V
Amount:
$150.00
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
Represents the disposal cost invoiced for the former CH19_RF System
Amount:
$2,960.00

Component Description:
WSYT_WNYS new INTERIM TX Disposal/Mobilization cost for its package as per new "Syracuse Repack WSYT-Estimate_Disposal Cost-Jun10-2019-Cover_Letter".
Amount:
$2,065.26

Component Description:
New Cover letter includes the quote and the Invoice which represents the cost for demo and disposal of 1/2 of the old WSYT CH19, IOT TX, CAB#2. Reviewer request of MSG 2954883
Amount:
$5,549.00

Component Description:
Eq Disposal cost for old TX WSYT, CAB#1, CC, ancillary equipment as per the new Disposal Estimate:"Syracuse Repack WSYT-Estimate_Disposal Cost-Jun10-2019-Cover_Letter".
Amount:
$9,595.00
FCC Filing Fees - Special Temporary Authorization request Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
DTV Medical Facility Notification Information not provided.
FCC Filing Fees - Form 2100 minor change CP application Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $5,476,184.04 $4,585,770.95 $2,196,316.50

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. 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.

Catalin O Popescu

Director of Engineering


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.

Catalin O Popescu

Director of Engineering


11/12/2019

Attachments

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