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:
31369
Service:
DCA
Call Sign:
KUTU-CD
Channel:
17 (UHF)
File Number:
0000027875
FRN:
0021905690
Date Submitted:
08/12/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

TYLER MEDIA LLC

Doing Business As: TYLER MEDIA LLC

ROBERT DENEGRI, CFO

5101 S. SHIELDS BLVD.

OKLAHOMA CITY, OK 73129

United States

+1 (405) 429-5006 ROBERT.D@TYLERMEDIA.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

John Charles Trent , Esq. .

Counsel to Tyler Media LLC

Putbrese Hunsaker & Trent, P.C.

John C. Trent, Esq.

200 South Church Street

Woodstock, VA 22664

United States

+1 (540) 459-7646 fccman3@shentel.net

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 KUTU-CD is required to move from Channel 25 to Channel 17. This change will require a new transmitter and directional antenna system. Final Reimbursement of Expenses are now attached.

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 EC710MP-BB
Year 2020
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1 kW

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model UAXTE-2R37
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1 kW
Justification for New Transmitter Old Transmitter will not work with new channel.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Gates Air

Mask Line/Connectors STDFLEX7-810FT7-16

Gates Air

Install Kit, Install Material, Maxiva UAXTE

Gates Air

Mask Filter System Reflective Standard ATSC Mask Filter

Gates Air

Exciter ATSC 1.0 UAXT-DD

Gates Air

Shipping

Gates Air

IO Kit, UAXTE I/O D/D Rack IO Plate

Gates Air

Surge Suppressor 740127800

Gates Air

Mask Coupler 9710078029

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 Class A
Mounting Side Mount
Antenna position in stack Middle
Polarization Horizontal
Type Other
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type SWR, Type SWLP8WC/25 horizontally polarized, directional antenna
ERP: 3.0 kW
Manufacturer
Model SWLP8WC/25
Year 2020

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? No
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 Class A
Mounting Side Mount
Antenna position in stack Middle
Polarization Elliptical
Type Broadband Panel
Number of Stations Supported 1
Number of Panels/Bays 8
Lower Limit 488.00 MHz
Upper Limit 494.00 MHz
Design power capacity in use 24.0 %
Other Antenna Type N/A
ERP: 6.55 kW
Manufacturer
Model SWEDL8WC/17
Year 2017
Justification for New Antenna Old antenna will not work with 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?
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

Sweep Antenna

Roberts Engineering

SWR Antenna Shipping

Shipping Costs

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)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? Located on Building
Is this tower currently shared with any other stations? No
One or more FM, AM or TV radio broadcaster(s) N/A
Others Types of Users N/A
Is tower documented for structural analysis? Unknown
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? No
ASR Number
Coordinates (NAD83) Latitude (NAD83) 36° 09' 01.0" N-
Longitude (NAD83) 095° 59' 26.1" W-
Overall Structure Height 445.20 feet
Support Structure Height 411.74 feet
Ground Elevation Above Mean Sea Level (AMSL) 732.27 feet
Structure Type B - Building
Tower Owner BOA Building (LLC)
Date Constructed 01/06/2011


Primary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower Located on Building
Helicopter Services Required Are helicopter services required? Yes

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Top Hand Tower

Tower/Antenna Rigging

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 No
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority No
Quantity N/A
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority No
Quantity N/A
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers No
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements No
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Broadcast General Store

Invoices for Shively Flange and Burk SNMPPULS

DTV Notification Services

MVPD Notification

DTV Notification Services

Medical Notification

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 Yes
BLM or NFS Coordination 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)? 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

DTV Notification Services

MVPD Notification

DTV Notification Services

Medical Notification

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 $205,051.00 $79,051.00 N/A $58,925.00 N/A
Total for all systems $784,396.00 $246,181.00 N/A $115,357.43 N/A
Primary Transmitter UAXTE-2R37 $205,051.00 $79,051.00 $58,925.00
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $0.00 N/A $0.00 No Charge Listed Earlier
Gates Air $79,051.00 $79,051.00 N/A $58,925.00 N/A

Components

Actual Information Description File Name
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW Information not provided.
Gates Air

Component Description:
Transmitter Purchase Price
Amount:
$58,925.00

Cost Information

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Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $54,110.00 $39,320.00 N/A $18,179.48 N/A
Total for all systems $784,396.00 $246,181.00 N/A $115,357.43 N/A
Primary Antenna SWEDL8WC/17 $54,110.00 $39,320.00 $18,179.48
Sweep Antenna $5,000.00 $5,000.00 N/A $16,967.74 The sweep is included in the total SWR Invoice and was not broken out.
UHF - Lower Power Side Mount, Class A broadband panel (cost per panel) $10,080.00 $9,600.00 N/A $0.00 No Charge Not Required
Sweep test of existing antenna $6,730.00 $5,000.00 N/A $0.00 Include in main invoice, not broken out.
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $26,300.00 $13,720.00 N/A $0.00 No Charge Not required
SWR Antenna Shipping $6,000.00 $6,000.00 N/A $1,211.74 N/A

Components

Actual Information Description File Name
Sweep Antenna

Component Description:
SWR Universal Invoice
Amount:
$16,967.74
UHF - Lower Power Side Mount, Class A broadband panel (cost per panel) Information not provided.
Sweep test of existing antenna Information not provided.
UHF - Lower Power Side Mount, Class A One Station antenna -- basic Information not provided.
SWR Antenna Shipping

Component Description:
shipping
Amount:
$1,211.74

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 $463,500.00 $67,500.00 N/A $8,000.00 N/A
Total for all systems $784,396.00 $246,181.00 N/A $115,357.43 N/A
Primary Tower B $463,500.00 $67,500.00 $8,000.00
Top Hand Tower $25,000.00 $25,000.00 N/A $8,000.00 N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $25,000.00 N/A $0.00 No Charge Not Required
Tower Helicopter Lift $17,500.00 $17,500.00 N/A $0.00 No Charge Not Needed

Components

Actual Information Description File Name
Top Hand Tower

Component Description:
Remove & Replace LPTV Antenna
Amount:
$8,000.00
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) Information not provided.
Tower Helicopter Lift 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 $31,350.00 $30,485.00 N/A $22,898.35 N/A
Total for all systems $784,396.00 $246,181.00 N/A $115,357.43 N/A
Outside Professional Services $31,350.00 $30,485.00 $22,898.35
DTV Notification Services $8,000.00 $8,000.00 N/A $7,354.60 N/A
Broadcast General Store $1,000.00 $1,000.00 N/A $843.75 N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $2,500.00 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A $2,250.00 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A $5,000.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,580.00 No Charge $0.00 No Charge
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,155.00 No Charge $0.00 No Charge
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $4,950.00 N/A

Components

Actual Information Description File Name
DTV Notification Services

Component Description:
MVPD Notification
Amount:
$2,235.40

Component Description:
DTV Medical Notification
Amount:
$5,119.20
Broadcast General Store

Component Description:
Shively Flange
Amount:
$274.75

Component Description:
Burk SNMP
Amount:
$569.00
Prepare and or review reimbursement form

Component Description:
Legal Fees
Amount:
$2,500.00
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
Legal Fees
Amount:
$2,250.00
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Legal Fees
Amount:
$5,000.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Perform engineering study for new channel assignment and antenna development

Component Description:
Doug Vernier Engineering
Amount:
$4,950.00

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 $30,385.00 $29,825.00 N/A $7,354.60 N/A
Total for all systems $784,396.00 $246,181.00 N/A $115,357.43 N/A
Other Expenses $30,385.00 $29,825.00 $7,354.60
DTV Notification Services $0.00 $0.00 N/A $0.00 No Charge
Equipment Storage $4,000.00 $4,000.00 N/A $0.00 No Charge
Non-zoning permits $1,000.00 $1,000.00 N/A $0.00 No Charge
Disposal Costs (for equipment and other waste, net of any salvage value) $2,500.00 $2,500.00 N/A $0.00 No Charge
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A $5,119.20 N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A $0.00 N/A
MVPD Notification of Channel Change $2,500.00 $2,500.00 N/A $2,235.40 N/A
Develop and air announcement of upcoming channel change $2,500.00 $2,500.00 N/A $0.00 No Charge
Equipment Delivery and Handling Charges $6,000.00 $6,000.00 N/A $0.00 No Charge

Components

Actual Information Description File Name
DTV Notification Services Information not provided.
Equipment Storage Information not provided.
Non-zoning permits Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
DTV Medical Facility Notification

Component Description:
Medical
Amount:
$5,119.20
FCC Filing Fees - Form 2100 license to cover application Information not provided.
MVPD Notification of Channel Change

Component Description:
DTV
Amount:
$2,235.40
Develop and air announcement of upcoming channel change Information not provided.
Equipment Delivery and Handling Charges Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $784,396.00 $246,181.00 $115,357.43

Reimbursement Status

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Question Response
The facility has ceased operating on its pre-auction channel. Yes
Construction of final facilities or all necessary modifications are complete. Yes
All receipts for reimbursement have been submitted no further costs are expected to be incurred. Note this will lock the Form 399 from further editing and begin close-out procedures with the Fund Administrator. Yes

Certification

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Section Question Response
Submission of Estimated Expenses Statements

WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.

  1. The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.

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

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

  4. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD).

  5. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

  6. The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred.

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

  8. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.

I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Robert P DeNegri

CFO


08/12/2020

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.

Robert P DeNegri

CFO


08/12/2020

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.

Robert P DeNegri

CFO


08/12/2020

Attachments

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