TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
KJZZ Licensee, LLC Doing Business As: KJZZ Licensee, LLC	Harvey Arnold 10706 Beaver Dam Road Cockeysville, MD 21030 United States	+1 (410) 568-1500	FCCContacts@sbgtv.com	Limited Liability Company

Applicant

Address

Phone

Applicant Type

KJZZ Licensee, LLC

Doing Business As: KJZZ Licensee, LLC

Harvey Arnold

10706 Beaver Dam Road

Cockeysville, MD 21030

United States

+1 (410) 568-1500

FCCContacts@sbgtv.com

Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant	Address	Phone	Email
[Confidential]

Preparer Contact Information

Preparer Contact Name and Information

Applicant	Address	Phone	Email
Paul A Cicelski Lerman Senter PLLC	Paul Cicelski 2001 L Street, NW Suite 400 Washington, DC 20036 United States	+1 (202) 429-8970	pcicelski@lermansenter.com

Applicant

Address

Phone

Paul A Cicelski

Lerman Senter PLLC

Paul Cicelski

2001 L Street, NW

Suite 400

Washington, DC 20036

United States

+1 (202) 429-8970

pcicelski@lermansenter.com

Broadcaster Information and Transition Plan

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	See Exhibit A.

Transmitters

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

Primary Transmitter

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	DHD45P2
	Year	2001
	Type	Solid State
	Solid State Cooling	Air Cooled
	Solid State Power Capacity	10.5 kW

Primary Transmitter

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-16
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	25.5 kW
	Justification for New Transmitter	Per the manufacturer, the current transmitter cannot be retuned. See Exhibit B.

Primary Transmitter

Other Transmitter Costs

Section	Question	Response
Electrical Service	Service Entrance (3 phases 800A 208V)	No
	Switchgear (industrial 800 amp)	Yes
	Transformer (480V)	Yes
	Power	300 kVA
	Rigid Conduit and Wiring	Yes
	Size	2 inches
	Length	800.0 feet
	Other Electrical Service	No
	Description	N/A
HVAC Service	Does the replacement transmitter require HVAC Service?	Yes
	Type	Heating and Cooling
	Size	50 tons
	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

Other Transmitter Cost Not Listed

Name	Description
Large Parallel Remote Interface	Large Parallel Remote Interface
Additional parts	Additional parts
Band 5 Harmonic Filter	Band 5 Harmonic Filter
Dummy Load and Switches	Dummy Load and Switches
Replacement Services	Replacement Services

Interim Transmitter

New Transmitter Costs

Section	Question	Response
New Transmitter	Use	Interim
	Description of Use	N/A
	Change Type	Purchase
	Manufacturer
	Model	ULXTE-20
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	12 kW
	Justification for New Transmitter	This interim transmitter cost will be shared by the eight stations that are collocated on this tower, and will aid all of the stations in transitioning to their new channels considering the terrain and phase time constraints.

Interim Transmitter

Other Transmitter Costs

Section	Question	Response
Electrical Service	Service Entrance (3 phases 800A 208V)	No
	Switchgear (industrial 800 amp)	Yes
	Transformer (480V)	Yes
	Power	300 kVA
	Rigid Conduit and Wiring	Yes
	Size	2 inches
	Length	800.0 feet
	Other Electrical Service	No
	Description	N/A
HVAC Service	Does the replacement transmitter require HVAC Service?	Yes
	Type	Heating and Cooling
	Size	50 tons
	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
Inside RF System	Is an additional interior RF system required to support this interim transmitter?	Yes

Interim Transmitter

Other Transmitter Cost Not Listed

Information not provided.

Antennas

Section	Question	Response
Antenna Related Expenses	Do you have antenna related expenses?	Yes

Primary Antenna

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?	Yes
	Is the existing antenna directional?	Yes
	Is antenna in operating condition?	Yes
	Is antenna located on or in close proximity to an antenna farm?	Yes
Existing Antenna Manufacturer and Type	Class	Full Power
	Mounting	Top Mount
	Antenna position in stack	Top
	Polarization	Horizontal
	Type	Broadband Panel
	Number of Stations Supported	8
	Number of Panels	48
	Design power capacity in use	77.0 %
	Lower Limit	773.00 MHz
	Upper Limit	928.00 MHz
	Other Antenna Type	N/A
	ERP:	200.0 kW
	Manufacturer
	Model	773 928
	Year	1999

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

Facility ID	Call Sign
69396	KUED
69582	KUEN
1136	KUCW
35823	KUTV
6359	KSL-TV
6823	KBYU-TV
68889	KTVX

Primary Antenna

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?	Yes
New Antenna Manufacturer and Types	Class	Full Power
	Mounting	Top Mount
	Antenna position in stack	Bottom
	Polarization	Circular
	Type	Broadband Panel
	Number of Stations Supported	8
	Number of Panels/Bays	48
	Lower Limit	470.00 MHz
	Upper Limit	608.00 MHz
	Design power capacity in use	90.0 %
	Other Antenna Type	N/A
	ERP:	114.0 kW
	Manufacturer
	Model	759 25063
	Year	2017
	Justification for New Antenna	FROM MANUFACTURER. These panel antennas are finely tuned to a specific band, but the new repacked channels are not within the specific band, so the current antenna cannot be used for the new repack channel.

Primary Antenna

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	8
	Frequencies of channels supported	Upper and lower frequency
	Frequency	470.0 MHz - 608.0 MHz
	Do you need a combiner output splitter/switcher for dual feed lines?	Yes
Elbow Complex	Do you require the separate purchase of the Elbow Complex?	Yes
	Broadband or Single Channel?	Broadband
	Feed Line Size	6 1/8 inches inches
Side Mount Brackets	Do you require the separate purchase of side mount brackets for a high power antenna?
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

Other Antenna Cost Not Listed

Name	Description
Antenna Installation	Antenna Installation Cost
Other Costs	Other Costs

Transmission Line

Section	Question	Response
Transmission Line Related Expenses	Do you have transmission line related expenses?	No

Tower Equipment And Rigging Costs

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

Primary Tower

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)	Yes
	Others Types of Users	Yes
	Is tower documented for structural analysis?	Yes
	Is tower compliant with Rev G?	Yes
Existing Tower Structure Registration	Do you have a tower registration number?	Yes
Existing Tower Structure Registration	ASR Number	1062408
Coordinates (NAD83)	Latitude (NAD83)	40° 39' 33.0" N-
	Longitude (NAD83)	112° 12' 10.0" W-
	Overall Structure Height	308.40 feet
	Support Structure Height	308.40 feet
	Ground Elevation Above Mean Sea Level (AMSL)	9035.32 feet
	Structure Type	TOWER - Free Standing or Guyed Structure
	Tower Owner	DTV UTAH, LC
	Date Constructed	10/28/1999

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
6823	KBYU-TV	DTV
68889	KTVX	DTV
69396	KUED	DTV
69582	KUEN	DTV
35823	KUTV	DTV
6359	KSL-TV	DTV
1136	KUCW	DTV

Other Types of Users

Users
KPNZ - Telev
Go Go Air

Primary Tower

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:	Major Reinforcements needed

Primary Tower

Tower Rigging Costs

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

Primary Tower

Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

Section	Question	Response
Outside Project Management Services	Do you require outside project management services?	Yes
	Number of Hours	800
	Explanation	Outside consulting engineering, legal work, and accounting services, as well as project management for regional and comprehensive repack execution. See Exhibit K.
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	2
	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	2
	NEPA Section 106 environmental review	No
	Environmental Assessment	No
	ASR Modification	Yes
	FAA Consultation (including preparation of FAA Form 7460)	Yes
	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

Other Professional Services Expenses Not Listed

Name	Description
Sinclair Internal Costs	Internal Employee Time Costs

Other Expenses

Section	Question	Response
AM Pattern Disturbance	Is an Impact Study needed?	No
AM Pattern Disturbance	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	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

Other Expenses Not Listed

Name	Description
DTV Utah Operating Agreement Equity Equalization	Per Operating Agreement signed July 1998. See Exhibit M.
Garbage Disposal	Remove general garbage from mountaintop site (does not include equipment removal). Billed as used.
KSTU Mask Filter	Needed for KSTU (channel 28) to protect KUED (channel 27). See Exhibit N.
Road Maintenance	Snow plowing, grading, and repairs to existing road to remote mountaintop site. See Exhibit R.
Tax	Tax
Temporary Sanitation	For onsite workers. See Exhibit S.
Temporary Storage	For tools and equipment onsite and staging area off-site. See Exhibit P.
Transportation Services	Snow cat and helicopter to move equipment and personnel to remote mountaintop site during winter season. See Exhibit R.
True-up	True-up

Cost Information

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	$2,449,046.85	$1,442,594.76	N/A	$425,317.57	N/A
Total for all systems	$4,505,788.32	$2,782,857.46	N/A	$1,203,584.34	N/A
Interim Transmitter ULXTE-20	$1,003,800.00	$262,847.91		$161,538.33
Transformer 3 phase/480v - 300 KVA	$36,800.00	$4,375.00	This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item.	$0.00	N/A
Switchgear - industrial 800 amp	$38,200.00	$4,537.50	This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item.	$3,645.79	N/A
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW	$494,500.00	$137,542.91	This cost is shared with all DTV Utah stations and represents 1/6 of the cost of this item.	$98,682.30	N/A
50 Ton system	$266,000.00	$96,392.50	Updated cost estimate per FCC guidelines. Check quote for CCI and Quote for WHW. 1/6 share of the entire quotes added including added scope.	$53,707.98	N/A
UHF inside RF system including switching	$147,500.00	$17,500.00	This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item.	$5,502.26	N/A
2" Rigid Conduit and Wiring (Cost per foot)	$20,800.00	$2,500.00	This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item.	$0.00	N/A
Primary Transmitter THU9evo-16	$1,445,246.85	$1,179,746.85		$263,779.24
Dummy Load and Switches	$49,879.14	$49,879.14	N/A	$49,879.14	N/A
Band 5 Harmonic Filter	$6,230.30	$6,230.30	N/A	$6,230.30	N/A
Additional parts	$190.05	$190.05	N/A	$190.05	N/A
Large Parallel Remote Interface	$934.94	$934.94	N/A	$934.94	N/A
50 Ton system	$266,000.00	$30,000.00	This cost is shared with eight stations, six of which are repacked, and we estimate $180,000 total for the cost of this HVAC service.	$25,484.27	The need more information can be removed.
2" Rigid Conduit and Wiring (Cost per foot)	$20,800.00	$20,000.00	N/A	$0.00	N/A
Transformer 3 phase/480v - 300 KVA	$36,800.00	$35,000.00	N/A	$0.00	N/A
Switchgear - industrial 800 amp	$38,200.00	$36,300.00	N/A	$0.00	N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW	$947,000.00	$922,000.00	N/A	$101,848.12	N/A
Replacement Services	$79,212.42	$79,212.42	N/A	$79,212.42	The need more information can be removed.

Components

Actual Information Description	File Name
Transformer 3 phase/480v - 300 KVA	Information not provided.
Switchgear - industrial 800 amp	Component Description: 1/6 share of switchgear related cost for transmitter. #17470 Amount: $3,149.19 Component Description: 1/6 share of transmitter switchgear related cost. #17051 Amount: $496.60
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW	Component Description: 1/6 share of costs for interim transmitter. #US0311663 Amount: $5,412.88 Component Description: Transmitter related cost. #9511 Amount: $459.77 Component Description: 1/6 share of cost for interim transmitter. #JW30003982-DP Amount: $27,365.14 Component Description: Transmitter related cost. #9510 Amount: $514.00 Component Description: Transmitter downpayment. #9500074989 Amount: $40,494.81 Component Description: 1/6 share of cost for interim transmitter. #JW30003982-BS Amount: $27,365.14 Component Description: Transmitter related cost. #9514 Amount: $660.43 Component Description: 1/6 share of cost for interim transmitter. #US0310264 Amount: $21,682.94 Component Description: Install station specific transmitter electrical equipment. #717-100 Amount: $15,222.00
50 Ton system	Component Description: Interim Transmitter related cost, progress payment 4. #147696 Amount: $8,627.50 Component Description: Updated 1/6 share of transmitter related cost. #171552 Amount: $933.33 Component Description: Interim Transmitter related cost, progress payment 2. #143250 Amount: $11,163.83 Component Description: 1/6 share of transmitter related cost. #170701 Amount: $2,400.00 Component Description: 1/6 share of cost for HVAC project, payment 2. #143250 Amount: $11,163.83 Component Description: 1/6 share of the cost of the transmitter HVAC project. Payment 2. #170702 Amount: $266.66 Component Description: 1/6 share of costs for HVAC project, payment 4. #147696 Amount: $8,627.50 Component Description: Interim transmitter related cost, progress payment 1. #141941 Amount: $16,416.66 Component Description: Interim Transmitter related cost, progress payment 5. #10833x-718 Amount: $10,255.33 Component Description: 1/6 cost of HVAC project. #171551 Amount: $7,466.66 Component Description: 1/6 share of cost for transmitter HVAC project. #171552 Amount: $933.33 Component Description: 1/6 cost of HVAC project payment 1. #141941 Amount: $16,416.66 Component Description: 1/6 share of cost for HVAC work. #145734 Amount: $14,166.66 Component Description: 1/6 share of the cost of transmitter HVAC project. #170701 Amount: $2,400.00
UHF inside RF system including switching	Component Description: Transmitter related cost. #233001 Amount: $557.63 Component Description: 1/6 share of interim transmitter related cost. #GTIA-1024 Amount: $308.50 Component Description: 1/6 share of interim transmitter cost. #GTIA-1018 Amount: $603.26 Component Description: 1/6 share of interim transmitter related cost. #267999 Amount: $2,589.33 Component Description: 1/6 share of interim transmitter related cost. #268011 Amount: $6.06 Component Description: 1/6 share of interim transmitter related cost. #266916 Amount: $1,236.39 Component Description: 1/6 share for 25% of Transmitter related cost. #GTIA-1010 Amount: $201.09
2" Rigid Conduit and Wiring (Cost per foot)	Information not provided.
Dummy Load and Switches	Component Description: Transmitter related cost. #002073 Amount: $12,695.34 Component Description: Transmitter related cost. #9500083984 Amount: $11,753.50 Component Description: Transmitter related cost. #9500085346 Amount: $25,430.30
Band 5 Harmonic Filter	Component Description: Transmitter related cost. #9500077414 Amount: $1,538.64 Component Description: Transmitter related cost. #75049 Amount: $4,691.66
Additional parts	Component Description: Transmitter related cost. #129 Amount: $190.05
Large Parallel Remote Interface	Component Description: Transmitter related cost. #9500084006 Amount: $934.94
50 Ton system	Component Description: Transmitter related cost. #10833x-718 Amount: $10,225.33 Component Description: Transmitter related cost. #149290 Amount: $11,160.91 Component Description: Transmitter related cost. #156557 Amount: $626.10 Component Description: Transmitter related cost. #147347 Amount: $2,118.15 Component Description: Transmitter related cost. #10833x-718 Amount: $10,255.33 Component Description: Transmitter related cost. #002073 Amount: N/A Component Description: Transmitter related cost. #171553 Amount: $933.33 Component Description: Transmitter related cost. #SLC0116329 Amount: $153.79 Component Description: 1/6 share of costs for HVAC system. #141941 Amount: $16,416.66 Component Description: Transmitter related cost. #170702 Amount: $266.66
2" Rigid Conduit and Wiring (Cost per foot)	Information not provided.
Transformer 3 phase/480v - 300 KVA	Information not provided.
Switchgear - industrial 800 amp	Information not provided.
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW	Component Description: Transmitter related cost. #6894 Amount: N/A Component Description: Transmitter cost. #9500074989 Amount: $101,848.12
Replacement Services	Component Description: Transmitter related cost. #6894 Amount: $79,212.42 Component Description: Transmitter related cost. #6894 Amount: $79,212.42

Cost Information

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	$554,566.67	$681,600.19	N/A	$568,946.72	N/A
Total for all systems	$4,505,788.32	$2,782,857.46	N/A	$1,203,584.34	N/A
Primary Antenna 759 25063	$554,566.67	$681,600.19		$568,946.72
Other Costs	$50,873.70	$50,873.70	*System Notice: Estimate adjusted and locked because line has been superseded.*Updated estimated amount per FCC's requirement.	$36,765.06	N/A
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed)	$13,700.00	$8,014.01	N/A	$8,014.01	N/A
Antenna Installation	$23,062.97	$23,062.97	N/A	$23,062.97	N/A
New combiner, cost per channel (without antenna)	$84,200.00	$223,649.51	As per the request of the FCC	$223,649.51	The share of the cost is greater than expected because the FCC requested to use 1/6 share as opposed to 1/8 share of the cost. Please delete the old entries as the new ones are updated.
Sweep test of existing antenna	$6,730.00	$6,000.00	N/A	$3,157.24	N/A
UHF - High Power Top Mount Eight Station broadband panel antenna elliptically or circularly polarized	$250,000.00	$250,000.00	This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. See Exhibit D.	$238,471.92	N/A
Combiner output splitting/switching for dual feed lines, if applicable	$126,000.00	$120,000.00	The station now has an invoice with this cost separated as a line item, and is entering it in the 399 as such.	$35,826.01	The need more information for KSL and Burk can be removed.

Components

Actual Information Description	File Name
Other Costs	Component Description: 1/6 share of antenna installation. #GTIA-1004 Amount: $11,754.09 Component Description: Antenna related cost. #261013 Amount: $191.95 Component Description: 1/6 share of cost for antenna installation. #GTIA-1036 Amount: $23,508.19 Component Description: 1/6 share of antenna installation. #GTIA-1021 Amount: $798.45 Component Description: 1/6 share of cost for antenna installation. #GTIA-1012 Amount: $1,310.83 Component Description: 1/6 share of antenna installation cost. #GTIA-1011 Amount: $1,748.05 Component Description: 1/6 share of remainder antenna installation cost. #GTIA-1055 Amount: $11,754.09
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed)	Component Description: Antenna related cost. #230017 Amount: $917.06 Component Description: Antenna related cost. #90003 Amount: $1,309.50 Component Description: Antenna related cost. #75050 Amount: $992.51 Component Description: 1/6 share of cost for antenna installation related cost. #GTIA-1050 Amount: $4,794.94
Antenna Installation	Component Description: Antenna related cost. #GTIA-1011 Amount: $1,748.05 Component Description: Antenna related cost. #GTIA-1108 Amount: $4,445.72 Component Description: Antenna related cost. #GTIA-1055 Amount: $11,754.09 Component Description: Antenna related cost. #273029 Amount: $4,316.66 Component Description: Antenna installation related cost 1/6 of 25% down payment. #GTIA-1011 Amount: $1,748.05 Component Description: Antenna related cost. #GTIA-1021 Amount: $798.45
New combiner, cost per channel (without antenna)	Component Description: Antenna related cost. #00068513-3 Amount: $2,561.53 Component Description: Updated 1/6 share of antenna related cost. #GTIA-1086 Amount: $6,727.52 Component Description: 1/6 share of new combiner cost. #GTIA-1086 Amount: $6,727.52 Component Description: 1/6 share of new combiner cost last balance due. #00068513-3 Amount: $2,561.53 Component Description: 1/6 share of antenna related reduced cost. #23001 Amount: $90,717.50 Component Description: 1/6 share of costs for interim transmitter. #US0311888 Amount: $3,320.18 Component Description: 1/6 share of cost for the construction of a new combiner and monitor system. #00068513 Amount: $5,123.06 Component Description: Updated 1/6 share of antenna related cost. Amount: $113,396.87 Component Description: 1/6 of antenna related reduced cost. #CLE 068 RevD-DP Amount: $22,679.35 Component Description: 1/6 share of cost for the construction for a new combiner and monitor system. #00068513 Amount: $5,123.06 Component Description: 1/6 share of antenna related reduced cost. #25008 Amount: $90,717.49 Component Description: 1/6 share of the second payment that is due for the associated new combiner cost. #00068513-2 Amount: $5,123.06
Sweep test of existing antenna	Component Description: 1/6 share of cost for antenna sweep test. #GTIA-1001 Amount: $329.16 Component Description: 1/6 share of cost for antenna sweep test. #GTIA-1000 Amount: $2,828.08
UHF - High Power Top Mount Eight Station broadband panel antenna elliptically or circularly polarized	Component Description: Antenna related cost. #GTIA-1111 Amount: $3,333.33 Component Description: 1/6 share of high power antenna cost. #STS87757-1 Amount: $4,160.41 Component Description: 1/6 share of progress payment for high power antenna related cost. #GTIA-1049 Amount: $6,400.09 Component Description: 1/6 share of antenna cost. #GTIA-1037 Amount: $7,710.92 Component Description: 1/6 share of final invoice for antenna related cost. #GTIA-1054 Amount: $9,575.39 Component Description: 1/6 share for second incremental invoice (25% of total) of High Power antenna installation. #GTIA-1035 Amount: $47,876.97 Component Description: 1/6 share for 25% down payment for Antenna related costs. #GTIA-1003 Amount: $7,710.92 Component Description: 1/6 share of cost for antenna installation. #GTIA-1057 Amount: $4,794.94 Component Description: 1/6 share of progress payment for high power antenna cost. #GTIA-1048 Amount: $86,178.56 Component Description: 1/6 share of cost for antenna installation. #GTIA-1002 Amount: $5,142.50 Component Description: 1/6 share for 25% of antenna related cost. #GTIA-1005 Amount: $47,876.97 Component Description: 1/6 share of final 25% invoiced for antenna related cost. #GTIA-1056 Amount: $7,710.92
Combiner output splitting/switching for dual feed lines, if applicable	Component Description: Antenna related cost. #0000000407 Amount: $213.19 Component Description: Antenna related cost. #US0311888 Amount: $3,320.18 Component Description: Antenna related cost. #273003 Amount: $22,679.29 Component Description: Antenna related cost. #0000000507 Amount: $246.05 Component Description: Antenna related cost. #414 Amount: $216.88 Component Description: Antenna related cost. #717-107 Amount: $106.33 Component Description: Antenna related cost. #69115 Amount: $3,906.86 Component Description: Combiner cost. #00068513-3 Amount: $2,561.53 Component Description: Antenna related cost. #6898 Amount: $2,321.33 Component Description: Antenna related cost. #403 Amount: $277.43 Component Description: Antenna related cost. #318 Amount: $61.85 Component Description: Antenna related cost. #242051 Amount: $406.25 Component Description: Antenna related cost. #0000000406 Amount: $4.51 Component Description: Antenna related cost. #235015 Amount: $1,401.51 Component Description: Antenna related cost. #0000000404 Amount: $196.25 Component Description: Antenna related cost. #00068513-3 Amount: $2,561.53 Component Description: Combiner related cost. #0000000318 Amount: $61.85 Component Description: Antenna related cost. #236006 Amount: $406.25

Cost Information

Transmission Line

Information not provided.

Cost Information

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	$854,600.00	$101,500.00	N/A	$2,413.47	N/A
Total for all systems	$4,505,788.32	$2,782,857.46	N/A	$1,203,584.34	N/A
Primary Tower TOWER	$854,600.00	$101,500.00		$2,413.47
Structural engineering tower load study for well documented tower	$12,600.00	$1,500.00	This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item.	$898.32	N/A
Major tower reinforcement/modifications	$421,000.00	$50,000.00	This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item.	$1,515.15	N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)	$421,000.00	$50,000.00	This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. See Exhibit L for partial cost.	$0.00	N/A

Components

Actual Information Description	File Name
Structural engineering tower load study for well documented tower	Component Description: 1/6 Share of cost for tower engineering study. #GTIA-1025 Amount: $671.66 Component Description: 1/6 share of cost for one month of structural engineering & design services. #8895 Amount: $226.66
Major tower reinforcement/modifications	Component Description: 1/6 share of tower related cost. #GTIA-1087 Amount: $1,515.15
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)	Information not provided.

Cost Information

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	$276,919.10	$187,586.81	N/A	$163,028.38	N/A
Total for all systems	$4,505,788.32	$2,782,857.46	N/A	$1,203,584.34	N/A
Outside Professional Services	$276,919.10	$187,586.81		$163,028.38
Project management of the transition	$126,400.00	$120,000.00	N/A	$109,254.97	N/A
RF Exposure Measurements	$21,050.00	$18,296.87	This cost is shared with all DTV Utah stations and represents 1/6 of the cost of this item.	$18,296.87	.
Sinclair Internal Costs	$409.10	$409.10	N/A	$409.10	.
Comprehensive coverage verification via field study, if needed	$84,200.00	$10,000.00	This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item.	$3,468.50	N/A
ASR modification (prepare FCC Form 854)	$2,105.00	$2,000.00	N/A	$0.00	N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization	$7,360.00	$659.45	N/A	$659.45	N/A
Attorney Fees - Negotiation of lease and other matters for shared locations	$4,210.00	$3,043.64	N/A	$3,043.64	N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	$2,365.00	$0.00	N/A	$0.00	N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	$5,260.00	$221.92	N/A	$221.92	.
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase	$2,105.00	$2,000.00	N/A	$0.00	N/A
Prepare request for Special Temporary Authorization	$4,100.00	$3,000.00	N/A	$2,565.00	N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	$1,580.00	$5,785.83	See Carl T. Jones invoices	$5,785.83	N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	$3,155.00	$10,170.00	See Carl T. Jones invoices	$10,170.00	N/A
Perform engineering study for new channel assignment and antenna development	$7,360.00	$7,000.00	N/A	$6,360.00	N/A
Prepare and or review reimbursement form	$2,630.00	$2,500.00	N/A	$2,418.10	N/A
Address transition timing and coordination issues w/ other stations and wireless	$2,630.00	$2,500.00	N/A	$375.00	N/A

Components

Actual Information Description	File Name
Project management of the transition	Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1123 Amount: $342.14 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #477820 Amount: $320.19 Component Description: Updated 1/6 share of outside consulting cost. #18-00056 Amount: $1,046.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 99 stations. #469573 Amount: $377.14 Component Description: 1/6 share of outside consulting cost. #18-00008 Amount: $545.14 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1105 Amount: $216.88 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #132 Amount: $589.44 Component Description: Legal Service Cost. #476372 Amount: $102.50 Component Description: 1/6 outside professional service cost. #17-0049 Amount: $703.95 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #107 Amount: $602.28 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #470923 Amount: $406.65 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #118 Amount: $468.97 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1090 Amount: $176.70 Component Description: Legal Service Cost. #472178 Amount: $956.25 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1130 Amount: $281.49 Component Description: Legal Service Cost. #475289 Amount: $757.50 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1045 Amount: $185.10 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #1010 Amount: $86.88 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #465173 Amount: $654.26 Component Description: 1/6 share of outside consulting cost. #18-00061 Amount: $2,803.83 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1145 Amount: $369.98 Component Description: Portion of general repack matter invoice attributable to this station - divided by 33 stations. #288 Amount: $1,726.96 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #479285 Amount: $372.60 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #471524 Amount: $322.83 Component Description: Legal Service Cost. #470875 Amount: $51.25 Component Description: Legal Service Cost. #473891 Amount: $1,168.75 Component Description: Outside professional service cost. #17-0021 Amount: $1,102.36 Component Description: Legal Service Cost. #470915 Amount: $212.50 Component Description: Legal Service Cost. #471530 Amount: $893.75 Component Description: 1/6 outside professional service cost. #17-0036 Amount: $916.62 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1133 Amount: $307.72 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #479829 Amount: $458.99 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #476885 Amount: $403.34 Component Description: Outside professional service cost. #19-0087 Amount: $1,112.19 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #470237 Amount: $436.37 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #467861 Amount: $470.30 Component Description: Legal Service Cost. #471525 Amount: $780.70 Component Description: Outside professional service cost. #854957 Amount: $357.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1098 Amount: $238.07 Component Description: Outside professional service cost. #859300 Amount: $362.91 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #478288 Amount: $194.86 Component Description: Legal Service Cost. #472589 Amount: $1,921.25 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1117 Amount: $282.68 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #468718 Amount: $349.51 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1093 Amount: $265.72 Component Description: Outside professional service cost. #18-045 Amount: $202.70 Component Description: Portion of general repack matter invoice attributable to this station - divided by 48 stations. #309 Amount: $1,299.46 Component Description: Portion of general repack matter invoice attributable to this station - divided by 33 stations. #486788 Amount: $583.82 Component Description: Portion of general repack matter invoice attributable to this station - divided by 43 stations. #306 Amount: $1,691.34 Component Description: Legal services cost. #487957 Amount: $57.50 Component Description: Portion of general repack matter invoice attributable to this station - divided by 59 stations. #295 Amount: $997.50 Component Description: Legal Service Cost. #469584 Amount: $963.75 Component Description: Portion of general repack matter invoice attributable to this station - divided by 46 stations. #485240 Amount: $541.57 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #480175 Amount: $377.96 Component Description: Legal Service Cost. #473544 Amount: $1,548.95 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #474405 Amount: $490.56 Component Description: Outside professional service cost. #18-119 Amount: $14.58 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #475283 Amount: $384.08 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #475744 Amount: $305.99 Component Description: Legal services cost. #487612 Amount: $57.50 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #473885 Amount: $318.62 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #453972 Amount: $716.28 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #476367 Amount: $364.80 Component Description: Legal Service Cost. #467387 Amount: $209.07 Component Description: Legal Service Cost. #464259 Amount: $575.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #472583 Amount: $279.89 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #473506 Amount: $421.40 Component Description: Portion of general repack matter invoice attributable to this station - divided by 43 stations. #487620 Amount: $337.32 Component Description: Outside professional service cost. #18-00039 Amount: $17.82 Component Description: Legal Service Cost. #478786 Amount: $1,417.70 Component Description: Legal services cost. #464259 Amount: $575.00 Component Description: Legal Service Cost. #467387 Amount: $209.07 Component Description: Legal services cost. #485259 Amount: $100.00 Component Description: Legal Service Cost. #473966 Amount: $57.50 Component Description: Legal Service Cost. #467497 Amount: $564.20 Component Description: Legal Service Cost. #468722 Amount: $57.50 Component Description: 1/6 share of outside consulting cost. #18-00017 Amount: $359.67 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #1029 Amount: $20.91 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #457851 Amount: $818.59 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #450412 Amount: $999.04 Component Description: 1/6 share of outside consulting services. #18-00043 Amount: $1,215.74 Component Description: 1/6 share of outside consulting cost. #17-0036 Amount: $916.62 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1063 Amount: $262.29 Component Description: 1/6 share of outside consulting cost. #191 Amount: $1,200.00 Component Description: Consulting cost. #1800032 Amount: $101.15 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1167 Amount: $313.41 Component Description: Outside professional service cost. #18-00074 Amount: $754.52 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759 Amount: $29.98 Component Description: Legal services cost. #487020 Amount: $58.75 Component Description: Portion of general repack matter invoice attributable to this station - divided by 60 stations. #487016 Amount: $267.75 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #466690 Amount: $446.87 Component Description: updated 1/6 share of outside consulting cost. #17-000137 Amount: $699.66 Component Description: 1/6 outside professional service cost. #17-0026 Amount: $916.41 Component Description: 1/6 share of costs for engineering consulting cost. #GTIA-1038 Amount: $1,750.00 Component Description: Legal service cost. #457856 Amount: $3,745.80 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #1012 Amount: $20.65 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1141 Amount: $406.17 Component Description: 1/6 share of cost for engineering consulting costs. #GTIA-1007 Amount: $2,763.54 Component Description: Outside professional service cost. #18-00039 Amount: $19.32 Component Description: 1/6 share of outside consulting service cost. #17-0053 Amount: $445.45 Component Description: Legal Service Cost. #465184 Amount: $4,462.50 Component Description: 1/6 share of outside consulting service cost. #17-0049 Amount: $703.95 Component Description: Outside professional service cost. #18-00069 Amount: $1,057.25 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #457331 Amount: $836.44 Component Description: Legal services cost. #464698 Amount: $240.00 Component Description: Legal services cost. #463022 Amount: $5,586.40 Component Description: 1/6 share of consulting cost. #18-00027 Amount: $525.66 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1114 Amount: $242.25 Component Description: Legal services cost. #460941 Amount: $765.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1078 Amount: $215.68 Component Description: Legal services cost. #477825 Amount: $57.50 Component Description: 1/6 share of outside consulting services. #GTIA-1007 Amount: $2,763.54 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #467378 Amount: $576.96 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1051 Amount: $105.97 Component Description: 1/6 share of outside consulting service cost. #17-00137 Amount: $699.66 Component Description: 1/6 share of outside consulting service cost. #17-0021 Amount: $1,102.36 Component Description: Updated outside consulting services. #1080 Amount: $4,032.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #472985 Amount: $282.68 Component Description: Outside professional service cost. #0000002214 Amount: $876.75 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1069 Amount: $246.68 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1055 Amount: $243.38 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1111 Amount: $159.58 Component Description: Legal services cost. #464356 Amount: $1,250.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #472173 Amount: $311.78 Component Description: Legal Service Cost. #471619 Amount: $1,773.75 Component Description: Outside professional service cost. #857095 Amount: $68.00 Component Description: $26,919.78 credit to be split across 93 Sinclair stations reimbursed $999.20 for Invoice 461759 (correct reimbursement amount is $709.74). #CM-11-21-2019-461759 Amount: ($289.46) Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1156 Amount: $399.52 Component Description: Legal Service Cost. #467895 Amount: $318.75 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1143 Amount: $436.90 Component Description: Legal Service Cost. #472993 Amount: $2,656.90 Component Description: 1/6 share of outside consulting cost. #17-0059 Amount: $696.62 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289 Amount: $91.50 Component Description: 1/6 share of outside consulting cost. #18-00037 Amount: $837.25 Component Description: Legal Service Cost. #466699 Amount: $1,760.95 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1039 Amount: $30.47 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #477305 Amount: $393.53 Component Description: 1/6 share of outside consulting service cost. #17-0042 Amount: $891.87 Component Description: Outside professional service cost. #19-0002 Amount: $182.02 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #478780 Amount: $271.41 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1058 Amount: $187.24 Component Description: Legal Service Cost. #468747 Amount: $2,552.90 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #463567 Amount: $566.48 Component Description: 1/6 outside professional service cost. #17-0053 Amount: $445.45 Component Description: Outside professional service cost. #18-069 Amount: $29.16 Component Description: Legal services cost. #474816 Amount: $562.50 Component Description: Legal services cost. #474912 Amount: $313.75 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #464321 Amount: $683.07 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1079 Amount: $177.14 Component Description: Legal Service Cost. #470280 Amount: $523.75 Component Description: 1/6 share of outside consulting services. #18-00056 Amount: $1,046.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1072 Amount: $237.64 Component Description: Outside professional service cost. #858220 Amount: $640.66 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #1032 Amount: $43.72 Component Description: Portion of general repack matter invoice attributable to this station - divided by 46 stations. #247 Amount: $1,105.31 Component Description: updated 1/6 share of outside consulting services. #17-0036 Amount: $916.62 Component Description: Legal services cost. #478786 Amount: $1,417.70 Component Description: 1/6 share of outside consulting services. #18-00065 Amount: $1,497.06 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1151 Amount: $388.07 Component Description: Legal Service Cost. #467841 Amount: $1,988.40 Component Description: 1/6 share of outside consulting cost. #18-00005 Amount: $742.45 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #463026 Amount: $801.57 Component Description: 1/6 share of outside consulting cost. #18-00039 Amount: $17.82 Component Description: Outside Consulting Cost. #1080 Amount: $4,032.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1161 Amount: $267.48 Component Description: 1/6 share of outside consulting cost. #18-00031 Amount: $521.19 Component Description: Outside professional service cost. #18-00005 Amount: $742.45 Component Description: 1/6 share of outside consulting cost. #18-00023 Amount: $358.38 Component Description: Legal services cost. #463575 Amount: $250.00 Component Description: Legal services cost. #453970 Amount: $172.50 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #1022 Amount: $32.35 Component Description: Legal Service Cost. #475750 Amount: $861.25 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #453686 Amount: $943.95 Component Description: Portion of general repack matter invoice attributable to this station - divided by 99 stations. #1086 Amount: $275.35 Component Description: 1/6 share of outside consulting service cost. #17-0026 Amount: $916.41 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #474809 Amount: $395.77 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #465001 Amount: $596.30 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1099 Amount: $266.93
RF Exposure Measurements	Component Description: RF related cost. #202023 Amount: $4,000.00 Component Description: 1/6 share of the outside professional service. #7251 Amount: $14,296.87
Sinclair Internal Costs	Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $23.96 Component Description: Portion of general repack matter invoice attributable to this station - divided by 35 stations. Amount: $30.43 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $6.09 Component Description: Portion of general repack matter invoice attributable to this station - divided by 46 stations. Amount: $1.53 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $7.96 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $11.39 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $11.03 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $26.93 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $15.08 Component Description: Portion of general repack matter invoice attributable to this station - divided by 35 stations. Amount: $5.25 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $7.86 Component Description: Portion of general repack matter invoice attributable to this station - divided by 48 stations. Amount: $24.96 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $8.66 Component Description: Portion of general repack matter internal time card attributable to this station - divided by 100. Amount: $66.55 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $17.02 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $16.53 Component Description: Portion of general repack matter invoice attributable to this station - divided by 60 stations. Amount: $4.95 Component Description: Portion of general repack matter invoice attributable to this station - divided by 60 stations. Amount: $23.77 Component Description: Portion of general repack matter invoice attributable to this station - divided by 46 stations. Amount: $23.56 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $5.37 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $33.53 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $9.47 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $25.53 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $1.69
Comprehensive coverage verification via field study, if needed	Component Description: Coverage cost. #17174 Amount: $3,468.50
ASR modification (prepare FCC Form 854)	Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization	Component Description: Updated 1/6 share of special temporary authorization cost. #18-032A Amount: $659.45 Component Description: 1/6 share of professional legal service cost. #18-032A Amount: $659.45
Attorney Fees - Negotiation of lease and other matters for shared locations	Component Description: 1/6 share of legal service cost. #843151 Amount: $1,960.50 Component Description: 1/6 share of legal service cost. #857095 Amount: $68.00 Component Description: 1/6 share of legal service cost. #844167 Amount: $501.40 Component Description: 1/6 share of legal service cost. #842108 Amount: $165.91 Component Description: 1/6 share of legal service cost. #854957 Amount: $357.00 Component Description: 1/6 share of legal cost. #856027 Amount: $415.83
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289 Amount: $122.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759 Amount: $99.92
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase	Information not provided.
Prepare request for Special Temporary Authorization	Component Description: Outside professional service cost. #878-74-0004 Amount: $2,565.00 Component Description: Outside professional service cost. #878-74-0004 Amount: $2,565.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	Component Description: Outside professional service cost. #878-74-0006 Amount: $4,567.50 Component Description: Outside professional service cost. #09282018 Amount: $933.33 Component Description: Outside professional service cost. #878-74-0007 Amount: $285.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	Component Description: Outside professional service cost. #878-74-0005 Amount: $5,797.50 Component Description: Outside professional service cost. #878-74-0002 Amount: $1,987.50 Component Description: Consulting engineering cost. #878-74-0001 Amount: $2,385.00 Component Description: Outside professional service cost. #878-74-0002 Amount: $1,987.50
Perform engineering study for new channel assignment and antenna development	Component Description: Consulting engineering services. #878-74-0001 Amount: $2,655.00 Component Description: Consulting engineering cost. #858-64-0001 Amount: $3,705.00
Prepare and or review reimbursement form	Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $152.01 Component Description: Legal services cost. #461804 Amount: $85.31 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289 Amount: $1,311.48 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759 Amount: $869.30
Address transition timing and coordination issues w/ other stations and wireless	Component Description: Legal services cost. Amount: $375.00

Cost Information

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	$370,655.70	$369,575.70	N/A	$43,878.20	N/A
Total for all systems	$4,505,788.32	$2,782,857.46	N/A	$1,203,584.34	N/A
Other Expenses	$370,655.70	$369,575.70		$43,878.20
True-up	$0.00	$0.00	N/A	($7,199.22)	N/A
Transportation Services	$5,000.00	$5,000.00	This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. To be used during inclement weather.	$1,871.65	N/A
Temporary Storage	$4,000.00	$4,000.00	This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. See Exhibit P.	$1,927.50	N/A
Temporary Sanitation	$3,000.00	$3,000.00	This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. See Exhibit S. Estimate is based on past experience at this site.	$0.00	N/A
FCC Filing Fees - Special Temporary Authorization request	$195.00	$0.00	N/A	$0.00	N/A
FCC Filing Fees - Form 2100 license to cover application	$335.00	$0.00	N/A	$0.00	N/A
DTV Medical Facility Notification	$11,550.00	$11,000.00	N/A	$4,549.00	N/A
Non-zoning permits	$1,875.00	$1,875.00	This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item.	$0.00	N/A
Disposal Costs (for equipment and other waste, net of any salvage value)	$28,566.00	$28,566.00	See Exhibit U.	$248.33	N/A
Equipment Delivery and Handling Charges	$11,440.22	$11,440.22	This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. See Exhibit P.	$11,440.22	N/A
Develop and air announcement of upcoming channel change	$28,050.00	$28,050.00	See Exhibit T.	$0.00	N/A
MVPD Notification of Channel Change	$5,000.00	$5,000.00	N/A	$0.00	N/A
DTV Utah Operating Agreement Equity Equalization	$223,083.00	$223,083.00	See Exhibit M.	$0.00	N/A
Garbage Disposal	$1,500.00	$1,500.00	This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. Billed as used, but the estimate is based on past experience at this site.	$1,212.50	N/A
KSTU Mask Filter	$6,756.25	$6,756.25	Mask filter to remedy adjacent channel problem with KSTU. This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. See Exhibit N.	$0.00	N/A
Road Maintenance	$10,000.00	$10,000.00	This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. See Exhibit R.	$0.00	N/A
Tax	$26,305.23	$26,305.23	N/A	$26,305.23	x
Equipment Storage	$4,000.00	$4,000.00	This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. See Exhibit Q.	$3,522.99	N/A

Components

Actual Information Description	File Name
True-up	Component Description: Dielectric Credit Memo. #CM-2021-10-01-KJZZ Amount: ($7,199.22)
Transportation Services	Component Description: 1/6 share of costs for transportation service. #900 Amount: $507.50 Component Description: Transportation cost. #1838-1 Amount: $216.66 Component Description: 1/6 share of cost for transportation service. #932 Amount: $362.50 Component Description: 1/6 share of transportation service cost. #1783 Amount: $108.33 Component Description: 1/6 share of cost for transportation service. #905 Amount: $676.66 Component Description: 1/6 Share of cost for transportation service. #932 Amount: $362.50
Temporary Storage	Component Description: Storage cost. #1 Amount: $1,927.50 Component Description: Temporary storage unit cost. #5-1-2017 Amount: $1,927.50 Component Description: Updated 1/6 share of temporary storage cost. #5-1-2017 Amount: $1,927.50
Temporary Sanitation	Information not provided.
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	Component Description: 1/6 share of DTV Medical Facility Notification. #INV-001827 Amount: $2,164.00 Component Description: 1/6 share of DTV Notification Service cost. #INV-001775 Amount: $2,385.00
Non-zoning permits	Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value)	Component Description: Disposal related cost. #85285 Amount: $173.33 Component Description: Equipment disposal cost. #10848 Amount: $75.00
Equipment Delivery and Handling Charges	Component Description: 1/6 share of cost for equipment rental and delivery. #179518 Amount: $503.82 Component Description: Equipment delivery and handling cost. #250008 Amount: $2,325.91 Component Description: Equipment delivery and handling cost. #0000002268 Amount: $955.98 Component Description: Equipment delivery and handling cost. #1862 Amount: $216.66 Component Description: Equipment delivery and handling cost. #0029311-IN Amount: $28.33 Component Description: Equipment delivery and handling. #0029274-IN Amount: $99.16 Component Description: Updated 1/6 share of cost for equipment delivery and handling. Amount: $264.97 Component Description: 1/6 share of equipment delivery and handling cost. #0029166-AD Amount: $14.16 Component Description: 1/6 share of equipment delivery and handling cost. #239940A Amount: $100.00 Component Description: 1/6 share of cost for equipment handling and transportation services. #0029150-IN Amount: $14.16 Component Description: 1/6 share of cost for equipment handling and transportation service. #0029079-IN Amount: $70.83 Component Description: Equipment delivery and handling cost. #1916 Amount: $241.66 Component Description: 1/6 share of equipment delivery and handling cost. #228748A Amount: $100.00 Component Description: 1/6 share of equipment delivery and handling cost. #239584A Amount: $68.75 Component Description: Equipment delivery and handling cost. #1838 Amount: $108.33 Component Description: Equipment delivery and handling cost. #237008 Amount: $443.17 Component Description: 1/6 share of cost for equipment handling and transportation service. #0029097-IN Amount: $77.91 Component Description: 1/6 share of cost for equipment and delivery. #189068-2 Amount: $385.58 Component Description: 1/6 share of cost for equipment handling and transportation services. #0029132-IN Amount: $42.50 Component Description: Equipment delivery and handling cost. #0029281-IN Amount: $308.33 Component Description: 1/6 share of equipment delivery and handling cost. #239583A Amount: $68.75 Component Description: 1/6 share of equipment delivery and handling cost. #189068 Amount: $1,020.24 Component Description: 1/6 share of cost for equipment handling and transportation services. #0029199-IN Amount: $28.33 Component Description: Equipment delivery and handling cost. #19-022 Amount: $727.51 Component Description: 1/6 share of equipment delivery and handling cost. #189065 Amount: $265.99 Component Description: 1/6 share of equipment delivery and handling cost. #9450 Amount: $1,553.69 Component Description: 1/6 share of cost for equipment handling and transportation services. #0029115-IN Amount: $55.66 Component Description: 1/6 share of equipment delivery and handling. #189067 Amount: $176.98 Component Description: 1/6 share of equipment delivery and handling cost. #100 Amount: $40.83 Component Description: Equipment delivery and handling reduced by 8.40%. #279013 Amount: $885.52 Component Description: 1/6 share of equipment delivery/handling cost. #244363A Amount: $62.50 Component Description: Freight cost. #239058A Amount: $450.00
Develop and air announcement of upcoming channel change	Information not provided.
MVPD Notification of Channel Change	Information not provided.
DTV Utah Operating Agreement Equity Equalization	Information not provided.
Garbage Disposal	Component Description: 1/6 share of garbage disposal cost. #10581 Amount: $300.00 Component Description: 1/6 share of garbage disposal cost. #10723 Amount: $225.00 Component Description: 1/6 share of garbage disposal cost. #10786 Amount: $150.00 Component Description: Garbage disposal. #10184 Amount: $312.50 Component Description: 1/6 share of garbage disposal cost. #10660 Amount: $225.00
KSTU Mask Filter	Information not provided.
Road Maintenance	Information not provided.
Tax	Component Description: Use Tax cost. #2018-Q3 UseTax Amount: $24,781.56 Component Description: Use tax cost. #2018-Q2 UseTax Amount: $91.81 Component Description: Use tax cost. #2018-Q4 UseTax Amount: $1,075.62 Component Description: Use Tax cost. #2018-Q1 UseTaxCorrected Amount: $17.81 Component Description: Use tax cost. #2017-Q4 UseTax Amount: $284.98 Component Description: Use tax cost. #2018-Q1 UseTax Amount: $53.45
Equipment Storage	Component Description: 1/6 share of cost for equipment storage. #002901-IN Amount: $120.83 Component Description: Equipment storage cost. #1-47568 Amount: $33.33 Component Description: 1/6 share of equipment storage cost. #0029122-IN Amount: $187.50 Component Description: 1/6 share of equipment storage cost. #0029234-IN Amount: $308.33 Component Description: 1/6 share of equipment storage cost. #0029104-IN Amount: $187.50 Component Description: 1/6 share of cost for equipment storage. #0029058-IN Amount: $187.50 Component Description: 1/6 share of equipment storage cost. 0029156-IN Amount: $187.50 Component Description: 1/6 share of equipment storage cost. #0029104-IN Amount: $187.50 Component Description: 1/6 share of equipment storage cost. #0029188-IN Amount: $187.50 Component Description: 1/6 share of equipment storage cost. #0029141-IN Amount: $187.50 Component Description: 1/6 share of equipment storage cost. #0029169-IN Amount: $187.50 Component Description: 1/6 share of equipment storage cost. #0029220-IN Amount: $308.33 Component Description: 1/6 share of equipment storage cost. #0029246-IN Amount: $308.33 Component Description: 1/6 share of equipment storage cost. #0029086 Amount: $187.50 Component Description: 1/6 share of equipment storage cost. #0029262-IN Amount: $308.33 Component Description: 1/6 share of equipment storage cost. #9568587381 Amount: $139.68 Component Description: 1/6 share of equipment storage cost. #0029067-In Amount: $187.50 Component Description: 1/6 share of cost for equipment storage. #0029207-IN Amount: $308.33

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$4,505,788.32	$2,782,857.46	$1,203,584.34

Reimbursement Status

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

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.
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. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. 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). 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. 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. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. 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.	Lucy Rutishauser CFO 10/01/2021

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.

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.
The above-named entity acknowledges that all certifications and attached documentation are considered material representations.
The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.
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).
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.
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.
The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.
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.

Lucy Rutishauser

CFO

10/01/2021

Certification

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).
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 certifies that the statements in this form and attached documentation are true, complete, and correct. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. 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) . 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. The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. 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.	Lucy Rutishauser CFO 10/01/2021

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).

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 certifies that the statements in this form and attached documentation are true, complete, and correct.
The above-named entity acknowledges that all certifications and attached documentation are considered material representations.
The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.
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) .
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.
The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred.
The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.
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.

Lucy Rutishauser

CFO

10/01/2021

(REFERENCE COPY - Not for submission) FCC Form 399: Reimbursement Request

Applicant Information

Applicant Name, Type, and Contact Information

Reimbursement Contact Information

Reimbursement Contact Name and Information

Preparer Contact Information

Preparer Contact Name and Information

Broadcaster Information and Transition Plan

Transmitters

Primary Transmitter

Existing Transmitter Information

Primary Transmitter

New Transmitter Costs

Primary Transmitter

Other Transmitter Costs

Primary Transmitter

Other Transmitter Cost Not Listed

Interim Transmitter

New Transmitter Costs

Interim Transmitter

Other Transmitter Costs

Interim Transmitter

Other Transmitter Cost Not Listed

Antennas

Primary Antenna

Existing Antenna Information

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

Primary Antenna

New Antenna Costs

Primary Antenna

Other Antenna Costs

Primary Antenna

Other Antenna Cost Not Listed

Transmission Line

Tower Equipment And Rigging Costs

Primary Tower

Existing Tower

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

Other Types of Users

Primary Tower

Tower Modification Costs

Primary Tower

Tower Rigging Costs

Primary Tower

Other Tower Expenses Not Listed

Outside Professional Services Costs

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Other Expenses

Other Expenses

Other Expenses Not Listed

Cost Information

Transmitters

Components

Cost Information

Antennas

Components