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:
35575
Service:
DTV
Call Sign:
WTVX
Channel:
20 (UHF)
File Number:
0000028831
FRN:
0021144092
Date Submitted:
08/26/2021

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

WTVX Licensee, LLC

Harvey Arnold

10706 Beaverdam Rd

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

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Preparer Contact Name and Information

Applicant Address Phone Email

Paul A. Cicelski , Esq .

Lerman Senter PLLC

Paul A. Cicelski

2001 L Street, NW

Suite 400

Washington, DC 20036

United States

+1 (202) 429-8970 pcicelski@lermansenter.com

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan See Exhibit A.

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 Sigma CD3200P2
Year 2002
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 50 kW

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Manufacturer
Model THU9-24
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 37 kW
Justification for New Transmitter Per the manufacturer, the current transmitter cannot be retuned. See Exhibit B.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) Yes
Transformer (480V) Yes
Power 300 kVA
Rigid Conduit and Wiring Yes
Size 2 inches
Length 800.0 feet
Other Electrical Service Yes
Description Electrical Installation
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

Information not provided.

Antennas

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

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type Class Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 1000.0 kW
Manufacturer
Model TFU-30JTT-P216
Year 1998

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 737.0 kW
Manufacturer
Model TFU-24JTT/VP-R P216
Year 2017
Justification for New Antenna Current antenna is a single channel antenna that cannot be used for the new post-auction channel.

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? No
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? N/A
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Single Channel
Feed Line Size 8 3/16 inches inches
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

Information not provided.

Interim Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Broadband Panel
Number of Stations Supported 1
Number of Panels/Bays 16
Lower Limit 470.00 MHz
Upper Limit 598.00 MHz
Design power capacity in use 100.0 %
Other Antenna Type N/A
ERP: 200.0 kW
Manufacturer
Model TFU-16WB-1-R
Year 2017
Justification for New Antenna Interim antenna to be used to stay on the air while the main antenna undergoes construction for the post-auction channel change.

Interim Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? B
Feed Line Size 3 1/8 inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for an antenna? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Interim Antenna

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Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 8 3/16 inches
Other Diameter N/A
Segment Length 19 1/2 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1525 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Rigid
Diameter 8 3/16 inches
Other Diameter N/A
Segment Length 19 1/2 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1550 feet per run
Justification for New Transmission Line Old transmission line has been obsolete for over 35 years and is no longer supported by Dielectric.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Interim Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Interim
Description of Use N/A
Change Type Purchase New
Type Rigid
Diameter 3 1/8 inches
Segment Length 19 ½ '
Other Segment Length
Number of parallel runs 1
Length 600 feet per run
Justification for New Transmission Line Interim transmission line will feed the interim antenna.

Interim Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Owned
Is this tower consider Complex? No
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users Yes
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1029632
Coordinates (NAD83) Latitude (NAD83) 27° 07' 20.0" N-
Longitude (NAD83) 080° 23' 19.0" W-
Overall Structure Height 1520.65 feet
Support Structure Height 1458.32 feet
Ground Elevation Above Mean Sea Level (AMSL) 28.87 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner WTVX Licensee, LLC
Date Constructed 09/10/1981

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
2680 WLDI FM
47554 WCNO FM

Other Types of Users

Users
FBI
Lo-Jack

Primary Tower

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Tower Modification Costs

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

Primary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower N/A
Helicopter Services Required Are helicopter services required? Yes

Primary Tower

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Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 470
Explanation Outside consulting engineering, legal work, and accounting services, as well as project management for regional and comprehensive repack execution.
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 Yes
Environmental Assessment Yes
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 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

Sinclair Internal Costs

Internal Employee Time Costs

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

Other Expenses

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Other Expenses Not Listed

Name Description

Road Repair

Road Repair

Tax

Tax

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 $1,739,816.42 $1,662,316.42 N/A $1,068,458.44 N/A
Total for all systems $4,190,324.21 $3,778,997.30 N/A $2,557,585.75 N/A
Primary Transmitter THU9-24 $1,739,816.42 $1,662,316.42 $1,068,458.44
Other Electrical Service: Electrical Installation $171,016.42 $171,016.42 N/A $171,016.42 N/A
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW $1,473,000.00 $1,400,000.00 N/A $843,949.15 The last two items should be removed as we've uploaded revised versions.
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A $9,424.80 The second item should be removed as we've uploaded revised version.
Transformer 3 phase/480v - 300 KVA $36,800.00 $35,000.00 N/A $29,439.19 The last two items should be removed as we've uploaded revised version.
2" Rigid Conduit and Wiring (Cost per foot) $20,800.00 $20,000.00 N/A $14,628.88 The second item should be removed as we've uploaded revised version.

Components

Actual Information Description File Name
Other Electrical Service: Electrical Installation

Component Description:
Transmitter related cost. #002854
Amount:
$27,192.05

Component Description:
Final installation and re-channeling for post repack channel. #002239
Amount:
$112,223.37

Component Description:
Transmitter installation. #WTVX2017-1
Amount:
$10,265.00

Component Description:
Transmitter related cost. #002846
Amount:
$21,336.00
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW

Component Description:
Load, 25KW, 3/50, LIQ, 115V and freight cost. #001935
Amount:
$18,034.20

Component Description:
Transmitter downpayment. #9500067486
Amount:
$150,000.00

Component Description:
Transmitter balance plus $28,738.95 in tax. #9500071622
Amount:
$478,738.95

Component Description:
Consisting of: RF System, Mask filter, Load, Interconnect install Kit, Installation services/project management.
Amount:
$140,113.00

Component Description:
Transmitter downpayment.
Amount:
$150,000.00

Component Description:
Consisting of: RF System, Mask filter, Load, Interconnect install Kit, Installation services/project management. #001891
Amount:
$140,113.00

Component Description:
Transmitter related cost. #002202
Amount:
$57,063.00

Component Description:
Broadcast transmitter system THx9.
Amount:
$478,738.95
Switchgear - industrial 800 amp

Component Description:
33% of the electrical work for new WTVX transmitter. #17205.01
Amount:
$9,424.80

Component Description:
33% of electrical work for new WTVX transmitter.
Amount:
$9,424.80
Transformer 3 phase/480v - 300 KVA

Component Description:
XFMR, order qty. 2 and freight cost. #001891
Amount:
$11,108.31

Component Description:
Transformer cost. #002090
Amount:
$7,927.80

Component Description:
34% of electrical work for new WTVX transmitter.
Amount:
$9,710.40

Component Description:
Transformer related cost. #267730
Amount:
$692.68

Component Description:
XFMR, order qty. 2 and freight cost.
Amount:
$11,108.31

Component Description:
34% of electrical work for new WTVX transmitter.
Amount:
$9,710.40
2" Rigid Conduit and Wiring (Cost per foot)

Component Description:
33% of Electrical work for new WTVX transmitter.
Amount:
$9,424.80

Component Description:
33% of the electrical work for new WTVX transmitter. #17205.01
Amount:
$9,424.80

Component Description:
Lighting for the new transmitter location.
Amount:
$5,204.08

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 $577,700.00 $552,413.20 N/A $263,673.91 N/A
Total for all systems $4,190,324.21 $3,778,997.30 N/A $2,557,585.75 N/A
Interim Antenna TFU-16WB-1-R $266,220.00 $253,364.40 $100,232.15
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $22,000.00 N/A N/A N/A
Elbow complex, broadband, at antenna input, per 3 1/8. feedline (if needed) $9,340.00 $8,880.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $6,484.40 N/A $6,484.40 N/A
UHF - Lower Power Side Mount, One station antenna -- 200-500 kW, elliptically or circularly polarized $227,000.00 $216,000.00 N/A $93,747.75 N/A
Primary Antenna TFU-24JTT/VP-R P216 $311,480.00 $299,048.80 $163,441.76
Elbow complex, single channel, at antenna input, per 8 3/16. feedline (if needed) $15,250.00 $14,500.00 N/A $10,132.91 N/A
Sweep test of existing antenna $6,730.00 $9,548.80 Two sweep tests were required. See Dielectric quotes. $9,548.80 N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $289,500.00 $275,000.00 N/A $143,760.05 N/A

Components

Actual Information Description File Name
Side mount brackets for high power antennas (if not included in antenna base cost) Information not provided.
Elbow complex, broadband, at antenna input, per 3 1/8. feedline (if needed) Information not provided.
Sweep test of existing antenna

Component Description:
Sweep test cost. #1952
Amount:
$1,710.00

Component Description:
Sweep test cost. #476012
Amount:
$4,774.40
UHF - Lower Power Side Mount, One station antenna -- 200-500 kW, elliptically or circularly polarized

Component Description:
Total amount reduced by 20.02%. #24928
Amount:
$93,747.75
Elbow complex, single channel, at antenna input, per 8 3/16. feedline (if needed)

Component Description:
Elbow complex cost. #408005
Amount:
$10,132.91
Sweep test of existing antenna

Component Description:
Total invoice amount reduced by 25.40%. #574045
Amount:
$4,774.40

Component Description:
Sweep test cost. #467021
Amount:
$4,774.40
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
UHF High power top mount cost. #329043
Amount:
$143,760.05

Cost Information

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Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $600,250.00 $333,332.72 N/A $326,607.47 N/A
Total for all systems $4,190,324.21 $3,778,997.30 N/A $2,557,585.75 N/A
Interim Transmission Line $62,400.00 $59,400.00 $52,674.75
Rigid Transmission Line - copper, 3 1/8" $62,400.00 $59,400.00 N/A $52,674.75 Second item should be removed.
Primary Transmission Line $537,850.00 $273,932.72 $273,932.72
Rigid Transmission Line - copper, 8 3/16" $537,850.00 $273,932.72 N/A $273,932.72 N/A

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 3 1/8"

Component Description:
Total amount reduced by 20.02%. #53001
Amount:
$48,836.58

Component Description:
Rigid transmission line cost. #404001
Amount:
$3,838.17

Component Description:
Rigid transmission line.
Amount:
$61,061.00
Rigid Transmission Line - copper, 8 3/16"

Component Description:
Transmission line cost. #INV9312
Amount:
$19,813.34

Component Description:
Total invoice amount reduced by 25.40%. #530003
Amount:
$252,073.20

Component Description:
Transmission line cost. #19357917
Amount:
$188.64

Component Description:
Total invoice amount reduced by 25.40%. #455013
Amount:
$1,857.54

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 $753,706.00 $741,756.00 N/A $672,230.00 N/A
Total for all systems $4,190,324.21 $3,778,997.30 N/A $2,557,585.75 N/A
Primary Tower TOWER $753,706.00 $741,756.00 $672,230.00
Tower Helicopter Lift $109,606.00 $109,606.00 See FDH Quote. $109,606.00 N/A
Tall Tower (greater than 500') $210,500.00 $200,000.00 N/A $136,974.00 N/A
Major tower reinforcement/modifications $421,000.00 $420,150.00 N/A $420,150.00 N/A
Structural engineering tower load study for well documented tower $12,600.00 $12,000.00 N/A $5,500.00 The last item should be removed as we've uploaded revised version.

Components

Actual Information Description File Name
Tower Helicopter Lift

Component Description:
Tower related cost. #SIN000550
Amount:
$109,606.00
Tall Tower (greater than 500')

Component Description:
Tower related cost. #294043
Amount:
$2,000.00

Component Description:
50% Upon Completion. #E-190557
Amount:
$67,487.00

Component Description:
Tower related cost. #SBG126184
Amount:
$20,920.00

Component Description:
50% Down Payment. #E-190545
Amount:
$67,487.00
Major tower reinforcement/modifications

Component Description:
Final balance upon completion. #E-1879554
Amount:
$39,220.20

Component Description:
50% Down Payment. #E-190545
Amount:
$13,974.00

Component Description:
30% downpayment. #E-149380
Amount:
$117,660.60

Component Description:
50% Upon Completion. #E-190557
Amount:
$13,974.00

Component Description:
60% upon shipment of steel. #E-186842
Amount:
$235,321.20
Structural engineering tower load study for well documented tower

Component Description:
Engineering structural analysis. #138029
Amount:
$2,750.00

Component Description:
Engineering structural analysis.
Amount:
$2,750.00

Component Description:
Engineering structural analysis. #142473
Amount:
$2,750.00

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $229,804.22 $200,736.39 N/A $91,880.38 N/A
Total for all systems $4,190,324.21 $3,778,997.30 N/A $2,557,585.75 N/A
Outside Professional Services $229,804.22 $200,736.39 $91,880.38
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $2,025.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $2,107.50 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $2,447.79 N/A
Project management of the transition $74,260.00 $70,500.00 N/A $44,572.70 N/A
Sinclair Internal Costs $9,654.22 $9,654.22 N/A $9,654.22 N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A $27,000.00 N/A
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 N/A N/A
ASR modification (prepare FCC Form 854) $2,105.00 $2,000.00 N/A N/A N/A
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet $10,520.00 $10,000.00 N/A N/A N/A
NEPA Section 106 environmental review, if needed $6,310.00 $6,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $7,360.00 $0.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $0.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $0.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $221.92 N/A $221.92 N/A
Prepare request for Special Temporary Authorization $4,100.00 $3,860.25 N/A $3,851.25 Invoice #858-50-0004 with status Need More Information can be removed.

Components

Actual Information Description File Name
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

Component Description:
Consulting engineering cost.
Amount:
$2,025.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Consulting engineering cost.
Amount:
$2,107.50
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
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:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759
Amount:
$869.30

Component Description:
Legal services cost.
Amount:
$115.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289
Amount:
$1,311.48
Project management of the transition

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. #468724
Amount:
$106.25

Component Description:
Legal services cost. #485263
Amount:
$57.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759
Amount:
$29.98

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. #1039
Amount:
$30.47

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #477820
Amount:
$320.19

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. #1072
Amount:
$237.64

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #480175
Amount:
$377.96

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 52 stations. #206
Amount:
$1,354.25

Component Description:
Legal services cost. #487023
Amount:
$50.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 46 stations. #247
Amount:
$1,105.31

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 54 stations. #236
Amount:
$1,117.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1045
Amount:
$185.10

Component Description:
Legal services cost. #486097
Amount:
$57.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #132
Amount:
$589.44

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. #477305
Amount:
$393.53

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #472173
Amount:
$311.78

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 45 stations. #226
Amount:
$1,364.80

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 46 stations. #485240
Amount:
$541.57

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 44 stations. #486091
Amount:
$491.47

Component Description:
Legal Service Cost. #479294
Amount:
$107.50

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 100 stations. #476885
Amount:
$403.34

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. #1143
Amount:
$436.90

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 100 stations. #1130
Amount:
$281.49

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #473885
Amount:
$318.62

Component Description:
Legal services cost. #474413
Amount:
$57.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1099
Amount:
$266.93

Component Description:
Legal services cost. #470284
Amount:
$177.50

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 100 stations. #476367
Amount:
$364.80

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 99 stations. #469573
Amount:
$377.14

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1117
Amount:
$282.68

Component Description:
Legal services cost. #473548
Amount:
$51.25

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 99 stations. #468718
Amount:
$349.51

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 48 stations. #483809
Amount:
$868.77

Component Description:
Legal services cost. #476891
Amount:
$832.50

Component Description:
Legal services cost. #469588
Amount:
$378.75

Component Description:
Legal services cost. #476376
Amount:
$825.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 59 stations. #295
Amount:
$997.50

Component Description:
Legal services cost. #477312
Amount:
$138.75

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #478288
Amount:
$194.86

Component Description:
Legal services cost. #474820
Amount:
$1,366.55

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #474405
Amount:
$490.56

Component Description:
Legal services cost. #470877
Amount:
$157.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$731.71

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$20.91

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #453972
Amount:
$716.28

Component Description:
Legal services cost. #466703
Amount:
$57.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #466690
Amount:
$446.87

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1058
Amount:
$187.24

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1098
Amount:
$238.07

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #457331
Amount:
$836.44

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #465173
Amount:
$654.26

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1114
Amount:
$242.25

Component Description:
Legal Service Cost. #484313
Amount:
$50.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #471524
Amount:
$322.83

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$32.35

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #463026
Amount:
$801.57

Component Description:
Legal services cost. #477829
Amount:
$457.50

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 98 stations. #1063
Amount:
$262.29

Component Description:
Legal services cost. #479294
Amount:
$45.00

Component Description:
Legal services cost. #484754
Amount:
$183.75

Component Description:
Legal services cost. #465188
Amount:
$427.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1078
Amount:
$215.68

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$1,954.93

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$912.82

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1167
Amount:
$313.41

Component Description:
Legal services cost. #467391
Amount:
$182.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289
Amount:
$91.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 99 stations. #1086
Amount:
$275.35

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).
Amount:
($289.46)

Component Description:
Legal Service Cost. #483812
Amount:
$100.00

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. #1151
Amount:
$388.07

Component Description:
Legal services cost. #462973
Amount:
$316.50

Component Description:
Legal Service Cost. #467900
Amount:
$112.50

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 100 stations. #1141
Amount:
$406.17

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #467861
Amount:
$470.30

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 48 stations. #483809
Amount:
N/A

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. #475744
Amount:
$305.99

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 93 stations. #450412
Amount:
$999.04

Component Description:
Legal services cost. #472997
Amount:
$102.50

Component Description:
Legal services cost. #471534
Amount:
$230.00

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 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. #1156
Amount:
$399.52

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. #1093
Amount:
$265.72

Component Description:
Legal services cost. #464360
Amount:
$312.30

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 46 stations. #273
Amount:
$1,685.59

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1105
Amount:
$216.88

Component Description:
Legal services cost. #457854
Amount:
$578.70

Component Description:
Legal services cost. #460937
Amount:
$345.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$43.72

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. #472593
Amount:
$163.75

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. #453686
Amount:
$943.95

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 98 stations. #464321
Amount:
$683.07

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #472985
Amount:
$282.68

Component Description:
Legal services cost. #479834
Amount:
$57.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #1012
Amount:
$20.64

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1090
Amount:
$176.70

Component Description:
Legal services cost. #472182
Amount:
$427.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #463567
Amount:
$566.48

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$107.53

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 100 stations. #1161
Amount:
$267.48

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1051
Amount:
$105.97

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #1032
Amount:
$43.71
Sinclair Internal Costs

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 45 stations.
Amount:
$5.66

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 48 stations.
Amount:
$6.78

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 45 stations.
Amount:
$25.78

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 54 stations.
Amount:
$23.95

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 46 stations.
Amount:
$50.03

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 54 stations.
Amount:
$8.64

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:
$6.09

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 100 stations.
Amount:
$25.53

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 48 stations.
Amount:
$31.70

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:
$9.47

Component Description:
Internal expense - 3-2019
Amount:
$4,784.80

Component Description:
Portion of general repack matter internal time card attributable to this station - divided by 100.
Amount:
$7.86

Component Description:
Internal expense - WTVX - 1-2019
Amount:
$191.25

Component Description:
Internal expense - 4-2019
Amount:
$4,150.16

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 100 stations.
Amount:
$11.03

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 45 stations.
Amount:
$25.78

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 46 stations.
Amount:
$1.23

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 60 stations.
Amount:
$4.95

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 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 60 stations.
Amount:
$23.77

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 100 stations.
Amount:
$8.66

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:
$33.53

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. #207052
Amount:
$27,000.00
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase Information not provided.
ASR modification (prepare FCC Form 854) Information not provided.
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet Information not provided.
NEPA Section 106 environmental review, if needed Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
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 98 stations. #461759
Amount:
$99.92

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289
Amount:
$122.00
Prepare request for Special Temporary Authorization

Component Description:
Consulting engineering cost. #858-50-0004
Amount:
$356.25

Component Description:
Consulting engineering cost. #858-50-0004
Amount:
$365.25

Component Description:
Preparation of a Request for Special Temporary Authority. #858-50-0003
Amount:
$3,495.00

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 $289,047.57 $288,442.57 N/A $134,735.55 N/A
Total for all systems $4,190,324.21 $3,778,997.30 N/A $2,557,585.75 N/A
Other Expenses $289,047.57 $288,442.57 $134,735.55
Tax $36,132.23 $36,132.23 N/A $36,132.23 N/A
Road Repair $20,920.00 $20,920.00 N/A $20,920.00 N/A
MVPD Notification of Channel Change $5,000.00 $5,000.00 See Exhibit J. $3,750.00 N/A
Develop and air announcement of upcoming channel change $75,000.00 $75,000.00 See Exhibit J. N/A N/A
Equipment Storage $27,960.08 $27,960.08 See Exhibit J. $27,960.08 N/A
Equipment Delivery and Handling Charges $30,845.26 $30,845.26 See Exhibit J. $30,845.26 Invoice #002864 with status Need More Information can be removed. A revised version has been submitted.
Disposal Costs (for equipment and other waste, net of any salvage value) $50,000.00 $50,000.00 See Exhibit J. $15,127.98 N/A
Non-zoning permits $10,000.00 $10,000.00 See Exhibit J. N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 N/A N/A N/A
Local Zoning $20,000.00 $20,000.00 See Exhibit J. N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Tax

Component Description:
Tax associated with Dielectric invoice #530003. #TAX19-0478
Amount:
$23,652.98

Component Description:
Sales tax. #Tax17-1253
Amount:
$4,274.27

Component Description:
Sales tax. #Tax17-0976
Amount:
$8,204.98
Road Repair

Component Description:
Legal services cost. #SBG126184
Amount:
$20,920.00
MVPD Notification of Channel Change

Component Description:
Medical notification. #1076
Amount:
$3,750.00
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage

Component Description:
Total invoice amount reduced by 25.40%. #489020
Amount:
$4,625.20

Component Description:
Total invoice amount reduced by 25.40%. #489018
Amount:
$23,334.88
Equipment Delivery and Handling Charges

Component Description:
Freight cost. #002864
Amount:
$2,513.18

Component Description:
Total invoice amount reduced by 25.40%. #547034
Amount:
$2,091.68

Component Description:
Total invoice amount reduced by 25.40%. #552021
Amount:
$1,125.26

Component Description:
Total invoice amount reduced by 25.40%. #489018
Amount:
$4,352.96

Component Description:
Total invoice amount reduced by 25.40%. #255013
Amount:
$2,547.58

Component Description:
Equipment delivery and handling cost. #002864
Amount:
$2,513.18

Component Description:
Equipment delivery and handling charge. #002202
Amount:
$2,000.00

Component Description:
Freight cost. #255013
Amount:
$2,547.58

Component Description:
Total invoice amount reduced by 25.40%. #550021
Amount:
$7,833.00

Component Description:
Total invoice amount reduced by 25.40%. #489020
Amount:
$8,381.60

Component Description:
Total invoice amount reduced by 25.40%. #455013
Amount:
$2,547.58
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
Disposal cost. #WTVX-091520
Amount:
$15,127.98

Component Description:
Disposal related cost. #WTVX2017-1
Amount:
$10,265.00
Non-zoning permits 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.
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
Local Zoning Information not provided.
DTV Medical Facility Notification Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $4,190,324.21 $3,778,997.30 $2,557,585.75

Reimbursement Status

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

Certification

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Section Question Response
Submission of Estimated Expenses Statements

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

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

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

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

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

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

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

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

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

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

Lucy Rutishauser

CFO


08/26/2021

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.

Lucy Rutishauser

CFO


08/26/2021

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