TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
ION TELEVISION LICENSE, LLC Doing Business As: ION TELEVISION LICENSE, LLC	601 CLEARWATER PARK ROAD WEST PALM BEACH, FL 33401 United States	+1 (561) 682-4110	BIANCAFRYE@IONMEDIA.COM	Corporation

Applicant

Address

Phone

Applicant Type

ION TELEVISION LICENSE, LLC

Doing Business As: ION TELEVISION LICENSE, LLC

601 CLEARWATER PARK ROAD

WEST PALM BEACH, FL 33401

United States

+1 (561) 682-4110

BIANCAFRYE@IONMEDIA.COM

Corporation

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
The Preparer is same as the reimbursement contact.

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	Relocate from ASR #1050615 to ASR #1234025. Install interim antenna to make repack deadline. Replace non-retunable transmitter, install side mount antenna and transmission line to operate on post-repack channel.

Question	Response
Sharee Station Facility ID	65130
Call Sign	WQCW
Type	Commercial
Licensee Name	GRAY TELEVISION LICENSEE, LLC
Status	LICENSED
DTS	No
Community of License	PORTSMOUTH, OH
Pre-auction RF Channel	15
Post-auction RF Channel	15
Neilsen DMA	Charleston-Huntington
Network Affiliation

Question	Response
Sharee Station Facility ID	23342
Call Sign	WOWK-TV
Type	Commercial
Licensee Name	NEXSTAR BROADCASTING, INC.
Status	LICENSED
DTS	No
Community of License	HUNTINGTON, WV
Pre-auction RF Channel	13
Post-auction RF Channel	10
Neilsen DMA	Charleston-Huntington
Network Affiliation

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	Millennium
	Year	2002
	Type	Inductive Output Tube
	IOT Power Type	Two
	Power Capacity	40 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	THU9-20 EVO
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	31 kW
	Justification for New Transmitter	See attached Transmitter Exhibits. See attached Transmitter Upgrade Disclaimer.

Primary Transmitter

Other Transmitter Costs

Section	Question	Response
Electrical Service	Service Entrance (3 phases 800A 208V)	No
	Switchgear (industrial 800 amp)	No
	Transformer (480V)	Yes
	Power	300 kVA
	Rigid Conduit and Wiring	No
	Size	N/A
	Length	N/A
	Other Electrical Service	Yes
	Description	Additional electric work needed for transmitter installation
HVAC Service	Does the replacement transmitter require HVAC Service?	Yes
	Type	Cooling Only
	Size	5 tons
	Other Size	N/A
Transmitter Building Addition/Modification or Leasehold Improvement	Does the Transmitter Building require an addition, modification, other leashold improvement?	Yes
	Size	500.0 square feet
Channel 14 Costs	Is an RF Consulting Engineer needed?	N/A
	Is a channel 14 Mask Filer needed?	N/A
	Is additional field engineering time needed?	N/A
	Number of Days	N/A

Primary Transmitter

Other Transmitter Cost Not Listed

Name	Description
Removal of Existing Equipment	Removal of existing transmitters and equipment / Site Prep
RF Interconnect	Interconnect between RF System and transmission line
Additional Installation Costs	Additional installation labor and materials for transmitter

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?	No
	Is the existing antenna directional?	Yes
	Is antenna in operating condition?	Yes
	Is antenna located on or in close proximity to an antenna farm?	No
Existing Antenna Manufacturer and Type	Class	Full Power
	Mounting	Side Mount
	Antenna position in stack	Not in Stack
	Polarization	Horizontal
	Type	Slotted Coaxial
	Number of Stations Supported	N/A
	Number of Panels	N/A
	Design power capacity in use	N/A
	Lower Limit	N/A
	Upper Limit	N/A
	Other Antenna Type	N/A
	ERP:	1000.0 kW
	Manufacturer
	Model	TFU-24DSC-R C170
	Year	2002

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?	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	Side Mount
	Antenna position in stack	Not in Stack
	Polarization	Elliptical
	Type	Slotted Coaxial
	Number of Stations Supported	N/A
	Number of Panels/Bays	N/A
	Lower Limit	N/A
	Upper Limit	N/A
	Design power capacity in use	N/A
	Other Antenna Type	N/A
	ERP:	765.0 kW
	Manufacturer
	Model	ATW26H3-ESC170-18H
	Year	2019
	Justification for New Antenna	See attached Antenna Exhibit

Primary Antenna

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	6 1/8 inches inches
Side Mount Brackets	Do you require the separate purchase of side mount brackets for a high power antenna?	Yes
Pattern Scatter Analysis	Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna?	No
Sweep Test	Do you require the sweep testing of transmission line and antenna?	Yes

Primary Antenna

Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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

Primary Transmission Line

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	6 1/8 inches
	Other Diameter	N/A
	Segment Length	20 inches
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	1000 feet per run

Primary Transmission Line

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?	Yes
	Type	Rigid
	Diameter	6 1/8 inches
	Other Diameter	N/A
	Segment Length	20 inches
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	1000 feet per run
	Justification for New Transmission Line	See attached Antenna Exhibit

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Name	Description
Sweep existing transmission line	Sweep existing transmission line

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

Add Tower

Section	Question	Response
Existing Tower Description	Type of change	Modify Existing
	Tower Use	Primary (Main)
	Description of Use	N/A
	Ownership	Leased
	Is this tower consider Complex?	No
	Is this tower currently shared with any other stations?	Yes
	One or more FM, AM or TV radio broadcaster(s)	Yes
	Others Types of Users	No
	Is tower documented for structural analysis?	Yes
	Is tower compliant with Rev G?	Unknown
Existing Tower Structure Registration	Do you have a tower registration number?	No
Existing Tower Structure Registration	ASR Number
Coordinates (NAD83)	Latitude (NAD83)	38° 30' 21.1" N-
	Longitude (NAD83)	082° 12' 32.3" W-
	Overall Structure Height	1159.11 feet
	Support Structure Height	1154.84 feet
	Ground Elevation Above Mean Sea Level (AMSL)	971.77 feet
	Structure Type	TOWER - Free Standing or Guyed Structure
	Tower Owner	Nexstar Broadcasting, Inc.
	Date Constructed	07/07/2015

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
23342	WOWK-TV	DTV
65130	WQCW	DTV

Primary Tower

Tower Modification Costs

Section	Question	Response
Engineering Study	Please what type of engineering study is required, if any:	No study needed
Tower Reinforcements	Please select whether tower reinforcements are needed:	No reinforcements needed

Primary Tower

Tower Rigging Costs

Section	Question	Response
Tower Rigging Costs	Complex Tower	N/A
Helicopter Services Required	Are helicopter services required?	No

Primary Tower

Other Tower Expenses Not Listed

Name	Description
Remove Interim Antenna	Cost to remove interim antenna
Structural analysis	Structural analysis

Primary Tower

Existing Tower

Section	Question	Response
Existing Tower Description	Type of change	Move Equipment
	Tower Use	Primary (Main)
	Description of Use	N/A
	Ownership	Leased
	Is this tower consider Complex?	No
	Is this tower currently shared with any other stations?	No
	One or more FM, AM or TV radio broadcaster(s)	N/A
	Others Types of Users	N/A
	Is tower documented for structural analysis?	Unknown
	Is tower compliant with Rev G?	No
Existing Tower Structure Registration	Do you have a tower registration number?	Yes
Existing Tower Structure Registration	ASR Number	1050615
Coordinates (NAD83)	Latitude (NAD83)	38° 28' 11.8" N-
	Longitude (NAD83)	081° 46' 35.2" W-
	Overall Structure Height	982.93 feet
	Support Structure Height	912.72 feet
	Ground Elevation Above Mean Sea Level (AMSL)	1001.96 feet
	Structure Type	TOWER - Free Standing or Guyed Structure
	Tower Owner	SpectraSite Communications, LLC. through American Towers, LLC.
	Date Constructed	02/21/2008

Primary Tower

Tower Rigging Costs

Section	Question	Response
Tower Rigging Costs	Complex Tower	N/A
Helicopter Services Required	Are helicopter services required?	No

Primary Tower

Other Tower Expenses Not Listed

Name	Description
Structural Study	Structural Studies and Engineering Review

Outside Professional Services Costs

Section	Question	Response
Outside Project Management Services	Do you require outside project management services?	Yes
	Number of Hours	180
	Explanation	Required by tower landlord
Outside RF consulting Engineering Services	Perform engineering study for new channel assignment and antenna development	Yes
	Prepare engineering section of Form FCC Construction Permit Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare engineering section of Form FCC License to Cover Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare request for Special Temporary Authority	Yes
	Quantity	1
	Do you have Distributed Transmission System engineering services?	N/A
	Critical Facility	N/A
	Terrain-Shielded Facility	N/A
Attorney and Other Outside Consulting Services	Prepare and file Form FCC Construction Permit Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare and file Form FCC License to Cover Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare request for Special Temporary Authority	Yes
	Quantity	1
	NEPA Section 106 environmental review	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	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
Impact Study	LPTV Impact Analysis

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	Yes
	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

Information not provided.

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	$1,195,745.00	$1,055,335.00	N/A	$1,032,118.42	N/A
Total for all systems	$2,316,203.51	$2,303,417.99	N/A	$2,048,798.05	N/A
Primary Transmitter THU9-20 EVO	$1,195,745.00	$1,055,335.00		$1,032,118.42
RF Interconnect	$25,000.00	$25,000.00	N/A	$20,808.30	N/A
Additional Installation Costs	$53,653.00	$53,653.00	Please see Rohde & Schwarz Quotes #268497.1 and #400446.0	$53,653.00	N/A
Other -- Building Addition Size: 500.0	$34,132.00	$34,132.00	Please see BPI Quote Ice Bridge 6-5-19_Rev.1.1 and IDS, LLC Quote for Heat Exchanger Pad	$34,132.00	N/A
5 Ton system	$20,250.00	$19,250.00	N/A	$2,000.00	N/A
Other Electrical Service: Additional electric work needed for transmitter installation	$51,410.00	$51,410.00	Please see IDS LLC Quote ION Media inside work plus applicable sales tax	$51,410.00	N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW	$947,000.00	$809,390.00	Please see attached Rohde & Schwarz quotes #114344.0 and #316129.2	$809,390.00	N/A
Removal of Existing Equipment	$27,500.00	$27,500.00	Please see Skyline Communications Quote EST21272	$27,500.00	N/A
Transformer 3 phase/480v - 300 KVA	$36,800.00	$35,000.00	N/A	$33,225.12	N/A

Components

Actual Information Description	File Name
RF Interconnect	Component Description: Cost of additional RF Interconnect equipment. Supporting documentation is attached. Amount: $7,325.30 Component Description: Cost of additional equipment needed for transmitter installation. Supporting documentation is attached. This invoice has been paid. Amount: $13,483.00
Additional Installation Costs	Component Description: Additional installation costs for main transmitter. Supporting documentation is attached. This invoice has been paid. Amount: $36,493.00 Component Description: Cost of additional equipment for transmitter installation. Supporting documentation is attached. This invoice has been paid. Amount: $17,160.00
Other -- Building Addition Size: 500.0	Component Description: Cost of concrete pad for heat exchangers. Supporting documentation is attached. This invoice has been paid. Amount: $2,332.00 Component Description: Cost of ice shield over heat exchangers and HVAC. Supporting documentation is attached. This invoice has been paid. Amount: $31,800.00
5 Ton system	Component Description: Cost of removing old ductwork from transmitter building. Supporting documentation is attached. This invoice has been paid. Amount: $2,000.00
Other Electrical Service: Additional electric work needed for transmitter installation	Component Description: Cost of electrical work needed for installation of main transmitter. Supporting documentation is attached. This invoice has been paid. Amount: $51,410.00
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW	Component Description: Cost to take line measurements, increase power to full operation, and proof transmitter performance. Supporting documentation is attached. This invoice has been paid. Amount: $15,500.00 Component Description: 3rd "milestone" (35%) payment for Rohde & Schwarz transmitter. Supporting documentation is attached. This invoice has been paid. Amount: $277,861.50 Component Description: 35% "payment upon proof of performance" for transmitter and accessories. Supporting documentation is attached. Amount: $276,861.50 Component Description: 2nd "milestone" (30%) payment for Rohde & Schwarz transmitter. Supporting documentation is attached. This invoice has been paid. Amount: $238,167.00 Component Description: $1,000 deposit payment for Rohde & Schwarz transmitter. Supporting documentation is attached. This invoice has been paid. Amount: $1,000.00
Removal of Existing Equipment	Component Description: Cost for removal of old transmitter equipment. Supporting documentation is attached. This invoice has been paid. Amount: $27,500.00
Transformer 3 phase/480v - 300 KVA	Component Description: Cost to install electric equipment for main transmitter. Supporting documentation is attached. Amount: $33,225.12

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	$175,468.51	$167,367.86	N/A	$167,367.86	N/A
Total for all systems	$2,316,203.51	$2,303,417.99	N/A	$2,048,798.05	N/A
Primary Antenna ATW26H3-ESC170-18H	$175,468.51	$167,367.86		$167,367.86
Side mount brackets for high power antennas (if not included in antenna base cost)	$23,150.00	$10,860.00	Cost of antenna side mount brackets. Please see attached Electronics Research, Inc. Quote #20180821-040 Rev A.	$10,860.00	N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)	$12,300.00	$10,719.35	Cost of primary elbow complex. Please see attached Electronics Research, Inc. Quote #20180821-040 Rev A.	$10,719.35	N/A
UHF - High Power, Side Mount, basic slot antenna, 765 kW input, directional,, elliptically or circularly polarized	$133,288.51	$133,288.51	Cost of primary side mount antenna. Estimate does not include elliptical polarization upgrade. Please see attached Electronics Research, Inc. Quote #20180821-040 Rev A. Final billing is $.01 higher than quote.	$133,288.51	N/A
Sweep test of existing antenna	$6,730.00	$12,500.00	See attached Electronics Research, Inc. Quote #20180821-040 Rev A. ERI did not perform "transmission line layout" and "site survey" on quote that had previously bee included in this section. 2nd sweep was needed after new cut section was installed.	$12,500.00	N/A

Components

Actual Information Description	File Name
Side mount brackets for high power antennas (if not included in antenna base cost)	Component Description: 35% "upon mfg" payment for antenna side mount brackets. Explanation of variance and supporting documentation is attached. Amount: $3,801.00 Component Description: 40% "invoiced prior to shipment" payment for antenna side mount brackets. Explanation of variance and supporting documentation is attached. This invoice has been paid. Amount: $4,344.00 Component Description: 10% "after proof of performance" payment for antenna side mount brackets. Explanation of variance and supporting documentation is attached. This invoice has been paid. Amount: $1,086.00 Component Description: 15% "payment with order" for antenna side mount brackets. Explanation of variance and supporting documentation is attached. Amount: $1,629.00
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)	Component Description: 35% "upon mfg" payment for primary elbow complex. Explanation of variance and supporting documentation is attached. Amount: $3,751.77 Component Description: 40% "invoiced prior to shipment" payment for primary elbow complex. Explanation of variance and supporting documentation is attached. This invoice has been paid. Amount: $4,287.74 Component Description: 10% "after proof of performance" payment for primary elbow complex. Explanation of variance and supporting documentation is attached. This invoice has been paid. Amount: $1,071.94 Component Description: 15% "payment with order" for primary elbow complex. Explanation of variance and supporting documentation is attached. Amount: $1,607.90
UHF - High Power, Side Mount, basic slot antenna, 765 kW input, directional,, elliptically or circularly polarized	Component Description: 35% "upon mfg" payment for primary antenna. Explanation of variance and supporting documentation is attached. Amount: $46,650.98 Component Description: 40% "invoiced prior to shipment" payment for primary antenna. Explanation of variance and supporting documentation is attached. This invoice has been paid. Amount: $53,315.40 Component Description: 10% "after proof of performance" payment for primary antenna. Explanation of variance and supporting documentation is attached. This invoice has been paid. Amount: $13,328.85 Component Description: 15% "payment with order" for primary antenna. Explanation of variance and supporting documentation is attached. Amount: $19,993.28
Sweep test of existing antenna	Component Description: 15% "payment with order" for repack sweep of primary antenna operations. Explanation of variance and supporting documentation is attached. Amount: $3,150.00 Component Description: 35% "upon mfg" payment for repack sweep of primary antenna operations. Explanation of variance and supporting documentation is attached. Amount: $7,350.00 Component Description: 40% "invoiced prior to shipment" payment for repack sweep of primary antenna operations. Explanation of variance and supporting documentation is attached. This invoice has been paid. Amount: $8,400.00 Component Description: 10% "after proof of performance" payment for repack sweep of primary antenna operations. Explanation of variance and supporting documentation is attached. This invoice has been paid. Amount: ($12,650.00) Component Description: Cost of antenna system sweep. A second sweep was required after installation of new cut section. Supporting documentation is attached. This invoice has been paid. Amount: $6,250.00

Cost Information

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	$208,400.00	$141,572.85	N/A	$135,847.85	N/A
Total for all systems	$2,316,203.51	$2,303,417.99	N/A	$2,048,798.05	N/A
Primary Transmission Line	$208,400.00	$141,572.85		$135,847.85
Sweep existing transmission line	$6,400.00	$6,400.00	N/A	$675.00	N/A
Rigid Transmission Line - copper, 6 1/8"	$202,000.00	$135,172.85	Cost of primary transmission line. Please see attached Electronics Research, Inc. Quote #20180821-040 Rev A. and ERI Quote for Change Order 37559B (WLPX). And Early Co proposal dated 5/26/20	$135,172.85	N/A

Components

Actual Information Description	File Name
Sweep existing transmission line	Component Description: Cost to sweep existing transmission line, instead of purchasing new interim line. Supporting documentation is attached. This invoice has been paid. Amount: $675.00
Rigid Transmission Line - copper, 6 1/8"	Component Description: Cost of additional pieces for main transmission line. Supporting documentation is attached. This invoice has been paid. Amount: $4,753.20 Component Description: Cost of additional pieces for main transmission line. Supporting documentation is attached. This invoice has been paid. Amount: $6,056.25 Component Description: 15% "payment with order" for primary transmission line. Explanation of variance and supporting documentation is attached. Amount: $18,358.85 Component Description: 35% "upon mfg" payment for primary transmission line. Explanation of variance and supporting documentation is attached. Amount: $42,837.32 Component Description: 40% "invoiced prior to shipment" payment for primary transmission line. Explanation of variance and supporting documentation is attached. This invoice has been paid. Amount: $48,956.94 Component Description: 10% "after proof of performance" payment for primary transmission line. Explanation of variance and supporting documentation is attached. This invoice has been paid. Amount: $12,239.24 Component Description: Cost of additional transmission line equipment for installation inside building. Supporting documentation is attached. This invoice has been paid. Amount: $1,371.05 Component Description: Cost to install an electrical outlet to power main transmission line compressor/dehydrator. Supporting documentation is attached. This invoice has been paid. Amount: $600.00

Actual Information Description

File Name

Sweep existing transmission line

Component Description:: Cost to sweep existing transmission line, instead of purchasing new interim line. Supporting documentation is attached. This invoice has been paid.
Amount:: $675.00

Rigid Transmission Line - copper, 6 1/8"

Component Description:: Cost of additional pieces for main transmission line. Supporting documentation is attached. This invoice has been paid.
Amount:: $4,753.20

Component Description:: Cost of additional pieces for main transmission line. Supporting documentation is attached. This invoice has been paid.
Amount:: $6,056.25

Component Description:: 15% "payment with order" for primary transmission line. Explanation of variance and supporting documentation is attached.
Amount:: $18,358.85

Component Description:: 35% "upon mfg" payment for primary transmission line. Explanation of variance and supporting documentation is attached.
Amount:: $42,837.32

Component Description:: 40% "invoiced prior to shipment" payment for primary transmission line. Explanation of variance and supporting documentation is attached. This invoice has been paid.
Amount:: $48,956.94

Component Description:: 10% "after proof of performance" payment for primary transmission line. Explanation of variance and supporting documentation is attached. This invoice has been paid.
Amount:: $12,239.24

Component Description:: Cost of additional transmission line equipment for installation inside building. Supporting documentation is attached. This invoice has been paid.
Amount:: $1,371.05

Component Description:: Cost to install an electrical outlet to power main transmission line compressor/dehydrator. Supporting documentation is attached. This invoice has been paid.
Amount:: $600.00

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	$458,010.00	$688,497.28	N/A	$688,497.28	N/A
Total for all systems	$2,316,203.51	$2,303,417.99	N/A	$2,048,798.05	N/A
Primary Tower TOWER	$217,500.00	$403,750.00		$403,750.00
Tall Tower (greater than 500')	$210,500.00	$396,750.00	Please see attached Worldwide Communications Quote S-19-973 WLPX. Plus weather delay costs.	$396,750.00	N/A
Structural Study	$7,000.00	$7,000.00	Please see American Tower Quote #310926_POR and Elevated Structural Quote WLPX Charleston	$7,000.00	N/A
Primary Tower TOWER	$240,510.00	$284,747.28		$284,747.28
Remove Interim Antenna	$9,010.00	$9,010.00	Please see Precision Communications - Interim Antenna Removal. Plus tax	$9,010.00	N/A
Tall Tower (greater than 500')	$210,500.00	$254,737.28	Cost for tower services. Please see attached Worldwide Communications Quote #S-18-927. Estimate includes weather delay charges and estimated tax. Precision Communication Quote #20420-5	$254,737.28	N/A
Structural analysis	$21,000.00	$21,000.00	Cost for site visit (tower mapping), structural analysis, and structural re-aalysis. Please see attached Elevated Structural Consultants Quote #1158 and Elevated Structural Consultants Quote dated 5-2-2019.	$21,000.00	N/A

Components

Actual Information Description	File Name
Tall Tower (greater than 500')	Component Description: Cost of weather delays during tower services. Supporting documentation is attached. This invoice has been paid. Amount: $3,900.00 Component Description: 75% "deposit" to remove antenna, transmission line and additional components. Supporting documentation is attached. Amount: $248,325.00 Component Description: Cost of weather delays during tower services. Supporting documentation is attached. Amount: $19,500.00 Component Description: Cost of weather delays during tower services. Supporting documentation is attached. Amount: $19,500.00 Component Description: 25% "balance due" to remove antenna, transmission line and additional components. Supporting documentation is attached. Amount: $82,775.00 Component Description: Cost of weather delays during tower services. Supporting documentation is attached. This invoice has been paid. Amount: $13,650.00 Component Description: Cost of weather delays during tower services. Supporting documentation is attached. Amount: $9,100.00
Structural Study	Component Description: Cost of engineer to review tower rigging plan. Supporting documentation is attached. This invoice has been paid. Amount: $3,000.00 Component Description: Cost of structural study required by landlord. Supporting documentation is attached. This invoice has been paid. Amount: $4,000.00
Remove Interim Antenna	Component Description: 50% "due on completion" payment to remove interim antenna. Supporting documentation is attached. This invoice has been paid. Amount: $4,505.00 Component Description: 50% "upon proposal acceptance" payment to remove interim antenna. Supporting documentation is attached. This invoice has been paid. Amount: $4,505.00
Tall Tower (greater than 500')	Component Description: Cost of additional tower work to install additional cut pieces and correct input complex. Supporting documentation is attached. This invoice has been paid. Amount: $6,877.28 Component Description: Cost for 3 days of weather delays during tower services. Supporting documentation is attached. Amount: $13,000.00 Component Description: 75% "deposit" for tower services. Supporting documentation is attached. Amount: $122,032.50 Component Description: Cost for 3 days of weather delays during tower services. Supporting documentation is attached. This invoice has been paid. Amount: $16,900.00 Component Description: 25% "balance" payment for tower services and tax. Supporting documentation is attached. This invoice has been paid. Amount: $40,677.50 Component Description: Cost for 6 days of weather delays during tower services. Supporting documentation is attached. This invoice has been paid. Amount: $26,650.00 Component Description: Cost for 5 days of weather delays during tower services. Supporting documentation is attached. Amount: $28,600.00
Structural analysis	Component Description: Cost for tower analysis. Supporting documentation is attached. This invoice has been paid. Amount: $7,000.00 Component Description: Cost for structural re-analysis. Supporting documentation is attached. Amount: $4,000.00 Component Description: Cost for site visit (tower mapping). Supporting documentation is attached. This invoice has been paid. Amount: $10,000.00

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	$189,900.00	$171,530.00	N/A	$7,117.99	N/A
Total for all systems	$2,316,203.51	$2,303,417.99	N/A	$2,048,798.05	N/A
Outside Professional Services	$189,900.00	$171,530.00		$7,117.99
Impact Study	$250.00	$250.00	Cost of LPTV impact analysis to check impact on surrounding low impact TV stations	$250.00	N/A
Comprehensive coverage verification via field study, if needed	$84,200.00	$80,000.00	N/A	N/A	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	$3,680.00	$3,500.00	N/A	N/A	N/A
Attorney Fees - Negotiation of lease and other matters for shared locations	$4,210.00	$4,000.00	N/A	N/A	N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	$2,365.00	$2,250.00	N/A	N/A	N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	$5,260.00	$5,000.00	N/A	$4,742.99	Duplicate line item. ION is only requesting reimbursement for Invoice Dated 5/1/2018.
Prepare request for Special Temporary Authorization	$2,050.00	$1,500.00	N/A	N/A	N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	$1,580.00	$1,500.00	N/A	N/A	N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	$3,155.00	$3,000.00	N/A	$2,000.00	N/A
Perform engineering study for new channel assignment and antenna development	$7,360.00	$7,000.00	N/A	$125.00	N/A
Address transition timing and coordination issues w/ other stations and wireless	$2,630.00	$2,500.00	N/A	N/A	N/A
Prepare and or review reimbursement form	$2,630.00	$2,500.00	N/A	N/A	N/A
Project management of the transition	$28,440.00	$18,530.00	See AT Exhibits for more information.	N/A	N/A
RF Exposure Measurements	$21,050.00	$20,000.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
Impact Study	Component Description: Cost of impact analysis for channel change on surrounding LPTV stations. This invoice has been paid. Amount: $250.00
Comprehensive coverage verification via field study, if needed	Information not provided.
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: Invoice for station's portion of general repack legal expenses incurred for 42 of the ION repack stations for period 2/1/2017 - 12/15/2017. Payee has corresponded with FCC staff and has provided corrected supporting documentation. Amount: $4,837.97 Component Description: Invoice for WLPX's portion of general repack legal expenses incurred for 42 of the ION repack stations for period 2/1/2017 - 12/15/2017. Payee has corresponded with FCC staff. Cover letter, hourly supporting documentation and invoice attached. Amount: $4,742.99 Component Description: Invoice for WLPX's portion of general repack legal expenses incurred for 42 of the ION repack stations for period 2/1/2017 - 12/15/2017. Payee has corresponded with FCC staff. Hourly supporting documentation and invoice attached. Amount: $4,742.99
Prepare request for Special Temporary Authorization	Information not provided.
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: Cost of engineering consultant preparation of engineering section of FCC Form 2100. Hourly supporting documentation attached. This invoice has been paid. Amount: $2,000.00
Perform engineering study for new channel assignment and antenna development	Component Description: Cost of Engineering consultant work for new channel assignment and antenna development. Hourly supporting documentation attached. This invoice has been paid. Amount: $62.50 Component Description: Cost of engineering consultant work for new channel assignment and antenna development. Hourly supporting documentation attached. This invoice has been paid. Amount: $62.50
Address transition timing and coordination issues w/ other stations and wireless	Information not provided.
Prepare and or review reimbursement form	Information not provided.
Project management of the transition	Information not provided.
RF Exposure Measurements	Information not provided.

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	$88,680.00	$79,115.00	N/A	$17,848.65	N/A
Total for all systems	$2,316,203.51	$2,303,417.99	N/A	$2,048,798.05	N/A
Other Expenses	$88,680.00	$79,115.00		$17,848.65
Equipment Storage	$10,000.00	$10,000.00	N/A	$9,462.72	N/A
Equipment Delivery and Handling Charges	$10,000.00	$10,000.00	N/A	$4,785.93	N/A
Disposal Costs (for equipment and other waste, net of any salvage value)	$15,000.00	$15,000.00	N/A	N/A	N/A
Non-zoning permits	$15,000.00	$15,000.00	N/A	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
DTV Medical Facility Notification	$11,550.00	$2,000.00	N/A	$2,000.00	N/A
MVPD Notification of Channel Change	$1,600.00	$1,600.00	A second MVPD notification was needed because of a timing change due to dependencies	$1,600.00	N/A
Develop and air announcement of upcoming channel change	$0.00	$0.00	The amount is yet to be determined (TBD) and ION will submit on-air announcement costs when finalized.	N/A	N/A
Local Zoning	$25,000.00	$25,000.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
Equipment Storage	Component Description: Cost of storage rental during repack transition. Supporting documentation is attached. Amount: $1,170.66 Component Description: Cost of rental for 1 month of storage container. Supporting documentation is attached. Amount: $170.02 Component Description: Cost of rental for 1 month of storage container. Supporting documentation is attached. Amount: $170.02 Component Description: Cost of rental for 1 month of storage container. Supporting documentation is attached. Amount: $170.02 Component Description: Cost of rental for 1 month of storage container. Supporting documentation is attached. Amount: $170.02 Component Description: Cost of storage rental during repack transition. Supporting documentation is attached. This invoice has been paid. Amount: $1,170.66 Component Description: Cost of storage rental during repack transition. Supporting documentation is attached. Amount: $1,170.66 Component Description: Cost for equipment storage. Supporting documentation is attached. Amount: $4,100.00 Component Description: Cost of storage rental during repack transition. Supporting documentation is attached. This invoice has been paid. Amount: $1,170.66
Equipment Delivery and Handling Charges	Component Description: Cost of freight for additional transmission line pieces. Supporting documentation is attached. This invoice has been paid. Amount: $287.78 Component Description: Cost of freight for additional transmission line pieces. Supporting documentation is attached. This invoice has been paid. Amount: $287.78 Component Description: Cost of freight for additional RF interconnect equipment. Supporting documentation is attached. Amount: $247.63 Component Description: Cost of freight for main antenna package. Explanation of variance and supporting documentation are attached. This invoice has been paid. Amount: $3,662.75 Component Description: Cost of freight for additional transmission line component. Supporting documentation is attached. This invoice has been paid. Amount: $299.99
Disposal Costs (for equipment and other waste, net of any salvage value)	Information not provided.
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.
DTV Medical Facility Notification	Component Description: Cost of medical notifications for repack channel change. Supporting documentation is attached. This invoice has been paid. Amount: $2,000.00
MVPD Notification of Channel Change	Component Description: Cost of MVPD notification for channel change. A second notice was needed because of a timing change due to dependencies. Supporting documentation is attached. This invoice has been paid. Amount: $800.00 Component Description: Cost of MVPD notifications for repack channel change. Supporting documentation is attached. This invoice has been paid. Amount: $800.00
Develop and air announcement of upcoming channel change	Information not provided.
Local Zoning	Information not provided.

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$2,316,203.51	$2,303,417.99	$2,048,798.05

Reimbursement Status

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

Certification

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.	Mario Vasquez Vice President - Finance, Operations 09/07/2021

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.

Mario Vasquez

Vice President - Finance, Operations

09/07/2021

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.	Mario Vasquez Vice President - Finance, Operations 09/07/2021

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.

Mario Vasquez

Vice President - Finance, Operations

09/07/2021

Certification

Section	Question	Response
Submission of Final Allocation or Accounting Information Statements	WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.
The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. 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 all costs identified as "actual costs" herein accurately represent the costs actually paid by the above-named entity, including any discounts, refunds, or rebates. 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 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.	Mario Vasquez Vice President - Finance, Operations 09/07/2021

Section

Question

Response

Submission of Final Allocation or Accounting Information Statements

The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.
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 all costs identified as "actual costs" herein accurately represent the costs actually paid by the above-named entity, including any discounts, refunds, or rebates.
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 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.

Mario Vasquez

Vice President - Finance, Operations

09/07/2021

(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

Antennas

Primary Antenna

Existing Antenna Information

Primary Antenna

New Antenna Costs

Primary Antenna

Other Antenna Costs

Primary Antenna

Other Antenna Cost Not Listed

Transmission Line

Primary Transmission Line

Existing Transmission Line

Primary Transmission Line

New Transmission Line

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Tower Equipment And Rigging Costs

Primary Tower

Add Tower

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

Primary Tower

Tower Modification Costs

Primary Tower

Tower Rigging Costs

Primary Tower

Other Tower Expenses Not Listed

Primary Tower

Existing Tower

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

Cost Information

Transmission Line

Components

Cost Information

Tower Equipment and Rigging Costs

Components

Cost Information

Outside Professional Services

Components

Cost Information

Other Expenses

Components