TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
VERMONT PUBLIC CO. Doing Business As: VERMONT PUBLIC CO.	Jack Efromson 365 TROY AVENUE COLCHESTER, VT 05446 United States	+1 (802) 846-8309	jefromson@vermontpbs.org	Not-for-Profit

Applicant

Address

Phone

Applicant Type

VERMONT PUBLIC CO.

Doing Business As: VERMONT PUBLIC CO.

Jack Efromson

365 TROY AVENUE

COLCHESTER, VT 05446

United States

+1 (802) 846-8309

jefromson@vermontpbs.org

Not-for-Profit

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.	No
Briefly describe transition plan	WVTB will need to replace transmitter and mask filter, and then operate into the existing antenna with a combiner for channels 18 (existing) and 28 (repack) during the test phase to maintain service. Existing antenna replacement will occur post test phase

Transmitters

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

Primary Transmitter

Add 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	Diamond CD DHD15P1
	Year	2005
	Type	Solid State
	Solid State Cooling	Air Cooled
	Solid State Power Capacity	4.4 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-evo-4
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	6.5 kW
	Justification for New Transmitter	Present transmitter not retunable to channel 28. ERP increasing to 84.1 KW at same antenna gain, at least 6.25 KW TPO required. Plan to upgrade to elliptical polarization when testing period is done.

Primary Transmitter

Other Transmitter Costs

Section	Question	Response
Electrical Service	Service Entrance (3 phases 800A 208V)	No
	Switchgear (industrial 800 amp)	No
	Transformer (480V)	No
	Power	N/A
	Rigid Conduit and Wiring	Yes
	Size	2 inches
	Length	100.0 feet
	Other Electrical Service	Yes
	Description	Furnish & Install 200 amp panelboard, breakers, feeders, branch circuits as required for transmitter and associated equipment
HVAC Service	Does the replacement transmitter require HVAC Service?	Yes
	Type	Cooling Only
	Size	15 tons
	Other Size	N/A
Transmitter Building Addition/Modification or Leasehold Improvement	Does the Transmitter Building require an addition, modification, other leashold improvement?	No
	Size	N/A
Channel 14 Costs	Is an RF Consulting Engineer needed?	N/A
	Is a channel 14 Mask Filer needed?	N/A
	Is additional field engineering time needed?	N/A
	Number of Days	N/A

Primary Transmitter

Other Transmitter Cost Not Listed

Name	Description
Primary Transmitter - Ice Bridge	Primary Transmitter - Ice Bridge
Factory Training	3 technicians at $1895 each Airfare & hotel $800 per person
Mask Filter	FCC Required ATSC compliant
Primary Transmitter-Additional Installation and Hardware	Primary Transmitter-Additional Installation and Hardware
Primary Transmitter - Heat Exchanger Pad	Primary Transmitter - Heat Exchanger Pad

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	Retune Existing
	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?	No
	Is antenna in operating condition?	Yes
	Is antenna located on or in close proximity to an antenna farm?	Yes
Existing Antenna Manufacturer and Type	Class	Full Power
	Mounting	Top Mount
	Antenna position in stack	Not in Stack
	Polarization	Horizontal
	Type	Broadband Panel
	Number of Stations Supported	1
	Number of Panels	12
	Design power capacity in use	100.0 %
	Lower Limit	494.00 MHz
	Upper Limit	560.00 MHz
	Other Antenna Type	N/A
	ERP:	67.0 kW
	Manufacturer	Dielectric
	Model	TUA-O4-12/48H-1-R-T
	Year	2006

Primary Antenna

Adjustment to Existing Antenna

Section	Question	Response
Sweep Test of Existing Antenna	Do you need a sweep test of existing antenna?

Primary Antenna

Other Antenna Costs

Section	Question	Response
Combiner for Shared Antenna	Do you need a Combiner for a Shared Antenna?
	Type
	Number of channels supported	N/A
	Frequencies of channels supported	N/A
	Frequency

Primary Antenna

Other Antenna Cost Not Listed

Name	Description
New Combiner	New combiner, 2 channels, RF Channel combiner (channels 18 and 28). No splitter/switcher needed.

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	Utilize Existing
	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	Andrew
	Type	Flexible Air
	Diameter	4 inches
	Other Diameter	N/A
	Segment Length	N/A
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	320 feet per run

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Name	Description
Utilize Existing Line - Mandatory Category due to LMS Bug	This category added because LMS throws an error when there are no costs added to a "Utilize Existing" type of change. This category exists only as a workaround for a bug in LMS

Tower Equipment And Rigging Costs

Section	Question	Response
Tower Equipment or Rigging Costs Changes	Do you have tower equipment or rigging costs changes?	No

Outside Professional Services Costs

Section	Question	Response
Outside Project Management Services	Do you require outside project management services?	Yes
	Number of Hours	595
	Explanation	WVTB requires the aid of outside project management services in order to fulfill the requirements of the repack. WVTB does not have sufficient resource capacity and expertise in house to handle all of the repack tasks.
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	No
	Environmental Assessment	Yes
	ASR Modification	No
	FAA Consultation (including preparation of FAA Form 7460)	No
	Negotiation of Lease and other Matter for Shared Locations	Yes
	Prepare or Review FCC Form 399 for Reimbursement	Yes
	Address transition timing and coordination issues w/ other stations and wireless providers	Yes
RF Field Engineering Services	Comprehensive coverage verification via field study	No
	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

Information not provided.

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

Other Expenses

Other Expenses Not Listed

Name	Description
Act 250 Application Filing Fees	Cost of filing Act 250 Application-state of Vermont
UAXTE-12R44 INSTALL COMM	GatesAir Installation & commissioning, from quote GA-00020078
Internal Labor	Internal Labor

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	$580,722.52	$380,341.21	N/A	$291,429.88	N/A
Total for all systems	$835,355.84	$625,522.48	N/A	$435,169.96	N/A
Primary Transmitter THU9-evo-4	$580,722.52	$380,341.21		$291,429.88
Primary Transmitter - Heat Exchanger Pad	$2,911.00	$2,911.00	Please see BC Johnsons Co. PC quote dated March 20, 2020 and breakdown of costs	$2,911.00	N/A
Primary Transmitter-Additional Installation and Hardware	$20,006.18	$20,006.18	Please see Estimated Cost Justification WVTB-110-1st Primary Transmitter - Additional Installation and Hardware v0	$19,542.65	N/A
Mask Filter	$12,007.77	$12,007.77	FCC required. Form GatesAir quote GA-00020078	$0.00	N/A
Factory Training	$8,085.00	$8,085.00	Technicians will be trained on new transmitting equipment at factory. Training $1895 each, airfare & hotel $800 each.	$0.00	N/A
Primary Transmitter - Ice Bridge	$829.00	$829.00	Please see BC Johnsons Co. PC quote dated March 20, 2020 and breakdown of costs	$829.00	N/A
15 Ton system	$55,800.00	$53,000.00	N/A	$0.00	N/A
Other Electrical Service: Furnish & Install 200 amp panelboard, breakers, feeders, branch circuits as required for transmitter and associated equipment	$2,205.67	$2,205.67	Please see BC Johnsons Co. PC quote dated March 20, 2020 and breakdown of costs	$2,205.67	N/A
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW	$273,500.00	$74,507.87	Please see the attached Rohde & Schwarz quote 210740.0, the invoice 9500106681 and Purchase Order C19649, less amount reimbursed in superseded category	$63,163.66	N/A
UHF - Air Cooled Solid State Transmitter 6.5 kW	$202,777.90	$202,777.90	*System Notice: Estimate adjusted and locked because line has been superseded.*Please see the attached Rohde & Schwarz quote 210740.0, the invoice 9500106681 and Purchase Order C19649	$202,777.90	N/A
2" Rigid Conduit and Wiring (Cost per foot)	$2,600.00	$4,010.82	$2500 for conduit and wiring $1510.82 for 3-phase surge protector (GatesAir quote GA-00020078)	$0.00	N/A

Components

Actual Information Description	File Name
Primary Transmitter - Heat Exchanger Pad	Component Description: Recieve, warehouse and transport to Burke Mtn summit building transmitter, waveguide and misc. Equipment Amount: $2,911.00
Primary Transmitter-Additional Installation and Hardware	Component Description: Fuel expense to travel to transmitter site Amount: $29.76 Component Description: Actuator and control for WVTB transmitter room heat exhaust - Expense for Dana Nahumck Amount: $318.23 Component Description: dining expense for WVTB transmitter install - Dana Nahumck Amount: $204.66 Component Description: Hotel expense for WVTB transmitter install - Dana Nahumck Amount: $688.88 Component Description: Additional Install Expenses Amount: $10,000.00 Component Description: hotel expense for WVTB transmitter install - Larry Page Amount: $694.26 Component Description: Hotel expense for WVTB transmitter install - Dana Nahumck Amount: $657.72 Component Description: Battery back for WVTB Rhode and Schwarz transmitter equipment - Expense for Dana Nahumck Amount: $426.64 Component Description: Bolt Together Aluminum Fram for Type 2 to 10 Heat Exchangers Amount: $6,522.50
Mask Filter	Information not provided.
Factory Training	Information not provided.
Primary Transmitter - Ice Bridge	Component Description: WVTB-110-1st Primary Transmitter - Ice Bridge Amount: $829.00
15 Ton system	Information not provided.
Other Electrical Service: Furnish & Install 200 amp panelboard, breakers, feeders, branch circuits as required for transmitter and associated equipment	Component Description: WVTB-110-1st Primary Transmitter - Other Electrical Service Amount: $2,205.67
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW	Component Description: Transmitter Amount: $63,163.66
UHF - Air Cooled Solid State Transmitter 6.5 kW	Component Description: Invoice moved as category has been superseded. Amount: N/A Component Description: DP 75% Final Payment Amount: $202,777.90
2" Rigid Conduit and Wiring (Cost per foot)	Information not provided.

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	$19,652.93	$19,652.93	N/A	$19,652.93	N/A
Total for all systems	$835,355.84	$625,522.48	N/A	$435,169.96	N/A
Primary Antenna TUA-O4-12/48H-1-R-T	$19,652.93	$19,652.93		$19,652.93
New Combiner	$19,652.93	$19,652.93	see Estimated Cost Justification WVTB-290-Primary Antenna - New Combiner 2 Channels v0	$19,652.93	N/A

Components

Actual Information Description	File Name
New Combiner	Component Description: Shipping PP&A, need crate size and weight for billing Amount: $9,632.50 Component Description: 82633-701, 2 Channel star point combiner Amount: $10,020.43

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	$0.00	$0.00	N/A	$0.00	N/A
Total for all systems	$835,355.84	$625,522.48	N/A	$435,169.96	N/A
Primary Transmission Line	$0.00	$0.00		$0.00
Utilize Existing Line - Mandatory Category due to LMS Bug	$0.00	$0.00	This category added because LMS throws an error when there are no costs added to a "Utilize Existing" type of change. This category exists only as a workaround for a bug in LMS.	$0.00	N/A

Components

Information not provided.

Cost Information

Tower Equipment and Rigging Costs

Information not provided.

Cost Information

Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$160,500.00	$151,597.95	N/A	$80,292.05	N/A
Total for all systems	$835,355.84	$625,522.48	N/A	$435,169.96	N/A
Outside Professional Services	$160,500.00	$151,597.95		$80,292.05
RF Exposure Measurements	$21,050.00	$20,000.00	N/A	$0.00	N/A
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet	$10,520.00	$0.00	N/A	$0.00	N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization	$3,680.00	$1,541.35	Please see WVTB Attorney - Prepare Request for Special Temporary Authority Budget Revision Justification Letter	$1,497.60	N/A
Attorney Fees - Negotiation of lease and other matters for shared locations	$4,210.00	$5,641.60	Please see WVTB Attorney-Other Matters and Act 250 Application Filing Fees Budget Justification Cover Letter	$5,626.60	N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	$2,365.00	$2,250.00	N/A	$864.00	N/A
Prepare and or review reimbursement form	$2,630.00	$2,500.00	N/A	$0.00	N/A
Project management of the transition	$94,010.00	$99,675.00	As per Widelity quote	$68,647.45	N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	$5,260.00	$5,000.00	N/A	$0.00	N/A
Prepare request for Special Temporary Authorization	$2,050.00	$990.00	Please see WVTB RF Engineering -STA Budget Revision Justification Letter	$990.00	N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	$1,580.00	$1,500.00	N/A	$438.90	N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	$3,155.00	$3,000.00	N/A	$0.00	N/A
Perform engineering study for new channel assignment and antenna development	$7,360.00	$7,000.00	N/A	$2,227.50	N/A
Address transition timing and coordination issues w/ other stations and wireless	$2,630.00	$2,500.00	N/A	$0.00	N/A

Components

Actual Information Description	File Name
RF Exposure Measurements	Information not provided.
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet	Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization	Component Description: WVTB-550-Attorney-STA Amount: $1,497.60
Attorney Fees - Negotiation of lease and other matters for shared locations	Component Description: Professional Services Rendered Amount: $324.00 Component Description: Professional Services Rendered Amount: $403.20 Component Description: For services rendered Amount: $899.00 Component Description: Legal services rendered Amount: $117.00 Component Description: Legal Services Rendered Amount: $945.00 Component Description: Legal Services Amount: $78.00 Component Description: Professional Services Rendered Amount: $195.00 Component Description: Legal services rendered Amount: $267.00 Component Description: For Services Rendered Amount: $411.15 Component Description: Services Rendered Amount: $300.00 Component Description: Professional services rendered Amount: $395.00 Component Description: Professional Services Rendered Amount: $108.00 Component Description: legal services rendered Amount: $135.00 Component Description: For Services Rendered Amount: $1,049.25
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	Component Description: WVTB-550-Attorney - License to Cover Application (Main) Amount: $864.00
Prepare and or review reimbursement form	Information not provided.
Project management of the transition	Component Description: Project Management Amount: $3,668.65 Component Description: Project Management Amount: $389.05 Component Description: Project Management Amount: $175.15 Component Description: Project Management Amount: $1,175.00 Component Description: Project Management Amount: $272.50 Component Description: Project Management Amount: $232.50 Component Description: Project Management Amount: $20.15 Component Description: Project Management Amount: $3,981.90 Component Description: Project Management Amount: $6,332.05 Component Description: Project Management Amount: $387.70 Component Description: Project management Amount: $2,174.75 Component Description: Project Management Amount: $750.45 Component Description: Project Management Amount: $2,330.35 Component Description: Project Management Amount: $3,649.10 Component Description: Project Management Amount: $1,567.35 Component Description: Project Management Amount: $3,086.10 Component Description: Project Management Amount: $1,912.00 Component Description: Project Management Amount: $1,152.40 Component Description: Project management Amount: $10,044.85 Component Description: Project Management Amount: $366.25 Component Description: Project Management Amount: $2,336.70 Component Description: Project Management Amount: $1,662.10 Component Description: Project management Amount: $3,832.45 Component Description: Project Management Amount: $1,557.80 Component Description: Project management Amount: $6,230.95 Component Description: Project Management Amount: $1,213.05 Component Description: Project Management Amount: $363.50 Component Description: Project Management Amount: $899.30 Component Description: Project management Amount: $1,957.85 Component Description: Project management Amount: $2,270.20 Component Description: Project management Amount: $2,655.30
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	Information not provided.
Prepare request for Special Temporary Authorization	Component Description: WVTB-530-RF Eng -STA Amount: $990.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	Component Description: WVTB-530-RF Eng - License to Cover Application (Main) Amount: $438.90
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	Information not provided.
Perform engineering study for new channel assignment and antenna development	Component Description: Professional Fees Amount: $165.00 Component Description: Professional Services Amount: $2,062.50
Address transition timing and coordination issues w/ other stations and wireless	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	$74,480.39	$73,930.39	N/A	$43,795.10	N/A
Total for all systems	$835,355.84	$625,522.48	N/A	$435,169.96	N/A
Other Expenses	$74,480.39	$73,930.39		$43,795.10
Internal Labor	$31,145.17	$31,145.17	Please see WVTB Internal Labor Budget Revision Justification Letter	$30,778.77	N/A
UAXTE-12R44 INSTALL COMM	$15,978.05	$15,978.05	Transmitter & Mask Filter Installation & Commissioning by GatesAir representatives.	$0.00	N/A
Act 250 Application Filing Fees	$148.00	$148.00	Please see WVTB Attorney-Other Matters and Act 250 Application Filing Fees Budget Justification Cover Letter	$148.00	N/A
MVPD Notification of Channel Change	$500.00	$500.00	estimated Charter	$0.00	N/A
Develop and air announcement of upcoming channel change	$500.00	$500.00	N/A	$0.00	N/A
Equipment Storage	$2,753.50	$2,753.50	Please see BC Johnson Co.PC dated March 20, 2020	$2,753.50	N/A
Equipment Delivery and Handling Charges	$9,200.00	$9,200.00	GatesAir quote GA-00020078, plus estimated delivery up mountain road: GatesAir shipping: $6200.00 Delivery to site: $3000.00	$4,959.16	N/A
Disposal Costs (for equipment and other waste, net of any salvage value)	$2,205.67	$2,205.67	Please see BC Johnson Co.PC dated March 20, 2020	$2,205.67	N/A
Local Zoning	$500.00	$500.00	N/A	$0.00	N/A
DTV Medical Facility Notification	$11,550.00	$11,000.00	N/A	$2,950.00	N/A

Components

Actual Information Description	File Name
Internal Labor	Component Description: Internal Labor for Kristopher Collett Amount: $1,848.75 Component Description: Internal Labor for Jack Efromson Amount: $7,714.94 Component Description: Internal Labor Dana Nahumck Amount: $13,543.83 Component Description: Internal Labor for Laurence Page Amount: $7,671.25
UAXTE-12R44 INSTALL COMM	Information not provided.
Act 250 Application Filing Fees	Component Description: WVTB-610-Act 250 Application Filing Fees Amount: $148.00
MVPD Notification of Channel Change	Information not provided.
Develop and air announcement of upcoming channel change	Information not provided.
Equipment Storage	Component Description: WVTB-610-Equipment Storage Amount: $2,753.50
Equipment Delivery and Handling Charges	Component Description: WVTB-610-Equipment Delivery and Handling Amount: $4,959.16
Disposal Costs (for equipment and other waste, net of any salvage value)	Component Description: WVTB-610-Disposal Costs Amount: $2,205.67
Local Zoning	Information not provided.
DTV Medical Facility Notification	Component Description: Medical Notification Amount: $2,950.00

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$835,355.84	$625,522.48	$435,169.96

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 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.	Dana Nahumck Director of Engineering 02/23/2022

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.

Dana Nahumck

Director of Engineering

02/23/2022

(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

Add 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

Adjustment to Existing Antenna

Primary Antenna

Other Antenna Costs

Primary Antenna

Other Antenna Cost Not Listed

Transmission Line

Primary Transmission Line

Existing Transmission Line

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Tower Equipment And Rigging Costs

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

Cost Information

Outside Professional Services

Components

Cost Information

Other Expenses

Components

Cost Information

Grand Total

Reimbursement Status

Certification

Attachments