TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
WTVQ-TV, LLC Doing Business As: WTVQ-TV, LLC	Bobby Berry 301 Poplar Street Macon, GA 40509 United States	+1 (478) 745-4141	bberry@morrisnetwork.com	Limited Liability Company

Applicant

Address

Phone

Applicant Type

WTVQ-TV, LLC

Doing Business As: WTVQ-TV, LLC

Bobby Berry

301 Poplar Street

Macon, GA 40509

United States

+1 (478) 745-4141

bberry@morrisnetwork.com

Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant	Address	Phone	Email
[Confidential]

Preparer Contact Information

Preparer Contact Name and Information

Applicant	Address	Phone	Email
Anne Goodwin Crump Communications Counsel Fletcher, Heald & Hildreth,P.L.C.	Anne Goodwin Crump 1300 N. 17th Street Eleventh Floor Arlington, VA 22209 United States	+1 (703) 812-0426	crump@fhhlaw.com

Applicant

Address

Phone

Anne Goodwin Crump

Communications Counsel

Fletcher, Heald & Hildreth,P.L.C.

Anne Goodwin Crump

1300 N. 17th Street

Eleventh Floor

Arlington, VA 22209

United States

+1 (703) 812-0426

crump@fhhlaw.com

Broadcaster Information and Transition Plan

Question	Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information.	Yes
Briefly describe transition plan	WTVQ-DT plans to replace its existing transmitters to accomodate its new channel. The antenna and line is provided by WLEX-TV under a contract.

Transmitters

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

Auxiliary Transmitter

Add Transmitter Information

Section	Question	Response
Existing Transmitter Description	Type of change	Purchase New
	Use	Auxiliary (Backup)
	Description of Use	use as backup for main when main transmitter is down for repairs or maintance
	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	Diamondcd DHD8P1
	Year	2001
	Type	Solid State
	Solid State Cooling	Air Cooled
	Solid State Power Capacity	1.8 kW

Auxiliary Transmitter

New Transmitter Costs

Section	Question	Response
New Transmitter	Use	Auxiliary (Backup)
	Change Type	Purchase New
	Is this a request for upgraded equipment?	No
	Manufacturer
	Model	UAXTE-4R37
	Transmitter Type	Solid State
	Solid State Cooling	Air Cooled
	Solid State Power capacity	2.5 kW
	Justification for New Transmitter	OLD TRANSMITTER WILL NOT TUNE TO NEW CHANNEL

Auxiliary 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	150 kVA
	Rigid Conduit and Wiring	Yes
	Size	3 inches
	Length	75.0 feet
	Other Electrical Service	No
	Description	N/A
HVAC Service	Does the replacement transmitter require HVAC Service?	No
	Type	N/A
	Size	N/A
	Other Size	N/A
Transmitter Building Addition/Modification or Leasehold Improvement	Does the Transmitter Building require an addition, modification, other leashold improvement?	No
	Size	N/A
Channel 14 Costs	Is an RF Consulting Engineer needed?	N/A
	Is a channel 14 Mask Filer needed?	N/A
	Is additional field engineering time needed?	N/A
	Number of Days	N/A

Auxiliary Transmitter

Other Transmitter Cost Not Listed

Information not provided.

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	sigmacd cd3200p2
	Year	2004
	Type	Inductive Output Tube
	IOT Power Type	Two
	Power Capacity	42 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	ULXTE-40
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	25 kW
	Justification for New Transmitter	WTVQ must go to V-POL because of contract with WLEX. WLEX upgrading to V-POL antenna,under contract WLEX provides antenna for both stations. Further, please see Attachment as to why change to solid state is simple replacement, not upgrade.

Primary Transmitter

Other Transmitter Costs

Section	Question	Response
Electrical Service	Service Entrance (3 phases 800A 208V)	Yes
	Switchgear (industrial 800 amp)	No
	Transformer (480V)	Yes
	Power	150 kVA
	Rigid Conduit and Wiring	Yes
	Size	3 inches
	Length	200.0 feet
	Other Electrical Service	No
	Description	N/A
HVAC Service	Does the replacement transmitter require HVAC Service?	Yes
	Type	Cooling Only
	Size	10 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
tv dmod and monitor	TV Tuner ATSC-SDI-4i HD for testing of new transmitter signal
site survey	Site survey By Gates/Air to provide electrical drawings and floor plan of transmitter site
Rigid line and componentss	6-1/8 rigid line and components to connect transmitter to combiner

Antennas

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

Auxiliary Antenna

Add Antenna Information

Section	Question	Response
Existing Antenna Description	Type of change	Purchase New
	Antenna Use	Auxiliary (Backup)
	Description of Use	back up antenna use when main system is down for maintance and repairs,will also be used for interim
	Ownership	Owned
	Owner	N/A
	Site	N/A
	Is this antenna currently shared with any other stations?	No
	Is this 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:	84.0 kW
	Manufacturer
	Model	TLP-16D
	Year	2001

Auxiliary Antenna

New Antenna Costs

Section	Question	Response
New Antenna Description	Use	Auxiliary (Backup)
	Description of Use	backup antenna will be used when main is down for maintance and repairs.will also be used as a inter
	Change Type	Purchase New
	Is this a request for upgraded equipment?	No
	Ownership	Owned
	Owner	N/A
	Is antenna shared?	No
	Is antenna directional?	No
	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	Horizontal
	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:	84.0 kW
	Manufacturer
	Model	SWEDM16NCS/27
	Year	2018
	Justification for New Antenna	old antenna will not tune to new channel

Auxiliary 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	N/A
	Do you need a combiner output splitter/switcher for dual feed lines?	N/A
Elbow Complex	Do you require the separate purchase of the Elbow Complex?	No
	Broadband or Single Channel?	N/A
	Feed Line Size	N/A
Side Mount Brackets	Do you require the separate purchase of side mount brackets for a high power antenna?	Yes
Pattern Scatter Analysis	Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna?	Yes
Sweep Test	Do you require the sweep testing of transmission line and antenna?	Yes

Auxiliary Antenna

Other Antenna Cost Not Listed

Information not provided.

Primary Antenna

Existing Antenna Information

Section	Question	Response
Existing Antenna Description	Type of change	Lease New
	Antenna Use	Primary (Main)
	Description of Use	N/A
	Ownership	Leased
	Owner	WLEX-TV
	Site	N/A
	Is the existing antenna shared with another station or stations?	Yes
	Is the existing antenna directional?	Yes
	Is antenna in operating condition?	Yes
	Is antenna located on or in close proximity to an antenna farm?	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-30DSC-R 3S180DC
	Year	2004

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

Facility ID	Call Sign
73203	WLEX-TV

Primary Antenna

New Antenna Costs

Section	Question	Response
New Antenna Description	Use	Primary (Main)
	Description of Use	N/A
	Change Type	Lease New
	Is this a request for upgraded equipment?	No
	Ownership	Leased
	Owner	WLEX-TV
	Is antenna shared?	Yes
	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:	487.0 kW
	Manufacturer
	Model	TFU-30DSC/VP-R 3S180
	Year	2018
	Justification for New Antenna	Old antenna will not tune to new channel. BY contract WLEX will supply antenna at no cost to WTVQ

Primary Antenna

Other Antenna Costs

Section	Question	Response
Combiner for Shared Antenna	Do you need a Combiner for a Shared Antenna?	Yes
	Type	New
	Number of channels supported	2
	Frequencies of channels supported	RF channel
	Frequency	N/A
	Do you need a combiner output splitter/switcher for dual feed lines?	No
Elbow Complex	Do you require the separate purchase of the Elbow Complex?	No
	Broadband or Single Channel?	N/A
	Feed Line Size	N/A
Side Mount Brackets	Do you require the separate purchase of side mount brackets for a high power antenna?	No
Pattern Scatter Analysis	Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna?	Yes
Sweep Test	Do you require the sweep testing of transmission line and antenna?	Yes

Enter a list of RF channel numbers.

RF Channel Number
28
27

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

Auxiliary Transmission Line

Add Transmission Line

Section	Question	Response
Existing Transmission Line Description	Type of change	Utilize Existing
	Use	Auxiliary (Backup)
	Description of Use	Backup
	Ownership	Owned
	Owner	N/A
	Site	N/A
	Is this transmission currently shared with any other stations?	No
	Is Transmission Line in operating condition?	Yes
Existing Transmission Line Manufacturer and Type	Manufacturer	Dielectric
	Type	Rigid
	Diameter	3 1/8 inches
	Other Diameter	N/A
	Segment Length	20 inches
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	560 feet per run

Auxiliary Transmission Line

Other Transmission Line Expenses Not Listed

Name	Description
Rigid line and componentss	line and components needed to connect backup transmitter to existing 3-1/8 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

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	No
	Is tower documented for structural analysis?	No
	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	1044034
Coordinates (NAD83)	Latitude (NAD83)	38° 02' 03.0" N-
	Longitude (NAD83)	084° 23' 39.0" W-
	Overall Structure Height	994.08 feet
	Support Structure Height	935.03 feet
	Ground Elevation Above Mean Sea Level (AMSL)	1000.64 feet
	Structure Type	TOWER - Free Standing or Guyed Structure
	Tower Owner	Nexstar Broadcasting, Inc.
	Date Constructed	01/01/1965

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
73203	WLEX-TV	DTV

Primary Tower

Tower Modification Costs

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

Information not provided.

Outside Professional Services Costs

Section	Question	Response
Outside Project Management Services	Do you require outside project management services?	Yes
	Number of Hours	1150
	Explanation	Station is one of a group of co-owned stations, all of which are subject to repack. There is no group director of engineering, and station has only IT engineer on staff. Co-ordination is needed for the entire group's transition in different phases.
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	No
	ASR Modification	No
	FAA Consultation (including preparation of FAA Form 7460)	No
	Negotiation of Lease and other Matter for Shared Locations	No
	Prepare or Review FCC Form 399 for Reimbursement	Yes
	Address transition timing and coordination issues w/ other stations and wireless providers	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
Additional legal fees	Additional legal fees for 399 forms and progress reports

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	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

Other Expenses Not Listed

Name	Description
Building Clean out and disposal	removal of old transmitters and rf equipment and dispose of transformer oil

Cost Information

Transmitters

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

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$2,672,620.00	$1,609,581.97	N/A	$1,038,804.27	N/A
Total for all systems	$3,931,212.50	$2,271,541.97	N/A	$1,392,798.87	N/A
Primary Transmitter ULXTE-40	$2,517,170.00	$1,483,894.91		$913,117.21
Rigid line and componentss	$5,440.00	$5,440.00	N/A	$5,438.70	N/A
site survey	$0.00	$0.00	N/A	N/A	N/A
tv dmod and monitor	$2,480.00	$2,480.00	N/A	$0.00	N/A
10 Ton system	$38,900.00	$37,000.00	N/A	$14,996.00	N/A
3" Rigid Conduit and Wiring (Cost per foot)	$10,400.00	$0.00	N/A	N/A	N/A
Transformer 3 phase/480v - 150 KVA	$25,550.00	$57,500.00	this is all electrical for both main and backup transmitters and includes conduit,panels,wiring,transformers and labor all other line estimates have been changed to 0 dollars	$57,500.00	this invoice is for 50% all electrical work for both main and backup transmitters includes all conduit,panels,wiring and labor
Service entrance 3 phase/800 amp/208 volt	$14,400.00	$0.00	N/A	N/A	N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW	$947,000.00	$842,179.89	N/A	$295,887.49	N/A
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW	$1,473,000.00	$539,295.02	*System Notice: Estimate adjusted and locked because line has been superseded.*	$539,295.02	N/A
Auxiliary Transmitter UAXTE-4R37	$155,450.00	$125,687.06		$125,687.06
3" Rigid Conduit and Wiring (Cost per foot)	$3,900.00	$1,510.82	N/A	$1,510.82	N/A
Transformer 3 phase/480v - 150 KVA	$25,550.00	$0.00	N/A	N/A	N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW	$126,000.00	$124,176.24	N/A	$124,176.24	shipping and state tax added making cost over estimate

Components

Actual Information Description	File Name
Rigid line and componentss	Component Description: 6-1/8 line sections used to connect filter to existing antenna line Amount: $5,438.70
site survey	Information not provided.
tv dmod and monitor	Component Description: TV dmod for testing of new transmitter Amount: $2,479.19
10 Ton system	Component Description: 10 TON HVAC System installed Amount: $14,996.00
3" Rigid Conduit and Wiring (Cost per foot)	Information not provided.
Transformer 3 phase/480v - 150 KVA	Component Description: Amteck Final invoice for all electrical work Amount: $28,750.00 Component Description: AMTECK Invoice is 50% down payment for all electrical work on both main and backup trensmitters Amount: $28,750.00
Service entrance 3 phase/800 amp/208 volt	Information not provided.
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW	Component Description: 3rd payment on main transmitter Amount: $222,939.18 Component Description: Main Transmitter final payment including installation, proof, freight and KY sales tax Amount: $72,948.31
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW	Component Description: 2nd payment due to ship transmitter Amount: $258,568.39 Component Description: WLEX tower lease for Justification information Amount: N/A Component Description: WTVQ Main tx Quote # 62143 Amount: N/A Component Description: WTVQ Transmitter Justification Letters Amount: N/A Component Description: 3rd transmitter payment only, freight , installation and proof not charged for at this time Amount: $222,939.18 Component Description: 1/3 down payment for Main tx Amount: $280,726.63
3" Rigid Conduit and Wiring (Cost per foot)	Component Description: total cost of electrical minus $38850.0 of transmitter 1/3 down payment invoice Amount: $1,510.82
Transformer 3 phase/480v - 150 KVA	Information not provided.
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW	Component Description: 2nd payment due to ship bku transmitter Amount: $35,348.41 Component Description: WTVQ 3rd Back up transmitter payment Amount: $25,026.58 Component Description: 1/3 down payment on backup tx minus $1510.82 for Electrical Amount: $38,850.01 Component Description: WTVQ Quote # 62144 Amount: N/A Component Description: Backup Transmitter final payment including installation, proof, freight and KY sales tax Amount: $24,951.24

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	$447,730.00	$91,400.00	N/A	$47,947.95	N/A
Total for all systems	$3,931,212.50	$2,271,541.97	N/A	$1,392,798.87	N/A
Primary Antenna TFU-30DSC/VP-R 3S180	$323,190.00	$0.00		$0.00
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)	$5,260.00	$0.00	N/A	N/A	N/A
New combiner, cost per channel (without antenna)	$84,200.00	$0.00	N/A	N/A	N/A
UHF - Lower Power Side Mount, One station antenna -- 200-500 kW, elliptically or circularly polarized	$227,000.00	$0.00	N/A	N/A	N/A
Sweep test of existing antenna	$6,730.00	$0.00	N/A	N/A	N/A
Auxiliary Antenna SWEDM16NCS/27	$124,540.00	$91,400.00		$47,947.95
Sweep test of existing antenna	$6,730.00	$6,400.00	N/A	N/A	N/A
UHF - Lower Power Side Mount, One station antenna - medium power (50-200 kW), horizontally polarized	$89,400.00	$85,000.00	N/A	$47,947.95	N/A
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)	$5,260.00	$0.00	N/A	N/A	N/A
Side mount brackets for high power antennas (if not included in antenna base cost)	$23,150.00	$0.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)	Information not provided.
New combiner, cost per channel (without antenna)	Information not provided.
UHF - Lower Power Side Mount, One station antenna -- 200-500 kW, elliptically or circularly polarized	Information not provided.
Sweep test of existing antenna	Information not provided.
Sweep test of existing antenna	Information not provided.
UHF - Lower Power Side Mount, One station antenna - medium power (50-200 kW), horizontally polarized	Component Description: WTVQ AUX/ Backup antenna and side mounts WITH JUSTIFICATION Amount: $47,947.95
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)	Information not provided.
Side mount brackets for high power antennas (if not included in antenna base cost)	Information not provided.

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	$9,000.00	$9,000.00	N/A	$0.00	N/A
Total for all systems	$3,931,212.50	$2,271,541.97	N/A	$1,392,798.87	N/A
Auxiliary Transmission Line	$9,000.00	$9,000.00		$0.00
Rigid line and componentss	$9,000.00	$9,000.00	N/A	$0.00	N/A

Components

Actual Information Description	File Name
Rigid line and componentss	Component Description: invoice with justification added Amount: $5,438.70

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	$394,800.00	$175,000.00	N/A	$104,697.00	N/A
Total for all systems	$3,931,212.50	$2,271,541.97	N/A	$1,392,798.87	N/A
Primary Tower TOWER	$394,800.00	$175,000.00		$104,697.00
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study	$26,300.00	$25,000.00	N/A	$6,500.00	N/A
Minor tower reinforcement/modifications	$158,000.00	$150,000.00	N/A	$98,197.00	N/A
Tall Tower (greater than 500')	$210,500.00	$0.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study	Component Description: 4SE TOWER ANALYSIS INVOICE Amount: $6,500.00 Component Description: 4SE W9 FORM Amount: N/A Component Description: 4SE QUOTE TOWER ANALYSIS Amount: N/A
Minor tower reinforcement/modifications	Component Description: deposit for antennas removal and installation Amount: $28,000.00 Component Description: Progress invoice for tower work Amount: $31,111.20 Component Description: FINAL PAYMENT CTC TOWER with information requested Amount: $18,345.00 Component Description: completion of tower work invoice Amount: $20,740.80 Component Description: CTC PROPOSAL # 10181701T Amount: N/A
Tall Tower (greater than 500')	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	$326,160.00	$314,427.50	N/A	$167,252.15	N/A
Total for all systems	$3,931,212.50	$2,271,541.97	N/A	$1,392,798.87	N/A
Outside Professional Services	$326,160.00	$314,427.50		$167,252.15
Additional legal fees	$8,500.00	$8,500.00	N/A	$787.50	N/A
RF Exposure Measurements	$21,050.00	$20,000.00	N/A	N/A	N/A
Comprehensive coverage verification via field study, if needed	$84,200.00	$80,000.00	N/A	N/A	N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization	$3,680.00	$3,500.00	N/A	$3,487.50	N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	$2,365.00	$2,250.00	N/A	$787.50	N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	$5,260.00	$5,000.00	N/A	$1,462.50	N/A
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 and or review reimbursement form	$2,630.00	$7,177.50	The process of completing the form and ensuring exact recording of information is time consuming in a way for which the predetermined estimate is inadequate.	$7,177.50	N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	$3,155.00	$3,000.00	N/A	N/A	N/A
Perform engineering study for new channel assignment and antenna development	$7,360.00	$7,000.00	N/A	N/A	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
Project management of the transition	$181,700.00	$172,500.00	N/A	$153,549.65	N/A

Components

Actual Information Description	File Name
Additional legal fees	Component Description: Legal advice and counsel concerning completing certification requirement for channel change public notice Amount: $112.50 Component Description: Assist with transition status reports and provide advice on FCC rules and policies governing repack Amount: $225.00 Component Description: Assisted with transition status progress reports Amount: $337.50 Component Description: Assist with required progress report Amount: $112.50
RF Exposure Measurements	Information not provided.
Comprehensive coverage verification via field study, if needed	Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization	Component Description: Legal fees for teleconfs. with FCC staff and station sharing antenna concerning STA request and advice to client regarding same Amount: $337.50 Component Description: Legal fees for completing and filing then modifying and reformatting request for transition phase change per request from FCC staff Amount: $1,237.50 Component Description: Legal fees for work on STA request for change in transition phase for WTVQ-DT Amount: $1,912.50
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	Component Description: Provide legal advice and assistance with license application and related matters Amount: $787.50
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	Component Description: Legal fees in connection with preparation of Form 2100 application for construction permit Amount: $787.50 Component Description: Legal fees in connection with the preparation and filing of Form 2100 construction permit application Amount: $562.50 Component Description: Legal fees for advice concerning preparation and filing of Form 2100 application for construction permit Amount: $112.50
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 and or review reimbursement form	Component Description: Legal advice and assistance with requesting reimbursement of repack expenses Amount: $225.00 Component Description: Legal advice and assistance with requesting reimbursement of repack expenses. Amount: $112.50 Component Description: Legal fees in connection with preparation and filing of information necessary to enable reimbursement Amount: $202.50 Component Description: Assisted client and contacted FCC in attempt to resolve technical difficulties with Form 399 and inability to update Amount: $225.00 Component Description: Legal advice and counsel in connection with requesting reimbursement of repack expenses Amount: $112.50 Component Description: Provide legal advice and assistance in connection with reimbursement requests Amount: $450.00 Component Description: Provided legal advice and counsel in connection with reimbursement Amount: $225.00 Component Description: Legal fees for advice concerning reimbursement process and forms Amount: $112.50 Component Description: Assist with compiling information for and preparation of Form 399 Amount: $337.50 Component Description: Legal fees in connection with the preparation and filing of Form 1876 and Schedule 399 Amount: $337.50 Component Description: Legal advice and assistance with reimbursement request Amount: $337.50 Component Description: Legal advice in connection with reimbursement Amount: $315.00 Component Description: Legal advice and assistance in connection with requesting reimbursement of repack expenses. Amount: $270.00 Component Description: Provide legal advice and counsel in connection with reimbursement issues Amount: $112.50 Component Description: Provide legal advice and assistance with reimbursement request Amount: $225.00 Component Description: Legal fees in connection with preparation and filing of Schedule 399 Amount: $540.00 Component Description: Legal advice and assistance with requesting reimbursement of repack expenses. Amount: $562.50 Component Description: Legal advice and assistance with requesting reimbursement of repack expenses Amount: $112.50 Component Description: Provide legal advice and counsel in connection with reimbursement requests Amount: $112.50 Component Description: Legal advice and assistance with seeking reimbursement of repack expenses Amount: $112.50 Component Description: Assist with preparation of Form 399 Amount: $1,012.50 Component Description: Provide legal advice and assistance with seeking reimbursement of repack expenses Amount: $1,125.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	Information not provided.
Perform engineering study for new channel assignment and antenna development	Information not provided.
Address transition timing and coordination issues w/ other stations and wireless	Information not provided.
Project management of the transition	Component Description: CSS INVOICE OCT. 2018 Amount: $562.50 Component Description: PROJECT MANAGEMENT INVOICE Amount: $712.50 Component Description: PROJECT MANAGEMENT INVOICE Amount: $825.00 Component Description: SEPT. 2017 PROJECT MANAGEMENT INVOICE Amount: $405.00 Component Description: APRIL 2018 PROJECT MANAGEMENT INVOICE Amount: $787.50 Component Description: PROJECT MANAGEMENT HOURS APRIL 2017 Amount: $2,625.00 Component Description: WTVQ CSS PROJECT MANAGEMENT INVOICE 21-0306 Amount: $3,787.50 Component Description: Project Management invoice Amount: $1,200.00 Component Description: Project Management invoice Amount: $2,662.50 Component Description: Project Management invoice Amount: $1,237.50 Component Description: Project Management invoice Amount: $975.00 Component Description: Project Management invoice Amount: $1,125.00 Component Description: Project Management invoice Amount: $1,612.50 Component Description: Project Management invoice Amount: $1,462.50 Component Description: Project Management invoice Amount: $1,237.50 Component Description: WTVQ Aug. 2019 project management invoice 19-0806 Amount: $16,790.10 Component Description: Oct. Project Management invoice 19-1006 Amount: $26,509.20 Component Description: REVISED LODGING PER DIEM Amount: $225.00 Component Description: WTVQ CSS PROJECT MANAGEMENT INVOICE 21-0206 Amount: $1,500.00 Component Description: Project Management invoice Amount: $6,000.00 Component Description: JULY 2017 PROJECT MANAGEMENT INVOICE Amount: $1,870.50 Component Description: Nov. 2018 CSS invoice Amount: $225.00 Component Description: Revised Lodging with camper invoice Amount: $2,175.00 Component Description: CSS JAN, 2018 INVOICE FOR PROJECT MANAGEMENT HOURS Amount: $1,800.00 Component Description: March 2019 invoice for project Management Amount: $1,650.00 Component Description: May 2019 Project Management invoice 19-0506 Amount: $1,987.50 Component Description: Project Management invoice Amount: $1,237.50 Component Description: CSS OCT. 2017 INVOICE FOR PROJECT MANAGEMENT HOURS Amount: $2,925.00 Component Description: Project Management invoice Amount: $1,387.50 Component Description: WTVQ Sept. 2019 project management invoice 19-0906 Amount: $22,767.00 Component Description: June 2019 Project Management invoice Amount: $2,325.00 Component Description: PROJECT MANAGEMENT HOURS MAY 2017 Amount: $1,548.00 Component Description: Jan. 2019 CSS invoice 19-0106 Amount: $562.50 Component Description: Dec. 2018 CSS invoice Amount: $450.00 Component Description: PROJECT MANAGEMENT INVOICE Amount: $1,575.00 Component Description: PROJECT MANAGEMENT INVOICE Amount: $2,025.00 Component Description: WTVQ CSS PROJECT MANAGEMENT INVOICE 21-0106 Amount: $1,237.50 Component Description: FEB Project Management invoice Amount: $1,612.50 Component Description: MARCH 2018 PROJECT MANAGEMENT INVOICE Amount: $862.50 Component Description: Lodging with camper invoice Amount: $1,125.00 Component Description: SEPT CSS INVOICE Amount: $1,575.00 Component Description: CSS April 2019 invoice A19-0406 Amount: $7,206.35 Component Description: DEC Project Management invoice Amount: $2,175.00 Component Description: CSS July 2019 project Management invoice Amount: $2,137.50 Component Description: JAN Project Management invoice Amount: $1,912.50 Component Description: FEB 2018 INVOICE FOR PROJECT MANAGEMENT Amount: $2,850.00 Component Description: PROJECT MANAGEMENT HOURS JUNE 2017 Amount: $2,341.50 Component Description: MAR Project Management invoice Amount: $1,650.00 Component Description: Nov. Project Management invoice 19-1106 Amount: $1,650.00 Component Description: April 2020 PM invoice Amount: $1,762.50 Component Description: DEC CSS INVOICE WITH NAMES Amount: $1,350.00 Component Description: NOV CSS INVOICE Amount: $1,275.00 Component Description: Feb. 2019 CSS invoice 19-0206 Amount: $1,912.50 Component Description: JULY CSS INVOICE Amount: $1,237.50 Component Description: CSS JUNE PROJECT MANAGEMENT INVOICE Amount: $1,387.50 Component Description: AUG. 2017 PROJECT MANAGEMENT INVOICE Amount: $837.00

Cost Information

Other Expenses

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

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$80,902.50	$72,132.50	N/A	$34,097.50	N/A
Total for all systems	$3,931,212.50	$2,271,541.97	N/A	$1,392,798.87	N/A
Other Expenses	$80,902.50	$72,132.50		$34,097.50
Building Clean out and disposal	$30,000.00	$30,000.00	N/A	$29,550.00	N/A
MVPD Notification of Channel Change	$1,375.00	$1,375.00	N/A	$1,375.00	N/A
Develop and air announcement of upcoming channel change	$337.50	$337.50	The prior estimate was slightly too low due to the need to provide more details about the notices when the time for airing them arrived.	$337.50	N/A
Equipment Storage	$10,000.00	$10,000.00	N/A	N/A	N/A
Equipment Delivery and Handling Charges	$20,000.00	$20,000.00	N/A	N/A	N/A
Disposal Costs (for equipment and other waste, net of any salvage value)	$5,000.00	$5,000.00	N/A	N/A	N/A
Non-zoning permits	$500.00	$500.00	N/A	N/A	N/A
Local Zoning	$500.00	$500.00	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
FCC Filing Fees - Form 2100 minor change CP application	$1,110.00	$1,070.00	N/A	N/A	N/A
DTV Medical Facility Notification	$11,550.00	$2,835.00	N/A	$2,835.00	N/A

Components

Actual Information Description	File Name
Building Clean out and disposal	Component Description: Clean out of building and removal of transformer oil Amount: $29,550.00
MVPD Notification of Channel Change	Component Description: MVPD notification invoice Amount: $1,375.00
Develop and air announcement of upcoming channel change	Component Description: Legal advice and assistance with preparing notices of channel change for viewers Amount: $112.50 Component Description: Provide legal advice and assistance in connection with required notices to consumers Amount: $225.00
Equipment Storage	Information not provided.
Equipment Delivery and Handling Charges	Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value)	Information not provided.
Non-zoning permits	Information not provided.
Local Zoning	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.
DTV Medical Facility Notification	Component Description: Medical notification invoice Amount: $2,835.00

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$3,931,212.50	$2,271,541.97	$1,392,798.87

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.	Bobby Berry Chief Operating Officer 03/21/2022

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.

Bobby Berry

Chief Operating Officer

03/21/2022

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.	Bobby Berry Chief Operating Officer 03/21/2022

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.

Bobby Berry

Chief Operating Officer

03/21/2022

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.	Bobby Berry Chief Operating Officer 03/21/2022

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.

Bobby Berry

Chief Operating Officer

03/21/2022

(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

Auxiliary Transmitter

Add Transmitter Information

Auxiliary Transmitter

New Transmitter Costs

Auxiliary Transmitter

Other Transmitter Costs

Auxiliary Transmitter

Other Transmitter Cost Not Listed

Primary Transmitter

Existing Transmitter Information

Primary Transmitter

New Transmitter Costs

Primary Transmitter

Other Transmitter Costs

Primary Transmitter

Other Transmitter Cost Not Listed

Antennas

Auxiliary Antenna

Add Antenna Information

Auxiliary Antenna

New Antenna Costs

Auxiliary Antenna

Other Antenna Costs

Auxiliary Antenna

Other Antenna Cost Not Listed

Primary Antenna

Existing Antenna Information

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

Primary Antenna

New Antenna Costs

Primary Antenna

Other Antenna Costs

Enter a list of RF channel numbers.

Primary Antenna

Other Antenna Cost Not Listed

Transmission Line

Auxiliary Transmission Line

Add Transmission Line

Auxiliary Transmission Line

Other Transmission Line Expenses Not Listed

Tower Equipment And Rigging Costs

Primary Tower

Existing Tower

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

Primary Tower

Tower Modification Costs

Primary Tower

Tower Rigging Costs

Primary Tower

Other Tower Expenses Not Listed

Outside Professional Services Costs

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Other Expenses

Other Expenses

Other Expenses Not Listed

Cost Information

Transmitters

Components

Cost Information

Antennas

Components

Cost Information

Transmission Line

Components

Cost Information

Tower Equipment and Rigging Costs

Components

Cost Information

Outside Professional Services

Components