Go to the Federal Communications Commission homepage at www.fcc.gov

FCC Form 399: Reimbursement Request

Approved by OMB 3060-1178
Go to the Federal Communications Commission homepage at www.fcc.gov

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

Facility ID:
33869
Service:
DCA
Call Sign:
WMKG-CD
Channel:
31 (UHF)
File Number:
0000028533
FRN:
0026207225
Date Submitted:
03/22/2022

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

WMKG-TV, LLC

Doing Business As: TV31

Steve Kanzer

4237 AIRLINE ROAD

NORTON SHORES, MI 49441

United States

+1 (561) 948-0950 steve@vrvc.com Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

The Preparer is same as the reimbursement contact.

 

 

 

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan WMKG-TV installed the new filter and antenna and retuning the encoder and transmitter to new channel 31 during the Phase 6 window.

Transmitters

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

Primary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Retune Existing
Use Primary (Main)
Ownership Owned
Owner 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 Hitachi Comark
Model AT73-1K5-8VSB
Year 2013
Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1.5 kW

Primary Transmitter

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Retuning Transmitter Costs

Section Question Response
New IOT Tubes Number of Tubes (including accessories) needed N/A
New Mask Filter
Power 1.5 kW
Other Power N/A
New Exciter Is a new exciter needed? No

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring No
Size N/A
Length N/A
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

Primary Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

Antennas

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

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? No
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 Class A
Mounting Side Mount
Antenna position in stack Top
Polarization Circular
Type Broadband Panel
Number of Stations Supported 1
Number of Panels 8
Design power capacity in use 50.0 %
Lower Limit 572.00 MHz
Upper Limit 578.00 MHz
Other Antenna Type N/A
ERP: 15.0 kW
Manufacturer
Model PSILP8OI-31-EP
Year 2019

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? 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 Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Broadband Panel
Number of Stations Supported 1
Number of Panels/Bays 8
Lower Limit 572.00 MHz
Upper Limit 578.00 MHz
Design power capacity in use 50.0 %
Other Antenna Type N/A
ERP: 15.0 kW
Manufacturer
Model PSILP8Oi-31-EP
Year 2019
Justification for New Antenna Prior antenna was only designed for channels 44-65. Station was broadcasting on channel 49 but repacked to channel 31 during the Phase 6 window. Hence need for new antenna.

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna?
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? No
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? No

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Antenna Freight

Freight costs for new antenna actual $660.08

Remove and Replace Antenna

Costs to remove and replace antenna on tower, actual $1,800.00

Transmission Line

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

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Flexible Foam
Diameter 1 5/8 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 200 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Flexible Foam
Diameter 1 5/8 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 200 feet per run
Justification for New Transmission Line Old transmission line was too short for required modifications.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Connectors

Connectors, angle adapaters, hangers, hoisting grip, grounding kit, coupling hardware and freight $1,489.98

Tower Equipment And Rigging Costs

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

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 10
Explanation We do not have an in-house engineer.
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 No
Quantity N/A
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 No
Quantity N/A
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 No
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 No
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Replace Antenna

Tower crew to remove and replace Ch. 49 antenna on tower with antenna for Ch. 31.

Electricians

One day service to add electrical service box for transmitter site

FCC Legal Counsel

Line items from Koerner invoices paid for time from Nov 2018 to April 2020 exclusively for repack $4,900.00

du Treil Engineeering

Engineering services for repack totaling $1,000.

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? No
Permit and Filing Costs Local Zoning No
Non-zoning permits No
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)? No
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? No
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Name Description

Channel 31 Band Pass Filter

Band pass filter for channel 31 replaced old channel 49 filter. $2,000 of $71,918.35 Anywave invoice and expense paid by station for new transmitter, exciter and encoder.

Cost Information

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Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $108,230.00 $5,950.00 N/A $0.00 N/A
Total for all systems $208,830.00 $74,447.32 N/A $1,400.00 N/A
Primary Transmitter AT73-1K5-8VSB $108,230.00 $5,950.00 $0.00
1.5 kW mask filter $3,030.00 $3,950.00 Cost estimate for new filter received from engineer. $0.00 $2,000 was spent for a channel 31 band pass filter since old channel 49 filter could not be retuned to channel 31 for less.
UHF and VHF - minor banding issues $105,200.00 $2,000.00 Retune transmitter estimate = $800 Remove an replace filter = $800 Freight for filter = $400 $0.00 N/A

Components

Actual Information Description File Name
1.5 kW mask filter

Component Description:
The channel 31 band pass filter was bought along with a new transmitter, exciter and encoder the cost of which, $69,918.35, WMKG-CD is not seeking reimbursement.
Amount:
$2,000.00
UHF and VHF - minor banding issues Information not provided.

Cost Information

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Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $42,280.00 $13,600.00 N/A $0.00 N/A
Total for all systems $208,830.00 $74,447.32 N/A $1,400.00 N/A
Primary Antenna PSILP8Oi-31-EP $42,280.00 $13,600.00 $0.00
Remove and Replace Antenna $5,000.00 $5,000.00 Remove and replace antenna = $5,000 $0.00 The Form 399 will not allow editing of the actual antenna cost, so the cost of the antenna is in with the installation work.
Antenna Freight $900.00 $900.00 Estimated freight for new antenna = $900 N/A N/A
UHF - Lower Power Side Mount, Class A broadband panel (cost per panel) $10,080.00 $1,000.00 New side mount for new antenna. N/A N/A
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $26,300.00 $6,700.00 Cost estimate for new antenna = $6700 $0.00 The antenna cost was underestimated at a time when there wasn't high demand and time critical nature of having one made before winter, ice and high winds of Lake Michigan winter would have delayed window until Spring.

Components

Actual Information Description File Name
Remove and Replace Antenna

Component Description:
FCC repack legal expenses from 11-1-18 thru 4-1-20 highlighted in five invoices.
Amount:
$4,900.00

Component Description:
Removal Ch 49 and installation of Ch 31 antenna by crew.
Amount:
$1,800.00

Component Description:
Engineering services for channel 31 repack antenna contour.
Amount:
$1,000.00

Component Description:
Transmission Line, connectors, angle adapters, hoisting and grounding kits.
Amount:
$2,597.32

Component Description:
Electrical work in the building for the new repack equipment.
Amount:
$712.00
Antenna Freight Information not provided.
UHF - Lower Power Side Mount, Class A broadband panel (cost per panel) Information not provided.
UHF - Lower Power Side Mount, Class A One Station antenna -- basic

Component Description:
Replacement antenna from Ch. 49 to Ch. 31. for the repack.
Amount:
$13,914.13

Cost Information

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Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $4,800.00 $2,597.32 N/A $0.00 N/A
Total for all systems $208,830.00 $74,447.32 N/A $1,400.00 N/A
Primary Transmission Line $4,800.00 $2,597.32 $0.00
Flexible Foam Transmission Line - dielectric, 1 5/8" $4,800.00 $2,597.32 Had hoped to use old line but it was too short and an unreliable installation. $0.00 We had hoped to use old transmission line but it was too short for the new equipment and could be unreliable.
Connectors $0.00 $0.00 Connectors for side mount not too expensive. $0.00 Connectors in transmission line invoice.

Components

Actual Information Description File Name
Flexible Foam Transmission Line - dielectric, 1 5/8"

Component Description:
Transmission line, couplings, adapters and freight.
Amount:
$2,597.32
Connectors Information not provided.

Cost Information

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Tower Equipment and Rigging Costs

Information not provided.

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $46,980.00 $45,800.00 N/A $1,400.00 N/A
Total for all systems $208,830.00 $74,447.32 N/A $1,400.00 N/A
Outside Professional Services $46,980.00 $45,800.00 $1,400.00
Electricians $2,000.00 $2,000.00 You get what you pay for. $0.00 Its a nice family business, but don't tell Dad the kid undercharged me.
FCC Legal Counsel $20,000.00 $20,000.00 He retired and in D.C. and I'm eating insects in Michigan. $0.00 The repack was nothing compared to all the legal and related expenses I incurred during the freeze that went on for years and only lifted after the pandemic and lockdowns. He, his partner and everyone else retired, like I should have 4 years ago!
du Treil Engineeering $1,000.00 $1,000.00 They're the best in the business! $0.00 And worth every penny for $1,000!
Replace Antenna $50.00 $50.00 I was hoping to do this myself since it looked like so much fun, but no one would rent me their equipment. I figured I just needed a spotter for $50. $0.00 Since everyone repacking in the U.S. ended up doing their tower work over the same weekend in August, I had a hard time finding a professional.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A $962.50 We needed more communication with our attorney than previously expected
Project management of the transition $1,580.00 $1,500.00 N/A $0.00 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
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $0.00 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
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A $0.00 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A $437.50 N/A

Components

Actual Information Description File Name
Electricians Information not provided.
FCC Legal Counsel Information not provided.
du Treil Engineeering Information not provided.
Replace Antenna Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
attorney fees for repack
Amount:
$1,312.50

Component Description:
Call re matters for possible reimbursement
Amount:
$87.50

Component Description:
Call re possible antenna changes, etc.
Amount:
$175.00

Component Description:
File ASR ownership change and email re same
Amount:
$175.00

Component Description:
Call re FCC letter and amendment applications, Email re FCC letter, Call with FCC re deficiency letter, email re same, Review form 2100 and email re power limits and allowed parameters, Call re application and other matters
Amount:
$875.00
Project management of the transition Information not provided.
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Perform engineering study for new channel assignment and antenna development Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
LMS application for a construction permit
Amount:
$595.00
Prepare engineering section of 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:
Email re FCC letter about CP application
Amount:
$87.50

Component Description:
Email re deadline for waiver requests, Call and email re filing for CP and reimbursement
Amount:
$262.50

Component Description:
Call re completion of Form 2100 for CP
Amount:
$87.50

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $6,540.00 $6,500.00 N/A $0.00 N/A
Total for all systems $208,830.00 $74,447.32 N/A $1,400.00 N/A
Other Expenses $6,540.00 $6,500.00 $0.00
MVPD Notification of Channel Change $0.00 $0.00 N/A $0.00 I did it this myself.
FCC Filing Fees - Special Temporary Authorization request $195.00 $195.00 $195 used to be a lot of money. $0.00 I didn't bother to submit this again.
FCC Filing Fees - Form 2100 license to cover application $335.00 $335.00 if you can find anyone that can do anything for $335 these, please have them call me. $0.00 I probably paid for this somewhere but not seeking reimbursement.
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 N/A $0.00 I'd rather not add up all the expenses I incurred thinking that the freeze was about to be lifted.
Equipment Delivery and Handling Charges $0.00 $0.00 N/A $0.00 I handled all deliveries myself with a pallet jack and a skateboard, narrowly avoiding getting crushed too many times to remember.
Develop and air announcement of upcoming channel change $0.00 $0.00 N/A $0.00 I did this myself using Powerpoint and my own voice because I face that's made for radio.
Channel 31 Band Pass Filter $4,900.00 $4,900.00 That's what they usually cost. $0.00 The filter was included for free with my equipment $71,000 equipment purchase from Anywave. Good guys.

Components

Actual Information Description File Name
MVPD Notification of Channel Change 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.
Equipment Delivery and Handling Charges Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Channel 31 Band Pass Filter

Component Description:
The attached spreadsheet of items submitted today totals $26,823.45. There may be prior expenses that were denied, but to make things tie out, this discount of $4,097.32 should assure things tie out and not a nickel over for the USA.
Amount:
($4,097.32)

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $208,830.00 $74,447.32 $1,400.00

Reimbursement Status

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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

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Section Question Response
Submission of Estimated Expenses Statements

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

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

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

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

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

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

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

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

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

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

Steve Kanzer

Managing Member VRVC LLC


03/22/2022

Certification

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Section Question Response
Submission of Actual Cost Documentation Statements

WILLFUL FALSE, FRAUDULENT, OR FICTITIOUS STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISIONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE AND/OR FRAUDULENT STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT (U.S. CODE, TITLE 31, SECTIONS 3729-3733).

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

  2. The above-named entity certifies that the statements in this form and attached documentation are true, complete, and correct.

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

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

  5. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (full power and Class A stations) and/or otherwise modify a television station’s facility as a result of the spectrum repack (LPTV/TV Translator stations); or to minimize service disruption resulting from a repacked television station (FM stations); or to continue to carry the signal of a broadcaster that changes channels (MVPD) .

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

  7. The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred.

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

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

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

Steve Kanzer

Managing Member VRVC LLC


03/22/2022

Certification

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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.

  1. The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

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

  3. 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.

  4. 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.

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

  6. 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.

Steve Kanzer

Managing Member VRVC LLC


03/22/2022

Attachments

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