TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
NW COMMUNICATIONS OF TEXAS, INC.	Joseph M. Di Scipio 101 Constitution Avenue NW 200 West WASHINGTON, DC 20001 United States	+1 (202) 824-6522	Joe.Discipio@fox.com	Corporation

Applicant

Address

Phone

Applicant Type

NW COMMUNICATIONS OF TEXAS, INC.

Joseph M. Di Scipio

101 Constitution Avenue NW

200 West

WASHINGTON, DC 20001

United States

+1 (202) 824-6522

Joe.Discipio@fox.com

Corporation

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant	Address	Phone	Email
[Confidential]

Preparer Contact Information

Preparer Contact Name and Information

Applicant	Address	Phone	Email
Dennis Wallace Managing Partner Meintel, Sgrignoli & Wallace, LLC	Dennis Wallace 1282 Smallwood Drive Suite 372 Waldorf, MD 20603 United States	+1 (202) 251-7589	Dennis.Wallace@mswdtv.com

Applicant

Address

Phone

Dennis Wallace

Managing Partner

Meintel, Sgrignoli & Wallace, LLC

Dennis Wallace

1282 Smallwood Drive

Suite 372

Waldorf, MD 20603

United States

+1 (202) 251-7589

Dennis.Wallace@mswdtv.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.	No
Briefly describe transition plan	Station KDFI is still working on its transition plan. However, the initial plan would be to install an interim facility to broadcast on the post-auction channel. Then replace the existing antenna and transmission line with new antenna and tx line.

Transmitters

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

Primary Transmitter

Existing Transmitter Information

Section	Question	Response
Existing Transmitter Description	Type of change	Purchase New
	Use	Primary (Main)
	Description of Use	N/A
	Ownership	Owned
	Owner	N/A
	Site	N/A
	Is this transmitter currently shared with another station?	No
	Is this transmitter currently in operating condition?	Yes
Existing Transmitter Manufacturer and Type	Manufacturer
	Model	DCXP-2
	Year	2004
	Type	Inductive Output Tube
	IOT Power Type	Two
	Power Capacity	30 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	THU9-48
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	73.5 kW
	Justification for New Transmitter	IOT Tube type transmitters no longer available by the time purchase was to be made. See 1118_servicebulletin180402 and 1118_Quote Rohde and Schwarz.

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	No
	Size	N/A
	Length	N/A
	Other Electrical Service	Yes
	Description	Comprehensive services entrance, panels, conduit and wiring.
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?	Yes
	Size	800.0 square feet
Channel 14 Costs	Is an RF Consulting Engineer needed?	N/A
	Is a channel 14 Mask Filer needed?	N/A
	Is additional field engineering time needed?	N/A
	Number of Days	N/A

Primary Transmitter

Other Transmitter Cost Not Listed

Name	Description
HVAC Modifications	Rework of current HVAC system
Additional Installation Costs	Unanticipated additional installation costs
UPS	UPS, Commissioning, Shipping
Filter	New Rohde and Schwarz filter to replace faulty ERI filter
Terminal Equipment	Various broadcast related equipment

Interim Transmitter

New Transmitter Costs

Section	Question	Response
New Transmitter	Use	Interim
	Description of Use	N/A
	Change Type	Purchase
	Manufacturer
	Model	TBD
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	30 kW
	Justification for New Transmitter	Interim Transmitter for operation at interim facility site while existing site is modified. ATC will decommission existing antenna waveguide run in early 2018.

Interim 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	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?	Yes
	Size	800.0 square feet
Channel 14 Costs	Is an RF Consulting Engineer needed?	N/A
	Is a channel 14 Mask Filer needed?	N/A
	Is additional field engineering time needed?	N/A
	Number of Days	N/A
Inside RF System	Is an additional interior RF system required to support this interim transmitter?	No

Interim Transmitter

Other Transmitter Cost Not Listed

Information not provided.

Antennas

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

Primary Antenna

Existing Antenna Information

Section	Question	Response
Existing Antenna Description	Type of change	Purchase New
	Antenna Use	Primary (Main)
	Description of Use	N/A
	Ownership	Leased
	Owner	ATC
	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?	Yes
Existing Antenna Manufacturer and Type	Class	Full Power
	Mounting	Top Mount
	Antenna position in stack	Bottom
	Polarization	Horizontal
	Type	Broadband Panel
	Number of Stations Supported	2
	Number of Panels	48
	Design power capacity in use	35.0 %
	Lower Limit	602.00 MHz
	Upper Limit	644.00 MHz
	Other Antenna Type	N/A
	ERP:	1000.0 kW
	Manufacturer
	Model	A/CUK40671/1
	Year	2008

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

Facility ID	Call Sign
68834	KPXD-TV

Primary Antenna

New Antenna Costs

Section	Question	Response
New Antenna Description	Use	Primary (Main)
	Description of Use	N/A
	Change Type	Purchase New
	Is this a request for upgraded equipment?	Yes
	Ownership	Owned
	Owner	N/A
	Is antenna shared?	No
	Is antenna directional?	Yes
	Will antenna be located on or in close proximity to an antenna farm?	Yes
New Antenna Manufacturer and Types	Class	Full Power
	Mounting	Top Mount
	Antenna position in stack	Not in Stack
	Polarization	Elliptical
	Type	Slotted Coaxial
	Number of Stations Supported	N/A
	Number of Panels/Bays	N/A
	Lower Limit	N/A
	Upper Limit	N/A
	Design power capacity in use	N/A
	Other Antenna Type	N/A
	ERP:	1000.0 kW
	Manufacturer
	Model	ATW28H3-ETC1-27H
	Year	2019
	Justification for New Antenna	Relocation was necessary to meet repack timeline. See attached 1118_Revised Narrative and Composite quote 1118_Quote ERI

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	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?
Pattern Scatter Analysis	Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna?	No
Sweep Test	Do you require the sweep testing of transmission line and antenna?	Yes

Primary Antenna

Other Antenna Cost Not Listed

Name	Description
Spinner System Install	Installation of spinner AMS system
Elbows	Elbows, reducer, freight
Antenna Installation	Installation of antenna
Structural Services Custom 55ft Spine	Custom build of spine for antenna to rest on

Interim Antenna

New Antenna Costs

Section	Question	Response
New Antenna Description	Use	Interim
	Description of Use	N/A
	Change Type	Purchase New
	Ownership	Owned
	Owner	N/A
	Is antenna shared?	No
	Is antenna directional?	Yes
	Will antenna be located on or in close proximity to an antenna farm?	Yes
New Antenna Manufacturer and Type	Class	Full Power
	Mounting	Top Mount
	Antenna position in stack	Bottom
	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:	829.0 kW
	Manufacturer
	Model	TBD
	Year	2017
	Justification for New Antenna	Interim Antenna for operation while main antenna transmission line is removed and replaced by ATC. Antenna manufacturer and model number is yet to be finalized.

Interim Antenna

Other Antenna Costs

Section	Question	Response
Elbow Complex	Do you require the separate purchase of the Elbow Complex?	Yes
	Broadband or Single Channel?	B
	Feed Line Size	6 1/8 inches
Side Mount Brackets	Do you require the separate purchase of side mount brackets for an antenna?
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

Interim Antenna

Other Antenna Cost Not Listed

Name	Description
Peter Eckman Services	Peter Eckman services and parts for preliminary work on antenna system.

Transmission Line

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

Primary Transmission Line

Existing Transmission Line

Section	Question	Response
Existing Transmission Line Description	Type of change	Purchase New
	Use	Primary (Main)
	Description of Use	N/A
	Ownership	Leased
	Owner	ATC
	Site	N/A
	Is the existing transmission line shared with another station or stations?	Yes
	Is Transmission Line in operating condition?	Yes
Existing Transmission Line Manufacturer and Type	Manufacturer
	Type	Waveguide
	Diameter	N/A
	Other Diameter	N/A
	Segment Length	N/A
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	1600 feet per run

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

Facility ID	Call Sign
68834	KPXD-TV

Primary Transmission Line

New Transmission Line

Section	Question	Response
New Transmission Line Costs	Use	Primary (Main)
	Description of Use	N/A
	Change Type	Purchase New
	Is this a request for upgraded equipment?	No
	Type	Rigid
	Diameter	7 3/16 inches
	Other Diameter	N/A
	Segment Length	20 inches
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	1600 feet per run
	Justification for New Transmission Line	New transmission line to feed to main antenna. See attached 1118_Revised Narrative and Composite quote 1118_Quote ERI

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Name	Description
Interior Line	Interior line inside building
Dehydrator	SARAG2A Dehydrator for transmission line

Tower Equipment And Rigging Costs

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

Auxiliary Tower

Existing Tower

Section	Question	Response
Existing Tower Description	Type of change	Modify Existing
	Tower Use	Auxiliary (Backup)
	Description of Use
	Ownership	Leased
	Is this tower consider Complex?	Candelabra
	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?	Unknown
	Is tower compliant with Rev G?	Unknown
Existing Tower Structure Registration	Do you have a tower registration number?	Yes
Existing Tower Structure Registration	ASR Number	1059733
Coordinates (NAD83)	Latitude (NAD83)	32° 32' 36.0" N-
	Longitude (NAD83)	096° 57' 33.0" W-
	Overall Structure Height	1635.15 feet
	Support Structure Height	1523.60 feet
	Ground Elevation Above Mean Sea Level (AMSL)	813.97 feet
	Structure Type	GTOWER - Guyed Structure Used for Communication Purposes
	Tower Owner	American Towers, LLC
	Date Constructed	06/18/2000

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
68834	KPXD-TV	DTV

Auxiliary 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

Auxiliary Tower

Tower Rigging Costs

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

Auxiliary Tower

Other Tower Expenses Not Listed

Information not provided.

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	Leased
	Is this tower consider Complex?	Candelabra
	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?	Unknown
	Is tower compliant with Rev G?	Unknown
Existing Tower Structure Registration	Do you have a tower registration number?	Yes
Existing Tower Structure Registration	ASR Number	1059733
Coordinates (NAD83)	Latitude (NAD83)	32° 32' 36.0" N-
	Longitude (NAD83)	096° 57' 33.0" W-
	Overall Structure Height	1635.15 feet
	Support Structure Height	1523.60 feet
	Ground Elevation Above Mean Sea Level (AMSL)	813.97 feet
	Structure Type	GTOWER - Guyed Structure Used for Communication Purposes
	Tower Owner	American Towers, LLC
	Date Constructed	06/18/2000

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
68834	KPXD-TV	DTV

Primary Tower

Tower Modification Costs

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

Primary Tower

Tower Rigging Costs

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

Primary Tower

Other Tower Expenses Not Listed

Name	Description
Weather Days	Weather days prevented tower work. Tower crew unable to mobilize to another job.
Pre-Construction Site Visit	Pre Construction Site Visit
Gin Pole Support Frames	Gin Pole support frames

Outside Professional Services Costs

Section	Question	Response
Outside Project Management Services	Do you require outside project management services?	Yes
	Number of Hours	350
	Explanation	Project management of transitioning facilities.
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	Yes
	For Main Facility	Yes
	Prepare engineering section of Form FCC License to Cover Application	Yes
	For Auxiliary Facility	Yes
	For Main Facility	Yes
	Prepare request for Special Temporary Authority	Yes
	Quantity	2
	Do you have Distributed Transmission System engineering services?	N/A
	Critical Facility	N/A
	Terrain-Shielded Facility	N/A
Attorney and Other Outside Consulting Services	Prepare and file Form FCC Construction Permit Application	Yes
	For Auxiliary Facility	Yes
	For Main Facility	Yes
	Prepare and file Form FCC License to Cover Application	Yes
	For Auxiliary Facility	Yes
	For Main Facility	Yes
	Prepare request for Special Temporary Authority	Yes
	Quantity	2
	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	No
	Additional Field Engineering Service	Yes
	Number of Days	20
	Justification	On Site RF Engineering Services to supervise installation of equipment and verify performance of new equipment.

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Name	Description
Land Survey Primary Tower	Easement/Land Survey for primary tower

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

Other Expenses

Other Expenses Not Listed

Name	Description
Prepare FCC Qtrly Reports	Prepare & file quarterly FCC Progress Reports
Lease Modifications	Lease modification for new facilities
Prepare FCC Qtrly Reports	Prepare & file quarterly FCC Progress Reports
Lease Modifications	Lease modification for new facilities

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	$3,525,695.73	$2,019,163.80	N/A	$1,374,011.14	N/A
Total for all systems	$6,571,167.71	$4,199,337.68	N/A	$2,838,541.60	N/A
Interim Transmitter TBD	$980,303.00	$33,303.00		$33,303.00
Other -- Building Addition Size: 800.0	$30,048.00	$30,048.00	*System Notice: Estimate adjusted and locked because line has been superseded.*Concrete Pad addition for Heat Exchangers.	$30,048.00	N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW	$947,000.00	$0.00	estimated costs from catalog	$0.00	N/A
Other Electrical Service: Electrical installation costs for Interim Transmitter at interim transmitter site.	$3,255.00	$3,255.00	*System Notice: Estimate adjusted and locked because line has been superseded.*Estimated electrical contractor costs for installation of new interim transmitter at interim site. See attached quote as proxy for costs.	$3,255.00	N/A
Primary Transmitter THU9-48	$2,545,392.73	$1,985,860.80		$1,340,708.14
Terminal Equipment	$19,198.53	$19,198.53	Monitoring equipment, supression filter, commissioning	$19,198.53	N/A
Other -- Building Addition Size: 800.0	$65,053.92	$65,053.92	See quote: Marsand new transmitter building quote-1	$35,005.92	N/A
Other Electrical Service: Comprehensive services entrance, panels, conduit and wiring.	$186,254.27	$186,254.27	N/A	$178,324.68	N/A
UHF - Liquid Cooled Solid State Transmitter 68.5 - 75 kW	$1,999,000.00	$1,439,468.07	N/A	$840,793.00	N/A
HVAC Modifications	$19,590.01	$19,590.01	N/A	$19,590.01	N/A
Additional Installation Costs	$10,000.00	$10,000.00	Unanticipated additional installation costs.	$1,500.00	N/A
UPS	$0.00	$0.00	N/A	$0.00	N/A
Filter	$246,296.00	$246,296.00	Requesting the difference between the new filter and the funds already received for the previous (faulty) ERI filter.	$246,296.00	N/A

Components

Actual Information Description	File Name
Other -- Building Addition Size: 800.0	Component Description: Building modifications for transmitter equipment- 50% deposit Amount: $30,048.00
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW	Component Description: Invoice reflects 50% downpayment. Amount: $719,734.00
Other Electrical Service: Electrical installation costs for Interim Transmitter at interim transmitter site.	Component Description: Eaton Powerware UPS- 20% deposit on Equipment Amount: $3,255.00
Terminal Equipment	Component Description: Smart TV's for monitoring Amount: $287.56 Component Description: Monitoring, supression filter. Please see note from vendor on invoice re: name change. Amount: $15,586.37 Component Description: UPS Commissioning. See note from vendor on quote about name change. Amount: $1,506.84 Component Description: Video patchbay Amount: $966.64 Component Description: UPS field engineering, startup labor Amount: $1,506.84 Component Description: Interconnect with 20 ft length cable Amount: $851.12
Other -- Building Addition Size: 800.0	Component Description: new transmitter building. See Marsand new transmitter building quote-1.pdf. Updated attachment with cover letter. Amount: $6,805.92 Component Description: New Transmitter building. See Marsand new transmitter building quote-1.pdf. Amount: $28,200.00
Other Electrical Service: Comprehensive services entrance, panels, conduit and wiring.	Component Description: UPS (Uninterrupted Power Supply plus freight). Updated attachment with cover letter. Amount: $15,271.99 Component Description: 3 Cycle bypass switch. Revised attachment with cover letter and quote. Amount: $25,058.00 Component Description: Transmitter parts - cables. See quote 'anixter.pdf' Amount: $306.04 Component Description: Transmitter parts - crimper. See quote 'anixter.pdf' Amount: $138.86 Component Description: Transmitter Electrical work. Please see 'innovative electrical services.pdf' for quote. Amount: $37,645.77 Component Description: Transmitter parts - crimp braid. See quote: 'anixter.pdf' Amount: $285.34 Component Description: Transmitter Electrical Work. See quote 'innovative electrical services.pdf' Amount: $31,371.48 Component Description: Transmitter Electrical Work. Please see quote 'innovative electrical services.pdf' Amount: $56,468.69 Component Description: Transmitter parts - cables. See quote 'anixter.pdf' Amount: $218.84 Component Description: Transmitter parts - cable ties Amount: $44.93 Component Description: Redundant Power Supply, Video Bypass Router. Revised attachment with quote and cover letter. Amount: $12,508.75
UHF - Liquid Cooled Solid State Transmitter 68.5 - 75 kW	Component Description: Primary transmitter. Additional time and scaffolding rental for installation. Quote included. Amount: $8,590.00 Component Description: Transmitter 30% downpayment. Includes upgrades. Quotes and variance included. Amount: $249,660.90 Component Description: Transmitter 10% down at proof. Includes upgrades. Quotes and variance attached. Amount: $83,220.30 Component Description: Transmitter 10% down at completion. Includes upgrade. Quotes and variance sheet attached. Amount: $83,220.30 Component Description: 50% transmitter downpayment. Includes upgrade. Quotes and variance sheet included Amount: $416,101.50
HVAC Modifications	Component Description: HVAC duct work modifications. Please also see KDFI_letter re KDFW.pdf. Amount: $16,591.48 Component Description: Duct removal associated with HVAC. Please also see KDFI_letter re KDFW.pdf. Amount: $1,169.10 Component Description: HVAC duct install. Please also see attachment KDFI_letter re KDFW.pdf. Amount: $1,829.43
Additional Installation Costs	Component Description: Transfer switch install. Revised attachment with cover letter Amount: $1,500.00
UPS	Information not provided.
Filter	Component Description: Filter. First 50% down. Amount: $123,148.00 Component Description: Final 50%, minus credit for previous filter Amount: $123,148.00 Component Description: 50% down, minus credit for previous filter Amount: $123,148.00 Component Description: Filter. 2nd, 3rd and 4th milestone payment Amount: $123,148.00 Component Description: Filter, 50% minus credit Amount: $123,148.00 Component Description: filter, 50% down minus credit Amount: $123,148.00

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	$1,133,507.09	$798,837.09	N/A	$783,837.09	N/A
Total for all systems	$6,571,167.71	$4,199,337.68	N/A	$2,838,541.60	N/A
Interim Antenna TBD	$283,964.90	$11,274.90		$11,274.90
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
Sweep test of existing antenna	$6,730.00	$0.00	N/A	N/A	N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized	$247,000.00	$0.00	N/A	N/A	N/A
Peter Eckman Services	$11,274.90	$11,274.90	N/A	$11,274.90	N/A
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed)	$13,700.00	$0.00	N/A	N/A	N/A
Primary Antenna ATW28H3-ETC1-27H	$849,542.19	$787,562.19		$772,562.19
Structural Services Custom 55ft Spine	$100,000.00	$100,000.00	See ERI quote 20171218-575 Rev G attached to invoices	$100,000.00	N/A
Antenna Installation	$445,158.00	$445,158.00	See ERI quote 20171218-575 Rev G attached to antenna installation invoices	$445,158.00	N/A
Spinner System Install	$3,272.34	$3,272.34	Install of spinner AMS system	$3,272.34	N/A
Elbows	$4,881.85	$4,881.85	Elbows, reducer, freight	$4,881.85	N/A
Sweep test of existing antenna	$6,730.00	$6,250.00	N/A	$6,250.00	N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized	$289,500.00	$228,000.00	See ERI quote 20171218-575 Rev G attached to antenna invoices	$213,000.00	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.
Sweep test of existing antenna	Information not provided.
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized	Information not provided.
Peter Eckman Services	Component Description: Downpayment for interim tower materials. Amount: $11,274.90
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed)	Information not provided.
Structural Services Custom 55ft Spine	Component Description: Total cost of custom 55ft spine 100,000. Requesting 30% of total cost 30 days ARO on this invoice. Amount: $30,000.00 Component Description: Total cost of custom 55ft spine 100,000. Requesting 30% of total cost prior to shipment on this invoice. Amount: $30,000.00 Component Description: Total cost for custom 55ft spine 100,000. Requesting 30% of cost at time of order on this invoice. Amount: $30,000.00 Component Description: Total cost of custom 55ft spine 100,000. Requesting final 10% of total on this invoice. Amount: $10,000.00
Antenna Installation	Component Description: Total cost of installation $445,158.00. Requesting 30% of total 30 day ARO on this invoice. Amount: $133,547.40 Component Description: Total installation cost $445,158.00. Requesting 30% of total at time or order. Amount: $133,547.40 Component Description: Total installation cost $445,158.00. Requesting 30% of total prior to shipment on this invoice. Amount: $133,547.40 Component Description: Total installation cost $445,158.00. Requesting final 10% of cost on this invoice. Amount: $44,515.80
Spinner System Install	Component Description: Spinner AMS system install Amount: $3,272.34
Elbows	Component Description: Elbows, reducers, freight. Amount: $4,881.85
Sweep test of existing antenna	Component Description: Total cost of TV System Sweep $6250. Requesting 30% of total cost 30 day ARO, on this invoice. Amount: $1,875.00 Component Description: Total cost of TV System Sweep $6250. Requesting 30% of total cost at time of order on this invoice. Amount: $1,875.00 Component Description: Total cost of TV System Sweep $6250. Requesting 30% of total cost at time of shipment, on this invoice. Amount: $1,875.00 Component Description: Total cost of TV System Sweep $6250. Requesting final 10% of total on this invoice. Amount: $625.00
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized	Component Description: Total antenna cost $228,000.00. Requesting 30% of like for like antenna cost prior to shipment on this invoice. Amount: $63,900.00 Component Description: Total antenna cost $228,000.00. Requesting final 10% of like for like antenna cost on this invoice. Amount: $21,300.00 Component Description: Requesting 30% of like for like antenna cost at time of order. Amount: $63,900.00 Component Description: Total antenna cost $228,000.00. Requesting 30% of like for like antenna cost ARO on this invoice. Amount: $63,900.00

Cost Information

Transmission Line

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

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$496,763.50	$457,513.70	N/A	$443,942.68	N/A
Total for all systems	$6,571,167.71	$4,199,337.68	N/A	$2,838,541.60	N/A
Primary Transmission Line	$496,763.50	$457,513.70		$443,942.68
Dehydrator	$7,557.25	$7,557.25	SARAH2A Dehydrator	$7,557.25	N/A
Interior Line	$25,206.25	$25,206.25	Interior RF line inside building.	$20,324.40	N/A
Rigid Transmission Line - copper, 7 3/16"	$464,000.00	$424,750.20	N/A	$416,061.03	N/A

Components

Actual Information Description	File Name
Dehydrator	Component Description: Total cost of dehydrator is $7557.25. Requesting 30% of total prior to shipping on this invoice. Amount: $2,267.18 Component Description: Total cost of dehydrator is $7557.25. Requesting final 10% of total on this invoice. Amount: $755.71 Component Description: Total cost for Dehydrator is $7557.25. Requesting 30% of total due at time of order. Amount: $2,267.18 Component Description: Total cost of dehydrator is $7557.25. Requesting 30% of total 30 days ARO on this invoice. Amount: $2,267.18
Interior Line	Component Description: 10% net invoice. Interior Run install and Transmission line system. Amount: $2,424.12 Component Description: 30% deposit with order. Interior run install and transmission line system. Amount: $7,272.36 Component Description: 30% prior to shipment. Interior Run install and transmission line system. Amount: $3,355.56 Component Description: 30% payment 30 days ARO. Interior Run install and Transmission Line System. Amount: $7,272.36
Rigid Transmission Line - copper, 7 3/16"	Component Description: Total cost of transmission line system $416,06.05. Requesting 30% at time of order on this invoice. Amount: $124,818.31 Component Description: Total cost of transmission line system $416,061.05. Requesting 30% of total 30 days ARO on this invoice. Amount: $124,818.31 Component Description: Total cost of main transmission line $416,061.05. Requesting 30% of total prior to shipment on this invoice. Amount: $124,818.31 Component Description: Total cost of main transmission line is $416,061.05. Requesting final 10% of total on this invoice. Amount: $41,606.10

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	$1,074,650.00	$573,775.60	N/A	$92,617.60	N/A
Total for all systems	$6,571,167.71	$4,199,337.68	N/A	$2,838,541.60	N/A
Auxiliary Tower GTOWER	$605,300.00	$44,267.60		$44,267.60
Minor tower reinforcement/modifications	$158,000.00	$0.00	N/A	N/A	N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study	$26,300.00	$44,267.60	See attached quote from ERI for tower mapping and tower studies for potential Interim/Aux site. Includes sales tax of $1,887.60. Plus additional fee of $7,500 for supplemental study of the original analysis.	$44,267.60	N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)	$421,000.00	$0.00	Catalog Price - tower rigging and new Aux Antenna Installation at Aux Site. Project abandoned.	N/A	N/A
Primary Tower GTOWER	$469,350.00	$529,508.00		$48,350.00
Weather Days	$12,350.00	$12,350.00	Bad weather prohibited work on tower. Station to pay weather days based on contract.	$12,350.00	N/A
Pre-Construction Site Visit	$9,000.00	$9,000.00	Pre Construction Site Visit see ERI quote 20171218-575 REV.G	$9,000.00	N/A
Gin Pole Support Frames	$27,000.00	$27,000.00	Gin Pole support frames. See ERI quote 20171218-575 REV.G	$27,000.00	N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)	$421,000.00	$481,158.00	Actual cost exceeded catalog.	N/A	N/A

Components

Actual Information Description	File Name
Minor tower reinforcement/modifications	Information not provided.
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study	Component Description: Supplemental study required for original analysis. Amount: $7,500.00 Component Description: Structural analysis and report PO 17-0230. Amount: $36,767.60
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)	Information not provided.
Weather Days	Component Description: Bad weather days for tower work Amount: $4,550.00 Component Description: Bad weather days for tower work Amount: $7,800.00
Pre-Construction Site Visit	Component Description: Total cost of pre-construction site visit $9000. Requesting final 10% on this invoice. Amount: $900.00 Component Description: Total cost of pre-construction site visit $9000. Requesting 30% of total prior to shipping on this invoice. Amount: $2,700.00 Component Description: Total cost of pre-construction visit is $9000. Requesting 30% of total due at time of order on this invoice. Amount: $2,700.00 Component Description: Total cost of pre-construction site visit $9000. Requesting 30% of total 30 days ARO on this invoice. Amount: $2,700.00
Gin Pole Support Frames	Component Description: Total cost of Gin Pole support frames is $27,000. Requesting final 10% of total on this invoice. Amount: $2,700.00 Component Description: Total cost of Gin Pole support frames is $27,000. Requesting 30% of the total due at time of order on this invoice. Amount: $8,100.00 Component Description: Total cost of Gin Pole support frames is 27,000. Requesting 30% of total prior to shipping on this invoice. Amount: $8,100.00 Component Description: Total cost of Gin Pole support frames is $27,000. Requesting 30% of total 30 days ARO on this invoice. Amount: $8,100.00
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)	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	$231,214.50	$244,410.60	N/A	$117,303.10	N/A
Total for all systems	$6,571,167.71	$4,199,337.68	N/A	$2,838,541.60	N/A
Outside Professional Services	$231,214.50	$244,410.60		$117,303.10
Land Survey Primary Tower	$4,979.50	$4,979.50	Easement/Land Survey for primary tower	$4,979.50	N/A
Additional Field Engineering Service, 20 Days	$42,400.00	$42,400.00	20 Days on site RF Engineering Supervision of equipment installation and performance verification.	$0.00	N/A
Comprehensive coverage verification via field study, if needed	$84,200.00	$80,000.00	N/A	$27,025.00	N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization	$7,360.00	$7,000.00	N/A	N/A	N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	$2,365.00	$2,250.00	N/A	N/A	N/A
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application	$4,210.00	$4,000.00	N/A	N/A	N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	$5,260.00	$5,000.00	N/A	N/A	N/A
Prepare request for Special Temporary Authorization	$4,100.00	$3,000.00	N/A	N/A	N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application	$1,580.00	$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
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application	$2,105.00	$2,000.00	N/A	N/A	N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	$3,155.00	$3,000.00	N/A	$2,996.25	N/A
Perform engineering study for new channel assignment and antenna development	$7,360.00	$7,000.00	N/A	$6,521.25	N/A
Address transition timing and coordination issues w/ other stations and wireless	$2,630.00	$2,500.00	N/A	N/A	N/A
Prepare and or review reimbursement form	$2,630.00	$2,500.00	N/A	N/A	N/A
Project management of the transition	$55,300.00	$75,781.10	RF Consulting and Project Mgmt	$75,781.10	RF consulting

Components

Actual Information Description	File Name
Land Survey Primary Tower	Component Description: Easement/Land Survey for primary tower. Amount: $4,979.50
Additional Field Engineering Service, 20 Days	Information not provided.
Comprehensive coverage verification via field study, if needed	Component Description: Full Site Survey of KDFI with Drawing Package- remaining 50% Amount: $13,512.50 Component Description: Full Site Survey of KDFI with Drawing Package- 50% down payment Amount: $13,512.50
Attorney Fees - Prepare and File request for Special Temporary Authorization	Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	Information not provided.
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application	Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	Information not provided.
Prepare request for Special Temporary Authorization	Information not provided.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application	Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	Information not provided.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application	Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	Component Description: Prepare and file FCC CP Application, technical exhibits Amount: $2,996.25
Perform engineering study for new channel assignment and antenna development	Component Description: Channel search, interference assessment, pop counts, coverage mapping. Amount: $6,521.25
Address transition timing and coordination issues w/ other stations and wireless	Information not provided.
Prepare and or review reimbursement form	Information not provided.
Project management of the transition	Component Description: RF Consulting/Project Management 1/4/18 - 12/31/18 Amount: $594.02 Component Description: RF Consulting July 2021 Amount: $453.75 Component Description: RF Consulting/Project Management 1/1/18 - 12/31/18 Amount: $19,035.00 Component Description: Repack Project Management 1/1/19 - 12/31/19 Amount: $1,077.08 Component Description: RF Consulting and Project Management 1/1/19 - 12/31/19 Amount: $14,785.00 Component Description: Prepare, amend, revise 399 budgets, respond to FCC tech review, develop narratives. Amount: $7,931.25 Component Description: RF Consulting 8/1/21 - 8/31/21 Amount: $323.75 Component Description: RF Consulting 1/1/20 - 12/31/20 Amount: $16,702.50 Component Description: Repack Project Management 1/4/18 - 12/31/18 Amount: $594.03 Component Description: Repack Project Management 1/5/17 - 12/31/17 Amount: $3,583.75 Component Description: Repack project management 1/1/18 - 12/31/18 Amount: $20,092.50 Component Description: RF Consulting/Project Management 1/4/18 - 12/31/18 Amount: $594.03 Component Description: RF Engineering/Project Mgmt 10/1/21-10/7/21 Amount: $717.50 Component Description: RF Consulting 1/1/21 - 1/28/21 Amount: $6,770.00 Component Description: RF Consulting 9/1/21 - 9/30/21 Amount: $635.00 Component Description: Equipment inventory, determine channel specific components, rechannel vs replacement determination Amount: $3,172.50 Component Description: Repack project management 1/1/19 - 12/31/19 Amount: $14,785.00 Component Description: zeroing this line item out Amount: N/A

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	$109,336.89	$105,636.89	N/A	$26,829.99	N/A
Total for all systems	$6,571,167.71	$4,199,337.68	N/A	$2,838,541.60	N/A
Other Expenses	$109,336.89	$105,636.89		$26,829.99
Lease Modifications	$15,000.00	$15,000.00	N/A	N/A	N/A
Prepare FCC Qtrly Reports	$23,850.00	$23,850.00	See attached vendor quote for FCC Progress Reporting.	N/A	N/A
MVPD Notification of Channel Change	$5,000.00	$5,000.00	N/A	$0.00	N/A
Develop and air announcement of upcoming channel change	$1,500.00	$1,500.00	N/A	N/A	N/A
Equipment Storage	$10,000.00	$10,000.00	N/A	N/A	N/A
Equipment Delivery and Handling Charges	$16,906.89	$16,906.89	Based on actual costs	$16,906.89	N/A
Disposal Costs (for equipment and other waste, net of any salvage value)	$15,000.00	$15,000.00	Disposal Costs	$2,058.10	N/A
Non-zoning permits	$10,000.00	$10,000.00	N/A	N/A	N/A
FCC Filing Fees - Special Temporary Authorization request	$195.00	$190.00	N/A	N/A	N/A
FCC Filing Fees - Form 2100 license to cover application	$335.00	$325.00	N/A	N/A	N/A
DTV Medical Facility Notification	$11,550.00	$7,865.00	N/A	$7,865.00	N/A

Components

Actual Information Description	File Name
Lease Modifications	Information not provided.
Prepare FCC Qtrly Reports	Information not provided.
MVPD Notification of Channel Change	Information not provided.
Develop and air announcement of upcoming channel change	Information not provided.
Equipment Storage	Information not provided.
Equipment Delivery and Handling Charges	Component Description: Freight for antenna, dehydrator, main transmission line (invoices KDFI-001, KDFI-002, KDFI-003A, KDFI-53434) Amount: $16,906.89
Disposal Costs (for equipment and other waste, net of any salvage value)	Component Description: Dumpster/Equipment Disposal 5/16/19-5/31/19. Revised attachment with cover letter and variance. Amount: $461.97 Component Description: Disposal container use 6/1/19-6/15/19. Updated with cover letter. Amount: $88.17 Component Description: Dumpster/Equipment Disposal 4/16/19-4/30/19. Revised attachment with cover letter. Amount: $88.17 Component Description: Dumpster/Equipment Disposal 6/16/19-6/30/19. Revised attachment with cover letter and variance sheet. Amount: $426.70 Component Description: Dumpster/Equipment disposal 4/1/19 - 4/15/19. This includes a revised attachment with cover letter. Amount: $537.00 Component Description: Dumpster/Equipment Disposal 5/1/19-5/15/19. Updated with cover letter Amount: $456.09
Non-zoning permits	Information not provided.
FCC Filing Fees - Special Temporary Authorization request	Information not provided.
FCC Filing Fees - Form 2100 license to cover application	Information not provided.
DTV Medical Facility Notification	Component Description: DTV notification for medical facilities. Please see 'DTV Notifications-1.pdf' for quote. Amount: $7,865.00

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$6,571,167.71	$4,199,337.68	$2,838,541.60

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.

Ann West Bobeck

VP, FCC Legal & Business Affairs

09/19/2022

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.

Ann West Bobeck

VP, FCC Legal & Business Affairs

09/19/2022

Certification

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.

Ann West Bobeck

VP, FCC Legal & Business Affairs

09/19/2022

(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

Existing Transmitter Information

Primary Transmitter

New Transmitter Costs

Primary Transmitter

Other Transmitter Costs

Primary Transmitter

Other Transmitter Cost Not Listed

Interim Transmitter

New Transmitter Costs

Interim Transmitter

Other Transmitter Costs

Interim Transmitter

Other Transmitter Cost Not Listed

Antennas

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

Primary Antenna

Other Antenna Cost Not Listed

Interim Antenna

New Antenna Costs

Interim Antenna

Other Antenna Costs

Interim Antenna

Other Antenna Cost Not Listed

Transmission Line

Primary Transmission Line

Existing Transmission Line

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

Primary Transmission Line

New Transmission Line

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Tower Equipment And Rigging Costs

Auxiliary 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

Auxiliary Tower

Tower Modification Costs

Auxiliary Tower

Tower Rigging Costs

Auxiliary Tower

Other Tower Expenses Not Listed

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