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:
49185
Service:
LPA
Call Sign:
W27EL-D
Channel:
27 (UHF)
File Number:
0000089635
FRN:
0006159552
Eligibility Status:
Eligible
Date Submitted:
10/23/2022

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

VENTANA TELEVISION, INC.

Doing Business As: VENTANA TELEVISION, INC.

Eric Yonkin

1 HSN Drive

St. Petersburg, FL 33729

United States

+1 (727) 872-7443 EASnotice@hsn.net Corporation

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

Warren A. Kessler

Hogan Lovells US LLP

555 Thirteenth Street, NW

Washington, DC 20004

United States

+1 (202) 637-3632 warren.kessler@hoganlovells.com

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 Receive new antenna and transmitter, install antenna at new location.

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 Purchase New
Use Primary (Main)
Ownership Owned
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model AUTV-1000
Year 2006
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity .3 kW

Primary Transmitter

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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 EC702HP-BB
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1.5 kW
Justification for New Transmitter The existing transmitter is incapable of generating necessary digital power level if converted from analog.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Other Transmitter Costs
Does the transmitter installation require a Transmitter Building Site Survey/Installation? Yes
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Rigid Conduit and Wiring No
Other Electrical Service No
HVAC Service Does the replacement transmitter require HVAC Service? No
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

SCMS CM1007

CELLFLEX Cabling (1 of 2)

20200414

NFB software plugins

SCMS INV11841

CELLFLEX Cabling (2 of 2)

13918- Hitachi

Shipping and handling

2020-1605 Davis

Davis Electric - transmitter-related install

13644 - Hitachi SHP-HAN

Shipping and handling of transmitter

13783 - Hitachi

Required items for EC7202HP

S10593 - Hitachi

UHF Air cooled DTV transmitter

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)
Ownership Owned
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
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
ERP: 12.5 kW
Manufacturer
Model SL-8
Year 1990

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Change Type Purchase New
Ownership Owned
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
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Slotted Coaxial
ERP: 5.0 kW
Manufacturer
Model PSILP8OI-27 EP
Year 2020
Justification for New Antenna The existing antenna will not operate on new, post-repack channel.

Primary Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? 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

INV101320

Mager Repair - Wall mount and related system installations

104652

MUTI SII Install P. 2

19039 RM Comms

Install prep and pre-install

6424 BW St Clair

Antenna w-support

104721

MUTI SII Antenna install

6418 BW St Clair

digital antenna

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 Utilize Existing
Use Primary (Main)
Ownership Owned
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 SCMS INC.
Type Flexible Air
Diameter 7/8 inches
Number of parallel runs 1
Length 795 feet per run

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Invoice No. INV11841 - HN813174835

Cost of connector and cellflex 7/8in low loss flexible cable, standard jacket

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? Yes

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Ownership Leased
Is this tower consider Complex? Located on Building
Is this tower currently shared with any other stations? 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? No
Coordinates (NAD83) Latitude (NAD83) 40° 06' 33.7" N-
Longitude (NAD83) 088° 14' 05.6" W-
Overall Structure Height 255.90 feet
Support Structure Height 229.70 feet
Ground Elevation Above Mean Sea Level (AMSL) 728.30 feet
Structure Type BPOLE - Building with Pole
Tower Owner American Campus Communities
Date Constructed 01/01/1990


Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Tower mapping and report for structural engineer
Tower Reinforcements Please select whether tower reinforcements are needed: Serious Reinforcements needed

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Mounting Pipe and Guy Lines

Modification of mounting pipe and addition of guy lines.

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? No
Outside RF consulting Engineering Services Perform engineering study for displacement application No
Prepare engineering section of Form FCC Construction Permit Application No
Prepare engineering section of Form FCC License to Cover Application No
Prepare request for Special Temporary Authority No
Prepare Form 601 No
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application No
Prepare and file Form FCC License to Cover Application No
Prepare request for Special Temporary Authority No
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement Yes
Form 399 assistance or other program management costs Yes
RF Field Engineering Services Comprehensive coverage verification via field study Yes
RF exposure measurements Yes
Additional Field Engineering Service No

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? Yes
Is Remediation needed? No
Permit and Filing Costs FCC Construction Permit Major Change No
FCC Construction Permit Minor Change No
FCC License to Cover Application Yes
FCC Special Temporary Authority Application No
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? 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
Point to Point Microwave (STL/ICR) Frequency Coordination for Unidirection System No
Frequency Coordination for Bi-Direction System No
New Point to Point Microwave System No

Other Expenses

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Other Expenses Not Listed

Information not provided.

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 $127,979.19 $130,481.19 N/A $29,539.41 N/A
Total for all systems $355,026.27 $323,953.27 N/A $46,336.59 N/A
Primary Transmitter EC702HP-BB $127,979.19 $130,481.19 $29,539.41
S10593 - Hitachi $26,314.41 $26,314.41 N/A $0.00 N/A
13783 - Hitachi $945.11 $945.11 N/A $0.00 N/A
13644 - Hitachi SHP-HAN $1,026.22 $1,026.22 N/A $0.00 N/A
Transmitter Building Site Survey/Installation $10,000.00 $12,502.00 Additional items $2,775.00 Addition Items
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $84,000.00 $84,000.00 N/A $26,314.41 N/A
SCMS INV11841 $1,012.18 $1,012.18 N/A $0.00 N/A
2020-1605 Davis $2,775.00 $2,775.00 Various work performed for new transmitter install $0.00 N/A
13918- Hitachi $792.76 $792.76 N/A $0.00 N/A
SCMS CM1007 $663.51 $663.51 Low loss flex cable $0.00 N/A
20200414 $450.00 $450.00 N/A $450.00 N/A

Components

Actual Information Description File Name
S10593 - Hitachi

Component Description:
Cost of digital tv transmitter
Amount:
N/A
13783 - Hitachi

Component Description:
This invoice does not belong to W27EL but was inadvertently included with the station. The invoice should be withdrawn - see attached letter.
Amount:
N/A
13644 - Hitachi SHP-HAN

Component Description:
Shipping and handling
Amount:
$1,026.22
Transmitter Building Site Survey/Installation

Component Description:
Wall mount and related services
Amount:
$9,727.00

Component Description:
Various transmitter installation and circuitry work
Amount:
$2,775.00
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
Cost of Digital TV transmitter
Amount:
$26,314.41
SCMS INV11841

Component Description:
Cost of cellflex 7/8in low loss flexible cable
Amount:
$1,012.18
2020-1605 Davis

Component Description:
Various transmitter installation and circuitry work
Amount:
$2,775.00
13918- Hitachi

Component Description:
This invoice was an error and did not belong to W27EL-D; it should be withdrawn.
Amount:
N/A
SCMS CM1007

Component Description:
los loss flex cable
Amount:
$663.51
20200414

Component Description:
Software plugin (statmon)
Amount:
$450.00

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 $70,229.90 $70,229.90 N/A $15,785.00 N/A
Total for all systems $355,026.27 $323,953.27 N/A $46,336.59 N/A
Primary Antenna PSILP8OI-27 EP $70,229.90 $70,229.90 $15,785.00
6418 BW St Clair $8,875.00 $8,875.00 N/A $0.00 N/A
6424 BW St Clair $8,875.00 $8,875.00 N/A $0.00 Additional cost for 50% deposit
19039 RM Comms $5,250.00 $5,250.00 N/A $0.00 N/A
104652 $9,440.00 $9,440.00 Antenna install $0.00 N/A
104721 $3,062.90 $3,062.90 N/A $0.00 antenna cost
UHF-Low Power, Top Mount, Slotted Coaxial, 5.0kW input, Elliptical $25,000.00 $25,000.00 N/A $15,785.00 N/A
INV101320 $9,727.00 $9,727.00 N/A $0.00 additional fees

Components

Actual Information Description File Name
6418 BW St Clair

Component Description:
Antenna
Amount:
N/A
6424 BW St Clair

Component Description:
Antenna 50% deposit
Amount:
N/A
19039 RM Comms

Component Description:
Install prep and coordination pre-install
Amount:
N/A
104652

Component Description:
Antenna install
Amount:
N/A
104721

Component Description:
antenna install - line rep c-o
Amount:
N/A
UHF-Low Power, Top Mount, Slotted Coaxial, 5.0kW input, Elliptical

Component Description:
Antenna 50% deposit
Amount:
$8,135.00

Component Description:
50% of Antenna Payment
Amount:
$7,650.00
INV101320

Component Description:
Wall mount and related services
Amount:
N/A

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 $1,012.18 $1,012.18 N/A $1,012.18 N/A
Total for all systems $355,026.27 $323,953.27 N/A $46,336.59 N/A
Primary Transmission Line $1,012.18 $1,012.18 $1,012.18
Invoice No. INV11841 - HN813174835 $1,012.18 $1,012.18 N/A $1,012.18 N/A

Components

Actual Information Description File Name
Invoice No. INV11841 - HN813174835

Component Description:
Cost of connectors and cellflex 7/8in low loss flexible cable
Amount:
$1,012.18

Cost Information

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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 $78,300.00 $78,300.00 N/A $0.00 N/A
Total for all systems $355,026.27 $323,953.27 N/A $46,336.59 N/A
Primary Tower BPOLE $78,300.00 $78,300.00 $0.00
Serious tower reinforcement/modifications $20,000.00 $20,000.00 N/A N/A N/A
Mounting Pipe and Guy Lines $12,300.00 $12,300.00 N/A N/A N/A
Complex Tower (includes, e.g., towers with candelabras and/or stacked antennas) $25,000.00 $25,000.00 N/A $0.00 N/A
Tower mapping and report for structural engineer $21,000.00 $21,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Serious tower reinforcement/modifications Information not provided.
Mounting Pipe and Guy Lines Information not provided.
Complex Tower (includes, e.g., towers with candelabras and/or stacked antennas)

Component Description:
Antenna install
Amount:
$9,440.00

Component Description:
Antenna install.
Amount:
$3,062.90
Tower mapping and report for structural engineer 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 $67,910.00 $34,335.00 N/A $0.00 N/A
Total for all systems $355,026.27 $323,953.27 N/A $46,336.59 N/A
Outside Professional Services $67,910.00 $34,335.00 $0.00
Form 399 assistance or other Program Management costs $1,500.00 $1,500.00 N/A N/A N/A
Prepare/ Review 399 reimbursement form $1,710.00 $1,710.00 N/A N/A N/A
Comprehensive coverage verification via field study, if needed $52,600.00 $25,125.00 N/A N/A N/A
RF Exposure Measurements $12,100.00 $6,000.00 N/A N/A N/A

Components

Information not provided.

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 $9,595.00 $9,595.00 N/A $0.00 N/A
Total for all systems $355,026.27 $323,953.27 N/A $46,336.59 N/A
Other Expenses $9,595.00 $9,595.00 $0.00
FCC Filing Fees - Form 2100 license to cover application $335.00 $335.00 N/A N/A N/A
AM Pattern Disturbance -- Impact study $5,260.00 $5,260.00 N/A N/A N/A
Equipment Delivery and Handling Charges $4,000.00 $4,000.00 Transmitter location very difficult to reach, requires specialize movers for transport N/A N/A

Components

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $355,026.27 $323,953.27 $46,336.59

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.

Eric Yonkin

Associate General Counsel, Legal


10/23/2022

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.

Eric Yonkin

Associate General Counsel, Legal


10/23/2022

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.

Eric Yonkin

Associate General Counsel, Legal


10/23/2022

Attachments

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