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:
84253
Service:
DTV
Call Sign:
WLOO
Channel:
36 (UHF)
File Number:
0000024809
FRN:
0017874009
Date Submitted:
05/28/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

TOUGALOO COLLEGE

Doing Business As: TOUGALOO COLLEGE

Robert Folliard

4370 Peachtree Road, NE

Atlanta, GA 30319

United States

+1 (202) 750-1585 rfolliard@graytv.com Private Not-for-Profit Educational Institution

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. Yes
Briefly describe transition plan Station will install a single channel antenna and line which replaces existing shared (WDBD) dual channel slotted antenna and line . This is the less expensive option over replacing the combined slot with a panel antenna.

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)
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 Visionary
Year 2003
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 36 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 ULXTE-60
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 36.1 kW
Justification for New Transmitter Axcera IOT transmitter can not be retuned

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) Yes
Transformer (480V) Yes
Power 300 kVA
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.

Interim Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Interim
Description of Use N/A
Change Type Purchase
Manufacturer
Model ULXTE-60
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 30 kW
Justification for New Transmitter Required to be installed in a rental building while the stations existing building is made ready for the main transmitter. Please see attached documentation. Station shares building with WDBD

Interim 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) Yes
Power 300 kVA
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
Inside RF System Is an additional interior RF system required to support this interim transmitter? Yes

Interim 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? Yes
Is the existing antenna directional? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 981.0 kW
Manufacturer
Model ATW28H3-HST1-40H
Year 2003

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

Facility ID Call Sign
71326 WDBD

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? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization 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: 950.0 kW
Manufacturer
Model TFU-29JSC-R
Year 2017
Justification for New Antenna existing shared broadband slot can not be retuned. (cut for ch 40/41) Station will install a new single channel antenna as it is less expensive than installing a combined shared system.

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? No
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? Yes
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

Information not provided.

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 Leased
Owner WDBD
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 Rigid
Diameter 8 3/16 inches
Other Diameter N/A
Segment Length Other
Other Segment Length 18.14 feet
Number of parallel runs 1
Length 1850 feet per run

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

Facility ID Call Sign
71326 WDBD

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 Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1830 feet per run
Justification for New Transmission Line Existing line custom lengths for Ch40/41. Sweep data shows line will not work at Ch-36 Data attached

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

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)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? No
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users No
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1210491
Coordinates (NAD83) Latitude (NAD83) 32° 12' 49.94" N-
Longitude (NAD83) 090° 22' 56.5" W-
Overall Structure Height 1998.00 feet
Support Structure Height 1889.90 feet
Ground Elevation Above Mean Sea Level (AMSL) 410.00 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner WLBT LLC
Date Constructed 08/01/1998

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
37177 WSTZ-FM FM
59822 WMSI-FM FM
68542 WLBT DTV
71326 WDBD DTV

Primary Tower

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Tower Modification Costs

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

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Information not provided.

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 400
Explanation RF coverage and population study Site analysis Equipment specifications Contract preparation Installation supervision Internal legal Internal accounting
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement No
Address transition timing and coordination issues w/ other stations and wireless providers No
RF Field Engineering Services Comprehensive coverage verification via field study Yes
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

Consulting Engineering

Prepare exhibits for STA application

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? Yes
Permit and Filing Costs Local Zoning No
Non-zoning permits No
BLM or NFS Coordination No
FCC Construction Permit Minor Change No
FCC License to Cover Application No
FCC Special Temporary Authority Application No
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? No
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

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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 $2,679,300.00 $2,415,853.48 N/A $2,007,922.67 N/A
Total for all systems $3,868,752.00 $3,504,199.48 N/A $2,765,961.84 N/A
Interim Transmitter ULXTE-60 $1,131,300.00 $1,158,821.48 $904,559.73
UHF inside RF system including switching $147,500.00 $148,225.00 Dielectric quote attached $0.00 N/A
Transformer 3 phase/480v - 300 KVA $36,800.00 $35,000.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW $947,000.00 $975,596.48 Gates Air Quote attached $904,559.73 N/A
Primary Transmitter ULXTE-60 $1,548,000.00 $1,257,032.00 $1,103,362.94
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW $1,473,000.00 $1,188,732.00 Quote attached $1,103,362.94 N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A
Transformer 3 phase/480v - 300 KVA $36,800.00 $32,000.00 N/A N/A N/A

Components

Actual Information Description File Name
UHF inside RF system including switching

Component Description:
N/A
Amount:
N/A
Transformer 3 phase/480v - 300 KVA Information not provided.
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW

Component Description:
TOTAL INVOICE DUE
Amount:
$254,162.07

Component Description:
1/3 PAYMENT DUE BEFORE SHIPMENT
Amount:
$325,198.83

Component Description:
1/3 Due 15 days after receipt
Amount:
$325,198.83
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW

Component Description:
1/3 DUE BEFORE SHIPMENT
Amount:
$363,497.65

Component Description:
BALANCE DUE
Amount:
$376,367.64

Component Description:
INITIAL DOWN PAYMENT
Amount:
$363,497.65
Switchgear - industrial 800 amp Information not provided.
Transformer 3 phase/480v - 300 KVA 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 $203,272.00 $203,012.00 N/A $187,277.50 N/A
Total for all systems $3,868,752.00 $3,504,199.48 N/A $2,765,961.84 N/A
Primary Antenna TFU-29JSC-R $203,272.00 $203,012.00 $187,277.50
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $5,000.00 N/A N/A N/A
UHF - High Power, Side Mount, basic slot antenna, 950 kW input, directional,, horizontally polarized $198,012.00 $198,012.00 Quote attached Estimated tax and shipping included in cost $187,277.50 THE TOTAL INCLUDES OLD REQUEST THAT HAD META DATA ISSUES BUT COULD NOT DELETE THEM

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.
UHF - High Power, Side Mount, basic slot antenna, 950 kW input, directional,, horizontally polarized

Component Description:
TOTAL INCLUDES 15 PERCENT OF LINE ITEMS 1,2,3 & 23
Amount:
$27,479.63

Component Description:
OUTSTANDING BALANCE
Amount:
$7,351.87

Component Description:
TOTAL OF LINES 1,2,3 & 23
Amount:
$27,479.63

Component Description:
OUTSTANDING BALANCE
Amount:
$10,297.50

Component Description:
TOTALS OF LINES 1,2,3,& 23
Amount:
$109,918.50

Component Description:
OUTSTANDING BALANCE
Amount:
$4,080.00

Component Description:
TOTAL OF LINE 1,2,3, & 23
Amount:
$27,479.63

Component Description:
OUTSTANDING BALANCE
Amount:
$21,750.00

Component Description:
OUTSTANDING BALANCE
Amount:
$6,400.00

Component Description:
60 PERCENT OF LINES 1, 2,3, & 23
Amount:
$109,918.50

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 $369,660.00 $283,874.00 N/A $278,636.67 N/A
Total for all systems $3,868,752.00 $3,504,199.48 N/A $2,765,961.84 N/A
Primary Transmission Line $369,660.00 $283,874.00 $278,636.67
Rigid Transmission Line - copper, 6 1/8" $369,660.00 $283,874.00 Quota attached (see main antenna quote) Estimated tax and shipping included in cost $278,636.67 THE TOTAL INCLUDES TWO INVOICES THAT HAD META DATA ISSUES THAT COULD NOT BE DELETED.

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 6 1/8"

Component Description:
OUTSTANDING BALANCE
Amount:
$1,025.37

Component Description:
TOTAL FOR 15 PERCENT OF LINE ITEM 4 RIGID TRANSMISSION LINE
Amount:
$37,058.91

Component Description:
TOTAL LINE 4
Amount:
$37,058.91

Component Description:
TOTAL LINE 4
Amount:
$148,235.64

Component Description:
TOTAL OF LINE 4
Amount:
$37,058.91

Component Description:
60 PERCENT OF LINE 4 RIGID TRANSMISSION LINE
Amount:
$148,235.64

Component Description:
OUTSTANDING BALANCE
Amount:
$2,954.00

Component Description:
OUTSTANDING BALANCE
Amount:
$56,333.85

Component Description:
OUTSTANDING BALANCE
Amount:
N/A

Component Description:
OUTSTANDING BALANCE
Amount:
$33,028.90

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 $394,800.00 $318,315.00 N/A $285,000.00 N/A
Total for all systems $3,868,752.00 $3,504,199.48 N/A $2,765,961.84 N/A
Primary Tower TOWER $394,800.00 $318,315.00 $285,000.00
Tall Tower (greater than 500') $210,500.00 $185,000.00 N/A $185,000.00 N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $8,315.00 quote attached N/A N/A
Minor tower reinforcement/modifications $158,000.00 $125,000.00 N/A $100,000.00 N/A

Components

Actual Information Description File Name
Tall Tower (greater than 500')

Component Description:
TOWER SERVICE- ANTENNA AND TRANSMISSION LINE INSTALLATION
Amount:
$185,000.00
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study Information not provided.
Minor tower reinforcement/modifications

Component Description:
TOWER SERVICE -MODIFICATIONS AND REINFORCEMENTS
Amount:
$100,000.00

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 $173,850.00 $244,225.00 N/A $7,125.00 N/A
Total for all systems $3,868,752.00 $3,504,199.48 N/A $2,765,961.84 N/A
Outside Professional Services $173,850.00 $244,225.00 $7,125.00
Consulting Engineering $1,000.00 $1,000.00 Prepare STA exhibits $1,000.00 N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $60,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,500.00 N/A 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
Prepare request for Special Temporary Authorization $2,050.00 $1,500.00 N/A $1,375.00 N/A
Project management of the transition $63,200.00 $159,675.00 This college station needs additional management assistance. Widelity Strategic Support Quote N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $6,800.00 N/A $2,750.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $2,000.00 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
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Consulting Engineering

Component Description:
ENGINEERING STUDY WORK
Amount:
$1,000.00
Comprehensive coverage verification via field study, if needed Information not provided.
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.
Prepare request for Special Temporary Authorization

Component Description:
STA Professional Services
Amount:
$1,375.00
Project management of the transition Information not provided.
Perform engineering study for new channel assignment and antenna development

Component Description:
WLOO- detailed interference analysis into KARD on ch. 36
Amount:
$1,500.00

Component Description:
Engineering study work for new channel assignment and antenna development
Amount:
$1,250.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
preparation of the engineering portion of FCC form 2100
Amount:
$2,000.00
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 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 $47,870.00 $38,920.00 N/A $0.00 N/A
Total for all systems $3,868,752.00 $3,504,199.48 N/A $2,765,961.84 N/A
Other Expenses $47,870.00 $38,920.00 $0.00
MVPD Notification of Channel Change $0.00 $0.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $2,850.00 $2,850.00 estimate for on air rescan announcement production Quote attached N/A N/A
DTV Medical Facility Notification $11,550.00 $2,600.00 Group quote attached N/A N/A
Equipment Delivery and Handling Charges $2,970.00 $2,970.00 On site forklift rental estimate Representative quote attached N/A N/A
Equipment Storage $30,500.00 $30,500.00 Estimate for Dielectric on site antenna storage Dielectric letter attached 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 $3,868,752.00 $3,504,199.48 $2,765,961.84

Reimbursement Status

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Question Response
The facility has ceased operating on its pre-auction channel. No
Construction of final facilities or all necessary modifications are complete. No
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. No

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.

Cynthia Melvin

CFO


05/28/2019

Attachments

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