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:
65670
Service:
DTV
Call Sign:
WETA-TV
Channel:
14 (UHF)
File Number:
0000028782
FRN:
0002107274
Date Submitted:
09/04/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

GREATER WASHINGTON EDUCATIONAL TELECOMMUNICATIONS ASSOC

Doing Business As: GREATER WASHINGTON EDUCATIONAL TELECOMMUNICATIONS ASSOC

Legal & Business Affairs Dept.

3939 Campbell Ave

Arlington, VA 22206

United States

+1 (703) 998-2851 Repack@weta.org Not-for-Profit

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

Joseph L. Snelson , Jr .

Technical Consultant

Meintel, Sgrignoli & Wallace

1282 Smallwood Drive, Suite 372

Waldorf, MD 20603

United States

+1 (303) 344-8037 Repack@weta.org

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 WETA proposes to build its repack facility on channel 31 and will be sharing its main antenna, transmission line and combiner with two other parties. See the attached updated narrative for the background and details of its transition plan.

Transmitters

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

Auxiliary Transmitter

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Add Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Auxiliary (Backup)
Description of Use Alternate Site backup transmitter
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 CD100P1
Year 1997
Type Inductive Output Tube
IOT Power Type Single
Power Capacity 17.5 kW

Auxiliary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Auxiliary (Backup)
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Manufacturer
Model ULXTE-20
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 12.9 kW
Justification for New Transmitter See attached letter from manufacturer regarding IOT transmitters.

Auxiliary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Auxiliary Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

Auxiliary Transmitter

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Add Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Auxiliary (Backup)
Description of Use Used in case of failure of main
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 DHD15P1
Year 2003
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 3.6 kW

Auxiliary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Auxiliary (Backup)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model ULXTE-50
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 31.7 kW
Justification for New Transmitter This higher power transmitter is required to minimize loss of coverage (ie population) due to lower antenna height at the interim site. WETA will operate at this site while transmitter is installed at the main site for operation on its post repack channel

Auxiliary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring Yes
Size 4 inches
Length 420.0 feet
Other Electrical Service Yes
Description Electrical contractor to connect transmitter into existing electrical panel and wire heat exchanger into transmitter. Includes material and labor. This was originally submitted and approved under another category and moved here.
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 600.0 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

Auxiliary Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

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 DHD15P1
Year 2003
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 3.6 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-90
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 56.4 kW
Justification for New Transmitter See attached letter from GatesAir regading inability to retune current transmitter. See revised narrative. Replacement upgrade is part of a multi-station resolution that includes moving WETA's repack channel from 14 to 31 at an ERP of 1000 kW.

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 500 kVA
Rigid Conduit and Wiring Yes
Size 4 inches
Length 420.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Heating and Cooling
Size 50 tons
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? Yes
Size 1000.0 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

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Other Transmitter Cost Not Listed

Name Description

Pre-installation survey

Site Survey by GatesAir of main and aux transmitter sites for transmitter layout.

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 Retune Existing
Antenna Use Primary (Main)
Description of Use N/A
Ownership Leased
Owner District of Columbia Joint Tower Venture
Site N/A
Is the existing antenna shared with another station or stations? Yes
Is the existing antenna directional? No
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 Top
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 3
Number of Panels 48
Design power capacity in use 47.0 %
Lower Limit 470.00 MHz
Upper Limit 860.00 MHz
Other Antenna Type N/A
ERP: 73.0 kW
Manufacturer DIE
Model TUP-04-12-2
Year 1999

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

Facility ID Call Sign
27772 WHUT-TV
74091 WPXW-TV

Primary Antenna

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Adjustment to Existing Antenna

Section Question Response
Sweep Test of Existing Antenna Do you need a sweep test of existing antenna? Yes

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? Yes
Type New
Number of channels supported 3
Frequencies of channels supported RF channel
Frequency N/A

Enter a list of RF channel numbers.

RF Channel Number
31
33
35

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

Auxiliary Antenna

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Add Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Auxiliary (Backup)
Description of Use Alternate site backup
Ownership Owned
Owner N/A
Site N/A
Is this antenna currently shared with any other stations? No
Is this antenna directional? No
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type Class 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: 30.0 kW
Manufacturer
Model TFU-8JST-R03
Year 1998

Auxiliary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Auxiliary (Backup)
Description of Use See attached Buget Justification: Auxiliary Transmitter Site
Change Type Purchase New
Is this a request for upgraded equipment? No
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? No
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 240.0 kW
Manufacturer
Model TFU-WB
Year 2018
Justification for New Antenna Current antenna is tuned to channel 27 and cannot be retuned to operate on channel 31. Proposed antenna costs less than exact replacement.

Auxiliary 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? Yes
Broadband or Single Channel? Single Channel
Feed Line Size 4 1/16 inches inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? Yes
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Auxiliary Antenna

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Other Antenna Cost Not Listed

Name Description

Auxiliary Antenna Installation

Includes Engineer Reviewed Rigging Plan

Transmission Line

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

Auxiliary Transmission Line

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Add Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Auxiliary (Backup)
Description of Use Alternate Transmitter Site
Ownership Owned
Owner N/A
Site N/A
Is this transmission currently shared with any other stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 3 1/8 inches
Other Diameter N/A
Segment Length 19 1/2 inches
Other Segment Length N/A
Number of parallel runs 1
Length 521 feet per run

Auxiliary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Auxiliary (Backup)
Description of Use Off site Interim
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Rigid
Diameter 4 1/16 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 550 feet per run
Justification for New Transmission Line See revised attached budget narrative. Line is not of standard length. Ability to support temporary operations reliably while main site is being converted to channel 31 is questionable. There is a high risk of failure.

Auxiliary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Primary Transmission Line

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Add Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is this transmission currently shared with any other stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 3 1/8 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 170 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
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 170 feet per run
Justification for New Transmission Line Current line will not support higher power level to meet ERP determined from multi-station resolution.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Installation

Estimated removal of current line and installation of new. installation

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

Auxiliary Tower

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Add Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Auxiliary (Backup)
Description of Use Alternate site for WETA
Ownership Owned
Is this tower consider Complex? No
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users Yes
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 1018169
Coordinates (NAD83) Latitude (NAD83) 38° 53' 30.0" N-
Longitude (NAD83) 077° 07' 54.0" W-
Overall Structure Height 495.40 feet
Support Structure Height 492.12 feet
Ground Elevation Above Mean Sea Level (AMSL) 370.07 feet
Structure Type LTOWER - Lattice Tower
Tower Owner GREATER WASHINGTON EDUCATIONAL TELECOMMUNICATIONS ASSN DBA = WETA FM
Date Constructed 02/12/2014

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
65669 WETA FM
12460 WGTS FM
4644 WAVA-FM FM

Other Types of Users

Users
Trunking
Amateur Radio
Cellular

Auxiliary 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 documented tower
Tower Reinforcements Please select whether tower reinforcements are needed: Major Reinforcements needed

Auxiliary 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

Auxiliary Tower

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Other Tower Expenses Not Listed

Name Description

Tower Rigging and Installation

Tower rigging and installation labor to install tower modifications: includes engineer review rigging plan, additional tower mounting materials related to modifications

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 1500
Explanation See attached Budget Justification: Outside Professional Services
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 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 Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study Yes
RF exposure measurements Yes
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Architect and Engineering services

Planning and layout of new equipment to be installed at main and aux transmitter sites.

Channel change

Engineering services to evaluate coverage and interference moving channel from 14 to 31.

Progress Reporting

Prepare and file 7 required progress reports on FCC Form 2100, Schedule 387 on a quarterly basis with the FCC.

Site Visits and Surveys

Site visits to establish what equipment is on premises, where new equipment will be located and do equipment inventory for both main and auxiliary sites.

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 Yes
BLM or NFS Coordination No
FCC Construction Permit Minor Change No
FCC License to Cover Application No
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

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Other Expenses Not Listed

Name Description

Additional Legal Expenses for Repack

Legal work related to WETA repack and reimbursement, including advice on FCC rules, regulations and policies, required FCC filings, reimbursement rules and procedures, and coordination of repack efforts with other site users at multi-party tower site.

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 $3,990,193.67 $3,441,215.67 N/A $860,523.94 N/A
Total for all systems $6,052,314.67 $5,458,912.47 N/A $1,835,673.33 N/A
Primary Transmitter ULXTE-90 $2,302,335.00 $2,249,957.00 $53,121.45
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 52 - 61 kW $1,788,000.00 $1,755,022.00 See attached quote. NOTE: Quote shows cost of both main and auxiliary transmitters. See revised narrative. N/A N/A
Transformer 3 phase/480v - 500 KVA $48,400.00 $46,000.00 N/A N/A N/A
4" Rigid Conduit and Wiring (Cost per foot) $42,420.00 $40,320.00 N/A N/A N/A
50 Ton system $266,000.00 $253,000.00 N/A N/A N/A
Other -- Building Addition Size: 1000.0 $99,590.00 $99,590.00 Arktx Proposal dated 20180626 - $26,590 -drawing & 3D laser imaging for initial planning purposes & OsbornEngineering proposal J20170990 - $73,000 total) -estimate for new roof structure to support transmitter heat exchanger. $33,396.45 N/A
Pre-installation survey $19,725.00 $19,725.00 Pre-installation survey by GatesAir to determine requirements for transmitter installation. $19,725.00 N/A
Auxiliary Transmitter ULXTE-20 $494,500.00 $0.00 $0.00
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW $494,500.00 $0.00 This category is no longer needed and may be removed. 10/18/18 JS $0.00 Estimated cost was incorrectly stated as 0. It should have been equal to the predetermined Cost Estimate $481,500
Auxiliary Transmitter ULXTE-50 $1,193,358.67 $1,191,258.67 $807,402.49
UHF - Liquid Cooled Solid State Transmitter 31.7 kW $1,086,938.67 $1,086,938.67 This is an auxiliary transmitter to replace what is currently in use. $804,087.49 N/A
4" Rigid Conduit and Wiring (Cost per foot) $42,420.00 $40,320.00 N/A N/A N/A
Other Electrical Service: Electrical contractor to connect transmitter into existing electrical panel and wire heat exchanger into transmitter. Includes material and labor. This was originally submitted and approved under another category and moved here. $14,000.00 $14,000.00 Electrical contractor to connect transmitter into existing electrical panel and wire heat exchanger into transmitter. Includes material and labor. N/A N/A
Other -- Building Addition Size: 600.0 $50,000.00 $50,000.00 See revised narrative. Remodeling needed to accommodate new transmitter and filter while current transmitter remains operational. Previously approved under another category and moved here. $3,315.00 N/A

Components

Actual Information Description File Name
Switchgear - industrial 800 amp Information not provided.
UHF - Liquid Cooled Solid State Transmitter 52 - 61 kW Information not provided.
Transformer 3 phase/480v - 500 KVA Information not provided.
4" Rigid Conduit and Wiring (Cost per foot) Information not provided.
50 Ton system Information not provided.
Other -- Building Addition Size: 1000.0

Component Description:
Monthly progress of Architectural and Engineering Design for existing Transmitter Facility alterations.
Amount:
$982.20

Component Description:
Item A - Drawing and 3D laser imaging for planning purposes
Amount:
$22,590.00

Component Description:
Professional Services
Amount:
$2,249.25

Component Description:
Completed work billed for May
Amount:
$7,575.00
Pre-installation survey

Component Description:
Site survey to determine site conditions, materials and components required for system installation
Amount:
$19,725.00
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW

Component Description:
The original invoice was incorrectly associated with this category. This category is no longer required and may be removed. 10/18/18 JS
Amount:
N/A
UHF - Liquid Cooled Solid State Transmitter 31.7 kW

Component Description:
1/3 down payment of total transmitter cost
Amount:
$358,689.76

Component Description:
ULXTE-50 Transmitter
Amount:
$358,689.76

Component Description:
A. Transmitter
Amount:
$93,154.85

Component Description:
1/3 Payment ULXTE-50 Transmitter
Amount:
$352,242.88
4" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Other Electrical Service: Electrical contractor to connect transmitter into existing electrical panel and wire heat exchanger into transmitter. Includes material and labor. This was originally submitted and approved under another category and moved here. Information not provided.
Other -- Building Addition Size: 600.0

Component Description:
Professional Services
Amount:
$3,315.00

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 $390,140.00 $264,280.50 N/A $179,928.02 N/A
Total for all systems $6,052,314.67 $5,458,912.47 N/A $1,835,673.33 N/A
Primary Antenna TUP-04-12-2 $90,930.00 $129,039.50 $123,084.25
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $3,200.00 N/A
New combiner, cost per channel (without antenna) $84,200.00 $122,639.50 WETA Share of a 3 channel combiner. See attached revised narrative: COMBINER as to the overage from catalog cost per station and cost breakout. $119,884.25 N/A
Auxiliary Antenna TFU-WB $299,210.00 $135,241.00 $56,843.77
UHF - Lower Power Side Mount, One station - 200-500 kW, horizontally polarized $189,500.00 $44,925.00 See narrative weta_budget_rev_070918.pdf. N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed) $9,570.00 $8,116.00 See narrative weta_budget_rev_070918.pdf $8,093.77 N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $6,750.00 Special side mount brackets required to optimize antenna pattern. N/A N/A
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $4,050.00 Revised. See narrative weta_budget_rev_070918.pdf. N/A N/A
Auxiliary Antenna Installation $65,000.00 $65,000.00 Please see attached VTS Quote 18334-VA $48,750.00 N/A

Components

Actual Information Description File Name
Sweep test of existing antenna

Component Description:
WETA-210-Primary Antenna - Sweep Test
Amount:
$3,200.00
New combiner, cost per channel (without antenna)

Component Description:
Combiner Costs - 50% WETA/WPXW
Amount:
$119,884.25
UHF - Lower Power Side Mount, One station - 200-500 kW, horizontally polarized Information not provided.
Sweep test of existing antenna Information not provided.
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed)

Component Description:
ELBOW 4-50 DIGIT 7 X 14
Amount:
$8,093.77
Side mount brackets for high power antennas (if not included in antenna base cost) Information not provided.
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) Information not provided.
Auxiliary Antenna Installation

Component Description:
Auxiliary Antenna Rigging and Installation
Amount:
$16,250.00

Component Description:
Auxiliary Antenna Rigging and Installation
Amount:
$32,500.00

Component Description:
Auxiliary Antenna - Antenna Rigging and Installation
Amount:
$850.00

Component Description:
Connection Redesign Sketches, Connection Redesign Drawings
Amount:
$2,600.00

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 $157,140.00 $197,489.50 N/A $3,859.00 N/A
Total for all systems $6,052,314.67 $5,458,912.47 N/A $1,835,673.33 N/A
Primary Transmission Line $79,040.00 $113,029.50 $0.00
Rigid Transmission Line - copper, 6 1/8" $34,340.00 $68,329.50 See attached quote 800163CMZ WETA COMPONENTS. N/A N/A
Installation $44,700.00 $44,700.00 See attached quote 800163CMZ WETA COMPONENTS for field survey and installation of line. N/A N/A
Auxiliary Transmission Line $78,100.00 $84,460.00 $3,859.00
Rigid Transmission Line - copper, 4 1/16" $78,100.00 $84,460.00 See narrative 070918.pdf.; See Justifying Change Order - R0019581504 $3,859.00 N/A

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 6 1/8" Information not provided.
Installation Information not provided.
Rigid Transmission Line - copper, 4 1/16"

Component Description:
T/L 4-50 EIA LENGTH 5' TO 10' FIXED FLG 1
Amount:
$1,017.00

Component Description:
HANGER HOR 4 3PT SUSPENSION
Amount:
$1,440.00

Component Description:
RIGID TRANSMISSION LINE T/L 4-50 EIA LENGTH 5' TO 10' FIXED FLG 1 END/ SWIVEL FLG 1 END"
Amount:
$1,402.00

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 $847,800.00 $652,000.00 N/A $434,250.00 N/A
Total for all systems $6,052,314.67 $5,458,912.47 N/A $1,835,673.33 N/A
Auxiliary Tower LTOWER $847,800.00 $652,000.00 $434,250.00
Tower Rigging and Installation $330,000.00 $330,000.00 Please see attached Vertical Technology Systems quote 18334-VA $248,700.00 N/A
Short Tower (less than 500') $84,200.00 $80,000.00 N/A N/A N/A
Major tower reinforcement/modifications $421,000.00 $230,000.00 Please see attached VTS Quote 18334-VA. Includes the task collect data for and provide all tower reinforcing materials per the MRA drawings dated 12/10/2018 $185,550.00 N/A
Structural engineering tower load study for well documented tower $12,600.00 $12,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Tower Rigging and Installation

Component Description:
Existing Aux Tower Major Tower Modification Installation
Amount:
$82,500.00

Component Description:
Existing Aux Tower Major Tower Modification Installation
Amount:
$165,000.00

Component Description:
Professional services
Amount:
$1,200.00
Short Tower (less than 500') Information not provided.
Major tower reinforcement/modifications

Component Description:
25% downpayment per Proposal 18334VA - per PO Terms
Amount:
$57,500.00

Component Description:
WETA Channel Repack Antenna Replacement
Amount:
$9,600.00

Component Description:
Connection Redesign Sketches and Drawings - by Morris & Ritchie
Amount:
$3,450.00

Component Description:
50% due upon mobilization - per proposal 18334VA - per PO Terms
Amount:
$115,000.00
Structural engineering tower load study for well documented tower 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 $545,615.00 $786,865.80 N/A $331,665.37 N/A
Total for all systems $6,052,314.67 $5,458,912.47 N/A $1,835,673.33 N/A
Outside Professional Services $545,615.00 $786,865.80 $331,665.37
Perform engineering study for new channel assignment and antenna development $7,360.00 $45,000.00 Extensive study has already been given to searching for a new channel and Land Mobile interference and remediation with WETA on ch. 14. Additional studies for multi-station resolution had to be performed. $5,575.00 N/A
Site Visits and Surveys $9,000.00 $9,000.00 Site visits to establish what equipment is on premises, where new equipment will be located and do equipment inventory for both main and auxiliary sites. $5,700.00 N/A
Progress Reporting $14,000.00 $14,000.00 Prepare and file 7 required progress reports on FCC Form 2100, Schedule 387 on a quarterly basis with the FCC. $2,606.95 N/A
Channel change $85,000.00 $85,000.00 Engineering services to evaluate coverage and interference moving channel from 14 to 31. $53,718.75 N/A
Architect and Engineering services $50,500.00 $50,500.00 Justifying Quote - WETA Arlington Auxiliary Fee Proposal 20180328 $22,270.43 N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $100,000.00 $80,000 for Main transmitter site and $20,000 for auxiliary site. N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $7,000.00 The need for filing two STA's in a project of this magnitude is anticipated. $0.00 N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $175,000.00 Fees related to multi-party resolution agreement between 3 parties to accommodate WETA moving from ch 14 to 31, 100,000. Lease mod negotiations for main ant/combiner and bldg. permit app., 50,000. Aux site apps and hearings for bldg expansion 25,000. $166,702.89 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,511.75 Actual Costs are Marginally higher than estimated costs $2,511.75 Actuals are marginally higher than estimates costs
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application $4,210.00 $4,000.00 N/A $834.70 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A $0.00 N/A
Prepare request for Special Temporary Authorization $4,100.00 $3,000.00 Two STA's are anticipated, one for the main site and the other for the auxiliary. $328.95 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 $3,000.00 Time required will be similar to that required of the main site to prepare this application. N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A N/A N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $11,000.00 Coordination with 4 TV stations and 3 FM stations. Cut over must be carefully planned with other two stations. Contacting Land Mobile operators on cutover to ensure no interference by WETA N/A N/A
Prepare and or review reimbursement form $2,630.00 $21,854.05 This is a complex project and requires careful attention to detail in assembling. Substantial time has been placed into the preparation of the form with supporting justification for both main and auxiliary sites. $22,694.05 Actuals are marginally higher than estimated costs.
Project management of the transition $237,000.00 $225,000.00 N/A $48,721.90 N/A
RF Exposure Measurements $21,050.00 $20,000.00 N/A $0.00 N/A

Components

Actual Information Description File Name
Perform engineering study for new channel assignment and antenna development

Component Description:
Regarding interim antenna for repack Ch-31, determine TV antenna parameters for RF exposure determination on tower structure.
Amount:
$575.00

Component Description:
Review of Land mobile interference with WETA on Ch. 14
Amount:
$5,000.00
Site Visits and Surveys

Component Description:
WETA-590-Site Visits and Surveys
Amount:
$5,700.00
Progress Reporting

Component Description:
Item G - Preparation of progress report
Amount:
$47.60

Component Description:
Legal Services Rendered
Amount:
$1,380.40

Component Description:
Item G - Preparation and submission of progress reports
Amount:
$285.60

Component Description:
Legal services
Amount:
$861.00

Component Description:
Item G - Prepare progress report
Amount:
$893.35
Channel change

Component Description:
FCC DIGITAL REPACK FRIDAY PROMO
Amount:
$370.00

Component Description:
FCC DIGITAL REPACK PROMO
Amount:
$180.00

Component Description:
Item B - Repack research issues related to Land Mobile interference on Ch. 14
Amount:
$20,362.50

Component Description:
Item A - Channel 14 issues and alternatives. SFN research options.
Amount:
$4,893.75

Component Description:
Item B - Land Mobile interference and remediation on Ch. 14
Amount:
$4,106.25

Component Description:
Item C - RF sweep at transmitter site and UHF panel testing for new repack channel
Amount:
$1,687.50

Component Description:
Item A - Auction repack analysis related to WETA Ch. 14
Amount:
$10,743.75

Component Description:
Item B - TV study for alternative channel assignments. WETA originally assigned channel 14. This was an unworkable channel due to numerous Land Mobile stations in DC. Studies we undertaken to find another channel. WETA ultimately found channel 31.
Amount:
$1,012.50

Component Description:
Item B - Coverage study and interference maps for various scenarios including Ch. 20 SFN option
Amount:
$2,868.75

Component Description:
Item A - Develop new channel options with MPT. Extensive work to obtain a multi-resolution agreement between 3 parties for channel changes for 5 stations so WETA could get ch 31.
Amount:
$2,193.75

Component Description:
Item A - Auction repack analysis for new Ch 14 assignment
Amount:
$5,850.00
Architect and Engineering services

Component Description:
Professional Services through June 28, 2019
Amount:
$4,781.15

Component Description:
Monthly progress of Architectural and Engineering Design for existing Transmitter Facility alterations.
Amount:
$7,203.72

Component Description:
Monthly progress of Architectural and Engineering Design for existing Transmitter Facility alterations.
Amount:
$9,362.29

Component Description:
Monthly progress of Architectural and Engineering Design for existing Transmitter Facility alterations.
Amount:
$7,061.65

Component Description:
Monthly progress of Architectural and Engineering Design for existing Transmitter Facility alteration for FCC Repack.
Amount:
$900.00

Component Description:
Professional Services
Amount:
$900.00

Component Description:
Professional Services
Amount:
$300.00

Component Description:
Professional Services
Amount:
$2,499.75

Component Description:
Professional Services
Amount:
$5,827.88
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 - Negotiation of lease and other matters for shared locations

Component Description:
Email to S. Amron (WETA Legal) regarding inquiries from other parket stations about WETA repack
Amount:
$5,481.65

Component Description:
Legal services
Amount:
$5,890.50

Component Description:
Legal Services
Amount:
$1,650.00

Component Description:
Item A - Attorney fees related to negotiation of WETA move to Ch. 31
Amount:
$17,227.32

Component Description:
Item A - Negotiate with 3rd parties re: move to Ch. 31 and related
Amount:
$4,093.60

Component Description:
Item A - Attorney fees for exploration and negotiation of Ch. 31 move
Amount:
$1,626.47

Component Description:
Legal services
Amount:
$2,250.00

Component Description:
Item A - Attorney fees for discussion regarding viability of Ch. 14 and move to Ch. 31
Amount:
$6,822.08

Component Description:
WETA-550-Attorney - Negotiate Lease and Other Matters:
Amount:
$2,280.90

Component Description:
Attorney - Negotiate Lease and Other Matters
Amount:
$1,666.00

Component Description:
Negotiating with 3rd parties (interference) for move to Ch. 31
Amount:
$476.00

Component Description:
Attorney - Negotiate Lease and Other Matters
Amount:
$1,047.20

Component Description:
Item A - Attorney fees for exploring and negotiating channel alternatives to Ch. 14
Amount:
$5,758.86

Component Description:
Legal Services
Amount:
$1,100.00

Component Description:
Item A - Negotiation with 3rd parties for WETA move to Ch. 31
Amount:
$12,350.00

Component Description:
Legal services
Amount:
$10,468.03

Component Description:
Work on WETA repack reimbursement issues
Amount:
$7,327.35

Component Description:
Legal Services Rendered
Amount:
$380.80

Component Description:
Item A - Attorney fees for negotiation of move to Channel 31. See attached invoice and items marked as A on page 2 for detail breakout.
Amount:
$1,190.00

Component Description:
Item A - Negotiation of move to Ch. 31 and related issues
Amount:
$20,644.80

Component Description:
Work on WETA repack issues with DCJTV-owned combiner
Amount:
$16,929.59

Component Description:
Work on WETA repack issues regarding DCJTV invoices for combiner and concerns with reimbursement of same.
Amount:
$7,587.46

Component Description:
Legal services
Amount:
$1,050.00

Component Description:
Legal Services Rendered
Amount:
$6,147.03

Component Description:
Work on WETA repack issues regarding combiner replacement
Amount:
$8,704.85

Component Description:
Item A - Attorney fees for various matter relating to channel 14 assignment and channel 31 move
Amount:
$6,330.80

Component Description:
Item A - Negotiation with 3rd parties in connection with WETA move to Ch. 31
Amount:
$4,700.00

Component Description:
Legal services
Amount:
$3,189.20

Component Description:
Attorney Fees- Negotiate Lease and Other Matters
Amount:
$2,332.40
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
Item B - Work related to construction permit application
Amount:
$476.00

Component Description:
Item B - Preparation of construction permit application and related
Amount:
$1,618.40

Component Description:
Item B - Follow-up work related to CP application
Amount:
$226.95

Component Description:
Item B - Monitor construction permit application
Amount:
$190.40
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application

Component Description:
Attorney - Construction Permit Application (Aux)
Amount:
$333.20

Component Description:
Construction Permit App Aux
Amount:
$36.55

Component Description:
Item C - Preparation of CP application for aux site
Amount:
$285.60

Component Description:
Attorney - Construction Permit Application (Aux
Amount:
$179.35
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application Information not provided.
Prepare request for Special Temporary Authorization

Component Description:
Item E - Attorney fees related to STA for waiver of repack construction permit app
Amount:
$328.95
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 Information not provided.
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form

Component Description:
Item F - Educate WETA staff on reimbursement
Amount:
$238.00

Component Description:
Item F - Attorney fees for preparation of Form 399
Amount:
$5,807.20

Component Description:
Legal Services
Amount:
$1,000.00

Component Description:
Item F - Attorney fees for educating WETA staff on reimbursement procedures
Amount:
$95.20

Component Description:
Item F - Attorney fees in preparation of Form 399
Amount:
$190.40

Component Description:
Item F - Educate WETA staff on reimbursement procedures and processes
Amount:
$2,760.80

Component Description:
Item F - Attorney fees related to preparation of Form 399
Amount:
$2,943.55

Component Description:
Emails with S. Amron
Amount:
$190.40

Component Description:
Item F - Attorney fees for preparation of Form 399
Amount:
$2,500.00

Component Description:
WETA-590-Prepare and/or Review Reimbursement Form
Amount:
$168.00

Component Description:
WETA-590-Prepare and/or Review Reimbursement Form
Amount:
$672.00

Component Description:
Prepare and/or Review Reimbursement Form
Amount:
$238.00

Component Description:
Item F - Attorney fees for preparation of Form 399
Amount:
$952.00

Component Description:
Item F - Educate WETA staff on reimbursement process & procedure and related
Amount:
$295.80

Component Description:
Item F - Attorney fees related to preparation of Form 399
Amount:
$1,643.90

Component Description:
Legal Services Rendered
Amount:
$2,998.80
Project management of the transition

Component Description:
Project Management
Amount:
$6,646.30

Component Description:
Project Management
Amount:
$993.75

Component Description:
work related to TV repack rebuild of WETA TV transmitter room
Amount:
$4,050.00

Component Description:
Project Management
Amount:
$6,489.15

Component Description:
Project Management
Amount:
$1,945.35

Component Description:
Project Management
Amount:
$4,626.65

Component Description:
Project Management
Amount:
$4,894.25

Component Description:
Project Management
Amount:
$3,879.85

Component Description:
Project Management
Amount:
$4,988.10

Component Description:
Project Management
Amount:
$6,954.05

Component Description:
Project Management
Amount:
$3,254.45
RF Exposure Measurements 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 $121,426.00 $117,061.00 N/A $25,447.00 N/A
Total for all systems $6,052,314.67 $5,458,912.47 N/A $1,835,673.33 N/A
Other Expenses $121,426.00 $117,061.00 $25,447.00
MVPD Notification of Channel Change $7,000.00 $7,000.00 Estimated cost of using outside firm to contact MVPD's regarding channel change to repack channel. $1,250.00 N/A
Develop and air announcement of upcoming channel change $7,500.00 $7,500.00 Costs for production and airtime of channel change announcements. N/A N/A
Equipment Storage $10,000.00 $10,000.00 See attached Budget Justification: FEES AND MISCELLANEOUS EXPENSES N/A N/A
Equipment Delivery and Handling Charges $34,500.00 $34,500.00 See WETA ULXTE90 6 pole CIF with RF Switch Load.pdf $13,500 See WETA Interim Site ULXTE-50 9-6-18.pdf 11,000 Est. Ship for antenna and transmission line and other equipment 10,000 N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $45,681.00 $45,681.00 Some disposal costs are anticipated for old equipment removed from service. Please see attached GatesAir Quote Q-79737. $19,947.00 N/A
Non-zoning permits $5,000.00 $5,000.00 Estimate of building permit costs to modify auxiliary transmitter site and extensive electrical work at main site. N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $380.00 Anticipate needing to file two STA's in a project this complex. N/A N/A
DTV Medical Facility Notification $11,550.00 $7,000.00 N/A $4,250.00 N/A
Additional Legal Expenses for Repack $0.00 $0.00 N/A N/A N/A

Components

Actual Information Description File Name
MVPD Notification of Channel Change

Component Description:
Medical Notification
Amount:
$1,250.00
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
Lump Sum: Decommissioning, Demolition, Transportation and Disposal of IOT Harris Transmission system and Components
Amount:
$19,947.00
Non-zoning permits Information not provided.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
DTV Medical Facility Notification

Component Description:
Medical Notification
Amount:
$4,250.00
Additional Legal Expenses for Repack Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $6,052,314.67 $5,458,912.47 $1,835,673.33

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. 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.

Sarah Gurfein-Amron

Contracts & Regulatory Specialist


09/04/2019

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.

Sarah Gurfein-Amron

Contracts & Regulatory Specialist


09/04/2019

Attachments

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