TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
COX TELEVISION TULSA, LLC Doing Business As: COX TELEVISION TULSA, LLC	Chief Engineer 2625 SOUTH MEMORIAL DRIVE TULSA, OK 74129 United States	+1 (918) 491-0023	darin.hall@coxinc.com	Limited Liability Company

Applicant

Address

Phone

Applicant Type

COX TELEVISION TULSA, LLC

Doing Business As: COX TELEVISION TULSA, LLC

Chief Engineer

2625 SOUTH MEMORIAL DRIVE

TULSA, OK 74129

United States

+1 (918) 491-0023

darin.hall@coxinc.com

Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant	Address	Phone	Email
[Confidential]

Preparer Contact Information

Preparer Contact Name and Information

Applicant	Address	Phone	Email
Darin Hall Chief Engineer Cox Television Tulsa, LLC	Chief Engineer 2625 South Memorial Drive Tulsa, OK 74129 United States	+1 (918) 491-0023	darin.hall@coxinc.com

Applicant

Address

Phone

Darin Hall

Chief Engineer

Cox Television Tulsa, LLC

Chief Engineer

2625 South Memorial Drive

Tulsa, OK 74129

United States

+1 (918) 491-0023

darin.hall@coxinc.com

Broadcaster Information and Transition Plan

Question	Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information.	Yes
Briefly describe transition plan	KMYT will construct interim facilities on nearby tower. KMYT will move to the interim tower on its current channel. KMYT's new equipment will be installed after serious tower modifications at existing site.

Transmitters

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

Primary Transmitter

Existing Transmitter Information

Section	Question	Response
Existing Transmitter Description	Type of change	Purchase New
	Use	Primary (Main)
	Description of Use	N/A
	Ownership	Owned
	Owner	N/A
	Site	N/A
	Is this transmitter currently shared with another station?	No
	Is this transmitter currently in operating condition?	Yes
Existing Transmitter Manufacturer and Type	Manufacturer
	Model	Sigma CD3200
	Year	2002
	Type	Inductive Output Tube
	IOT Power Type	Two
	Power Capacity	42 kW

Primary Transmitter

New Transmitter Costs

Section	Question	Response
New Transmitter	Use	Primary (Main)
	Change Type	Purchase New
	Is this a request for upgraded equipment?	Yes
	Manufacturer
	Model	ULXTE-80
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	50 kW
	Justification for New Transmitter	Current IOT Transmitter cannot be retuned per manufacturer and solid state transmitter is less than a comparable IOT transmitter. 08/18/2018 Transmitter size was increased See attachment: TP Required to Compensate Ant AGL Reduction rev2.pdf

Primary Transmitter

Other Transmitter Costs

Section	Question	Response
Electrical Service	Service Entrance (3 phases 800A 208V)	No
	Switchgear (industrial 800 amp)	Yes
	Transformer (480V)	No
	Power	N/A
	Rigid Conduit and Wiring	Yes
	Size	3 inches
	Length	100.0 feet
	Other Electrical Service	Yes
	Description	Required new 208vac Transformer, Switch and Panel with Breakers
HVAC Service	Does the replacement transmitter require HVAC Service?	Yes
	Type	Cooling Only
	Size	10 tons
	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

Other Transmitter Cost Not Listed

Name	Description
Indoor RF Equipment	New mask filter, reject loads, main load and switch control equipment
Transmitter Disposal	Removal and environmental disposal of existing transmitter coolant and High Voltage Beam Supply oil.
Spare Parts Kit	Current Spare parts kit is not compatible with new transmitter.

Interim Transmitter

New Transmitter Costs

Section	Question	Response
New Transmitter	Use	Interim
	Description of Use	N/A
	Change Type	Purchase
	Manufacturer
	Model	ULXTE-72
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	47.2 kW
	Justification for New Transmitter	Interim transmitter needed for continued viewer service during the repack process.

Interim Transmitter

Other Transmitter Costs

Section	Question	Response
Electrical Service	Service Entrance (3 phases 800A 208V)	Yes
	Switchgear (industrial 800 amp)	Yes
	Transformer (480V)	Yes
	Power	150 kVA
	Rigid Conduit and Wiring	Yes
	Size	3 inches
	Length	250.0 feet
	Other Electrical Service	Yes
	Description	208vAC Transformer, Switch and Panel with Breakers for Pumps, Loads, Generator, lighting and UPS.
HVAC Service	Does the replacement transmitter require HVAC Service?	Yes
	Type	Cooling Only
	Size	20 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	1200.0 square feet
Channel 14 Costs	Is an RF Consulting Engineer needed?	N/A
	Is a channel 14 Mask Filer needed?	N/A
	Is additional field engineering time needed?	N/A
	Number of Days	N/A
Inside RF System	Is an additional interior RF system required to support this interim transmitter?	Yes

Interim Transmitter

Other Transmitter Cost Not Listed

Name	Description
Transmitter Control	Required Transmitter control, Rack, UPS and remote monitoring system
STL Signal Link	STL/TSL microwave equipment, dish, line and rigging installation costs

Antennas

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

Primary Antenna

Existing Antenna Information

Section	Question	Response
Existing Antenna Description	Type of change	Purchase New
	Antenna Use	Primary (Main)
	Description of Use	N/A
	Ownership	Owned
	Owner	N/A
	Site	N/A
	Is the existing antenna shared with another station or stations?	No
	Is the existing antenna directional?	No
	Is antenna in operating condition?	Yes
	Is antenna located on or in close proximity to an antenna farm?	No
Existing Antenna Manufacturer and Type	Class	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:	900.0 kW
	Manufacturer
	Model	ATW30H5-HSOL-41H
	Year	2002

Primary Antenna

New Antenna Costs

Section	Question	Response
New Antenna Description	Use	Primary (Main)
	Description of Use	N/A
	Change Type	Purchase New
	Is this a request for upgraded equipment?	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:	770.0 kW
	Manufacturer
	Model	TFU-29JSC-R-04
	Year	2018
	Justification for New Antenna	Current antenna cannot be retuned on new Repacked channel.

Primary Antenna

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	7 3/16 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

Primary Antenna

Other Antenna Cost Not Listed

Information not provided.

Interim Antenna

New Antenna Costs

Section	Question	Response
New Antenna Description	Use	Interim
	Description of Use	N/A
	Change Type
	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 Type	Class	Full Power
	Mounting	Side Mount
	Antenna position in stack	Not in Stack
	Polarization	Horizontal
	Type	Broadband Panel
	Number of Stations Supported	1
	Number of Panels/Bays	3
	Lower Limit	521.00 MHz
	Upper Limit	641.00 MHz
	Design power capacity in use	100.0 %
	Other Antenna Type	N/A
	ERP:	1000.0 kW
	Manufacturer
	Model	TFU-24WB-R
	Year	2018
	Justification for New Antenna	Broadband panel antenna required to approximate the current viewer coverage without exceeding licensed contour.

Interim Antenna

Other Antenna Costs

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

Interim Antenna

Other Antenna Cost Not Listed

Name	Description
Interim Tower Rigging	Rigging and installation costs for Interim Antenna and Line.

Transmission Line

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

Primary Transmission Line

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	7 3/16 inches
	Other Diameter	N/A
	Segment Length	19 1/2 inches
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	1285 feet per run

Primary Transmission Line

New Transmission Line

Section	Question	Response
New Transmission Line Costs	Use	Primary (Main)
	Description of Use	N/A
	Change Type	Purchase New
	Is this a request for upgraded equipment?	No
	Type	Rigid
	Diameter	7 3/16 inches
	Other Diameter	N/A
	Segment Length	19 1/2 inches
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	1285 feet per run
	Justification for New Transmission Line	Current line will not technically operate within specs at channel 34 per manufacturer.

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Information not provided.

Interim Transmission Line

New Transmission Line

Section	Question	Response
New Transmission Line Costs	Use	Interim
	Description of Use	N/A
	Change Type	Purchase New
	Type	Rigid
	Diameter	6 1/8 inches
	Segment Length	19 ½ '
	Other Segment Length
	Number of parallel runs	1
	Length	1720 feet per run
	Justification for New Transmission Line	Rigid Coaxial Transmission line for Interim Antenna located at the Interim site.

Interim Transmission Line

Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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

Primary Tower

Existing Tower

Section	Question	Response
Existing Tower Description	Type of change	Modify Existing
	Tower Use	Primary (Main)
	Description of Use	N/A
	Ownership	Leased
	Is this tower consider Complex?	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?	No
	Is tower compliant with Rev G?	No
Existing Tower Structure Registration	Do you have a tower registration number?	Yes
Existing Tower Structure Registration	ASR Number	1048931
Coordinates (NAD83)	Latitude (NAD83)	36° 01' 36.0" N-
	Longitude (NAD83)	095° 40' 45.0" W-
	Overall Structure Height	1268.03 feet
	Support Structure Height	1200.12 feet
	Ground Elevation Above Mean Sea Level (AMSL)	709.97 feet
	Structure Type	TOWER - Free Standing or Guyed Structure
	Tower Owner	IWG Towers Assets II, LLC
	Date Constructed	03/28/2003

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
11910	KOKI-TV	DTV

Other Types of Users

Users
Action Radio Co

Primary Tower

Tower Modification Costs

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

Primary Tower

Tower Rigging Costs

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

Primary Tower

Other Tower Expenses Not Listed

Name	Description
Additional Tower Engineering	Additional tower studies and modifications engineering.

Outside Professional Services Costs

Section	Question	Response
Outside Project Management Services	Do you require outside project management services?	Yes
	Number of Hours	160
	Explanation	Manage and coordinate delivery of all equipment at both the Interim Site as well as the Main Site. Confirm all contractors arrival and schedule.
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	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

Other Professional Services Expenses Not Listed

Name	Description
Interim Facility Engineering	Service Fees for engineering, mechanical and utilities design and management.

Other Expenses

Section	Question	Response
AM Pattern Disturbance	Is an Impact Study needed?	No
AM Pattern Disturbance	Is Remediation needed?	No
Facility Expenses	Name	N/A
	Other Distributed Transmission System Expenses Not listed	N/A
	Name	N/A
	Is Notification of a Medical Facility required as a result of DTV broadcasting?	Yes
Permit and Filing Costs	Local Zoning	Yes
	Non-zoning permits	No
	BLM or NFS Coordination	No
	FCC Construction Permit Minor Change	No
	FCC License to Cover Application	Yes
	FCC Special Temporary Authority Application	Yes
Other Miscellaneous Expenses	Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)?	Yes
	Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs?	Yes
	Does this relocation require Equipment Storage?	Yes
	Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change?	Yes
	Does this relocation require MVPD Notification of a Channel Change?	Yes

Other Expenses

Other Expenses Not Listed

Name	Description
Interim Tower and Ground Lease	Interim Tower and Ground Lease will be required by Interim Tower Owner for 5 years minimum.
Interim Tower Mapping and Studies	Tower Mapping and Studies will be needed to be performed on Interim Tower and grounds to determine loading.
Interim Tower Modifications	Modifications will needed on Interim Tower to bring to TIA/ANSI Rev. G standard.

Cost Information

Transmitters

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

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$4,470,697.25	$3,919,279.42	N/A	$3,743,294.76	N/A
Total for all systems	$8,168,987.89	$7,582,252.89	N/A	$5,778,824.28	N/A
Interim Transmitter ULXTE-72	$2,702,173.89	$2,254,738.75		$2,121,250.81
Other -- Building Addition Size: 1200.0	$458,149.23	$458,149.23	Building constructed at Interim Site. No existing facility available at site. This build includes floor, walls, roof, and ice protection. Outdoor concrete pads for heat exchangers with ice protection. *Earlier price provided on 399 was just an estimate	$456,360.92	Earlier price provided on 399 was just an estimate and after bid process and full installation the cost was increased.
STL Signal Link	$222,634.64	$222,634.64	STL/TSL Signal from Studio. Dish, Line, Radios for both ends. Includes Rigging and path alignment. Frequency path analysis and line sweeps.	$151,752.53	N/A
UHF inside RF system including switching	$147,500.00	$106,939.86	Indoor RF equipment and control including dummy load, switch, mask filter and control equipment.	$106,939.86	Earlier price provided on 399 was just an estimate and after full installation the cost was increased.
Other -- HVAC Service Type: C Size:20 (Other)	$37,600.00	$37,600.00	2-10 ton Cooling only HVAC units for interim site.	$23,660.00	N/A
Other Electrical Service: 208vAC Transformer, Switch and Panel with Breakers for Pumps, Loads, Generator, lighting and UPS.	$272,140.02	$272,140.02	208vac transformer and TVSS from Gates Air. Interim transmitter panel and breakers. Generator and ATS switch for building including installation.	$251,780.50	N/A
3" Rigid Conduit and Wiring (Cost per foot)	$13,000.00	$12,250.00	N/A	$6,625.00	N/A
Transformer 3 phase/480v - 150 KVA	$25,550.00	$24,300.00	N/A	$9,875.00	N/A
Service entrance 3 phase/800 amp/208 volt	$14,400.00	$15,562.00	Earlier price provided on 399 was just an estimate and after bid process and full installation the cost was increased.	$15,562.00	Earlier price provided on 399 was just an estimate and after bid process and full installation the cost was increased.
Switchgear - industrial 800 amp	$38,200.00	$36,300.00	N/A	$29,832.00	N/A
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW	$1,473,000.00	$1,068,863.00	Earlier price provided on 399 was just an estimate and after full installation the cost was increased.	$1,068,863.00	Earlier price provided on 399 was just an estimate and after full installation the cost was increased.
Transmitter Control	$0.00	$0.00	N/A	N/A	N/A
Primary Transmitter ULXTE-80	$1,768,523.36	$1,664,540.67		$1,622,043.95
Spare Parts Kit	$13,931.27	$13,931.27	Current Parts kit is not compatible with new transmitter. New kit replaces existing parts kit of PA module, power supply, control boards.	$13,931.27	Earlier price provided on 399 was just an estimate and after full installation the cost was increased.
Transmitter Disposal	$1,788.00	$1,788.00	Environmental disposal of existing Sigma coolant and Beam supply oil. 10 Drums/550 gallons.	N/A	N/A
Indoor RF Equipment	$144,685.80	$144,685.80	Inside RF System including Mask Filter, dummy load system and control from Gates Air.	$120,342.08	N/A
Other Electrical Service: Required new 208vac Transformer, Switch and Panel with Breakers	$52,818.29	$52,818.29	208VAC Transformer and Surge Suppressor from Gates Air, installation and 208VAC panel board and breakers including associated wiring. Early estimate was low and after final quotes the cost had increased.	$52,818.29	Earlier price provided on 399 was just an estimate and after full installation the cost was increased.
3" Rigid Conduit and Wiring (Cost per foot)	$5,200.00	$4,900.00	N/A	$4,900.00	N/A
Switchgear - industrial 800 amp	$38,200.00	$36,300.00	N/A	$19,935.00	N/A
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW	$1,473,000.00	$1,402,017.31	Main transmitter required for operation, Gates Air quote minus the spare parts kit, Indoor RF, and Electrical.Cost increased after the estimate was provided and tower antenna/line was finalized.	$1,402,017.31	Earlier price provided on 399 was just an estimate and after full installation the cost was increased.
10 Ton system	$38,900.00	$8,100.00	N/A	$8,100.00	N/A

Components

Actual Information Description	File Name
Other -- Building Addition Size: 1200.0	Component Description: Payment for the portion of the invoice pertaining to the Interim Building Addition. See Call Sign Allocation 09192018.pdf Includes Change Order #1 and #2 applied to Building Category. Amount: $29,584.88 Component Description: Invoice pertaining to the portion of geotech in the category of Interim Facility. See also PO Upload and Call Sign Allocation 01252018.pdf Amount: $2,100.00 Component Description: Payment for the portion of the invoice pertaining to the Interim Building Addition. See Call Sign Allocation 09192018.pdf Includes Letter explaining Retainage Allocations for Final Invoice. Amount: $44,982.18 Component Description: Payment for the portion of the invoice pertaining to the Interim Building Addition. See Call Sign Allocation 09192018.pdf Amount: $7,905.58 Component Description: Payment for Facility Construction Inspections. See Call Sign Allocation 09192018.pdf Amount: $606.50 Component Description: Payment for temporary power required for Facility Construction. See Call Sign Allocation 09192018.pdf Amount: $2,057.92 Component Description: Payment for Facility Construction Inspections. See Call Sign Allocation 09192018.pdf Amount: $1,774.75 Component Description: Payment for the portion of the invoice pertaining to the Interim Building Addition. See Call Sign Allocation 09192018.pdf Amount: $103,672.33 Component Description: Payment for the portion of the invoice pertaining to the Interim Building Addition. See Call Sign Allocation 09192018.pdf Amount: $156,828.87 Component Description: Payment for the portion of the invoice pertaining to the Interim Building Addition. See Call Sign Allocation 09192018.pdf Amount: $106,847.91
STL Signal Link	Component Description: Payment for the invoice pertaining to the category of Interim STL/TSL. See Call Sign Allocation 09192018.pdf. See IMT Vislink Quote_PO Interim STL.pdf. Equipment was sold as a package price. Amount: $23,088.82 Component Description: Payment for the invoice pertaining to the category of Interim STL/TSL. See Call Sign Allocation 11042018 PO Invoice.pdf. Amount: $8,761.00 Component Description: Payment for the invoice pertaining to the category of Interim STL/TSL. See Call Sign Allocation 09192018.pdf Amount: $357.38 Component Description: Payment for the invoice pertaining to the category of Interim STL/TSL. See Call Sign Allocation 09192018.pdf. See IMT Vislink Quote_PO Interim STL.pdf. Equipment was sold as a package price. Amount: $10,049.60 Component Description: Payment for the invoice pertaining to the category of Interim STL/TSL. See Call Sign Allocation 09192018.pdf Amount: $5,492.11 Component Description: Invoice to category of Interim STL/TSL. See Call Sign Allocation 09192018.pdf. See PO and Quote included in attachment with Invoice.System does not allow the use of the "&" symbol that is part of the companies name so I replaced it with "and". Amount: $1,475.00 Component Description: Payment for the invoice pertaining to the category of Interim STL/TSL. See Call Sign Allocation 09192018.pdf Amount: $719.68 Component Description: Payment for the invoice pertaining to the category of Interim STL/TSL. See Call Sign Allocation 09192018.pdf See IMT Vislink Quote_PO Interim STL.pdf. Equipment was sold as a package price. Amount: $98,962.67 Component Description: Invoice to category of Interim STL/TSL. See Call Sign Allocation 09192018.pdf. See PO and Quote included in attachment with Invoice.System does not allow the use of the "&" symbol that is part of the companies name so I replaced it with "and". Amount: $1,100.00 Component Description: Payment for STL/TSL Fiber I/O Connection adaptor. See Call Sign Allocation 09192018.pdf Amount: $1,746.27
UHF inside RF system including switching	Component Description: Payment for additional materials for the installation of the Indoor RF system. Amount: $395.19 Component Description: Final Payment for the portion of invoice pertaining to the category of Indoor RF. See Call Sign Allocation 09192018.pdf Amount: $35,337.39 Component Description: 1/3 Pre-Ship Payment for the portion of invoice pertaining to the category of Indoor RF. See Call Sign Allocation 09192018.pdf Amount: $35,337.39 Component Description: Payment for additional materials for the installation of the Indoor RF system. Amount: $532.50 Component Description: 1/3 Down Payment for the portion of invoice pertaining to the category of Indoor RF. See also PO Upload and Call Sign Allocation 01252018.pdf Amount: $35,337.39
Other -- HVAC Service Type: C Size:20 (Other)	Component Description: Payment for the portion of the invoice pertaining to the Interim Building HVAC. See Call Sign Allocation 09192018.pdf Amount: $9,582.30 Component Description: Payment for the portion of the invoice pertaining to the Interim Building HVAC. See Call Sign Allocation 09192018.pdf Amount: $1,064.70 Component Description: Please delete component. Amount: N/A Component Description: Payment for the portion of the invoice pertaining to the Interim Building HVAC. See Call Sign Allocation 09192018.pdf Amount: $10,647.00 Component Description: Please delete component. Amount: N/A Component Description: Payment for the portion of the invoice pertaining to the Interim Building HVAC. See Call Sign Allocation 09192018.pdf Includes Letter explaining Retainage Allocations for Final Invoice. Amount: $2,366.00
Other Electrical Service: 208vAC Transformer, Switch and Panel with Breakers for Pumps, Loads, Generator, lighting and UPS.	Component Description: Payment for the invoice pertaining to the new electrical service commissioning. Amount: $447.09 Component Description: Down Payment for the portion of invoice pertaining to the category of Electrical provided by Gates Air. Amount: $3,378.27 Component Description: Payment for Interim Transmitter Electrical Installation. See Call Sign Allocation 09192018.pdf Amount: $47,498.00 Component Description: Final Payment for the portion of invoice pertaining to the category of Electrical provided by Gates Air. See Call Sign Allocation 09192018.pdf Amount: $3,378.27 Component Description: Payment for the portion of the invoice pertaining to the Interim Building Generator/ATS. See Call Sign Allocation 09192018.pdf Includes Letter explaining Retainage Allocations for Final Invoice. Amount: $18,952.00 Component Description: Please delete component. Amount: N/A Component Description: 1/3 Pre-Ship Payment for the portion of invoice pertaining to the category of Electrical provided by Gates Air. See Call Sign Allocation 09192018.pdf Amount: $3,378.27 Component Description: Payment for the portion of the invoice pertaining to the Interim Building Generator/ATS. See Call Sign Allocation 09192018.pdf Amount: $170,568.00 Component Description: Please delete component. Amount: N/A Component Description: Please delete component. Amount: N/A Component Description: Please delete component. Amount: N/A Component Description: Payment for the invoice pertaining to the Interim Building Generator/ATS. First required generator fuel fill to test tank. Amount: $4,106.08 Component Description: Payment for the invoice pertaining to the new electrical commissioning. Amount: $74.52
3" Rigid Conduit and Wiring (Cost per foot)	Component Description: Please delete component. Amount: N/A Component Description: Please delete component. Amount: N/A Component Description: Please delete component. Amount: N/A Component Description: Please delete component. Amount: N/A Component Description: Payment for the portion of the invoice pertaining to the Interim Building 3" Conduit. See Call Sign Allocation 09192018.pdf Amount: $5,962.50 Component Description: Payment for the portion of the invoice pertaining to the Interim Building 3" Conduit. See Call Sign Allocation 09192018.pdf Includes Letter explaining Retainage Allocations for Final Invoice. Amount: $662.50
Transformer 3 phase/480v - 150 KVA	Component Description: Please delete component. Amount: N/A Component Description: Payment for the portion of the invoice pertaining to the Interim Building Transformer. See Call Sign Allocation 09192018.pdf Includes Letter explaining Retainage Allocations for Final Invoice. Amount: $987.50 Component Description: Please delete component. Amount: N/A Component Description: Please delete component. Amount: N/A Component Description: Payment for the portion of the invoice pertaining to the Interim Building Transformer. See Call Sign Allocation 09192018.pdf Amount: $8,887.50 Component Description: Please delete component. Amount: N/A
Service entrance 3 phase/800 amp/208 volt	Component Description: Payment for the portion of the invoice pertaining to the Interim Building Service Entrance. See Call Sign Allocation 09192018.pdf Amount: $4,747.50 Component Description: Payment for the portion of the invoice pertaining to the Interim Building Service Entrance. See Call Sign Allocation 09192018.pdf Includes Change Order #3 applied to Service Entrance Category. Amount: $1,675.80 Component Description: Please delete component. Amount: N/A Component Description: Payment for the portion of the invoice pertaining to the Interim Building Service Entrance. See Call Sign Allocation 09192018.pdf Amount: $4,500.00 Component Description: Payment for the portion of the invoice pertaining to the Interim Building Service Entrance. See Call Sign Allocation 09192018.pdf Amount: $1,556.20 Component Description: Payment for the portion of the invoice pertaining to the Interim Building Service Entrance. See Call Sign Allocation 09192018.pdf Amount: $3,082.50
Switchgear - industrial 800 amp	Component Description: Please delete component. Amount: N/A Component Description: Payment for the portion of the invoice pertaining to the Interim Building Switch Gear. See Call Sign Allocation 09192018.pdf Amount: $13,419.07 Component Description: Payment for the portion of the invoice pertaining to the Interim Building Switch Gear. See Call Sign Allocation 09192018.pdf Amount: $6,211.80 Component Description: Payment for the portion of the invoice pertaining to the Interim Building Switch Gear. See Call Sign Allocation 09192018.pdf Includes Letter explaining Retainage Allocations for Final Invoice. Amount: $2,983.20 Component Description: Please delete component. Amount: N/A Component Description: Payment for the portion of the invoice pertaining to the Interim Building Switch Gear. See Call Sign Allocation 09192018.pdf Amount: $7,217.93
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW	Component Description: Payment for additional materials for the installation of the Transmitter cooling system. Amount: $933.68 Component Description: Final Payment for portion of the invoice pertaining to the category of transmitter, installation and freight, including required Change Orders for Installation.See Call Sign Allocation 09192018.pdf Amount: $367,476.82 Component Description: 1/3 Pre-Ship Payment for portion of the invoice pertaining to the category of transmitter, installation and freight. See Call Sign Allocation 09192018.pdf Amount: $348,896.55 Component Description: Payment for pertaining to the category of transmitter and installation. Amount: $919.28 Component Description: Payment for additional plumbing parts for the installation of the transmitter cooling system. Amount: $136.54 Component Description: 1/3 Down payment for portion of the invoice pertaining to the category of transmitter, installation and freight. See also PO Upload and Call Sign Allocation 01252018.pdf Amount: $348,896.55 Component Description: Payment for additional plumbing parts for the installation of the transmitter cooling system. Amount: $218.49 Component Description: Containers needed for required H20 for transmitter install. See Call Sign Allocation 09192018.pdf Amount: $1,385.09
Transmitter Control	Information not provided.
Spare Parts Kit	Component Description: Down Payment for the portion of invoice pertaining to the category of Spare parts provided by Gates Air. See also PO Upload and Call Sign Allocation 02072018.pdf Amount: $3,482.82 Component Description: Payment for the portion of invoice pertaining to the category of Spare parts provided by Gates Air. See also PO Upload and Call Sign Allocation 11042018.pdf Amount: $4,690.19 Component Description: Payment for the portion of invoice pertaining to the category of Spare parts provided by Gates Air. See also PO Upload and Call Sign Allocation 11042018.pdf Amount: $4,643.76 Component Description: Down Payment for the portion of invoice pertaining to the category of Spare parts provided by Gates Air. See also PO Upload and Call Sign Allocation 02072018.pdf Amount: $1,114.50
Transmitter Disposal	Information not provided.
Indoor RF Equipment	Component Description: Payment for the portion of invoice pertaining to the category of Indoor RF. See Call Sign Allocation 11042018.pdf Amount: $40,114.03 Component Description: Down Payment for the portion of invoice pertaining to the category of Indoor RF. See also PO Upload and Call Sign Allocation 02072018.pdf Amount: $29,272.09 Component Description: Payment for the portion of invoice pertaining to the category of Indoor RF. See Call Sign Allocation 11042018.pdf Amount: $41,588.89 Component Description: Down Payment for the portion of invoice pertaining to the category of Indoor RF. See also PO Upload and Call Sign Allocation 02072018.pdf Amount: $9,367.07
Other Electrical Service: Required new 208vac Transformer, Switch and Panel with Breakers	Component Description: Payment for the portion of invoice pertaining to the category of Electrical provided by Gates Air. See Call Sign Allocation 11042018.pdf Amount: $3,361.15 Component Description: Down Payment for the portion of invoice pertaining to the category of Electrical provided by Gates Air. See also PO Upload and Call Sign Allocation 02072018.pdf Amount: $798.69 Component Description: Payment for the portion of invoice pertaining to the category of Electrical provided by Gates Air. See Call Sign Allocation 11042018.pdf Amount: $3,327.87 Component Description: Payment for the portion of the invoice pertaining to the 2" Conduit, Transformer, 208v Switch Gear.See Call Sign Allocation 11262018.pdf Amount: $12,753.00 Component Description: Down Payment for the portion of invoice pertaining to the category of Electrical provided by Gates Air. See also PO Upload and Call Sign Allocation 02072018.pdf Amount: $2,495.91 Component Description: Payment for the portion of the invoice pertaining to the 2" Conduit, Transformer, 208v Switch Gear.See Call Sign Allocation 11042018 PO Invoice.pdf. Amount: $29,757.00 Component Description: Payment for additional materials for the cover of the electrical panel. Amount: $324.67
3" Rigid Conduit and Wiring (Cost per foot)	Component Description: Payment for the portion of the invoice pertaining to the 3" Conduit. See Call Sign Allocation 11042018 PO Invoice.pdf. Amount: $3,430.00 Component Description: Payment for the portion of the invoice pertaining to the 3" Conduit. See Call Sign Allocation 11262018.pdf Amount: $1,470.00
Switchgear - industrial 800 amp	Component Description: Payment for the portion of the invoice pertaining to the Switch Gear. See Call Sign Allocation 11262018.pdf Amount: $5,980.50 Component Description: Payment for the portion of the invoice pertaining to the Switch Gear. See Call Sign Allocation 11042018 PO Invoice.pdf. Amount: $13,954.50
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW	Component Description: Payment for additional plumbing parts for the installation of the transmitter cooling system. Amount: $156.00 Component Description: Payment for additional materials for the installation of the Transmitter cooling system. Amount: $555.29 Component Description: Down payment for portion of the invoice pertaining to the category of transmitter and installation and freight. See also PO Upload and Call Sign Allocation 02072018.pdf Amount: $99,403.45 Component Description: Final Payment for portion of the invoice pertaining to the category of transmitter, installation and freight, including required Change Orders for Installation. Amount: $103,032.45 Component Description: Payment for portion of the invoice pertaining to the category of transmitter and installation and freight. See and Call Sign Allocation 11042018.pdf Amount: $434,659.32 Component Description: Down payment for portion of the invoice pertaining to the category of transmitter and installation and freight. See also PO Upload and Call Sign Allocation 02072018.pdf Amount: $310,635.77 Component Description: Payment for pertaining to the category of transmitter and installation. Amount: $564.44 Component Description: Payment for portion of the invoice pertaining to the category of transmitter and installation and freight. See and Call Sign Allocation 11042018.pdf Amount: $453,010.59
10 Ton system	Component Description: Payment for HVAC at Main Site for new transmitter. See Call Sign Allocation 09192018.pdf System does not allow the use of the "&" symbol that is part of the companies name so I replaced it with "and". Amount: $8,100.00

Cost Information

Antennas

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

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$644,118.43	$639,338.43	N/A	$451,394.68	N/A
Total for all systems	$8,168,987.89	$7,582,252.89	N/A	$5,778,824.28	N/A
Interim Antenna TFU-24WB-R	$410,178.43	$407,838.43		$269,268.43
Interim Tower Rigging	$200,000.00	$200,000.00	Interim Site rigging, installation of antenna and line using Widelity Estimate for Tower Rigging.	$85,242.00	N/A
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	$2,700.00	N/A
UHF â€“ Broadband Panel, Side Mount Auxiliary/Interim, 1000 horizontally polarized	$27,333.43	$27,333.43	Duplicate entry created from 399 system. Was Recommended by Reimburse Viewer to add this explanation and put no cost in the estimate.	$27,333.43	Previous Antenna Line was superseded, thus this new antenna line. Earlier price provided on 399 was just an estimate and after full installation the cost was increased.
Sweep test of existing antenna	$6,730.00	$6,400.00	N/A	$0.00	N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)	$12,300.00	$11,700.00	N/A	N/A	N/A
Side mount brackets for high power antennas (if not included in antenna base cost)	$23,150.00	$22,000.00	N/A	$18,588.00	N/A
UHF – Broadband Panel, Side Mount Auxiliary/Interim, 1000 horizontally polarized	$135,405.00	$135,405.00	*System Notice: Estimate adjusted and locked because line has been superseded.*Interim Panel Antenna required to approximate the current viewer coverage without exceeding licensed contour. Vendor Change	$135,405.00	N/A
Primary Antenna TFU-29JSC-R-04	$233,940.00	$231,500.00		$182,126.25
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	$2,700.00	N/A
Side mount brackets for high power antennas (if not included in antenna base cost)	$23,150.00	$22,000.00	N/A	$19,575.00	N/A
Elbow complex, single channel, at antenna input, per 7 3/16. feedline (if needed)	$13,900.00	$13,200.00	N/A	$9,268.20	N/A
Sweep test of existing antenna	$6,730.00	$6,400.00	N/A	$2,340.55	N/A
UHF - High Power, Side Mount, basic slot antenna, 770 kW input, horizontally polarized	$184,900.00	$184,900.00	Main Antenna replacement, current antenna cannot be retuned. Price includes shipping. Vendor Change	$148,242.50	N/A

Components

Actual Information Description	File Name
Interim Tower Rigging	Component Description: Payment for the portion of invoice pertaining to the Interim Tower Rigging. Amount: $40,996.00 Component Description: Payment for the portion of invoice pertaining to the category of Interim Antenna Radome Tower rigging. Amount: $3,250.00 Component Description: Payment for the portion of invoice pertaining to the Interim Tower Rigging. See Call Sign Allocation 09192018.pdf Amount: $40,996.00
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)	Component Description: Invoice pertaining to the portion of design in the category of Scatter Study. See also PO Upload and Call Sign Allocation 01252018.pdf Amount: $2,700.00
UHF â€“ Broadband Panel, Side Mount Auxiliary/Interim, 1000 horizontally polarized	Component Description: Payment for the Invoice pertaining to the Category of Interim Antenna. Amount: $15,045.00 Component Description: Payment for the portion of invoice pertaining to the category of Interim Antenna.See Call Sign Allocation 09192018.pdf Previous Line was superseded. Amount: $15,045.00 Component Description: Payment for the portion of invoice pertaining to the category of Interim Antenna - Radome. Amount: $12,288.43
Sweep test of existing antenna	Information not provided.
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)	Information not provided.
Side mount brackets for high power antennas (if not included in antenna base cost)	Component Description: Payment for the portion of invoice pertaining to the category of side mount bracket. See Call Sign Allocation 09192018.pdf Amount: $1,858.80 Component Description: Down Payment for the portion of invoice pertaining to the category of side mount bracket. Amount: $8,364.60 Component Description: Pre-Ship Payment for the portion of invoice pertaining to the category of side mount bracket. See Call Sign Allocation 09192018.pdf Amount: $8,364.60
UHF – Broadband Panel, Side Mount Auxiliary/Interim, 1000 horizontally polarized	Component Description: Removed due to they system new line superseding this line. Amount: N/A Component Description: Pre-Ship Payment for the portion of invoice pertaining to the category of Interim Antenna. See Call Sign Allocation 09192018.pdf Amount: $67,702.50 Component Description: Down Payment for the portion of invoice pertaining to the category of Interim Antenna. Amount: $67,702.50
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)	Component Description: Invoice pertaining to the portion of design in the category of Scatter Study. See also PO Upload and Call Sign Allocation 01252018.pdf Amount: $2,700.00
Side mount brackets for high power antennas (if not included in antenna base cost)	Component Description: Down Payment for the portion of invoice pertaining to the category of side mount bracket. Amount: $9,787.50 Component Description: Pre-Ship Payment for the portion of invoice pertaining to the category of side mount bracket. See Call Sign Allocation 09192018.pdf Amount: $9,787.50
Elbow complex, single channel, at antenna input, per 7 3/16. feedline (if needed)	Component Description: Down Payment for the portion of invoice pertaining to the category of Elbow Complex Amount: $4,634.10 Component Description: Pre-Ship Payment for the portion of invoice pertaining to the category of Elbow Complex. See Call Sign Allocation 09192018.pdf Amount: $4,634.10
Sweep test of existing antenna	Component Description: Invoice for line sweep of existing line and antenna for repack. Amount: $2,340.55
UHF - High Power, Side Mount, basic slot antenna, 770 kW input, horizontally polarized	Component Description: Pre-Ship Payment for the portion of invoice pertaining to the category of Primary Antenna. See Call Sign Allocation 09192018.pdf Amount: $70,200.00 Component Description: Down Payment for the portion of invoice pertaining to the category of Primary Antenna. Amount: $70,200.00 Component Description: Payment for the invoice pertaining to the category of Main Antenna. Freight and storage. Amount: $7,842.50

Cost Information

Transmission Line

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

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$720,090.00	$708,291.63	N/A	$529,913.05	N/A
Total for all systems	$8,168,987.89	$7,582,252.89	N/A	$5,778,824.28	N/A
Interim Transmission Line	$347,440.00	$324,945.63		$324,945.63
Rigid Transmission Line - copper, 6 1/8"	$347,440.00	$324,945.63	Earlier price provided on 399 was just an estimate and after full installation the cost was increased.	$324,945.63	Earlier price provided on 399 was just an estimate and after full installation the cost was increased.
Primary Transmission Line	$372,650.00	$383,346.00		$204,967.42
Rigid Transmission Line - copper, 7 3/16"	$372,650.00	$383,346.00	Cost includes all hangars, line, pressure windows and required dehydrator. Line design and site evaluation included in cost.	$204,967.42	N/A

Components

Actual Information Description	File Name
Rigid Transmission Line - copper, 6 1/8"	Component Description: Payment for the invoice pertaining to the category of Interim Line. Amount: $7,631.43 Component Description: Payment for the invoice pertaining to the category of Interim Line. Amount: $2,981.97 Component Description: Payment for the invoice pertaining to the category of Interim Line. Amount: $85.40 Component Description: Payment for the portion of invoice pertaining to the category of Interim Line. See Call Sign Allocation 09192018.pdf Amount: $19,934.38 Component Description: Payment for the portion of invoice pertaining to the category of Interim Line. Quote, Letter included. Amount: $7,668.79 Component Description: Down Payment for the portion of invoice pertaining to the category of Interim Line. Amount: $136,212.26 Component Description: Pre-Ship Payment for the portion of invoice pertaining to the category of Interim Line. See Call Sign Allocation 09192018.pdf Amount: $136,212.26 Component Description: Payment for the invoice pertaining to the category of Interim Line Amount: $7,819.14 Component Description: Payment for the invoice pertaining to the category of Interim Line that involves line sweep and tuning. Amount: $6,400.00
Rigid Transmission Line - copper, 7 3/16"	Component Description: Payment for the portion of invoice pertaining to the category of Main Line Amount: $4,253.41 Component Description: Payment for the portion of invoice pertaining to the category of Main Line and Tuning. Amount: $6,400.00 Component Description: Down Payment for the portion of invoice pertaining to the category of Primary Line. Amount: $92,117.36 Component Description: Payment for the portion of invoice pertaining to the category of Main Line. Quote, Letter included. Amount: $7,668.79 Component Description: Pre-Ship Payment for the portion of invoice pertaining to the category of Primary Line. See Call Sign Allocation 09192018.pdf. Amount: $92,117.36 Component Description: Payment for the invoice pertaining to the category of Main Line. Amount: $2,410.50

Actual Information Description

File Name

Rigid Transmission Line - copper, 6 1/8"

Component Description:: Payment for the invoice pertaining to the category of Interim Line.
Amount:: $7,631.43

Component Description:: Payment for the invoice pertaining to the category of Interim Line.
Amount:: $2,981.97

Component Description:: Payment for the invoice pertaining to the category of Interim Line.
Amount:: $85.40

Component Description:: Payment for the portion of invoice pertaining to the category of Interim Line. See Call Sign Allocation 09192018.pdf
Amount:: $19,934.38

Component Description:: Payment for the portion of invoice pertaining to the category of Interim Line. Quote, Letter included.
Amount:: $7,668.79

Component Description:: Down Payment for the portion of invoice pertaining to the category of Interim Line.
Amount:: $136,212.26

Component Description:: Pre-Ship Payment for the portion of invoice pertaining to the category of Interim Line. See Call Sign Allocation 09192018.pdf
Amount:: $136,212.26

Component Description:: Payment for the invoice pertaining to the category of Interim Line
Amount:: $7,819.14

Component Description:: Payment for the invoice pertaining to the category of Interim Line that involves line sweep and tuning.
Amount:: $6,400.00

Rigid Transmission Line - copper, 7 3/16"

Component Description:: Payment for the portion of invoice pertaining to the category of Main Line
Amount:: $4,253.41

Component Description:: Payment for the portion of invoice pertaining to the category of Main Line and Tuning.
Amount:: $6,400.00

Component Description:: Down Payment for the portion of invoice pertaining to the category of Primary Line.
Amount:: $92,117.36

Component Description:: Payment for the portion of invoice pertaining to the category of Main Line. Quote, Letter included.
Amount:: $7,668.79

Component Description:: Pre-Ship Payment for the portion of invoice pertaining to the category of Primary Line. See Call Sign Allocation 09192018.pdf.
Amount:: $92,117.36

Component Description:: Payment for the invoice pertaining to the category of Main Line.
Amount:: $2,410.50

Cost Information

Tower Equipment and Rigging Costs

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

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$1,319,324.00	$1,255,524.00	N/A	$659,031.00	N/A
Total for all systems	$8,168,987.89	$7,582,252.89	N/A	$5,778,824.28	N/A
Primary Tower TOWER	$1,319,324.00	$1,255,524.00		$659,031.00
Serious tower reinforcement/modifications	$1,052,000.00	$1,000,000.00	Serious Tower Modification are required to bring tower to current standards.	$467,833.00	N/A
Additional Tower Engineering	$30,524.00	$30,524.00	Additional tower engineering due to serious tower modifications and studies.	$26,220.00	N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study	$26,300.00	$25,000.00	N/A	$19,740.00	N/A
Tall Tower (greater than 500')	$210,500.00	$200,000.00	N/A	$145,238.00	N/A

Components

Actual Information Description	File Name
Serious tower reinforcement/modifications	Component Description: Payment for the portion of invoice pertaining to the category of Main Tower Modifications. Amount: $8,250.00 Component Description: Payment for the portion of invoice pertaining to the category of Main Tower Modifications. Amount: $49,169.80 Component Description: Payment for the portion of invoice pertaining to the category of Main Tower Modifications. Amount: $98,339.60 Component Description: Payment for the portion of invoice pertaining to the category of Main Tower Modifications and Mobilization. See Call Sign Allocation1104018.pdf Amount: $40,400.00 Component Description: 20% Payment for the portion of invoice pertaining to the category of Main Tower Modifications. See Insite Tower RIO Mod Quote Main. See Call Sign Allocation 09192018.pdf Amount: $49,169.80 Component Description: Payment for the portion of invoice pertaining to the category of Main Tower Modifications. Amount: $166,750.00 Component Description: Payment for the portion of invoice to the category of Tower Modifications. System does not allow the use of the "&" symbol that is part of the companies name so I replaced it with "and". Amount: $6,584.00 Component Description: 20 % Payment for the portion of invoice pertaining to the category of Main Tower Modifications. See Insite Tower RIO Mod Quote Main. See Call Sign Allocation 09192018.pdf Amount: $49,169.80
Additional Tower Engineering	Component Description: Invoice pertaining to the category of Tower Mod Studies for difficult Tower. Amount: $26,220.00
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study	Component Description: Invoice pertaining to the category of Tower Mapping. See also PO Upload and Call Sign Allocation 01252018.pdf as well as revised PO#CPG7869Rev1 uploaded on 04/27/2018 Amount: $6,300.00 Component Description: Invoice pertaining to the category of Tower Mapping. See also PO Upload and Call Sign Allocation 01252018.pdf Amount: $13,440.00
Tall Tower (greater than 500')	Component Description: Payment for the portion of invoice to the category of Main Rigging. System does not allow the use of the "&" symbol that is part of the companies name so I replaced it with "and". Amount: $29,047.60 Component Description: Payment for the portion of invoice to the category of Main Rigging. System does not allow the use of the "&" symbol that is part of the companies name so I replaced it with "and". Amount: $29,047.60 Component Description: Payment for the portion of invoice to the category of Main Rigging. System does not allow the use of the "&" symbol that is part of the companies name so I replaced it with "and". Amount: $29,047.60 Component Description: 20% Payment for the portion of invoice to the category of Main Rigging. System won't allow the use of the "&" symbolfor vendor name, replaced it with "and". See Call Sign Allocation 09192018.pdf. See Rio Steel Quote 03212018 Main. Amount: $29,047.60 Component Description: Payment for the portion of invoice to the category of Main Rigging. System does not allow the use of the "&" symbol that is part of the companies name so I replaced it with "and". Amount: $29,047.60

Cost Information

Outside Professional Services

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

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$214,304.40	$258,660.60	N/A	$127,271.00	N/A
Total for all systems	$8,168,987.89	$7,582,252.89	N/A	$5,778,824.28	N/A
Outside Professional Services	$214,304.40	$258,660.60		$127,271.00
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	$5,260.00	$9,029.80	Earlier price provided on 399 was just an estimate and after actual cost was increased.	$9,029.80	Earlier price provided on 399 was just an estimate and after actual cost was increased.
Interim Facility Engineering	$48,854.40	$48,854.40	Interim Facility building engineering, mechanical, A/E, and utilities. Civil design and stamped drawing package.	$48,854.40	Earlier price provided on 399 was just an estimate and after bid process and full installation the cost was increased.
RF Exposure Measurements	$21,050.00	$20,000.00	N/A	N/A	N/A
Comprehensive coverage verification via field study, if needed	$84,200.00	$80,000.00	N/A	N/A	N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization	$3,680.00	$3,500.00	N/A	$1,411.90	Earlier price provided on 399 was just an estimate and after full installation the cost was increased.
Attorney Fees - Negotiation of lease and other matters for shared locations	$4,210.00	$8,000.00	This is for both the Main Tower Site as well as the Interim Site.	$6,998.50	Earlier price provided on 399 was just an estimate and after full installation the cost was increased.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	$2,365.00	$7,556.00	Earlier price provided on 399 was just an estimate and after actual cost was increased.	$7,556.00	Earlier price provided on 399 was just an estimate and after actual cost was increased.
Prepare request for Special Temporary Authorization	$2,050.00	$4,950.00	Earlier price provided on 399 was just an estimate and after actual cost was increased.	$4,950.00	Earlier price provided on 399 was just an estimate and after actual cost was increased.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	$3,155.00	$3,000.00	N/A	$2,700.00	Earlier price provided on 399 was just an estimate and after actual cost was increased.
Perform engineering study for new channel assignment and antenna development	$7,360.00	$33,814.00	Earlier price provided on 399 was just an estimate and after actual cost was increased. Cost was also higher due to Interim Site.	$33,814.00	Earlier price provided on 399 was just an estimate and after actual cost was increased. Cost was also higher due to Interim Site.
Address transition timing and coordination issues w/ other stations and wireless	$2,630.00	$2,500.00	N/A	N/A	N/A
Prepare and or review reimbursement form	$2,630.00	$11,956.40	Earlier price provided on 399 was just an estimate and after actual cost was increased.	$11,956.40	Earlier price provided on 399 was just an estimate and after actual cost was increased.
Project management of the transition	$25,280.00	$24,000.00	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

Components

Actual Information Description	File Name
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	Component Description: Portion of the Invoice pertaining to the category of legal CP fees. Amount: $235.50 Component Description: Portion of the Invoice pertaining to the category of legal CP fees. Amount: $1,411.10 Component Description: Portion of the Invoice pertaining to the category of legal CP fees. Amount: $299.20 Component Description: Portion of the Invoice pertaining to the category of legal CP fees. Amount: $1,228.50 Component Description: Portion of the Invoice pertaining to the category of legal CP fees. Amount: $314.00 Component Description: Portion of the Invoice pertaining to the category of legal CP fees. Amount: $3,656.90 Component Description: Portion of the Invoice pertaining to the category of legal CP fees. Amount: $849.50 Component Description: Portion of the Invoice pertaining to the category of legal CP fees. Amount: $401.90 Component Description: Portion of the Invoice pertaining to the category of legal CP fees. Amount: $83.70 Component Description: Portion of the Invoice pertaining to the category of legal CP fees. Amount: $549.50
Interim Facility Engineering	Component Description: Invoice pertaining to the portion of design in the category of Interim Facility Engineering.See Call Sign Allocation 11042018 PO Invoice.pdf. Amount: $3,600.00 Component Description: Invoice pertaining to the portion of design in the category of Interim Facility Engineering. Amount: $33,600.00 Component Description: Invoice pertaining to the portion of design in the category of Interim Facility Engineering. Amount: $7,200.00 Component Description: Invoice pertaining to the portion of design in the category of Interim Facility Engineering. See Call Sign Allocation 09192018.pdf Amount: $3,600.00 Component Description: Invoice pertaining to the portion of design in the category of Interim Facility Engineering. See Call Sign Allocation 09192018.pdf Amount: $854.40
RF Exposure Measurements	Information not provided.
Comprehensive coverage verification via field study, if needed	Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization	Component Description: Portion of the Invoice pertaining to the category of legal STA fees. Amount: $146.50 Component Description: Portion of the Invoice pertaining to the category of legal STA fees. Amount: $1,236.10 Component Description: Portion of the Invoice pertaining to the category of legal STA fees. Amount: $29.30
Attorney Fees - Negotiation of lease and other matters for shared locations	Component Description: Portion of the Invoice pertaining to the category of legal lease negotiations. Amount: $2,582.60 Component Description: Portion of the Invoice pertaining to the category of legal lease negotiations. Amount: $150.60 Component Description: Invoice related to the category of legal lease negotiations. System will not allow "&" symbol in company name and replaced it with "and". Amount: $3,065.00 Component Description: Portion of the Invoice pertaining to the category of legal lease negotiations. Amount: $376.50 Component Description: Portion of the Invoice pertaining to the category of legal lease negotiations. Amount: $224.40 Component Description: Portion of the Invoice pertaining to the category of legal lease negotiations. Amount: $599.40
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	Component Description: Portion of the Invoice pertaining to the category of legal main license fees. Amount: $3,140.00 Component Description: Portion of the Invoice pertaining to the category of legal main license fees. Amount: $74.80 Component Description: Portion of the Invoice pertaining to the category of legal main license fees. Amount: $224.40 Component Description: Portion of the Invoice pertaining to the category of legal main license fees. Amount: $2,275.40 Component Description: Portion of the Invoice pertaining to the category of legal main license fees. Amount: $734.70 Component Description: Portion of the Invoice pertaining to the category of legal main license fees. Amount: $78.50 Component Description: Portion of the Invoice pertaining to the category of legal main license fees. Amount: $1,028.20
Prepare request for Special Temporary Authorization	Component Description: Payment for the portion of invoice pertaining to the category of STA Prepare. Amount: $4,950.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	Component Description: Payment for the portion of invoice pertaining to the category of CP Prepare. Amount: $2,325.00 Component Description: Payment for the portion of invoice pertaining to the category of CP Prepare. Amount: $375.00
Perform engineering study for new channel assignment and antenna development	Component Description: Payment for the portion of invoice pertaining to the category of new assignment engineering Amount: $2,100.00 Component Description: Payment for the portion of invoice pertaining to the category of new assignment engineering Amount: $14,944.00 Component Description: Payment for the portion of invoice pertaining to the category of new assignment engineering Amount: $975.00 Component Description: Payment for the portion of invoice pertaining to the category of new assignment engineering Amount: $14,944.50 Component Description: Payment for the portion of invoice pertaining to the category of new assignment engineering Amount: $15,795.00
Address transition timing and coordination issues w/ other stations and wireless	Information not provided.
Prepare and or review reimbursement form	Component Description: Payment for the portion of invoice pertaining to the category of 399 reimbursement. Amount: $1,605.00 Component Description: Portion of the Invoice pertaining to the category of legal reimbursement fees. Amount: $598.40 Component Description: Portion of the Invoice pertaining to the category of legal reimbursement fees. Amount: $3,617.40 Component Description: Portion of the Invoice pertaining to the category of legal reimbursement fees. Amount: $314.00 Component Description: Portion of the Invoice pertaining to the category of legal reimbursement fees. Amount: $111.60 Component Description: Portion of the Invoice pertaining to the category of legal reimbursement fees. Amount: $682.10 Component Description: Portion of the Invoice pertaining to the category of legal reimbursement fees. Amount: $157.00 Component Description: Portion of the Invoice pertaining to the category of legal reimbursement fees. Amount: $736.60 Component Description: Portion of the Invoice pertaining to the category of legal reimbursement fees. Amount: $2,252.90 Component Description: Portion of the Invoice pertaining to the category of legal reimbursement fees. Amount: $225.00 Component Description: Portion of the Invoice pertaining to the category of legal reimbursement fees. Amount: $74.80 Component Description: Portion of the Invoice pertaining to the category of legal reimbursement fees. Amount: $149.60 Component Description: Portion of the Invoice pertaining to the category of legal reimbursement fees. Amount: $157.00 Component Description: Payment for the portion of invoice pertaining to the category of 399 reimbursement. Amount: $1,275.00
Project management of the transition	Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	Information not provided.

Cost Information

Other Expenses

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

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$800,453.81	$801,158.81	N/A	$267,919.79	N/A
Total for all systems	$8,168,987.89	$7,582,252.89	N/A	$5,778,824.28	N/A
Other Expenses	$800,453.81	$801,158.81		$267,919.79
Interim Tower and Ground Lease	$541,531.85	$541,531.85	Interim site tower and ground lease for $8,500.00 month for minimum 5 years. Negotiated from 10 year to 5 year.	$93,500.00	Earlier price provided on 399 was just an estimate and after Legal process and full installation the cost was increased.
Develop and air announcement of upcoming channel change	$2,500.00	$2,500.00	General Public information and channel change campaign including cost of production.	$392.50	N/A
Interim Tower Modifications	$150,000.00	$150,000.00	Tower Modifications to bring Interim tower to latest standard before interim antenna and line may be installed. Widelity Estimate for Minor Tower Modifications used.	$81,992.00	N/A
Interim Tower Mapping and Studies	$39,088.00	$39,088.00	Interim Tower Mapping, Structural and engineering studies required by tower owner. *Earlier price provided on 399 was just an estimate and after full installation the cost was increased.	$39,088.00	Earlier price provided on 399 was just an estimate and after full installation the cost was increased.
MVPD Notification of Channel Change	$2,500.00	$2,500.00	Certified letter services and notification for FCC Repack channel change.	$549.50	N/A
Equipment Storage	$9,983.56	$9,983.56	Container purchase and delivery for Main and Interim site requiring storage of equipment during construction and tower modifications.	$7,385.89	N/A
Equipment Delivery and Handling Charges	$38,770.40	$38,770.40	Large equipment rental to unload deliveries. Main and Interim Site will be needed. Prior cost was just an estimate. This will continue to increase until project is completed due to tower crew and manufacturer delays.	$38,770.40	Earlier price provided on 399 was just an estimate and after installation the cost was increased due to lead times with manufacturers and tower crew delays.
Disposal Costs (for equipment and other waste, net of any salvage value)	$4,000.00	$4,000.00	Cost of antenna and line removal from property for environmental disposal.	N/A	N/A
Local Zoning	$0.00	$0.00	Interim Building Permit and Zoning Permits for Wagoner County, Oklahoma	N/A	N/A
FCC Filing Fees - Special Temporary Authorization request	$195.00	$380.00	Earlier price provided on 399 was just an estimate and after full installation the cost was increased.	$380.00	Earlier price provided on 399 was just an estimate and after actual cost was increased.
FCC Filing Fees - Form 2100 license to cover application	$335.00	$1,405.00	Earlier price provided on 399 was just an estimate and after full installation the cost was increased.	$1,405.00	Earlier price provided on 399 was just an estimate and after actual cost was increased.
DTV Medical Facility Notification	$11,550.00	$11,000.00	N/A	$4,456.50	N/A

Components

Actual Information Description	File Name
Interim Tower and Ground Lease	Component Description: Payment for the portion of the invoice pertaining to the Interim Lease. Invoice Number was created from date of first lease. Amount: $93,500.00 Component Description: Payment for the portion of the invoice pertaining to the Interim Lease. See Call Sign Allocation 11042018 PO Invoice.pdf. Amount: $541,531.85
Develop and air announcement of upcoming channel change	Component Description: Portion of the Invoice pertaining to the category of legal Consumer Education fees. Amount: $157.00 Component Description: Portion of the Invoice pertaining to the category of legal Consumer Education fees. Amount: $235.50
Interim Tower Modifications	Component Description: Payment for the portion of invoice pertaining to the Interim Tower Modifications. Amount: $40,996.00 Component Description: Payment for the portion of invoice pertaining to the Interim Tower Modifications. See Call Sign Allocation 09192018.pdf. Amount: $40,996.00
Interim Tower Mapping and Studies	Component Description: Invoice pertaining to the portion of design in the category of Interim Mapping/Study. Amount: $10,438.00 Component Description: Payment for Interim Rigging Review and Post Inspection. See Call Sign Allocation 09192018.pdf. Quote and PO attached. Amount: $7,700.00 Component Description: Invoice pertaining to the portion of design in the category of Interim Mapping/Study. See also PO Upload and Call Sign Allocation 01252018.pdf Amount: $6,500.00 Component Description: Invoice pertaining to the portion of design in the category of Interim Mapping/Study. Amount: $6,750.00 Component Description: Payment for Interim Rigging Review and Post Inspection Amount: $7,700.00
MVPD Notification of Channel Change	Component Description: Portion of the Invoice pertaining to the category of legal MVPD fees. Amount: $314.00 Component Description: Portion of the Invoice pertaining to the category of legal MVPD fees. Amount: $235.50
Equipment Storage	Component Description: Payment for the invoice pertaining to the category of Storage. Main See Call Sign Allocation 11042018 PO Invoice.pdf. Amount: $3,712.50 Component Description: Payment for the invoice pertaining to the category of Storage. Interim See Call Sign Allocation 11042018 PO Invoice.pdf. Amount: $3,673.39
Equipment Delivery and Handling Charges	Component Description: Payment pertaining to the category of Equipment Delivery & Handling Charges. See Call Sign Allocation 11262018.pdf Amount: $3,860.34 Component Description: Payment pertaining to the category of Equipment Delivery & Handling Charges. See Call Sign Allocation 11262018.pdf Amount: $3,987.34 Component Description: Payment pertaining to the category of Equipment Delivery & Handling Charges Amount: $3,114.01 Component Description: Payment pertaining to the category of Equipment Delivery & Handling Charges Amount: $3,114.01 Component Description: Payment pertaining to the category of Equipment Delivery & Handling Charges Amount: $1,500.00 Component Description: Payment pertaining to the category of Equipment Delivery & Handling Charges. Amount: $622.94 Component Description: Payment pertaining to the category of Equipment Delivery & Handling Charges Amount: $3,114.01 Component Description: Payment pertaining to the category of Equipment Delivery & Handling Charges. See Call Sign Allocation 11262018.pdf Amount: $1,764.72 Component Description: Payment pertaining to the category of Equipment Delivery & Handling Charges Amount: $3,114.01 Component Description: Payment pertaining to the category of Equipment Delivery & Handling Charges Amount: $1,640.00 Component Description: Payment pertaining to the category of Equipment Delivery & Handling Charges Amount: $2,648.43 Component Description: Payment pertaining to the category of Equipment Delivery & Handling Charges. See Call Sign Allocation 11262018.pdf Amount: $3,114.01 Component Description: Payment pertaining to the category of Equipment Delivery & Handling Charges Amount: $3,114.01 Component Description: Payment pertaining to the category of Equipment Delivery & Handling Charges. See Call Sign Allocation 11262018.pdf Amount: $3,383.25 Component Description: Payment pertaining to the category of Equipment Delivery & Handling Charges. See Call Sign Allocation 11262018.pdf Amount: $679.32
Disposal Costs (for equipment and other waste, net of any salvage value)	Information not provided.
Local Zoning	Information not provided.
FCC Filing Fees - Special Temporary Authorization request	Component Description: Portion of the Invoice pertaining to the category of FCC STA fees. Amount: $190.00 Component Description: Portion of the Invoice pertaining to the category of FCC STA fees. Amount: $190.00
FCC Filing Fees - Form 2100 license to cover application	Component Description: Portion of the Invoice pertaining to the category of FCC main license fees. Amount: $335.00 Component Description: Portion of the Invoice pertaining to the category of FCC main license fees. Amount: $1,070.00
DTV Medical Facility Notification	Component Description: Portion of the Invoice pertaining to the category of legal DTV Medical Notification fees. Amount: $235.50 Component Description: Portion of the Invoice pertaining to the category of legal DTV Medical Notification fees. Amount: $314.00 Component Description: Portion of the Invoice pertaining to the category of legal DTV Medical Notification fees. Amount: $157.00 Component Description: Payment for DTV Medical Notifications. See Call Sign Allocation 09192018.pdf Amount: $3,750.00

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$8,168,987.89	$7,582,252.89	$5,778,824.28

Reimbursement Status

Question	Response
The facility has ceased operating on its pre-auction channel.	Yes
Construction of final facilities or all necessary modifications are complete.	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

Section	Question	Response
Submission of Estimated Expenses Statements	WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.
The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD). The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund. The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.	Darin Hall Chief Engineer 10/15/2019

Section

Question

Response

Submission of Estimated Expenses Statements

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

The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.
The above-named entity acknowledges that all certifications and attached documentation are considered material representations.
The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.
The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD).
The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.
The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred.
The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.
The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.

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

Darin Hall

Chief Engineer

10/15/2019

Certification

Section	Question	Response
Submission of Actual Cost Documentation Statements	WILLFUL FALSE, FRAUDULENT, OR FICTITIOUS STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISIONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE AND/OR FRAUDULENT STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT (U.S. CODE, TITLE 31, SECTIONS 3729-3733).
The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity certifies that the statements in this form and attached documentation are true, complete, and correct. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (full power and Class A stations) and/or otherwise modify a television station’s facility as a result of the spectrum repack (LPTV/TV Translator stations); or to minimize service disruption resulting from a repacked television station (FM stations); or to continue to carry the signal of a broadcaster that changes channels (MVPD) . The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund. The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a prerequisite for obtaining the payments herein requested.
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.	Darin Hall Chief Engineer 10/15/2019

Section

Question

Response

Submission of Actual Cost Documentation Statements

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

The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.
The above-named entity certifies that the statements in this form and attached documentation are true, complete, and correct.
The above-named entity acknowledges that all certifications and attached documentation are considered material representations.
The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.
The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (full power and Class A stations) and/or otherwise modify a television station’s facility as a result of the spectrum repack (LPTV/TV Translator stations); or to minimize service disruption resulting from a repacked television station (FM stations); or to continue to carry the signal of a broadcaster that changes channels (MVPD) .
The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.
The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred.
The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.
The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a prerequisite for obtaining the payments herein requested.

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

Darin Hall

Chief Engineer

10/15/2019

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

Applicant Information

Applicant Name, Type, and Contact Information

Reimbursement Contact Information

Reimbursement Contact Name and Information

Preparer Contact Information

Preparer Contact Name and Information

Broadcaster Information and Transition Plan

Transmitters

Primary Transmitter

Existing Transmitter Information

Primary Transmitter

New Transmitter Costs

Primary Transmitter

Other Transmitter Costs

Primary Transmitter

Other Transmitter Cost Not Listed

Interim Transmitter

New Transmitter Costs

Interim Transmitter

Other Transmitter Costs

Interim Transmitter

Other Transmitter Cost Not Listed

Antennas

Primary Antenna

Existing Antenna Information

Primary Antenna

New Antenna Costs

Primary Antenna

Other Antenna Costs

Primary Antenna

Other Antenna Cost Not Listed

Interim Antenna

New Antenna Costs

Interim Antenna

Other Antenna Costs

Interim Antenna

Other Antenna Cost Not Listed

Transmission Line

Primary Transmission Line

Add Transmission Line

Primary Transmission Line

New Transmission Line

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Interim Transmission Line

New Transmission Line

Interim Transmission Line

Other Transmission Line Expenses Not Listed

Tower Equipment And Rigging Costs

Primary Tower

Existing Tower

FM, AM or TV radio broadcasters. Facility ID's, Call Signs and Services of other broadcast stations with whom the tower is shared

Other Types of Users

Primary Tower

Tower Modification Costs

Primary Tower

Tower Rigging Costs

Primary Tower

Other Tower Expenses Not Listed

Outside Professional Services Costs

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Other Expenses

Other Expenses

Other Expenses Not Listed

Cost Information

Transmitters

Components