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:
40618
Service:
DTV
Call Sign:
WCPB
Channel:
16 (UHF)
File Number:
0000027915
FRN:
0003857380
Date Submitted:
10/24/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

MARYLAND PUBLIC BROADCASTING COMMISSION

Larry D. Unger, President & CEO

11767 OWINGS MILLS BOULEVARD

OWINGS MILLS, MD 21117

United States

+1 (410) 356-5600 lunger@mpt.org Government Entity

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 joe.snelson@mswdtv.com

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan Current transmission system consists of a transmitter feeding a transmission line which connects to an antenna on the tower. Work includes installing new transmission line, attaching to antenna and connecting to new repack channel transmitter.

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 Auxiliary use in case of main transmitter failure
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 TDU2-10K0LV
Year 2003
Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power Capacity 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 PRLX-U8
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 13 kW
Justification for New Transmitter Current transmitter is not supported for a channel change. See attached Transmitter Replace Justification letter from manufacturer. Power upgrade is part of an agreement provided to the FCC to move WCPB to Ch. 16 to accommodate moving WETA to channel 31.

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 Yes
Description Electrical contractor to connect transmitter into existing electrical panel and wire heat exchanger into transmitter. Includes material and labor.
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

Name Description

Remote Control Interface

License required to interface transmitter into current remote control system

Rigid Coax Line

Rigid interconnection coax lines from transmitter to filter to antenna switch.

Bag Filter

Bag type water filtration for heat exchanger system.

Coolant

The coolant used for the transmitter heat exchanger is not included in the transmitter price

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 TDU2-10K0LV
Year 2003
Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power Capacity 5 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 MPTV-PRLX-U8
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 13 kW
Justification for New Transmitter Current transmitter is not supported for a channel change. See attached Transmitter Replace Justification letter from manufacturer. Power upgrade is part of an agreement provided to the FCC to move WCPB to Ch. 16 to accommodate moving WETA to channel 31.

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) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service Yes
Description Electrical contractor to connect transmitter into existing electrical panel and wire heat exchanger into transmitter. Includes material and labor.
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Site Design and Survey

Incorporates all aspects of the transmitter room design, including power distribution requirements, equipment placement, RF system layout, plumbing, and remote control.

CIF Mask filter

Constant Impedance mask Filter. Station currently utilizes a CIF. The 8-Pole filter is required to protect Land Mobile operations in Washington D.C. with WCPB being assigned ch. 16.

Remote Control Interface

License required to interface transmitter into current remote control system

Rigid Coax Line

Rigid interconnection coax lines from transmitter to filter to antenna switch.

Motorized Switch - Filter Input

Switches main or aux transmitter into mask filter

Coolant

The coolant used for the transmitter heat exchanger is not included in the transmitter price

Motorized Switch

Electric actuated switch to switch between antenna and load

Bag Filter

Bag type water filtration for heat exchanger system.

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 Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type Class Full Power
Mounting Top Mount
Antenna position in stack Top
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 1
Number of Panels 16
Design power capacity in use 50.0 %
Lower Limit 470.00 MHz
Upper Limit 698.00 MHz
Other Antenna Type N/A
ERP: 132.0 kW
Manufacturer DIE
Model TUP-16-O4-1
Year 2009

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? No
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Antenna Optimizing

Optimize match to operate on channel 16 from 28

Transmission Line

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Section Question Response
Transmission Line Related Expenses Do you have transmission line related expenses? No

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? No

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 280
Explanation Applicant has limited internal resources to oversee installing and commissioning this repack project. It will rely on outside services to manage all work required.
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 No
Quantity N/A
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 No
Quantity N/A
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 No
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements No
Additional Field Engineering Service Yes
Number of Days 1
Justification Initial sweep of the antenna to verify if antenna could operate on original repack channel 21.

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Progress Reports

Prepare and file 8 required progress reports on FCC Form 2100, Schedule 387 on a quarterly basis with the FCC.

Other Expenses

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

Other Expenses

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Other Expenses Not Listed

Information not provided.

Cost Information

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Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $1,175,700.00 $1,090,800.00 N/A $798,270.42 N/A
Total for all systems $1,341,500.00 $1,249,170.00 N/A $819,395.17 N/A
Primary Transmitter MPTV-PRLX-U8 $654,413.50 $629,913.50 $575,696.36
Other Electrical Service: Electrical contractor to connect transmitter into existing electrical panel and wire heat exchanger into transmitter. Includes material and labor. $14,200.00 $14,200.00 Electrical contractor to connect transmitter into existing electrical panel and wire heat exchanger into transmitter. Includes material and labor. $5,290.00 N/A
Rigid Coax Line $2,600.00 $2,600.00 Rigid interconnection coax lines from transmitter to filter to antenna switch. Part of the internal RF systems and will be cut to length needed. This IS NOT an upgrade. $2,470.00 N/A
Motorized Switch $26,195.00 $26,195.00 Electric actuated switch to switch between antenna and load. Current transmitter has this capability but switch cannot be moved as it is in pre-repack service. See budget rev 061918.pdf $24,885.25 N/A
Motorized Switch - Filter Input $16,425.00 $16,425.00 Motorized switch switches main or aux transmitter into filter. Station currently uses motorized switch but can't be moved while on pre-repack channel. See narrative budget rev 061918.pdf $15,603.75 N/A
CIF Mask filter $75,207.00 $75,207.00 Constant Impedance mask Filter. Station currently utilizes a CIF. The 8-Pole filter is required to protect Land Mobile operations in Washington D.C. with WCPB being assigned ch. 16. $71,446.65 N/A
Bag Filter $6,975.00 $6,975.00 Bag type water filtration for heat exchanger system. Current pre-repack cooling system has this filtering. This IS NOT an upgrade. $6,626.25 N/A
Coolant $814.00 $814.00 The coolant used for the transmitter heat exchanger is not included in the transmitter price. See attached coolant quote. $736.56 N/A
Remote Control Interface $2,197.50 $2,197.50 License required to interface transmitter into current remote control system. These are in use now on the Comark transmitters. This IS NOT an upgrade. $0.00 N/A
Site Design and Survey $15,300.00 $15,300.00 Incorporates all aspects of the transmitter room design, including power distribution requirements, equipment placement, RF system layout, plumbing, and remote control. $2,137.90 N/A
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW $494,500.00 $470,000.00 N/A $446,500.00 N/A
Auxiliary Transmitter PRLX-U8 $521,286.50 $460,886.50 $222,574.06
Other Electrical Service: Electrical contractor to connect transmitter into existing electrical panel and wire heat exchanger into transmitter. Includes material and labor. $14,200.00 $14,200.00 Electrical contractor to connect transmitter into existing electrical panel and wire heat exchanger into transmitter. Includes material and labor. See attached electrical quote. $0.00 N/A
Coolant $814.00 $814.00 The coolant used for the transmitter heat exchanger is not included in the transmitter price. See attached coolant quote. $736.56 N/A
Bag Filter $6,975.00 $6,975.00 Bag type water filtration for heat exchanger system. Current pre-repack cooling system has this filtering. This IS NOT an upgrade. $3,487.50 N/A
Rigid Coax Line $2,600.00 $2,600.00 Rigid interconnection coax lines from transmitter to filter to antenna switch. Part of the internal RF systems and will be cut to length needed. This IS NOT an upgrade. $1,300.00 N/A
Remote Control Interface $2,197.50 $2,197.50 License required to interface transmitter into current remote control system. Current Comark transmitters have this interface. This IS NOT an upgrade. N/A N/A
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW $494,500.00 $434,100.00 N/A $217,050.00 The final quote is attached and is less than what was originally estimated.

Components

Actual Information Description File Name
Other Electrical Service: Electrical contractor to connect transmitter into existing electrical panel and wire heat exchanger into transmitter. Includes material and labor.

Component Description:
Salisbury location installation of wiring for new transmitter
Amount:
$5,290.00
Rigid Coax Line

Component Description:
WCPB-110-1st Primary Transmitter - Rigid Coax Line
Amount:
$1,170.00

Component Description:
20' coax sections line 3.2 on quote d included on invoice line 3 50% deposit
Amount:
$1,300.00
Motorized Switch

Component Description:
WCPB-110-1st Primary Transmitter - Motorized Coaxial Switch
Amount:
$11,787.75

Component Description:
line 3.3 on quote included in line 3 on invoice
Amount:
$13,097.50
Motorized Switch - Filter Input

Component Description:
WCPB-110-1st Primary Transmitter - Motorized Coaxial Switch for Mask Filter Input
Amount:
$7,391.25

Component Description:
line 3.5 on quote. part of line 3 on invoice
Amount:
$8,212.50
CIF Mask filter

Component Description:
WCPB-110-1st Primary Transmitter - CIF Mask Filter
Amount:
$33,843.15

Component Description:
line 3.4 on quote, included on line 3 on invoice,
Amount:
$37,603.50
Bag Filter

Component Description:
WCPB-110-1st Primary Transmitter - Bag Filter
Amount:
$3,138.75

Component Description:
bag filler line 3.1 on quote included on line 3 on invoice. 50% deposit
Amount:
$3,487.50
Coolant

Component Description:
Coolant for Transmitter
Amount:
$736.56
Remote Control Interface Information not provided.
Site Design and Survey

Component Description:
Site Survey
Amount:
$2,137.90
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW

Component Description:
SYSTEM, WCPB PRLX U8 D16
Amount:
$211,500.00

Component Description:
line 1a,1b,1c on invoice. Line 1-1.17 on quote D 50% deposit
Amount:
$235,000.00
Other Electrical Service: Electrical contractor to connect transmitter into existing electrical panel and wire heat exchanger into transmitter. Includes material and labor. Information not provided.
Coolant

Component Description:
Coolant for Transmitter
Amount:
$736.56
Bag Filter

Component Description:
Bag Filter 50% deposit line 3.1 on quote a part of line 6 on invoice 11448a
Amount:
$3,487.50
Rigid Coax Line

Component Description:
20' coax sections. line 3.2 on quote a Included in cost of line6 on quote. 50% deposit
Amount:
$1,300.00
Remote Control Interface Information not provided.
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW

Component Description:
This is for items 4a,4b,4c on invoice. Also quote p#2958A Auxiliary. 1.1-1.17
Amount:
$217,050.00

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 $9,730.00 $9,400.00 N/A $3,000.00 N/A
Total for all systems $1,341,500.00 $1,249,170.00 N/A $819,395.17 N/A
Primary Antenna TUP-16-O4-1 $9,730.00 $9,400.00 $3,000.00
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $3,000.00 N/A
Antenna Optimizing $3,000.00 $3,000.00 Optimize antenna match from channel 28 to channel 16 N/A N/A

Components

Actual Information Description File Name
Sweep test of existing antenna

Component Description:
Sweep of existing system at WCPB salisbury
Amount:
$3,000.00
Antenna Optimizing Information not provided.

Cost Information

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Transmission Line

Information not provided.

Cost Information

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Tower Equipment and Rigging Costs

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 $105,200.00 $102,650.00 N/A $1,892.75 N/A
Total for all systems $1,341,500.00 $1,249,170.00 N/A $819,395.17 N/A
Outside Professional Services $105,200.00 $102,650.00 $1,892.75
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A $168.00 N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $89.25 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A 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
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $5,000.00 Fees related to multi-party resolution agreement with Maryland Public TV, WETA and HME Equity Fund II, LLC. Involved several stations moving channels to accommodate WETA moving from ch 14 to 31. $444.00 N/A
Additional Field Engineering Service, 1 Days $6,400.00 $6,400.00 Initial sweep of antenna to evaluate operation on channel 21 from channel 28. N/A N/A
Progress Reports $28,000.00 $28,000.00 Prepare and file 8 required progress reports on FCC Form 2100, Schedule 387 on a quarterly basis with the FCC. $802.50 N/A
Project management of the transition $44,240.00 $42,000.00 N/A $389.00 N/A

Components

Actual Information Description File Name
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
Legal fees associated with the repacking project
Amount:
$168.00
Prepare and or review reimbursement form

Component Description:
Legal fees for FCC repacking
Amount:
$89.25
Perform engineering study for new channel assignment and antenna development Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations

Component Description:
Legal Fees for Salisbury location only
Amount:
$444.00
Additional Field Engineering Service, 1 Days Information not provided.
Progress Reports

Component Description:
Legal fees for Progress Reporting for Repacking Project
Amount:
$104.50

Component Description:
Legal fees for Progress Reporting for Repacking Project
Amount:
$31.50

Component Description:
Legal fees for Progress Reporting for Repacking Project
Amount:
$104.50

Component Description:
Legal fees for Progress Reporting for Repacking Project
Amount:
$79.50

Component Description:
Legal fees associated with the repacking project
Amount:
$85.00

Component Description:
Legal fees associated with the repacking project
Amount:
$255.00

Component Description:
Legal fees for Progress Reporting for repacking project
Amount:
$142.50
Project management of the transition

Component Description:
Project Management
Amount:
$174.85

Component Description:
Project Management
Amount:
$214.15

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 $50,870.00 $46,320.00 N/A $16,232.00 N/A
Total for all systems $1,341,500.00 $1,249,170.00 N/A $819,395.17 N/A
Other Expenses $50,870.00 $46,320.00 $16,232.00
DTV Medical Facility Notification $11,550.00 $7,000.00 N/A $2,950.00 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $20,000.00 $20,000.00 Applicant will be required to dispose of the current transmission line and transmitter and heavy oil filled high voltage power supplies. These cannot be disposed of in a typical landfill. N/A N/A
Equipment Delivery and Handling Charges $18,320.00 $18,320.00 Transmitter shipping shown as options on attached quotes. $13,282.00 N/A
MVPD Notification of Channel Change $1,000.00 $1,000.00 Notification will need to be made to MVPD's as required. Applicant to explore using an outside firm to determine which facilities will need to be notified and send the appropriate notification letters. N/A N/A

Components

Actual Information Description File Name
DTV Medical Facility Notification

Component Description:
Medical Notification Mailing for WCPB
Amount:
$2,950.00
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Equipment Delivery and Handling Charges

Component Description:
WCPB-610-Equipment Delivery and Handling
Amount:
$4,122.00

Component Description:
Line 2.1 and 2.2 on quote p#2958A Line 5 on invoice 11448A transportation and offloading 50% deposit
Amount:
$4,580.00

Component Description:
Line item 2 on invoice Line s 2.1 and 2.2 on quote. transportation and offloading 50% deposit
Amount:
$4,580.00
MVPD Notification of Channel Change Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $1,341,500.00 $1,249,170.00 $819,395.17

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.

Carl R Wolfe

Director, Transmission and Distribution


10/24/2019

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.

Carl R Wolfe

Director, Transmission and Distribution


10/24/2019

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