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:
73354
Service:
DTV
Call Sign:
WNWO-TV
Channel:
23 (UHF)
File Number:
0000028785
FRN:
0022491864
Date Submitted:
02/03/2020

Applicant Information

Back to Top

Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

WNWO LICENSEE, LLC Doing Business As: WNWO LICENSEE, LLC

Doing Business As: WNWO LICENSEE, LLC

Harvey Arnold

10706 Beaver Dam Road

Cockeysville, MD 21030

United States

+1 (410) 568-1500 harnold@sbgtv.com Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

Back to Top

Preparer Contact Name and Information

Applicant Address Phone Email

Paul A. Cicelski , Esq .

Lerman Senter PLLC

Paul Cicelski

2001 L Street NW

Suite 400

Washington, DC 20036

United States

+1 (202) 416-6756 Sinclair399s@SummitRidgeGroup.com

Broadcaster Information and Transition Plan

Back to Top
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 See Exhibit A.

Transmitters

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

Auxiliary Transmitter

Back to Top

Add Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Retune Existing
Use Auxiliary (Backup)
Ownership Owned
Owner 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 Rohde & Schwarz
Model NV8608
Year 2005
Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 7 kW

Auxiliary Transmitter

Back to Top

Retuning Transmitter Costs

Section Question Response
New IOT Tubes Number of Tubes (including accessories) needed N/A
New Mask Filter
Power 7 kW
Other Power N/A
New Exciter Is a new exciter needed? No

Auxiliary Transmitter

Back to Top

Other Transmitter Costs

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

Auxiliary Transmitter

Back to Top

Other Transmitter Cost Not Listed

Information not provided.

Primary Transmitter

Back to Top

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 Quantum QXD1
Year 2003
Type Inductive Output Tube
IOT Power Type Single
Power Capacity 30 kW

Primary Transmitter

Back to Top

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 THU9evo-20
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 31 kW
Justification for New Transmitter Per the manufacturer, the current transmitter cannot be retuned. See Exhibit B.

Primary Transmitter

Back to Top

Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) Yes
Transformer (480V) Yes
Power 300 kVA
Rigid Conduit and Wiring Yes
Size 2 inches
Length 800.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

Back to Top

Other Transmitter Cost Not Listed

Name Description

Employee Travel

Employee Travel

Antennas

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

Primary Antenna

Back to Top

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? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
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: 105.0 kW
Manufacturer
Model TFU-12DSC/VP-R
Year 2014

Primary Antenna

Back to Top

New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
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: 62.5 kW
Manufacturer
Model TFU-12DSC/VP-R C190
Year 2017
Justification for New Antenna Current antenna is a single channel antenna that cannot be used for the new post-auction channel.

Primary Antenna

Back to Top

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 8 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

Back to Top

Other Antenna Cost Not Listed

Information not provided.

Interim Antenna

Back to Top

New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
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 Elliptical
Type Broadband Panel
Number of Stations Supported 1
Number of Panels/Bays 8
Lower Limit 470.00 MHz
Upper Limit 598.00 MHz
Design power capacity in use 50.0 %
Other Antenna Type N/A
ERP: 62.5 kW
Manufacturer
Model TFU-8WB/VP C160
Year 2017
Justification for New Antenna Interim antenna to be used to stay on the air while the main antenna undergoes construction for the post-auction channel change.

Interim Antenna

Back to Top

Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? B
Feed Line Size 3 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? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Interim Antenna

Back to Top

Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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

Primary Transmission Line

Back to Top

Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Utilize Existing
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer Dielectric
Type Rigid
Diameter 8 3/16 inches
Other Diameter N/A
Segment Length 19 3/4 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1400 feet per run

Primary Transmission Line

Back to Top

Other Transmission Line Expenses Not Listed

Information not provided.

Auxiliary Transmission Line

Back to Top

Add Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Utilize Existing
Use Auxiliary (Backup)
Description of Use Backup
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 Dielectric
Type Rigid
Diameter 3 1/8 inches
Other Diameter N/A
Segment Length 19 3/4 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1400 feet per run

Auxiliary Transmission Line

Back to Top

Other Transmission Line Expenses Not Listed

Name Description

Trans Test

Trans Test 3-50

Elbow Complex

Elbow Complex, 4 1/16", broadband, jumper 4" Air Flex HJ11-50 20ft, LG w/ 3-50 GP Connectors installed both ends for antenna input

Reducer

Reducer 4-50 EIA X 3-50 EIA STD "QS"

Tower Equipment And Rigging Costs

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

Primary Tower

Back to Top

Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Owned
Is this tower consider Complex? No
Is this tower currently shared with any other stations? No
One or more FM, AM or TV radio broadcaster(s) N/A
Others Types of Users N/A
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1012091
Coordinates (NAD83) Latitude (NAD83) 41° 40' 03.0" N-
Longitude (NAD83) 083° 21' 22.0" W-
Overall Structure Height 1436.99 feet
Support Structure Height 1372.03 feet
Ground Elevation Above Mean Sea Level (AMSL) 579.06 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner WNWO Licensee, LLC
Date Constructed 01/01/1983


Primary Tower

Back to Top

Tower Modification Costs

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

Primary Tower

Back to Top

Tower Rigging Costs

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

Primary Tower

Back to Top

Other Tower Expenses Not Listed

Name Description

Tower Leasing

Tower Leasing

Auxiliary Tower

Back to Top

Add Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Auxiliary (Backup)
Description of Use Interim Tower for repack
Ownership Leased
Is this tower consider Complex? No
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users No
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1025392
Coordinates (NAD83) Latitude (NAD83) 41° 40' 60.0" N-
Longitude (NAD83) 083° 24' 49.0" W-
Overall Structure Height 1048.87 feet
Support Structure Height 973.09 feet
Ground Elevation Above Mean Sea Level (AMSL) 580.05 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Gray Television Group, Inc.
Date Constructed 01/01/1959

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
74150 WTVG DTV

Auxiliary Tower

Back to Top

Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: No study needed
Tower Reinforcements Please select whether tower reinforcements are needed: No reinforcements needed

Auxiliary Tower

Back to Top

Tower Rigging Costs

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

Auxiliary Tower

Back to Top

Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

Back to Top
Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 470
Explanation Outside consulting engineering, legal work, and accounting services, as well as project management for regional and comprehensive repack execution.
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 2
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility 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 2
NEPA Section 106 environmental review Yes
Environmental Assessment Yes
ASR Modification Yes
FAA Consultation (including preparation of FAA Form 7460) Yes
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 No
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

Back to Top

Other Professional Services Expenses Not Listed

Name Description

Sinclair Internal Costs

Internal Employee Time Costs

Other Expenses

Back to Top
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 Yes
Non-zoning permits Yes
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

Back to Top

Other Expenses Not Listed

Information not provided.

Cost Information

Back to Top

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 $1,652,071.88 $647,184.84 N/A $590,318.34 N/A
Total for all systems $3,947,301.80 $3,521,916.72 N/A $2,057,500.81 N/A
Primary Transmitter THU9evo-20 $1,540,661.88 $540,935.84 $494,184.96
Employee Travel $3,361.88 $3,361.88 N/A $0.00 N/A
Transformer 3 phase/480v - 300 KVA $36,800.00 $35,000.00 N/A $4,056.00 N/A
2" Rigid Conduit and Wiring (Cost per foot) $20,800.00 $20,000.00 N/A $15,725.00 N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A $28,130.00 N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW $947,000.00 $436,955.91 N/A $436,955.91 Item Need More Information - 322,776.91 should be removed.
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW $494,500.00 $9,318.05 ***System Notice: Estimate adjusted and locked because line has been superseded.*** $9,318.05 N/A
Auxiliary Transmitter NV8608 $111,410.00 $106,249.00 $96,133.38
7 kW mask filter $6,210.00 $6,249.00 Check the Rohde invoice 9500096017 $6,249.00 N/A
UHF and VHF - minor banding issues $105,200.00 $100,000.00 N/A $89,884.38 N/A

Components

Actual Information Description File Name
Employee Travel

Component Description:
Travel expense. #180415
Amount:
$3,361.88
Transformer 3 phase/480v - 300 KVA

Component Description:
Transformer related cost. #002140
Amount:
$4,056.00
2" Rigid Conduit and Wiring (Cost per foot)

Component Description:
Transmitter related cost. #15820
Amount:
$5,550.00

Component Description:
Electrical cost. #17102
Amount:
$10,175.00
Switchgear - industrial 800 amp

Component Description:
Transmitter related cost. #17199
Amount:
$28,130.00
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW

Component Description:
Transmitter related cost. #002140
Amount:
$46,076.00

Component Description:
Transmitter related cost. #002139
Amount:
$68,103.00

Component Description:
Transmitter cost, upgrade excluded. #9500081148
Amount:
$322,776.91

Component Description:
Transmitter cost, upgrade excluded. #9500081148
Amount:
$322,776.91
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW

Component Description:
Transmitter related cost. #CD60160561
Amount:
$9,318.05

Component Description:
Transmitter related cost reduced by 20.02%. #220006
Amount:
$15,646.07
7 kW mask filter

Component Description:
Transmitter related cost. #9500096017
Amount:
$6,249.00
UHF and VHF - minor banding issues

Component Description:
Transmitter related cost, 25% down. #9500078956
Amount:
$89,884.38

Cost Information

Back to Top

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 $295,810.00 $248,476.96 N/A $197,653.40 N/A
Total for all systems $3,947,301.80 $3,521,916.72 N/A $2,057,500.81 N/A
Interim Antenna TFU-8WB/VP C160 $142,320.00 $104,170.06 $69,008.78
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $25,000.00 Updated cost of estimated amount per FCC requirement. $0.00 N/A
Elbow complex, broadband, at antenna input, per 3 1/8. feedline (if needed) $9,340.00 $8,880.00 N/A $0.00 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $5,118.72 N/A
UHF - Lower Power Side Mount, One Station antenna . medium power (50-200 kW), elliptically or circularly polarized $103,100.00 $63,890.06 See attached quotes from Dielectric. $63,890.06 N/A
Primary Antenna TFU-12DSC/VP-R C190 $153,490.00 $144,306.90 $128,644.62
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $5,000.00 N/A N/A N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $16,425.00 N/A $13,136.71 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
UHF - Lower Power Side Mount, One Station antenna . medium power (50-200 kW), elliptically or circularly polarized $103,100.00 $101,956.90 See attached quote from Dielectric. $101,956.90 N/A
Elbow complex, single channel, at antenna input, per 8 3/16. feedline (if needed) $15,250.00 $14,525.00 See attached price quote. $13,551.01 N/A

Components

Actual Information Description File Name
Side mount brackets for high power antennas (if not included in antenna base cost)

Component Description:
Antenna related cost reduced by 20.02%. #217016
Amount:
$24,753.81
Elbow complex, broadband, at antenna input, per 3 1/8. feedline (if needed) Information not provided.
Sweep test of existing antenna

Component Description:
Antenna related sweep test cost reduced by 20.02%. #257018
Amount:
$5,118.72
UHF - Lower Power Side Mount, One Station antenna . medium power (50-200 kW), elliptically or circularly polarized

Component Description:
Elbows for aux antenna project. #220006
Amount:
$15,646.07

Component Description:
Antenna related cost. #CD16010513
Amount:
$6,923.13

Component Description:
Total invoice amount reduced by 20.02%. #24887
Amount:
$41,320.86

Component Description:
Total amount reduced by 20.02%. #24887
Amount:
$41,320.86

Component Description:
Total amount reduced by 20.02%. #192014
Amount:
N/A
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) Information not provided.
Side mount brackets for high power antennas (if not included in antenna base cost)

Component Description:
Line item 1 on the invoice reduced by 20.02%. #217016
Amount:
$13,136.71
Sweep test of existing antenna Information not provided.
UHF - Lower Power Side Mount, One Station antenna . medium power (50-200 kW), elliptically or circularly polarized

Component Description:
Antenna related cost reduced by 20.02%. #261017
Amount:
$4,114.97

Component Description:
Antenna cost, upgrade excluded. #192014
Amount:
$97,841.93
Elbow complex, single channel, at antenna input, per 8 3/16. feedline (if needed)

Component Description:
Line item 2-7 reduced by 20.02%. #217016
Amount:
$11,617.10

Component Description:
Total invoice amount reduced by 20.02%. #327032
Amount:
$1,933.91

Cost Information

Back to Top

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 $5,707.37 $5,707.37 N/A $5,707.37 N/A
Total for all systems $3,947,301.80 $3,521,916.72 N/A $2,057,500.81 N/A
Primary Transmission Line $0.00 $0.00 $0.00
Auxiliary Transmission Line $5,707.37 $5,707.37 $5,707.37
Reducer $991.75 $991.75 See attached updated quote from Dielectric. $991.75 Item "Need more information - $991.75" should be removed.
Elbow Complex $3,291.98 $3,291.98 See attached updated quote from Dielectric. $3,291.98 Item "Need more information - $3291.98" should be removed.
Trans Test $1,423.64 $1,423.64 See attached updated quote from Dielectric. $1,423.64 Item "Need more information - $1423.64" should be removed.

Components

Actual Information Description File Name
Reducer

Component Description:
Reducer 4-50 EIA X 3-50 EIA STD
Amount:
$1,240.00

Component Description:
2nd line item reduced by 20.02%. #24951
Amount:
$991.75

Component Description:
2nd line item reduced by 20.02%. #24951
Amount:
$991.75
Elbow Complex

Component Description:
1st line item reduced by 20.02%. #24951
Amount:
$3,291.98

Component Description:
Elbow Complex, broadband 4-1/16'' Feedline.
Amount:
$4,116.00

Component Description:
1st line item reduced by 20.02%. #24951
Amount:
$3,291.98
Trans Test

Component Description:
3rd line item reduced by 20.02%. #24951
Amount:
$1,423.64

Component Description:
3rd line item reduced by 20.02%. #24951
Amount:
$1,423.64

Component Description:
Trans test 3-50.
Amount:
$1,780.00

Cost Information

Back to Top

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 $1,644,800.00 $2,283,815.50 N/A $1,213,657.15 N/A
Total for all systems $3,947,301.80 $3,521,916.72 N/A $2,057,500.81 N/A
Auxiliary Tower TOWER $210,500.00 $205,000.00 $53,913.00
Tall Tower (greater than 500') $210,500.00 $205,000.00 N/A $53,913.00 N/A
Primary Tower TOWER $1,434,300.00 $2,078,815.50 $1,159,744.15
Serious tower reinforcement/modifications $1,052,000.00 $1,749,791.00 See attached letter and quotation from Stainless explaining the tower reinforcement, rigging, and modifications situation and quoted prices. $981,506.15 N/A
Tall Tower (greater than 500') $210,500.00 $123,043.00 See attached letter and quotation from Stainless explaining the tower reinforcement, rigging, and modifications situation and quoted prices. This price includes the "ALL RIGGING" and "ALL ANTENNA AND LINE INSTALL" line items. $10,605.00 N/A
Structural engineering tower load study for well documented tower $12,600.00 $46,781.50 Updated cost of estimated amount per FCC requirement. $18,383.00 N/A
Tower Leasing $159,200.00 $159,200.00 Tower Leasing Cost per agreement for Gray Television through 2020. $149,250.00 N/A

Components

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

Component Description:
50% down. #E-166091
Amount:
$26,956.50

Component Description:
50% balance. #E-174780
Amount:
$26,956.50
Serious tower reinforcement/modifications

Component Description:
Construction services. #E159081
Amount:
$25,248.50

Component Description:
Tower modifications cost. #206500
Amount:
$2,673.21

Component Description:
Tower related cost. #SIN000462
Amount:
$178,478.40

Component Description:
50% balance. #E-173396
Amount:
$25,248.50

Component Description:
Final balance upon completion. #E-182137
Amount:
$187,283.40

Component Description:
30% downpayment. #E150078
Amount:
$561,850.20

Component Description:
Tower modifications cost. #206499
Amount:
$723.94
Tall Tower (greater than 500')

Component Description:
Tower related cost. #3908
Amount:
$1,800.00

Component Description:
Tower related cost. #SIN000462
Amount:
$8,805.00

Component Description:
50% downpayment. #166091
Amount:
$26,956.50
Structural engineering tower load study for well documented tower

Component Description:
50% final. #148378
Amount:
$3,150.00

Component Description:
Tower related cost. #E-173399
Amount:
$5,500.00

Component Description:
Engineering soil borings. #138032
Amount:
$3,291.50

Component Description:
Engineering soil borings. #143122
Amount:
$3,291.50

Component Description:
Engineering structural analysis.
Amount:
$3,150.00

Component Description:
Tower related cost. #E-173396
Amount:
$25,248.50

Component Description:
Engineering soil borings.
Amount:
$3,291.50

Component Description:
Engineering structural analysis - 50% downpayment. #148378
Amount:
$3,150.00

Component Description:
Engineering structural analysis. #138476
Amount:
$3,150.00
Tower Leasing

Component Description:
Tower lease cost. #872553-10
Amount:
$9,950.00

Component Description:
Tower lease cost. #872553-11
Amount:
$9,950.00

Component Description:
Tower lease cost. #872553-8
Amount:
$9,950.00

Component Description:
Tower lease cost. #872553-1
Amount:
$9,950.00

Component Description:
Tower lease cost. #872553-3
Amount:
$9,950.00

Component Description:
Tower lease cost. #872553-2
Amount:
$9,950.00

Component Description:
Tower lease cost. #872553-15
Amount:
$9,950.00

Component Description:
Tower lease cost. #872553-6
Amount:
$9,950.00

Component Description:
Tower lease cost. #872553-7
Amount:
$9,950.00

Component Description:
Tower lease cost. #872553-9
Amount:
$9,950.00

Component Description:
Tower lease cost. #872553-14
Amount:
$9,950.00

Component Description:
Tower lease cost. #872553-5
Amount:
$9,950.00

Component Description:
Tower lease cost. #872553-13
Amount:
$9,950.00

Component Description:
Tower lease cost. #872553-4
Amount:
$9,950.00

Component Description:
Tower lease cost. #872553-12
Amount:
$9,950.00

Cost Information

Back to Top

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 $220,216.55 $208,601.05 N/A $41,818.36 N/A
Total for all systems $3,947,301.80 $3,521,916.72 N/A $2,057,500.81 N/A
Outside Professional Services $220,216.55 $208,601.05 $41,818.36
Project management of the transition $74,260.00 $70,500.00 N/A $27,927.60 N/A
Sinclair Internal Costs $66.55 $66.55 N/A $66.55 N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A N/A N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase $2,105.00 $2,000.00 N/A N/A N/A
ASR modification (prepare FCC Form 854) $2,105.00 $2,000.00 N/A N/A N/A
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet $10,520.00 $10,000.00 N/A N/A N/A
NEPA Section 106 environmental review, if needed $6,310.00 $6,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $7,360.00 $7,000.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $4,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A $221.92 N/A
Prepare request for Special Temporary Authorization $4,100.00 $3,187.50 N/A $3,187.50 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
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,097.00 N/A $3,097.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $4,870.00 N/A
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 $2,500.00 N/A $2,447.79 N/A

Components

Actual Information Description File Name
Project management of the transition

Component Description:
Legal Service Cost. #467898
Amount:
$112.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #457331
Amount:
$836.44

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #453972
Amount:
$716.28

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 99 stations. #1086
Amount:
$275.35

Component Description:
Legal services cost. #466702
Amount:
$370.00

Component Description:
Legal Service Cost. #468723
Amount:
$212.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1072
Amount:
$237.64

Component Description:
Legal services cost. #460938
Amount:
$172.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1069
Amount:
$246.68

Component Description:
Legal services cost. #474819
Amount:
$678.75

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1133
Amount:
$307.72

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #470237
Amount:
$436.37

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1141
Amount:
$406.17

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 99 stations. #469573
Amount:
$377.14

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1099
Amount:
$266.93

Component Description:
Legal services cost. #472181
Amount:
$867.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1151
Amount:
$388.07

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1114
Amount:
$242.25

Component Description:
Legal services cost. #474502
Amount:
$742.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #470923
Amount:
$406.65

Component Description:
Legal services cost. #475753
Amount:
$102.50

Component Description:
Legal services cost. #476375
Amount:
$102.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #471524
Amount:
$322.83

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #473506
Amount:
$421.40

Component Description:
Legal services cost. #469587
Amount:
$600.75

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #473885
Amount:
$318.62

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1156
Amount:
$399.52

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1111
Amount:
$159.58

Component Description:
Legal services cost. #471533
Amount:
$532.50

Component Description:
Legal services cost. #472592
Amount:
$731.25

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1145
Amount:
$369.98

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1130
Amount:
$281.49

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #472583
Amount:
$279.89

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1093
Amount:
$265.72

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1098
Amount:
$238.07

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #476367
Amount:
$364.80

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1161
Amount:
$267.48

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1105
Amount:
$216.88

Component Description:
Legal services cost. #464701
Amount:
$177.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #474405
Amount:
$490.56

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #463026
Amount:
$801.57

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$1,954.93

Component Description:
Legal Service Cost. #467795
Amount:
$125.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #463567
Amount:
$566.48

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$107.53

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #450412
Amount:
$999.04

Component Description:
Legal services cost. #474412
Amount:
$257.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #464321
Amount:
$683.07

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #453686
Amount:
$943.95

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #1010
Amount:
$86.88

Component Description:
Legal services cost. #467390
Amount:
$57.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1045
Amount:
$185.10

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1058
Amount:
$187.24

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$20.91

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 99 stations. #468718
Amount:
$349.51

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1055
Amount:
$243.38

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$731.72

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$912.82

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1143
Amount:
$436.90

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1051
Amount:
$105.97

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #466690
Amount:
$446.87

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1063
Amount:
$262.29

Component Description:
$26,919.78 credit to be split across 93 Sinclair stations reimbursed $999.20 for Invoice 461759 (correct reimbursement amount is $709.74). #CM-11-21-2019-461759
Amount:
($289.46)

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #467861
Amount:
$470.30

Component Description:
Legal services cost. #467355
Amount:
$57.50

Component Description:
Legal services cost. #461801
Amount:
$267.75

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1090
Amount:
$176.70

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289
Amount:
$91.50

Component Description:
Legal services cost. #464359
Amount:
$57.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1117
Amount:
$282.68

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #457851
Amount:
$818.59

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1123
Amount:
$342.14

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #475283
Amount:
$384.08

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #465173
Amount:
$654.26

Component Description:
Legal services cost. #470283
Amount:
$182.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1079
Amount:
$177.14

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$32.35

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$43.72

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1039
Amount:
$30.47

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759
Amount:
$29.98

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #1012
Amount:
$20.64

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #465001
Amount:
$596.30

Component Description:
Legal services cost. #465187
Amount:
$240.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #467378
Amount:
$576.96

Component Description:
Legal services cost. #457853
Amount:
$890.40

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1078
Amount:
$215.68
Sinclair Internal Costs

Component Description:
Portion of general repack matter internal time card attributable to this station - divided by 100.
Amount:
$66.55
Comprehensive coverage verification via field study, if needed Information not provided.
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase Information not provided.
ASR modification (prepare FCC Form 854) Information not provided.
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet Information not provided.
NEPA Section 106 environmental review, if needed Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759
Amount:
$99.92

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289
Amount:
$122.00
Prepare request for Special Temporary Authorization

Component Description:
Consulting engineering cost. #878-03-0007
Amount:
$3,187.50
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Consulting engineering cost. #878-03-0008
Amount:
$765.00

Component Description:
Consulting engineering cost.
Amount:
$2,332.00
Perform engineering study for new channel assignment and antenna development

Component Description:
WNWO CP application. #466671
Amount:
$265.00

Component Description:
Consulting engineering cost.
Amount:
$4,605.00
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289
Amount:
$1,311.48

Component Description:
Legal services cost.
Amount:
$115.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759
Amount:
$869.30

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$152.01

Cost Information

Back to Top

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 $128,696.00 $128,131.00 N/A $8,346.19 N/A
Total for all systems $3,947,301.80 $3,521,916.72 N/A $2,057,500.81 N/A
Other Expenses $128,696.00 $128,131.00 $8,346.19
MVPD Notification of Channel Change $5,000.00 $5,000.00 See Exhibit J. N/A N/A
Develop and air announcement of upcoming channel change $28,050.00 $28,050.00 See Response to August 9 Inquiry. N/A N/A
Equipment Storage $15,000.00 $15,000.00 See Exhibit J. N/A N/A
Equipment Delivery and Handling Charges $10,000.00 $10,000.00 See Exhibit J. $5,396.19 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $28,566.00 $28,566.00 See Response to August 9 Inquiry. N/A N/A
Non-zoning permits $10,000.00 $10,000.00 See Exhibit J. N/A N/A
Local Zoning $20,000.00 $20,000.00 See Exhibit J. N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A $2,950.00 N/A

Components

Actual Information Description File Name
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges

Component Description:
Equipment freight cost. #002139
Amount:
$3,261.00

Component Description:
Equipment freight cost. #002140
Amount:
$2,135.19
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Non-zoning permits Information not provided.
Local Zoning Information not provided.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
DTV Medical Facility Notification

Component Description:
Medical notification. #1049
Amount:
$2,950.00

Cost Information

Back to Top

Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $3,947,301.80 $3,521,916.72 $2,057,500.81

Reimbursement Status

Back to Top
Question Response
The facility has ceased operating on its pre-auction channel. No
Construction of final facilities or all necessary modifications are complete. No
All receipts for reimbursement have been submitted no further costs are expected to be incurred. Note this will lock the Form 399 from further editing and begin close-out procedures with the Fund Administrator. No

Certification

Back to Top
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.

Lucy Rutishauser

CFO


02/03/2020

Certification

Back to Top
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.

Lucy Rutishauser

CFO


02/03/2020

Attachments

Back to Top