TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
WTTO LICENSEE, LLC Doing Business As: WTTO LICENSEE, LLC	Harvey Arnold 10706 Beaver Dam Road Cockeysville, MD 21030 United States	+1 (410) 568-1500	harnold@sbgtv.com	Limited Liability Company

Applicant

Address

Phone

Applicant Type

WTTO LICENSEE, LLC

Doing Business As: WTTO 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

Preparer Contact Name and Information

Applicant	Address	Phone	Email
Paul A. Cicelski , Esq . LermanSenter PLLC	Paul A. Cicelski, Esq. 2001 L Street NW Suite 400 Washington, DC 20036 United States	+1 (202) 429-8970	sinclair399s@summitridgegroup.com

Applicant

Address

Phone

Paul A. Cicelski , Esq .

LermanSenter PLLC

Paul A. Cicelski, Esq.

2001 L Street NW

Suite 400

Washington, DC 20036

United States

+1 (202) 429-8970

sinclair399s@summitridgegroup.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	See Exhibit A.

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	Quantum 60QXD2
	Year	2002
	Type	Inductive Output Tube
	IOT Power Type	Two
	Power Capacity	60 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	THU9evo-36
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	55 kW
	Justification for New Transmitter	Per the manufacturer, the current transmitter cannot be retuned. See Exhibit B.

Primary Transmitter

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

Other Transmitter Cost Not Listed

Name	Description
Electrical Installation	Electrical Installation
Additional Equipment	Additional Equipment

Interim Transmitter

New Transmitter Costs

Section	Question	Response
New Transmitter	Use	Interim
	Description of Use	N/A
	Change Type	Purchase
	Manufacturer
	Model	NV8608
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	7 kW
	Justification for New Transmitter	Interim transmitter is needed due to the tight schedule of Phase 5. To make the transition on time the interim transmitter was needed.

Interim Transmitter

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
Inside RF System	Is an additional interior RF system required to support this interim transmitter?	No

Interim Transmitter

Other Transmitter Cost Not Listed

Information not provided.

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?	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	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:	765.0 kW
	Manufacturer
	Model	TFU-26GTH-R 6T160
	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?	Yes
	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	Top Mount
	Antenna position in stack	Top
	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:	654.0 kW
	Manufacturer
	Model	TFU-27ETT/VP-R 6T160
	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

Other Antenna Costs

Section	Question	Response
Combiner for Shared Antenna	Do you need a Combiner for a Shared Antenna?
	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?	Broadband
	Feed Line Size	6 1/8 inches inches
Side Mount Brackets	Do you require the separate purchase of side mount brackets for a high power antenna?
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

Primary Antenna

Other Antenna Cost Not Listed

Name	Description
Wedding Cake Adapter	Wedding Cake Adapter
Antenna Mounting Pole	Antenna Mounting Pole

Interim Antenna

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?	Yes
	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	2
	Number of Panels/Bays	16
	Lower Limit	470.00 MHz
	Upper Limit	598.00 MHz
	Design power capacity in use	100.0 %
	Other Antenna Type	N/A
	ERP:	200.0 kW
	Manufacturer
	Model	TFU-16WB-1-R
	Year	2017
	Justification for New Antenna	Interim antenna to be used to stay on the air for both WTTO and WABM while the main antenna undergoes construction for the post-auction channel change.

Interim Antenna

Other Antenna Costs

Section	Question	Response
Combiner for Shared Antenna	Do you need a Combiner for a Shared Antenna?	Yes
	Type	New
	Number of channels supported	2
	Frequencies of channels supported	RF channel
	Frequency	N/A
	Do you need a combiner output splitter/switcher for dual feed lines?	No
Elbow Complex	Do you require the separate purchase of the Elbow Complex?	Yes
	Broadband or Single Channel?	B
	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?	No
Sweep Test	Do you require the sweep testing of transmission line and antenna?	Yes

Enter a list of RF channel numbers.

RF Channel Number
21
20

Interim Antenna

Other Antenna Cost Not Listed

Name	Description
Interim Antenna Rent	Interim Antenna Rent

Transmission Line

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

Primary Transmission Line

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	6 1/8 inches
	Other Diameter	N/A
	Segment Length	Broadband
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	1325 feet per run

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Name	Description
Flexible Transmission Line	Flexible Transmission Line

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	Broadband
	Other Segment Length
	Number of parallel runs	1
	Length	700 feet per run
	Justification for New Transmission Line	Interim transmission line will feed the interim antenna for both WTTO and WABM.

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?	Candelabra
	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	1226663
Coordinates (NAD83)	Latitude (NAD83)	33° 29' 04.8" N-
	Longitude (NAD83)	086° 48' 25.2" W-
	Overall Structure Height	1102.02 feet
	Support Structure Height	956.03 feet
	Ground Elevation Above Mean Sea Level (AMSL)	946.84 feet
	Structure Type	GTOWER - Guyed Structure Used for Communication Purposes
	Tower Owner	American Towers, LLC.
	Date Constructed	07/23/2002

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
5360	WIAT	DTV
62278	WERC-FM	FM
65227	WBHK	FM
717	WBIQ	DTV
71417	WPYA	FM
5355	WBPT	FM
48724	WZZK-FM	FM
16820	WABM	DTV
6401	WUHT	FM

Other Types of Users

Users
DTV America
Daystar
Low Power TV
Ricardson Bdcst
Govt
Untd Wless Hld

Primary Tower

Tower Modification Costs

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

Primary Tower

Tower Rigging Costs

Section	Question	Response
Tower Rigging Costs	Complex Tower	Candelabra
Helicopter Services Required	Are helicopter services required?	Yes

Primary Tower

Other Tower Expenses Not Listed

Name	Description
Tower Permit Drawing Package	Tower Permit Drawing Package

Outside Professional Services Costs

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

Other Professional Services Expenses Not Listed

Name	Description
Sinclair Internal Costs	Internal Employee Time Costs

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	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

Other Expenses Not Listed

Information not provided.

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	$2,106,309.30	$2,054,809.30	N/A	$1,118,078.44	N/A
Total for all systems	$4,299,856.50	$3,952,298.16	N/A	$2,200,229.90	N/A
Interim Transmitter NV8608	$56,465.00	$56,465.00		$56,465.00
UHF - Liquid Cooled Solid State Transmitter 7 kW	$56,465.00	$56,465.00	N/A	$56,465.00	N/A
Primary Transmitter THU9evo-36	$2,049,844.30	$1,998,344.30		$1,061,613.44
Additional Equipment	$11,060.50	$11,060.50	N/A	$11,060.50	N/A
2" Rigid Conduit and Wiring (Cost per foot)	$20,800.00	$20,000.00	N/A	$0.00	N/A
Transformer 3 phase/480v - 300 KVA	$36,800.00	$35,000.00	N/A	N/A	N/A
Switchgear - industrial 800 amp	$38,200.00	$36,300.00	N/A	N/A	N/A
UHF - Liquid Cooled Solid State Transmitter 52 - 61 kW	$1,788,000.00	$1,741,000.00	N/A	$919,590.89	N/A
Electrical Installation	$154,983.80	$154,983.80	N/A	$130,962.05	N/A

Components

Actual Information Description	File Name
UHF - Liquid Cooled Solid State Transmitter 7 kW	Component Description: Transmitter related cost. #002284 Amount: $56,465.00
Additional Equipment	Component Description: Additional transmitter parts. #9500106157 Amount: $11,060.50
2" Rigid Conduit and Wiring (Cost per foot)	Component Description: Transmitter related cost. #51822 Amount: $9,301.00
Transformer 3 phase/480v - 300 KVA	Information not provided.
Switchgear - industrial 800 amp	Information not provided.
UHF - Liquid Cooled Solid State Transmitter 52 - 61 kW	Component Description: Transmitter related cost 75%. #9500096561 Amount: $705,804.84 Component Description: Transmitter related cost. #002282 Amount: $1,350.00 Component Description: Transmitter related cost. #51904 Amount: $77,036.50 Component Description: 25% down payment. #9500082398 Amount: $211,734.20 Component Description: Transmitter related cost. #9898469862 Amount: $211.85 Component Description: Transmitter related cost. #4368 Amount: $1,840.00 Component Description: Transmitter related cost. #52005 Amount: $46,221.90
Electrical Installation	Component Description: Transmitter electrical installation cost. #51904 Amount: $77,036.50 Component Description: Transmitter electrical installation cost. #52005 Amount: $46,221.90 Component Description: Transmitter electrical installation cost. #52086 Amount: $23,306.75 Component Description: Transmitter related cost. #52190 Amount: $715.00 Component Description: Transmitter electrical installation cost. #52168 Amount: $7,703.65

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	$909,489.63	$840,150.29	N/A	$400,549.20	N/A
Total for all systems	$4,299,856.50	$3,952,298.16	N/A	$2,200,229.90	N/A
Interim Antenna TFU-16WB-1-R	$447,680.00	$420,600.00		$93,747.75
Interim Antenna Rent	$38,400.00	$38,400.00	N/A	$0.00	N/A
Side mount brackets for high power antennas (if not included in antenna base cost)	$23,150.00	$11,000.00	This cost is shared with WABM.	N/A	N/A
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed)	$13,700.00	$6,500.00	This cost is shared with WABM.	N/A	N/A
New combiner, cost per channel (without antenna)	$84,200.00	$80,000.00	N/A	N/A	N/A
Sweep test of existing antenna	$6,730.00	$3,200.00	This cost is shared with WABM.	N/A	N/A
UHF - High Power, Side Mount, broadband panel, 16 bay,, 200 kW input, directional,, elliptically or circularly polarized	$281,500.00	$281,500.00	WTTO is responsible for 100% of the cost.	$93,747.75	N/A
Primary Antenna TFU-27ETT/VP-R 6T160	$461,809.63	$419,550.29		$306,801.45
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed)	$13,700.00	$27,244.66	See Dielectric quote.	$0.00	N/A
Wedding Cake Adapter	$20,925.30	$20,925.30	N/A	$20,925.30	N/A
Antenna Mounting Pole	$130,954.33	$130,954.33	N/A	$130,954.33	N/A
Sweep test of existing antenna	$6,730.00	$6,400.00	N/A	$4,774.40	N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized	$289,500.00	$234,026.00	See Response to August 24 Inquiry.	$150,147.42	N/A

Components

Actual Information Description	File Name
Interim Antenna Rent	Component Description: Interim antenna rent. #406446085 Amount: $38,400.00
Side mount brackets for high power antennas (if not included in antenna base cost)	Information not provided.
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed)	Information not provided.
New combiner, cost per channel (without antenna)	Information not provided.
Sweep test of existing antenna	Information not provided.
UHF - High Power, Side Mount, broadband panel, 16 bay,, 200 kW input, directional,, elliptically or circularly polarized	Component Description: Total amount reduced by 20.02%. #24930 Amount: $93,747.75 Component Description: Antenna related cost reduced by 20.02%. #24930 Amount: $93,747.75 Component Description: This cost represents the 1/2 allocations to WTTO for its share of the antenna. Amount: $58,607.00
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed)	Component Description: Total invoice amount reduced by 25.40%. #591019 Amount: $27,244.66
Wedding Cake Adapter	Component Description: Antenna related cost. #574002 Amount: $20,925.30
Antenna Mounting Pole	Component Description: Total invoice amount reduced by 25.40%. #559039 Amount: $130,954.33
Sweep test of existing antenna	Component Description: Antenna related cost reduced by 25.40%. #613048 Amount: $4,774.40
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized	Component Description: Antenna related cost. #574002 Amount: $150,147.42

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	$176,032.05	$171,632.05	N/A	$109,125.13	N/A
Total for all systems	$4,299,856.50	$3,952,298.16	N/A	$2,200,229.90	N/A
Interim Transmission Line	$162,400.00	$158,000.00		$95,493.08
Rigid Transmission Line - copper, 6 1/8" broadband	$162,400.00	$158,000.00	N/A	$95,493.08	N/A
Primary Transmission Line	$13,632.05	$13,632.05		$13,632.05
Flexible Transmission Line	$13,632.05	$13,632.05	N/A	$13,632.05	N/A

Components

Actual Information Description	File Name
Rigid Transmission Line - copper, 6 1/8" broadband	Component Description: Transmission line related cost reduced by 20.02%. #32004 Amount: $95,493.08 Component Description: Total invoice amount reduced by 25.40%. #675008 Amount: $28,943.97 Component Description: Total invoice amount reduced by 8.40%. #753029 Amount: $3,128.29 Component Description: Total invoice amount reduced by 8.40%. #754023 Amount: $6,296.32 Component Description: Transmission line related cost reduced by 8.40%. #742011 Amount: $2,310.19 Component Description: Total amount reduced by 20.02%. #32004 Amount: $95,493.08 Component Description: Rigid transmission line. Amount: $119,396.20
Flexible Transmission Line	Component Description: Total invoice amount reduced by 25.40%. #617033 Amount: $3,170.50 Component Description: Transmission line related cost reduced by 25.40%. #613008 Amount: $10,461.55

Actual Information Description

File Name

Rigid Transmission Line - copper, 6 1/8" broadband

Component Description:: Transmission line related cost reduced by 20.02%. #32004
Amount:: $95,493.08

Component Description:: Total invoice amount reduced by 25.40%. #675008
Amount:: $28,943.97

Component Description:: Total invoice amount reduced by 8.40%. #753029
Amount:: $3,128.29

Component Description:: Total invoice amount reduced by 8.40%. #754023
Amount:: $6,296.32

Component Description:: Transmission line related cost reduced by 8.40%. #742011
Amount:: $2,310.19

Component Description:: Total amount reduced by 20.02%. #32004
Amount:: $95,493.08

Component Description:: Rigid transmission line.
Amount:: $119,396.20

Flexible Transmission Line

Component Description:: Total invoice amount reduced by 25.40%. #617033
Amount:: $3,170.50

Component Description:: Transmission line related cost reduced by 25.40%. #613008
Amount:: $10,461.55

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	$733,893.00	$524,039.00	N/A	$476,831.00	N/A
Total for all systems	$4,299,856.50	$3,952,298.16	N/A	$2,200,229.90	N/A
Primary Tower GTOWER	$733,893.00	$524,039.00		$476,831.00
Minor tower reinforcement/modifications	$158,000.00	$75,000.00	This cost is shared with WABM.	$27,792.00	N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)	$421,000.00	$292,246.00	This cost is shared with WABM.	$292,246.00	N/A
Tower Helicopter Lift	$132,543.00	$132,543.00	N/A	$132,543.00	N/A
Structural engineering tower load study for a documented tower with candelabra	$20,000.00	$21,900.00	Please see the American Tower quote.	$21,900.00	N/A
Tower Permit Drawing Package	$2,350.00	$2,350.00	N/A	$2,350.00	N/A

Components

Actual Information Description	File Name
Minor tower reinforcement/modifications	Component Description: Tower related cost. #E-188225 Amount: $13,896.00 Component Description: Tower related cost. #SIN002242 Amount: $13,896.00 Component Description: 50% invoiced upon order. #E-188225 Amount: $13,896.00
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)	Component Description: Tower related cost. #E-188225 Amount: $146,123.00 Component Description: Tower related cost. #SIN002242 Amount: $146,123.00 Component Description: 50% invoiced upon order. #E-188225 Amount: $146,123.00
Tower Helicopter Lift	Component Description: Tower related cost. #SIN002479 Amount: $42,539.50 Component Description: Helicopter cost. #SIN001151 Amount: $47,464.00 Component Description: Tower related cost. #SIN002249 Amount: $42,539.50
Structural engineering tower load study for a documented tower with candelabra	Component Description: Broadcast tower mapping. #460223973 Amount: $12,400.00 Component Description: Structural engineering tower load study. #460223970 Amount: $9,500.00
Tower Permit Drawing Package	Component Description: Tower permit drawing package cost. #373448 Amount: $2,350.00

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	$220,353.56	$208,453.56	N/A	$50,728.02	N/A
Total for all systems	$4,299,856.50	$3,952,298.16	N/A	$2,200,229.90	N/A
Outside Professional Services	$220,353.56	$208,453.56		$50,728.02
Sinclair Internal Costs	$203.56	$203.56	N/A	$171.47	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	$3,000.00	N/A	$2,066.25	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	$3,000.00	N/A	N/A	N/A
Perform engineering study for new channel assignment and antenna development	$7,360.00	$7,000.00	N/A	$6,570.00	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	$2,455.59	N/A
Project management of the transition	$74,260.00	$70,500.00	N/A	$39,242.79	N/A

Components

Actual Information Description	File Name
Sinclair Internal Costs	Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $11.39 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $15.08 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $9.47 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $8.66 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $25.53 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $26.93 Component Description: Portion of general repack matter internal time card attributable to this station - divided by 100. Amount: $66.55 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $7.86
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 93 stations. #461289 Amount: $122.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759 Amount: $99.92
Prepare request for Special Temporary Authorization	Component Description: Outside professional service cost. #858-11-0011 Amount: $2,066.25
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	Information not provided.
Perform engineering study for new channel assignment and antenna development	Component Description: Consulting engineering cost. Amount: $6,570.00
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 98 stations. #461759 Amount: $869.30 Component Description: Legal services cost. Amount: $122.80 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $152.01 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289 Amount: $1,311.48
Project management of the transition	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. #457331 Amount: $836.44 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $20.91 Component Description: Legal Service Cost. #466742 Amount: $57.50 Component Description: $207.48 credit to be split across 52 Sinclair stations reimbursed $269.71 for invoice 1093 (correct reimbursement amount is $265.72). #1093 Amount: ($3.99) Component Description: Legal Service Cost. #478814 Amount: $465.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1069 Amount: $246.68 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #463026 Amount: $801.57 Component Description: Project management cost. #373448 Amount: $4,740.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #465173 Amount: $654.26 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. #1167 Amount: $313.41 Component Description: Legal services cost. #474446 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 99 stations. #469573 Amount: $377.14 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. #475283 Amount: $384.08 Component Description: Legal services cost. #473587 Amount: $688.75 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1145 Amount: $369.98 Component Description: Legal services cost. #472209 Amount: $221.25 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #107 Amount: $602.28 Component Description: Legal services cost. #472627 Amount: $163.75 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. #1143 Amount: $436.90 Component Description: Legal services cost. #470299 Amount: $177.50 Component Description: Legal services cost. #473930 Amount: $476.25 Component Description: Legal services cost. #476927 Amount: $4,951.60 Component Description: Legal Service Cost. #474859 Amount: $172.50 Component Description: Legal services cost. #476415 Amount: $356.25 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. #472173 Amount: $311.78 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1105 Amount: $216.88 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: Legal services cost. #471572 Amount: $221.25 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #477820 Amount: $320.19 Component Description: Legal Service Cost. #479324 Amount: $122.50 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 100 stations. #1099 Amount: $266.93 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #478288 Amount: $194.86 Component Description: Legal services cost. #475793 Amount: $108.75 Component Description: Legal services cost. #473036 Amount: $212.50 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. #1161 Amount: $267.48 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #473885 Amount: $318.62 Component Description: Legal Service Cost. #477346 Amount: $390.00 Component Description: Legal Service Cost. #477861 Amount: $51.25 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #118 Amount: $468.97 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 93 stations. #453686 Amount: $943.95 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1078 Amount: $215.68 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 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: 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 98 stations. #1063 Amount: $262.29 Component Description: Portion of general repack matter invoice attributable to this station - divided by 99 stations. #468718 Amount: $349.51 Component Description: Legal Service Cost. #467430 Amount: $120.00 Component Description: Legal Service Cost. #461817 Amount: $328.90 Component Description: Legal Service Cost. #465227 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: 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 93 stations. #1010 Amount: $86.88 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. #1051 Amount: $105.97 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #463567 Amount: $566.48 Component Description: Legal Service Cost. #460923 Amount: $787.50 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 98 stations. #467861 Amount: $470.30 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1114 Amount: $242.25 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. Amount: $1,954.93 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #450412 Amount: $999.04 Component Description: Legal Service Cost. #464717 Amount: $292.50 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #470923 Amount: $406.65 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 100 stations. #473506 Amount: $421.40 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. #1072 Amount: $237.64 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 98 stations. #461759 Amount: $29.98 Component Description: Legal Service Cost. #467781 Amount: $125.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $731.71 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1111 Amount: $159.58 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 93 stations. #457851 Amount: $818.59 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 98 stations. #1058 Amount: $187.24 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #453972 Amount: $716.28 Component Description: Legal services cost. #469627 Amount: $274.80 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. #1093 Amount: $269.71 Component Description: Legal Service Cost. #467938 Amount: $112.50 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 98 stations. #465001 Amount: $596.30 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $43.72 Component Description: Legal Service Cost. #462998 Amount: $727.30 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. #1086 Amount: $275.35

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	$153,778.96	$153,213.96	N/A	$44,918.11	N/A
Total for all systems	$4,299,856.50	$3,952,298.16	N/A	$2,200,229.90	N/A
Other Expenses	$153,778.96	$153,213.96		$44,918.11
Equipment Storage	$25,384.59	$25,384.59	See Exhibit J.	$14,873.49	N/A
Local Zoning	$20,000.00	$20,000.00	See Exhibit J.	$500.00	N/A
Disposal Costs (for equipment and other waste, net of any salvage value)	$28,566.00	$28,566.00	See Response to August 24 Inquiry.	$5,623.52	N/A
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 24 Inquiry.	$20.00	N/A
Equipment Delivery and Handling Charges	$24,698.37	$24,698.37	See Exhibit J.	$20,626.10	Grammer Heating & Air, Inc. invoice #5541 can be removed.
Non-zoning permits	$10,000.00	$10,000.00	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	$3,275.00	N/A

Components

Actual Information Description	File Name
Equipment Storage	Component Description: Total invoice amount reduced by 8.40%. #706005 Amount: $5,715.84 Component Description: Total invoice amount reduced by 25.40%. #622022 Amount: $7,862.84 Component Description: Equipment storage cost. #9006833689 Amount: $581.13 Component Description: Total invoice amount reduced by 8.40%. #708014 Amount: $10,511.10 Component Description: Equipment Storage cost. #9007837930 Amount: $176.44 Component Description: Equipment storage cost. #9006833690 Amount: $537.24
Local Zoning	Component Description: Local zoning cost. #373448 Amount: $500.00
Disposal Costs (for equipment and other waste, net of any salvage value)	Component Description: Disposal cost. #81339922 Amount: $3,000.70 Component Description: Disposal cost. #0000009926H Amount: $1,111.30 Component Description: Disposal costs. #0000010161H Amount: $474.16 Component Description: Disposal cost. #0000010369H Amount: $504.42 Component Description: Disposal cost. #0000010041H Amount: $532.94
MVPD Notification of Channel Change	Information not provided.
Develop and air announcement of upcoming channel change	Component Description: Repack announcement cost. #1907-2080b Amount: $20.00
Equipment Delivery and Handling Charges	Component Description: Total invoice amount reduced by 8.40%. #757007 Amount: $2,248.88 Component Description: Total invoice amount reduced by 8.40%. #706005 Amount: $9,486.40 Component Description: Total invoice amount reduced by 25.40%. #683015 Amount: $3,424.14 Component Description: Equipment delivery and handling cost. #9944388660 Amount: $256.80 Component Description: Equipment delivery and handling cost. #9944388678 Amount: $282.48 Component Description: Equipment delivery and handling cost. #5572 Amount: $1,840.00 Component Description: Equipment delivery and handling cost. #5019 Amount: $1,840.00 Component Description: Total invoice amount reduced by 8.40%. #708014 Amount: $4,072.27 Component Description: Equipment delivery and handling cost. #5541 Amount: N/A Component Description: Equipment delivery and handling cost. #9944388694 Amount: $653.40 Component Description: Equipment delivery and handling cost. #9944388686 Amount: $594.00
Non-zoning permits	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 cost. #1220 Amount: $3,275.00

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$4,299,856.50	$3,952,298.16	$2,200,229.90

Reimbursement Status

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

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.	Lucy Rutishauser CFO 05/27/2020

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.

Lucy Rutishauser

CFO

05/27/2020

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.	Lucy Rutishauser CFO 05/27/2020

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.

Lucy Rutishauser

CFO

05/27/2020

(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

Enter a list of RF channel numbers.

Interim Antenna

Other Antenna Cost Not Listed

Transmission Line

Primary Transmission Line

Existing 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

Cost Information

Antennas

Components

Cost Information

Transmission Line

Components

Cost Information

Tower Equipment and Rigging Costs

Components

Cost Information

Outside Professional Services

Components