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:
66402
Service:
DTV
Call Sign:
KIMT
Channel:
24 (UHF)
File Number:
0000027601
FRN:
0025670290
Date Submitted:
06/29/2020

Applicant Information

Back to Top

Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

ROCHESTER TV LICENSE COMPANY, LLC

Doing Business As: ROCHESTER TV LICENSE COMPANY, LLC

John Burgett

Wiley Rein LLP

1776 K St NW

Washington, DC 20006

United States

+1 (202) 719-4239 jburgett@wiley.law 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

Samuel Hariton

Widelity

Samuel Hariton

4031 University Drive

Ste 100

Fairfax, VA 22030

United States

+1 (339) 222-8107 sam.hariton@widelity.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. Yes
Briefly describe transition plan Install new primary transmitter and interim side-mount antenna/line for temporary operation on repack ch. 24 while install new primary top-mount antenna/line for permanent ch. 24 operations. Maintain interim antenna as backup.

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 Purchase New
Use Auxiliary (Backup)
Description of Use Backup
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 Diamond
Year 2002
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1.8 kW

Auxiliary Transmitter

Back to Top

New Transmitter Costs

Section Question Response
New Transmitter Use Auxiliary (Backup)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model UAXTE 4R37
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2.4 kW
Justification for New Transmitter Existing aux/backup transmitter cannot be re-channeled to meet repack channel assignment and is no longer supported by manufacturer.

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 CD3260P2-CF
Year 2007
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 60 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 ULXTE72
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 47.2 kW
Justification for New Transmitter Current primary transmitter cannot be re-channeled to meet repack channel assignment and is no longer supported by manufacturer. See Attachment 1.

Primary 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? Yes
Size 425.0 square feet
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

Back to Top

Other Transmitter Cost Not Listed

Name Description

Building Expansion electrical work

Station building, other electrical work to support the re-pack transition

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? No
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type Class Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 800.0 kW
Manufacturer
Model TFU-30GTH-R-04
Year 2007

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? Yes
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? No
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class Full Power
Mounting Top 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: 553.0 kW
Manufacturer
Model ATW22H3-ETO-24H
Year 2017
Justification for New Antenna Current primary antenna cannot be re-tuned for use on repack 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?
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 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

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? No
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 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: 553.0 kW
Manufacturer
Model ATW18H3-ESO-24H
Year 2017
Justification for New Antenna Interim antenna and transmission line needed to maintain on-air service while new primary antenna and transmission line installed.

Interim Antenna

Back to Top

Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? No
Broadband or Single Channel? N/A
Feed Line Size N/A
Side Mount Brackets Do you require the separate purchase of side mount brackets for an antenna? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? Yes
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Interim Antenna

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 Purchase New
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
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 19 1/2 inches
Other Segment Length N/A
Number of parallel runs 3
Length 1400 feet per run

Primary Transmission Line

Back to Top

New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 19 3/4 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1680 feet per run
Justification for New Transmission Line New transmission line is required for installation of primary antenna. Repack channel necessitates a change in transmission line segment length.

Primary Transmission Line

Back to Top

Other Transmission Line Expenses Not Listed

Information not provided.

Interim Transmission Line

Back to Top

New Transmission Line

Section Question Response
New Transmission Line Costs Use Interim
Description of Use N/A
Change Type Purchase New
Type Rigid
Diameter 6 1/8 inches
Segment Length 19 ½ '
Other Segment Length
Number of parallel runs 1
Length 1141 feet per run
Justification for New Transmission Line Interim antenna and transmission line needed to maintain on-air service while new primary antenna and transmission line installed.

Interim Transmission Line

Back to Top

Other Transmission Line Expenses Not Listed

Information not provided.

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 Move Equipment
Tower Use Primary (Main)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? No
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users No
Is tower documented for structural analysis? Unknown
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1253749
Coordinates (NAD83) Latitude (NAD83) 43° 28' 32.0" N-
Longitude (NAD83) 092° 45' 30.0" W-
Overall Structure Height 1553.13 feet
Support Structure Height 1499.98 feet
Ground Elevation Above Mean Sea Level (AMSL) 1274.92 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner Iowa Public Broadcasting
Date Constructed 09/18/2007

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
29086 KYIN DTV

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 Rigging - Other Expenses

Structural Analysis and Report

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 595
Explanation KIMT does not have sufficient resource capacity and expertise in house to handle all of the reimbursement filing by the construction deadline for Phase 1. KIMT will hire an outside firm to ensure a timely and well managed transition.
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 No
Environmental Assessment No
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations No
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 No
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

Attorney Fees and Other Matters

Legal Services

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 No
Non-zoning permits No
BLM or NFS Coordination No
FCC Construction Permit Minor Change No
FCC License to Cover Application Yes
FCC Special Temporary Authority Application Yes
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? Yes
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

Back to Top

Other Expenses Not Listed

Name Description

Taxes and Freight

Taxes & Freight from invoice KIMT-004 for Primary & Interim Antenna, Interim Side Mount Brackets, Primary & Interim Transmission Lines, Primary System Sweep & All Install. These Costs were not originally included in separate est costs

Transmission Site Remediation

Repairs to road and surrounding land needed due to damage caused by increased construction traffic to transmission site; a direct result of the repack

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 $1,695,529.86 $1,678,112.14 N/A $1,520,263.20 N/A
Total for all systems $4,112,832.61 $3,788,452.67 N/A $2,966,058.05 N/A
Primary Transmitter ULXTE72 $1,569,529.86 $1,558,112.14 $1,401,861.24
Building Expansion electrical work $37,529.86 $37,529.86 Per Estimated Cost Justification KIMT-110-1st Primary Transmitter - Building Expansion Electrical Work v0 $37,529.86 N/A
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW $1,473,000.00 $1,461,582.28 see Estimated Cost Justification KIMT-110-1st Primary Transmitter - UHF Liquid Cooled Solid State, 35-50 kW v0 $1,364,291.62 invoices
Other -- Building Addition Size: 425.0 $59,000.00 $59,000.00 Cost for construction of small transmitter building per attached quote from Thermobond Buildings $39.76 N/A
Auxiliary Transmitter UAXTE 4R37 $126,000.00 $120,000.00 $118,401.96
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $120,000.00 N/A $118,401.96 N/A

Components

Actual Information Description File Name
Building Expansion electrical work

Component Description:
Labor and materials
Amount:
$33,787.86

Component Description:
10/11/2018 Meet w/electrician about Gates install
Amount:
$3,375.00

Component Description:
GREAT STUFF BIG GAP 12OZ
Amount:
$7.00

Component Description:
Electrician Prep 9/21/2018
Amount:
$360.00
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW

Component Description:
Primary Transmitter ULXTE-72. Request does not include cost for shipping and taxes, which will be requested when these expenses are incurred. See Attachment "KIMT - GatesAir Purchase Order Quote Q-58773 ULXTE-72."
Amount:
$1,313,427.96

Component Description:
Repair Brass Tube, Silicone TIG Rod
Amount:
$119.44

Component Description:
IPTV Personnel Services: On-site time and services during KIMT re-pack
Amount:
$14,264.07

Component Description:
Nitrogen size 80
Amount:
$102.72

Component Description:
12" LOCK N LOAD SPADE EXTENSION
Amount:
$44.53

Component Description:
V2076 S HOOK 1 1/2" HEAVY OPEN GORILLA CONSTRUCT ADHESIVE 9OZ
Amount:
$16.72

Component Description:
Change Fittings (Mike)
Amount:
$26.75

Component Description:
1INX60YD SAFE RELEASE BLUE TAPE 3/8" DR X 8 PC SOCKET SET
Amount:
$31.12

Component Description:
Oxygen, Acetylene
Amount:
$59.92

Component Description:
July Storage 2018
Amount:
$1,400.00

Component Description:
Acetylene Cylinders
Amount:
$39.91

Component Description:
Inbound Handling 22Mar18
Amount:
$150.00

Component Description:
Storage, August 2018
Amount:
$1,400.00

Component Description:
Storage April 2018
Amount:
$1,400.00

Component Description:
A. Transmitter
Amount:
$6,895.83

Component Description:
Storage September 2018
Amount:
$1,400.00

Component Description:
Acetylene, nitrogen, oxygen cylinders
Amount:
$43.46

Component Description:
Stainless Steel Welding at Transmitter
Amount:
$167.00

Component Description:
M18 Fuel 7"/9" HP Large Angle KT
Amount:
$455.22

Component Description:
Repair 6" Cut Piece, Repair 6" Cut Piece
Amount:
$119.44

Component Description:
3" Air, Transmission Line, Coaxial
Amount:
$6,605.50

Component Description:
Assist Engineer w/ unloading transmitter & equipment
Amount:
$12,799.50

Component Description:
Inbound Handling 11May18
Amount:
$75.00

Component Description:
Cylinder Propane 20# Typei, Tie-down 6" Gray 400#, LP 20 lb.
Amount:
$63.73

Component Description:
May Storage 2018
Amount:
$1,400.00

Component Description:
REG EXP FOAM INSULATION 12 oz
Amount:
$32.71

Component Description:
4 IN Adjustable C-Clamp
Amount:
$64.36

Component Description:
Inbound Handling 02Apr18
Amount:
$75.00

Component Description:
June Storage 2018
Amount:
$1,400.00

Component Description:
1-OZ Pack rosin core solder
Amount:
$24.12

Component Description:
20V MAX GRINDER KIT 2-6.0AH
Amount:
$307.05
Other -- Building Addition Size: 425.0

Component Description:
Tie-Down 30' GRN 10000#
Amount:
$39.76
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
Aux Transmitter
Amount:
$11,763.84

Component Description:
Angle Grinder 4-1/2"
Amount:
$11.81

Component Description:
Auxiliary Transmitter UAXTE-4R37. Request does not include costs for shipping and taxes, which will be requested when these expenses are incurred. Invoice includes cover letter requested by Fund Administrator.
Amount:
$106,626.31

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 $1,037,170.00 $614,496.68 N/A $490,742.68 N/A
Total for all systems $4,112,832.61 $3,788,452.67 N/A $2,966,058.05 N/A
Interim Antenna ATW18H3-ESO-24H $481,640.00 $252,775.00 $186,094.53
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 $1,750.00 N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $22,000.00 N/A $13,200.00 N/A
UHF - High Power, Side Mount, basic slot antenna, 553 kW input, elliptically or circularly polarized $67,500.00 $67,500.00 The remaining costs for a like-for-like replacement, per ERI Proposal 20171027-119. KIMT has been reimbursed $101,250.00 via the two previous antenna categories. $18,149.53 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $1,120.00 N/A
UHF - Lower Power Side Mount, One station - 200-500 kW, horizontally polarized $189,500.00 $50,625.00 ***System Notice: Estimate adjusted and locked because line has been superseded.*** $50,625.00 Total cost of Interim Antenna ATW18H3-HSO-24H is $168,750.00. Form 399 system has split estimate into two separate line items, which when combined equal $168,750.00.
UHF - Lower Power Side Mount, One station - 200-500 kW, horizontally polarized $189,500.00 $101,250.00 ***System Notice: Estimate adjusted and locked because line has been superseded.***Total cost of Interim Antenna ATW18H3-HSO-24H is $168,750.00. Form 399 system has split estimate into two separate line items, which when combined equal $168,750.00. $101,250.00 Total cost of Interim Antenna ATW18H3-HSO-24H is $168,750.00. Form 399 system has split estimate into two separate line items, which when combined equal $168,750.00.
Primary Antenna ATW22H3-ETO-24H $555,530.00 $361,721.68 $304,648.15
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $0.00 N/A $0.00 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $6,250.00 N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $289,500.00 $81,250.00 The remaining costs for a like-for-like replacement, per ERI Proposal 20171027-119. KIMT has been reimbursed $121,875.00 via the previous antenna category. $24,326.47 N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized $247,000.00 $274,071.68 ***System Notice: Estimate adjusted and locked because line has been superseded.***Estimated cost includes tax and freight expenses totalling $91,259.18 for primary and interim antennas. See Attachment "Invoice-KIMT-004, Cover Letter, Explanation of Variance and Quote (submitted 8.31.18).pdf." $274,071.68 Invoice KIMT-004 includes total sales tax and freight charges for all equipment provided by ERI and identified on invoice.

Components

Actual Information Description File Name
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)

Component Description:
Chamber Testing
Amount:
$1,750.00
Side mount brackets for high power antennas (if not included in antenna base cost)

Component Description:
Interim Antenna, Primary Antenna, Installation Services - Primary and Interim
Amount:
$1,320.00

Component Description:
Interim Antenna Side Mount Brackets. Second 30% payment.
Amount:
$3,960.00

Component Description:
Interim Antenna Side Mount Brackets. Third 30% payment.
Amount:
$3,960.00

Component Description:
Interim Antenna Side Mount Brackets. Initial 30% payment.
Amount:
$3,960.00
UHF - High Power, Side Mount, basic slot antenna, 553 kW input, elliptically or circularly polarized

Component Description:
KIMT-280-Interim Antenna - UHF Lower Power Side Mount, E-POL
Amount:
$16,875.00

Component Description:
Uni. clip Angle for vert. spring hangers
Amount:
$1,274.53
Sweep test of existing antenna

Component Description:
Antenna & transmission line testing, KIMT
Amount:
$1,120.00

Component Description:
Sweep test for interim antenna not included on invoice.
Amount:
N/A
UHF - Lower Power Side Mount, One station - 200-500 kW, horizontally polarized

Component Description:
Interim Antenna ATW18H3-HSO-24H (H-pol pricing). Initial 30% payment.
Amount:
$50,625.00
UHF - Lower Power Side Mount, One station - 200-500 kW, horizontally polarized

Component Description:
Interim Antenna ATW18H3-HSO-24H (H-pol pricing). Third 30% payment.
Amount:
$50,625.00

Component Description:
Interim Antenna ATW18H3-HSO-24H (H-pol pricing). Second 30% payment.
Amount:
$50,625.00
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) Information not provided.
Sweep test of existing antenna

Component Description:
KIMT-210-Primary Antenna - Sweep Test
Amount:
$625.00

Component Description:
Primary Antenna System Sweep Test. Initial 30% payment.
Amount:
$1,875.00

Component Description:
Primary Antenna System Sweep Test. Third 30% payment.
Amount:
$1,875.00

Component Description:
Primary Antenna System Sweep Test. Second 30% payment.
Amount:
$1,875.00
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
Elbow 6-1/8" 50 OHM 90DEG REINFORCED
Amount:
$3,949.53

Component Description:
KIMT-210-Primary Antenna - UHF High Power Top Mount, E-POL
Amount:
$20,312.50

Component Description:
Mag 1-3/4" COV LCK 1.5 3pk, Nuts Bolt Screws
Amount:
$40.79

Component Description:
Link Chain LAP 3/16 X 1"
Amount:
$23.65
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized

Component Description:
Primary Antenna ATW22H3-HTO-24H (H-pol pricing). Second 30% payment.
Amount:
$60,937.50

Component Description:
Primary Antenna ATW22H3-HTO-24H (H-pol pricing). Initial 30% payment.
Amount:
$60,937.50

Component Description:
Primary Antenna ATW22H3-HTO24H (H-pol pricing). Amount requested includes third 30% payment for primary antenna plus total sales tax and freight charges.
Amount:
$152,196.68

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 $569,842.00 $541,632.00 N/A $392,876.05 N/A
Total for all systems $4,112,832.61 $3,788,452.67 N/A $2,966,058.05 N/A
Interim Transmission Line $230,482.00 $219,072.00 $156,144.40
Rigid Transmission Line - copper, 6 1/8" $230,482.00 $219,072.00 N/A $156,144.40 N/A
Primary Transmission Line $339,360.00 $322,560.00 $236,731.65
Rigid Transmission Line - copper, 6 1/8" $339,360.00 $322,560.00 N/A $236,731.65 N/A

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 6 1/8"

Component Description:
KIMT-380-Interim Transmission Line - Rigid Copper, 6 1/8"
Amount:
$14,556.91

Component Description:
Interim Antenna Rigid Transmission Line System - Copper 6-1/8". Third 30% payment.
Amount:
$47,195.83

Component Description:
Interim Antenna Rigid Transmission Line System - Copper 6-1/8". Second 30% payment.
Amount:
$47,195.83

Component Description:
Interim Antenna Rigid Transmission Line System - Copper 6-1/8". Initial 30% payment.
Amount:
$47,195.83
Rigid Transmission Line - copper, 6 1/8"

Component Description:
KIMT-310-Primary Transmission Line - Rigid Copper, 6 1/8"
Amount:
$23,673.15

Component Description:
Primary Antenna Rigid Transmission Line System - Copper 6-1/8". Initial 30% payment.
Amount:
$71,019.50

Component Description:
Primary Antenna Rigid Transmission Line System - Copper 6-1/8". Second 30% payment
Amount:
$71,019.50

Component Description:
Primary Antenna Rigid Transmission Line System - Copper 6-1/8". Third 30% payment.
Amount:
$71,019.50

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 $476,065.00 $575,433.60 N/A $338,317.29 N/A
Total for all systems $4,112,832.61 $3,788,452.67 N/A $2,966,058.05 N/A
Primary Tower GTOWER $476,065.00 $575,433.60 $338,317.29
Tower Rigging - Other Expenses $265,565.00 $265,565.00 ERI Proposal 20180403-601 and Justifying Quote KIMT ERI Proposal 20171027-119 $32,406.50 N/A
Tall Tower (greater than 500') $210,500.00 $309,868.60 Rigging for interim antenna and primary antenna per attached proposal from ERI; derig and demobilization of existing antenna; ERI Quote #20180718-729 $305,910.79 X

Components

Actual Information Description File Name
Tower Rigging - Other Expenses

Component Description:
KIMT-410-Existing Primary Tower - Tower Rigging, Tall Tower
Amount:
$25,906.50

Component Description:
50% deposit - Structural analysis and report
Amount:
$3,250.00

Component Description:
Balance due - structural analysis & report
Amount:
$3,250.00
Tall Tower (greater than 500')

Component Description:
Weather Day
Amount:
$7,800.00

Component Description:
Move tower from Meyer Site
Amount:
$1,637.10

Component Description:
Meyer, IA line install
Amount:
$3,670.83

Component Description:
M8178 CIEUIS
Amount:
$77.46

Component Description:
50% deposit - increased antenna installation cost
Amount:
$23,740.00

Component Description:
Installation Services - Primary, Interim antennas, and transmission lines. Initial 30% payment.
Amount:
$77,719.50

Component Description:
Balance due - increased antenna installation cost
Amount:
$27,063.60

Component Description:
Additional work, Installed 1-5/8" Connector
Amount:
$8,763.30

Component Description:
Installation Services - Primary, Interim antennas, and transmission lines. Third 30% payment.
Amount:
$77,719.50

Component Description:
Installation Services - Primary, Interim antennas, and transmission lines. Second 30% payment.
Amount:
$77,719.50

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 $163,856.50 $208,964.00 N/A $185,249.50 N/A
Total for all systems $4,112,832.61 $3,788,452.67 N/A $2,966,058.05 N/A
Outside Professional Services $163,856.50 $208,964.00 $185,249.50
Project management of the transition $94,010.00 $99,675.00 Per Widelity quote KIMT Strategic support quote 12-16-18 (uploaded) $89,023.00 N/A
Attorney Fees and Other Matters $33,406.50 $33,406.50 see Estimated Cost Justification KIMT-550-Attorney Fees - Other Matters v2 $33,406.50 N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $7,360.00 $7,175.00 See Justifying Invoice - KIMT WILEY REIN 1475240 $7,175.00 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $3,353.75 See Justifying Invoice - KIMT WILEY REIN 1475240, 1405467 $2,608.75 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $725.00 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $6,310.00 Wiley Rein invoice #1482487 $4,272.50 N/A
Prepare request for Special Temporary Authorization $4,100.00 $3,000.00 N/A $2,250.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A $250.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $4,798.75 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 $42,043.75 see Estimated Cost Justification KIMT-590-Prepare and_or Review Reimbursement Form v3 $40,740.00 N/A

Components

Actual Information Description File Name
Project management of the transition

Component Description:
Project Management
Amount:
$2,084.20

Component Description:
Project Management
Amount:
$8,706.05

Component Description:
Project Management
Amount:
$4,570.80

Component Description:
Project Management
Amount:
$3,353.30

Component Description:
Project Management
Amount:
$3,766.15

Component Description:
Project Management
Amount:
$6,587.65

Component Description:
Project Management
Amount:
$3,105.10

Component Description:
Project Management
Amount:
$7,031.10

Component Description:
Project Management
Amount:
$7,467.60

Component Description:
Project Management
Amount:
$4,640.60

Component Description:
Project Management
Amount:
$7,013.10

Component Description:
Project Management
Amount:
$2,292.10

Component Description:
Project Management
Amount:
$3,868.55

Component Description:
Project Management
Amount:
$3,053.45

Component Description:
Project Management
Amount:
$2,025.30

Component Description:
Project Management
Amount:
$7,855.70

Component Description:
Project Management
Amount:
$6,533.05

Component Description:
Project Management
Amount:
$5,069.20

Component Description:
N/A
Amount:
N/A
Attorney Fees and Other Matters

Component Description:
Professional Services
Amount:
$905.00

Component Description:
KIMT-550-Attorney Fees - Other Matters
Amount:
$4,285.25

Component Description:
Total Professional Services
Amount:
$410.00

Component Description:
KIMT-550-Attorney Fees - Other Matters
Amount:
$4,715.00

Component Description:
Total Professional Services
Amount:
$410.00

Component Description:
Total Professional Services
Amount:
$1,435.00

Component Description:
Review and revise third quarter transition plan progress report
Amount:
$1,117.50

Component Description:
General FCC Advice
Amount:
$1,435.00

Component Description:
Total Professional Services
Amount:
$1,230.00

Component Description:
Prepare quarterly transition plan progress report
Amount:
$372.50

Component Description:
Total Professional Services
Amount:
$205.00

Component Description:
Total Professional Services
Amount:
$820.00

Component Description:
Professional Services
Amount:
$226.25

Component Description:
Legal services
Amount:
$931.25

Component Description:
KIMT-550-Attorney Fees - Other Matters
Amount:
$2,255.00

Component Description:
Total Professional Services, Total Disbursements
Amount:
$4,510.00

Component Description:
Prepare and submit Form 387 fourth quarter report
Amount:
$410.00

Component Description:
Total Professional Services, Total Disbursements
Amount:
$1,583.75

Component Description:
KIMT-550-Attorney Fees - Other Matters
Amount:
$1,230.00

Component Description:
Professional legal services
Amount:
$4,100.00

Component Description:
General FCC Advice
Amount:
$820.00
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
Prepare Form 399 repack reimbursement request
Amount:
$1,845.00

Component Description:
Legal Services
Amount:
$2,870.00

Component Description:
Professional services
Amount:
$1,230.00

Component Description:
Legal services
Amount:
$1,230.00
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
KIMT-550-Attorney - License to Cover Application (Main)
Amount:
$1,025.00

Component Description:
KIMT-550-Attorney - License to Cover Application (Main)
Amount:
$1,583.75

Component Description:
Prepare Form 2100/Schedule A application re; KIMT
Amount:
$745.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Develop final technical parameters for side-mount antenna on repack Ch-24
Amount:
$725.00
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
KIMT-550-Attorney - Construction Permit Application (Main)
Amount:
$1,845.00

Component Description:
Total Professional Services, Total Disbursement
Amount:
$1,310.00

Component Description:
Prepare Form 399
Amount:
$1,117.50
Prepare request for Special Temporary Authorization

Component Description:
Consulting Engineer - Review final operating constants regarding construction of repack Ch-24, develop technical parameters based on as-built transmitter and top-mount antenna.
Amount:
$1,312.50

Component Description:
Consulting Engineer - Develop technical parameters for auxiliary/interim sidemount antenna on repackCh-24 for use during transition.
Amount:
$937.50
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
Consulting Engineer - J. Davis - Hourly (@ $250/hr)
Amount:
$250.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Consulting Engineer - Regarding repack Ch-24 implementation at phase 1, conduct channel study to identify existing LPTV & translator stations that would cause interference to KIMT's new channel
Amount:
$250.00

Component Description:
Consulting Engineer - Obtain main antenna manufacturer's as-built specifications and determine ERP as realized with new transmitter on repack Ch-24.
Amount:
$1,125.00

Component Description:
Consulting Engineer - Hourly
Amount:
$312.50

Component Description:
BILL ONLY
Amount:
$500.00

Component Description:
Review specifications from antenna vendor for repack Ch-24 implementation
Amount:
$275.00

Component Description:
10/19/2018 work on channel change
Amount:
$2,148.75

Component Description:
Consulting Engineering - Hourly
Amount:
$187.50
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form

Component Description:
Legal services
Amount:
$3,075.00

Component Description:
KIMT-590-Prepare and/or Review Reimbursement Form
Amount:
$820.00

Component Description:
Review FCC requirements for repack reimbursement
Amount:
$1,676.25

Component Description:
Review Form 399 audit letter
Amount:
$2,487.50

Component Description:
Total Professional Services
Amount:
$3,538.75

Component Description:
Prepare Form 399 repack reimbursement request
Amount:
$2,048.75

Component Description:
Prepare Form 399 for submission
Amount:
$226.25

Component Description:
Prepare and review Form 399 reimbursement request
Amount:
$3,352.50

Component Description:
Legal services
Amount:
$226.25

Component Description:
Total Professional Services
Amount:
$1,845.00

Component Description:
KIMT-590-Prepare and/or Review Reimbursement Form
Amount:
$3,911.25

Component Description:
Prepare and submit Form 399
Amount:
$226.25

Component Description:
Legal services
Amount:
$905.00

Component Description:
Total Professional Services
Amount:
$1,435.00

Component Description:
KIMT-590-Prepare and/or Review Reimbursement Form
Amount:
$1,303.75

Component Description:
Total professional Services Total Disbursements
Amount:
$2,870.00

Component Description:
Prepare Form 399 repack reimbursement request
Amount:
$1,230.00

Component Description:
KIMT-590-Prepare and/or Review Reimbursement Form
Amount:
$226.25

Component Description:
KIMT-590-Prepare and/or Review Reimbursement Form
Amount:
$8,405.00

Component Description:
Total Professional Services
Amount:
$2,235.00

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 $170,369.25 $169,814.25 N/A $38,609.33 N/A
Total for all systems $4,112,832.61 $3,788,452.67 N/A $2,966,058.05 N/A
Other Expenses $170,369.25 $169,814.25 $38,609.33
Transmission Site Remediation $23,240.13 $23,240.13 Please see attached Dolan’s Landscaping Quote $23,240.13 N/A
Taxes and Freight $91,259.18 $91,259.18 Per ERI Invoice KIMT-004 N/A N/A
MVPD Notification of Channel Change $5,000.00 $5,000.00 Mailing notification letters to cable and satellite providers. $4,734.00 N/A
Develop and air announcement of upcoming channel change $7,500.00 $7,500.00 N/A N/A N/A
Equipment Storage $6,289.94 $6,289.94 per Estimated Cost Justification KIMT-610-Equipment Storage v3 $6,289.94 Invoices
Equipment Delivery and Handling Charges $6,000.00 $6,000.00 Equipment Delivery and Handling Charges, fork lift, manpower, etc.. $1,240.26 N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A $2,770.00 N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $335.00 see Estimated Cost Justification KIMT-610-FCC Filing Fee - License to Cover Application v0 $335.00 N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $19,000.00 $19,000.00 Removal of old copper and old transmitter. $0.00 N/A

Components

Actual Information Description File Name
Transmission Site Remediation

Component Description:
38 Yards - Shredded Soil
Amount:
$23,240.13
Taxes and Freight Information not provided.
MVPD Notification of Channel Change

Component Description:
Notification of Cable and Satellite MVPD Providers of new RF Channel and Transport Stream Parameters on the Repack Channel.
Amount:
$1,578.00

Component Description:
MVPD Notification Services
Amount:
$1,578.00

Component Description:
MVPD Notification Services
Amount:
$1,578.00
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage

Component Description:
45' High cube storage container lease, storage container
Amount:
$1,429.56

Component Description:
45' High Cube Storage Container Lease, 53' Storage Container
Amount:
$329.56

Component Description:
45' High Cube Storage Container Lease- APLU451628 - 2621 490th
Amount:
$329.56

Component Description:
45' High Cube Storage Container Lease- APLU451628-2621 490th
Amount:
$329.56

Component Description:
45' High Cube Storage Container Lease- APLU451628-2621 490th
Amount:
$329.56

Component Description:
High Cube Storage Container Lease
Amount:
$329.56

Component Description:
45' High Cube Storage Container Lease - APLU451628 - 2621 490th
Amount:
$329.56

Component Description:
Storage, October 2018
Amount:
$1,400.00

Component Description:
45' High Cube Storage Container Lease - APLU451628 - 2621 490th
Amount:
$329.56

Component Description:
45' High Cube Storage Container Lease - APLU451628 - 2621 490th
Amount:
$329.56

Component Description:
45' high cube storage container leas. 53' storage container
Amount:
$329.56

Component Description:
45' High Cube Storage Container Lease
Amount:
$329.56

Component Description:
53' Storage Container- PTSU842451- 2621 490th St. Mcintire, IA
Amount:
$164.78
Equipment Delivery and Handling Charges

Component Description:
Transportation, Peosta, IA Mcintire, IA Del 10/29
Amount:
$600.00

Component Description:
Hydraulic pallet dollie/jack
Amount:
$640.26
DTV Medical Facility Notification

Component Description:
DTVNotification
Amount:
$2,770.00
FCC Filing Fees - Form 2100 license to cover application

Component Description:
KIMT, Mason City, IA Channel Repack
Amount:
$335.00
FCC Filing Fees - Special Temporary Authorization request Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.

Cost Information

Back to Top

Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $4,112,832.61 $3,788,452.67 $2,966,058.05

Reimbursement Status

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

Robert S. Prather , Jr. .

CEO, Allen Media Broadcasting, LLC


06/29/2020

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.

Robert S. Prather , Jr. .

CEO, Allen Media Broadcasting, LLC


06/29/2020

Certification

Back to Top
Section Question Response
Submission of Final Allocation or Accounting Information 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 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 acknowledges that all certifications and attached documentation are considered material representations.

  2. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.

  3. The above-named entity certifies that all costs identified as "actual costs" herein accurately represent the costs actually paid by the above-named entity, including any discounts, refunds, or rebates.

  4. 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.

  5. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.

  6. 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.

Robert S. Prather , Jr. .

CEO, Allen Media Broadcasting, LLC


06/29/2020

Attachments

Back to Top