TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
ION MEDIA SAN JOSE LICENSE, INC. Doing Business As: ION MEDIA SAN JOSE LICENSE, INC.	Bianca Frye 601 Clearwater Park Road West Palm Beach, FL 33401 United States	+1 (561) 682-4110	BiancaFrye@ionmedia.com	Corporation

Applicant

Address

Phone

Applicant Type

ION MEDIA SAN JOSE LICENSE, INC.

Doing Business As: ION MEDIA SAN JOSE LICENSE, INC.

Bianca Frye

601 Clearwater Park Road

West Palm Beach, FL 33401

United States

+1 (561) 682-4110

BiancaFrye@ionmedia.com

Corporation

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
The Preparer is same as the reimbursement contact.

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.	No
Briefly describe transition plan	Install and operate from interim antenna on pre repack channel utilizing current non re-tunable transmitter. Replace current top mounted on a pole antenna, transmission line and transmitter for operation on post repack channel Ch 33.

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	DCX
	Year	2002
	Type	Inductive Output Tube
	IOT Power Type	Two
	Power Capacity	40 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	THU9-16 EVO
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	25.5 kW
	Justification for New Transmitter	See attached Transmitter Exhibits. See attached Transmitter Upgrade Disclaimer.

Primary 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	Yes
	Description	Electrical Installation for replacement transmitter
HVAC Service	Does the replacement transmitter require HVAC Service?	Yes
	Type	Cooling Only
	Size	5 tons
	Other Size	N/A
Transmitter Building Addition/Modification or Leasehold Improvement	Does the Transmitter Building require an addition, modification, other leashold improvement?	No
	Size	N/A
Channel 14 Costs	Is an RF Consulting Engineer needed?	N/A
	Is a channel 14 Mask Filer needed?	N/A
	Is additional field engineering time needed?	N/A
	Number of Days	N/A

Primary Transmitter

Other Transmitter Cost Not Listed

Name	Description
RF Interconnect	Interconnect between RF System and transmission line
Connection double pump	Connection double pump for cooling hoses
Reconfigure existing transmitter for Interim Operation	Reconfigure 2 Cabinet IOT transmitter to operate as 1 cabinet interim transmitter
Removal of Existing Equipment	Removal of existing transmitters and equipment / Site Prep

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?	Yes
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:	1000.0 kW
	Manufacturer
	Model	TFU-20DSC-R C170
	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?	Yes
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:	510.0 kW
	Manufacturer
	Model	TFU-20DSC/VP-R C170
	Year	2018
	Justification for New Antenna	Current slot antenna cannot be re-channeled

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?	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?	Yes
Sweep Test	Do you require the sweep testing of transmission line and antenna?	Yes

Primary Antenna

Other Antenna Cost Not Listed

Name	Description
Support Mounts	Custom Mounts to Existing Support 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?	No
	Is antenna directional?	Yes
	Will antenna be located on or in close proximity to an antenna farm?	Yes
New Antenna Manufacturer and Type	Class	Full Power
	Mounting	Side Mount
	Antenna position in stack	Not in Stack
	Polarization	Horizontal
	Type	Broadband Slot
	Number of Stations Supported	1
	Number of Panels/Bays	8
	Lower Limit	470.00 MHz
	Upper Limit	698.00 MHz
	Design power capacity in use	25.0 %
	Other Antenna Type	N/A
	ERP:	100.0 kW
	Manufacturer
	Model	TFU-8WB-R C160
	Year	2018
	Justification for New Antenna	Interim antenna needed to complete move to new channel.

Interim Antenna

Other Antenna Costs

Section	Question	Response
Elbow Complex	Do you require the separate purchase of the Elbow Complex?	Yes
	Broadband or Single Channel?	S
	Feed Line Size	4 1/16 inches
Side Mount Brackets	Do you require the separate purchase of side mount brackets for an antenna?	No
Pattern Scatter Analysis	Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna?	No
Sweep Test	Do you require the sweep testing of transmission line and antenna?	Yes

Interim Antenna

Other Antenna Cost Not Listed

Name	Description
Interim Antenna Rent	Agreement with ATC to allow Interim Antenna on tower

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	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	1
	Length	350 feet per run

Primary Transmission Line

New Transmission Line

Section	Question	Response
New Transmission Line Costs	Use	Primary (Main)
	Description of Use	N/A
	Change Type	Purchase New
	Is this a request for upgraded equipment?	No
	Type	Rigid
	Diameter	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	350 feet per run
	Justification for New Transmission Line	See attached Transmission Line Exhibit

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Name	Description
Sweep existing transmission line	Sweep existing transmission line

Tower Equipment And Rigging Costs

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

Primary Tower

Existing Tower

Section	Question	Response
Existing Tower Description	Type of change	Modify Existing
	Tower Use	Primary (Main)
	Description of Use	N/A
	Ownership	Leased
	Is this tower consider Complex?	No
	Is this tower currently shared with any other stations?	Yes
	One or more FM, AM or TV radio broadcaster(s)	Yes
	Others Types of Users	No
	Is tower documented for structural analysis?	Unknown
	Is tower compliant with Rev G?	Unknown
Existing Tower Structure Registration	Do you have a tower registration number?	Yes
Existing Tower Structure Registration	ASR Number	1205149
Coordinates (NAD83)	Latitude (NAD83)	37° 41' 14.4" N-
	Longitude (NAD83)	122° 26' 05.3" W-
	Overall Structure Height	311.02 feet
	Support Structure Height	306.10 feet
	Ground Elevation Above Mean Sea Level (AMSL)	1255.89 feet
	Structure Type	LTOWER - Lattice Tower
	Tower Owner	American Towers, LLC.
	Date Constructed	03/02/2001

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
52887	KCNZ-CD	DTV
37511	KTSF	DTV

Primary Tower

Tower Modification Costs

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

Primary Tower

Tower Rigging Costs

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

Primary Tower

Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

Section	Question	Response
Outside Project Management Services	Do you require outside project management services?	Yes
	Number of Hours	180
	Explanation	Required by tower landlord
Outside RF consulting Engineering Services	Perform engineering study for new channel assignment and antenna development	Yes
	Prepare engineering section of Form FCC Construction Permit Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare engineering section of Form FCC License to Cover Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare request for Special Temporary Authority	Yes
	Quantity	1
	Do you have Distributed Transmission System engineering services?	N/A
	Critical Facility	N/A
	Terrain-Shielded Facility	N/A
Attorney and Other Outside Consulting Services	Prepare and file Form FCC Construction Permit Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare and file Form FCC License to Cover Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare request for Special Temporary Authority	Yes
	Quantity	1
	NEPA Section 106 environmental review	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	Yes
	Additional Field Engineering Service	No
	Number of Days	N/A
	Justification	N/A

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Information not provided.

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

Other Expenses

Other Expenses Not Listed

Name	Description
Dielectric Antenna New Channel	Cost of Dielectric Antenna New Channel for KDJT
GatesAir SS Transmitter	Cost of GatesAir SS Transmitter for KDJT
Installation	Cost of Installation for KDJT
Legal Fees	Legal Fees for KDJT
Project Management	Cost of Widelity project management for KDJT
Structural Analysis	Cost of Structural Analysis for KDJT
Tower Work Installation	Cost of Tower Work Installation for KDJT
Forklift Rental	Cost to rent forklift during repack equipment installation

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	$1,124,391.46	$866,205.96	N/A	$819,912.54	N/A
Total for all systems	$2,805,152.86	$2,973,170.69	N/A	$2,276,976.03	N/A
Primary Transmitter THU9-16 EVO	$1,124,391.46	$866,205.96		$819,912.54
Connection double pump	$1,753.46	$1,753.46	Please see Rohde & Schwarz Quote #292586-KKPX	$1,753.46	N/A
Removal of Existing Equipment	$25,000.00	$25,000.00	N/A	$22,620.28	N/A
Reconfigure existing transmitter for Interim Operation	$12,236.00	$12,236.00	Please see Rohde & Schwarz Quote #264381.0 Needed to remove 1 cabinet of old IOT transmitter to make space to install new transmitter, cost was to reconfigure the remaining cabinet to operate on pre-repack channel until change.	$12,236.00	N/A
Other Electrical Service: Electrical Installation for replacement transmitter	$96,289.00	$96,289.00	Please see McClure Electric Quote KKPX	$94,363.00	N/A
RF Interconnect	$21,863.00	$21,863.00	Please see Rohde & Schwarz Quote #294756.0.KKPX and #290665.1.KKPX	$21,173.74	N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW	$947,000.00	$689,814.50	Please see attached Rohde Quotes #113835.0 and #289480.0. Estimate includes estimated taxes.	$667,766.06	N/A
5 Ton system	$20,250.00	$19,250.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
Connection double pump	Component Description: Cost for connection double pump for internal pump unit. Supporting documentation is attached. This invoice has been paid. Amount: $1,753.46
Removal of Existing Equipment	Component Description: Cost for demolition and removal of old transmitter. Supporting documentation is attached. Amount: $17,731.28 Component Description: Cost to remove old HVAC to make room for new equipment. Supporting documentation is attached. This invoice has been paid. Amount: $4,889.00
Reconfigure existing transmitter for Interim Operation	Component Description: Cost to reconfigure existing transmitter for 1 cabinet operation. Supporting documentation is attached. Amount: $12,236.00
Other Electrical Service: Electrical Installation for replacement transmitter	Component Description: Progress Billing #2 for electrical work for transmitter install. Supporting documentation is attached. Amount: $36,589.00 Component Description: Progress Billing #1 for electrical work for transmitter install. Supporting documentation is attached. This invoice has been paid. Amount: $57,774.00
RF Interconnect	Component Description: Cost of additional equipment for installation. Supporting documentation is attached. This invoice has been paid. Amount: $471.96 Component Description: Cost of additional equipment needed for transmitter installation. Supporting documentation is attached. This invoice has been paid. Amount: $20,701.78
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW	Component Description: 30% "upon acceptance" and 35% "upon factory acceptance" payments for new transmitter. Supporting documentation is attached. This invoice has been paid. Amount: $383,358.00 Component Description: Final "upon proof of performance" and sales tax payment for new transmitter. Supporting documentation is attached. Amount: $255,478.28 Component Description: "Deposit" payment for new transmitter. Supporting documentation is attached. This invoice has been paid. Amount: $1,000.00 Component Description: Additional costs for new transmitter installation. Supporting documentation is attached. Amount: $27,929.78 Component Description: This invoice is being resubmitted in another cost per FCC instruction. Amount: N/A
5 Ton system	Information not provided.

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	$475,834.31	$313,599.83	N/A	$293,432.60	N/A
Total for all systems	$2,805,152.86	$2,973,170.69	N/A	$2,276,976.03	N/A
Interim Antenna TFU-8WB-R C160	$144,100.00	$112,004.31		$112,004.31
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed)	$9,570.00	$18,123.75	Please see attached Dielectric Quote #900071CMZ KKPX ION INTERIM and Dielectric Quote #1930492. Plus sales tax.	$18,123.75	N/A
UHF - Lower Power Side Mount, One station antenna - medium power (50-200 kW), horizontally polarized	$89,400.00	$49,080.56	Please see attached Dielectric Quote #900071CMZ KKPX ION INTERIM plus sales tax	$49,080.56	N/A
Interim Antenna Rent	$38,400.00	$38,400.00	Please see American Tower - KKPX Fully executed interim agreement	$38,400.00	N/A
Sweep test of existing antenna	$6,730.00	$6,400.00	N/A	$6,400.00	N/A
Primary Antenna TFU-20DSC/VP-R C170	$331,734.31	$201,595.52		$181,428.29
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized	$289,500.00	$146,913.94	Please see attached Dielectric Quote #700527CMZ-1 w Change Orders. V-Pol cost not included in reimbursement request. Plus sales tax.	$134,475.00	N/A
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)	$5,260.00	$5,000.00	N/A	N/A	N/A
Support Mounts	$17,944.31	$17,944.31	Please see attached Dielectric Quote #700527CMZ-1 w Change Orders. Plus sales tax.	$16,425.00	N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)	$12,300.00	$25,337.27	Please see attached Dielectric Quote #700527CMZ-1 w Change Orders and Dielectric Quote #1930967 and Dielectric Quote #1931117. Plus sales tax.	$24,128.29	N/A
Sweep test of existing antenna	$6,730.00	$6,400.00	N/A	$6,400.00	N/A

Components

Actual Information Description	File Name
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed)	Component Description: Sales tax for interim elbow complex. Supporting documentation and cover letter attached. Amount: $893.83 Component Description: Cost of additional equipment needed for interim elbow complex. Supporting documentation is attached. This invoice has been paid. Amount: $6,926.24 Component Description: Sales tax charges for additional equipment needed for interim elbow complex. Supporting documentation and cover letter attached. Amount: $640.68 Component Description: Cost of interim elbow complex. Supporting documentation is attached. This invoice has been paid. Amount: $9,663.00
UHF - Lower Power Side Mount, One station antenna - medium power (50-200 kW), horizontally polarized	Component Description: Sales tax for interim antenna. Supporting documentation and cover letter attached. Amount: $4,155.56 Component Description: Cost of interim antenna. Supporting documentation is attached. This invoice has been paid. Amount: $44,925.00
Interim Antenna Rent	Component Description: ATC one-time tower rental during market repack period for interim antenna. Supporting documentation and cover letter regarding payment is attached. This one-time payment has been paid. Amount: $38,400.00
Sweep test of existing antenna	Component Description: Cost of sweep for interim operations. Supporting documentation is attached. This invoice has been paid. Amount: $6,400.00
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized	Component Description: 10% "balance upon sweep" payment for main antenna. Explanation of variance and supporting documentation is attached. This invoice has been paid. Amount: $13,447.50 Component Description: 25% "with order" payment for main antenna. Explanation of variance and supporting documentation is attached. Amount: $33,618.75 Component Description: 65% "prior to ship" payment for main antenna. Explanation of variance and supporting documentation is attached. Amount: $87,408.75 Component Description: Sales tax for main antenna. Supporting documentation, cover letter, and explanation of variance attached. Amount: $12,438.94
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)	Information not provided.
Support Mounts	Component Description: 10% "balance upon sweep" payment for support mounts. Explanation of variance and supporting documentation is attached. This invoice has been paid. Amount: $1,642.50 Component Description: 65% "prior to ship" payment for support mounts. Explanation of variance and supporting documentation is attached. Amount: $10,676.25 Component Description: 25% "with order" payment for support mounts. Explanation of variance and supporting documentation is attached. Amount: $4,106.25 Component Description: Sales tax for antenna mounts. Supporting documentation, cover letter, and explanation of variance attached. Amount: $1,519.31
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)	Component Description: 10% "balance upon sweep" payment for input and elbow complex. Explanation of variance and supporting documentation is attached. This invoice has been paid. Amount: $1,307.00 Component Description: 25% "with order" payment for input and elbow complex. Explanation of variance and supporting documentation is attached. Amount: $3,267.50 Component Description: 65% "prior to ship" payment for input and elbow complex. Explanation of variance and supporting documentation is attached. Amount: $8,495.50 Component Description: Sales tax for main elbow complex. Supporting documentation, cover letter, and explanation of variance attached. Amount: $1,208.98 Component Description: Sales tax charges for additional equipment needed for main elbow complex. Supporting documentation and cover letter attached. Amount: $312.10 Component Description: Sales tax charges for additional equipment needed for main elbow complex. Supporting documentation and cover letter attached. Amount: $624.19 Component Description: Cost of additional equipment needed for elbow complex. Supporting documentation is attached. This invoice has been paid. Amount: $6,748.00 Component Description: Cost of additional equipment for elbow complex. Supporting documentation is attached. This invoice has been paid. Amount: $3,374.00
Sweep test of existing antenna	Component Description: 10% "after repack sweep" payment for repack sweep. Supporting documentation is attached. This invoice has been paid. Amount: $640.00 Component Description: 25% "with order" payment for repack sweep. Explanation of variance and supporting documentation is attached. Amount: $1,600.00 Component Description: 65% "prior to ship" payment for repack sweep. Explanation of variance and supporting documentation is attached. Amount: $4,160.00

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	$77,100.00	$85,786.73	N/A	$78,871.19	N/A
Total for all systems	$2,805,152.86	$2,973,170.69	N/A	$2,276,976.03	N/A
Primary Transmission Line	$77,100.00	$85,786.73		$78,871.19
Rigid Transmission Line - copper, 6 1/8"	$70,700.00	$79,386.73	Please see attached Dielectric Quote #700527CMZ-1 w Change Orders and Dielectric Quote #1930967. Plus sales tax.	$78,871.19	N/A
Sweep existing transmission line	$6,400.00	$6,400.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
Rigid Transmission Line - copper, 6 1/8"	Component Description: Sales tax charges main transmission line. Supporting documentation and cover letter attached. Amount: $5,750.19 Component Description: 25% "with order" payment for transmission line. Explanation of variance and supporting documentation is attached. Amount: $16,829.93 Component Description: 65% "prior to ship" payment for transmission line. Explanation of variance and supporting documentation is attached. Amount: $43,757.81 Component Description: Sales tax charges for additional pieces of transmission line. Supporting documentation and cover letter attached. Amount: $534.84 Component Description: 10% "balance" payment for transmission line. Explanation of variance and supporting documentation is attached. Amount: $6,216.42 Component Description: Cost of additional cut pieces of transmission line. Supporting documentation is attached. This invoice has been paid. Amount: $5,782.00
Sweep existing transmission line	Information not provided.

Actual Information Description

File Name

Rigid Transmission Line - copper, 6 1/8"

Component Description:: Sales tax charges main transmission line. Supporting documentation and cover letter attached.
Amount:: $5,750.19

Component Description:: 25% "with order" payment for transmission line. Explanation of variance and supporting documentation is attached.
Amount:: $16,829.93

Component Description:: 65% "prior to ship" payment for transmission line. Explanation of variance and supporting documentation is attached.
Amount:: $43,757.81

Component Description:: Sales tax charges for additional pieces of transmission line. Supporting documentation and cover letter attached.
Amount:: $534.84

Component Description:: 10% "balance" payment for transmission line. Explanation of variance and supporting documentation is attached.
Amount:: $6,216.42

Component Description:: Cost of additional cut pieces of transmission line. Supporting documentation is attached. This invoice has been paid.
Amount:: $5,782.00

Sweep existing transmission line

Information not provided.

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	$531,500.00	$948,874.48	N/A	$548,874.48	N/A
Total for all systems	$2,805,152.86	$2,973,170.69	N/A	$2,276,976.03	N/A
Primary Tower LTOWER	$531,500.00	$948,874.48		$548,874.48
Short Tower (less than 500')	$84,200.00	$522,054.48	PR Tower Quote #19-082 ION and P&R Tower KKPX Change Order Package	$522,054.48	N/A
Major tower reinforcement/modifications	$421,000.00	$400,000.00	See AT Exhibits for more information.	$0.00	N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study	$26,300.00	$26,820.00	Please see attached American Tower Corp Quote #12944345	$26,820.00	N/A

Components

Actual Information Description	File Name
Short Tower (less than 500')	Component Description: 50% "down payment" for tower services. Supporting documentation is attached. This invoice has been paid. Amount: $241,776.50 Component Description: Balance payment for tower services and change order package. Supporting documentation is attached. Amount: $91,692.31 Component Description: Progress payment for tower services. Supporting documentation is attached. Amount: $188,585.67
Major tower reinforcement/modifications	Information not provided.
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study	Component Description: Cost of tower structural study. Supporting documentation is attached. This invoice has been paid. Amount: $10,475.00 Component Description: Cost of tower mapping. Supporting documentation is attached. This invoice has been paid. Amount: $16,345.00

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	$189,650.00	$357,091.60	N/A	$216,573.60	N/A
Total for all systems	$2,805,152.86	$2,973,170.69	N/A	$2,276,976.03	N/A
Outside Professional Services	$189,650.00	$357,091.60		$216,573.60
RF Exposure Measurements	$21,050.00	$20,000.00	N/A	N/A	N/A
Comprehensive coverage verification via field study, if needed	$84,200.00	$80,000.00	N/A	N/A	N/A
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	$3,680.00	$8,885.70	See attached Cooley #501527-147 (Revised).	$8,885.70	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	$19,104.75	See attached Cooley #501527-147 (Revised).	$19,104.75	N/A
Prepare request for Special Temporary Authorization	$2,050.00	$1,500.00	N/A	N/A	N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	$1,580.00	$1,500.00	N/A	N/A	N/A
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	N/A	N/A
Address transition timing and coordination issues w/ other stations and wireless	$2,630.00	$167,996.55	See attached Cooley #501527-147 (Revised) and du Treil invoices already forwarded for payment.	$167,996.55	N/A
Prepare and or review reimbursement form	$2,630.00	$3,324.60	See attached Cooley invoice.	$3,324.60	N/A
Project management of the transition	$28,440.00	$18,530.00	Please see American Tower Corp Quote #12944345	$17,262.00	N/A

Components

Actual Information Description	File Name
RF Exposure Measurements	Information not provided.
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	Component Description: Revised attorney fees for services rendered preparing request for Special Temporary Authorization Unable to Construct Waiver Request. Supporting documentation attached. This invoice has been paid. Amount: $8,885.70
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: Revised attorney fees for services rendered preparing and filing FCC Form 2100, Construction Permit Application. Supporting documentation attached. This invoice has been paid. Amount: $19,104.75
Prepare request for Special Temporary Authorization	Information not provided.
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	Information not provided.
Address transition timing and coordination issues w/ other stations and wireless	Component Description: RF Consulting Engineering to determine correct mask filter to avoid interference for Channel 14 reassignment; Including channel search for alternate UHF channel options. Hourly supporting documentation attached. This invoice has been paid. Amount: $5,062.50 Component Description: RF Consulting Engineering to determine correct mask filter to avoid interference for Channel 14 reassignment for assumed Mt. Sutro transmitter site location. Hourly supporting documentation attached. This invoice has been paid. Amount: $500.00 Component Description: RF Consulting Engineering to determine correct mask filter to avoid interference for Channel 14 reassignment; Including channel search for alternate UHF channel options. Hourly supporting documentation attached. This invoice has been paid. Amount: $1,750.00 Component Description: RF Consulting Engineering to determine correct mask filter to avoid interference for Channel 14 reassignment; Including channel search for alternate UHF channel options. Hourly supporting documentation attached. This invoice has been paid. Amount: $7,625.00 Component Description: RF Consulting Engineering to determine correct mask filter to avoid interference for Channel 14 reassignment; Including channel search for alternate UHF channel options. Hourly supporting documentation attached. This invoice has been paid. Amount: $9,500.00 Component Description: Revised attorney fees for services rendered solving the Channel 14 interference issues, including agreements with licensees and relocation of stations. Supporting documentation attached. This invoice has been paid. Amount: $138,559.05 Component Description: RF Consulting Engineering to determine correct mask filter to avoid interference for Channel 14 reassignment for assumed Mt. Sutro transmitter site location. Hourly supporting documentation attached. This invoice has been paid. Amount: $5,000.00
Prepare and or review reimbursement form	Component Description: Revised attorney fees for services rendered preparing, reviewing and revising the Reimbursement Form (FCC Form 2100 Schedule 399). Supporting documentation attached. This invoice has been paid. Amount: $3,324.60
Project management of the transition	Component Description: Cost of landlord site coordination and transition planning. Supporting documentation is attached. This invoice has been paid. Amount: $5,000.00 Component Description: Cost of project management charged by landlord. Supporting documentation is attached. This invoice has been paid. Amount: $9,480.00 Component Description: Cost of project management coordinating transmitter installation. Supporting documentation is attached. Amount: $2,782.00

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	$406,677.09	$401,612.09	N/A	$319,311.62	N/A
Total for all systems	$2,805,152.86	$2,973,170.69	N/A	$2,276,976.03	N/A
Other Expenses	$406,677.09	$401,612.09		$319,311.62
Forklift Rental	$11,729.50	$11,729.50	Please see attached invoices from A-1 Rentals	$11,729.50	N/A
Tower Work Installation	$87,870.83	$87,870.83	Per attached KDJT Channel Change Budget. Please see attached KKPX's "Request for Waiver of Repack Reimbursement Restriction".	$87,870.83	N/A
Structural Analysis	$12,500.00	$12,500.00	Per attached KDJT Channel Change Budget. Please see attached KKPX's "Request for Waiver of Repack Reimbursement Restriction".	$12,500.00	N/A
Project Management	$8,750.10	$8,750.10	Per attached KDJT Channel Change Budget. Please see attached KKPX's "Request for Waiver of Repack Reimbursement Restriction".	$8,750.10	N/A
Legal Fees	$8,560.00	$8,560.00	Per attached KDJT Channel Change Budget. Please see attached KKPX's "Request for Waiver of Repack Reimbursement Restriction".	$8,560.00	N/A
Installation	$585.00	$585.00	Per attached KDJT Channel Change Budget. Please see attached KKPX's "Request for Waiver of Repack Reimbursement Restriction".	$585.00	N/A
GatesAir SS Transmitter	$80,359.75	$80,359.75	Per attached KDJT Channel Change Budget. Please see attached KKPX's "Request for Waiver of Repack Reimbursement Restriction".	$80,359.75	N/A
Dielectric Antenna New Channel	$39,053.99	$39,053.99	Per attached KDJT Channel Change Budget. Please see attached KKPX's "Request for Waiver of Repack Reimbursement Restriction".	$39,053.99	N/A
MVPD Notification of Channel Change	$2,500.00	$2,500.00	N/A	N/A	N/A
Develop and air announcement of upcoming channel change	$0.00	$0.00	The amount is yet to be determined (TBD) and ION will submit on-air announcement costs when finalized.	N/A	N/A
Equipment Storage	$13,180.82	$13,180.82	This is what vendors have charged KKPX to store equipment needed for repack	$13,180.82	N/A
Equipment Delivery and Handling Charges	$49,507.10	$49,507.10	This is what KKPX has been charged by vendors to deliver equipment needed for repack.	$49,507.10	N/A
Disposal Costs (for equipment and other waste, net of any salvage value)	$15,000.00	$15,000.00	N/A	N/A	N/A
BLM or NFS Coordination	$25,000.00	$25,000.00	N/A	N/A	N/A
Non-zoning permits	$15,000.00	$15,000.00	N/A	$7,214.53	N/A
Local Zoning	$25,000.00	$25,000.00	N/A	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	$6,500.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
Forklift Rental	Component Description: 1st and 2nd months payment for forklift rental. Supporting documentation and cover letters are attached. This invoice has been paid. Amount: $8,360.00 Component Description: Balance payment for forklift rental. Supporting documentation and cover letters are attached. This invoice has been paid. Amount: $3,369.50
Tower Work Installation	Component Description: Cost of tower services for KDJT channel change. Supporting documentation and explanation of variance is attached. This invoice has been paid. Amount: $87,870.83
Structural Analysis	Component Description: Cost of structural analysis for KDJT channel change. Supporting documentation and explanation of variance is attached. This invoice has been paid. Amount: $12,500.00
Project Management	Component Description: Cost of project management for KDJT channel change. Supporting documentation and explanation of variance is attached. This invoice has been paid. Amount: $8,750.10
Legal Fees	Component Description: Cost of legal fees for KDJT channel change. Supporting documentation and explanation of variance is attached. This invoice has been paid. Amount: $8,560.00
Installation	Component Description: Cost of electric work for KDJT transmitter installation. Supporting documentation and explanation of variance is attached. This invoice has been paid. Amount: $585.00
GatesAir SS Transmitter	Component Description: Cost of new transmitter for KDJT channel change. Supporting documentation and explanation of variance is attached. This invoice has been paid. Amount: $80,359.75
Dielectric Antenna New Channel	Component Description: Cost of new Dieletric equipment for KDJT channel change. Supporting documentation and explanation of variance is attached. This invoice has been paid. Amount: $39,053.99
MVPD Notification of Channel Change	Information not provided.
Develop and air announcement of upcoming channel change	Information not provided.
Equipment Storage	Component Description: Cost for storage of transmitter equipment before installation. Supporting documentation is attached. Amount: $10,438.84 Component Description: First month's bill for one storage container rental during repack. Supporting documentation is attached. This invoice has been paid. Amount: $1,119.05 Component Description: Cost of one month rental for storage container during repack. Supporting documentation is attached. This invoice has been paid. Amount: $167.96 Component Description: First month's bill for second storage container rental during repack. Supporting documentation is attached. This invoice has been paid. Amount: $1,119.05 Component Description: Cost of one month rental for storage container during repack. Supporting documentation is attached. This invoice has been paid. Amount: $167.96 Component Description: Cost of one month rental for storage container during repack. Supporting documentation is attached. This invoice has been paid. Amount: $167.96
Equipment Delivery and Handling Charges	Component Description: Cost of freight for additional equipment in interim elbow complex. Supporting documentation is attached. This invoice has been paid. Amount: $1,147.50 Component Description: Cost of freight for main antenna package. Supporting documentation is attached. This invoice has been paid. Amount: $16,530.00 Component Description: Cost of freight for interim antenna package. Supporting documentation is attached. This invoice has been paid. Amount: $4,852.50 Component Description: Cost for last mile transport and offloading of transmitter equipment. Supporting documentation is attached. Amount: $26,977.10
Disposal Costs (for equipment and other waste, net of any salvage value)	Information not provided.
BLM or NFS Coordination	Information not provided.
Non-zoning permits	Component Description: Cost of permit review fee from local jurisdiction. Supporting documentation is attached. This invoice has been paid. Amount: $1,514.53 Component Description: Cost of permit drawings, preparation, and submission of forms for permits. Supporting documentation is attached. This invoice has been paid. Amount: $5,700.00
Local Zoning	Information not provided.
FCC Filing Fees - Special Temporary Authorization request	Information not provided.
FCC Filing Fees - Form 2100 license to cover application	Information not provided.
DTV Medical Facility Notification	Information not provided.

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$2,805,152.86	$2,973,170.69	$2,276,976.03

Reimbursement Status

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

Certification

Section	Question	Response
Submission of Estimated Expenses Statements	WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.
The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD). The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund. The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.	Mario Vasquez Vice President - Finance, Operations 06/03/2020

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.

Mario Vasquez

Vice President - Finance, Operations

06/03/2020

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.	Mario Vasquez Vice President - Finance, Operations 06/03/2020

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.

Mario Vasquez

Vice President - Finance, Operations

06/03/2020

(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

Antennas

Primary Antenna

Existing Antenna Information

Primary Antenna

New Antenna Costs

Primary Antenna

Other Antenna Costs

Primary Antenna

Other Antenna Cost Not Listed

Interim Antenna

New Antenna Costs

Interim Antenna

Other Antenna Costs

Interim Antenna

Other Antenna Cost Not Listed

Transmission Line

Primary Transmission Line

Existing Transmission Line

Primary Transmission Line

New Transmission Line

Primary 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

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

Cost Information

Other Expenses

Components