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:
25932
Service:
DTV
Call Sign:
WHRO-TV
Channel:
31 (UHF)
File Number:
0000027736
FRN:
0002062511
Date Submitted:
09/21/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

Hampton Roads Educational Telecommunications Association, Inc.

Chris G. Gunnufsen

5200 HAMPTON BOULEVARD

NORFOLK, VA 23508

United States

+1 (757) 889-9394 chris.gunnufsen@whro.org Not-for-Profit

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

The Preparer is same as the reimbursement contact.

 

 

 

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. Yes
Briefly describe transition plan The transition plan is being handled by the Owner of the Tower, American Tower Corporation. The tower is complicated due to the total number of broadcasters collocated on the tower. There will be a Wide Band interim antenna side mounted on the tower 987'

Transmitters

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

Primary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model DCX Millenium
Year 2001
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 60 kW

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model HPTV PRLX-U36
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 58 kW
Justification for New Transmitter The Channels are to Far apart for Re-tuning. Channel 16 Pre and Channel 31 post Repacking. This has been verified with Hitachi Comark LLC. Manufacturer of the existing channel 16 antenna. The IOT Transmitters has been replaced by the Parallax SS

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) Yes
Transformer (480V) Yes
Power 500 kVA
Rigid Conduit and Wiring Yes
Size 4 inches
Length 300.0 feet
Other Electrical Service Yes
Description Installation of Transmitter Electrical systems
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 15 tons
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? Yes
Size 4500.0 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

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Other Transmitter Cost Not Listed

Information not provided.

Antennas

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

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Lease 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 Bottom
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-24GBH-R 08SP
Year 2000

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Lease New
Is this a request for upgraded equipment? Yes
Ownership Leased
Owner American Tower LLC
Is antenna shared? Yes
Is antenna directional? No
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 Broadband Panel
Number of Stations Supported 4
Number of Panels/Bays 70
Lower Limit 470.00 MHz
Upper Limit 700.00 MHz
Design power capacity in use 41.0 %
Other Antenna Type N/A
ERP: 1950.0 kW
Manufacturer
Model PEP70E-05-2-T
Year 2019
Justification for New Antenna Combining Stations to reduce load and Total FCC Costs

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? Yes
Type New
Number of channels supported 4
Frequencies of channels supported RF channel
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? Yes
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Broadband
Feed Line Size 8 3/16 inches inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna?
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Enter a list of RF channel numbers.

RF Channel Number
20
16
31
33

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Combiner Installation

ATC Estimated Costs for line item 3-C-2

Interim Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
Ownership Leased
Owner American Tower Corp
Is antenna shared? Yes
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 Elliptical
Type Broadband Slot
Number of Stations Supported 5
Number of Panels/Bays 24
Lower Limit 482.00 MHz
Upper Limit 590.00 MHz
Design power capacity in use 75.0 %
Other Antenna Type N/A
ERP: 60.0 kW
Manufacturer
Model SBBEP-24C160
Year 2018
Justification for New Antenna Complex antenna structure with multiple stations trying to remain on the air during the transition to new channels. See American Tower Plan.

Interim Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? Yes
Type New
Number of channels supported 5
Frequencies of channels supported RF channel
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? Yes
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? B
Feed Line Size 7 3/16 inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for an antenna? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Enter a list of RF channel numbers.

RF Channel Number
16
20
31
32
33

Interim Antenna

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Other Antenna Cost Not Listed

Name Description

Interim Tower Rental

One time tower rental during repack line item 1-B-1

Transmission Line

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

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Lease New
Use Primary (Main)
Description of Use N/A
Ownership Leased
Owner American Tower LLC
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 1307 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Lease New
Is this a request for upgraded equipment? No
Type Rigid
Diameter 8 3/16 inches
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 2
Length 1350 feet per run
Justification for New Transmission Line Part of a shared Broadband antenna system

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Combiner system

Combiner system for shared Broadband antenna

Interim Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Interim
Description of Use N/A
Change Type Purchase New
Type Rigid
Diameter 8 3/16 inches
Segment Length Broadband
Other Segment Length
Number of parallel runs 1
Length 1100 feet per run
Justification for New Transmission Line Single run Dielectric 8-3/16" Digitline with 950 ft vertical plus 150 ft. run equals 1100 ft. total; Includes nitrogen generator plus 200' of vertical run to get to the combiner network in ATC owned building located in the compound total WHRO 1300

Interim Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Transmission line interim

200 Ft of 6 1/8 " line to connect to the Wibeband Interim antenna located in the ATC building approx 200 ft away.

Elbows

3 Elbows are needed to connect a new sections of 6 1/8' line to the interim broadband antenna located in American Tower owned building.

Tower Equipment And Rigging Costs

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

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? Candelabra
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users No
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1057874
Coordinates (NAD83) Latitude (NAD83) 36° 48' 31.8" N-
Longitude (NAD83) 076° 30' 11.3" W-
Overall Structure Height 1258.84 feet
Support Structure Height 1254.91 feet
Ground Elevation Above Mean Sea Level (AMSL) 22.97 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner American Towers, LLC
Date Constructed 02/03/2006

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
82574 WTPC-TV DTV
47401 WTKR DTV
67077 WPXV-TV DTV
9762 WGNT DTV
25940 WHRO-FM FM
40759 WTVZ-TV DTV
25932 WHRO-TV DTV
25933 WHRV FM

Primary Tower

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Tower Modification Costs

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

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Tower Permit Drawing Package

Tower Permit Drawing Package

Tower Construction Project Management

Tower Construction Project Management

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 770
Explanation This is for the project management costs associated with American Tower Corporation. This is a very complicated site and will require Project management from all Broadcasters collocated on the tower. Est is based on Previous conversion to digital in 2001
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

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Other Professional Services Expenses Not Listed

Name Description

Migratory Bird Assessment

Tower located in a migratory Bird Path

RF System Test

Testing of the combiner to ensure all one (1) frequencies are tuned for optimal patterns.

Site Coordination Meeting

Site coordination meetings with all broadcasters, contractors and vendors involved with the site deliveries and construction. This cost is for travel and logistics expenses accrued.

Ground and Building Drawing Package

Ground & Building A&E Permit Drawing Package

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning 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

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Other Expenses Not Listed

Name Description

Comark System Design and Site Survey

Cost associated with Hitachi Comark to do a site visit and design for the Transmitter installation

ATC One Time Tower Rental

ATC have 3 repack customers, one non repacked customer and one new customer on the Norfolk TT. The interim Main side mount antenna will allow the broadcasters to minimize their OTA disruption, maintain their coverage contour, complete in safe manner

Grading Road

The Gravel Road Will be destroyed during the repacking andwill require several Gradings during the process due to the complexity of the site and total number of broadcasters impacted

Public Hearing

Cost associated with Public hearings that might be required due to the repacking process and proximity of houses located around the tower

Site Security

Site Security Company during construction for theft prevention and vandalism

Special Insurance Rider

Special insurance rider will need to be purchased by WHRO for the Homes located within 1000' ft of the tower. WHRO owns all of the property surrounding the tower America Tower Leases only a small portion of the ground space, Anchor point Base and Buildin

Cost Information

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Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $2,212,700.00 $2,638,621.00 N/A $0.00 N/A
Total for all systems $6,635,411.53 $4,403,186.86 N/A $803,242.66 N/A
Primary Transmitter HPTV PRLX-U36 $2,212,700.00 $2,638,621.00 $0.00
Transformer 3 phase/480v - 500 KVA $48,400.00 $276,401.00 This is to replace the existing 3 wire 600 KVA Clean source UPS with a 4 wire 500KVA Clean Source UPS from Pillar Formerly Active Power $0.00 The Existing 3 wire 600 Kva UPS from Active power is not compatible with any solid state transmitter. The replacement is a 4 wire 500 kva UPS from Active power a division of Pillar power systems.
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A $0.00 N/A
4" Rigid Conduit and Wiring (Cost per foot) $30,300.00 $28,800.00 After Digital conversion in 2009 all conduits and switch gear was removed that connected to the analog transmitter. $0.00 N/A
Other -- Building Addition Size: 4500.0 $52,000.00 $52,000.00 Walls have to be removed to install the new transmitter. This includes removing a mezzanine to mount and install the magic Tee and Mask filter. $0.00 N/A
UHF - Liquid Cooled Solid State Transmitter 52 - 61 kW $1,788,000.00 $1,992,120.00 Includes 342,120 dollars for the RFS 6 pole filter and switches to change from the interim antenna to the main antenna $0.00 N/A
15 Ton system $55,800.00 $53,000.00 The new transmitter, CIF and Magic Tee will need to be located in a room that does not have AC at this time. A new AC will be needed to keep the CIF, magic tee, Combiner and temperature from Overheating and drifting in power. N/A N/A
Other Electrical Service: Installation of Transmitter Electrical systems $200,000.00 $200,000.00 N/A $0.00 N/A

Components

Actual Information Description File Name
Transformer 3 phase/480v - 500 KVA

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A
Switchgear - industrial 800 amp Information not provided.
4" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Other -- Building Addition Size: 4500.0 Information not provided.
UHF - Liquid Cooled Solid State Transmitter 52 - 61 kW

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A
15 Ton system Information not provided.
Other Electrical Service: Installation of Transmitter Electrical systems Information not provided.

Cost Information

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Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $1,713,743.33 $658,649.66 N/A $347,562.48 N/A
Total for all systems $6,635,411.53 $4,403,186.86 N/A $803,242.66 N/A
Interim Antenna SBBEP-24C160 $374,530.00 $236,766.33 $130,449.99
Interim Tower Rental $57,600.00 $57,600.00 Interim antenna Tower rental during repack $43,200.00 N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $8,500.00 Shared cost with Other Broadcasters being repacked See WHRO IM Norfolk Tall Tower 10152 Repack Cost Estimates $0.00 N/A
Elbow complex, broadband, at antenna input, per 7 3/16. feedline (if needed) $16,850.00 $4,000.00 Please see WHRO American Towers Customer Project Cost Estimation $3,000.00 N/A
Combiner output splitting/switching for dual feed lines, if applicable $126,000.00 $50,000.00 Shared Costs See American Tower document: WHRO IM Norfolk Tall Tower 10152 Repack Cost Estimates plus 10,000.00 as shared installation Costs line item 3-C-2 $0.00 25 percent payment on combiners
New combiner, cost per channel (without antenna) $84,200.00 $48,333.00 Shared Costs with other Broadcasters being repacked see American Tower Project Costs Estimate. Microsoft Excel Document WHRO IM Norfolk Tall Tower 10152 Repack Cost Estimates $33,000.00 Combiner 25 % payment
Sweep test of existing antenna $6,730.00 $8,333.33 Shared expense with Other Broadcasters Being repacked See American Tower Document: WHRO IM Norfolk Tall Tower 10152 Repack Cost Estimates $6,249.99 25 percent payment for sweep tests
UHF - High Power, Side Mount, basic slot antenna, 24 bay,, 60 - 65 kW input, directional,, elliptically or circularly polarized $60,000.00 $60,000.00 the original number of 235,000 has been reduced to 60,000 due to the number of Broadcasters using the Broadband antenna. See American Tower Project Costs Est. Microsoft Excel Document: WHRO IM Norfolk Tall Tower 10152 Repack Cost Estimates $45,000.00 N/A
Primary Antenna PEP70E-05-2-T $1,339,213.33 $421,883.33 $217,112.49
New combiner, cost per channel (without antenna) $84,200.00 $66,000.00 N/A $49,500.00 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Combiner output splitting/switching for dual feed lines, if applicable $126,000.00 $126,000.00 N/A $0.00 N/A
Elbow complex, broadband, at antenna input, per 8 3/16. feedline (if needed) $18,950.00 $12,000.00 N/A $9,000.00 N/A
Combiner Installation $13,333.33 $13,333.33 Per station combiner installation costs $9,999.99 N/A
UHF - High Power Top Mount (200-1000 kW), Four Station broadband panel antenna, elliptically or circularly polarized $1,090,000.00 $198,150.00 This is the per cost per station with 4 station total using the BBA $148,612.50 N/A

Components

Actual Information Description File Name
Interim Tower Rental

Component Description:
23. WHRO-TV-280-Interim Antenna - Interim Tower Rental
Amount:
$28,800.00

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
23. WHRO-TV-280-Interim Antenna - Interim Tower Rental
Amount:
$14,400.00
Side mount brackets for high power antennas (if not included in antenna base cost) Information not provided.
Elbow complex, broadband, at antenna input, per 7 3/16. feedline (if needed)

Component Description:
3. WHRO-TV-280-Interim Antenna - 7 3/16" Broadband Elbow Complex
Amount:
$1,000.00

Component Description:
3. WHRO-TV-280-Interim Antenna - 7 3/16" Broadband Elbow Complex
Amount:
$2,000.00
Combiner output splitting/switching for dual feed lines, if applicable Information not provided.
New combiner, cost per channel (without antenna)

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
21. WHRO-TV-280-Interim Antenna - New Combiner
Amount:
$11,000.00

Component Description:
21. WHRO-TV-280-Interim Antenna - New Combiner
Amount:
$22,000.00

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A
Sweep test of existing antenna

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
22. WHRO-TV-280-Interim Antenna - Sweep Test
Amount:
$4,166.66

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
22. WHRO-TV-280-Interim Antenna - Sweep Test
Amount:
$2,083.33
UHF - High Power, Side Mount, basic slot antenna, 24 bay,, 60 - 65 kW input, directional,, elliptically or circularly polarized

Component Description:
20. WHRO-TV-280-Interim Antenna - UHF High Power Side Mount, Directional, E-POL
Amount:
$15,000.00

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
20. WHRO-TV-280-Interim Antenna-UHF High Power Side Mount, Directional, E-POL
Amount:
$30,000.00

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A
New combiner, cost per channel (without antenna)

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
1. WHRO-TV-210-Primary Antenna - New Combiner
Amount:
$16,500.00

Component Description:
1. WHRO-TV-210-Primary Antenna - New Combiner
Amount:
$33,000.00

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A
Sweep test of existing antenna Information not provided.
Combiner output splitting/switching for dual feed lines, if applicable Information not provided.
Elbow complex, broadband, at antenna input, per 8 3/16. feedline (if needed)

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
4. WHRO-TV-210-Primary Antenna - 8 3/16" Broadband Elbow Complex
Amount:
$3,000.00

Component Description:
4. WHRO-TV-210-Primary Antenna - 8 3/16" Broadband Elbow Complex
Amount:
$6,000.00

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A
Combiner Installation

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
2. WHRO-TV-210-Primary Antenna - Combiner Installation
Amount:
$3,333.33

Component Description:
2. WHRO-TV-210-Primary Antenna - Combiner Installation
Amount:
$6,666.66

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A
UHF - High Power Top Mount (200-1000 kW), Four Station broadband panel antenna, elliptically or circularly polarized

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
CAPITAL CONTRIBUTION - NORFOLK TALL TOWER
Amount:
$99,075.00

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
CAPITAL CONTRIBUTION - NORFOLK TALL TOWER
Amount:
$49,537.50

Cost Information

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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 $1,624,530.70 $421,768.70 N/A $232,939.75 N/A
Total for all systems $6,635,411.53 $4,403,186.86 N/A $803,242.66 N/A
Interim Transmission Line $503,230.70 $157,097.70 $67,436.50
Rigid Transmission Line - copper, 8 3/16" broadband $438,900.00 $92,767.00 The remaining costs are covered by other broadcasters collocated on the same tower that will be repacked Per American Tower Document WHRO IM Norfolk Tall Tower 10152 Repack Cost Estimates $66,000.00 N/A
Elbows $28,730.70 $28,730.70 Elbows to connect the vertical run to the interim antenna 3 Total @ 1930.00 each per Dielectric Quote $1,436.50 Includes additional items not in the original quote
Transmission line interim $35,600.00 $35,600.00 200 Ft of 6 1/8" line to connect to the interim antenna per American Tower Document WHRO IM Norfolk Tall Tower 10152 Repack Cost Estimates $0.00 N/A
Primary Transmission Line $1,121,300.00 $264,671.00 $165,503.25
Combiner system $44,000.00 $44,000.00 N/A $0.00 N/A
Rigid Transmission Line - copper, 8 3/16" broadband $1,077,300.00 $220,671.00 N/A $165,503.25 N/A

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 8 3/16" broadband

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
24. WHRO-TV-380-Interim Transmission Line - 8 3/16" Broadband Rigid Copper
Amount:
$44,000.00

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
24. WHRO-TV-380-Interim Transmission Line - 8 3/16"" Broadband Rigid Copper
Amount:
$22,000.00

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A
Elbows

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
item 1 R0004542501 field Flange 5 at 287.30
Amount:
$1,436.50
Transmission line interim

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A
Combiner system Information not provided.
Rigid Transmission Line - copper, 8 3/16" broadband

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
5. WHRO-TV-310-Primary Transmission Line - 8 3/16" Broadband Rigid Copper
Amount:
$110,335.50

Component Description:
5. WHRO-TV-310-Primary Transmission Line - 8 3/16" Broadband Rigid Copper
Amount:
$55,167.75

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Cost Information

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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 $610,887.50 $281,887.50 N/A $175,878.24 N/A
Total for all systems $6,635,411.53 $4,403,186.86 N/A $803,242.66 N/A
Primary Tower GTOWER $610,887.50 $281,887.50 $175,878.24
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $200,000.00 Shared cost of the broadcasters that are going to be repacked per American Tower Document WHRO IM Norfolk Tall Tower 10152 Repack Cost Estimates $121,250.12 N/A
Tower Permit Drawing Package $4,700.00 $4,700.00 Please see American Towers Customer Project Cost Estimation $3,525.00 N/A
Minor tower reinforcement/modifications $158,000.00 $50,000.00 Shared cost with Other Broadcasters that are being repacked per ATC document WHRO IM Norfolk Tall Tower 10152 Repack Cost Estimates $37,500.00 N/A
Tower Construction Project Management $7,187.50 $7,187.50 Please see American Towers Customer Project Cost Estimation $5,390.62 N/A
Structural engineering tower load study for a documented tower with candelabra $20,000.00 $20,000.00 Part of the total tower rebuild with 4 other broadcasters American Tower Document WHRO IM Norfolk Tall Tower 10152 Repack Cost Estimates $8,212.50 this included structural and tower mapping for structural

Components

Actual Information Description File Name
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)

Component Description:
8. WHRO-TV-410-Existing Primary Tower - Tower Rigging, Complex Tower
Amount:
$80,833.42

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
8. WHRO-TV-410-Existing Primary Tower - Tower Rigging, Complex Tower
Amount:
$40,416.70
Tower Permit Drawing Package

Component Description:
9. WHRO-TV-410-Existing Primary Tower - Tower Permit Drawing Package
Amount:
$2,350.00

Component Description:
9. WHRO-TV-410-Existing Primary Tower - Tower Permit Drawing Package
Amount:
$1,175.00
Minor tower reinforcement/modifications

Component Description:
7. WHRO-TV-410-Existing Primary Tower - Minor Reinforcement/Modifications
Amount:
$25,000.00

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
7. WHRO-TV-410-Existing Primary Tower - Minor Reinforcement/Modifications
Amount:
$12,500.00
Tower Construction Project Management

Component Description:
11. WHRO-TV-410-Existing Primary Tower-Tower Construction Project Management
Amount:
$3,593.75

Component Description:
11. WHRO-TV-410-Existing Primary Tower - Tower Construction Project Management
Amount:
$1,796.87
Structural engineering tower load study for a documented tower with candelabra

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
6. WHRO-TV-410-Existing Primary Tower - Tower Load Study for Documented Tower with Candelabra
Amount:
$5,475.00

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
6. WHRO-TV-410-Existing Primary Tower - Tower Load Study for Documented Tower with Candelabra
Amount:
$2,737.50

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $300,620.00 $229,895.00 N/A $25,957.84 N/A
Total for all systems $6,635,411.53 $4,403,186.86 N/A $803,242.66 N/A
Outside Professional Services $300,620.00 $229,895.00 $25,957.84
Ground and Building Drawing Package $11,000.00 $11,000.00 Cost to Generate the Construction Drawing package for 4 Broadcast stations. Cover the interim and Main antenna packages $3,525.00 All of these were under Non Zoning Permit which have been Zeroed out but I can't remove them.
Site Coordination Meeting $1,250.00 $1,250.00 Complex tower rebuild multiple Broadcaster involvement ATC Doc WHRO IM Norfolk Tall Tower 10152 Repack Cost Estimates $1,875.00 Complex tower with many broadcasters to coordinate. WTKR, WGNT, WTVZ-TV, WHRO-TV
RF System Test $5,000.00 $5,000.00 Perform systems checks on Combiner network due to the volume of broadcaster using the antenna ATC Doc WHRO IM Norfolk Tall Tower 10152 Repack Cost Estimates $3,750.00 N/A
Migratory Bird Assessment $500.00 $500.00 estimated costs for being in a bird migration mitigation ATC DocWHRO IM Norfolk Tall Tower 10152 Repack Cost Estimates $437.49 N/A
RF Exposure Measurements $21,050.00 $6,500.00 Shared Expense 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 $700.00 To reimburse American Tower if needed N/A N/A
ASR modification (prepare FCC Form 854) $2,105.00 $800.00 Shared cost of the Broadcasters being repacked N/A N/A
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet $10,520.00 $3,500.00 Per ATC Doc WHRO IM Norfolk Tall Tower 10152 Repack Cost Estimates N/A N/A
NEPA Section 106 environmental review, if needed $6,310.00 $2,000.00 Per ATC Doc WHRO IM Norfolk Tall Tower 10152 Repack Cost Estimates N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,500.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $4,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A N/A 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 $3,750.00 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A $1,875.00 N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A
Project management of the transition $121,660.00 $85,895.00 Shared Expense via American Tower Doc WHRO IM Norfolk Tall Tower 10152 Repack Cost Estimates. Also see Widelity Strategic Support Quote. $10,745.35 N/A

Components

Actual Information Description File Name
Ground and Building Drawing Package

Component Description:
10. WHRO-TV-590-Ground and Building Drawing Package
Amount:
$2,350.00

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
10. WHRO-TV-590-Ground and Building Drawing Package
Amount:
$1,175.00
Site Coordination Meeting

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
15. WHRO-TV-590-Site Coordination Meeting
Amount:
$625.00

Component Description:
15. WHRO-TV-590-Site Coordination Meeting
Amount:
$1,250.00

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A
RF System Test

Component Description:
17. WHRO-TV-580-Field Engineering Service - RF System Test
Amount:
$1,250.00

Component Description:
17. WHRO-TV-580-Field Engineering Service - RF System Test
Amount:
$2,500.00

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A
Migratory Bird Assessment

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
16. WHRO-TV-590-Migratory Bird Assessment
Amount:
$291.66

Component Description:
16. WHRO-TV-590-Migratory Bird Assessment
Amount:
$145.83
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 Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application Information not provided.
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

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
14. WHRO-TV-530-RF Eng - Engineering Study for New Channel Assignment
Amount:
$2,500.00

Component Description:
14. WHRO-TV-530-RF Eng - Engineering Study for New Channel Assignment
Amount:
$1,250.00
Address transition timing and coordination issues w/ other stations and wireless

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
13. WHRO-TV-590-Transition Timing and Coordination Issues
Amount:
$625.00

Component Description:
13. WHRO-TV-590-Transition Timing and Coordination Issues
Amount:
$1,250.00
Prepare and or review reimbursement form Information not provided.
Project management of the transition

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
12. WHRO-TV-510-Project Management
Amount:
$4,740.00

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
Project Management
Amount:
$3,635.35

Component Description:
12. WHRO-TV-510-Project Management
Amount:
$2,370.00

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $172,930.00 $172,365.00 N/A $20,904.35 N/A
Total for all systems $6,635,411.53 $4,403,186.86 N/A $803,242.66 N/A
Other Expenses $172,930.00 $172,365.00 $20,904.35
Comark System Design and Site Survey $15,300.00 $15,300.00 This is to visit the tower site location and design the transmitter installation locations and RF plumbing of the system. $15,300.00 See P3921E WHRO Site design and Survey quote.
Special Insurance Rider $2,500.00 $2,500.00 Special insurance Rider to cover the costs of the homes that are within 2000 ft of the tower. ATC owes the tower WHRO Owns all the Land. ATC Lease the Base, Anchors and Building land from WHRO N/A N/A
Site Security $16,200.00 $16,200.00 Very complicated site installation. lots o expensive materials lying around very easy to steal. The compound is gated but access under ditch area is possible N/A N/A
Public Hearing $500.00 $500.00 Costs associated with Public hearing materials sent to surrounding homes, newspapers ETC. N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A N/A N/A
Non-zoning permits $5,000.00 $5,000.00 N/A $562.50 Includes multiple broadcasters coordination
Equipment Delivery and Handling Charges $12,500.00 $12,500.00 N/A $5,041.85 N/A
Grading Road $4,500.00 $4,500.00 Regrading drive access to the site for at least 1 year N/A N/A
ATC One Time Tower Rental $57,600.00 $57,600.00 Rental Fee associated with repacking for the Interim antenna N/A N/A
MVPD Notification of Channel Change $500.00 $500.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $15,000.00 $15,000.00 N/A N/A N/A
Equipment Storage $24,000.00 $24,000.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $3,500.00 $3,500.00 N/A N/A N/A
BLM or NFS Coordination $2,000.00 $2,000.00 N/A N/A N/A
Local Zoning $1,750.00 $1,750.00 N/A $0.00 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

Components

Actual Information Description File Name
Comark System Design and Site Survey

Component Description:
System Design Service / Site Survey
Amount:
$15,300.00

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A
Special Insurance Rider Information not provided.
Site Security Information not provided.
Public Hearing Information not provided.
DTV Medical Facility Notification Information not provided.
Non-zoning permits

Component Description:
18. WHRO-TV-610-Non-Zoning Permits
Amount:
$375.00

Component Description:
3-D-1 Ground and building permit package MS1 at 25% of total
Amount:
N/A

Component Description:
ATC MS2 item 3-D-1 Tower Permit additional 50% payment 25% remaining
Amount:
N/A

Component Description:
18. WHRO-TV-610-Non-Zoning Permits
Amount:
$187.50

Component Description:
ATC MS2 3-D-1 Ground and building Permit additional 50% payment 25% remaining
Amount:
N/A

Component Description:
3-D-1 Tower Permits drawing package
Amount:
N/A
Equipment Delivery and Handling Charges

Component Description:
Dielectric Freight Charges for invoice 637004. Cover letter for Dielectric Shipping is located in the Attachments
Amount:
$41.86

Component Description:
ATC MS1 1-A-4 at 25% of total
Amount:
N/A

Component Description:
19. WHRO-TV-610-Equipment Delivery and Handling
Amount:
$3,333.33

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
19. WHRO-TV-610-Equipment Delivery and Handling
Amount:
$1,666.66
Grading Road Information not provided.
ATC One Time Tower Rental Information not provided.
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
BLM or NFS Coordination Information not provided.
Local Zoning

Component Description:
Invoice to be resubmitted to LMS.
Amount:
N/A

Component Description:
ATC MS2 item 1-A-3 permit costs Additional 50% payment 25% remaining
Amount:
N/A
FCC Filing Fees - Special Temporary Authorization request Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $6,635,411.53 $4,403,186.86 $803,242.66

Reimbursement Status

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

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Section Question Response
Submission of Estimated Expenses Statements

WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.

  1. The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.

  2. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

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

  4. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD).

  5. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

  6. The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred.

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

  8. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.

I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Chris Gunnar Gunnufsen

Vice President Technology


09/21/2020

Certification

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Section Question Response
Submission of Actual Cost Documentation Statements

WILLFUL FALSE, FRAUDULENT, OR FICTITIOUS STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISIONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE AND/OR FRAUDULENT STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT (U.S. CODE, TITLE 31, SECTIONS 3729-3733).

  1. The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.

  2. The above-named entity certifies that the statements in this form and attached documentation are true, complete, and correct.

  3. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

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

  5. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (full power and Class A stations) and/or otherwise modify a television station’s facility as a result of the spectrum repack (LPTV/TV Translator stations); or to minimize service disruption resulting from a repacked television station (FM stations); or to continue to carry the signal of a broadcaster that changes channels (MVPD) .

  6. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

  7. The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred.

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

  9. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a prerequisite for obtaining the payments herein requested.

I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Chris Gunnar Gunnufsen

Vice President Technology


09/21/2020

Certification

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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.

Chris Gunnar Gunnufsen

Vice President Technology


09/21/2020

Attachments

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