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:
9154
Service:
LPD
Call Sign:
WCRN-LD
Channel:
30 (UHF)
File Number:
0000086771
FRN:
0025130725
Eligibility Status:
Eligible
Date Submitted:
09/17/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

TYCHE MEDIA LLC

Doing Business As: TYCHE MEDIA LLC

143 West St.

#208

New Milford, CT 06776

United States

+1 (203) 349-9000 sf@intriguegroup.net Limited Liability Company

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

Dan J Alpert

Esq

The Law Office of Dan J. Alpert

Dan Alpert

2120 21st Rd. N

Arlington, VA 22201

United States

+1 (703) 243-8690 dja@commlaw.tv

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. No
Briefly describe transition plan WCRN CH 25 was displaced by WJAR CH 50 move to CH 25 as described in the WCRN displacement application. WCRN filed for the only available channel and site available to it specifying an ATC antenna for CH 30 operation.

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)
Ownership Owned
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model SLIM5 01 UHF SD PCM
Year 2016
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1.4 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 SLIM5_02_UHF_SD_PCM-LP
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2.6 kW
Justification for New Transmitter Our consulting engineer determined we need 2.6 kw pre-mask and that is the rating for this transmitter.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Other Transmitter Costs
Does the transmitter installation require a Transmitter Building Site Survey/Installation? No
Electrical Service Service Entrance (3 phases 800A 208V) Yes
Switchgear (industrial 800 amp) No
Transformer (480V) No
Rigid Conduit and Wiring No
Other Electrical Service No
HVAC Service Does the replacement transmitter require HVAC Service? No
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

SYES

COMMISSIONING AND SHIPPING

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 Purchase New
Antenna Use Primary (Main)
Ownership Owned
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Other
Other Antenna Type Tuned panel antenna
ERP: 15.0 kW
Manufacturer
Model ATC-BPE4C1S-25
Year 2016

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Change Type Purchase New
Ownership Owned
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Slotted Coaxial
ERP: 15.0 kW
Manufacturer
Model ATC-BCE410P3R-V1-30
Year 2019
Justification for New Antenna Existing panel antenna is tuned to channel 25 and our new channel is 30. The manufacturer stated the existing antenna cannot be used.

Primary Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? No
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power 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

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Industrial Communications

Structural study of tower for antenna

Alive

Shipping of antenna

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 Purchase New
Use Primary (Main)
Ownership Owned
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 Flexible Foam
Diameter 1 5/8 inches
Number of parallel runs 1
Length 540 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Flexible Foam
Diameter 1 5/8 inches
Number of parallel runs 0
Length 540 feet per run
Justification for New Transmission Line We need 1 5/8 inch coax to run to the antenna on the tower.
Interior RF Systems Does the Installation of the Transmission Line require an additional or replacement Inside RF system including switching, patch panels, and dehydrators? No

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

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 Move Equipment
Tower Use Primary (Main)
Ownership Leased
Is this tower consider Complex? No
Is this tower currently shared with any other stations? No
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1002111
Coordinates (NAD83) Latitude (NAD83) 42° 05' 44.1" N-
Longitude (NAD83) 071° 13' 48.6" W-
Overall Structure Height 490.81 feet
Support Structure Height 449.47 feet
Ground Elevation Above Mean Sea Level (AMSL) 386.81 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Industrial Tower and Wireless, LLC
Date Constructed 08/20/2008


Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Tower crew

Taking down old antenna and installing new antenna

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? No
Outside RF consulting Engineering Services Perform engineering study for displacement application 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 3
Prepare Form 601 Yes
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 3
Negotiation of Lease and other Matter for Shared Locations Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Form 399 assistance or other program management costs Yes
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements No
Additional Field Engineering Service No

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

DISPLACEMENT STUDIES

CTI INVOICE 008694

Engineering services

decommission old site and install equipment at new site

Tower Structural study

Tower Structural Study

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Permit and Filing Costs FCC Construction Permit Major Change No
FCC Construction Permit Minor Change Yes
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)? No
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? No
Point to Point Microwave (STL/ICR) Frequency Coordination for Unidirection System No
Frequency Coordination for Bi-Direction System No
New Point to Point Microwave System No

Other Expenses

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Other Expenses Not Listed

Information not provided.

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 $198,900.00 $80,866.21 N/A $77,866.21 N/A
Total for all systems $324,575.00 $192,899.33 N/A $168,274.94 N/A
Primary Transmitter SLIM5_02_UHF_SD_PCM-LP $198,900.00 $80,866.21 $77,866.21
SYES $78,200.00 $78,200.00 N/A $75,200.00 N/A
Service entrance 3 phase/800 amp/208 volt $14,400.00 $2,666.21 N/A $2,666.21 N/A
UHF - Air Cooled Solid State Transmitter 2.501 - 3.999 kW $106,300.00 $0.00 N/A N/A N/A

Components

Actual Information Description File Name
SYES

Component Description:
cost of transmitter and provisioning
Amount:
$75,200.00
Service entrance 3 phase/800 amp/208 volt

Component Description:
Electrical needs for WCRN Foxboro
Amount:
$2,666.21
UHF - Air Cooled Solid State Transmitter 2.501 - 3.999 kW 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 $20,630.00 $17,400.00 N/A $14,900.00 N/A
Total for all systems $324,575.00 $192,899.33 N/A $168,274.94 N/A
Primary Antenna ATC-BCE410P3R-V1-30 $20,630.00 $17,400.00 $14,900.00
Industrial Communications $0.00 $0.00 Take antenna down at Webster tower, transport, and installation in Foxboro $0.00 N/A
Sweep test of transmission line and antenna $5,730.00 $2,500.00 N/A N/A N/A
UHF-Low Power, Side Mount, Slotted Coaxial, 15.0kW input, Elliptical $0.00 $0.00 N/A $0.00 N/A
Alive $14,900.00 $14,900.00 N/A $14,900.00 N/A

Components

Actual Information Description File Name
Industrial Communications Information not provided.
Sweep test of transmission line and antenna Information not provided.
UHF-Low Power, Side Mount, Slotted Coaxial, 15.0kW input, Elliptical Information not provided.
Alive

Component Description:
50% BALANCE INVOICE. Freight under freight section.
Amount:
$7,450.00

Component Description:
50% Deposit on antenna
Amount:
$7,450.00

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 $0.00 $25,000.00 N/A $17,765.61 N/A
Total for all systems $324,575.00 $192,899.33 N/A $168,274.94 N/A
Primary Transmission Line $0.00 $25,000.00 $17,765.61
Flexible Foam Transmission Line - dielectric, 1 5/8" $0.00 $25,000.00 Cost of 1 5/8 inch line including hangers, jumper from Dielectric. $17,765.61 N/A

Components

Actual Information Description File Name
Flexible Foam Transmission Line - dielectric, 1 5/8"

Component Description:
Jumper from coax coming into building to transmitter, No expedited freight reimbursement requested. This request is for actual components only, no frieght.
Amount:
$2,111.00

Component Description:
1 5/8 Coax transmission line and hangers for Foxborough tower. Labor in tower rigging section.
Amount:
$11,589.44

Component Description:
Expedited Freight for new mask filter. Not reimbursable.
Amount:
N/A

Component Description:
New filter for new channel 30 from old channel 25
Amount:
$3,698.10

Component Description:
reducer and adapter from new Dielectric filter to transmitter.
Amount:
$367.07

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 $56,190.00 $18,778.12 N/A $18,778.12 N/A
Total for all systems $324,575.00 $192,899.33 N/A $168,274.94 N/A
Primary Tower TOWER $56,190.00 $18,778.12 $18,778.12
Tower Rigging Short Tower (less than 500') $56,190.00 $18,778.12 N/A $18,778.12 N/A
Tower crew $0.00 $0.00 Estimated cost from tower company $0.00 Quote from tower company for tower work

Components

Actual Information Description File Name
Tower Rigging Short Tower (less than 500')

Component Description:
Remove antenna from Webster, transport, and install antenna in Foxboro. Paid invoice
Amount:
$13,978.12

Component Description:
Labor for rigging 1 5/8 coax on Foxborough tower
Amount:
$4,800.00
Tower crew Information not provided.

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 $42,355.00 $44,255.00 N/A $33,535.00 N/A
Total for all systems $324,575.00 $192,899.33 N/A $168,274.94 N/A
Outside Professional Services $42,355.00 $44,255.00 $33,535.00
Form 399 assistance or other Program Management costs $6,525.00 $6,525.00 Provide information re FCC Form eligibility; issues concerning operating periods; review of information re FCC Form 399; review FCC correspondence $6,525.00 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $3,025.00 $5,512.50 The estimated cost is greater than the predetermined costs estimate due to actual attorneys' fees charged $5,512.50 THAT IS WHAT WAS CHARGED
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $1,577.50 $1,350.00 N/A $1,350.00 N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $3,262.50 $3,037.50 Fees charges from counsel $3,037.50 Slightly more time was spent on the negotiation of leases for the new site
Tower Structural study $5,000.00 $5,000.00 STRUCTURAL REPORT FOR TOWER $5,000.00 N/A
Engineering services $5,000.00 $5,000.00 decommission previous site and install equipment at new site $0.00 N/A
DISPLACEMENT STUDIES $0.00 $0.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $6,705.00 $2,812.50 N/A $2,812.50 N/A
Prepare Form 601 $755.00 $755.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,052.50 $1,052.50 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $2,102.50 $3,000.00 This is the amount our consulting engineer bills us ON INVOICE 008694 FOR THE INITIAL DISPLACEMENT APPLICATION $2,913.75 THESE ARE THE ACTUAL COSTS REQUIRED TO OBTAIN DISPLACEMENT FACILITY AT ORIGINAL DISPLACEMENT SITE.
Prepare request for Special Temporary Authorization $3,840.00 $3,500.00 N/A $0.00 N/A
Perform engineering study for displacement application $1,800.00 $5,000.00 THIS EXPENSE IS IN THE DISPLACEMENT ENGINEERING APPLICATION FOR CP $4,950.00 N/A
Prepare/ Review 399 reimbursement form $1,710.00 $1,710.00 N/A $1,433.75 N/A

Components

Actual Information Description File Name
Form 399 assistance or other Program Management costs

Component Description:
Form 399 Eligibility and Form 399 Assistance
Amount:
$6,525.00
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
LEGAL FEES FOR CONSTRUCTION PERMIT APPLICATION
Amount:
$5,512.50
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
Legal work for License to Cover
Amount:
$1,350.00
Attorney Fees - Negotiation of lease and other matters for shared locations

Component Description:
THAT IS WHAT HE CHARGED
Amount:
$3,037.50
Tower Structural study

Component Description:
STRUCTURAL REPORT FOR TOWER
Amount:
$5,000.00
Engineering services Information not provided.
DISPLACEMENT STUDIES Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
THAT IS WHAT HE CHARGED.
Amount:
$2,812.50
Prepare Form 601 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

Component Description:
MINOR MOD TO DISPLACEMENT CP TO PROPOSE USE OF CH 25 LICENSED ANTENNA
Amount:
$1,433.75

Component Description:
WHEN LICENSED ANTENNA DID NOT PERFORM MOVE TO ELLIPTICAL POLARIZED ANTENNA NOW ON ORDER FROM ATC
Amount:
$1,480.00
Prepare request for Special Temporary Authorization Information not provided.
Perform engineering study for displacement application

Component Description:
WCRN Displacement Consulting engineer
Amount:
$2,527.50

Component Description:
INVOICE FOR INITIAL ENGINEERING WORK AND INITIAL APPLICATION FOR CP
Amount:
N/A

Component Description:
FURTHER REFINEMENT OF ENGINEERING LEADING TO FINAL DISPLACEMENT FACILITY
Amount:
$2,422.50
Prepare/ Review 399 reimbursement form

Component Description:
INVOICE FOR BUDGET PREPARATION ASSISTANCE AND 399 FORMS
Amount:
$1,433.75

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 $6,500.00 $6,600.00 N/A $5,430.00 N/A
Total for all systems $324,575.00 $192,899.33 N/A $168,274.94 N/A
Other Expenses $6,500.00 $6,600.00 $5,430.00
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,110.00 N/A N/A N/A
Equipment Delivery and Handling Charges $4,750.00 $4,750.00 N/A $4,690.00 N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $340.00 Total amount of Receipts $340.00 N/A
FCC Filing Fees - Special Temporary Authorization request $305.00 $400.00 2 STA Requests for for $200.00 each $400.00 N/A

Components

Actual Information Description File Name
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
Equipment Delivery and Handling Charges

Component Description:
FREIGHT FOR TRANSMITTER
Amount:
$3,000.00

Component Description:
FREIGHT FOR ANTENNA
Amount:
$1,690.00
FCC Filing Fees - Form 2100 license to cover application

Component Description:
Receipt for License to Cover
Amount:
$170.00

Component Description:
April 9, 2020 Receipt
Amount:
$170.00
FCC Filing Fees - Special Temporary Authorization request

Component Description:
STA Request 11/22/2019
Amount:
$200.00

Component Description:
FCC Receipt
Amount:
$200.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $324,575.00 $192,899.33 $168,274.94

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. 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

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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.

Frank Copsidas

CEO


09/17/2020

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.

Frank Copsidas

CEO


09/17/2020

Attachments

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