TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
NEW AGE MEDIA OF TENNESSEE LICENSE, LLC	1181 HIGHWAY 315 WILKES-BARRE, PA 18702 United States	+1 (570) 970-5600	jparente1966@gmail.com	Limited Liability Company

Applicant

Address

Phone

Applicant Type

NEW AGE MEDIA OF TENNESSEE LICENSE, LLC

1181 HIGHWAY 315

WILKES-BARRE, PA 18702

United States

+1 (570) 970-5600

jparente1966@gmail.com

Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant	Address	Phone	Email
[Confidential]

Preparer Contact Information

Preparer Contact Name and Information

Applicant	Address	Phone	Email
Paul A. Cicelski , Esq . Lerman Senter PLLC	Paul Cicelski 2001 L Street NW Suite 400 Washington, DC 20036 United States	+1 (202) 416-6756	Sinclair399s@SummitRidgeGroup.com

Applicant

Address

Phone

Paul A. Cicelski , Esq .

Lerman Senter PLLC

Paul Cicelski

2001 L Street NW

Suite 400

Washington, DC 20036

United States

+1 (202) 416-6756

Sinclair399s@SummitRidgeGroup.com

Broadcaster Information and Transition Plan

Question	Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information.	Yes
Briefly describe transition plan	See Exhibit A.

Transmitters

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

Primary Transmitter

Existing Transmitter Information

Section	Question	Response
Existing Transmitter Description	Type of change	Purchase New
	Use	Primary (Main)
	Description of Use	N/A
	Ownership	Owned
	Owner	N/A
	Site	N/A
	Is this transmitter currently shared with another station?	No
	Is this transmitter currently in operating condition?	Yes
Existing Transmitter Manufacturer and Type	Manufacturer
	Model	ABS TC30I1D
	Year	2006
	Type	Inductive Output Tube
	IOT Power Type	Single
	Power Capacity	30 kW

Primary Transmitter

New Transmitter Costs

Section	Question	Response
New Transmitter	Use	Primary (Main)
	Change Type	Purchase New
	Is this a request for upgraded equipment?	Yes
	Manufacturer
	Model	THU9evo-4
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	5.11 kW
	Justification for New Transmitter	The current transmitter cannot be retuned because the transmitter manufacturer is no longer in business.

Primary Transmitter

Other Transmitter Costs

Section	Question	Response
Electrical Service	Service Entrance (3 phases 800A 208V)	No
	Switchgear (industrial 800 amp)	Yes
	Transformer (480V)	Yes
	Power	300 kVA
	Rigid Conduit and Wiring	Yes
	Size	2 inches
	Length	800.0 feet
	Other Electrical Service	No
	Description	N/A
HVAC Service	Does the replacement transmitter require HVAC Service?	No
	Type	N/A
	Size	N/A
	Other Size	N/A
Transmitter Building Addition/Modification or Leasehold Improvement	Does the Transmitter Building require an addition, modification, other leashold improvement?	No
	Size	N/A
Channel 14 Costs	Is an RF Consulting Engineer needed?	N/A
	Is a channel 14 Mask Filer needed?	N/A
	Is additional field engineering time needed?	N/A
	Number of Days	10

Primary Transmitter

Other Transmitter Cost Not Listed

Name	Description
Combiner	Combiner
Electrical Service and Ice Bridge	Electrical Service and Ice Bridge

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:	84.0 kW
	Manufacturer
	Model	ALP24M4-HSOC-40
	Year	2006

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	Side Mount
	Antenna position in stack	Not in Stack
	Polarization	Elliptical
	Type	Slotted Coaxial
	Number of Stations Supported	N/A
	Number of Panels/Bays	N/A
	Lower Limit	N/A
	Upper Limit	N/A
	Design power capacity in use	N/A
	Other Antenna Type	N/A
	ERP:	47.5 kW
	Manufacturer
	Model	TFU-24WB/VP-C160
	Year	2017
	Justification for New Antenna	Old antenna is a single channel antenna that cannot be used for the new post-auction channel.

Primary Antenna

Other Antenna Costs

Section	Question	Response
Combiner for Shared Antenna	Do you need a Combiner for a Shared Antenna?
	Type
	Number of channels supported	N/A
	Frequencies of channels supported	N/A
	Frequency	N/A
	Do you need a combiner output splitter/switcher for dual feed lines?	N/A
Elbow Complex	Do you require the separate purchase of the Elbow Complex?	Yes
	Broadband or Single Channel?	Single Channel
	Feed Line Size	4 1/16 inches inches
Side Mount Brackets	Do you require the separate purchase of side mount brackets for a high power antenna?	Yes
Pattern Scatter Analysis	Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna?	Yes
Sweep Test	Do you require the sweep testing of transmission line and antenna?	Yes

Primary Antenna

Other Antenna Cost Not Listed

Name	Description
Station Load	Station Load
Antenna Line	Antenna Line

Interim Antenna

New Antenna Costs

Section	Question	Response
New Antenna Description	Use	Interim
	Description of Use	N/A
	Change Type	Purchase New
	Ownership	Owned
	Owner	N/A
	Is antenna shared?	Yes
	Is antenna directional?	Yes
	Will antenna be located on or in close proximity to an antenna farm?	Yes
New Antenna Manufacturer and Type	Class	Full Power
	Mounting	Side Mount
	Antenna position in stack	Not in Stack
	Polarization	Elliptical
	Type	Broadband Panel
	Number of Stations Supported	2
	Number of Panels/Bays	8
	Lower Limit	470.00 MHz
	Upper Limit	598.00 MHz
	Design power capacity in use	100.0 %
	Other Antenna Type	N/A
	ERP:	100.0 kW
	Manufacturer
	Model	TFU-8WB-1-R
	Year	2017
	Justification for New Antenna	Interim antenna to be shared with WFLI-TV and used to stay on the air while the main antenna undergoes construction for the post-auction channel change.

Interim Antenna

Other Antenna Costs

Section	Question	Response
Combiner for Shared Antenna	Do you need a Combiner for a Shared Antenna?	Yes
	Type	New
	Number of channels supported	2
	Frequencies of channels supported	RF channel
	Frequency	N/A
	Do you need a combiner output splitter/switcher for dual feed lines?	No
Elbow Complex	Do you require the separate purchase of the Elbow Complex?	No
	Broadband or Single Channel?	N/A
	Feed Line Size	N/A
Side Mount Brackets	Do you require the separate purchase of side mount brackets for an antenna?	Yes
Pattern Scatter Analysis	Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna?	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
14
23

Interim Antenna

Other Antenna Cost Not Listed

Name	Description
Interim Direct Antenna Connection	Interim Direct Antenna Connection

Transmission Line

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

Primary Transmission Line

Existing Transmission Line

Section	Question	Response
Existing Transmission Line Description	Type of change	Utilize Existing
	Use	Primary (Main)
	Description of Use	N/A
	Ownership	Owned
	Owner	N/A
	Site	N/A
	Is the existing transmission line shared with another station or stations?	No
	Is Transmission Line in operating condition?	Yes
Existing Transmission Line Manufacturer and Type	Manufacturer	Andrew
	Type	Flexible Air
	Diameter	4 inches
	Other Diameter	N/A
	Segment Length	N/A
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	654 feet per run

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Name	Description
Rigid Transmission Line - copper X	Rigid Transmission Line - copper, X

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?	Yes
	Is tower compliant with Rev G?	No
Existing Tower Structure Registration	Do you have a tower registration number?	Yes
Existing Tower Structure Registration	ASR Number	1042692
Coordinates (NAD83)	Latitude (NAD83)	35° 12' 36.0" N-
	Longitude (NAD83)	085° 16' 42.3" W-
	Overall Structure Height	579.06 feet
	Support Structure Height	529.85 feet
	Ground Elevation Above Mean Sea Level (AMSL)	1985.87 feet
	Structure Type	GTOWER - Guyed Structure Used for Communication Purposes
	Tower Owner	SpectraSite Communications, LLC. through American Towers, LLC.
	Date Constructed	04/15/1999

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
72060	WFLI-TV	DTV

Primary Tower

Tower Modification Costs

Section	Question	Response
Engineering Study	Please what type of engineering study is required, if any:	Study needed for 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	470
	Explanation	Outside consulting engineering, legal work, and accounting services, as well as project management for regional and comprehensive repack execution.
Outside RF consulting Engineering Services	Perform engineering study for new channel assignment and antenna development	Yes
	Prepare engineering section of Form FCC Construction Permit Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare engineering section of Form FCC License to Cover Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare request for Special Temporary Authority	Yes
	Quantity	2
	Do you have Distributed Transmission System engineering services?	N/A
	Critical Facility	N/A
	Terrain-Shielded Facility	N/A
Attorney and Other Outside Consulting Services	Prepare and file Form FCC Construction Permit Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare and file Form FCC License to Cover Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare request for Special Temporary Authority	Yes
	Quantity	2
	NEPA Section 106 environmental review	Yes
	Environmental Assessment	Yes
	ASR Modification	Yes
	FAA Consultation (including preparation of FAA Form 7460)	Yes
	Negotiation of Lease and other Matter for Shared Locations	Yes
	Prepare or Review FCC Form 399 for Reimbursement	Yes
	Address transition timing and coordination issues w/ other stations and wireless providers	Yes
RF Field Engineering Services	Comprehensive coverage verification via field study	Yes
	RF exposure measurements	No
	Additional Field Engineering Service	No
	Number of Days	N/A
	Justification	N/A

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Name	Description
Sinclair Internal Costs	Internal Employee Time Costs

Other Expenses

Section	Question	Response
AM Pattern Disturbance	Is an Impact Study needed?	No
AM Pattern Disturbance	Is Remediation needed?	No
Facility Expenses	Name	N/A
	Other Distributed Transmission System Expenses Not listed	N/A
	Name	N/A
	Is Notification of a Medical Facility required as a result of DTV broadcasting?	Yes
Permit and Filing Costs	Local Zoning	Yes
	Non-zoning permits	Yes
	BLM or NFS Coordination	No
	FCC Construction Permit Minor Change	No
	FCC License to Cover Application	Yes
	FCC Special Temporary Authority Application	Yes
Other Miscellaneous Expenses	Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)?	Yes
	Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs?	Yes
	Does this relocation require Equipment Storage?	No
	Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change?	Yes
	Does this relocation require MVPD Notification of a Channel Change?	Yes

Other Expenses

Other Expenses Not Listed

Information not provided.

Cost Information

Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$758,691.85	$719,476.43	N/A	$390,579.43	N/A
Total for all systems	$2,239,056.29	$2,023,280.29	N/A	$805,798.04	N/A
Primary Transmitter THU9evo-4	$758,691.85	$719,476.43		$390,579.43
Additional field engineering time, 10-30 days	$63,100.00	$60,000.00	N/A	N/A	N/A
Channel 14 Mask Filter	$189,500.00	$180,000.00	N/A	N/A	N/A
RF Consulting Engineer	$5,260.00	$5,000.00	N/A	$5,000.00	N/A
2" Rigid Conduit and Wiring (Cost per foot)	$20,800.00	$20,000.00	N/A	N/A	N/A
Transformer 3 phase/480v - 300 KVA	$36,800.00	$35,000.00	N/A	$2,403.00	N/A
Switchgear - industrial 800 amp	$38,200.00	$36,300.00	N/A	N/A	N/A
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW	$273,500.00	$251,644.58	N/A	$251,644.58	The "$175,741.88" can be removed.
Combiner	$34,672.75	$34,672.75	N/A	$34,672.75	N/A
Electrical Service and Ice Bridge	$96,353.00	$96,353.00	N/A	$96,353.00	N/A
UHF - Liquid Cooled Solid State Transmitter 4 kW	$506.10	$506.10	*System Notice: Estimate adjusted and locked because line has been superseded.*See Response to August 11 Inquiry.	$506.10	N/A

Components

Actual Information Description	File Name
Additional field engineering time, 10-30 days	Information not provided.
Channel 14 Mask Filter	Information not provided.
RF Consulting Engineer	Component Description: Land mobile services related cost. #1094 Amount: $5,000.00
2" Rigid Conduit and Wiring (Cost per foot)	Information not provided.
Transformer 3 phase/480v - 300 KVA	Component Description: Transmitter related cost. #002074 Amount: $2,403.00 Component Description: Transmitter related cost. #9500088566 Amount: $8,324.46 Component Description: Resubmitted under elbow complex. #9500094781 Amount: N/A
Switchgear - industrial 800 amp	Information not provided.
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW	Component Description: Transmitter related cost. #9500080817 Amount: $55,245.63 Component Description: Transmitter related cost. #9500086982 Amount: $17,473.08 Component Description: Transmitter related cost. #9500086981 Amount: $165,736.87 Component Description: Transmitter related cost. #002074 Amount: $13,189.00 Component Description: Transmitter cost. #9500086981 Amount: $175,741.88
Combiner	Component Description: Transmitter related cost. #9500094589 Amount: $26,616.50 Component Description: Transmitter related cost. #9500083869 Amount: $8,056.25
Electrical Service and Ice Bridge	Component Description: Transmitter related cost. #9500085356 Amount: $96,353.00
UHF - Liquid Cooled Solid State Transmitter 4 kW	Component Description: Pallet Jack. #420007025 Amount: $506.10 Component Description: Pallet Jack. #420007025 Amount: $335.00

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	$350,229.06	$233,939.06	N/A	$138,233.32	N/A
Total for all systems	$2,239,056.29	$2,023,280.29	N/A	$805,798.04	N/A
Interim Antenna TFU-8WB-1-R	$166,943.72	$52,863.72		$0.00
Side mount brackets for high power antennas (if not included in antenna base cost)	$23,150.00	$0.00	WDSI no longer requires interim facilities.	N/A	N/A
Sweep test of existing antenna	$6,730.00	$0.00	WDSI no longer requires interim facilities.	N/A	N/A
UHF - High Power, Side Mount, broadband panel, 8 bay,, 100 kW input, directional,, elliptically or circularly polarized	$50,000.00	$50,000.00	WDSI no longer requires interim facilities.	N/A	N/A
Interim Direct Antenna Connection	$2,863.72	$2,863.72	N/A	$0.00	N/A
New combiner, cost per channel (without antenna)	$84,200.00	$0.00	WDSI no longer requires interim facilities.	N/A	N/A
Primary Antenna TFU-24WB/VP-C160	$183,285.34	$181,075.34		$138,233.32
Antenna Line	$4,881.43	$4,881.43	N/A	$0.00	N/A
Station Load	$579.31	$579.31	N/A	$0.00	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
Side mount brackets for high power antennas (if not included in antenna base cost)	$23,150.00	$22,000.00	N/A	N/A	N/A
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed)	$9,570.00	$9,100.00	N/A	$0.00	N/A
UHF - High Power, Side Mount, basic slot antenna, 48 kW input, directional,, elliptically or circularly polarized	$133,114.60	$133,114.60	See attached quote from Dielectric.	$133,114.60	N/A
Sweep test of existing antenna	$6,730.00	$6,400.00	N/A	$5,118.72	N/A

Components

Actual Information Description	File Name
Side mount brackets for high power antennas (if not included in antenna base cost)	Information not provided.
Sweep test of existing antenna	Information not provided.
UHF - High Power, Side Mount, broadband panel, 8 bay,, 100 kW input, directional,, elliptically or circularly polarized	Information not provided.
Interim Direct Antenna Connection	Component Description: Interim antenna cost. #9500088566 Amount: $2,863.72
New combiner, cost per channel (without antenna)	Information not provided.
Antenna Line	Component Description: Antenna cost. #9500088566 Amount: $4,881.43
Station Load	Component Description: Antenna cost. #9500088566 Amount: $579.31
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)	Information not provided.
Side mount brackets for high power antennas (if not included in antenna base cost)	Information not provided.
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed)	Component Description: Elbow cost. #9500094781 Amount: $4,850.70
UHF - High Power, Side Mount, basic slot antenna, 48 kW input, directional,, elliptically or circularly polarized	Component Description: Antenna related freight cost reduced by 20.02%. #242027 Amount: $12,784.69 Component Description: Antenna cost reduced by 20.02%. #242014 Amount: $120,329.91
Sweep test of existing antenna	Component Description: Antenna related cost reduced by 20.02%. #245012 Amount: $5,118.72 Component Description: Repack sweep related cost for antenna reduced by 20.02%. #245012 Amount: $5,118.72

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	$100,000.00	$100,000.00	N/A	$0.00	N/A
Total for all systems	$2,239,056.29	$2,023,280.29	N/A	$805,798.04	N/A
Primary Transmission Line	$100,000.00	$100,000.00		$0.00
Rigid Transmission Line - copper X	$100,000.00	$100,000.00	N/A	$0.00	N/A

Components

Actual Information Description	File Name
Rigid Transmission Line - copper X	Component Description: Transmission Line Related Cost. #242046 Amount: $46,443.90 Component Description: Transmitter line related cost. #242014 Amount: N/A

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	$644,100.00	$612,000.00	N/A	$149,344.00	N/A
Total for all systems	$2,239,056.29	$2,023,280.29	N/A	$805,798.04	N/A
Primary Tower GTOWER	$644,100.00	$612,000.00		$149,344.00
Structural engineering tower load study for well documented tower	$12,600.00	$12,000.00	N/A	$5,500.00	N/A
Tall Tower (greater than 500')	$210,500.00	$200,000.00	N/A	$99,879.00	N/A
Major tower reinforcement/modifications	$421,000.00	$400,000.00	N/A	$43,965.00	N/A

Components

Actual Information Description	File Name
Structural engineering tower load study for well documented tower	Component Description: Final 50% for structural evaluation. #E-167643 Amount: $2,750.00 Component Description: 50% down payment. #E-166090 Amount: $2,750.00
Tall Tower (greater than 500')	Component Description: 50% down payment. #E-166092 Amount: $49,939.50 Component Description: Tower related cost. #E-173400 Amount: $49,939.50
Major tower reinforcement/modifications	Component Description: Tower related cost. #E-182371 Amount: $21,982.50 Component Description: Final balance invoiced upon completion. #E-190553 Amount: $21,982.50

Cost Information

Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$220,585.38	$192,979.80	N/A	$48,327.27	N/A
Total for all systems	$2,239,056.29	$2,023,280.29	N/A	$805,798.04	N/A
Outside Professional Services	$220,585.38	$192,979.80		$48,327.27
Sinclair Internal Costs	$435.38	$435.38	N/A	$435.38	N/A
Comprehensive coverage verification via field study, if needed	$84,200.00	$80,000.00	N/A	$3,400.00	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
Address transition timing and coordination issues w/ other stations and wireless	$2,630.00	$2,500.00	N/A	N/A	N/A
Prepare and or review reimbursement form	$2,630.00	$3,900.00	Updated cost of estimated amount per FCC requirement.	$3,750.79	N/A
Project management of the transition	$74,260.00	$70,500.00	N/A	$33,574.18	The line items with status Need More Information and file uploads 9-29-2018_Out Serv_SR #1093.pdf and 11-13-18_ OS_LS_471524.pdf can be deleted.
Attorney Fees - Prepare and File request for Special Temporary Authorization	$7,360.00	$0.00	N/A	N/A	N/A
Attorney Fees - Negotiation of lease and other matters for shared locations	$4,210.00	$0.00	N/A	N/A	N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	$2,365.00	$0.00	N/A	N/A	N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	$5,260.00	$221.92	N/A	$221.92	The $122.35 line item from August 2017 should be removed due to a requested revision of this invoice by FCC staff.
Prepare request for Special Temporary Authorization	$4,100.00	$3,000.00	N/A	N/A	N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	$1,580.00	$2,422.50	See Carl T. Jones Corporation invoice.	$2,422.50	N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	$3,155.00	$3,000.00	N/A	$1,882.50	N/A
Perform engineering study for new channel assignment and antenna development	$7,360.00	$7,000.00	N/A	$2,640.00	N/A

Components

Actual Information Description	File Name
Sinclair Internal Costs	Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $7.86 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $11.03 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $9.47 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $25.53 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $16.53 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $11.39 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $15.08 Component Description: Portion of general repack matter invoice attributable to this station - divided by 52 stations. Amount: $41.33 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $23.96 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $1.69 Component Description: Portion of general repack matter internal time card attributable to this station - divided by 100. Amount: $66.55 Component Description: Portion of general repack matter invoice attributable to this station - divided by 33 stations. Amount: $40.92 Component Description: Portion of general repack matter invoice attributable to this station - divided by 40 stations. Amount: $58.48 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $32.09 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $5.37 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $8.66 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $33.53 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $7.96 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $6.09 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $26.93 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. Amount: $17.02
Comprehensive coverage verification via field study, if needed	Component Description: Coverage related cost. #187007 Amount: $3,400.00
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.
Address transition timing and coordination issues w/ other stations and wireless	Information not provided.
Prepare and or review reimbursement form	Component Description: Legal services cost. #461813 Amount: $125.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289 Amount: $1,311.48 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #463622 Amount: $127.80 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $1,315.27 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $152.01 Component Description: Legal services cost. #460894 Amount: $305.00 Component Description: Legal services cost. #462956 Amount: $630.20 Component Description: Legal services cost. Amount: $230.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759 Amount: $869.30
Project management of the transition	Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1105 Amount: $216.88 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #477820 Amount: $320.19 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #467861 Amount: $470.30 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $20.91 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #478780 Amount: $271.41 Component Description: Portion of general repack matter invoice attributable to this station - divided by 99 stations. #469573 Amount: $377.14 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #473506 Amount: $421.40 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1090 Amount: $176.70 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $43.72 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1117 Amount: $282.68 Component Description: Portion of general repack matter invoice attributable to this station - divided by 99 stations. #468718 Amount: $349.51 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1098 Amount: $238.07 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #478288 Amount: $194.86 Component Description: Legal services cost. #475336 Amount: $188.75 Component Description: Portion of general repack matter invoice attributable to this station - divided by 99 stations. #1086 Amount: $275.35 Component Description: Legal services cost. #479328 Amount: $57.50 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #474809 Amount: $395.77 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #470923 Amount: $406.65 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #472173 Amount: $311.78 Component Description: Portion of general repack matter invoice attributable to this station - divided by 40 stations. #141 Amount: $1,800.46 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1114 Amount: $242.25 Component Description: Legal Service Cost. #473573 Amount: $106.25 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #476367 Amount: $364.80 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1141 Amount: $406.17 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1145 Amount: $369.98 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #472583 Amount: $279.89 Component Description: Legal Service Cost. #472630 Amount: $157.50 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #475283 Amount: $384.08 Component Description: Legal services cost. #475797 Amount: $211.25 Component Description: $26,919.78 credit to be split across 93 Sinclair stations reimbursed $999.20 for Invoice 461759 (correct reimbursement amount is $709.74). #CM-11-21-2019-461759 Amount: ($289.46) Component Description: Legal services cost. #474450 Amount: $245.00 Component Description: Legal Service Cost. #472210 Amount: $353.50 Component Description: Legal services cost. #478817 Amount: $126.25 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1156 Amount: $399.52 Component Description: Legal services cost. #474863 Amount: $568.75 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #107 Amount: $602.28 Component Description: Legal Service Cost. #470891 Amount: $1,346.25 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1123 Amount: $342.14 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1143 Amount: $436.90 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #480175 Amount: $377.96 Component Description: Portion of general repack matter invoice attributable to this station - divided by 52 stations. #153 Amount: $1,287.27 Component Description: Legal services cost. #481352 Amount: $45.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1072 Amount: $237.64 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1111 Amount: $159.58 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #474405 Amount: $490.56 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1069 Amount: $246.68 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1167 Amount: $313.41 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1079 Amount: $177.14 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #473506 Amount: N/A Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1133 Amount: $307.72 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1099 Amount: $266.93 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1078 Amount: $215.68 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. Amount: $105.97 Component Description: Legal services cost. #467434 Amount: $62.50 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1093 Amount: $265.72 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #471524 Amount: $322.83 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #118 Amount: $468.97 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #464321 Amount: $683.07 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $716.28 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $818.59 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1093 Amount: $269.71 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #463567 Amount: $566.48 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $91.76 Component Description: Legal services cost. #476419 Amount: $160.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1161 Amount: $267.48 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1058 Amount: $187.24 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1063 Amount: $262.29 Component Description: Legal Service Cost. #469701 Amount: N/A Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $836.44 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #465173 Amount: $654.26 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #132 Amount: $589.44 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. Amount: $185.10 Component Description: Legal Service Cost. #467942 Amount: $57.50 Component Description: Legal Service Cost. #464745 Amount: $177.50 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #475744 Amount: $305.99 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $86.88 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $999.04 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #473885 Amount: $318.62 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1072 Amount: $237.64 Component Description: Legal Service Cost. #470327 Amount: $568.75 Component Description: Legal Service Cost. #471575 Amount: $399.90 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1055 Amount: $243.38 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759 Amount: $29.98 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1130 Amount: $281.49 Component Description: Legal Service Cost. #465231 Amount: $177.50 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #463026 Amount: $801.57 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #467378 Amount: $576.96 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1151 Amount: $388.07 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $943.95 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #477305 Amount: $393.53 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. Amount: $30.47 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $20.65 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #470237 Amount: $436.37 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #465001 Amount: $596.30 Component Description: Legal Service Cost. #466746 Amount: $302.50 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $32.35 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289 Amount: $91.50 Component Description: Portion of general repack matter invoice attributable to this station - divided by 100 stations. #471524 Amount: $341.18 Component Description: Legal Service Cost. #469631 Amount: $115.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #466690 Amount: $446.87
Attorney Fees - Prepare and File request for Special Temporary Authorization	Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations	Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. Amount: $122.35 Component Description: Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289 Amount: $122.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759 Amount: $99.92
Prepare request for Special Temporary Authorization	Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	Component Description: Consulting engineering services cost. #882-09-0004 Amount: $2,422.50
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	Component Description: Consulting engineering cost. Amount: $1,882.50
Perform engineering study for new channel assignment and antenna development	Component Description: Consulting engineering cost. Amount: $2,640.00

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	$165,450.00	$164,885.00	N/A	$79,314.02	N/A
Total for all systems	$2,239,056.29	$2,023,280.29	N/A	$805,798.04	N/A
Other Expenses	$165,450.00	$164,885.00		$79,314.02
MVPD Notification of Channel Change	$5,000.00	$5,000.00	See Exhibit J.	N/A	N/A
Develop and air announcement of upcoming channel change	$28,050.00	$28,050.00	See Response to August 11 Inquiry.	N/A	N/A
Equipment Delivery and Handling Charges	$20,000.00	$20,000.00	See Exhibit J.	$1,044.02	N/A
Disposal Costs (for equipment and other waste, net of any salvage value)	$70,320.00	$70,320.00	See Response to August 11 Inquiry.	$70,320.00	N/A
Non-zoning permits	$10,000.00	$10,000.00	See Exhibit J.	N/A	N/A
Local Zoning	$20,000.00	$20,000.00	See Exhibit J.	N/A	N/A
FCC Filing Fees - Special Temporary Authorization request	$195.00	$190.00	N/A	N/A	N/A
FCC Filing Fees - Form 2100 license to cover application	$335.00	$325.00	N/A	N/A	N/A
DTV Medical Facility Notification	$11,550.00	$11,000.00	N/A	$7,950.00	N/A

Components

Actual Information Description	File Name
MVPD Notification of Channel Change	Information not provided.
Develop and air announcement of upcoming channel change	Information not provided.
Equipment Delivery and Handling Charges	Component Description: Equipment delivery and handling cost reduced by 8.40%. #781013 Amount: $136.02 Component Description: Equipment Delivery related cost. #002074 Amount: $908.00
Disposal Costs (for equipment and other waste, net of any salvage value)	Component Description: Disposal cost. #2611 Amount: $26,875.00 Component Description: Disposal cost. #2590 Amount: $26,875.00 Component Description: Disposal cost. #33464 Amount: $16,570.00
Non-zoning permits	Information not provided.
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	Component Description: Land mobile service cost. #1017 Amount: $5,000.00 Component Description: Medical notification. #1047 Amount: $2,950.00

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$2,239,056.29	$2,023,280.29	$805,798.04

Reimbursement Status

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

Certification

Section	Question	Response
Submission of Estimated Expenses Statements	WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.
The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD). The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund. The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.	John Parente CEO 11/06/2020

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.

John Parente

CEO

11/06/2020

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.	John Parente CEO 11/06/2020

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.

John Parente

CEO

11/06/2020

(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

Enter a list of RF channel numbers.

Interim Antenna

Other Antenna Cost Not Listed

Transmission Line

Primary Transmission Line

Existing Transmission Line

Primary Transmission Line

Other Transmission Line Expenses Not Listed

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