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:
16820
Service:
DTV
Call Sign:
WABM
Channel:
20 (UHF)
File Number:
0000028627
FRN:
0003180684
Date Submitted:
01/18/2021

Applicant Information

Back to Top

Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

Birmingham (WABM-TV) Licensee, Inc.

Doing Business As: Birmingham (WABM-TV) Licensee, Inc.

Miles S. Mason, Esq.

Pillsbury Winthrop Shaw Pittman LLP

1200 Seventeenth Street, NW

Washington, DC 20036

United States

+1 (202) 663-8195 miles.mason@pillsburylaw.com Corporation

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

Back to Top

Preparer Contact Name and Information

Applicant Address Phone Email

Paul A. Cicelski , Esq .

Lerman Senter PLLC

Paul A. Cicelski, Esq.

2001 L Street NW

Suite 400

Washington, DC 20036

United States

+1 (202) 416-6756 pcicelski@lermansenter.com

Broadcaster Information and Transition Plan

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

Transmitters

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

Primary Transmitter

Back to Top

Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model Quantum 60QXD2
Year 2002
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 60 kW

Primary Transmitter

Back to Top

New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Manufacturer
Model THU9evo-30
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 46 kW
Justification for New Transmitter Per the manufacturer, the current transmitter cannot be retuned. See Exhibit B.

Primary Transmitter

Back to Top

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 N/A

Primary Transmitter

Back to Top

Other Transmitter Cost Not Listed

Name Description

Installation

Installation

Other Costs

Other Costs

Tunable Elbow

Tunable Elbow

Fine Matcher

Fine Matcher

Single Cabinet Conversion

Single Cabinet Conversion

Transient Voltage Surge Suppressor

Transient Voltage Surge Suppressor

Additional parts

Additional parts

Antennas

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

Primary Antenna

Back to Top

Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? 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 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: 855.0 kW
Manufacturer
Model TFU-26DSC-R C170
Year 2002

Primary Antenna

Back to Top

New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class Full Power
Mounting Top Mount
Antenna position in stack Bottom
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: 626.0 kW
Manufacturer
Model TFU-26DSC/VP-R C170
Year 2017
Justification for New Antenna Current antenna is a single channel antenna that cannot be used for the new post-auction channel.

Primary Antenna

Back to Top

Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna?
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? N/A
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Single Channel
Feed Line Size 6 1/8 inches inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna?
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? Yes
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

Back to Top

Other Antenna Cost Not Listed

Name Description

Antenna Input

Antenna Input

Feed Through Complex

Feed Through Complex

Interim Antenna

Back to Top

New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
Ownership Owned
Owner N/A
Is antenna shared? Yes
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Broadband Panel
Number of Stations Supported 2
Number of Panels/Bays 16
Lower Limit 470.00 MHz
Upper Limit 598.00 MHz
Design power capacity in use 100.0 %
Other Antenna Type N/A
ERP: 200.0 kW
Manufacturer
Model TFU-16WB-1-R
Year 2017
Justification for New Antenna Interim antenna to be used to stay on the air for both WTTO and WABM while the main antenna undergoes construction for the post-auction channel change.

Interim Antenna

Back to Top

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? Yes
Broadband or Single Channel? B
Feed Line Size 8 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? Yes
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
22

Interim Antenna

Back to Top

Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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

Primary Transmission Line

Back to Top

Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change 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 Dielectric
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 1
Length 1220 feet per run

Primary Transmission Line

Back to Top

Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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

Primary Tower

Back to Top

Existing Tower

Section Question Response
Existing Tower Description Type of change 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 Yes
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
ASR Number 1226663
Coordinates (NAD83) Latitude (NAD83) 33° 29' 04.8" N-
Longitude (NAD83) 086° 48' 25.2" W-
Overall Structure Height 1102.02 feet
Support Structure Height 956.03 feet
Ground Elevation Above Mean Sea Level (AMSL) 946.84 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner American Towers, LLC.
Date Constructed 07/23/2002

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
48724 WZZK-FM FM
65227 WBHK FM
71417 WPYA FM
717 WBIQ DTV
62278 WERC-FM FM
6401 WUHT FM
5355 WBPT FM
74138 WTTO DTV
5360 WIAT DTV

Other Types of Users

Users
DTV America
Daystar
United Wireless
Low Power TV
Richardson Br

Primary Tower

Back to Top

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

Back to Top

Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower Candelabra
Helicopter Services Required Are helicopter services required? Yes

Primary Tower

Back to Top

Other Tower Expenses Not Listed

Name Description

Building Permits

Building Permits

Tower permit drawing package

Tower permit drawing package

Outside Professional Services Costs

Back to Top
Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 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

Back to Top

Other Professional Services Expenses Not Listed

Name Description

Sinclair Internal Costs

Internal Employee Time Costs

Site Coordination Meeting

Site Coordination Meeting

Other Expenses

Back to Top
Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning 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? Yes
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

Back to Top

Other Expenses Not Listed

Information not provided.

Cost Information

Back to Top

Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $2,727,673.56 $946,817.36 N/A $855,517.29 N/A
Total for all systems $4,254,485.54 $2,257,170.86 N/A $1,607,581.83 N/A
Primary Transmitter THU9evo-30 $2,727,673.56 $946,817.36 $855,517.29
Fine Matcher $2,241.80 $2,241.80 N/A $2,241.80 N/A
Tunable Elbow $1,991.81 $1,991.81 N/A $1,991.81 N/A
Other Costs $970.00 $970.00 Updated cost of the estimated amount per FCC requirement. $969.93 N/A
2" Rigid Conduit and Wiring (Cost per foot) $20,800.00 $20,000.00 N/A $0.00 N/A
Transformer 3 phase/480v - 300 KVA $36,800.00 $35,000.00 N/A N/A N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW $1,473,000.00 $641,313.75 N/A $641,313.75 N/A
Installation $135,343.00 $135,343.00 N/A $135,343.00 N/A
Single Cabinet Conversion $50,084.10 $50,084.10 N/A $50,084.10 N/A
Transient Voltage Surge Suppressor $2,629.75 $2,629.75 N/A $2,629.75 N/A
Additional parts $18,613.10 $18,613.10 N/A $18,613.10 N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW $947,000.00 $2,330.05 ***System Notice: Estimate adjusted and locked because line has been superseded.*** $2,330.05 N/A

Components

Actual Information Description File Name
Fine Matcher

Component Description:
Fine matcher cost. #9500127816
Amount:
$2,241.80
Tunable Elbow

Component Description:
Transmitter related cost. #002342
Amount:
$1,991.81
Other Costs

Component Description:
Transmitter related cost. #9890479588
Amount:
$245.03

Component Description:
Transmitter related cost. #9890479570
Amount:
$724.90
2" Rigid Conduit and Wiring (Cost per foot)

Component Description:
Total invoice amount reduced by 25.40%. #616053
Amount:
$13,511.57
Transformer 3 phase/480v - 300 KVA Information not provided.
Switchgear - industrial 800 amp Information not provided.
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW

Component Description:
Transmitter related cost. #9500120519
Amount:
N/A

Component Description:
Resubmitted under Transient Voltage Surge Suppressor. #002336
Amount:
N/A

Component Description:
Resubmitted under Antenna Input. #616053
Amount:
N/A

Component Description:
Resubmitted under Tunable Elbow. #002342
Amount:
N/A

Component Description:
25% down payment. #9500082402
Amount:
$147,031.82

Component Description:
Transmitter cost, balance plus tax payment. #9500093191
Amount:
$494,281.93
Installation

Component Description:
Transmitter related cost.. #9500120519
Amount:
$135,343.00
Single Cabinet Conversion

Component Description:
Transmitter related cost. #9500113715
Amount:
$50,084.10
Transient Voltage Surge Suppressor

Component Description:
Transmitter related cost. #002336
Amount:
$2,629.75
Additional parts

Component Description:
Transmitter related cost. #9500106158
Amount:
$18,613.10
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW

Component Description:
Transmitter related cost. #4332
Amount:
$1,840.00

Component Description:
Transmitter related cost. #9898469870
Amount:
$490.05

Cost Information

Back to Top

Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $484,810.84 $324,864.19 N/A $194,326.59 N/A
Total for all systems $4,254,485.54 $2,257,170.86 N/A $1,607,581.83 N/A
Interim Antenna TFU-16WB-1-R $138,290.00 $131,400.00 $5,862.40
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, broadband, at antenna input, per 8 3/16. feedline (if needed) $18,950.00 $18,000.00 N/A N/A N/A
New combiner, cost per channel (without antenna) $84,200.00 $80,000.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $5,862.40 N/A
UHF - High Power, Side Mount, broadband panel, 16 bay,, 200 kW input, directional,, elliptically or circularly polarized $0.00 $0.00 WTTO is responsible for 100% of the cost. $0.00 The above item should be removed. WTTO is responsible for 100% of the cost.
Primary Antenna TFU-26DSC/VP-R C170 $346,520.84 $193,464.19 $188,464.19
Feed Through Complex $19,219.27 $19,219.27 N/A $19,219.27 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
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $21,633.55 See Dielectric quote. $21,633.55 N/A
Sweep test of existing antenna $6,730.00 $5,862.40 N/A $5,862.40 N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $289,500.00 $128,237.40 N/A $128,237.40 N/A
Antenna Input $13,511.57 $13,511.57 N/A $13,511.57 N/A

Components

Actual Information Description File Name
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, broadband, at antenna input, per 8 3/16. feedline (if needed) Information not provided.
New combiner, cost per channel (without antenna) Information not provided.
Sweep test of existing antenna

Component Description:
Antenna related cost reduced by 8.40%. #796008
Amount:
$5,862.40
UHF - High Power, Side Mount, broadband panel, 16 bay,, 200 kW input, directional,, elliptically or circularly polarized

Component Description:
Shared antenna cost between WABM and WTTO
Amount:
N/A
Feed Through Complex

Component Description:
Antenna related cost reduced by 8.40%. #753003
Amount:
$4,282.10

Component Description:
Antenna related cost 25.40%. #597039
Amount:
$13,092.30

Component Description:
Total invoice amount reduced by 8.40%. #754027
Amount:
$1,686.35

Component Description:
Antenna related cost reduced by 25.40%. #589010
Amount:
$158.52
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) Information not provided.
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
Antenna related cost reduced by 8.40%. #734010
Amount:
$10,191.41

Component Description:
Antenna related cost reduced by 25.40%. #597039
Amount:
$11,442.14
Sweep test of existing antenna

Component Description:
Antenna related cost reduced by 8.40%. #755021
Amount:
$5,862.40
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
Total invoice amount reduced by 25.40%. #559025
Amount:
$112,011.90

Component Description:
Total invoice amount reduced by 25.40%. #579002
Amount:
$16,225.50
Antenna Input

Component Description:
Total invoice amount reduced by 25.40%. #616053
Amount:
$13,511.57

Cost Information

Back to Top

Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $0.00 $0.00 N/A $0.00 N/A
Total for all systems $4,254,485.54 $2,257,170.86 N/A $1,607,581.83 N/A
Primary Transmission Line $0.00 $0.00 $0.00

Components

Information not provided.

Cost Information

Back to Top

Tower Equipment and Rigging Costs

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $686,929.00 $659,829.00 N/A $451,329.00 N/A
Total for all systems $4,254,485.54 $2,257,170.86 N/A $1,607,581.83 N/A
Primary Tower GTOWER $686,929.00 $659,829.00 $451,329.00
Tower permit drawing package $2,350.00 $2,350.00 N/A $2,350.00 N/A
Structural engineering tower load study for a documented tower with candelabra $20,000.00 $21,900.00 See quote attached to American Tower invoices. $21,900.00 N/A
Minor tower reinforcement/modifications $158,000.00 $150,000.00 N/A $84,775.00 N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $400,000.00 N/A $256,725.00 N/A
Tower Helicopter Lift $85,079.00 $85,079.00 N/A $85,079.00 N/A
Building Permits $500.00 $500.00 N/A $500.00 N/A

Components

Actual Information Description File Name
Tower permit drawing package

Component Description:
Tower related cost. #373447
Amount:
$2,350.00
Structural engineering tower load study for a documented tower with candelabra

Component Description:
Tower study cost. #460223969
Amount:
$12,400.00

Component Description:
Tower study cost. #460223968
Amount:
$9,500.00
Minor tower reinforcement/modifications

Component Description:
Tower related cost. #SIN002256
Amount:
$9,757.50

Component Description:
Tower reinforcements cost. #460224182
Amount:
$65,260.00

Component Description:
50% invoiced upon order. #E-188226
Amount:
$9,757.50
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)

Component Description:
Tower related cost. #SIN002256
Amount:
$104,630.50

Component Description:
Tower related cost. #SIN001152
Amount:
$47,464.00

Component Description:
Complex tower related cost. #E-188226
Amount:
$104,630.50
Tower Helicopter Lift

Component Description:
Tower related cost. #SIN002250
Amount:
$42,539.50

Component Description:
Tower related cost. #SIN002336
Amount:
$42,539.50
Building Permits

Component Description:
Tower related cost. #373447
Amount:
$500.00

Cost Information

Back to Top

Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $221,847.07 $193,000.24 N/A $70,468.19 N/A
Total for all systems $4,254,485.54 $2,257,170.86 N/A $1,607,581.83 N/A
Outside Professional Services $221,847.07 $193,000.24 $70,468.19
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,781.25 Please see Carl T. Jones invoice $1,781.25 N/A
Project management of the transition $74,260.00 $70,500.00 N/A $54,612.41 N/A
Site Coordination Meeting $1,250.00 $1,250.00 N/A $1,250.00 N/A
Sinclair Internal Costs $447.07 $447.07 N/A $447.07 N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A N/A N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase $2,105.00 $2,000.00 N/A N/A N/A
ASR modification (prepare FCC Form 854) $2,105.00 $2,000.00 N/A N/A N/A
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet $10,520.00 $10,000.00 N/A N/A N/A
NEPA Section 106 environmental review, if needed $6,310.00 $6,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $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 $2,351.25 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $2,167.50 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $3,127.50 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A $1,250.00 N/A
Prepare and or review reimbursement form $2,630.00 $3,300.00 Update of estimated cost per FCC requirement. $3,259.29 N/A

Components

Actual Information Description File Name
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
Consulting engineering cost. #858-92-0004
Amount:
$1,781.25
Project management of the transition

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 100 stations. #477305
Amount:
$393.53

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 98 stations.
Amount:
$185.10

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 52 stations. #153
Amount:
$1,287.27

Component Description:
Project management cost. #373447
Amount:
$4,740.00

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. #132
Amount:
$589.44

Component Description:
Legal Service Cost. #479857
Amount:
$2,231.25

Component Description:
Legal services cost. #477863
Amount:
$51.25

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations.
Amount:
$105.97

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$20.91

Component Description:
Legal services cost. #479326
Amount:
$122.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 52 stations. #481318
Amount:
$814.01

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #465001
Amount:
$596.30

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. #1069
Amount:
$246.68

Component Description:
Legal Service Cost. #466744
Amount:
$302.50

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 100 stations. #474809
Amount:
$395.77

Component Description:
Legal services cost. #481927
Amount:
$57.50

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 98 stations. #463026
Amount:
$801.57

Component Description:
Legal Service Cost. #480203
Amount:
$1,647.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #466690
Amount:
$446.87

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 43 stations. #194
Amount:
$1,696.84

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. #1143
Amount:
$436.90

Component Description:
Legal services cost. #474861
Amount:
$412.50

Component Description:
Legal services cost. #473574
Amount:
$370.00

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 100 stations. #472583
Amount:
$279.89

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 100 stations. #1151
Amount:
$388.07

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. #472629
Amount:
$163.75

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. #470923
Amount:
$406.65

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 100 stations. #1145
Amount:
$369.98

Component Description:
Legal services cost. #470300
Amount:
$440.00

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. #1117
Amount:
$282.68

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. #478816
Amount:
$362.50

Component Description:
Legal services cost. #480788
Amount:
$57.50

Component Description:
Legal services cost. #476417
Amount:
$280.00

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 100 stations. #1098
Amount:
$238.07

Component Description:
$207.48 credit to be split across 52 Sinclair stations reimbursed $269.71 for invoice #1093 (correct reimbursement amount is $265.72). #CM-7-29-2019-1093
Amount:
($3.99)

Component Description:
Legal services cost. #476929
Amount:
$4,112.20

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. #107
Amount:
$602.28

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #475744
Amount:
$305.99

Component Description:
Legal services cost. #482453
Amount:
$493.75

Component Description:
Legal services cost. #482725
Amount:
$682.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1072
Amount:
$237.64

Component Description:
Legal services cost. #477348
Amount:
$836.25

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$91.76

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 99 stations. #1086
Amount:
$275.35

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #471524
Amount:
$322.83

Component Description:
Legal Service Cost. #481350
Amount:
$286.25

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #463567
Amount:
$566.48

Component Description:
Outside professional service cost. #460224182
Amount:
$2,500.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 52 stations. #153
Amount:
$1,287.27

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 100 stations. #476367
Amount:
$364.80

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 33 stations. #179
Amount:
$2,234.33

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. #1130
Amount:
$281.49

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1063
Amount:
$262.29

Component Description:
Legal services cost. #470890
Amount:
$163.75

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 31 stations. #189
Amount:
$1,968.06

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 100 stations. #1123
Amount:
$342.14

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. #475283
Amount:
$384.08

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. #461289
Amount:
$91.50

Component Description:
Legal Service Cost. #465229
Amount:
$310.00

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 98 stations. #1055
Amount:
$243.38

Component Description:
Legal services cost. #473038
Amount:
$212.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1058
Amount:
$187.24

Component Description:
Legal Service Cost. #467940
Amount:
$57.50

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 100 stations. #1099
Amount:
$266.93

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. #417524
Amount:
$341.18

Component Description:
Legal Service Cost. #464401
Amount:
$442.90

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$999.04

Component Description:
Legal Service Cost. #467432
Amount:
$62.50

Component Description:
Legal services cost. #475795
Amount:
$153.75

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:
$32.35

Component Description:
Legal Service Cost. #469629
Amount:
$57.50

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. #1114
Amount:
$242.25

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 100 stations. #1093
Amount:
$269.71

Component Description:
Legal Service Cost. #469629
Amount:
$57.50

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 98 stations. #1079
Amount:
$177.14

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 93 stations.
Amount:
$943.95

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. #478288
Amount:
$194.86

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #477820
Amount:
$320.19
Site Coordination Meeting

Component Description:
Site coordination meeting cost. #460224182
Amount:
$1,250.00
Sinclair Internal Costs

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 31 stations.
Amount:
$4.10

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 43 stations.
Amount:
$4.60

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 52 stations.
Amount:
$41.33

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 33 stations.
Amount:
$15.86

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 43 stations.
Amount:
$35.82

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 100 stations.
Amount:
$15.08

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:
$26.93

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:
$7.86

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 100 stations.
Amount:
$16.53

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 52 stations.
Amount:
$9.79

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:
$17.02

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:
$8.66

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:
$1.69

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations.
Amount:
$33.53
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

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759
Amount:
$99.92

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
Prepare request for Special Temporary Authorization

Component Description:
Outside professional service cost. #858-92-0003
Amount:
$2,351.25
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Consulting engineering cost.
Amount:
$2,167.50
Perform engineering study for new channel assignment and antenna development

Component Description:
Consulting engineering cost.
Amount:
$3,127.50
Address transition timing and coordination issues w/ other stations and wireless

Component Description:
Transition coordination cost. #460224182
Amount:
$1,250.00
Prepare and or review reimbursement form

Component Description:
Legal services cost.
Amount:
$172.50

Component Description:
Legal services cost. #460896
Amount:
$173.10

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$1,315.27

Component Description:
Legal services cost. #461815
Amount:
$580.90

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759
Amount:
$869.30

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$152.01

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289
Amount:
$1,311.48

Cost Information

Back to Top

Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $133,225.07 $132,660.07 N/A $35,940.76 N/A
Total for all systems $4,254,485.54 $2,257,170.86 N/A $1,607,581.83 N/A
Other Expenses $133,225.07 $132,660.07 $35,940.76
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 24 Inquiry. $60.00 N/A
Equipment Storage $15,000.00 $15,000.00 See Exhibit J. $7,144.80 N/A
Equipment Delivery and Handling Charges $14,529.07 $14,529.07 See Exhibit J. $19,660.96 The line item with the status Need More Information and description Delivery related cost. #9944388652 can be deleted.
Disposal Costs (for equipment and other waste, net of any salvage value) $28,566.00 $28,566.00 See Response to August 24 Inquiry. $5,800.00 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 $3,275.00 N/A

Components

Actual Information Description File Name
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change

Component Description:
Other related cost. #1907-2080a
Amount:
$60.00
Equipment Storage

Component Description:
Total invoice amount reduced by 8.40% #706011
Amount:
$7,144.80
Equipment Delivery and Handling Charges

Component Description:
Equipment delivery and handling reduced by 8.40%. #757015
Amount:
$1,642.28

Component Description:
Equipment Delivery and Handling cost. #4788
Amount:
$1,840.00

Component Description:
Equipment delivery and handling cost reduced by 8.40%. #837028
Amount:
$5,131.89

Component Description:
Delivery cost. #9944388652
Amount:
$659.00

Component Description:
Delivery related cost. #9944388652
Amount:
$659.00

Component Description:
Equipment delivery and handling reduced by 8.40%. #706011
Amount:
$8,451.37

Component Description:
Equipment delivery and handling related costs. #5541
Amount:
$1,840.00

Component Description:
Total invoice amount reduced by 25.40%. #591056
Amount:
$96.42
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
Disposal cost. #381
Amount:
$5,800.00
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:
Medical notification cost. #1211
Amount:
$3,275.00

Cost Information

Back to Top

Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $4,254,485.54 $2,257,170.86 $1,607,581.83

Reimbursement Status

Back to Top
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

Back to Top
Section Question Response
Submission of Estimated Expenses Statements

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

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

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

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

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

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

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

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

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

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

Lucy Rutishauser

CFO


01/18/2021

Certification

Back to Top
Section Question Response
Submission of Actual Cost Documentation Statements

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

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

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

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

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

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

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

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

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

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

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

Lucy Rutishauser

CFO


01/18/2021

Attachments

Back to Top