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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:
81508
Service:
DTV
Call Sign:
WEPX-TV
Channel:
36 (UHF)
File Number:
0000028434
FRN:
0001808468
Date Submitted:
01/19/2021

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

ION TELEVISION LICENSE, LLC

Doing Business As: ION TELEVISION LICENSE, LLC

601 CLEARWATER PARK ROAD

WEST PALM BEACH, FL 33401

United States

 +1 (561) 682-4110 BIANCAFRYE@IONMEDIA.COM Corporation

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 

Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

The Preparer is same as the reimbursement contact.

 

 

 

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan Relocate from ASR #1050614 to ASR #1007564. Install interim antenna and transmitter to meet repack deadline. Replace non-retunable transmitter, install top mounted antenna and transmission line to operate on post-repack channel.

Transmitters

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

Primary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model DCX
Year 1998
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 40 kW

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Manufacturer
Model HPTV-PRLX-U32
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 55 kW
Justification for New Transmitter See attached Transmitter Exhibits. See attached Transmitter Upgrade Disclaimer.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) Yes
Power 500 kVA
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 5 tons
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? Yes
Size 480.0 square feet
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Removal of Existing Equipment

Removal of existing transmitters and equipment / Site Prep

RF Interconnect

Interconnect between RF System and transmission line

Interim Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Interim
Description of Use N/A
Change Type Purchase
Manufacturer
Model SLIM5 01 UHF SD PCM LP Air Cooled 1KW
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1.3 kW
Justification for New Transmitter Needed to make phase deadline for channel change

Interim Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service 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
Inside RF System Is an additional interior RF system required to support this interim transmitter? No

Interim Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

Antennas

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

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change 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? No
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 Circular
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: 271.0 kW
Manufacturer
Model JSH-24/26-TCO
Year 2012

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type 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 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: 850.0 kW
Manufacturer
Model TFU-16JSC/VP-R C170
Year 2019
Justification for New Antenna Current slot antenna cannot be re-channeled. ION is not seeking reimbursement for VPOL upgrade

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna?
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? 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

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

Interim Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
Ownership 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 Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
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: 20.0 kW
Manufacturer
Model TFU-8WB
Year 2019
Justification for New Antenna Interim antenna needed to meet repack deadline

Interim Antenna

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Other Antenna Costs

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

Interim Antenna

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Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 8 3/16 inches
Other Diameter N/A
Segment Length 19 1/2 inches
Other Segment Length N/A
Number of parallel runs 1
Length 548 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1000 feet per run
Justification for New Transmission Line See attached Transmission Line Exhibit

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Transmission Line Bridge

Cost to design, fabricate, and install transmission line bridge from tower to building

Sweep existing transmission line

Sweep existing transmission line

Tower Equipment And Rigging Costs

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

Primary Tower

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Add 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? No
One or more FM, AM or TV radio broadcaster(s) N/A
Others Types of Users N/A
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1007564
Coordinates (NAD83) Latitude (NAD83) 35° 12' 02.6" N-
Longitude (NAD83) 077° 11' 12.8" W-
Overall Structure Height 1036.73 feet
Support Structure Height 954.71 feet
Ground Elevation Above Mean Sea Level (AMSL) 27.89 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Beasley Media Group Licenses, LLC
Date Constructed 01/01/1986


Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: No study needed
Tower Reinforcements Please select whether tower reinforcements are needed: Minor Reinforcements needed

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Structural analysis

Structural analysis

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Move Equipment
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? No
One or more FM, AM or TV radio broadcaster(s) N/A
Others Types of Users N/A
Is tower documented for structural analysis? Unknown
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1050614
Coordinates (NAD83) Latitude (NAD83) 35° 24' 10.0" N-
Longitude (NAD83) 077° 25' 09.0" W-
Overall Structure Height 498.68 feet
Support Structure Height 495.73 feet
Ground Elevation Above Mean Sea Level (AMSL) 67.91 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner SpectraSite Communications, LLC. through American Towers, LLC.
Date Constructed 04/01/1999


Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Structural Study

Structural Study required by Landlord

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 180
Explanation Required by tower landlord
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
NEPA Section 106 environmental review Yes
Environmental Assessment Yes
ASR Modification Yes
FAA Consultation (including preparation of FAA Form 7460) Yes
Negotiation of Lease and other Matter for Shared Locations Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study Yes
RF exposure measurements Yes
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Impact Study

Impact study for LPTV

Other Expenses

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

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Other Expenses Not Listed

Information not provided.

Cost Information

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Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $2,202,610.25 $1,452,352.25 N/A $1,402,352.25 N/A
Total for all systems $3,536,586.66 $2,946,720.81 N/A $2,655,433.37 N/A
Interim Transmitter SLIM5 01 UHF SD PCM LP Air Cooled 1KW $126,000.00 $34,816.00 $34,816.00
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $34,816.00 Please see BGS Quotes #556192 and#558661 $34,816.00 N/A
Primary Transmitter HPTV-PRLX-U32 $2,076,610.25 $1,417,536.25 $1,367,536.25
5 Ton system $20,250.00 $31,480.00 Please see Delcor quotes #Q2051160 and #Q2052294 $31,480.00 N/A
RF Interconnect $25,000.00 $25,000.00 N/A N/A N/A
Removal of Existing Equipment $25,000.00 $25,000.00 N/A N/A N/A
Transformer 3 phase/480v - 500 KVA $48,400.00 $110,671.00 Please see attached R. Brown Electric Services Quote #5688 $110,671.00 N/A
UHF - Liquid Cooled Solid State Transmitter 52 - 61 kW $1,788,000.00 $1,055,425.00 See attached Hitachi Comark Quote #P3475PRLXU32-011818-R1 and Hitachi Comark Quote P3475R2 WEPX Change Order $1,055,425.00 N/A
Other -- Building Addition Size: 480.0 $169,960.25 $169,960.25 Please see Thermobond Quote #1902-85B and R. Brown Quote #5660 and Worldwide Quote #S-19-982 $169,960.25 N/A

Components

Actual Information Description File Name
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
Cost to commission interim transmitter. Supporting documentation is attached. This invoice has been paid.
Amount:
$3,000.00

Component Description:
Cost of interim transmitter and filter. Supporting documentation is attached. This invoice has been paid.
Amount:
$31,816.00
5 Ton system

Component Description:
Cost of electric work for new HVAC system. Supporting documentation is attached. This invoice has been paid.
Amount:
$1,800.00

Component Description:
Cost of additional 10 Ton HVAC for transmitter cooling. Supporting documentation is attached. This invoice has been paid.
Amount:
$16,480.00

Component Description:
Cost of 5 Ton HVAC for new transmitter. Supporting documentation is attached. This invoice has been paid.
Amount:
$13,200.00
RF Interconnect Information not provided.
Removal of Existing Equipment Information not provided.
Transformer 3 phase/480v - 500 KVA

Component Description:
Cost of electric installation for new transmitter. Supporting documentation is attached. This invoice has been paid.
Amount:
$110,671.00
UHF - Liquid Cooled Solid State Transmitter 52 - 61 kW

Component Description:
30% "deposit" payment for Comark Transmitter. Supporting documentation attached.
Amount:
$306,969.00

Component Description:
Cost of Dielectric 8 pole filter. Supporting documentation is attached.
Amount:
$32,195.00

Component Description:
20% "due upon proof of performance" payment for Comark transmitter. Supporting documentation is attached.
Amount:
$204,646.00

Component Description:
50% "progress" payment on Comark transmitter. Supporting documentation attached.
Amount:
$511,615.00
Other -- Building Addition Size: 480.0

Component Description:
Prorated cost to install ice bridge. Supporting documentation and explanation of variance are attached. This invoice has been paid.
Amount:
$40,031.25

Component Description:
25% "deposit" payment for transmitter building. Supporting documentation is attached. This invoice has been paid.
Amount:
$29,801.00

Component Description:
Cost of concrete pads for building and heat exchangers. Explanation of variance and supporting documentation attached. This invoice has been paid.
Amount:
$28,700.00

Component Description:
75% "balance" payment for transmitter building. Supporting documentation is attached. This invoice has been paid.
Amount:
$71,428.00

Cost Information

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Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $229,195.00 $231,498.45 N/A $225,098.45 N/A
Total for all systems $3,536,586.66 $2,946,720.81 N/A $2,655,433.37 N/A
Interim Antenna TFU-8WB $61,225.00 $60,988.00 $54,588.00
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed) $9,570.00 $9,663.00 Cost of elbow complex and reducer for interim antenna. Please see attached Dielectric Quote #900073CMZ WEPX ION INTERIM. $9,663.00 N/A
UHF - High Power, Side Mount, basic slot antenna, 20 kW input, directional,, horizontally polarized $44,925.00 $44,925.00 Please see attached Dielectric Quote #900073CMZ WEPX ION INTERIM. $44,925.00 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Primary Antenna TFU-16JSC/VP-R C170 $167,970.00 $170,510.45 $170,510.45
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $6,400.00 N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $21,895.45 Please see attached Dielectric Quote #1929768 WEPX and Dielectric DMS056-2B ION WEPX, Dielectric Quote #1930440, and Quote #900203CMZ $21,895.45 N/A
UHF - High Power, Side Mount, basic slot antenna, 850 kW input, directional,, elliptically or circularly polarized $125,790.00 $125,790.00 Cost of side mount antenna. Estimate does not include vertical polarization upgrade. Please see attached Dielectric Main Antenna Quote #C-71237-3. $125,790.00 N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $16,425.00 Cost of antenna mount brackets. Please see attached Dielectric Main Antenna Quote #C-71237-3. $16,425.00 N/A

Components

Actual Information Description File Name
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed)

Component Description:
Cost of elbow complex for interim antenna. Supporting documentation is attached. This invoice has been paid.
Amount:
$8,200.00

Component Description:
Cost of reducer for interim operations. Supporting documentation is attached. This invoice has been paid.
Amount:
$1,463.00
UHF - High Power, Side Mount, basic slot antenna, 20 kW input, directional,, horizontally polarized

Component Description:
Cost of interim antenna including standard mount. Supporting documentation is attached. This invoice has been paid.
Amount:
$44,925.00
Sweep test of existing antenna Information not provided.
Sweep test of existing antenna

Component Description:
25% "deposit" for repack sweep. Explanation of variance and supporting documentation is attached.
Amount:
$1,600.00

Component Description:
65% "prior to ship" payment for repack sweep. Explanation of variance and supporting documentation is attached.
Amount:
$4,160.00

Component Description:
10% "after sweep" for repack sweep. Supporting documentation is attached. This invoice has been paid.
Amount:
$640.00
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
Balance billing for main elbow package. Supporting documentation is attached. This invoice has been paid.
Amount:
$370.80

Component Description:
25% "deposit" for elbow complex. Explanation of variance and supporting documentation is attached.
Amount:
$2,574.50

Component Description:
10% "after sweep" for elbow complex. Supporting documentation is attached.
Amount:
$1,071.00

Component Description:
Cost of additional equipment needed for elbow complex. Supporting documentation and justification for expedited shipping is attached.
Amount:
$5,930.45

Component Description:
Cost of additional equipment needed for elbow complex. Supporting documentation and justification for expedited shipping is attached. This invoice has been paid.
Amount:
$1,881.00

Component Description:
65% "prior to ship" payment for elbow complex. Explanation of variance and supporting documentation is attached.
Amount:
$6,693.70

Component Description:
Cost of additional equipment for elbow complex. Supporting documentation is attached. This invoice has been paid.
Amount:
$3,374.00
UHF - High Power, Side Mount, basic slot antenna, 850 kW input, directional,, elliptically or circularly polarized

Component Description:
Balance billing for main antenna. Supporting documentation is attached. This invoice has been paid.
Amount:
$4,320.00

Component Description:
10% "after sweep" payment for main antenna. Supporting documentation and cover letter are attached. This invoice has been paid.
Amount:
$12,579.00

Component Description:
25% "deposit" for primary antenna. Explanation of variance and supporting documentation is attached.
Amount:
$30,247.50

Component Description:
65% "prior to ship" payment for primary antenna. Explanation of variance and supporting documentation is attached.
Amount:
$78,643.50
Side mount brackets for high power antennas (if not included in antenna base cost)

Component Description:
25% "deposit" for antenna mounting brackets. Explanation of variance and supporting documentation is attached.
Amount:
$4,106.25

Component Description:
65% "prior to ship" payment for primary antenna. Explanation of variance and supporting documentation is attached.
Amount:
$10,676.25

Component Description:
10% "after sweep" for antenna mounting brackets. Supporting documentation is attached.
Amount:
$1,642.50

Cost Information

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Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $299,137.50 $272,911.21 N/A $259,502.18 N/A
Total for all systems $3,536,586.66 $2,946,720.81 N/A $2,655,433.37 N/A
Primary Transmission Line $299,137.50 $272,911.21 $259,502.18
Sweep existing transmission line $6,400.00 $6,400.00 N/A N/A N/A
Rigid Transmission Line - copper, 6 1/8" $202,000.00 $175,773.71 Cost of transmission line. Please see attached Dielectric Main Antenna Quote #C-71237-3, Dielectric Quote 900182CMZ, and Dielectric Quote #1930464R1 WEPX $168,764.68 N/A
Transmission Line Bridge $90,737.50 $90,737.50 Please see attached Worldwide Quote #S-19-982 $90,737.50 N/A

Components

Actual Information Description File Name
Sweep existing transmission line Information not provided.
Rigid Transmission Line - copper, 6 1/8"

Component Description:
10% "after sweep" payment for primary transmission line. Supporting documentation is attached. This invoice has been paid.
Amount:
$14,247.10

Component Description:
Cost of additional transmission line pieces and components. Supporting documentation is attached.
Amount:
$617.24

Component Description:
25% "deposit" for transmission line. Explanation of variance and supporting documentation is attached.
Amount:
$33,978.53

Component Description:
65% "prior to ship" payment for transmission line. Explanation of variance and supporting documentation is attached.
Amount:
$88,344.17

Component Description:
Cost of additional transmission line pieces and components. Supporting documentation is attached.
Amount:
$3,430.43

Component Description:
Cost of additional equipment for transmission line. Supporting documentation is attached. This invoice has been paid.
Amount:
$7,395.00

Component Description:
Balance billing for main transmission line. Supporting documentation is attached.
Amount:
$10,541.16

Component Description:
Cost of additional pieces of transmission line. Supporting documentation is attached.
Amount:
$10,211.05
Transmission Line Bridge

Component Description:
Cost to design, fabricate, and install transmission line bridge from tower to building. Supporting documentation and explanation of variance are attached. This invoice has been paid.
Amount:
$90,737.50

Cost Information

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Tower Equipment and Rigging Costs

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $467,120.00 $679,089.13 N/A $679,089.13 N/A
Total for all systems $3,536,586.66 $2,946,720.81 N/A $2,655,433.37 N/A
Primary Tower TOWER $379,000.00 $504,337.13 $504,337.13
Tall Tower (greater than 500') $210,500.00 $428,474.63 Cost of tower services. Please see attached Worldwide Communications Quotes #S-19-935 and #S-19-982. Plus applicable sales tax and weather delay charges. $428,474.63 N/A
Minor tower reinforcement/modifications $158,000.00 $65,362.50 N/A $65,362.50 N/A
Structural analysis $10,500.00 $10,500.00 Cost of structural analysis. Please see attached Elevated Structural Consultants Quote dated 12-28-2018 and Invoice #253 $10,500.00 N/A
Primary Tower TOWER $88,120.00 $174,752.00 $174,752.00
Structural Study $3,920.00 $3,920.00 Cost of structural study required by landlord $3,920.00 N/A
Short Tower (less than 500') $84,200.00 $170,832.00 See attached WEPX antenna removal Worldwide quote S-20-1026. $20k deposit to Worldwide was applied towards other tower $170,832.00 N/A

Components

Actual Information Description File Name
Tall Tower (greater than 500')

Component Description:
Cost of weather delays of 5 men for 4 days. Supporting documentation is attached. This invoice has been paid.
Amount:
$13,000.00

Component Description:
25% "balance" and all sales tax for tower services. Supporting documentation is attached.
Amount:
$117,649.63

Component Description:
Cost to install transmission line from wall of building to transmitter. Supporting documentation and explanation of variance are attached. This invoice has been paid.
Amount:
$16,012.50

Component Description:
75% "deposit" for tower services. Supporting documentation is attached.
Amount:
$277,912.50

Component Description:
Cost of weather delays of 6 men for 1 day. Supporting documentation is attached. This invoice has been paid.
Amount:
$3,900.00
Minor tower reinforcement/modifications

Component Description:
10% "deposit" payment to plumb and tension tower. Supporting documentation is attached. This invoice has been paid.
Amount:
$2,800.00

Component Description:
Balance due for 100 custom built brackets for tower. Supporting documentation is attached. This invoice has been paid.
Amount:
$8,750.00

Component Description:
Balance payment to plumb and tension tower. Supporting documentation is attached. This invoice has been paid.
Amount:
$25,200.00

Component Description:
Cost of sales tax for custom built brackets. Supporting documentation is attached. This invoice has been paid.
Amount:
$2,362.50

Component Description:
75% deposit for 100 custom built brackets for tower. Supporting documentation is attached. This invoice has been paid.
Amount:
$26,250.00
Structural analysis

Component Description:
Cost of structural analysis. Supporting documentation is attached.
Amount:
$7,500.00

Component Description:
Cost of structural analysis. Supporting documentation is attached. This invoice has been paid.
Amount:
$3,000.00
Structural Study

Component Description:
Cost of structural study charged by landlord. Supporting documentation is attached.
Amount:
$3,920.00
Short Tower (less than 500')

Component Description:
25% "balance due" payment to remove old antenna system. Supporting documentation is attached.
Amount:
$37,708.00

Component Description:
75% "deposit" payment to remove old antenna system. Supporting documentation is attached.
Amount:
$113,124.00

Component Description:
Down payment associated with securing tower service. Note that amount is not additional to cost of tower rigging and will be deducted from total cost of tower rigging at the time it is quoted. Supporting documentation attached. This invoice has been paid.
Amount:
$20,000.00

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $190,025.00 $171,935.86 N/A $7,280.86 N/A
Total for all systems $3,536,586.66 $2,946,720.81 N/A $2,655,433.37 N/A
Outside Professional Services $190,025.00 $171,935.86 $7,280.86
Impact Study $375.00 $375.00 Professional study for LPTV impact analysis $375.00 N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A N/A N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase $2,105.00 $2,000.00 N/A N/A N/A
ASR modification (prepare FCC Form 854) $2,105.00 $2,000.00 N/A N/A N/A
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet $10,520.00 $10,000.00 N/A N/A N/A
NEPA Section 106 environmental review, if needed $6,310.00 $6,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,500.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $4,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,280.86 Please see attached Cooley invoices with detailed billing backups $5,280.86 N/A
Prepare request for Special Temporary Authorization $2,050.00 $1,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $1,500.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $125.00 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 $2,500.00 N/A N/A N/A
Project management of the transition $28,440.00 $18,530.00 See AT Exhibits for more information. N/A N/A
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Impact Study

Component Description:
Cost of LPTV impact study. Supporting documentation is attached. This invoice has been paid.
Amount:
$375.00
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:
Invoice for WEPX's portion of general repack legal expenses incurred for 42 of the ION repack stations for period 2/1/2017 - 12/15/2017. Payee has corresponded with FCC staff. Hourly supporting documentation and invoice attached.
Amount:
$4,742.99

Component Description:
Invoice for station's portion of general repack legal expenses incurred for 42 of the ION repack stations for period 2/1/2017 - 12/15/2017. Payee has corresponded with FCC staff and has provided corrected supporting documentation.
Amount:
$4,837.97

Component Description:
Legal fees allocated to WEPX for repack work between 1/1/18 and 6/30/18. Supporting documentation and explanation of variance are attached. These fees have been paid.
Amount:
$537.87
Prepare request for Special Temporary Authorization Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Cost of RF consultant preparation of engineering part of FCC Form 2100. Hourly supporting documentation attached. This invoice has been paid.
Amount:
$1,500.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Cost of RF consultant work for new channel assignment and antenna development. Hourly supporting documentation attached. This invoice has been paid.
Amount:
$62.50

Component Description:
Cost of RF consultant work for new channel assignment and antenna development. Hourly supporting documentation attached. This invoice has been paid.
Amount:
$62.50
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form Information not provided.
Project management of the transition Information not provided.
RF Exposure Measurements Information not provided.

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $148,498.91 $138,933.91 N/A $82,110.50 N/A
Total for all systems $3,536,586.66 $2,946,720.81 N/A $2,655,433.37 N/A
Other Expenses $148,498.91 $138,933.91 $82,110.50
MVPD Notification of Channel Change $500.00 $500.00 N/A $500.00 N/A
Develop and air announcement of upcoming channel change $0.00 $0.00 The amount is yet to be determined (TBD) and ION will submit on-air announcement costs when finalized. N/A N/A
Local Zoning $25,000.00 $25,000.00 N/A N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $2,000.00 N/A $2,000.00 N/A
Equipment Storage $10,000.00 $10,000.00 N/A $8,691.59 N/A
Equipment Delivery and Handling Charges $70,918.91 $70,918.91 This is the actual amount ION has been charged by vendors to deliver equipment for repack. $70,918.91 Sub-total and estimate are equal
Disposal Costs (for equipment and other waste, net of any salvage value) $15,000.00 $15,000.00 N/A N/A N/A
Non-zoning permits $15,000.00 $15,000.00 N/A N/A N/A

Components

Actual Information Description File Name
MVPD Notification of Channel Change

Component Description:
Cost of MVPD notification for channel change. Supporting documentation is attached. This invoice has been paid.
Amount:
$500.00
Develop and air announcement of upcoming channel change 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:
Cost of medical notifications for repack channel change. Supporting documentation is attached. This invoice has been paid.
Amount:
$2,000.00
Equipment Storage

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation and explanation of variance are attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation and explanation of variance are attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of first month for storage unit rental. Supporting documentation is attached. This invoice has been paid.
Amount:
$742.56

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.50

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation and explanation of variance are attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation and explanation of variance are attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation and explanation of variance are attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of first month for additional storage unit rental. Supporting documentation is attached. This invoice has been paid.
Amount:
$483.17

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation and explanation of variance are attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of first month for storage unit rental. Supporting documentation is attached. This invoice has been paid.
Amount:
$742.56

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation and explanation of variance are attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation and explanation of variance are attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation and explanation of variance are attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.50

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of first month for storage unit rental. Supporting documentation is attached. This invoice has been paid.
Amount:
$742.56

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11

Component Description:
Cost of another month rental for onsite storage unit. Supporting documentation is attached. This invoice has been paid.
Amount:
$166.11
Equipment Delivery and Handling Charges

Component Description:
Cost of freight for additional equipment needed for elbow complex and transmission line. Supporting documentation and justification for expedited shipping is attached. This invoice has been paid.
Amount:
$5,684.01

Component Description:
Cost of freight for additional equipment needed for transmission line. Supporting documentation and justification for expedited shipping is attached. This invoice has been paid.
Amount:
$3,725.03

Component Description:
Cost of freight for additional equipment needed for elbow complex. Supporting documentation and justification for expedited shipping is attached. This invoice has been paid.
Amount:
$253.73

Component Description:
Cost of freight for interim antenna components. Supporting documentation is attached. This invoice has been paid.
Amount:
$1,723.46

Component Description:
Cost of freight for additional equipment needed for elbow complex. Supporting documentation and justification for expedited shipping is attached.
Amount:
$1,243.03

Component Description:
Cost of shipping for interim transmitter. Supporting documentation is attached. This invoice has been paid.
Amount:
$743.24

Component Description:
Cost of freight for addditional interim transmission line components. Supporting documentation and justification for expedited shipping is attached. This invoice has been paid.
Amount:
$1,261.89

Component Description:
Cost of freight for additional equipment needed for elbow complex. Supporting documentation and justification for expedited shipping is attached.
Amount:
$8,922.64

Component Description:
Cost of shipping for transmitter building. Supporting documentation is attached. This invoice has been paid.
Amount:
$17,975.00

Component Description:
Cost of freight for additional equipment needed for elbow complex. Supporting documentation and justification for expedited shipping is attached.
Amount:
$3,725.03

Component Description:
Cost of freight for additional equipment needed for elbow complex. Supporting documentation and justification for expedited shipping is attached.
Amount:
$2,465.83

Component Description:
Cost of freight for additional equipment for elbow complex. Supporting documentation is attached. This invoice has been paid.
Amount:
$1,248.83

Component Description:
Cost of freight for main transmitter package. Supporting documentation is attached.
Amount:
$25,672.22

Component Description:
Cost of freight for additional equipment needed for transmission line and elbow complex. Supporting documentation and justification for expedited shipping is attached. This invoice has been paid.
Amount:
$8,922.64
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Non-zoning permits Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate 		Estimated Cost Actual Cost
Total for all systems $3,536,586.66 $2,946,720.81 $2,655,433.37

Reimbursement Status

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

Certification

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Section Question Response
Submission of Estimated Expenses Statements

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

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

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

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

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

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

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

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

  8. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Mario Vasquez

Vice President - Finance, Operations


01/19/2021

Certification

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Section Question Response
Submission of Actual Cost Documentation Statements

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

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

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

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

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

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

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

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

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

  9. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a prerequisite for obtaining the payments herein requested.
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Mario Vasquez

Vice President - Finance, Operations


01/19/2021

Attachments

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