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:
66536
Service:
DTV
Call Sign:
WTIU
Channel:
33 (UHF)
File Number:
0000028550
FRN:
0005268222
Date Submitted:
02/25/2021

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

TRUSTEES OF INDIANA UNIVERSITY

Doing Business As: TRUSTEES OF INDIANA UNIVERSITY

Deborah A. Lemon, Secretary of the Board of Trustees

FRANKLIN HALL 200

601 E. KIRKWOOD AVE.

BLOOMINGTON, IN 47405

United States

+1 (812) 856-3731 DALEMON@IU.EDU Private Not-for-Profit Educational Institution

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

George C. Hopstetter

Director Operation and Engineering

Indiana University

George C. Hopstetter

WTIU, Indiana University

1229 E. 7th Street

Bloomington, IN 47405

United States

+1 (812) 855-3177 GHOPSTET@INDIANA.EDU

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 WTIU will need to replace the current transmitter, exciter with backup, mask filter, combiner, dehydrator and top mount antenna to re-locate to digital Ch. 33. Current transmission line was sweep to verify acceptable RF/VSWR to operate on Ch.33.

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 Diamond DHD45P2
Year 2003
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 10.5 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 ULXTE-72
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 47.2 kW
Justification for New Transmitter Existing transmitter can not be re-channeled to meet the new FCC Ch. assignment. WTIU is upgrading to maximize TPO for Ch. 33 from a Like-for-like Transmitter ULXTE-30 to -72, see attached "Indiana_Univ_JW30004503V.1_WTIU_TV_TV_(002)"

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) No
Power N/A
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service Yes
Description New electrical breaker panel is required to facilitate Ch. 33 transmitter and supporting equipment. See attached Quote "20170384-BL800A Sare Rd Transmitter-New Transmitter"
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? 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

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Other Transmitter Cost Not Listed

Name Description

Transmitter unloading

Unload transmitter from semi, Transmitter, heat-exchangers, associated gear.

Coolant water for Liquid cooled transmitter

Distilled water for Liquid cooled transmitter purchased local

Electrical Cable trays

Required Electrical cabling trays to install Gates Air ULXTE-72 liquid cooled transmitter

Core Concret wall

Hire Professional Concrete coring provider to core 1- 10" hole and 8-3" diameter holes in 8"concrete wall for TX coolant lines and transmission line

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? 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 Broadband Panel
Number of Stations Supported 1
Number of Panels 32
Design power capacity in use 35.0 %
Lower Limit 470.00 MHz
Upper Limit 806.00 MHz
Other Antenna Type N/A
ERP: 224.0 kW
Manufacturer
Model TUA-SP4A-8/32H-1-TR
Year 2002

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 Top 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: 797.0 kW
Manufacturer
Model ATW18H3-ETTX-33H
Year 2019
Justification for New Antenna Current broadband antenna is not efficient single channel operations and limited capabilities. Antenna sweep indicated that power divider had a high than desired reflection on assigned channel.Initial Report when installed had a higher than desired VSWR

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?
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Main Antenna Sweep Test

TV Sweep test of New MAIN Ch. 33 antenna.

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? No
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 1
Number of Panels/Bays 16
Lower Limit 470.00 MHz
Upper Limit 698.00 MHz
Design power capacity in use 95.0 %
Other Antenna Type N/A
ERP: 132.43 kW
Manufacturer
Model i230ECW-16-14/33
Year 2019
Justification for New Antenna Interim antenna, side mount broadband operation on Ch. 14 during transition of primary top mount antenna to single CH. 33. Dielectric/ERI does not rent or lease interim antennas or transmission line.

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 6 1/8 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

Name Description

Interim Antenna and line Sweep test

Interim antenna and 5-inch transmission line TV sweep test

Transmission Line

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

Auxiliary Transmission Line

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Add Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Auxiliary (Backup)
Description of Use Interim Transmission line currently exist
Ownership Owned
Owner N/A
Site N/A
Is this transmission currently shared with any other stations? No
Is Transmission Line in operating condition? No
Existing Transmission Line Manufacturer and Type Manufacturer
Type Flexible Air
Diameter 5 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 530 feet per run

Auxiliary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Auxiliary (Backup)
Description of Use Pre/Post-transition 5" transmission Line
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Flexible Air
Diameter 5 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 530 feet per run
Justification for New Transmission Line Flex 5 inch Andrew HJ9-50 for interim side mount antenna feed. To service while primary top mount antenna is removed and replace by new single Ch. 33 antenna.

Auxiliary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Primary Transmission Line

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Add 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 this transmission currently shared with any other stations? No
Is Transmission Line in operating condition? No
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 19 3/4 inches
Other Segment Length N/A
Number of parallel runs 0
Length 710 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? No
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 19 3/4 inches
Other Segment Length N/A
Number of parallel runs 0
Length 710 feet per run
Justification for New Transmission Line "Main" Dielectric 6 1/8" Dielectric DigiTLine transmission line fialed 2- months after transitioning over from UHF Ch. 14 to UHF Ch. 33 repack. Current 18-year old line is now non-operational and need replaced as soon as possible. Main antenna off air

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

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 6 1/8 inches
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 1
Length 650 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? No
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 0
Length 0 feet per run
Justification for New Transmission Line Primary 6 1/8 DigiLine transmission line does not need to be changed out. Disregard this entery

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Interim Aux

New 5 inch flexible transmission line is for the Interim AUX antenna not the Primary Main

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 Owned
Is this tower consider Complex? No
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users Yes
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1234684
Coordinates (NAD83) Latitude (NAD83) 39° 08' 31.0" N-
Longitude (NAD83) 086° 29' 42.9" W-
Overall Structure Height 645.99 feet
Support Structure Height 610.23 feet
Ground Elevation Above Mean Sea Level (AMSL) 806.09 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner Trustees of Indiana University
Date Constructed 12/28/2015

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
68269 WFIU FM

Other Types of Users

Users
Verizon
T-Mobile
New Cingular
Sprint

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

Antenna replacement

Costs to remove existing top mounted antenna and install new Ch. 33 top mount antenna

Lower Guy support upgrade

Lower Guy supports upgraded to handle the added "AUX" Interim antenna loading on tower

Interim Antenna installation

Cost to install Aux antenna and 500ft of 4" transmission line for Ch. 14 while Primary antenna is removed and replaced.

MAIn Transmission Line installation

Main 6 1/8" Dielectric DigiTLine failed 2-months after transition date from Ch. 14 to Ch. 33.

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? No
Number of Hours N/A
Explanation N/A
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 Yes
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
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 Yes
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification Yes
FAA Consultation (including preparation of FAA Form 7460) Yes
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers No
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements No
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

Information not provided.

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 No
Non-zoning permits No
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)? No
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? No
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Name Description

Endeavor Communications

New Ch. 33 receive element for provided PR-450 receive antenna feed local cable system programming. Change Ch. 14 element to CH. 33 element on Receive tower

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 $1,651,904.20 $843,356.62 N/A $735,947.84 N/A
Total for all systems $3,006,624.20 $1,913,426.62 N/A $1,499,703.27 N/A
Primary Transmitter ULXTE-72 $1,651,904.20 $843,356.62 $735,947.84
5 Ton system $20,250.00 $34,350.50 Upload Technical operating data showing the room heat dissipation of the Gate Air transmitter. New transmitter is to be installed in a separate room with limited HVAC service. See 20170384_CO Proposal #03_HVAC.rev.1 $0.00 N/A
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW $1,473,000.00 $650,351.92 Requesting reimbursement for Like-for-like transmitter Gates Air ULXTE-30 Only. WTIU will be responsible for the Maximization cost to upgrade to a Gates Air ULXTE-72. $642,651.92 N/A
Coolant water for Liquid cooled transmitter $330.00 $330.00 Transmitter manufacture requires that all distilled water to be purchased local to the transmitter site for water cooled transmitters. $329.18 N/A
Electrical Cable trays $2,250.00 $2,250.00 Gates Air required electrical cable trays to be installed with Gates Air ULXTE-72 transmitter $2,250.00 Gates Air required electrical cable trays/elbows to be installed with Gates Air ULXTE-72 transmitter
Transmitter unloading $466.00 $466.00 Cost to rent a Telehandler (Forklift) to unload transmitter from semi to ground. Gates air required on-site unloading semi. $466.00 N/A
Other Electrical Service: New electrical breaker panel is required to facilitate Ch. 33 transmitter and supporting equipment. See attached Quote "20170384-BL800A Sare Rd Transmitter-New Transmitter" $155,178.20 $155,178.20 Electrical contractor bid and university Physical plant charges for Transfer switch, electrical distribution panel for new transmitter. See Attachment: "20170384-BL800A Sare Rd Transmitter-new Transmitter" $89,821.27 N/A
Core Concret wall $430.00 $430.00 Core concrete waal for 8-3" TX coolant hoses and 1-10" transmission line trough 8" concrete wall for installation of Gate Air transmitter. $429.47 N/A

Components

Actual Information Description File Name
5 Ton system

Component Description:
Payment for purchase and installation of 5-ton HVAC unit to support WTIU Gates Air Transmitter CH. 33 installation.
Amount:
$30,018.38
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW

Component Description:
Gates Air Installation & Proof "Like-for-Like" equivalent cost
Amount:
$31,616.00

Component Description:
Shipment due payment for transmitter ship to site for installation of Like-for-like reimburse expense of transmitter.
Amount:
$396,818.61

Component Description:
Gates Air requires purchasing distilled water locally for the install of their transmitter, had to go to 2 location to gain enough water.
Amount:
N/A

Component Description:
Gates Air Install & Proof "Like-for-Like" equivalent cost.
Amount:
$31,616.00

Component Description:
Cable tray to support coolant hoses from transmitter over head.
Amount:
N/A

Component Description:
30% down payment for the Like-for-like ULXTE-30 transmitter. WTIU will be responsible for the Maximization ULXTE-72 Down PMT $251,696.83 difference. See Invoice Attachment: "Indiana Univ JW30004503V.1 WTIU-TV-TV (002)"
Amount:
$214,217.31

Component Description:
Telehandler (Forklift) rental to unload Transmitter components from semi.
Amount:
N/A

Component Description:
Gates Air requires client to core/drill all holes in customers wall for coolant lines and transmission line.
Amount:
N/A

Component Description:
Gates Air requires customer to provide distilled water for water cooled transmitter to be purchased locally.
Amount:
N/A
Coolant water for Liquid cooled transmitter

Component Description:
Distilled water for transmitter coolant, 228 1-gallon containers
Amount:
$215.26

Component Description:
Distilled water for Transmitter coolant purchased local, 128 1-gallon containers.
Amount:
$113.92
Electrical Cable trays

Component Description:
Gates Air required electrical cable trays to be installed with Gates Air ULXTE-72 transmitter
Amount:
$2,250.00
Transmitter unloading

Component Description:
Telehandler, (Forklift) to unload transmitter from semi
Amount:
$466.00
Other Electrical Service: New electrical breaker panel is required to facilitate Ch. 33 transmitter and supporting equipment. See attached Quote "20170384-BL800A Sare Rd Transmitter-New Transmitter"

Component Description:
1st payment for completed-to-date based on invoice date electrical work completed for electrical installation of Ch. 33 transmitter.
Amount:
$19,475.00

Component Description:
4th Payment-to-date for Electrical installation of WTIU Ch. 33 transmitter repack.
Amount:
$10,655.31

Component Description:
2nd Payment-to-date of completion for electrical installation for repack transmitter WTIU Ch. 33
Amount:
$44,673.66

Component Description:
5th Payment-to-date for electrical installation for WTIU Ch. 33 transmitter repack.
Amount:
$15,017.30

Component Description:
3rd Payment-to-date for electrical installation of WTIU Ch. 33 repack installation.
Amount:
$49,109.78
Core Concret wall

Component Description:
Gates Air requires client to core/drill all holes in clients walls for coolant and transmission through lines.
Amount:
$429.47

Component Description:
Core 1-10" hole for transmission line through wall and 8-3" holes for transmitter coolant hoses through 8" concrete wall. Quote attached.
Amount:
$429.47

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 $443,160.00 $417,709.00 N/A $375,595.00 N/A
Total for all systems $3,006,624.20 $1,913,426.62 N/A $1,499,703.27 N/A
Interim Antenna i230ECW-16-14/33 $128,380.00 $182,231.00 $175,981.00
Interim Antenna and line Sweep test $6,250.00 $6,250.00 Interim Antenna and 5-inch TV sweep test $6,250.00 Previous submission is lock to editing not to update more information, resubmitted. Total request remains $6250.00
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $5,168.00 6 1/8" 90 degree miter elbow and hardware, $5,168.00 Item requesting addition information is lock and can not access to modify submission, Total for Interim Elbow complex will be $5,168.00
UHF - Lower Power Side Mount, One Station antenna . medium power (50-200 kW), elliptically or circularly polarized $103,100.00 $170,813.00 Change in interim antenna, ERI does not rent or lease interim antenna. Requires purchase of new interim antenna. Includes side mounts $9,800 increasing the cost of the interim antenna system $164,563.00 Cost of ERI Interim side mounted antenna i230ECW-16-14/33, new design and currently the one the manufacture now offers as a interim antenna.
Sweep test of existing antenna $6,730.00 $0.00 N/A $0.00 N/A
Primary Antenna ATW18H3-ETTX-33H $314,780.00 $235,478.00 $199,614.00
Main Antenna Sweep Test $6,250.00 $6,250.00 Main Antenna TV Sweep test after installation $6,250.00 Previous submission is locked to editing to update for more information
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $18,016.00 Replace failed 6 1/8" Dielectric line with ERI MACXLine, will need to replace existing elbow complex with ERI to match inner conductors $6,452.00 Previous submission for "More Information" is locked and unable to edit, resubmitted entries.
Sweep test of existing antenna $6,730.00 $12,500.00 Re-sweep replacement 6 1/8" transmission line after failed line has been replace to fine match tune to antenna. (See attachment $3,700.00 N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $289,500.00 $198,712.00 ERI Cost is Hpol - Vpol cost of $15,500.00, See ERI quote: "ERI-Main_AUX_antenna_quote.pdf" $183,212.00 Prior Submission is locked to edit, can not update with updated information. Resubmitted request with updates.

Components

Actual Information Description File Name
Interim Antenna and line Sweep test

Component Description:
ERI 1/3rd down payment for Interim Antenna and 5in transmission system Sweep Test.
Amount:
$2,022.64

Component Description:
ERI 2nd payment for Interim Transmission Line & Antenna TV Sweep test.
Amount:
$4,227.36

Component Description:
ERI 1/3 down payment with order for TV Transmission Sweep test.
Amount:
$2,022.64

Component Description:
Interim Antenna and transmission line TV sweep test 2nd payment due reimbursement.
Amount:
$4,227.36

Component Description:
Interim Antenna and 5-in transmission line TV Sweep down payment.
Amount:
$2,022.64

Component Description:
Interim Antenna & Transmission TV Line Sweep, 2nd payment due
Amount:
$4,227.36

Component Description:
Interim Antenna & Transmission TV Line sweep , down payment
Amount:
$2,022.64
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
2nd ERI payment prior to shipment of Interim Transmission line Elbow-Complex
Amount:
$3,495.52

Component Description:
1/3 down payment for Interim transmission line Elbow-complex.
Amount:
$1,672.48

Component Description:
Revised Invoiced Down Payment for ERI RF system for interim antenna elbow complex: See attached invoice with notes.
Amount:
$1,672.48

Component Description:
Interim Transmission TV line break out of Elbow complex, 2nd Payment due Hardware shipment.
Amount:
$3,495.52

Component Description:
2nd payment upon shipping material for interim antenna elbow complex
Amount:
$3,305.76

Component Description:
down payment of Interim antenna "AUX" elbow complex cost.
Amount:
$1,862.24

Component Description:
Interim TV transmission line elbow complex breakout, down payment
Amount:
$1,672.48

Component Description:
ERI 1/3 down payment of Interim Elbow Complex transmission system
Amount:
$1,672.48

Component Description:
Interim Antenna Elbow Complex 2nd payment. Quote Line item # 26 ERI Proposal 20190323-51.
Amount:
$3,495.52
UHF - Lower Power Side Mount, One Station antenna . medium power (50-200 kW), elliptically or circularly polarized

Component Description:
2nd payment prior to shipment of Interim Antenna and Mounting Hardware
Amount:
$111,306.67

Component Description:
1/3 Down Payment for Interim Antenna and Mounting hardware
Amount:
$53,256.33

Component Description:
ERI 1/3rd down payment for Interim Antenna and mounting system.
Amount:
$53,256.32

Component Description:
Down Payment for Interim antenna: See attached invoice and Note of breakdown of payment.
Amount:
$53,256.32

Component Description:
Interim antenna 2nd payment due for reimbursement.
Amount:
$111,306.68

Component Description:
2nd payment for shipping material for interim antenna.
Amount:
$103,001.70

Component Description:
Down Payment for Interim antenna: See attached invoice and Note of breakdown of payment. Also see attached (ERI Letter - WTIU) for additional information
Amount:
$53,256.32

Component Description:
Interim Antenna and mounting, 2nd payment due at hardware shipment.
Amount:
$111,306.68

Component Description:
Down payment of Interim Antenna "AUX" cost.
Amount:
$67,811.30
Sweep test of existing antenna

Component Description:
No existing interim "AUX" antenna exist to sweep test.
Amount:
N/A
Main Antenna Sweep Test

Component Description:
ERI, 2nd payment for Main Antenna TV-Sweep test.
Amount:
$4,227.36

Component Description:
ERI, 1/3 down payment with order for Main Antenna TV Sweep test.
Amount:
$2,022.64

Component Description:
MAIN Antenna TV Sweep 2nd payment due reimbursement.
Amount:
$4,227.36

Component Description:
Main Antenna TV sweep test Ch. 33, down payment
Amount:
$2,022.64

Component Description:
MAIN Antenna Sweep test Ch. 33, 2nd payment due
Amount:
$4,227.36

Component Description:
MAIN Antenna TV Sweep test down payment due.
Amount:
$2,022.64

Component Description:
ERI 1/3rd down payment for MAIN WTIU Antenna TV sweep test
Amount:
$2,022.64
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
ERI 1/3rd down payment for MAIN TV transmission system Elbow Complex.
Amount:
$2,088.01

Component Description:
ERI, 2nd payment prior to shipping for MAIN Antenna Transmission Elbow-Complex.
Amount:
$4,363.99

Component Description:
ERI, 1/3 down payment with order for MAIN Antenna transmission line Elbow-complex.
Amount:
$2,088.01

Component Description:
Main Antenna Ch.33 Transmission TV Line elbow Complex, 2nd payment due at hardware shipment.
Amount:
$4,363.99

Component Description:
Main Antenna Ch. 33 Transmission TV line Elbow complex breakout, Down payment
Amount:
$2,088.01

Component Description:
Down payment of Elbow complex for Main antenna system.
Amount:
$2,324.91

Component Description:
MAIN Antenna Elbow complex 2nd payment due for reimbursement.
Amount:
$4,363.99

Component Description:
Down payment for Main antenna elbow Complex: See attached invoice and note for details.
Amount:
$2,088.01

Component Description:
2nd payment for shipping material for MAIN antenna elbow complex
Amount:
$4,127.09
Sweep test of existing antenna

Component Description:
System Sweep of existing 6.125" line and antenna operating on Ch.14 to determine use on Ch.33. 50% down with order and 50% due NET-30. See attachment: Note-ERI invoice PO 1998688 WTIU Line Sweep
Amount:
$1,850.00

Component Description:
50% down payment, Remaining 50% payment was prior entry only showed total marked out and $1850 remaining.
Amount:
$1,850.00
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
ERI 1/3 down payment for MAIN antenna and mounting hardware
Amount:
$59,291.56

Component Description:
ERI, 2nd payment prior to shipping MAIN Antenna & Hardware.
Amount:
$123,920.44

Component Description:
ERI, 1/3 down payment with order for MAIN Antenna and hardware.
Amount:
$59,291.56

Component Description:
MAIN Antenna 2nd payment due for reimbursement.
Amount:
$123,920.44

Component Description:
WTIU Main antenna Ch. 33, down payment.
Amount:
$59,291.56

Component Description:
Down payment of ERI ATW18H3-16-14/33 "MAIN" antenna top mount Ch. 33
Amount:
$68,273.99

Component Description:
Requesting Down payment for Main Antenna less V-pol cost. See note attached to invoice.
Amount:
$59,291.56

Component Description:
2nd payment upon shipping material for MAIN antenna
Amount:
$121,188.01

Component Description:
WTIU MAIN Antenna, Ch. 33, 2nd payment due at hardware shipment.
Amount:
$123,920.44

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 $55,650.00 $166,786.00 N/A $60,304.00 N/A
Total for all systems $3,006,624.20 $1,913,426.62 N/A $1,499,703.27 N/A
Primary Transmission Line $0.00 $106,482.00 $0.00
Rigid Transmission Line - copper, 6 1/8" $0.00 $106,482.00 Main transmission line failure 2-months after repack from UHF Ch. 14 to UHF Ch. 33. Main Dielectric 6 1/8" line inner connections failed. Report attached. (WTIU Failed Transmission line Quote) $0.00 N/A
Primary Transmission Line $0.00 $0.00 $0.00
Auxiliary Transmission Line $55,650.00 $60,304.00 $60,304.00
Flexible Air Transmission Line - dielectric, 5" $55,650.00 $60,304.00 New 5" coax line to feed interim antenna wideband. Pre & Post transition Ch. 14 Pre channel operation, CH. 33 Post Channel operation as an "AUX" antenna. Included hoist grips, hangers, gas stop, through-wall seal, ground kits and 6 1/8" connectors. $60,304.00 Previous Submission is locked to edit, resubmitted entries with updated information.

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 6 1/8" Information not provided.
Flexible Air Transmission Line - dielectric, 5"

Component Description:
ERI, 2nd payment prior to shipping 5-inch Heliax/Coax interim transmission line and hardware.
Amount:
$40,788.25

Component Description:
ERI, 1/3 down payment for 5-inch Heliax Coax & Hardware
Amount:
$19,515.75

Component Description:
Interim Antenna 5" flex transmission TV-line, 2nd payment due at hardware Shipment.
Amount:
$40,788.25

Component Description:
2nd payment for shipping material for AUX Interim antenna 5in feed line
Amount:
$44,834.60

Component Description:
Interim Antenna 5-inch Transmission line 2nd payment due for reimbursement.
Amount:
$40,788.25

Component Description:
5" Interim coax line feed for Interim antenna, 1/3rd down payment request at this time.
Amount:
$19,515.75

Component Description:
ERI 1/3rd down payment for Interim 5in Flex Coax Transmission Line and hardware.
Amount:
$19,515.75

Component Description:
Interim antenna 5" transmission flex TV-line, down payment
Amount:
$19,515.75

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 $783,336.00 $414,836.00 N/A $290,057.00 N/A
Total for all systems $3,006,624.20 $1,913,426.62 N/A $1,499,703.27 N/A
Primary Tower GTOWER $783,336.00 $414,836.00 $290,057.00
Antenna replacement $95,251.00 $95,251.00 Cost to remove existing top mounted Ch. 14 antenna replace with Ch. 33 top mounted antenna (TFU-18GTH/VP-R 6S250), hook to existing 6 1/8" line. install and wire top AOL beacon. Installation cost increased since original quotes $95,251.00 Previous submission is locked form editing, resubmitted updates for more information.
Interim Antenna installation $134,914.00 $134,914.00 Interim aux antenna (i230ECW-16-14/33) installation with 530-ft 5" flexible transmission line. Aux antenna needed to maintain air operations while top antenna is being replaced. Note: Installation cost tripled since original quote. $134,914.00 Previous submission is locked from editing and adding updated/revised information, resubmitted.
MAIn Transmission Line installation $121,339.00 $121,339.00 Installation cost to remove and replace existing failed 6 1/8" DigiTLine transmission line with ERI 6 1/8" MACXLine' Transmission line failure after transition to Ch. 33. N/A N/A
Lower Guy support upgrade $63,332.00 $63,332.00 Structural Analysis shows lower guy over stressed with "AUX" Interim antenna added to tower, manufacture recommends lower guy supports be upgraded to elevate over stress points on the lower guy. $59,892.00 N/A
Tall Tower (greater than 500') $210,500.00 $0.00 No new tower needed. N/A N/A
Minor tower reinforcement/modifications $158,000.00 $0.00 N/A N/A N/A

Components

Actual Information Description File Name
Antenna replacement

Component Description:
Remaining installation cost of WTIU "Main" antenna reimbursement.
Amount:
$61,841.72

Component Description:
ERI 1/3rd down payment for Main TV Antenna Installation and Site survey.
Amount:
$33,409.28

Component Description:
ERI, 1/3 down payment due with order for MAIN Antenna installation.
Amount:
$33,409.28

Component Description:
MAIN Antenna installation Ch. 33, down payment
Amount:
$33,409.28

Component Description:
.334 down deposit with order and 50% of $6500 applied for Layout Site survey for installation of Antennas.
Amount:
$33,409.28

Component Description:
Invoiced down payment for Main antenna replacement installation. See attached invoice with notes.
Amount:
$33,409.28
Interim Antenna installation

Component Description:
Remaining installation cost of WTIU "interim" antenna and 5" transmission line.
Amount:
$85,385.62

Component Description:
ERI, 1/3 down payment for Interim Antenna and 5-inch coax installation due with order.
Amount:
$49,528.38

Component Description:
Interim Antenna and 5" transmission line installation, down payment.
Amount:
$49,528.38

Component Description:
.333 down and includes 50% layout site survey cost of $6,500, .333 of $3250 applied.
Amount:
$49,528.38

Component Description:
Invoiced down payment for Interim antenna installation/5-in Transmission Line installation, See attached invoice with notes.
Amount:
$49,528.38

Component Description:
ERI 1/3rd down payment for Interim Antenna and 5in Coax Installation
Amount:
$49,528.38
MAIn Transmission Line installation Information not provided.
Lower Guy support upgrade

Component Description:
50% shipping material and 70% mobilization to site.
Amount:
$37,262.40

Component Description:
Uploaded note with ERI invoice 2342077: "Note_ERI Invoice 20190522-630 Rev A_Guy Material Down Payment" with terms of payments.
Amount:
$11,655.00

Component Description:
Remaining 50% of Guy material shipped payment.
Amount:
$10,974.60
Tall Tower (greater than 500') Information not provided.
Minor tower reinforcement/modifications Information not provided.

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $40,185.00 $38,665.00 N/A $18,715.00 N/A
Total for all systems $3,006,624.20 $1,913,426.62 N/A $1,499,703.27 N/A
Outside Professional Services $40,185.00 $38,665.00 $18,715.00
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase $2,105.00 $2,050.00 N/A N/A N/A
ASR modification (prepare FCC Form 854) $2,105.00 $2,050.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,585.00 N/A $975.00 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,305.00 N/A $0.00 N/A
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application $4,210.00 $4,100.00 N/A $0.00 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,120.00 N/A $5,200.00 3-hours (approximately $1,392.85) listed as 7/12/17 applied to cost related to the FCC computer website slow or non-responsive for hours on July12, 2017. Conferences with FCC and client to determine filing option in the last hours before deadline.
Prepare request for Special Temporary Authorization $2,050.00 $1,535.00 N/A $1,370.00 N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application $1,580.00 $1,535.00 N/A $675.00 N/A
Prepare and or review reimbursement form $2,630.00 $2,560.00 N/A $900.00 Lohnes and Culver is the Engineering firm that review Form 399 for the technical engineering. Fletcher, Heald and Hildreth, P.L.C. was for Legal review of the application and Form 399 and submittal.
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,170.00 N/A $3,900.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,070.00 N/A $3,370.00 Construction Permit Modification, comprehensive technical study for proposing minor change in Main directional antenna.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application $2,105.00 $2,050.00 N/A $1,650.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,535.00 N/A $675.00 N/A

Components

Actual Information Description File Name
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.
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
Modification applications and interim special Temporary Authority (STA) for WTIU
Amount:
$975.00
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
Revise and finalize FCC application for license for MAIN antenna. 1.5hr highlighted time
Amount:
$750.00
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application

Component Description:
Highlighted- legal time for revise and finalize CP application for license for Main antenna.
Amount:
$2,350.00

Component Description:
Finalize and file auxiliary antenna license application with FCC. Legal (Highlighted time)
Amount:
$1,100.00
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Legal Services modification of application, draft Construction Permit and Legal Certification. Review Form 399, file attached.
Amount:
$5,200.00
Prepare request for Special Temporary Authorization

Component Description:
Using an interim antenna on the pre-repack channel and prepare a request for STA to operate.
Amount:
$1,370.00
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application

Component Description:
Auxiliary Antenna License App., Prepare license application to cover construction Permit No. 0000086567
Amount:
$675.00
Prepare and or review reimbursement form

Component Description:
Reimbursement Form check for accuracy and completeness, technical specifications and engineering.
Amount:
$900.00

Component Description:
Cost of Review and edit FCC Form 399 Application,
Amount:
$900.00

Component Description:
Legal Services modification of application, draft Construction Permit and Legal Certification. Review Form 399, file Application as listed
Amount:
N/A
Perform engineering study for new channel assignment and antenna development

Component Description:
New Channel and Antenna Development, RF studies Post-Auction Plan for transitioning to new channel
Amount:
$3,900.00

Component Description:
Cost to conduct technical studies for new UHF channel and replacement directional antenna.
Amount:
$3,900.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Prepare engineering section of FCC Form 2100 for filing Construction Permit filling in the 90-day filing window.
Amount:
$1,970.00

Component Description:
Cost of preparing engineering section of FCC Form 2100 and prepare comprehensive technical exhibits attachment for filing in the initial 90-day window. FCC Construction Permit ApplicationApplication
Amount:
$1,970.00

Component Description:
Construction Permit Modification, comprehensive technical exhibit for proposing minor change in Main directional antenna.
Amount:
$1,400.00
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application

Component Description:
Auxiliary Antenna Construction Permit App., Perform Studies to determine parameters for operation on the reassignment Channel
Amount:
$1,650.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
Main Antenna License Application to Cover Permit No. 0000081146
Amount:
$675.00

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $32,389.00 $32,074.00 N/A $19,084.43 N/A
Total for all systems $3,006,624.20 $1,913,426.62 N/A $1,499,703.27 N/A
Other Expenses $32,389.00 $32,074.00 $19,084.43
Endeavor Communications $3,985.00 $3,985.00 Uploaded quote for tower crew to change out PR-450 element for Cloverdale (Endeavor Communications) cable headend to receive new Ch. 33. Cost of tower service N/A N/A
MVPD Notification of Channel Change $2,974.00 $2,974.00 Estimate uploaded <EST-001591 MVDP Notification.pdf> $2,974.00 N/A
Develop and air announcement of upcoming channel change $2,500.00 $2,500.00 N/A N/A N/A
Equipment Delivery and Handling Charges $10,850.00 $10,850.00 Gates Air transmitter freight charge increase, Quote #Q-86957 for $10,141.33 from vendor for freight is attached $10,824.43 Gates Air actual Freight cost increase, Quote #Q-86957 for $10,141.33 from vendor, attached .
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 $11,250.00 N/A $5,286.00 N/A

Components

Actual Information Description File Name
Endeavor Communications Information not provided.
MVPD Notification of Channel Change

Component Description:
Attached Invoice: INV-002206_DTV Notification_MVDP.pdf
Amount:
$2,974.00
Develop and air announcement of upcoming channel change Information not provided.
Equipment Delivery and Handling Charges

Component Description:
Freight cost on Guy material delivered from ERI.
Amount:
$683.10

Component Description:
Gates Air Freight cost increased from original quote of $5,100.00. New freight cost and Quote # Q-86957 for $10,141.33 attached
Amount:
$10,141.33
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:
Invoice attached: INV-002205_DTV Notification_Medical.pdf
Amount:
$5,286.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $3,006,624.20 $1,913,426.62 $1,499,703.27

Reimbursement Status

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

Certification

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Section Question Response
Submission of Estimated Expenses Statements

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

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

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

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

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

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

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

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

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

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

George C. Hopstetter

Director, Operations & Engineering


02/25/2021

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.

George C Hopstetter

Director, Operations and Engineering


02/25/2021

Certification

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Section Question Response
Submission of Final Allocation or Accounting Information Statements

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

  1. The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

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

  3. The above-named entity certifies that all costs identified as "actual costs" herein accurately represent the costs actually paid by the above-named entity, including any discounts, refunds, or rebates.

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

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

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

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

Deborah A Lemon

Secretary of the board of trustees


02/25/2021

Attachments

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