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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:
72052
Service:
DTV
Call Sign:
WEYI-TV
Channel:
18 (UHF)
File Number:
0000028816
FRN:
0022522981
Date Submitted:
05/06/2021

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

HSH FLINT (WEYI) LICENSEE, LLC

Doing Business As: HSH FLINT (WEYI) LICENSEE, LLC

201 MASSACHUSETTS AVENUE, NE

WASHINGTON, DC 20002

United States

 +1 (202) 546-5400 arightside@aol.com Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 

Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

Paul A. Cicelski , Esq .

Lerman Senter PLLC

2001 L Street NW

Suite 400

Washington, DC 20036

United States

 +1 (202) 416-6756 sinclair399s@summitridgegroup.com

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 See Exhibit A.

Transmitters

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

Auxiliary Transmitter

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Add Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Retune Existing
Use Auxiliary (Backup)
Ownership Owned
Owner 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 Rohde & Schwarz
Model UHF DMQ-T
Year 2009
Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2.5 kW

Auxiliary Transmitter

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Retuning Transmitter Costs

Section Question Response
New IOT Tubes Number of Tubes (including accessories) needed N/A
New Mask Filter
Power 3 kW
Other Power N/A
New Exciter Is a new exciter needed? Yes
Exciter Type Dual exciter with changeover

Auxiliary 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

Auxiliary Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

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 2002
Type Inductive Output Tube
IOT Power Type Single
Power Capacity 25 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 THU9evo-20
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 31 kW
Justification for New Transmitter Per the manufacturer, the current transmitter cannot be retuned.

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

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Additional parts

Additional parts

Additional Site Requirement

Additional Site Requirement

Electrical Installation

Electrical Installation

RF System

RF System

Transmitter Building

Transmitter Building

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 Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 193.0 kW
Manufacturer
Model TLP16DSB-A(C)
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? No
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: 147.0 kW
Manufacturer
Model TFU-26GTH/VP-R-O4
Year 2017
Justification for New Antenna Old antenna is a single channel antenna that cannot be used for the new post-auction channel. This antenna will ultimately be on the top of the tower, and the current antenna will be used as an interim until the transition is complete.

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 7 3/16 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

Antenna Input

Antenna Input

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 Utilize Existing
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer Dielectric
Type Flexible Air
Diameter 3 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 1322 feet per run

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change 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? 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? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1010544
Coordinates (NAD83) Latitude (NAD83) 43° 13' 01.0" N-
Longitude (NAD83) 083° 43' 17.0" W-
Overall Structure Height 1322.82 feet
Support Structure Height 1267.04 feet
Ground Elevation Above Mean Sea Level (AMSL) 689.95 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner HSH Flint (WEYI) Licensee, LLC
Date Constructed 08/02/2004


Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Study needed for documented tower
Tower Reinforcements Please select whether tower reinforcements are needed: Major Reinforcements needed

Primary Tower

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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

Information not provided.

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

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Sinclair Internal Costs

Internal Employee Time Costs

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 No
FCC Special Temporary Authority Application No
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

Name Description

Drill Holes in Cement Walls

Drill Holes in Cement Walls

Tax

Tax

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 $1,326,371.87 $1,289,116.87 N/A $463,016.87 N/A
Total for all systems $2,703,424.11 $3,130,581.66 N/A $1,688,279.10 N/A
Primary Transmitter THU9evo-20 $1,169,666.87 $1,140,166.87 $463,016.87
Transmitter Building $1,300.00 $1,300.00 N/A $1,300.00 N/A
Additional parts $23,438.00 $23,438.00 N/A $23,438.00 N/A
Additional Site Requirement $16,061.00 $16,061.00 N/A $16,061.00 N/A
RF System $70,034.00 $70,034.00 See Acrodyne Quote. $70,034.00 N/A
Transformer 3 phase/480v - 300 KVA $36,800.00 $35,000.00 N/A N/A N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW $947,000.00 $922,000.00 N/A $325,542.50 N/A
2" Rigid Conduit and Wiring (Cost per foot) $20,800.00 $20,000.00 N/A $10,607.50 N/A
Electrical Installation $16,033.87 $16,033.87 N/A $16,033.87 N/A
Auxiliary Transmitter UHF DMQ-T $156,705.00 $148,950.00 $0.00
UHF and VHF - minor banding issues $105,200.00 $100,000.00 N/A $0.00 N/A
Dual exciter system with change over $47,350.00 $45,000.00 N/A N/A N/A
3 kW mask filter $4,155.00 $3,950.00 N/A N/A N/A

Components

Actual Information Description File Name
Transmitter Building

Component Description:
Transmitter building cost. #1300.JUN2819
Amount:
$1,300.00
Additional parts

Component Description:
Transmitter related cost. #9500104334
Amount:
$12,683.00

Component Description:
Transmitter related cost. #9500104428
Amount:
$950.00

Component Description:
Transmitter related cost. #9500112203
Amount:
$7,530.00

Component Description:
Transmitter related cost. #9500104335
Amount:
$2,275.00
Additional Site Requirement

Component Description:
Transmitter related cost. #9500122386
Amount:
$16,061.00
RF System

Component Description:
Transmitter related cost. #002136
Amount:
$68,102.00

Component Description:
RF system cost. #002136
Amount:
$70,034.00
Transformer 3 phase/480v - 300 KVA Information not provided.
Switchgear - industrial 800 amp Information not provided.
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW

Component Description:
Transmitter related cost. #2279
Amount:
$2,995.00

Component Description:
Resubmitted under Rigid Conduit and Wiring. #5355
Amount:
N/A

Component Description:
Resubmitted under Equipment Delivery and Handling Charges. #SR2 52769
Amount:
N/A

Component Description:
Resubmitted under Drill Holes in Cement Walls. #330798
Amount:
N/A

Component Description:
Transmitter related cost. #1300.00JUN2819
Amount:
$1,300.00

Component Description:
Resubmitted under Equipment Delivery and Handling. #SR2 51777
Amount:
N/A

Component Description:
Transmitter cost. #9500082403
Amount:
$322,547.50
2" Rigid Conduit and Wiring (Cost per foot)

Component Description:
Transmitter related cost. #5355
Amount:
$4,500.00

Component Description:
Transmitter related cost. #7172
Amount:
$6,107.50

Component Description:
Transmitter related cost. #7172
Amount:
$6,107.50
Electrical Installation

Component Description:
Transmitter related cost. #5051
Amount:
$15,117.81

Component Description:
Transmitter related cost. #5357
Amount:
$916.06
UHF and VHF - minor banding issues

Component Description:
Total invoice amount reduced by 25.40%. #518005
Amount:
$4,226.37

Component Description:
Resubmitted under Antenna Input. #511002
Amount:
N/A
Dual exciter system with change over Information not provided.
3 kW mask filter Information not provided.

Cost Information

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Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $318,692.44 $260,633.67 N/A $196,076.43 N/A
Total for all systems $2,703,424.11 $3,130,581.66 N/A $1,688,279.10 N/A
Primary Antenna TFU-26GTH/VP-R-O4 $318,692.44 $260,633.67 $196,076.43
Antenna Input $8,562.44 $8,562.44 N/A $8,562.44 N/A
Elbow complex, single channel, at antenna input, per 7 3/16. feedline (if needed) $13,900.00 $16,850.83 Look at Dielectric invoice. $16,850.83 N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $289,500.00 $230,446.00 N/A $165,888.76 N/A
Sweep test of existing antenna $6,730.00 $4,774.40 N/A $4,774.40 N/A

Components

Actual Information Description File Name
Antenna Input

Component Description:
Total invoice amount reduced by 25.40%. #511002
Amount:
$8,562.44
Elbow complex, single channel, at antenna input, per 7 3/16. feedline (if needed)

Component Description:
Antenna related cost reduced by 25.40%.
Amount:
$16,850.83
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
Antenna related cost reduced by 25.40%. #395038
Amount:
$142,617.29

Component Description:
Total invoice amount reduced by 25.40%. #457001
Amount:
$11,600.30

Component Description:
Total invoice amount reduced by 25.40%. #458015
Amount:
$11,671.17

Component Description:
Antenna related cost reduced by 25.40%. #395038
Amount:
$142,617.29

Component Description:
Antenna related cost reduced by 25.40%. #395038
Amount:
$142,617.29
Sweep test of existing antenna

Component Description:
Total invoice amount reduced by 25.40%. #530013
Amount:
$4,774.40

Cost Information

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Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $0.00 $0.00 N/A $0.00 N/A
Total for all systems $2,703,424.11 $3,130,581.66 N/A $1,688,279.10 N/A
Primary Transmission Line $0.00 $0.00 $0.00

Components

Information not provided.

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 $644,100.00 $1,196,784.40 N/A $916,856.00 N/A
Total for all systems $2,703,424.11 $3,130,581.66 N/A $1,688,279.10 N/A
Primary Tower TOWER $644,100.00 $1,196,784.40 $916,856.00
Structural engineering tower load study for well documented tower $12,600.00 $12,000.00 N/A $10,600.00 The second item should be removed as we've uploaded revised version with purchase order and quote.
Major tower reinforcement/modifications $421,000.00 $984,784.40 See FDH Infrastructure Services Invoices $789,270.00 N/A
Tall Tower (greater than 500') $210,500.00 $200,000.00 N/A $116,986.00 N/A

Components

Actual Information Description File Name
Structural engineering tower load study for well documented tower

Component Description:
Engineering structural analysis. #138972
Amount:
$2,750.00

Component Description:
Final 50% of structural analysis tower cost. #167646
Amount:
$2,750.00

Component Description:
Engineering structural analysis.
Amount:
$2,750.00

Component Description:
Tower related cost. #SIN000878
Amount:
$5,100.00
Major tower reinforcement/modifications

Component Description:
Tower related cost. #E-189773
Amount:
$344,613.60

Component Description:
Tower modification cost. #E-186352
Amount:
$147,691.80

Component Description:
Tower related cost. #E-179096
Amount:
$296,964.60

Component Description:
Tower related cost. #E-186352
Amount:
$147,691.80
Tall Tower (greater than 500')

Component Description:
Tower related cost. #E-189773
Amount:
$81,890.20

Component Description:
Tower related cost. #E-186352
Amount:
$35,095.80

Component Description:
Tower related cost. #E-186352
Amount:
$35,095.80

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 $221,529.63 $191,866.55 N/A $49,939.06 N/A
Total for all systems $2,703,424.11 $3,130,581.66 N/A $1,688,279.10 N/A
Outside Professional Services $221,529.63 $191,866.55 $49,939.06
Project management of the transition $74,260.00 $70,500.00 N/A $39,519.77 N/A
Sinclair Internal Costs $1,379.63 $1,379.63 N/A $1,379.63 N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A N/A N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase $2,105.00 $2,000.00 N/A N/A N/A
ASR modification (prepare FCC Form 854) $2,105.00 $2,000.00 N/A N/A N/A
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet $10,520.00 $10,000.00 N/A N/A N/A
NEPA Section 106 environmental review, if needed $6,310.00 $6,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $7,360.00 $0.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $0.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $0.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $486.92 N/A $486.92 N/A
Prepare request for Special Temporary Authorization $4,100.00 $3,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $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 $2,478.75 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $2,235.00 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 $3,838.99 The actual costs came out to more than the Widelity Report estimate.

Components

Actual Information Description File Name
Project management of the transition

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

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #474405
Amount:
$490.56

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

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1143
Amount:
$436.90

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

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

Component Description:
Legal Service Cost. #475762
Amount:
$1,497.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #475283
Amount:
$384.08

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #465173
Amount:
$654.26

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 48 stations. #206
Amount:
$1,354.25

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

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #450412
Amount:
$999.04

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289
Amount:
$91.50

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

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

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #479829
Amount:
$458.99

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #472583
Amount:
$279.89

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #472985
Amount:
$282.68

Component Description:
$26,919.78 to be split across 93 Sinclair stations reimbursed $999.20 for invoice 461759 (correct invoice amount is $709.72).
Amount:
($289.46)

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1069
Amount:
$246.68

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #476885
Amount:
$403.34

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #474809
Amount:
$395.77

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #132
Amount:
$589.44

Component Description:
Legal Service Cost. #473537
Amount:
$421.25

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #478288
Amount:
$194.86

Component Description:
Legal Service Cost. #473005
Amount:
$212.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1117
Amount:
$282.68

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1111
Amount:
$159.58

Component Description:
Legal Service Cost. #470292
Amount:
$177.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #476367
Amount:
$364.80

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1151
Amount:
$388.07

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1141
Amount:
$406.17

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #473885
Amount:
$318.62

Component Description:
Legal Service Cost. #474421
Amount:
$57.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1098
Amount:
$238.07

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

Component Description:
Legal Service Cost. #472600
Amount:
$157.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #107
Amount:
$602.28

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1099
Amount:
$266.93

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1156
Amount:
$399.52

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1114
Amount:
$242.25

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 48 stations. #483809
Amount:
$407.18

Component Description:
Legal services cost. #485268
Amount:
$58.75

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #479285
Amount:
$372.60

Component Description:
Legal services cost. #483815
Amount:
$252.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 46 stations. #247
Amount:
$1,105.31

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1090
Amount:
$176.70

Component Description:
Legal services cost. #474828
Amount:
$320.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$43.72

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1123
Amount:
$342.14

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #453686
Amount:
$943.95

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$1,954.93

Component Description:
Legal services cost. #466711
Amount:
$182.50

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

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1167
Amount:
$313.41

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$912.82

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$731.72

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #1010
Amount:
$86.88

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #118
Amount:
$468.97

Component Description:
Legal Service Cost. #457842
Amount:
$415.50

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

Component Description:
Legal Service Cost. #467399
Amount:
$62.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #478780
Amount:
$271.41

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #480175
Amount:
$377.96

Component Description:
Legal Service Cost. #473515
Amount:
$40.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1051
Amount:
$105.97

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #1012
Amount:
$20.65

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759
Amount:
$29.98

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #477305
Amount:
$393.53

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #457331
Amount:
$836.44

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1055
Amount:
$243.38

Component Description:
Legal Service Cost. #467792
Amount:
$917.60

Component Description:
Legal services cost. #476897
Amount:
$51.25

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

Component Description:
Legal services cost. #481326
Amount:
$425.00

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

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #463026
Amount:
$801.57

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #470237
Amount:
$436.37

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

Component Description:
Legal Service Cost. #467907
Amount:
$170.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1078
Amount:
$215.68

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1161
Amount:
$267.48

Component Description:
Legal services cost. #476384
Amount:
$610.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$32.35

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

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1079
Amount:
$177.14

Component Description:
Legal Service Cost. #471542
Amount:
$163.75

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1130
Amount:
$281.49

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 48 stations. #206
Amount:
$1,354.25

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1039
Amount:
$30.47

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #453972
Amount:
$716.28

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #463026
Amount:
$815.02

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

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1133
Amount:
$307.72

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #467861
Amount:
$470.30

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1145
Amount:
$369.98

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #473506
Amount:
$421.40

Component Description:
Legal Service Cost. #468729
Amount:
$425.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 99 stations. #469573
Amount:
$377.14

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #464321
Amount:
$683.07

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #470923
Amount:
$406.65

Component Description:
Legal services cost, non-reimbursable amount excluded. #467792
Amount:
$531.25

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1045
Amount:
$185.10

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$107.53

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #472173
Amount:
$311.78

Component Description:
Legal Service Cost. #469596
Amount:
$106.25

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 99 stations. #468718
Amount:
$349.51

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #457851
Amount:
$818.59

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1105
Amount:
$216.88

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1093
Amount:
$269.71

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #467378
Amount:
$576.96

Component Description:
Legal services cost. #465196
Amount:
$355.00
Sinclair Internal Costs

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 48 stations.
Amount:
$6.78

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations.
Amount:
$15.08

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations.
Amount:
$11.39

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 46 stations.
Amount:
$50.03

Component Description:
Internal expense - WEYI - 4-2019
Amount:
$879.84

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations.
Amount:
$1.69

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations.
Amount:
$23.96

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 43 stations.
Amount:
$35.82

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 46 stations.
Amount:
$1.53

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations.
Amount:
$7.86

Component Description:
Portion of general repack matter internal time card attributable to this station - divided by 100.
Amount:
$66.55

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations.
Amount:
$9.47

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

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations.
Amount:
$8.66

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations.
Amount:
$26.93

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 46 stations.
Amount:
$23.56

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

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 52 stations.
Amount:
$41.33

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations.
Amount:
$11.03

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations.
Amount:
$16.53

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations.
Amount:
$25.53

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations.
Amount:
$5.37

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 48 stations.
Amount:
$31.70

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations.
Amount:
$17.02

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations.
Amount:
$6.09

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations.
Amount:
$7.96

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 52 stations.
Amount:
$9.79
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:
Legal services cost. #466668
Amount:
$265.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289
Amount:
$122.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759
Amount:
$99.92
Prepare request for Special Temporary Authorization Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Outside professional service Cost. #325-01-0013
Amount:
$783.75

Component Description:
Consulting engineering cost.
Amount:
$1,695.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Outside professional service cost. #325-01-0012
Amount:
$600.00

Component Description:
Consulting engineering cost.
Amount:
$1,635.00
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form

Component Description:
Legal services cost. #464710
Amount:
$172.50

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

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

Component Description:
Legal services cost. #460929
Amount:
$558.20

Component Description:
Legal services cost. #464368
Amount:
$177.50

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

Component Description:
Legal services cost. #461792
Amount:
$182.50

Component Description:
Legal services cost. #457842
Amount:
$415.50

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 $192,730.17 $192,180.17 N/A $62,390.74 N/A
Total for all systems $2,703,424.11 $3,130,581.66 N/A $1,688,279.10 N/A
Other Expenses $192,730.17 $192,180.17 $62,390.74
Tax $40,938.48 $40,938.48 N/A $36,816.94 N/A
Drill Holes in Cement Walls $558.00 $558.00 N/A $558.00 N/A
MVPD Notification of Channel Change $5,000.00 $5,000.00 See Exhibit J. N/A N/A
Develop and air announcement of upcoming channel change $28,050.00 $28,050.00 See reesponse to August 10 inquiry. N/A N/A
Equipment Storage $15,000.00 $15,000.00 See Exhibit J. $6,509.22 N/A
Equipment Delivery and Handling Charges $11,633.69 $11,633.69 See Exhibit J. $10,140.88 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $50,000.00 $50,000.00 See Exhibit J. $4,615.70 N/A
Non-zoning permits $10,000.00 $10,000.00 See Exhibit J. N/A N/A
Local Zoning $20,000.00 $20,000.00 See Exhibit J. N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A $3,750.00 N/A

Components

Actual Information Description File Name
Tax

Component Description:
Sales tax. #Tax18-1050
Amount:
$19,352.85

Component Description:
Sales Tax. #Tax 18-1050
Amount:
$4,121.54

Component Description:
Sales tax. #Tax19-0478
Amount:
$1,047.53

Component Description:
Sales tax. #TAX19-0231
Amount:
$14,544.86

Component Description:
Sales tax. #TAX19-0478
Amount:
$1,047.53

Component Description:
Sales tax. #TAX19-0388
Amount:
$1,871.70
Drill Holes in Cement Walls

Component Description:
Drilling cost. #330798
Amount:
$558.00
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage

Component Description:
Storage related cost reduced by 25.40%. #553022
Amount:
$6,509.22
Equipment Delivery and Handling Charges

Component Description:
Equipment delivery and handling cost reduced by 25.40%. #518005
Amount:
$4,226.37

Component Description:
Total invoice amount reduced by 25.40%. #521022
Amount:
$2,794.51

Component Description:
Equipment delivery and handling cost. #SR2 52769
Amount:
$841.89

Component Description:
Equipment delivery related cost. #002136
Amount:
$1,932.00

Component Description:
Equipment delivery and handling cost. #SR2 51777
Amount:
$650.92

Component Description:
Resubmitted under Disposal Cost. #80794923
Amount:
N/A

Component Description:
Equipment delivery related cost. #183720
Amount:
$3,120.00

Component Description:
Resubmitted under Disposal Cost. #81164711
Amount:
N/A
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
Equipment Disposal Cost. #0237-001748624
Amount:
$563.84

Component Description:
Disposal cost. #0237-001755460
Amount:
$207.78

Component Description:
Disposal cost. #0237-001730036
Amount:
$505.08

Component Description:
Disposal cost. #0237-001761585
Amount:
$207.65

Component Description:
Disposal related cost. #0237-001768421
Amount:
$449.64

Component Description:
Disposal cost. #0237-001723955
Amount:
$232.13

Component Description:
Equipment disposal cost. #0237-001742230
Amount:
$207.29

Component Description:
Disposal cost. #0237-001736631
Amount:
$527.69

Component Description:
Disposal cost. #81164711
Amount:
$1,174.00

Component Description:
Disposal cost. #81164711
Amount:
$1,714.00

Component Description:
Equipment disposal cost. #0237-001755460
Amount:
$212.78

Component Description:
Disposal cost. #80794923
Amount:
$540.60

Component Description:
Disposal related cost. #0237-001761585
Amount:
$219.22
Non-zoning permits Information not provided.
Local Zoning Information not provided.
DTV Medical Facility Notification

Component Description:
DTV medical notification cost. #1105
Amount:
$3,750.00

Cost Information

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Grand Total

Predetermined
Cost Estimate 		Estimated Cost Actual Cost
Total for all systems $2,703,424.11 $3,130,581.66 $1,688,279.10

Reimbursement Status

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

Certification

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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.

Armstrong P. Williams

Managing Member


05/06/2021

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.

Armstrong P. Williams

Managing Member


05/06/2021

Attachments

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