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:
9762
Service:
DTV
Call Sign:
WGNT
Channel:
20 (UHF)
File Number:
0000028466
FRN:
0002710192
Date Submitted:
03/29/2021

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

Scripps Broadcasting Holdings LLC

Dave Giles

312 Walnut Street

28th Floor

Cincinnati, OH 45202

United States

+1 (513) 977-3000 DAVE.GILES@SCRIPPS.COM Corporation

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

Ray Thurber

E.W. Scripps Media

312 Walnut St.

Suite 2800

Cincinnati, OH 45202

United States

+1 (513) 898-4050 ray.thurber@scripps.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. Yes
Briefly describe transition plan WGNT current leased tower will not pass Rev G without major upgrades. ATC the tower owner, wants to forgo upgrades an move WGNT to share antenna on alternate site. WGNT will replace its transmitter

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 SigmaCD -P2
Year 2002
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 50 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-90
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 56.4 kW
Justification for New Transmitter Current transmitter can not be re-tuned and if it could moving to the new site would be cost prohibitive.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) Yes
Switchgear (industrial 800 amp) Yes
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring Yes
Size 2 inches
Length 100.0 feet
Other Electrical Service Yes
Description Connection of transformers and other electrical services
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Heating and Cooling
Size 15 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

Disposal removal

Remove old transmitter per lease

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 Lease 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: 800.0 kW
Manufacturer
Model TFU-30DSC-R04
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 Lease New
Is this a request for upgraded equipment? No
Ownership Leased
Owner American Tower
Is antenna shared? Yes
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 Broadband Panel
Number of Stations Supported 4
Number of Panels/Bays 14
Lower Limit 470.00 MHz
Upper Limit 700.00 MHz
Design power capacity in use 80.0 %
Other Antenna Type N/A
ERP: 2200.0 kW
Manufacturer
Model PEPL56D-04-14/56-2-T
Year 2020
Justification for New Antenna Current antenna will not work on assigned channel. Moving to a leased antenna on another tower

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? Yes
Type New
Number of channels supported 4
Frequencies of channels supported RF channel
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? Yes
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Broadband
Feed Line Size 8 3/16 inches inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power 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

Enter a list of RF channel numbers.

RF Channel Number
31
16
20
33

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Removal Disposal

Removal of antenna form current site

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 Lease New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 8 3/16 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1000 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 Lease New
Is this a request for upgraded equipment? No
Type Rigid
Diameter 8 3/16 inches
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 2
Length 1300 feet per run
Justification for New Transmission Line Moving to another site.

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 Move Equipment
Tower Use Primary (Main)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? Candelabra
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users No
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1057874
Coordinates (NAD83) Latitude (NAD83) 36° 48' 31.8" N-
Longitude (NAD83) 076° 30' 11.3" W-
Overall Structure Height 1258.84 feet
Support Structure Height 1254.91 feet
Ground Elevation Above Mean Sea Level (AMSL) 22.97 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner American Towers, LLC
Date Constructed 02/03/2006

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
67077 WPXV-TV DTV
82574 WTPC-TV DTV
25940 WHRO-FM FM
4627 KBCS FM
47401 WTKR DTV
25933 WHRV FM
40755 WNVZ FM
25932 WHRO-TV DTV
40759 WTVZ-TV DTV

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Removal of current

Remove current antenna system from tower per lease

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 100
Explanation Landlord Management services
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
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 Yes
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

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 Yes
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)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? Yes
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Information not provided.

Cost Information

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Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $3,524,431.00 $1,855,313.30 N/A $957,030.89 N/A
Total for all systems $6,475,681.64 $2,788,221.54 N/A $1,061,214.11 N/A
Primary Transmitter ULXTE-90 $3,524,431.00 $1,855,313.30 $957,030.89
Disposal removal $25,000.00 $25,000.00 N/A $7,305.00 N/A
Other Electrical Service: Connection of transformers and other electrical services $94,831.00 $94,831.00 Please see Tri-Star Electric proposal dated 7-30-19 $60,108.63 N/A
2" Rigid Conduit and Wiring (Cost per foot) $2,600.00 $2,500.00 N/A N/A N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A $15,721.50 N/A
Service entrance 3 phase/800 amp/208 volt $14,400.00 $13,700.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 52 - 61 kW $1,788,000.00 $1,048,397.20 Please see attached GatesAir Quotes Q-87642, Q-87778, Q-87877, and Q-78561 $304,310.66 N/A
15 Ton system $88,400.00 $65,000.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW $1,473,000.00 $569,585.10 ***System Notice: Estimate adjusted and locked because line has been superseded.*** $569,585.10 N/A

Components

Actual Information Description File Name
Disposal removal

Component Description:
Transmitter Demo
Amount:
$1,680.15

Component Description:
Transmitter Demo
Amount:
$5,624.85
Other Electrical Service: Connection of transformers and other electrical services

Component Description:
WGNT-110-1st Primary Transmitter - Other Electrical
Amount:
$6,638.17

Component Description:
Transmitter demo
Amount:
$5,106.65

Component Description:
WGNT-110-1st Primary Transmitter - Other Electrical
Amount:
$14,661.63

Component Description:
Transmitter demo; transmitter installation & Material
Amount:
$26,552.68

Component Description:
Transmitter Demo
Amount:
$7,149.50
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Switchgear - industrial 800 amp

Component Description:
SWITCH S60 6-50 4 PORT 115VAC/8-30VDC
Amount:
$7,713.75

Component Description:
Freight and Shipping
Amount:
$22.00

Component Description:
SWITCH S60 6-50 4 PORT 115VAC/8-30VDC
Amount:
$7,713.75

Component Description:
Cable Dsc To 60000 Switch 50 FT
Amount:
$272.00
Service entrance 3 phase/800 amp/208 volt Information not provided.
UHF - Liquid Cooled Solid State Transmitter 52 - 61 kW

Component Description:
Transmitter
Amount:
$230,562.55

Component Description:
ULXTE-60 Transmitter
Amount:
$73,748.11
15 Ton system Information not provided.
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW

Component Description:
2nd payment ULXTE-60
Amount:
$284,792.55

Component Description:
deposit ULXTE-60
Amount:
$284,792.55

Component Description:
Invoice moved as category has been superseded.
Amount:
N/A

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 $1,350,880.00 $341,550.00 N/A $0.00 N/A
Total for all systems $6,475,681.64 $2,788,221.54 N/A $1,061,214.11 N/A
Primary Antenna PEPL56D-04-14/56-2-T $1,350,880.00 $341,550.00 $0.00
Elbow complex, broadband, at antenna input, per 8 3/16. feedline (if needed) $18,950.00 $12,000.00 N/A N/A N/A
Combiner output splitting/switching for dual feed lines, if applicable $126,000.00 $20,000.00 N/A N/A N/A
New combiner, cost per channel (without antenna) $84,200.00 $80,000.00 WGNT share of combiner with installation N/A N/A
Removal Disposal $25,000.00 $25,000.00 N/A N/A N/A
UHF - High Power Top Mount (200-1000 kW), Four Station broadband panel antenna, elliptically or circularly polarized $1,090,000.00 $198,150.00 WGNT share of the antenna $0.00 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A

Components

Information not provided.

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 $1,037,400.00 $220,671.00 N/A $32,685.29 N/A
Total for all systems $6,475,681.64 $2,788,221.54 N/A $1,061,214.11 N/A
Primary Transmission Line $1,037,400.00 $220,671.00 $32,685.29
Rigid Transmission Line - copper, 8 3/16" broadband $1,037,400.00 $220,671.00 WGNT 25% share of Transmission line $32,685.29 N/A

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 8 3/16" broadband

Component Description:
Flange Field 6 1/8 Bolt
Amount:
$304.20

Component Description:
FREIGHT AND SHIPPING
Amount:
$1,333.12

Component Description:
WGNT-310-Primary Transmission Line - 8 3/16" Rigid Copper, Broadband
Amount:
$13,015.80

Component Description:
WGNT-310-Primary Transmission Line - 8 3/16" Rigid Copper, Broadband
Amount:
$17,859.40

Component Description:
Freight and Shipping
Amount:
$172.77

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 $446,000.00 $175,000.00 N/A $0.00 N/A
Total for all systems $6,475,681.64 $2,788,221.54 N/A $1,061,214.11 N/A
Primary Tower GTOWER $446,000.00 $175,000.00 $0.00
Removal of current $25,000.00 $25,000.00 N/A N/A N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $150,000.00 N/A N/A N/A

Components

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 $64,930.00 $140,975.00 N/A $45,707.90 N/A
Total for all systems $6,475,681.64 $2,788,221.54 N/A $1,061,214.11 N/A
Outside Professional Services $64,930.00 $140,975.00 $45,707.90
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $2,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $1,800.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $2,000.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $2,050.00 $1,500.00 N/A $525.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A N/A N/A
Project management of the transition $15,800.00 $99,675.00 see Estimated Cost Justification WGNT-510-Project Management v0 $45,182.90 N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A

Components

Actual Information Description File Name
RF Exposure Measurements Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization 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 Information not provided.
Prepare request for Special Temporary Authorization

Component Description:
Preparation of Application for STA on Post-Repack Channel
Amount:
$525.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Perform engineering study for new channel assignment and antenna development Information not provided.
Project management of the transition

Component Description:
Project Management
Amount:
$1,602.85

Component Description:
Project Management
Amount:
$2,447.45

Component Description:
Project Management
Amount:
$28.75

Component Description:
Project Management
Amount:
$1,859.55

Component Description:
Project Management
Amount:
$2,558.70

Component Description:
Project Management
Amount:
$2,468.90

Component Description:
Project management
Amount:
$3,624.30

Component Description:
Project Management
Amount:
$201.25

Component Description:
Project Management
Amount:
$64.95

Component Description:
Project management
Amount:
$3,220.60

Component Description:
Project Management
Amount:
$182.80

Component Description:
Project Management
Amount:
$2,584.70

Component Description:
Project Management
Amount:
$540.00

Component Description:
Project Management
Amount:
$179.55

Component Description:
Project Management
Amount:
$613.75

Component Description:
FCC Repack
Amount:
$75.00

Component Description:
Project Management
Amount:
$93.55

Component Description:
Project management
Amount:
$8,961.80

Component Description:
Project management
Amount:
$8,295.25

Component Description:
Project Management
Amount:
$2,166.40

Component Description:
Project management
Amount:
$3,412.80
Prepare and or review reimbursement form Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $52,040.64 $54,712.24 N/A $25,790.03 N/A
Total for all systems $6,475,681.64 $2,788,221.54 N/A $1,061,214.11 N/A
Other Expenses $52,040.64 $54,712.24 $25,790.03
Equipment Storage $5,000.00 $5,000.00 N/A $305.79 N/A
Equipment Delivery and Handling Charges $15,000.00 $15,000.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $10,000.00 $10,000.00 N/A $3,287.00 N/A
Local Zoning $2,000.00 $2,000.00 N/A N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $14,236.60 See Estimated Cost Justification WGNT-610-Medical Facility Notifications V0 $14,236.60 N/A
MVPD Notification of Channel Change $7,960.64 $7,960.64 Estimated Cost Justification WGNT-610-MVPD Notifications v0 $7,960.64 N/A
Develop and air announcement of upcoming channel change $0.00 $0.00 N/A N/A N/A

Components

Actual Information Description File Name
Equipment Storage

Component Description:
40' STANDARD TRI CAM CONTAINER
Amount:
$157.34

Component Description:
20' STANDARD TRI CAM CONTAINER
Amount:
$148.45
Equipment Delivery and Handling Charges Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
Glycol removal and disposal
Amount:
$3,287.00
Local Zoning Information not provided.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
DTV Medical Facility Notification

Component Description:
DTV Notification Service
Amount:
$5,480.80

Component Description:
DTV Notification Service
Amount:
$5,480.80

Component Description:
Medical Notification
Amount:
$3,275.00
MVPD Notification of Channel Change

Component Description:
MVPD Notification Services
Amount:
$3,980.32

Component Description:
MVPD Notification Services
Amount:
$3,980.32
Develop and air announcement of upcoming channel change Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $6,475,681.64 $2,788,221.54 $1,061,214.11

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.

Sravan V Reddy , Reddy .

Senior Director, General Accounting


03/29/2021

Attachments

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