TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
Nexstar Media Inc.	Elizabeth Ryder 545 E. JOHN CARPENTER FREEWAY Suite 700 Irving, TX 75062 United States	+1 (972) 373-8800	eryder@nexstar.tv	Corporation

Applicant

Address

Phone

Applicant Type

Nexstar Media Inc.

Elizabeth Ryder

545 E. JOHN CARPENTER FREEWAY

Suite 700

Irving, TX 75062

United States

+1 (972) 373-8800

eryder@nexstar.tv

Corporation

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant	Address	Phone	Email
[Confidential]

Preparer Contact Information

Preparer Contact Name and Information

Applicant	Address	Phone	Email
Elizabeth Ryder General Counsel Nexstar Media Inc.	Elizabeth Ryder 545 E. John Carpenter Freeway Suite 700 Irving, TX 75062 United States	+1 (972) 373-8800	eryder@nexstar.tv

Applicant

Address

Phone

Elizabeth Ryder

General Counsel

Nexstar Media Inc.

Elizabeth Ryder

545 E. John Carpenter Freeway

Suite 700

Irving, TX 75062

United States

+1 (972) 373-8800

eryder@nexstar.tv

Broadcaster Information and Transition Plan

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	Replace transmitter, antenna and transmission line. Acquire interim antenna and line for continued operation during construction and duration of the assigned phase. Map and analyze tower; design and implement modifications if required. See attachment.

Transmitters

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

Primary Transmitter

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	SIGMA CD3260P2-CF
	Year	2005
	Type	Inductive Output Tube
	IOT Power Type	Two
	Power Capacity	60 kW

Primary Transmitter

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-48 73.5 kW ATSC
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	73.5 kW
	Justification for New Transmitter	The manufacturer of the existing IOT transmitter advises that the transmitter cannot be re-tuned to the assigned channel. Budgeting for a LCSS TX equivalent to a ULXTE-120 which is fully reimbursable with the one-step-up allowance. See R&S for actual.

Primary Transmitter

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	3 inches
	Length	100.0 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

Other Transmitter Cost Not Listed

Name	Description
Additional Interior RF System	Interior RF System Existing Transmitter to Interim Transmission line
Transmitter Stacking Parts	Transmitter Stacking Parts
Transmitter Additional Components	Transmitter Additional Components
Transmitter Heat Exchanger pad and Ice Bridge	New Transmitter requires new concrete pad for heat exchangers and Ice Bridge
Transmitter Electrical and Installation	Transmitter Electrical and Installation
Transmitter Electrical Services	Transmitter Electrical Services

Antennas

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

Primary Antenna

Existing Antenna Information

Section	Question	Response
Existing Antenna Description	Type of change	Purchase New
	Antenna Use	Primary (Main)
	Description of Use	N/A
	Ownership	Owned
	Owner	N/A
	Site	N/A
	Is the existing antenna shared with another station or stations?	No
	Is the existing antenna directional?	Yes
	Is antenna in operating condition?	Yes
	Is antenna located on or in close proximity to an antenna farm?	No
Existing Antenna Manufacturer and Type	Class	Full Power
	Mounting	Top Mount
	Antenna position in stack	Not in Stack
	Polarization	Horizontal
	Type	Slotted Coaxial
	Number of Stations Supported	N/A
	Number of Panels	N/A
	Design power capacity in use	N/A
	Lower Limit	N/A
	Upper Limit	N/A
	Other Antenna Type	N/A
	ERP:	1000.0 kW
	Manufacturer
	Model	TFU-22GTH-R 4C160
	Year	2005

Primary Antenna

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	Horizontal
	Type	Slotted Coaxial
	Number of Stations Supported	N/A
	Number of Panels/Bays	N/A
	Lower Limit	N/A
	Upper Limit	N/A
	Design power capacity in use	N/A
	Other Antenna Type	N/A
	ERP:	961.0 kW
	Manufacturer
	Model	TUM-C4-10/34H-1-R
	Year	2018
	Justification for New Antenna	The existing primary antenna is a single channel slotted coaxial which cannot accommodate the assigned channel.

Primary Antenna

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

Other Antenna Cost Not Listed

Name	Description
Additional Antenna Costs	Additional Antenna Costs

Interim Antenna

New Antenna Costs

Section	Question	Response
New Antenna Description	Use	Interim
	Description of Use	N/A
	Change Type	Purchase New
	Ownership	Owned
	Owner	N/A
	Is antenna shared?	Yes
	Is antenna directional?	Yes
	Will antenna be located on or in close proximity to an antenna farm?	No
New Antenna Manufacturer and Type	Class	Full Power
	Mounting	Side Mount
	Antenna position in stack	Not in Stack
	Polarization	Elliptical
	Type	Other
	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	Multi-Channel
	ERP:	1000.0 kW
	Manufacturer
	Model	TUM-C4-10/34H-1-R
	Year	2018
	Justification for New Antenna	An interim antenna is necessary to keep the WKRG and WFNA stations on the air during primary antenna replacements and for the duration of the assigned phases. This will be a shared expense.

Interim Antenna

Other Antenna Costs

Section	Question	Response
Combiner for Shared Antenna	Do you need a Combiner for a Shared Antenna?	Yes
	Type	New
	Number of channels supported	2
	Frequencies of channels supported	RF channel
	Frequency	N/A
	Do you need a combiner output splitter/switcher for dual feed lines?	No
Elbow Complex	Do you require the separate purchase of the Elbow Complex?	Yes
	Broadband or Single Channel?	B
	Feed Line Size	8 3/16 inches
Side Mount Brackets	Do you require the separate purchase of side mount brackets for an antenna?	Yes
Pattern Scatter Analysis	Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna?	Yes
Sweep Test	Do you require the sweep testing of transmission line and antenna?	Yes

Enter a list of RF channel numbers.

RF Channel Number
25
27

Interim Antenna

Other Antenna Cost Not Listed

Name	Description
Additional Antenna Costs	Additional Antenna Costs
Additional Combiner Costs	Additional Combiner Costs

Transmission Line

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

Primary Transmission Line

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?	Yes
Existing Transmission Line Manufacturer and Type	Manufacturer
	Type	Rigid
	Diameter	7 3/16 inches
	Other Diameter	N/A
	Segment Length	20 inches
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	1940 feet per run

Primary Transmission Line

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	7 3/16 inches
	Other Diameter	N/A
	Segment Length	19 3/4 inches
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	1940 feet per run
	Justification for New Transmission Line	Attached sweep demonstrates that existing transmission line is suitable for pre-auction Channel 27 but is not suitable for post-auction Channel 20 and must be replaced.

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Information not provided.

Interim Transmission Line

New Transmission Line

Section	Question	Response
New Transmission Line Costs	Use	Interim
	Description of Use	N/A
	Change Type	Purchase New
	Type	Rigid
	Diameter	8 3/16 inches
	Segment Length	20'
	Other Segment Length
	Number of parallel runs	1
	Length	1900 feet per run
	Justification for New Transmission Line	An interim transmission line is necessary for the interim antenna to keep station on the air during primary antenna replacement and for the duration of the assigned phase.

Interim Transmission Line

Other Transmission Line Expenses Not Listed

Name	Description
Additional Transmission Line Components	Additional Transmission Line Components

Tower Equipment And Rigging Costs

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

Primary Tower

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?	Yes
	One or more FM, AM or TV radio broadcaster(s)	Yes
	Others Types of Users	Yes
	Is tower documented for structural analysis?	No
	Is tower compliant with Rev G?	Yes
Existing Tower Structure Registration	Do you have a tower registration number?	Yes
Existing Tower Structure Registration	ASR Number	1035771
Coordinates (NAD83)	Latitude (NAD83)	30° 41' 20.4" N-
	Longitude (NAD83)	087° 49' 50.6" W-
	Overall Structure Height	1878.91 feet
	Support Structure Height	1819.86 feet
	Ground Elevation Above Mean Sea Level (AMSL)	169.95 feet
	Structure Type	GTOWER - Guyed Structure Used for Communication Purposes
	Tower Owner	Nexstar Broadcasting, Inc.
	Date Constructed	04/15/2015

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
53142	WRKH	FM
8696	WMXC	FM
70657	WABD	FM
61999	WHIL	FM

Other Types of Users

Users
Several RPU ant
Many microwave

Primary Tower

Tower Modification Costs

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

Primary Tower

Tower Rigging Costs

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

Primary Tower

Other Tower Expenses Not Listed

Name	Description
Weather Delays, Additional Charges	Weather Delays, Additional Charges
Land Clearing for Tower Rigging	Land Clearing required to rig tower for antenna and Line change out.
Tower License Permit Fees	Coast to Coast Tower does not have construction license in the state of Alabama

Outside Professional Services Costs

Section	Question	Response
Outside Project Management Services	Do you require outside project management services?	Yes
	Number of Hours	350
	Explanation	Schedule and coordinate multiple vendors, complete progress reports, and update Schedule 399. Station does not have available personnel or personnel trained in project management for such complex projects. Internal accounting and Project management.
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	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	Yes
RF Field Engineering Services	Comprehensive coverage verification via field study	No
	RF exposure measurements	No
	Additional Field Engineering Service	Yes
	Number of Days	25
	Justification	It will be necessary to survey the site, plan the equipment, develop specifications for purchasing, and oversee multiple vendor RF projects. Station does not have available personnel or personnel trained in such services.

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

Section	Question	Response
AM Pattern Disturbance	Is an Impact Study needed?	No
AM Pattern Disturbance	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	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

Other Expenses Not Listed

Name	Description
Sales Tax	Sales and use tax on goods and services
Equipment Rentals	Equipment Rentals
Transmitter Road Grading	Tower Crew has informed the station that delivery trucks are too low for the road condition and must be graded before trucks can use the road.

Cost Information

Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$2,386,681.00	$1,608,821.00	N/A	$1,601,803.65	N/A
Total for all systems	$5,429,305.50	$3,653,071.50	N/A	$3,462,951.73	N/A
Primary Transmitter THU9EVO-48 73.5 kW ATSC	$2,386,681.00	$1,608,821.00		$1,601,803.65
Transmitter Electrical Services	$32,000.00	$32,000.00	See Williams Electric quotes	$28,232.65	N/A
Transmitter Electrical and Installation	$169,800.00	$169,800.00	See Land Communications quote 1031	$166,550.00	N/A
Transmitter Heat Exchanger pad and Ice Bridge	$36,100.00	$36,100.00	Cost will be shared with WFNA as they both will use this pad and Ice Shield; see PCI proposal 19348-5	$36,100.00	N/A
Transmitter Additional Components	$62,451.00	$62,451.00	See Rohde & Schwarz quote 206363.0	$62,451.00	N/A
Switchgear - industrial 800 amp	$38,200.00	$0.00	See Transmitter Electrical and Installation	N/A	N/A
Additional Interior RF System	$0.00	$0.00	See Transmitter Electrical and Installation	N/A	N/A
Transmitter Stacking Parts	$7,130.00	$7,130.00	See Rohde & Schwarz quote 199650.0	$7,130.00	N/A
3" Rigid Conduit and Wiring (Cost per foot)	$5,200.00	$0.00	See Transmitter Electrical and Installation	N/A	N/A
Transformer 3 phase/480v - 300 KVA	$36,800.00	$0.00	See Transmitter Electrical and Installation	N/A	N/A
UHF - Liquid Cooled Solid State Transmitter 68.5 - 75 kW	$1,999,000.00	$1,301,340.00	See Rohde & Schwarz quote 157873.4 attached.	$1,301,340.00	N/A

Components

Actual Information Description	File Name
Transmitter Electrical Services	Component Description: Transmitter electrical services Amount: $23,717.96 Component Description: Transmitter electrical services Amount: $4,514.69
Transmitter Electrical and Installation	Component Description: Transmitter electrical and installation, installment #2 Amount: $83,275.00 Component Description: Transmitter electrical and installation, installment #1 Amount: $83,275.00
Transmitter Heat Exchanger pad and Ice Bridge	Component Description: Concrete pad and ice shield, installment #1, 50% shared cost with WFNA Amount: $12,032.50 Component Description: Concrete pad and ice shield, installment #2, 50% shared cost with WFNA Amount: $12,032.50 Component Description: Concrete pad and ice shield, installment #3, 50% shared cost with WFNA Amount: $12,035.00
Transmitter Additional Components	Component Description: Additional transmitter components Amount: $62,451.00
Switchgear - industrial 800 amp	Information not provided.
Additional Interior RF System	Information not provided.
Transmitter Stacking Parts	Component Description: Transmitter stacking parts Amount: $7,130.00
3" Rigid Conduit and Wiring (Cost per foot)	Information not provided.
Transformer 3 phase/480v - 300 KVA	Information not provided.
UHF - Liquid Cooled Solid State Transmitter 68.5 - 75 kW	Component Description: Transmitter, installment #1 Amount: $325,335.00 Component Description: Transmitter, installment #3 Amount: $130,134.00 Component Description: Transmitter, installment #2 Amount: $845,871.00

Cost Information

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	$640,354.50	$505,940.00	N/A	$496,955.12	N/A
Total for all systems	$5,429,305.50	$3,653,071.50	N/A	$3,462,951.73	N/A
Interim Antenna TUM-C4-10/34H-1-R	$356,724.50	$263,893.50		$261,375.62
Additional Antenna Costs	$4,750.00	$4,750.00	See Dielectric order confirmations 1697266,1932302 and 1932357; 50% shared cost with WFNA	$4,732.12	a
Side mount brackets for high power antennas (if not included in antenna base cost)	$23,150.00	$10,875.00	See Dielectric quote DMS171-2; 50% shared cost with WFNA FAC ID 83943	$10,875.00	N/A
New combiner, cost per channel (without antenna)	$84,200.00	$20,559.00	The catalog price is $80,000; however, this will be a shared expense with WFNA since both stations will operate on one multi-channel interim antenna. Therefore, both stations will budget $40,000. Cost reduced to $20,559 per Dielectric quote 800309CMZ	$20,559.00	N/A
UHF - High Power, Side Mount, basic slot antenna, 1000 kW input, directional,, elliptically or circularly polarized	$204,092.50	$204,092.50	See Dielectric quote DMS171-2; 50% shared cost with WFNA FAC ID 83943	$204,092.50	N/A
Additional Combiner Costs	$9,592.00	$9,592.00	See R&S quote 206354.1; 50% shared cost with WFNA	$9,592.00	N/A
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)	$5,260.00	$2,500.00	The catalog price is $5,000; however, this will be a shared expense with WFNA since both stations will operate on one multi-channel interim antenna. Therefore, both stations will budget $2,500.	N/A	N/A
Sweep test of existing antenna	$6,730.00	$3,200.00	The catalog price is $6,400; however, this will be a shared expense with WFNA since both stations will operate on one multi-channel interim antenna. Therefore, both stations will budget $3,200.	$3,200.00	N/A
Elbow complex, broadband, at antenna input, per 8 3/16. feedline (if needed)	$18,950.00	$8,325.00	See Dielectric quote DMS171-2; 50% shared cost with WFNA FAC ID 83943	$8,325.00	N/A
Primary Antenna TUM-C4-10/34H-1-R	$283,630.00	$242,046.50		$235,579.50
Additional Antenna Costs	$16,000.00	$16,000.00	See Dielectric order confirmation 1929699 and 1697264	$15,933.00	N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized	$247,000.00	$207,264.00	Cost reduced from $235,000 to $207,264 per Dielectric quote DMS139-2 less vpol cost $18,000 which is not reimbursable	$207,264.00	N/A
Sweep test of existing antenna	$6,730.00	$6,400.00	N/A	N/A	N/A
Elbow complex, single channel, at antenna input, per 7 3/16. feedline (if needed)	$13,900.00	$12,382.50	Cost reduced from $13200 to $12382.50 per Dielectric quote DMS139-2	$12,382.50	N/A

Components

Actual Information Description	File Name
Additional Antenna Costs	Component Description: Additional antenna component, 50% shared cost with WFNA Amount: $1,486.50 Component Description: Additional elbow, 50% shared cost with WFNA Amount: $1,560.00 Component Description: Additional antenna component, 50% shared cost with WFNA Amount: $1,685.62
Side mount brackets for high power antennas (if not included in antenna base cost)	Component Description: Antenna mounting brackets, installment #2, line 2 of invoice, 50% shared cost with WFNA Amount: $4,893.75 Component Description: Antenna mounting brackets, installment #1, line 2 of invoice, 50% shared cost with WFNA Amount: $4,893.75 Component Description: Antenna mounting brackets, installment #3, 50% shared cost with WFNA Amount: $1,087.50
New combiner, cost per channel (without antenna)	Component Description: Combiner, balance due, 50% shared cost with WFNA FAC ID 83943 Amount: $2,055.90 Component Description: Combiner, installment #2, 50% of shared cost with WFNA FAC ID 83943 Amount: $9,251.55 Component Description: Combiner, installment #1, 50% of shared cost with WFNA FAC ID 83943 Amount: $9,251.55
UHF - High Power, Side Mount, basic slot antenna, 1000 kW input, directional,, elliptically or circularly polarized	Component Description: Antenna, installment #3, 50% shared cost with WFNA Amount: $20,409.25 Component Description: Antenna, installment #2, line 1 of invoice, 50% shared cost with WFNA Amount: $91,841.63 Component Description: Antenna, installment #1, line 1 of invoice, 50% shared cost with WFNA Amount: $91,841.62
Additional Combiner Costs	Component Description: Additional combiner components, 50% shared cost with WFNA Amount: $9,592.00
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)	Information not provided.
Sweep test of existing antenna	Component Description: Interim antenna sweep test, 50% shared cost with WFNA Amount: $3,200.00
Elbow complex, broadband, at antenna input, per 8 3/16. feedline (if needed)	Component Description: Elbow complex, installment #3, 50% shared cost with WFNA Amount: $832.50 Component Description: Elbow complex, installment #2, line 3 of invoice, 50% shared cost with WFNA Amount: $3,746.25 Component Description: Elbow complex, installment #1, line 3 of invoice, 50% shared cost with WFNA Amount: $3,746.25
Additional Antenna Costs	Component Description: Additional antenna components Amount: $6,780.00 Component Description: Additional antenna component Amount: $9,153.00
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized	Component Description: Main antenna, balance due Amount: $20,726.40 Component Description: Main antenna, installment #1, line 1 of invoice Amount: $93,268.80 Component Description: Main antenna, installment #2, line 1 of invoice Amount: $93,268.80
Sweep test of existing antenna	Information not provided.
Elbow complex, single channel, at antenna input, per 7 3/16. feedline (if needed)	Component Description: Elbow complex, balance due Amount: $1,238.24 Component Description: Elbow complex, installment #2, line 3 of invoice Amount: $5,572.13 Component Description: Elbow complex, installment #1, line 3 of invoice Amount: $5,572.13

Cost Information

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	$1,222,650.00	$578,149.50	N/A	$578,124.50	N/A
Total for all systems	$5,429,305.50	$3,653,071.50	N/A	$3,462,951.73	N/A
Interim Transmission Line	$660,050.00	$220,290.00		$220,265.00
Additional Transmission Line Components	$750.00	$750.00	See Dielectric order confirmation 1932357; 50% shared cost with WFNA	$725.00	N/A
Rigid Transmission Line - copper, 8 3/16"	$659,300.00	$219,540.00	See Dielectric quote DMS171-2; 50% shared cost with WFNA	$219,540.00	N/A
Primary Transmission Line	$562,600.00	$357,859.50		$357,859.50
Rigid Transmission Line - copper, 7 3/16"	$562,600.00	$357,859.50	The main transmission line measures well on the pre-auction channel and does not measure well on the post-auction channel (see attached sweep). Therefore, the main transmission line must be replaced. Cost reduced to $357859.50 per Dielectric quote	$357,859.50	N/A

Components

Actual Information Description	File Name
Additional Transmission Line Components	Component Description: Transmission line tuner, 50% shared cost with WFNA Amount: $725.00
Rigid Transmission Line - copper, 8 3/16"	Component Description: Transmission line, installment #1, line 4 of invoice, 50% shared cost with WFNA Amount: $98,793.00 Component Description: Transmission line, installment #1, line 4 of invoice, 50% shared cost with WFNA Amount: $98,793.00 Component Description: Transmission line, installment #3, 50% shared cost with WFNA Amount: $21,954.00
Rigid Transmission Line - copper, 7 3/16"	Component Description: Transmission line, installment #3 Amount: $23,403.46 Component Description: Rigid transmission line, installment #1, line 4 of invoice Amount: $161,036.77 Component Description: Transmission line, balance due Amount: $12,382.50 Component Description: Rigid transmission line, installment #2, line 4 of invoice Amount: $161,036.77

Cost Information

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	$712,350.00	$498,411.00	N/A	$473,352.84	N/A
Total for all systems	$5,429,305.50	$3,653,071.50	N/A	$3,462,951.73	N/A
Primary Tower GTOWER	$712,350.00	$498,411.00		$473,352.84
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study	$26,300.00	$25,000.00	N/A	$2,750.00	N/A
Major tower reinforcement/modifications	$421,000.00	$81,486.00	See Coast to Coast proposal #01231901T and FDH Infrastructure P18_322024_001 (shared cost with WFNA)	$81,486.00	N/A
Land Clearing for Tower Rigging	$3,000.00	$3,000.00	N/A	$2,600.00	N/A
Tower License Permit Fees	$25,000.00	$25,000.00	N/A	$22,594.00	N/A
Tall Tower (greater than 500')	$210,500.00	$337,375.00	See Coast to Coast quote 01231904T	$337,375.00	N/A
Weather Delays, Additional Charges	$26,550.00	$26,550.00	See Coast to Coast rate sheet, daily field updates and related invoices	$26,547.84	N/A

Components

Actual Information Description	File Name
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study	Component Description: Structural analysis, 50% shared cost with WFNA Amount: $2,750.00
Major tower reinforcement/modifications	Component Description: Tower modifications materials, installment #1 Amount: $17,745.00 Component Description: Tower modifications, installment #2 Amount: $41,432.00 Component Description: Tower modifications Amount: $12,309.00 Component Description: Tower modification services, installment #1 Amount: $22,309.00 Component Description: Tower modification materials Amount: $17,745.00 Component Description: Deposit as agreed per Nexstar Commitment Letter and Coast to Coast Tower Service Amount: $10,000.00 Component Description: Reverse request - cost should be shared with WFNA. Amount: ($17,745.00) Component Description: Tower modifications, installment #1 Amount: $22,309.00
Land Clearing for Tower Rigging	Component Description: Land clearing for tower crew, 50% shared cost with WFNA Amount: $1,150.00 Component Description: Road grading for tower equipment, 50% shared cost with WFNA Amount: $1,450.00
Tower License Permit Fees	Component Description: Fees for permitting in AL Amount: $22,594.00
Tall Tower (greater than 500')	Component Description: Antenna installation, balance due Amount: $14,294.00 Component Description: Antenna installation, installment #4 Amount: $60,000.00 Component Description: Antenna installation Amount: $10,000.00 Component Description: Antenna installation, installment #2 Amount: $35,000.00 Component Description: Antenna replacement, installment #1 Amount: $118,081.00 Component Description: Antenna installation, installment #3 Amount: $100,000.00
Weather Delays, Additional Charges	Component Description: Antenna installation additional charges Amount: $7,406.84 Component Description: Weather delays, additional work and materials required Amount: $19,141.00

Cost Information

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	$140,220.00	$135,250.00	N/A	$43,111.50	N/A
Total for all systems	$5,429,305.50	$3,653,071.50	N/A	$3,462,951.73	N/A
Outside Professional Services	$140,220.00	$135,250.00		$43,111.50
Additional Field Engineering Service, 25 Days	$50,000.00	$50,000.00	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
Attorney Fees - Prepare and File request for Special Temporary Authorization	$3,680.00	$3,500.00	N/A	N/A	N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	$2,365.00	$2,250.00	N/A	N/A	N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	$5,260.00	$5,000.00	N/A	N/A	N/A
Prepare request for Special Temporary Authorization	$2,050.00	$1,500.00	N/A	$1,500.00	N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	$1,580.00	$1,500.00	N/A	$625.00	N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	$3,155.00	$3,000.00	N/A	$3,000.00	N/A
Perform engineering study for new channel assignment and antenna development	$7,360.00	$7,000.00	N/A	$7,000.00	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	$2,500.00	N/A
Project management of the transition	$55,300.00	$52,500.00	N/A	$28,486.50	N/A

Components

Actual Information Description	File Name
Additional Field Engineering Service, 25 Days	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.
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: STA to operate using Dielectric interim antenna while new post auction main facility is built out Amount: $1,500.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	Component Description: Prepare engineering portion of License to Cover Application Amount: $625.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	Component Description: Prepare engineering section FCC Form 2100, item 4 from invoice summary Amount: $3,000.00
Perform engineering study for new channel assignment and antenna development	Component Description: Perform engineering study for new channel assignment, item 3 from invoice summary Amount: $7,000.00
Address transition timing and coordination issues w/ other stations and wireless	Information not provided.
Prepare and or review reimbursement form	Component Description: Prepare reimbursement form, item 2 from invoice summary Amount: $2,500.00
Project management of the transition	Component Description: Project management services Aug 2019 Amount: $205.00 Component Description: Project management services Oct 2019 Amount: $50.00 Component Description: Project management services 6.1.19 through 6.28.19 Amount: $525.00 Component Description: Project management services Amount: $1,284.00 Component Description: Project management services 4.27.19 through 5.31.19 Amount: $975.00 Component Description: Project management services July 2019 Amount: $130.00 Component Description: Project management services Amount: $1,098.00 Component Description: Project management services July 2019 Amount: $270.00 Component Description: Project management services 3.30.19 through 4.26.19 Amount: $375.00 Component Description: Prepare FCC Schedule 387, item 6 from invoice summary Amount: $150.00 Component Description: Project management services April 2019 Amount: $201.50 Component Description: Project management services 1.1.19 through 1.31.19 Amount: $525.00 Component Description: Project management services May 2019 Amount: $100.00 Component Description: Project management services, item 1 from invoice summary Amount: $2,325.00 Component Description: Project management services March 2019 Amount: $143.00 Component Description: Prepare FCC Schedule 387, item 5 from invoice summary Amount: $300.00 Component Description: Project Management for Structural Analysis and Tower Modifications including consultants Kessler and Gehman Associates. Services from January 27, 2018 through February 23, 2018. Amount: $375.00 Component Description: Project management services June 2019 Amount: $50.00 Component Description: Project management services 10.27.18 through 11.30.18 Amount: $4,975.00 Component Description: Project management services 2.1.19 through 3.1.19 Amount: $225.00 Component Description: Project management services 12.1.18 through 12.31.18 Amount: $300.00 Component Description: Project management services 1/1/18 through 1/26/18 Amount: $75.00 Component Description: Project management services Amount: $50.00 Component Description: Project management services Amount: $229.00 Component Description: Project management services 9.29.18 through 10.26.18 Amount: $825.00 Component Description: Project management services Amount: $7,071.00 Component Description: Project management services 01.2019 Amount: $75.00 Component Description: Project management services Amount: $558.00 Component Description: Project management services 3.2.19 through 3.29.19 Amount: $300.00 Component Description: Project management services Sep 2020 Amount: $125.00 Component Description: Project management services April 2019 Amount: $190.00 Component Description: Project management services June 2019 Amount: $195.00 Component Description: Project management services various, item 7 from invoice summary Amount: $2,987.00 Component Description: Project management services 5/26/18 through 6/29/18 Amount: $300.00 Component Description: Project management services 12.2018 Amount: $250.00 Component Description: Project management services 7.28.18 through 9.28.18 Amount: $675.00

Cost Information

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	$327,050.00	$326,500.00	N/A	$269,604.12	N/A
Total for all systems	$5,429,305.50	$3,653,071.50	N/A	$3,462,951.73	N/A
Other Expenses	$327,050.00	$326,500.00		$269,604.12
Sales Tax	$160,000.00	$160,000.00	We included sales and use tax for transmitter, antenna, line and tower work at the broadcast equipment tax rate of 4.75% for the state of AL. See related invoices	$159,413.70	N/A
Transmitter Road Grading	$3,000.00	$3,000.00	N/A	N/A	N/A
Equipment Rentals	$5,000.00	$5,000.00	Equipment rentals required; see related invoices	$3,435.00	N/A
MVPD Notification of Channel Change	$2,000.00	$2,000.00	N/A	N/A	N/A
Develop and air announcement of upcoming channel change	$3,500.00	$3,500.00	N/A	N/A	N/A
Equipment Storage	$25,000.00	$25,000.00	N/A	$12,742.50	N/A
Equipment Delivery and Handling Charges	$55,000.00	$55,000.00	See related invoices	$54,049.72	N/A
Disposal Costs (for equipment and other waste, net of any salvage value)	$37,000.00	$37,000.00	See quotes from USA Commercial Removal	$37,000.00	N/A
Non-zoning permits	$25,000.00	$25,000.00	N/A	N/A	N/A
DTV Medical Facility Notification	$11,550.00	$11,000.00	N/A	$2,963.20	N/A

Components

Actual Information Description	File Name
Sales Tax	Component Description: Tax on transmitter stacking parts Amount: $713.00 Component Description: Tax due on transmitter components Amount: $4,683.85 Component Description: Tax due on transmitter Amount: $97,600.48 Component Description: WKRG State Sales and Use Tax Amount: $16,701.00 Component Description: WKRG City and County Sales and Use Tax Amount: $37,356.00 Component Description: Tax on transmitter consolidation services Amount: $1,136.55 Component Description: Tax on additional combiner components, 50% shared cost with WFNA Amount: $719.41 Component Description: Tax due on antenna component Amount: $503.41
Transmitter Road Grading	Information not provided.
Equipment Rentals	Component Description: Equipment rentals Amount: $3,435.00
MVPD Notification of Channel Change	Information not provided.
Develop and air announcement of upcoming channel change	Information not provided.
Equipment Storage	Component Description: Antenna storage cost Amount: $5,460.00 Component Description: Antenna storage, 50% shared cost with WFNA Amount: $1,170.00 Component Description: Combiner storage, 50% shared cost with WFNA Amount: $3,772.50 Component Description: Dielectric storage charges Amount: $2,340.00 Component Description: Antenna storage, 50% shared cost with WFNA Amount: $1,170.00
Equipment Delivery and Handling Charges	Component Description: Antenna freight cost Amount: $6,608.54 Component Description: Antenna shipping cost, 50% shared cost with WFNA Amount: $313.50 Component Description: Antenna shipping cost, 50% shared cost with WFNA Amount: $27.11 Component Description: Antenna shipping cost, 50% shared cost with WFNA Amount: $599.52 Component Description: Additional antenna components shipping cost Amount: $3,170.01 Component Description: Antenna freight, 50% shared cost with WFNA Amount: $6,068.50 Component Description: Antenna shipping cost Amount: $1,272.43 Component Description: Combiner freight cost, 50% shared cost with WFNA Amount: $3,138.75 Component Description: Antenna shipping cost, 50% shared cost with WFNA Amount: $1,019.62 Component Description: Antenna freight cost, 50% shared cost with WFNA Amount: $6,068.50 Component Description: Antenna freight cost Amount: $10,732.50 Component Description: Freight costs related to concrete pad and ice shield, 50% shared cost with WFNA Amount: $900.00 Component Description: Interim antenna freight; 50% shared cost with WFNA Amount: $3,304.22 Component Description: Transmitter consolidation services Amount: $15,154.00 Component Description: Antenna components shipping; 50% shared cost with WFNA Amount: $763.12 Component Description: Additional antenna component shipping cost, 50% shared cost with WFNA Amount: $314.18 Component Description: Antenna shipping cost Amount: $663.72
Disposal Costs (for equipment and other waste, net of any salvage value)	Component Description: Transmitter site removal of transmitter units, dummy loads, transmission and conduit lines with quote. Amount: $20,000.00 Component Description: Disposal costs Amount: $17,000.00
Non-zoning permits	Information not provided.
DTV Medical Facility Notification	Component Description: Notification of Medical Facilities Amount: $2,963.20

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$5,429,305.50	$3,653,071.50	$3,462,951.73

Reimbursement Status

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

Certification

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.
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. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. 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). 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. 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. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. 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.	Elizabeth Ryder General Counsel 09/27/2021

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.

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.
The above-named entity acknowledges that all certifications and attached documentation are considered material representations.
The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.
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).
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.
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.
The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.
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.

Elizabeth Ryder

General Counsel

09/27/2021

Certification

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).
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 certifies that the statements in this form and attached documentation are true, complete, and correct. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. 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) . 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. The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. 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.	Elizabeth Ryder General Counsel 09/27/2021

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).

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 certifies that the statements in this form and attached documentation are true, complete, and correct.
The above-named entity acknowledges that all certifications and attached documentation are considered material representations.
The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.
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) .
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.
The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred.
The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.
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.

Elizabeth Ryder

General Counsel

09/27/2021

(REFERENCE COPY - Not for submission) FCC Form 399: Reimbursement Request

Applicant Information

Applicant Name, Type, and Contact Information

Reimbursement Contact Information

Reimbursement Contact Name and Information

Preparer Contact Information

Preparer Contact Name and Information

Broadcaster Information and Transition Plan

Transmitters

Primary Transmitter

Existing Transmitter Information

Primary Transmitter

New Transmitter Costs

Primary Transmitter

Other Transmitter Costs

Primary Transmitter

Other Transmitter Cost Not Listed

Antennas

Primary Antenna

Existing Antenna Information

Primary Antenna

New Antenna Costs

Primary Antenna

Other Antenna Costs

Primary Antenna

Other Antenna Cost Not Listed

Interim Antenna

New Antenna Costs

Interim Antenna

Other Antenna Costs

Enter a list of RF channel numbers.

Interim Antenna

Other Antenna Cost Not Listed

Transmission Line

Primary Transmission Line

Add Transmission Line

Primary Transmission Line

New Transmission Line

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Interim Transmission Line

New Transmission Line

Interim Transmission Line

Other Transmission Line Expenses Not Listed

Tower Equipment And Rigging Costs

Primary Tower

Existing Tower

FM, AM or TV radio broadcasters. Facility ID's, Call Signs and Services of other broadcast stations with whom the tower is shared

Other Types of Users

Primary Tower

Tower Modification Costs

Primary Tower

Tower Rigging Costs

Primary Tower

Other Tower Expenses Not Listed

Outside Professional Services Costs

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Other Expenses

Other Expenses

Other Expenses Not Listed

Cost Information

Transmitters

Components

Cost Information

Antennas

Components

Cost Information

Transmission Line

Components

Cost Information

Tower Equipment and Rigging Costs

Components

Cost Information

Outside Professional Services

Components