TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
Mission Broadcasting, Inc.	Dennis Thatcher 901 Indiana Avenue Suite 375 Wichita Falls, TX 76301 United States	+1 (940) 228-7861	missionbroadcasting@gmail.com	Corporation

Applicant

Address

Phone

Applicant Type

Mission Broadcasting, Inc.

Dennis Thatcher

901 Indiana Avenue

Suite 375

Wichita Falls, TX 76301

United States

+1 (940) 228-7861

missionbroadcasting@gmail.com

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
Henry Gola Wiley Rein LLP	1776 K Street, N.W. Washington, DC 20006 United States	+1 (202) 719-7561	hgola@wiley.law

Applicant

Address

Phone

Henry Gola

Wiley Rein LLP

1776 K Street, N.W.

Washington, DC 20006

United States

+1 (202) 719-7561

hgola@wiley.law

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	WJET & WFXP are co-located. The initial 399 requested to share the same antenna and line; however, the azimuth patterns are directional and significantly different. Accordingly, both facilities are filing amendments to budget and operate independently.

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	QXD1U Quantum
	Year	2008
	Type	Inductive Output Tube
	IOT Power Type	Single
	Power Capacity	30 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-12
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	19.0 kW
	Justification for New Transmitter	Existing transmitter cannot be converted to repacked channel per manufacturer. Station has greater than 10% TPO Headroom and is eligible for the 1-Step-Up Allowance.

Primary Transmitter

Other Transmitter Costs

Section	Question	Response
Electrical Service	Service Entrance (3 phases 800A 208V)	Yes
	Switchgear (industrial 800 amp)	Yes
	Transformer (480V)	Yes
	Power	500 kVA
	Rigid Conduit and Wiring	Yes
	Size	3 inches
	Length	300.0 feet
	Other Electrical Service	Yes
	Description	See attached electrical quotes for new building addition. NOTE: New building addition and associated costs will be shared with WJET.
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?	Yes
	Size	900.0 square feet
Channel 14 Costs	Is an RF Consulting Engineer needed?	N/A
	Is a channel 14 Mask Filer needed?	N/A
	Is additional field engineering time needed?	N/A
	Number of Days	N/A

Primary Transmitter

Other Transmitter Cost Not Listed

Name	Description
Halo Ground System	Grounding and Surge Suppression for New Transmitter Building. Shared Cost with WJET
Transmitter Building Permit	Transmitter Building Permit
Wiring and Signal Cabling	Wiring and signal cabling from one building to the transmitter building and internal signal wiring
Transmitter Site Security System	Transmitter Site Key Card Entry and Video Surveillance
Additional Transmitter Costs	Additional transmitter costs
Transmitter Electrical and Installation	Transmitter Electrical and Installation

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	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:	850.0 kW
	Manufacturer
	Model	TFU-24DSB-E
	Year	2008

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	Side Mount
	Antenna position in stack	Not in Stack
	Polarization	Elliptical
	Type	Slotted Coaxial
	Number of Stations Supported	N/A
	Number of Panels/Bays	N/A
	Lower Limit	N/A
	Upper Limit	N/A
	Design power capacity in use	N/A
	Other Antenna Type	N/A
	ERP:	930.0 kW
	Manufacturer
	Model	TFU-24DSB-E/VP-R
	Year	2019
	Justification for New Antenna	Existing coaxial slot antenna is not designed to operate on repacked 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	6 1/8 inches inches
Side Mount Brackets	Do you require the separate purchase of side mount brackets for a high power antenna?	Yes
Pattern Scatter Analysis	Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna?	Yes
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?	No
	Is antenna directional?	Yes
	Will antenna be located on or in close proximity to an antenna farm?	No
New Antenna Manufacturer and Type	Class	Full Power
	Mounting	Side Mount
	Antenna position in stack	Not in Stack
	Polarization	Horizontal
	Type	Slotted Coaxial
	Number of Stations Supported	N/A
	Number of Panels/Bays	N/A
	Lower Limit	N/A
	Upper Limit	N/A
	Design power capacity in use	N/A
	Other Antenna Type	N/A
	ERP:	1000.0 kW
	Manufacturer
	Model	TFU-16DSB-E-R BB
	Year	2019
	Justification for New Antenna	An interim antenna is necessary to keep the station on air during primary antenna replacement and for the duration of the assigned phase. Licensed ERP is 850 kW but 1,000 kW will be required for replication due to lower height of interim antenna.

Interim Antenna

Other Antenna Costs

Section	Question	Response
Elbow Complex	Do you require the separate purchase of the Elbow Complex?	Yes
	Broadband or Single Channel?	S
	Feed Line Size	6 1/8 inches
Side Mount Brackets	Do you require the separate purchase of side mount brackets for an antenna?	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

Interim Antenna

Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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

Primary Transmission Line

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	Rigid
	Diameter	3 1/8 inches
	Other Diameter	N/A
	Segment Length	20 inches
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	805 feet per run

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Name	Description
Additional Line	Additional transmission line required from new building addition to base of tower.
Transmission Line Sweep	Sweep is required to verify that existing line measures well on new post-transition channel.
Additional Transmission Line Components	Additional Transmission Line Components

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	4 1/16 inches
	Segment Length	20'
	Other Segment Length
	Number of parallel runs	1
	Length	550 feet per run
	Justification for New Transmission Line	New interim transmission line is required for operation of the new interim facility since the existing line will be repurposed for post-transition operation.

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	No
	Is tower documented for structural analysis?	No
	Is tower compliant with Rev G?	Unknown
Existing Tower Structure Registration	Do you have a tower registration number?	Yes
Existing Tower Structure Registration	ASR Number	1033280
Coordinates (NAD83)	Latitude (NAD83)	42° 02' 25.0" N-
	Longitude (NAD83)	080° 04' 08.0" W-
	Overall Structure Height	816.59 feet
	Support Structure Height	750.98 feet
	Ground Elevation Above Mean Sea Level (AMSL)	1305.10 feet
	Structure Type	TOWER - Free Standing or Guyed Structure
	Tower Owner	Nexstar Broadcasting, Inc.
	Date Constructed	01/01/1997

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
65749	WJET-TV	DTV

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
Tower Crew Weather Delay Costs	Tower Crew Weather Delay Costs June and July 2019
Ice Bridge	Ice bridge from new building addition to base of tower required (see attached PCI quote)
Rerouting of Transmission Lines feeding Main Antenna	Extend 4' Feedline to main antenna, and removal of 300' of 3' transmission line Please see Addendum to Proposal 19364-5ADD attached

Outside Professional Services Costs

Section	Question	Response
Outside Project Management Services	Do you require outside project management services?	Yes
	Number of Hours	750
	Explanation	It will be necessary to 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.
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	15
	Justification	It is necessary to survey the site, plan the equipment, develop specifications for purchasing, & oversee multiple vendor RF projects. Station does not have available 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?	Yes
AM Pattern Disturbance	Is Remediation needed?	Yes
Facility Expenses	Name	N/A
	Other Distributed Transmission System Expenses Not listed	N/A
	Name	N/A
	Is Notification of a Medical Facility required as a result of DTV broadcasting?	Yes
Permit and Filing Costs	Local Zoning	Yes
	Non-zoning permits	Yes
	BLM or NFS Coordination	No
	FCC Construction Permit Minor Change	No
	FCC License to Cover Application	Yes
	FCC Special Temporary Authority Application	Yes
Other Miscellaneous Expenses	Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)?	Yes
	Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs?	Yes
	Does this relocation require Equipment Storage?	Yes
	Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change?	Yes
	Does this relocation require MVPD Notification of a Channel Change?	Yes

Other Expenses

Other Expenses Not Listed

Name	Description
Sales and Use Tax Due	Sales and Use Tax Due

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	$1,118,462.00	$746,537.00	N/A	$621,882.88	N/A
Total for all systems	$2,724,864.00	$2,069,337.20	N/A	$1,607,260.94	N/A
Primary Transmitter THU9evo-12	$1,118,462.00	$746,537.00		$621,882.88
Other Electrical Service: See attached electrical quotes for new building addition. NOTE: New building addition and associated costs will be shared with WJET.	$29,500.00	$29,500.00	Total electrical costs for new building addition is $59,000; however, costs are shared with WJET. See attached Building Addition Electrical Quote (Connecto Electric).	$24,201.88	N/A
Transmitter Electrical and Installation	$76,300.00	$76,300.00	See Land Communications quote 1020	$76,300.00	N/A
Additional Transmitter Costs	$28,158.00	$28,158.00	See Rohde & Schwarz quote 199622.2	$28,158.00	N/A
Transmitter Site Security System	$1,650.00	$1,650.00	Transmitter Site Security Key Card Entry and Video Surveillance. Please see Mobilecom TX Site Security Quote attached	$1,627.50	N/A
Wiring and Signal Cabling	$5,000.00	$5,000.00	N/A	$325.00	N/A
Transmitter Building Permit	$354.00	$354.00	Summit Township permit fee, 50% shared cost with WJET	$354.00	N/A
Other -- Building Addition Size: 900.0	$73,500.00	$73,500.00	Insufficient space in existing building for new RF systems. New building addition is required. Total costs for new building addition is $118,300; however, costs are shared with WJET. See attached Quote (Frontier General Contracting), change orders, paint	$73,467.50	N/A
15 Ton system	$88,400.00	$10,125.00	Insufficient space in existing building for new RF systems. HVAC required for new building addition. Total costs for new HVAC is 20,250; however, costs are shared with WJET. See attached Building Addition HVAC Quote (KEEP Heating & Cooling).	$10,125.00	N/A
3" Rigid Conduit and Wiring (Cost per foot)	$15,600.00	$15,000.00	N/A	N/A	N/A
Transformer 3 phase/480v - 500 KVA	$48,400.00	$47,100.00	N/A	$0.00	N/A
Switchgear - industrial 800 amp	$38,200.00	$37,150.00	N/A	$0.00	N/A
Service entrance 3 phase/800 amp/208 volt	$14,400.00	$14,050.00	N/A	N/A	N/A
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW	$684,000.00	$393,650.00	Cost reduced from $666000 to $393650; see Rohde & Schwarz quote 133636.2	$393,650.00	N/A
Halo Ground System	$15,000.00	$15,000.00	N/A	$13,674.00	N/A

Components

Actual Information Description	File Name
Other Electrical Service: See attached electrical quotes for new building addition. NOTE: New building addition and associated costs will be shared with WJET.	Component Description: Transmitter building electrical work, 50% shared cost with WJET Amount: $18,600.00 Component Description: Transmitter building electrical work, 50% shared cost with WJET Amount: $2,150.00 Component Description: Transmitter building electric work, 50% shared cost with WJET Amount: $1,075.00 Component Description: Wiring and distribution amps, 50% shared cost with WJET Amount: $1,126.88 Component Description: Transmitter building electrical work, 50% shared cost with WJET Amount: $1,250.00
Transmitter Electrical and Installation	Component Description: Transmitter electrical and installation, 50% down payment Amount: $38,150.00 Component Description: Transmitter electrical and installation, 50% due on completion Amount: $38,150.00
Additional Transmitter Costs	Component Description: Additional transmitter parts Amount: $28,158.00
Transmitter Site Security System	Component Description: Transmitter building security, 50% shared cost with WJET Amount: $1,627.50
Wiring and Signal Cabling	Component Description: Transmitter building electrical work, 50% shared cost with WJET Amount: $325.00
Transmitter Building Permit	Component Description: Transmitter building construction permit Amount: $354.00
Other -- Building Addition Size: 900.0	Component Description: Transmitter building, installment #1, 50% shared cost with WJET Amount: $5,000.00 Component Description: Transmitter building, installment #5, 50% shared cost with WJET Amount: $17,432.50 Component Description: Transmitter building, installment #3, 50% shared cost with WJET Amount: $16,975.00 Component Description: Transmitter building, installment #2 Amount: $10,440.00 Component Description: Transmitter building, installment #4, 50% shared cost with WJET Amount: $21,335.00 Component Description: Transmitter building paint interior; 50% shared cost with WJET Amount: $2,285.00
15 Ton system	Component Description: HVAC and installation, installment #3, 50% shared cost with WJET FAC ID 65749 Amount: $3,375.00 Component Description: HVAC and installation, installment #2, 50% shared cost with WJET FAC ID 65749 Amount: $3,375.00 Component Description: HVAC and installation, installment #1, 50% shared cost with WJET FAC ID 65749 Amount: $3,375.00
3" Rigid Conduit and Wiring (Cost per foot)	Information not provided.
Transformer 3 phase/480v - 500 KVA	Information not provided.
Switchgear - industrial 800 amp	Information not provided.
Service entrance 3 phase/800 amp/208 volt	Information not provided.
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW	Component Description: Transmitter, installment #1 Amount: $98,412.50 Component Description: Transmitter, installment #2 Amount: $295,237.50
Halo Ground System	Component Description: Halo ground system, 50% shared cost with WJET Amount: $13,674.00

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	$270,072.00	$239,042.00	N/A	$216,319.00	N/A
Total for all systems	$2,724,864.00	$2,069,337.20	N/A	$1,607,260.94	N/A
Interim Antenna TFU-16DSB-E-R BB	$109,480.00	$89,715.00		$72,445.00
Side mount brackets for high power antennas (if not included in antenna base cost)	$23,150.00	$4,005.00	Cost reduced from $22500 to $4005; see Dielectric quote 900048CMZ-2.	$4,005.00	N/A
UHF - High Power, Side Mount, basic slot antenna, 1000 kW input, directional,, horizontally polarized	$62,040.00	$62,040.00	Cost Catalog Pricing - Waiting on quote from Dielectric; cost reduced from $185500 to $62040. See Dielectric quote 900048CMZ-2	$62,040.00	N/A
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)	$5,260.00	$5,120.00	N/A	N/A	N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)	$12,300.00	$12,000.00	N/A	N/A	N/A
Sweep test of existing antenna	$6,730.00	$6,550.00	N/A	$6,400.00	N/A
Primary Antenna TFU-24DSB-E/VP-R	$160,592.00	$149,327.00		$143,874.00
Additional Antenna Costs	$23,650.00	$23,650.00	See Dielectric order confirmations 1770120,1929271,1929343 and quote 1929458	$23,638.90	N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)	$12,300.00	$12,017.00	See Dielectric Quote (Quote No. DMS173-4) ELBOW COMPLEX: $10,298.00 T/L 6-75 EIA LENGTH: $1,719.00 TOTAL: $12,017.00	$11,845.10	N/A
Side mount brackets for high power antennas (if not included in antenna base cost)	$23,150.00	$12,488.00	See Dielectric Quote (Quote No. DMS173-4)	$12,488.00	N/A
UHF - High Power, Side Mount, basic slot antenna, 930 kW input, directional,, elliptically or circularly polarized	$89,502.00	$89,502.00	See Dielectric Quote (Quote No. DMS173-4); total antenna cost $98,502 less vpol cost ($9,000) which is not reimbursable	$89,502.00	N/A
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)	$5,260.00	$5,120.00	N/A	N/A	N/A
Sweep test of existing antenna	$6,730.00	$6,550.00	N/A	$6,400.00	N/A

Components

Actual Information Description	File Name
Side mount brackets for high power antennas (if not included in antenna base cost)	Component Description: Leg mounts, balance due Amount: $400.50 Component Description: Leg mounts, installment #2, line 3 of invoice Amount: $1,802.25 Component Description: Leg Mounts, installment #1, line 3 of invoice Amount: $1,802.25
UHF - High Power, Side Mount, basic slot antenna, 1000 kW input, directional,, horizontally polarized	Component Description: Interim antenna, balance due Amount: $6,204.00 Component Description: Interim antenna, installment #1, line 2 of invoice Amount: $27,918.00 Component Description: Interim antenna, installment #2, line 2 of invoice Amount: $27,918.00
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)	Information not provided.
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)	Information not provided.
Sweep test of existing antenna	Component Description: Interim antenna sweep test Amount: $6,400.00
Additional Antenna Costs	Component Description: Additional antenna components Amount: $17,560.15 Component Description: Manifold, 50% shared cost with WJET Amount: $236.25 Component Description: Additional anchors Amount: $764.00 Component Description: Additional antenna component Amount: $472.50 Component Description: Additional antenna components Amount: $4,606.00
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)	Component Description: Elbow complex, balance due Amount: $1,029.80 Component Description: Elbow complex, installment #2, line 4 of invoice Amount: $4,634.10 Component Description: T/L Length, installment #1, line 5 of invoice Amount: $773.55 Component Description: T/L Length, installment #2, line 5 of invoice Amount: $773.55 Component Description: Elbow complex, installment #1, line 4 of invoice Amount: $4,634.10
Side mount brackets for high power antennas (if not included in antenna base cost)	Component Description: Side mount brackets, balance due Amount: $1,248.80 Component Description: Side mount brackets, installment #1, line 3 of invoice Amount: $5,619.60 Component Description: Side mount brackets, installment #2, line 3 of invoice Amount: $5,619.60
UHF - High Power, Side Mount, basic slot antenna, 930 kW input, directional,, elliptically or circularly polarized	Component Description: Main antenna, installment #2, line 1 of invoice Amount: $40,275.90 Component Description: Main antenna, balance due Amount: $8,950.20 Component Description: Main antenna, installment #1, line 1 of invoice Amount: $40,275.90
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: Main antenna sweep test Amount: $6,400.00

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	$151,000.00	$139,106.70	N/A	$128,667.00	N/A
Total for all systems	$2,724,864.00	$2,069,337.20	N/A	$1,607,260.94	N/A
Interim Transmission Line	$89,600.00	$77,706.70		$75,099.70
Additional Transmission Line Components	$11,500.00	$11,500.00	See Dielectric order confirmation 1698398	$11,175.00	N/A
Rigid Transmission Line - copper, 4 1/16"	$78,100.00	$66,206.70	Cost reduced from $75900 to $66206.70; see Dielectric quote 900048CMZ-2	$63,924.70	N/A
Primary Transmission Line	$61,400.00	$61,400.00		$53,567.30
Transmission Line Sweep	$6,400.00	$6,400.00	N/A	N/A	N/A
Additional Transmission Line Components	$30,000.00	$30,000.00	See Dielectric order confirmations	$29,117.30	N/A
Additional Line	$25,000.00	$25,000.00	Additional transmission line required from new building addition to base of tower.	$24,450.00	N/A

Components

Actual Information Description	File Name
Additional Transmission Line Components	Component Description: Additional transmission line components Amount: $5,395.50 Component Description: Additional transmission line components Amount: $3,678.50 Component Description: Additional transmission line components Amount: $2,101.00
Rigid Transmission Line - copper, 4 1/16"	Component Description: Transmission line, installment #2, line 8 of invoice Amount: $1,540.35 Component Description: Transmission line, installment #2, line 4 of invoice Amount: $28,252.67 Component Description: Transmission line, installment #3 Amount: $3,197.66 Component Description: Transmission line, installment #1, line 8 of invoice Amount: $1,540.35 Component Description: Transmission line, installment #4 Amount: $1,141.00 Component Description: Transmission line, installment #1, line 4 of invoice Amount: $28,252.67
Transmission Line Sweep	Information not provided.
Additional Transmission Line Components	Component Description: Additional transmission line component Amount: $9,120.00 Component Description: Additional transmission line costs Amount: $1,668.70 Component Description: Additional transmission line components Amount: $9,858.60 Component Description: Additional transmission line components Amount: $8,470.00
Additional Line	Component Description: Additional transmission line Amount: $24,450.00

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	$778,690.00	$545,738.50	N/A	$545,660.00	N/A
Total for all systems	$2,724,864.00	$2,069,337.20	N/A	$1,607,260.94	N/A
Primary Tower TOWER	$778,690.00	$545,738.50		$545,660.00
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study	$26,300.00	$14,000.00	See related invoices	$13,934.50	N/A
Tower Crew Weather Delay Costs	$15,000.00	$15,000.00	N/A	$15,000.00	N/A
Rerouting of Transmission Lines feeding Main Antenna	$39,575.00	$39,575.00	Extend 4' Feedline to main antenna, and removal of 300' of 3' transmission line Please see Addendum to Proposal 19364-5ADD attached	$39,575.00	N/A
Weather Delays, Additional Charges	$7,000.00	$7,000.00	See PCI Addendum to Proposal 19338-5; 50% shared cost with WJET	$6,987.00	N/A
Tall Tower (greater than 500')	$210,500.00	$263,260.00	Interim antenna installation- see PCI quote 19351-5; main antenna installation - see PCI quote 19364-5	$263,260.00	N/A
Major tower reinforcement/modifications	$421,000.00	$147,588.50	See PCI quote 19350-5; proposal is WFXP 50% share of cost with WJET; see also FDH Infrastructure P19_170813_001 for modification materials; proposal is 100% cost which will be split with WJET.	$147,588.50	N/A
Ice Bridge	$59,315.00	$59,315.00	A new building addition is required which necessitates an ice bridge from the new building addition to the base of the tower. Total costs for new Ice Bridge and Shield is $118,630; however, costs are shared with WJET. See attached Ice Bridge Quotes PCI	$59,315.00	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: Climatic study, 50% shared cost with WJET Amount: $400.00 Component Description: Structural analysis, 50% shared cost with WJET Amount: $750.00 Component Description: Structural analysis, installment #2, 50% shared cost with WJET Amount: $1,375.00 Component Description: Structural analysis, 50% of shared cost with WJET FAC ID 65749 Amount: $1,375.00 Component Description: Structural analysis, installment #1, 50% shared cost with WJET Amount: $1,500.00 Component Description: Structural analysis, 50% shared cost with WJET Amount: $3,000.00 Component Description: Tower mapping, 50% of shared cost with WJET FAC ID 65749 Amount: $2,017.25 Component Description: Structural analysis, installment #2, 50% shared cost with WJET Amount: $1,500.00 Component Description: Tower mapping, 50% of shared cost with WJET FAC ID 65749 Amount: $2,017.25
Tower Crew Weather Delay Costs	Component Description: Tower modifications weather delays, 50% shared cost with WJET Amount: $15,000.00
Rerouting of Transmission Lines feeding Main Antenna	Component Description: Reroute transmission lines Amount: $39,575.00
Weather Delays, Additional Charges	Component Description: Weather delays and additional charges; 50% shared cost with WJET Amount: $6,987.00
Tall Tower (greater than 500')	Component Description: Interim antenna installation, installment #3 Amount: $59,840.00 Component Description: Interim antenna installation, installment #2 Amount: $59,830.00 Component Description: Main antenna installation Amount: $83,760.00 Component Description: Interim antenna installation, installment #1 Amount: $59,830.00
Major tower reinforcement/modifications	Component Description: Tower modifications, installment #1 Amount: $32,465.00 Component Description: Tower modification materials, installment #2, 50% shared cost with WJET FAC ID 65749 Amount: $25,094.25 Component Description: Tower modifications, installment #2 Amount: $32,465.00 Component Description: Tower modification materials, installment #1, 50% shared cost with WJET FAC ID 65749 Amount: $25,094.25 Component Description: Tower modifications, installment #3 Amount: $32,470.00
Ice Bridge	Component Description: Ice bridge, installment #3, 50% shared cost with WJET Amount: $8,940.00 Component Description: Ice Bridge, installment #1, 50% shared cost with WJET FAC ID 65749 Amount: $8,937.50 Component Description: Ice Bridge additional work, installment #1, 50% shared cost with WJET FAC ID 65749 Amount: $21,650.00 Component Description: Ice bridge additional costs, installment #2, 50% shared cost with WJET Amount: $10,850.00 Component Description: Ice Bridge, installment #2, 50% shared cost with WJET FAC ID 65749 Amount: $8,937.50 Component Description: Ice bridge, installment #2, 50% shared cost with WJET Amount: $8,937.50

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	$234,420.00	$233,005.00	N/A	$40,570.65	N/A
Total for all systems	$2,724,864.00	$2,069,337.20	N/A	$1,607,260.94	N/A
Outside Professional Services	$234,420.00	$233,005.00		$40,570.65
Project management of the transition	$118,500.00	$115,500.00	N/A	$33,345.65	N/A
Additional Field Engineering Service, 15 Days	$81,000.00	$81,000.00	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	$2,050.00	N/A	N/A	N/A
ASR modification (prepare FCC Form 854)	$2,105.00	$2,050.00	N/A	N/A	N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization	$3,680.00	$3,585.00	N/A	N/A	N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	$2,365.00	$2,305.00	N/A	N/A	N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	$5,260.00	$5,120.00	N/A	N/A	N/A
Prepare request for Special Temporary Authorization	$2,050.00	$4,500.00	See related invoices	$4,500.00	N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	$1,580.00	$1,535.00	N/A	$625.00	N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	$3,155.00	$3,070.00	N/A	N/A	N/A
Perform engineering study for new channel assignment and antenna development	$7,360.00	$7,170.00	N/A	N/A	N/A
Address transition timing and coordination issues w/ other stations and wireless	$2,630.00	$2,560.00	N/A	N/A	N/A
Prepare and or review reimbursement form	$2,630.00	$2,560.00	N/A	$2,100.00	N/A

Components

Actual Information Description	File Name
Project management of the transition	Component Description: Project management services May 2019 Amount: $84.50 Component Description: Project management services Jun 2019 Amount: $375.00 Component Description: Project management services Amount: $1,902.50 Component Description: Project management services Amount: $387.00 Component Description: Project management services Mar 2019 Amount: $117.00 Component Description: Project management services Sep 2019 Amount: $130.00 Component Description: Project management services Jul 2019 Amount: $230.00 Component Description: Project management services Nov 2019 Amount: $50.00 Component Description: Project management services July 2017 Amount: $1,575.00 Component Description: Project management services Amount: $237.00 Component Description: Project management services Amount: $6,728.15 Component Description: Project management services April 2019 Amount: $40.00 Component Description: Project management services December 2018 Amount: $100.00 Component Description: Project management services Apr 2019 Amount: $78.00 Component Description: Project management services Amount: $1,407.50 Component Description: Project management services 3.30.19 through 4.26.19 Amount: $375.00 Component Description: Project management services 7.28.18 through 9.28.18. Amount: $825.00 Component Description: Project management services 9.29.18 through 10.26.18 including subcontractor invoice from Kessler and Gehman Associates for Form 387 Transition Plan Progress Report 2018 Q3 preparation. Amount: $975.00 Component Description: Project management services 6.30.18 through 7.27.18 Amount: $300.00 Component Description: Project management services Amount: $4,909.00 Component Description: Project management services Amount: $675.00 Component Description: Project management services May 2019 Amount: $90.00 Component Description: Project management services 3.2.19 through 3.29.19 Amount: $7,525.00 Component Description: Project management services 5.26.18 through 6.29.18 Amount: $975.00 Component Description: Project management services October 2018 Amount: $65.00 Component Description: Project management services Jun 2019 Amount: $422.50 Component Description: Project management services Amount: $150.00 Component Description: Project management services, 50% shared cost with WJET Amount: $462.50 Component Description: Project management services 2.24.18 through 3.30.18 Amount: $450.00 Component Description: Project Management for Structural Analysis and Tower Modifications for dates January 1, 2019 through January 31, 2019 including consultants Kessler and Gehman Associates. Amount: $225.00 Component Description: Project management services March 2019 Amount: $130.00 Component Description: See cover letter item 1 - Project Management of the transition for services October 27, 2018 through November 30, 2018. Amount: $1,350.00
Additional Field Engineering Service, 15 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: Prepare request for STA Amount: $1,500.00 Component Description: Prepare request for STA Amount: $1,500.00 Component Description: Prepare request for STA Amount: $1,500.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	Component Description: Prepare License to Cover application Amount: $625.00
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.
Address transition timing and coordination issues w/ other stations and wireless	Information not provided.
Prepare and or review reimbursement form	Component Description: See cover letter item 2 - Prepare and or review reimbursement form. Services provided by contractor Kesller and Gehman Associates for Form 399 Amendment. Amount: $1,275.00 Component Description: Prepare and or review reimbursement form. Services provided by contractor Kessler and Gehman Associates for Form 399 Amendment. Amount: $825.00

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	$172,220.00	$165,908.00	N/A	$54,161.41	N/A
Total for all systems	$2,724,864.00	$2,069,337.20	N/A	$1,607,260.94	N/A
Other Expenses	$172,220.00	$165,908.00		$54,161.41
Develop and air announcement of upcoming channel change	$1,500.00	$1,500.00	Costs to develop and produce spots and crawls for viewer notifications.	N/A	N/A
Equipment Storage	$25,000.00	$25,000.00	N/A	$1,595.00	N/A
Equipment Delivery and Handling Charges	$50,500.00	$50,500.00	See related invoices	$50,480.76	N/A
Disposal Costs (for equipment and other waste, net of any salvage value)	$25,000.00	$25,000.00	N/A	N/A	N/A
Non-zoning permits	$25,000.00	$25,000.00	N/A	N/A	N/A
FCC Filing Fees - Special Temporary Authorization request	$195.00	$195.00	N/A	N/A	N/A
MVPD Notification of Channel Change	$3,500.00	$3,500.00	N/A	N/A	N/A
Sales and Use Tax Due	$200.00	$200.00	Estimated tax due	$97.65	N/A
AM Pattern Disturbance -- Impact study	$7,890.00	$7,680.00	N/A	N/A	N/A
AM Pattern Disturbance -- Remedy	$21,050.00	$20,500.00	N/A	N/A	N/A
DTV Medical Facility Notification	$11,550.00	$6,000.00	N/A	$1,988.00	N/A
FCC Filing Fees - Form 2100 license to cover application	$335.00	$333.00	N/A	N/A	N/A
Local Zoning	$500.00	$500.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
Develop and air announcement of upcoming channel change	Information not provided.
Equipment Storage	Component Description: Main antenna storage cost Amount: $1,595.00
Equipment Delivery and Handling Charges	Component Description: Transmitter consolidation services Amount: $16,924.00 Component Description: Antenna shipping cost Amount: $271.22 Component Description: Main antenna parts freight and shipping Amount: $412.86 Component Description: Transmission line shipping cost Amount: $5,865.47 Component Description: Transmission line shipping costs Amount: $6,128.43 Component Description: Antenna shipping cost Amount: $2,733.95 Component Description: Main antenna freight cost Amount: $3,341.25 Component Description: Antenna shipping cost Amount: $1,149.49 Component Description: Transmission line freight cost Amount: $3,541.25 Component Description: Manifold shipping, 50% shared cost with WJET Amount: $231.80 Component Description: Antenna shipping costs Amount: $2,317.19 Component Description: Freight costs on additional ice bridge materials, 50% shared cost with WJET Amount: $250.00 Component Description: Anchor shipping cost Amount: $229.76 Component Description: Wiring and distribution amp shipping Amount: $88.65 Component Description: Transmission line shipping cost Amount: $433.54 Component Description: Interim freight and shipping costs Amount: $2,822.07 Component Description: Transmission line shipping cost Amount: $2,393.06 Component Description: Freight on ice bridge materials, 50% shared cost with WJET Amount: $1,200.00 Component Description: Antenna shipping cost Amount: $146.77
Disposal Costs (for equipment and other waste, net of any salvage value)	Information not provided.
Non-zoning permits	Information not provided.
FCC Filing Fees - Special Temporary Authorization request	Information not provided.
MVPD Notification of Channel Change	Information not provided.
Sales and Use Tax Due	Component Description: Tax on transmitter building security, 50% shared cost with WJET Amount: $97.65
AM Pattern Disturbance -- Impact study	Information not provided.
AM Pattern Disturbance -- Remedy	Information not provided.
DTV Medical Facility Notification	Component Description: Notification of medical facilities Amount: $1,988.00
FCC Filing Fees - Form 2100 license to cover application	Information not provided.
Local Zoning	Information not provided.

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$2,724,864.00	$2,069,337.20	$1,607,260.94

Reimbursement Status

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

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.	Dennis P. Thatcher President 08/18/2021

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.

Dennis P. Thatcher

President

08/18/2021

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.	Dennis P. Thatcher President 08/18/2021

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.

Dennis P. Thatcher

President

08/18/2021

(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

Interim Antenna

Other Antenna Cost Not Listed

Transmission Line

Primary Transmission Line

Existing 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

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