Go to the Federal Communications Commission homepage at www.fcc.gov

FCC Form 399: Reimbursement Request

Approved by OMB 3060-1178
Go to the Federal Communications Commission homepage at www.fcc.gov

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

Facility ID:
70536
Service:
DTV
Call Sign:
WSEC
Channel:
18 (UHF)
File Number:
0000027251
FRN:
0005941323
Date Submitted:
04/20/2022

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY

Doing Business As: SOUTHERN ILLINOIS UNIVERSITY

Fred Martino

PO Box 62708

MAILCODE 6602

CARBONDALE, IL 62901

United States

+1 (618) 453-6181 fred.martino@wsiu.org Government Entity

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

Greg Best

Consulting Engineer

Greg Best Consulting, Inc.

16100 Outlook Avenue

Stilwell, KS 66085

United States

+1 (816) 792-2913 gbconsulting54@gmail.com

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan WSEC requires a new tower as two structural analyses confirmed it is required. A new antenna & xmtr will be purchased to replicate coverage. Final xmtr facility will be constructed with new tower & antenna. See attached Transition plan document.

Transmitters

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

Primary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model DCD20PL1
Year 2001
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 5 kW

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model UAXTE-12
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 6.7 kW
Justification for New Transmitter Existing Harris DiamondCD transmitter is not supported for new channel of operation. New xmtr will be needed. See transition plan document.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) Yes
Switchgear (industrial 800 amp) Yes
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring Yes
Size 3 inches
Length 50.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Heating and Cooling
Size 10 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 150.0 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

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Other Transmitter Cost Not Listed

Information not provided.

Interim Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Interim
Description of Use N/A
Change Type Lease New
Manufacturer
Model Custom
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 19 kW
Justification for New Transmitter Transmitter is temporary unit self contained in a trailer with all cooling and RF interconnect included.

Interim Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service Yes
Description Portable generator to provide power for temporary transmitter.
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
Inside RF System Is an additional interior RF system required to support this interim transmitter? No

Interim Transmitter

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Other Transmitter Cost Not Listed

Name Description

Trailer rental

trailer for temporary transmitter unit and associated equipment required for operation

Antennas

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

Primary Antenna

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Add 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 this antenna currently shared with any other stations? No
Is this antenna directional? No
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type Class Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Other
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 Slot Antenna - single channel tuned
ERP: 75.0 kW
Manufacturer
Model TFU-24GTH-R O4
Year 2002

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? No
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 80.8 kW
Manufacturer
Model ATW28H3-ETO12-18H
Year 2019
Justification for New Antenna Existing antenna will not function on the assigned frequency.

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna?
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? N/A
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Single Channel
Feed Line Size 4 1/16 inches inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna?
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Dehydrator

Replace existing dehydration system no longer supported.

Interim Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? No
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization 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: 120.0 kW
Manufacturer
Model ALP24L3-HSO-18
Year 2020
Justification for New Antenna Antenna will be used as an interim until tower and top mount antenna is completed and installed.

Interim Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? S
Feed Line Size 4 1/16 inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for an antenna? No
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Interim Antenna

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Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 4 1/16 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1000 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Rigid
Diameter 4 1/16 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1000 feet per run
Justification for New Transmission Line New transmission line must be in place at the time transmission begins on new tower or a loss of service will occur.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Construct New
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) No
Others Types of Users Yes
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1221865
Coordinates (NAD83) Latitude (NAD83) 39° 36' 09.2" N-
Longitude (NAD83) 090° 02' 47.4" W-
Overall Structure Height 976.04 feet
Support Structure Height 915.67 feet
Ground Elevation Above Mean Sea Level (AMSL) 672.89 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner West Central Illinois Educational Telecommunications Corporation
Date Constructed 09/23/2002


Other Types of Users

Users
W40CV-D

Primary Tower

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Tower Construction Costs

Section Question Response
Construct New Tower Use Primary (Main)
Description of Use N/A
Is this a request for upgraded equipment? No
Height 912.00 feet
Justification for New Tower Two structural analyses were conducted and both found that the existing structure and foundation do not meet current tower standard. See attachment WSEC Documentation for new tower.pdf (attached).

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Tower site restoration

Installation of rock and fencing to be lease compliant.

Interim Tower structural analysis

Structural analysis to determine interim tower height available to support antenna for interim plan.

Rental of heavy equipment mats.

Rental of mats for heavy equipment for tower and foundation installation.

STL-TSL Equipment

Please refer to file - WSEC-Microwave Justification.PDF This tower is the 2nd in a string of 7 towers sending programming, transmitter control & telemetry between master control and our three broadcast stations.

Weather Days for tower crew

Additional costs for tower crew based on unforecasted weather days where it was impossible to work.

Primary Tower

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Add Tower

Section Question Response
Existing Tower Description Type of change Construct New
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) No
Others Types of Users Yes
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1221865
Coordinates (NAD83) Latitude (NAD83) 39° 36' 09.2" N-
Longitude (NAD83) 090° 02' 47.4" W-
Overall Structure Height 976.04 feet
Support Structure Height 915.67 feet
Ground Elevation Above Mean Sea Level (AMSL) 672.89 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner West Central Illinois Educational Telecommunications Corporation
Date Constructed 09/23/2002


Other Types of Users

Users
W40CV-D

Primary Tower

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Tower Construction Costs

Section Question Response
Construct New Tower Use Primary (Main)
Description of Use N/A
Is this a request for upgraded equipment? No
Height 912.00 feet
Justification for New Tower EXISTING STRUCTURE DOES NOT MEET CURRENT TOWER STANDARDS

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Information not provided.

Interim Tower

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Tower Construction Costs

Section Question Response
Construct New Tower Use Interim
Description of Use N/A
Height 900.00 feet
Justification for New Tower Existing tower will be rigged for interim antenna and existing transmission line will be used.

Interim Tower

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Tower Rigging Costs

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

Interim Tower

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Other Tower Expenses Not Listed

Name Description

Tower Inspection

Post Construction Tower Inspection

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 320
Explanation 399 Forms assistance, onsite planning and supervision during transmitter, antenna & tower work; coordination of involved entities in the project.
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 No
Quantity N/A
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 No
Quantity N/A
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 Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements No
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning No
Non-zoning permits No
BLM or NFS Coordination No
FCC Construction Permit Minor Change No
FCC License to Cover Application Yes
FCC Special Temporary Authority Application No
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? Yes
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Name Description

Fiber equipment for WSEC

See justification & explanation of lower tower cost without microwave. Fiber equipment replaces STL-TSL equipment.

Cost Information

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Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $1,084,691.00 $420,591.00 N/A $299,545.10 N/A
Total for all systems $7,175,199.30 $5,570,938.90 N/A $3,266,334.80 N/A
Interim Transmitter Custom $708,991.00 $47,991.00 $22,995.24
Trailer rental $20,991.00 $20,991.00 See Quote 20-0165-A $20,991.00 N/A
Other Electrical Service: Portable generator to provide power for temporary transmitter. $4,000.00 $4,000.00 N/A $2,004.24 N/A
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW $684,000.00 $23,000.00 N/A $0.00 N/A
Primary Transmitter UAXTE-12 $375,700.00 $372,600.00 $276,549.86
10 Ton system $60,500.00 $58,900.00 N/A $24,109.00 N/A
UHF - Air Cooled Solid State Transmitter 6.7 kW $245,000.00 $245,000.00 N/A $239,795.86 N/A
Service entrance 3 phase/800 amp/208 volt $14,400.00 $14,050.00 N/A N/A N/A
3" Rigid Conduit and Wiring (Cost per foot) $2,600.00 $2,500.00 N/A N/A N/A
Other -- Building Addition Size: 150.0 $15,000.00 $15,000.00 Building size expansion to accomodate new transmitter and HVAC ductwork. $12,645.00 N/A
Switchgear - industrial 800 amp $38,200.00 $37,150.00 N/A N/A N/A

Components

Actual Information Description File Name
Trailer rental

Component Description:
trainer rental for generator to run the temporary transmitter
Amount:
$20,991.00
Other Electrical Service: Portable generator to provide power for temporary transmitter.

Component Description:
rental for temporary transmitter: generator 70-84 KVA Tier 4
Amount:
$2,420.58

Component Description:
rental for temporary transmitter: generator 70-84 KVA Tier 4 (credit memo included)
Amount:
$2,004.24
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW Information not provided.
10 Ton system

Component Description:
10 ton air conditioning system
Amount:
$24,109.00
UHF - Air Cooled Solid State Transmitter 6.7 kW

Component Description:
Change Order to JW30004551, PO 136813: Burke equipment
Amount:
$2,185.00

Component Description:
WSEC DTV Transmitter
Amount:
$237,610.86
Service entrance 3 phase/800 amp/208 volt Information not provided.
3" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Other -- Building Addition Size: 150.0

Component Description:
modification of building ground system
Amount:
$12,645.00
Switchgear - industrial 800 amp Information not provided.

Cost Information

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Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $665,000.00 $241,105.60 N/A $215,529.48 N/A
Total for all systems $7,175,199.30 $5,570,938.90 N/A $3,266,334.80 N/A
Interim Antenna ALP24L3-HSO-18 $105,700.00 $56,300.00 $39,466.15
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed) $9,570.00 $9,570.00 N/A $0.00 N/A
Sweep test of existing antenna $6,730.00 $6,730.00 N/A $0.00 N/A
UHF - Lower Power Side Mount, One station antenna - medium power (50-200 kW), horizontally polarized $89,400.00 $40,000.00 N/A $39,466.15 N/A
Primary Antenna ATW28H3-ETO12-18H $559,300.00 $184,805.60 $176,063.33
Dehydrator $6,500.00 $6,500.00 N/A $1,681.30 Invoice WSEC-1000 is meant to replace Invoice WSEC-001. No additional payment is requested for Invoice WSEC-1000.
Sweep test of existing antenna $6,730.00 $6,250.00 Sweep test of new line and antenna. See ERI Proposal 20190207-592 Rev A $6,250.00 Invoice WSEC-1000 is meant to replace Invoice WSEC-001. No additional payment is requested for Invoice WSEC-1000.
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $289,500.00 $72,785.60 N/A $72,785.60 N/A
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed) $9,570.00 $9,320.00 N/A $5,396.43 N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized $247,000.00 $89,950.00 ***System Notice: Estimate adjusted and locked because line has been superseded.***ERI Proposal 20190207-592 Rev A- Attached. Price above indicates deduction for Hpol version. $89,950.00 N/A

Components

Actual Information Description File Name
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed) Information not provided.
Sweep test of existing antenna Information not provided.
UHF - Lower Power Side Mount, One station antenna - medium power (50-200 kW), horizontally polarized

Component Description:
interim antenna plus freight
Amount:
$39,466.15

Component Description:
interim antenna plus freight
Amount:
$39,466.15
Dehydrator

Component Description:
air dryer (balance due)
Amount:
$1,681.30

Component Description:
air dryer (final due on permanent antenna)
Amount:
$1,412.96

Component Description:
Air Dryer (WSEC-1000 replaces inv WSEC-001 previously paid at 70%; see memo with details)
Amount:
N/A
Sweep test of existing antenna

Component Description:
system sweep (balance due)
Amount:
$1,875.00

Component Description:
Revised Inv WSEC-1000, dated 9/5/19, reflects the reduced cost. Any difference between Inv WSEC-001 and WSEC-1000 will be reconciled upon final invoice of the project completion. Memo attached to further explain.
Amount:
N/A

Component Description:
System Sweep (WSEC-1000 replaces inv WSEC-001 previously paid at 70%; see memo with details)
Amount:
N/A

Component Description:
system sweep (final due on permanent antenna)
Amount:
$1,875.00

Component Description:
Line and antenna sweep. Balance Due
Amount:
$1,875.00

Component Description:
Line and antenna sweep. Please refer to uploaded ERI Invoice WSEC-001.PDF for explanation.
Amount:
$4,375.00
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
antenna (balance due, includes freight prorated)
Amount:
$72,785.60
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed)

Component Description:
fine tuner/elbow
Amount:
$5,396.43

Component Description:
custom cuts for line installation
Amount:
$3,064.25
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized

Component Description:
ERI Antenna 70% down payment - Please refer to uploaded ERI Invoice WSEC-001.PDF for explanation.
Amount:
$89,950.00

Cost Information

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Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $142,000.00 $135,000.00 N/A $134,669.33 N/A
Total for all systems $7,175,199.30 $5,570,938.90 N/A $3,266,334.80 N/A
Primary Transmission Line $142,000.00 $135,000.00 $134,669.33
Rigid Transmission Line - copper, 4 1/16" $142,000.00 $135,000.00 See ERI proposal 20190207-592 Rev A. This quote includes transmission line and air dryer. Additional materials not included in original proposal. $134,669.33 Inv WSEC-1000 intended to replace Inv WSEC-001 that was previously paid 70%. No additional payment is requested for Inv WSEC-1000.

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 4 1/16"

Component Description:
transmission line (balance due)
Amount:
$27,415.01

Component Description:
materials for transmission line run
Amount:
$3,991.79

Component Description:
update transmission bridge length
Amount:
$14,119.00

Component Description:
Transmission line and air dryer, balance due
Amount:
$29,096.32

Component Description:
Transmission line and air dryer for ERI antenna system. NOTE this is a percentage of the invoiced amount and pennies may be rounded. Please refer to uploaded ERI Invoice WSEC-001.PDF for explanation.
Amount:
$68,183.53

Component Description:
Transmission Line System (WSEC-1000 replaces inv WSEC-001 previously paid at 70%; see memo with details)
Amount:
N/A

Component Description:
tuning section for transmission line
Amount:
$2,966.50

Component Description:
custom cuts for line installation
Amount:
$3,064.25

Component Description:
transmission line system
Amount:
$27,771.00

Component Description:
Revised Inv WSEC-1000, dated 9/5/19, reflects the reduced cost. Any difference between Inv WSEC-001 and WSEC-1000 will be reconciled upon final invoice of the project completion. Memo attached to further explain.
Amount:
N/A

Component Description:
materials for transmission line run
Amount:
$851.70

Component Description:
materials for line run
Amount:
$14,077.55

Cost Information

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Tower Equipment and Rigging Costs

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $5,065,769.00 $4,417,870.00 N/A $2,351,521.81 N/A
Total for all systems $7,175,199.30 $5,570,938.90 N/A $3,266,334.80 N/A
Primary Tower TOWER $0.00 $0.00 $0.00
Primary Tower TOWER $0.00 $0.00 $0.00
Interim Tower $237,000.00 $26,501.00 $6,471.00
Tower Inspection $6,500.00 $6,500.00 Tower Inspection, post construction $6,471.00 N/A
Tall Tower (greater than 500') $210,500.00 $1.00 The interim tower is the existing tower so no modifications are necessary except rigging. N/A N/A
New tower $20,000.00 $20,000.00 N/A $0.00 N/A
Primary Tower $4,129,269.00 $3,902,369.00 $1,860,009.41
New tower $1,842,469.00 $1,842,469.00 See attached quote 20190207-592 REV. D $0.00 Inv WSEC-1000 intended to replace Inv WSEC-001 that was previously reimbursed 70%. No additional funds requested for WSEC-1000.
New tower $1,852,000.00 $1,852,000.00 Estimate increased to include freight on final delivery. See ERI Proposal 20190207-592. Manufacture (discounted), construct and equip replacement 912' tower and decommission existing tower. $1,850,109.41 N/A
Interim Tower structural analysis $1,200.00 $1,200.00 N/A N/A N/A
STL-TSL Equipment $0.00 $0.00 Please refer to file - WSEC - Microwave Justification ... and per quote from Heartland Video Systems - see file - WSEC - HVS Commscope Antennas Gear.PDF. This amount is zero as fiber equipment costs were substituted for microwave equipment & install. N/A N/A
Tall Tower (greater than 500') $210,500.00 $200,000.00 Replacement antennae and waveguide for microwave on new tower plus rigging to remove old antennae and replaced tower structure once new structure is complete and online. $3,200.00 N/A
Structural engineering tower load study for well documented tower $12,600.00 $6,700.00 ***System Notice: Estimate adjusted and locked because line has been superseded.*** $6,700.00 N/A
Tall Tower (greater than 500') $210,500.00 $0.00 N/A N/A N/A
Primary Tower $699,500.00 $489,000.00 $485,041.40
Interim Tower structural analysis $0.00 $0.00 N/A N/A N/A
Tall Tower (greater than 500') $210,500.00 $0.00 N/A N/A N/A
New tower $0.00 $0.00 N/A N/A N/A
Rental of heavy equipment mats. $397,000.00 $397,000.00 second round of crane mats and temporary stone road required for installation of equipment and to protect property around the tower site. $395,565.00 N/A
Weather Days for tower crew $30,000.00 $30,000.00 N/A $29,830.00 N/A
STL-TSL Equipment $0.00 $0.00 N/A N/A N/A
Tower site restoration $62,000.00 $62,000.00 install fencing around guy anchors and the transmitter/tower compound; install ground cover inside the fenced areas. $59,646.40 N/A

Components

Actual Information Description File Name
Tower Inspection

Component Description:
tower inspection, post construction
Amount:
$6,471.00
Tall Tower (greater than 500') Information not provided.
New tower Information not provided.
New tower

Component Description:
New Tower installation and decommission of old tower (WSEC-1000 replaces inv WSEC-001 previously paid at 70%; see memo with details)
Amount:
N/A

Component Description:
construct/deconstruct and install of new tower (includes freight costs, see invoice WSEC-36584A)
Amount:
$560,381.10

Component Description:
Corrected tower invoice for 912' tower.
Amount:
N/A

Component Description:
tower grounding electrical work
Amount:
$12,645.00
New tower

Component Description:
tower (balance due, includes freight prorated)
Amount:
$537,617.94

Component Description:
construct/deconstruct and install of new tower (includes freight costs, see invoice WSEC-36584A)
Amount:
$538,717.53

Component Description:
Tower portion of invoice. Refer to uploaded file ERI Invoice WSEC-001 Memo.pdf for explanation.
Amount:
$1,333,778.78

Component Description:
returning funds advanced in excess of invoice
Amount:
($21,287.31)

Component Description:
Revised Inv WSEC-1000, dated 9/5/19, reflects the reduced cost. Any difference between Inv WSEC-001 and WSEC-1000 will be reconciled upon final invoice of the project completion. Memo attached to further explain.
Amount:
N/A
Interim Tower structural analysis Information not provided.
STL-TSL Equipment Information not provided.
Tall Tower (greater than 500')

Component Description:
Land survey for construction of new tall tower.
Amount:
$3,200.00
Structural engineering tower load study for well documented tower

Component Description:
Geotechnical and structural analysis of broadcast tower for the TIA-222-G standard
Amount:
$3,200.00

Component Description:
Structural analysis of WSEC Tower. Reg #1221865 For TIA/EIA 222-G standards. Valmont order #156273-2-1
Amount:
$3,500.00
Tall Tower (greater than 500') Information not provided.
Interim Tower structural analysis Information not provided.
Tall Tower (greater than 500') Information not provided.
New tower Information not provided.
Rental of heavy equipment mats.

Component Description:
Crane Mats: 20% - necessary to protect heavy equipment due to muddy ground at construction site
Amount:
$23,475.00

Component Description:
Crane Mats: 10% (final invoice) - necessary to protect heavy equipment due to muddy ground at construction site
Amount:
$11,737.50

Component Description:
crane mats and temporary stone road
Amount:
$278,190.00

Component Description:
Crane Mats: 70% - necessary to protect heavy equipment due to muddy ground at construction site
Amount:
$82,162.50
Weather Days for tower crew

Component Description:
weather days and rental equipment downtime: 04/23/20, 04/24/20, 04/29/20, 05/16/20, 06/09/20
Amount:
$22,030.00

Component Description:
weather days: 07/27/20 & 07/30/20
Amount:
$7,800.00
STL-TSL Equipment Information not provided.
Tower site restoration

Component Description:
restore property for lease compliance
Amount:
$13,066.00

Component Description:
ground cover inside transmitter/tower compound area and around guy anchor areas
Amount:
$17,690.40

Component Description:
transmitter/tower site fencing
Amount:
$28,890.00

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $83,960.00 $224,145.00 N/A $187,259.83 N/A
Total for all systems $7,175,199.30 $5,570,938.90 N/A $3,266,334.80 N/A
Outside Professional Services $83,960.00 $224,145.00 $187,259.83
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 $2,000.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $4,095.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $4,500.00 Please refer to uploaded file "WSEC Legal Counsel Budget.PDF" -- Additional legal counsel costs incurred due to unanticipated need for a new tower at this site. $2,416.50 Additional legal counsel required due to problems with 'saving' the 399 schedule without losing tower work dollar amounts. Received numerous errors on "saving & exiting'. Required repeated contact with FCC I.T. personnel (Raphael) to rectify.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $65,000.00 Additional amount added to budget for legal counsel expenses due to legal complexities associated with unanticipated construction of a new tower at this site. $55,689.66 Additional legal fees due to unanticipated need to replace tower.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $2,343.50 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A N/A 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 N/A N/A
Project management of the transition $50,560.00 $130,000.00 Unanticipated equipment delays and project changes required additional engineering services beyond the initial expectations. $126,810.17 Unanticipated equipment delays and project changes required additional engineering services beyond the initial expectations.

Components

Actual Information Description File Name
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase Information not provided.
ASR modification (prepare FCC Form 854) Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
Legal Counsel - WSEC repack issues August 2017
Amount:
$101.00

Component Description:
Legal Counsel - WSEC repack issues June 2017
Amount:
$1,130.50

Component Description:
Legal Counsel - WSEC repack issues September 2017
Amount:
$56.00

Component Description:
Legal Counsel - WSEC repack issues July 2017
Amount:
$1,129.00
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Legal Counsel - WSEC repack issues February 2020 (with memo)
Amount:
$115.20

Component Description:
Legal Counsel for repack oriented work performed during September 2018
Amount:
$9,897.31

Component Description:
PAYMENT DUE date is 30 days following the invoice date. LEGAL COUNSEL - WSEC repack issues - June - 2018
Amount:
$3,535.00

Component Description:
Legal Counsel - WSEC repack issues June 2020
Amount:
$5,241.60

Component Description:
Legal Counsel - WSEC Repack Issues May 2018
Amount:
$202.00

Component Description:
Legal Counsel - WSEC Repack April 2018
Amount:
$50.50

Component Description:
Legal Counsel for 12/2017
Amount:
$454.50

Component Description:
Legal Counsel - WSEC repack issues April 2019
Amount:
$1,620.00

Component Description:
Legal Counsel - WSEC repack issues March 2019
Amount:
$2,700.00

Component Description:
Legal Counsel - WSEC repack issues May 2020
Amount:
$1,324.80

Component Description:
Legal Counsel - WSEC repack issues March 2020
Amount:
$1,958.40

Component Description:
Legal Counsel - WSEC repack issues June 2019
Amount:
$2,106.00

Component Description:
Legal Counsel - WSEC repack issues October 2019
Amount:
$432.00

Component Description:
Legal Counsel - WSEC repack issues July 2019
Amount:
$2,484.00

Component Description:
Engineering Services 10/1-11/1/19: Project management - quarterly report & support for 399 form
Amount:
$1,012.50

Component Description:
WSEC's portion of this invoice for Legal Counsel for repack issues in 03/2017 split evenly between WSEC-TV (facility 70536) & WMEC-TV. (facility 70537)
Amount:
$101.00

Component Description:
Legal Counsel - WSEC repack issues July 2020
Amount:
$576.00

Component Description:
Legal Counsel - WSEC repack issues February 2018
Amount:
$168.00

Component Description:
Legal Counsel - WSEC repack issues May 2019
Amount:
$2,668.05

Component Description:
Legal Counsel - WSEC repack issues April 2020
Amount:
$1,612.80

Component Description:
Legal Counsel - WSEC repack issues January 2020
Amount:
$172.80

Component Description:
Legal Counsel - WSEC repack issues December 2018
Amount:
$375.00

Component Description:
Line budget exceeded due to issues involved in awarding new tower manufacture and construction contract
Amount:
$1,414.00

Component Description:
Legal Counsel - WSEC repack issues August 2019
Amount:
$2,646.00

Component Description:
Legal Counsel - WSEC repack issues March 2019
Amount:
$6,230.30

Component Description:
Legal Counsel - 01/2018
Amount:
$622.50

Component Description:
Legal Counsel - WSEC repack issues October 2020
Amount:
$57.60

Component Description:
Legal Counsel - WSEC repack issues July 2019
Amount:
$2,484.00

Component Description:
Legal Counsel - WSEC repack issues February 2019 (includes memo re: reimbursement)
Amount:
$1,215.00

Component Description:
Legal Counsel - WSEC repack issues December 2019
Amount:
$540.00

Component Description:
Legal Counsel - WSEC repack issues August 2020
Amount:
$115.20

Component Description:
Legal Counsel - WSEC repack issues October 2017
Amount:
$431.00

Component Description:
PAYMENT DUE date is 30 days following the invoice date. Legal Counsel - WSEC repack issues - August - 2018
Amount:
$5,757.00

Component Description:
Legal Counsel - WSEC repack issues November 2017
Amount:
$39.00

Component Description:
Legal Counsel - WSEC repack issues in October 2018, Amount due net 30
Amount:
$2,828.00

Component Description:
Legal Counsel - WSEC repack issues December 2020
Amount:
$345.60

Component Description:
Legal Counsel - WSEC repack issues November 2019
Amount:
$216.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
WSEC Portion of invoice for planning meeting to discuss assigned frequency for repack
Amount:
$742.50

Component Description:
Prepare WSEC engineering section of Form 2100 Construction Permit Application.
Amount:
$1,500.00

Component Description:
REVISED Legal Counsel for WSEC repack issues during the month of March 2017
Amount:
$101.00
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 Information not provided.
Project management of the transition

Component Description:
WSEC: Engineering Services 4/1-4/30/21 - project management
Amount:
$675.00

Component Description:
WSEC: Engineering Services 3/1-4/01/21 - project management
Amount:
$900.00

Component Description:
Engineering Services: WSEC Project Management, 09/01 - 09/30/20
Amount:
$5,062.50

Component Description:
Engineering Services: WSEC Project Management, 11/01 - 11/30/20
Amount:
$6,300.00

Component Description:
Program Management Services
Amount:
$18,000.00

Component Description:
Engineering Services: WSEC Project Management, 11/01/19 - 11/30/19
Amount:
$1,237.50

Component Description:
WSEC: Engineering Services: 2/1-3/31/19. investigate/analyze other options for interim/final transmission facilities; search of alternative tower locations/engineering options to meet repack transition date
Amount:
$4,900.00

Component Description:
WSEC: Engineering Services: 6/1-6/30/19 - modify 399 for phase delay; initial draft of transmitter bid spec.
Amount:
$1,050.00

Component Description:
WSEC: Engineering Services: 4/1-5/31/19 - progress report; upload new 399 info; report re: tower cost delta
Amount:
$875.00

Component Description:
Engineering Services: WSEC Project Management, 03/29 - 05/01/20
Amount:
$7,312.50

Component Description:
Engineering Services 11/1-12/31/18: Project management - review transmitter needs & support costs
Amount:
$350.00

Component Description:
Engineering Services: WSEC Project Management, 06/01 - 06/27/20
Amount:
$19,125.00

Component Description:
Engineering Services: WSEC Project Management, 08/01 - 08/31/20
Amount:
$10,800.00

Component Description:
WSEC: Engineering Services: 9/1-9/28/19 - plan transition & followup on 399 form support
Amount:
$450.00

Component Description:
Engineering Services: WSEC Project Management, 03/01 - 03/31/20
Amount:
$3,937.50

Component Description:
GBC Revised Invoice #1653 Engineering Services 2/1-2/28/20: Project management & travel expenses for site visit.
Amount:
$8,210.17

Component Description:
Engineering Services: WSEC Project Management, 02/01 - 02/28/21
Amount:
$1,800.00

Component Description:
WSEC: Engineering Services: 7/1-8/2/19 - review transmitter bid spec; revise transmission system & timetable
Amount:
$525.00

Component Description:
Engineering Services: WSEC Project Management, 01/01 - 01/31/21
Amount:
$1,462.50

Component Description:
WSEC: Engineering Services: 8/1-8/30/19 - review/investigate equipment needs & update/modify reports/applications accordingly
Amount:
$2,187.50

Component Description:
WSEC: Engineering Services: 1/1/-2/1/19. 2018 Q4 Quarterly report. Analyze different antenna/transmitter options; Investigate utility power/cooling requirements for facility mods
Amount:
$2,100.00

Component Description:
WSEC: 912' Franklin IL guyed tower WSEC TV Tower Analysis: tower modification drawings
Amount:
$1,200.00

Component Description:
Engineering Services: WSEC Project Management, 12/01 - 12/31/20
Amount:
$2,137.50

Component Description:
WSEC: Engineering Services 6/1-6/30/21 - project management
Amount:
$225.00

Component Description:
Engineering Services: WSEC Project Management, 10/01 - 10/31/20
Amount:
$562.50

Component Description:
Engineering Services: WSEC Project Management, 07/01 - 07/31/20
Amount:
$11,475.00

Component Description:
Engineering Services: WSEC Project Management, 02/01 - 02/28/20
Amount:
$8,210.17

Component Description:
Engineering Services 10/1-11/2/18: Project management - review transmitter needs
Amount:
$525.00

Component Description:
Engineering Services: WSEC Project Management, 05/02 - 05/31/20
Amount:
$12,825.00

Component Description:
Engineering Services: WSEC Project Management, 12/01/19 - 01/04/20
Amount:
$1,125.00

Component Description:
Engineering Services: WSEC Project Management, 01/01 - 01/31/20
Amount:
$675.00

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $133,779.30 $132,227.30 N/A $77,809.25 N/A
Total for all systems $7,175,199.30 $5,570,938.90 N/A $3,266,334.80 N/A
Other Expenses $133,779.30 $132,227.30 $77,809.25
Fiber equipment for WSEC $90,394.30 $90,394.30 This cost is substituted in place of the microwave STL-TSL equipment and installation services. See attached justification and quote from HVS for fiber equipment. $70,511.25 N/A
MVPD Notification of Channel Change $5,000.00 $5,000.00 N/A $2,758.00 N/A
Develop and air announcement of upcoming channel change $5,000.00 $5,000.00 N/A N/A N/A
Equipment Storage $2,500.00 $2,500.00 N/A N/A N/A
Equipment Delivery and Handling Charges $15,000.00 $15,000.00 Tx @ 5400 Antenna @ 7700 Misc @ 1900 N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $4,000.00 $4,000.00 Antenna, transmitter, packaging materials. N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $333.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $10,000.00 N/A $4,540.00 N/A

Components

Actual Information Description File Name
Fiber equipment for WSEC

Component Description:
fiber equipment for signal delivery
Amount:
$70,511.25
MVPD Notification of Channel Change

Component Description:
Notification of Cable & Satellite MVPD Providers of new RF Channel and Transport Stream Parameters (WSEC)
Amount:
$2,758.00
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
DTV Medical Facility Notification

Component Description:
Notification of Medical Facilities - Transmitter Medical Facility Notification (WSEC)
Amount:
$4,540.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $7,175,199.30 $5,570,938.90 $3,266,334.80

Reimbursement Status

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

Certification

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Section Question Response
Submission of Estimated Expenses Statements

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

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

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

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

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

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

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

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

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

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

Dan Mahony

President, Southern Illinois University


04/20/2022

Certification

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Section Question Response
Submission of Actual Cost Documentation Statements

WILLFUL FALSE, FRAUDULENT, OR FICTITIOUS STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISIONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE AND/OR FRAUDULENT STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT (U.S. CODE, TITLE 31, SECTIONS 3729-3733).

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

  2. The above-named entity certifies that the statements in this form and attached documentation are true, complete, and correct.

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

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

  5. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (full power and Class A stations) and/or otherwise modify a television station’s facility as a result of the spectrum repack (LPTV/TV Translator stations); or to minimize service disruption resulting from a repacked television station (FM stations); or to continue to carry the signal of a broadcaster that changes channels (MVPD) .

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

  7. The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred.

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

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

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

Dan Mahony

President, Southern Illinois University


04/20/2022

Certification

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Section Question Response
Submission of Final Allocation or Accounting Information Statements

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

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

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

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

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

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

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

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

Dan Mahony

President, Southern Illinois University


04/20/2022

Attachments

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