TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
CAGUAS EDUCATIONAL TV, INC. Doing Business As: CAGUAS EDUCATIONAL TV, INC.	JOSUE SALGADO PO Box 00982 SABANA ABAJO INDUSTRIAL PARK CAROLINA, PR 00982 United States	+1 (787) 750-4090	JOSUESAL@YAHOO.COM	Private Not-for-Profit Educational Institution

Applicant

Address

Phone

Applicant Type

CAGUAS EDUCATIONAL TV, INC.

Doing Business As: CAGUAS EDUCATIONAL TV, INC.

JOSUE SALGADO

PO Box 00982

SABANA ABAJO INDUSTRIAL PARK

CAROLINA, PR 00982

United States

+1 (787) 750-4090

JOSUESAL@YAHOO.COM

Private Not-for-Profit Educational Institution

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
Alejandro Luciano , PE . ALEJANDRO LUCIANO PE	Alejandro Luciano PE PO Box 194528 SAN JUAN, PR 00919 United States	+1 (787) 717-6984	aluciano@aluciano.com

Applicant

Address

Phone

Alejandro Luciano , PE .

ALEJANDRO LUCIANO PE

Alejandro Luciano PE

PO Box 194528

SAN JUAN, PR 00919

United States

+1 (787) 717-6984

aluciano@aluciano.com

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.	No
Briefly describe transition plan	File for CP as needed, Perform Towers Structural Study, modify tower, file for STA, relocate existing main antenna, install new transmitter, transmission line and antenna, broadcast channel change notifications, notify cable, final antenna sweep and tests

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	A3.0KST8U
	Year	2009
	Type	Solid State
	Solid State Cooling	Air Cooled
	Solid State Power Capacity	3.0 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	UAXTE-12R44
	Transmitter Type	Solid State
	Solid State Cooling	Air Cooled
	Solid State Power capacity	7.2 kW
	Justification for New Transmitter	According to the present transmitter manufacturer, It is not cost effective to re-tune the existing transmitter to the new channel. WUJA IS RESPONSIBLE FOR THE PRICE DIFFERENCE BETWEEN ALREADY VERIFIED 3.0KW TRANSMITTER AND THE PROPOSED 7.2 kW TX.

Primary Transmitter

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	Yes
	Size	2 inches
	Length	40.0 feet
	Other Electrical Service	No
	Description	N/A
HVAC Service	Does the replacement transmitter require HVAC Service?	Yes
	Type	Cooling Only
	Size	5 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	120.0 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
Internal RF Components	Internal RF components needed to complete the transmitter installation .
Additional Electrical Components	Main Breaker, Transmitter Room wall disconnect, and electric wiring

Interim Transmitter

New Transmitter Costs

Section	Question	Response
New Transmitter	Use	Interim
	Description of Use	N/A
	Change Type	Purchase
	Manufacturer
	Model	UAXTE-1R37
	Transmitter Type	Solid State
	Solid State Cooling	Air Cooled
	Solid State Power capacity	.6 kW
	Justification for New Transmitter	Due to room dimensions it is unlikely to install a new ch. 24 transmitter with the existing ch. 48 transmitter in the room. A new small interim transmitter is needed to remain on the air while the existing is removed to create space for the ch.24

Interim Transmitter

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	AC wiring service from main panel including circuit breaker.
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

Other Transmitter Cost Not Listed

Information not provided.

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	Class A
	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:	50.0 kW
	Manufacturer
	Model	ALP16L6-HSW-48
	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:	100.0 kW
	Manufacturer
	Model	TLP-24W/VP-R (SP)
	Year	2018
	Justification for New Antenna	According to the existing antenna manufacturer, retuning the existing antenna from channel 48 to channel 24 is not feasible.

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?	No
	Broadband or Single Channel?	N/A
	Feed Line Size	N/A
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

Information not provided.

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:	5.0 kW
	Manufacturer
	Model	750 10402
	Year	2018
	Justification for New Antenna	WUJA need an Interim Antenna and transmission line to transition to the new channel while construction of a replacement tower is completed.

Interim Antenna

Other Antenna Costs

Section	Question	Response
Elbow Complex	Do you require the separate purchase of the Elbow Complex?	No
	Broadband or Single Channel?	N/A
	Feed Line Size	N/A
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

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	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	Flexible Air
	Diameter	3 inches
	Other Diameter	N/A
	Segment Length	N/A
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	200 feet per run

Primary Transmission Line

New Transmission Line

Section	Question	Response
New Transmission Line Costs	Use	Primary (Main)
	Description of Use	N/A
	Change Type	Purchase New
	Is this a request for upgraded equipment?	No
	Type	Flexible Air
	Diameter	3 inches
	Other Diameter	N/A
	Segment Length	N/A
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	200 feet per run
	Justification for New Transmission Line	The existing transmission line and antenna will be relocated and used with an interim transmitter to remain on the air while the existing is removed, tower modifications, new ch. 24 antenna, transmission line and transmitter installations are finalized.

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Information not provided.

Interim Transmission Line

New Transmission Line

Section	Question	Response
New Transmission Line Costs	Use	Interim
	Description of Use	N/A
	Change Type	Purchase New
	Type	Flexible Foam
	Diameter	1 5/8 inches
	Segment Length	N/A
	Other Segment Length
	Number of parallel runs	1
	Length	150 feet per run
	Justification for New Transmission Line	WUJA need an interim transmission line to transition to the new channel using interim facilities while construction of a new tower is completed.

Interim Transmission Line

Other Transmission Line Expenses Not Listed

Information not provided.

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	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?	No
	One or more FM, AM or TV radio broadcaster(s)	N/A
	Others Types of Users	N/A
	Is tower documented for structural analysis?	No
	Is tower compliant with Rev G?	No
Existing Tower Structure Registration	Do you have a tower registration number?	No
Existing Tower Structure Registration	ASR Number
Coordinates (NAD83)	Latitude (NAD83)	18° 16' 40.83" N-
	Longitude (NAD83)	066° 06' 31.6" W-
	Overall Structure Height	120.00 feet
	Support Structure Height	120.00 feet
	Ground Elevation Above Mean Sea Level (AMSL)	501.10 feet
	Structure Type	UTOWER - Unguyed - Free Standing Tower
	Tower Owner	CAGUAS EDUCATIONAL TV INC.
	Date Constructed	07/24/1985

Primary Tower

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	140.00 feet
	Justification for New Tower	See Attached Justifications document for New Tower .

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
Dissmantling of Old Tower	Dismantling of old tower as required by the new tower local construction permit.
Tower Mapping New Tower	Tower Mapping for WUJA New documented tower.
Tower Mapping Old Tower	Tower mapping for WUJA old undocumented tower.
Change Order	Change order for tower construction due to materials and labor increases.
Tower Installation Supervision	Tower Installation resident supervisor is required by the local construction permits office,OGPE

Outside Professional Services Costs

Section	Question	Response
Outside Project Management Services	Do you require outside project management services?	Yes
	Number of Hours	1200
	Explanation	Due to extreme budget constrains TV Station WUJA does not have the necessary technical staff to perform the repack project management services.
Outside RF consulting Engineering Services	Perform engineering study for new channel assignment and antenna development	Yes
	Prepare engineering section of Form FCC Construction Permit Application	Yes
	For Auxiliary Facility	Yes
	For Main Facility	Yes
	Prepare engineering section of Form FCC License to Cover Application	Yes
	For Auxiliary Facility	Yes
	For Main Facility	Yes
	Prepare request for Special Temporary Authority	Yes
	Quantity	2
	Do you have Distributed Transmission System engineering services?	N/A
	Critical Facility	N/A
	Terrain-Shielded Facility	N/A
Attorney and Other Outside Consulting Services	Prepare and file Form FCC Construction Permit Application	Yes
	For Auxiliary Facility	Yes
	For Main Facility	Yes
	Prepare and file Form FCC License to Cover Application	Yes
	For Auxiliary Facility	Yes
	For Main Facility	Yes
	Prepare request for Special Temporary Authority	Yes
	Quantity	2
	NEPA Section 106 environmental review	No
	Environmental Assessment	No
	ASR Modification	No
	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	Yes
	RF exposure measurements	Yes
	Additional Field Engineering Service	No
	Number of Days	N/A
	Justification	N/A

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Name	Description
Quarterly Progress Reports.	Quarterly Progress Report Preparation.

Other Expenses

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

Other Expenses

Other Expenses Not Listed

Name	Description
Local Service Tax	Local Service Tax 4.0 percent
Employees Time	Station Employees Time Dedicated to Repack Functions
Local Sales Tax	Local Goods Tax 11.5 percent

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	$303,611.57	$288,658.55	N/A	$253,238.51	N/A
Total for all systems	$1,592,283.97	$1,365,200.30	N/A	$1,096,668.29	N/A
Interim Transmitter UAXTE-1R37	$34,857.02	$34,857.02		$34,857.02
UHF - Air Cooled Solid State Transmitter .6 kW	$34,857.02	$34,857.02	See Attached RGB Broadcast Services proposal HMDRQ3065	$34,857.02	N/A
Other Electrical Service: AC wiring service from main panel including circuit breaker.	$0.00	$0.00	Included in Main and Auxiliary transmitters electric installation.	N/A	N/A
Primary Transmitter UAXTE-12R44	$268,754.55	$253,801.53		$218,381.49
Internal RF Components	$3,000.00	$3,000.00	Estimated cost for additional RF components needed for the transmitter to antenna interface.	N/A	N/A
Additional Electrical Components	$6,990.00	$6,990.00	See uploaded quotation, from Word Interiors Quote Number WI103020WUJA, for transmitters electric installation.	$6,990.00	N/A
Other -- Building Addition Size: 120.0	$15,000.00	$15,000.00	See uploaded World Interiors Building addition proposal WI083020WUJA.	$15,000.00	N/A
5 Ton system	$20,250.00	$6,336.98	See Uploaded 5 tons AC unit quote. Quote # 0000948	$6,336.98	N/A
2" Rigid Conduit and Wiring (Cost per foot)	$1,040.00	$0.00	Included in Main transmitters electric installation.	N/A	N/A
UHF - Air Cooled Solid State Transmitter 7.2 kW	$220,460.12	$220,460.12	See Attached RGB Broadcast Services proposal HMDRQ3063. THIS IS AN UPGRADE. WUJA IS RESPONSIBLE FOR THE PRICE DIFFERENCE BETWEEN THE ALREADY VERIFIED FUNDS AND THE COST OF THIS TRANSMITTER.	$188,040.08	N/A
Other Electrical Service: VOLTAGE REGULATOR, LINE CONDITIONER/SURGE PROTECTION AND UPS ARE NEEDED FOR THE NEW TRANSMITTER INSTALLATION.	$2,014.43	$2,014.43	*System Notice: Estimate adjusted and locked because line has been superseded.*See Uploaded UPS Proposal. RGB Broadcast Services Corp. Quote Number HMDRQ3344	$2,014.43	N/A

Components

Actual Information Description	File Name
UHF - Air Cooled Solid State Transmitter .6 kW	Component Description: WUJA Interim transmitter, See WUJA Interim Transmitter Invoice Explanation Cover Letter, Invoice and Verified proposal document Amount: $34,857.02
Other Electrical Service: AC wiring service from main panel including circuit breaker.	Information not provided.
Internal RF Components	Information not provided.
Additional Electrical Components	Component Description: WUJA transmitters electric installation. Amount: $6,990.00
Other -- Building Addition Size: 120.0	Component Description: WUJA Building addition reimbursement request. Amount: $15,000.00
5 Ton system	Component Description: WUJA TX Room 5 tons ac unit. invoice Number 3251-PMFCC Amount: $6,336.98
2" Rigid Conduit and Wiring (Cost per foot)	Information not provided.
UHF - Air Cooled Solid State Transmitter 7.2 kW	Component Description: See Attached Document: WUJA Explanation Cover Letter Baseline Proposal and Transmitter Invoice. Amount: $188,040.08
Other Electrical Service: VOLTAGE REGULATOR, LINE CONDITIONER/SURGE PROTECTION AND UPS ARE NEEDED FOR THE NEW TRANSMITTER INSTALLATION.	Component Description: See Explanation Cover Letter Included with Transmitter Invoice Document. Amount: $2,014.43

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	$151,504.00	$67,771.00	N/A	$62,571.00	N/A
Total for all systems	$1,592,283.97	$1,365,200.30	N/A	$1,096,668.29	N/A
Interim Antenna 750 10402	$13,264.00	$9,034.00		$9,034.00
Sweep test of existing antenna	$6,730.00	$2,500.00	See quote from Alejandro Luciano P.E. for the auxilliary antenna sweep. Quote number WUJA-220815-AS.	$2,500.00	N/A
UHF - High Power, Side Mount, basic slot antenna, 5 kW input, directional,, horizontally polarized	$6,534.00	$6,534.00	*System Notice: Estimate adjusted and locked because line has been superseded.*See Attached Kathrein Quote Number 20180358-1	$6,534.00	N/A
Primary Antenna TLP-24W/VP-R (SP)	$138,240.00	$58,737.00		$53,537.00
Sweep test of existing antenna	$6,730.00	$6,400.00	N/A	$6,400.00	N/A
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)	$5,260.00	$5,200.00	N/A	N/A	N/A
Side mount brackets for high power antennas (if not included in antenna base cost)	$23,150.00	$10,615.00	See attached Dielectric Proposal 800097CMZ line 2	$10,615.00	N/A
UHF - Lower Power Side Mount, One Station antenna . medium power (50-200 kW), elliptically or circularly polarized	$103,100.00	$36,522.00	See Attached Dielectric Quote 800097CMZ Line 1 Minus the VPOL Price Contribution To The Net Price. $ 45,301.00 - $8779.00 VPOL Price Contribution = $36,522.00	$36,522.00	N/A

Components

Actual Information Description	File Name
Sweep test of existing antenna	Component Description: Alejandro Luciano P.E. reimbursement request for WUJA auxiliary facilities antenna system sweep. Invoice 1293 line 12. Amount: $2,500.00
UHF - High Power, Side Mount, basic slot antenna, 5 kW input, directional,, horizontally polarized	Component Description: WUJA Interim Antenna, Kathrein USA, Invoice Number 181710 Amount: $6,534.00
Sweep test of existing antenna	Component Description: WUJA Main Antenna Repack Sweep 50% Reimbursement request. Dielectric Invoice MAN00723 Line 30 Amount: $3,200.00 Component Description: Main Antenna Sweep 2nd 50% Reimbursement Request. WUJA Main. Amount: $3,200.00 Component Description: WUJA Main Antenna 2nd 50% reimbursement request, Invoice 1696407 line 21 REPACK SWEEP. Amount: $3,200.00
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost)	Information not provided.
Side mount brackets for high power antennas (if not included in antenna base cost)	Component Description: Main Antenna 2nd 50% Custom Brackets Reimbursement Request. WUJA Main Antenna. Amount: $5,307.50 Component Description: WUJA Main Antenna 2nd 50% Reimbursement Request. Invoice 1696407 Line 3 Custom Antenna Brackets. Amount: $5,307.50 Component Description: WUJA Main Antenna Mounting Brackets 50% Reimbursement Request. Dielectric Invoice MAN00723 Line 3 Amount: $5,307.50
UHF - Lower Power Side Mount, One Station antenna . medium power (50-200 kW), elliptically or circularly polarized	Component Description: WUJA Main Antenna 2nd 50% reimbursement request, Invoice 1696407 Line 1 Antenna UHF Side Mount Amount: $18,261.00 Component Description: Main Antenna 2nd 50% Reimbursement Request. Invoice Line 1 Amount: $18,261.00 Component Description: 50% Reimbursement Request on WUJA Main Antenna. Invoice MAN00723 Item 1 Amount: $18,261.00

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	$15,400.00	$15,888.07	N/A	$15,888.07	N/A
Total for all systems	$1,592,283.97	$1,365,200.30	N/A	$1,096,668.29	N/A
Interim Transmission Line	$3,600.00	$2,920.01		$2,920.01
Flexible Foam Transmission Line - dielectric, 1 5/8"	$3,600.00	$2,920.01	See Attached RGB Broadcast Corporation Proposal HMDRQ3095	$2,920.01	N/A
Primary Transmission Line	$11,800.00	$12,968.06		$12,968.06
Flexible Air Transmission Line - dielectric, 3"	$11,800.00	$12,968.06	See Attached Dielectric Invoice 800097CMZ Items 4-19.	$12,968.06	N/A

Components

Actual Information Description	File Name
Flexible Foam Transmission Line - dielectric, 1 5/8"	Component Description: Interim Transmission Line RGB Broadcast Services Corp. Invoice HMDRQ3095 Amount: $2,920.01
Flexible Air Transmission Line - dielectric, 3"	Component Description: Main Transmission Line 2nd 50% Reimbursement Request Amount: $6,484.03 Component Description: WUJA Main Flexible Transmission Line and Related Components 50% Reimbursement Request. Dielectric Invoice MAN00723 Lines 4 thru 7, 10, 11, 13-20, 27-29 and 31 Amount: $6,484.03 Component Description: WUJA Main Antenna 2nd 50% reimbursement request. Invoice 1696409 line 4, FLEXIBLE TRANSMISSION LINE. Amount: $6,484.03

Actual Information Description

File Name

Flexible Foam Transmission Line - dielectric, 1 5/8"

Component Description:: Interim Transmission Line RGB Broadcast Services Corp. Invoice HMDRQ3095
Amount:: $2,920.01

Flexible Air Transmission Line - dielectric, 3"

Component Description:: Main Transmission Line 2nd 50% Reimbursement Request
Amount:: $6,484.03

Component Description:: WUJA Main Flexible Transmission Line and Related Components 50% Reimbursement Request. Dielectric Invoice MAN00723 Lines 4 thru 7, 10, 11, 13-20, 27-29 and 31
Amount:: $6,484.03

Component Description:: WUJA Main Antenna 2nd 50% reimbursement request. Invoice 1696409 line 4, FLEXIBLE TRANSMISSION LINE.
Amount:: $6,484.03

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	$556,695.00	$499,448.00	N/A	$476,610.50	N/A
Total for all systems	$1,592,283.97	$1,365,200.30	N/A	$1,096,668.29	N/A
Primary Tower UTOWER	$0.00	$0.00		$0.00
Primary Tower	$556,695.00	$499,448.00		$476,610.50
Tower Installation Supervision	$95,000.00	$95,000.00	Estimated Tower installation resident supervisor cost.	$74,200.00	N/A
New tower	$249,945.00	$249,945.00	See Attached Sabre Tower Proposal 19-0572-TAB-R2. Items I, II and III.	$249,945.00	N/A
Short Tower (less than 500')	$84,200.00	$26,953.00	See Attached Sabre Tower Proposal 19-0572-TAB-R2. ITEM IV and V, Antenna and Line Installation and Bridge.	$26,953.00	N/A
Dissmantling of Old Tower	$47,500.00	$47,500.00	See quote from Dynamic Wireless for the removal on the old WUJA tower.	$47,500.00	N/A
Tower Mapping New Tower	$3,500.00	$3,500.00	Estimated tower mapping documents preparation for WUJA new Repack verified tower.	$1,462.50	N/A
Change Order	$73,750.00	$73,750.00	See uploaded quote from Sabre Industries for WUJA tower construction cost increase. Quote number 19-0572-TAB-R2 Additional Install Cost.	$73,750.00	N/A
Tower Mapping Old Tower	$2,800.00	$2,800.00	See Attached invoice 1192 for WUJA old tower mapping for structural study. Structural study resuilts indicated that tower replacement was needed and the repack administrator verified the funds for a new tower.	$2,800.00	N/A

Components

Actual Information Description	File Name
Tower Installation Supervision	Component Description: WUJA Tower Installation Resident Inspector Service. Invoice Number 2022-1021 Amount: $8,760.00 Component Description: Eng. Alfredo Luciano WUJA Tower Installation Resident Inspector Service Invoice 2022-1111 reimbursement request. Amount: $10,800.00 Component Description: Eng. Alfredo Luciano WUJA Tower Installation Resident Inspector Service Invoice 2022-1028 reimbursement request. Amount: $4,760.00 Component Description: Eng. Alfredo Luciano WUJA Tower Installation Resident Inspector Service Invoice 2022-1014 reimbursement request. Amount: $7,560.00 Component Description: Eng. Alfredo Luciano invoice 2022-0906 for the resident supervision of the installation of the WUJA tower. Amount: $5,840.00 Component Description: WUJA Tower Installation resident inspector invoice 2022-0930 reimbursement request. Amount: $7,160.00 Component Description: WUJA Tower installation resident inspector invoice 2022-0916. Amount: $7,880.00 Component Description: Eng. Alfredo Luciano WUJA Tower Installation Resident Inspector Service Invoice 2022-1007 Amount: $6,360.00 Component Description: Eng. Alfredo Luciano Invoice 2022-0831b for the installation of the WUJA tower. Amount: $10,960.00 Component Description: WUJA tower Installation resident inspector invoice 2022-0909. Amount: $4,120.00
New tower	Component Description: WUJA-TV Tower Request for Reimbursement. Sabre Industries Invoice 422588B Items 1, III, IV. Proposal Items I, II, III. Amount: $249,945.00
Short Tower (less than 500')	Component Description: WUJA-TV Tower Request for Reimbursement. Sabre Industries Invoice 422588B Items II and V. Proposal Items IV and V.. Amount: $26,953.00
Dissmantling of Old Tower	Component Description: Invoice from Dynamic Wireless Solutions for the removal of the old WUJA tower. Invoice Number 20220833101 Amount: $47,500.00
Tower Mapping New Tower	Component Description: WUJA new tower mapping preparation by Alejandro Luciano. Invoice 1281 line 1 Amount: $1,462.50
Change Order	Component Description: WUJA Tower Installation cost change order reimbursement request. Amount: $73,750.00 Component Description: Increased construction costs for WUJA tower. Amount: $73,750.00
Tower Mapping Old Tower	Component Description: Tower Mapping of Old WUJA tower for Structural Study. Amount: $2,800.00

Cost Information

Outside Professional Services

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

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$345,890.00	$282,754.28	N/A	$176,306.28	N/A
Total for all systems	$1,592,283.97	$1,365,200.30	N/A	$1,096,668.29	N/A
Outside Professional Services	$345,890.00	$282,754.28		$176,306.28
Quarterly Progress Reports.	$4,600.00	$4,600.00	Estimated amount for the preparation of the quarterly repack progress reports	$4,525.00	N/A
RF Exposure Measurements	$21,050.00	$20,000.00	N/A	N/A	N/A
Comprehensive coverage verification via field study, if needed	$84,200.00	$60,929.28	Please see uploaded Comprehensive Coverage verification quote from QCommunications, LLC. Quote# 863C. WUJA Facility ID: 8156	$45,481.28	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	$2,000.00	N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization	$7,360.00	$7,000.00	N/A	N/A	N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	$2,365.00	$2,250.00	N/A	N/A	N/A
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application	$4,210.00	$4,000.00	N/A	N/A	N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	$5,260.00	$5,000.00	N/A	N/A	N/A
Prepare request for Special Temporary Authorization	$4,100.00	$3,000.00	N/A	$1,500.00	N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application	$1,580.00	$1,500.00	N/A	$1,250.00	N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	$1,580.00	$1,500.00	N/A	N/A	N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application	$2,105.00	$2,100.00	N/A	$2,081.25	N/A
Perform engineering study for new channel assignment and antenna development	$7,360.00	$7,000.00	N/A	$1,662.50	N/A
Address transition timing and coordination issues w/ other stations and wireless	$2,630.00	$2,500.00	N/A	N/A	N/A
Prepare and or review reimbursement form	$2,630.00	$2,500.00	N/A	$2,493.75	N/A
Project management of the transition	$189,600.00	$150,000.00	N/A	$108,487.50	N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	$3,155.00	$6,825.00	Two different application were prepared to optimize the WUJA facilities	$6,825.00	Two application were needed to optimize WUJA facilities.

Components

Actual Information Description	File Name
Quarterly Progress Reports.	Component Description: Quarterly Progress report by Alejandro Luciano P.E. reimbursement request. Invoice 1284 lines 1,2,3,4,5. Amount: $1,125.00 Component Description: Transition Progress Report for TV Station WUJA-TV Amount: $2,000.00 Component Description: Continued Transition Progress Report for WUJA. Amount: $1,400.00
RF Exposure Measurements	Information not provided.
Comprehensive coverage verification via field study, if needed	Component Description: WUJA reimbursement request on QCommunications coverage and antenna pattern verification. Amount: $45,481.28
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase	Component Description: WUJA FAA Form 7460 Research, Preparation and Filling. Amount: $2,000.00
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 - Aux Antenna, prepare and File Form 2100 Construction Permit or License 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 Special Temporary Authorization Application for WUJA-TV Amount: $1,500.00
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application	Component Description: Alejandro Luciano PE Invoice 1284 line 7, Prepare Frorm 2100 License to cover for WUJA aux facility. Amount: $1,250.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	Information not provided.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application	Component Description: Preparation of WUJA Aux antenna application. Invoice 1285 line 6 Amount: $2,081.25
Perform engineering study for new channel assignment and antenna development	Component Description: Invoice 1193 WUJA Antenna Development for new channel. Amount: $1,662.50
Address transition timing and coordination issues w/ other stations and wireless	Information not provided.
Prepare and or review reimbursement form	Component Description: WUJA Form 399 preparation. Amount: $2,493.75
Project management of the transition	Component Description: Repack Management services Invoice Amount: $12,400.00 Component Description: Alejandro Luciano P.E. repack management invoice for WUJA. Invoice number 1288 Amount: $21,062.50 Component Description: Alejandro Luciano P.E. Invoice for WUJA Repack Management Services. Invoice number 1296 Amount: $7,375.00 Component Description: Alejandro Luciano P.E. WUJA Repack Management invoice. Invoice number 1282. Amount: $11,368.75 Component Description: Invoice 1181 for Project Management of the transition of WUJA. Amount: $4,950.00 Component Description: Repack management services by Alejandro Luciano P.E. Invoice 1281 lines 2,3 Amount: $1,237.50 Component Description: Alejandro Luciano P.E. invoice for WUJA Repack management services. Invoice number 1286 Amount: $6,581.25 Component Description: Alejandro Luciano P.E. WUJA repack management reimbursement request. Invoice 1293 Lines 1-11 Amount: $20,000.00 Component Description: Alejandro Luciano P.E. WUJA Repack Management invoice reimbursement request. Invoice number 1280. Rev1 Amount: $16,312.50 Component Description: Alejandro Luciano Invoice for WUJA Repack management services. Invoice number 1287. Amount: $7,200.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	Component Description: Alejandro Luciano P.E. reimbursement request for a minor change for WUJA. Invoice 1293 line 13. Amount: $3,937.50 Component Description: Invoice 1194. TV Station WUJA FCC Engineering Form 2100 preparation for main construction permit. Amount: $2,887.50

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	$219,183.40	$210,680.40	N/A	$112,053.93	N/A
Total for all systems	$1,592,283.97	$1,365,200.30	N/A	$1,096,668.29	N/A
Other Expenses	$219,183.40	$210,680.40		$112,053.93
Local Sales Tax	$59,790.80	$59,790.80	Estimated State and City Sales on goods, Tax = 11.5%. All equipment purchases for the channel repack are locally taxable at a rate of 11.5% of the actual cost. See Attached Worksheet.	$36,803.42	N/A
MVPD Notification of Channel Change	$316.20	$316.20	See attached WUJA MVPD proposal document.	$316.20	N/A
Develop and air announcement of upcoming channel change	$0.00	$0.00	Based on previous experience during the analog to digital transition.	N/A	N/A
Equipment Storage	$10,250.00	$10,250.00	Based on previous experience during the analog to digital transition.	$6,300.00	N/A
Equipment Delivery and Handling Charges	$55,000.00	$55,000.00	Up to today the Equipment Delivery and Handling Charges totalize $41,328.56, at the end of the repack it is expected to totalize close to $55,000.00. Therefore an allocation of $55,000.00 is requested	$45,528.56	N/A
Disposal Costs (for equipment and other waste, net of any salvage value)	$4,500.00	$4,500.00	Based on previous experience during the analog to digital transition.	N/A	N/A
Local Zoning	$19,000.00	$19,000.00	Estimated engineeering fees for WUJA tower application for construction permit.	$18,680.00	N/A
FCC Filing Fees - Special Temporary Authorization request	$195.00	$190.00	N/A	N/A	N/A
FCC Filing Fees - Form 2100 license to cover application	$335.00	$325.00	N/A	N/A	N/A
DTV Medical Facility Notification	$11,550.00	$3,062.00	See Attached WUJA Medical Proposal document.	$3,062.00	N/A
Employees Time	$36,005.20	$36,005.20	Estimated amount for station personnel repack dedicated time. See Attached Worksheet	N/A	N/A
Local Service Tax	$22,241.20	$22,241.20	Estimated State Service Tax 4% of services provided by locals.	$1,363.75	N/A

Components

Actual Information Description	File Name
Local Sales Tax	Component Description: 11.5% Merchandises Local Sales Tax. Amount: $4,526.06 Component Description: Reimbursement request on WUJA Tower import taxes. Amount: $9,412.41 Component Description: Sales Tax on Baseline transmitter. See Explanation Cover Letter Amount: $22,454.27 Component Description: Sales Tax on Interim Transmission LIne Invoice RGB Broadcast Services Corp. Invoice HMDRQ3095 Amount: $410.68
MVPD Notification of Channel Change	Component Description: WUJA MVPD Notification DTVNotification invoice INV-001809 Amount: $316.20
Develop and air announcement of upcoming channel change	Information not provided.
Equipment Storage	Component Description: WUJA tower and antena storage reimbursement request. Item: Warehouse Handling and Storage Services. Amount: $6,300.00
Equipment Delivery and Handling Charges	Component Description: Shipping Charges on Baseline Transmitter. See Explanation in Cover Letter. Amount: $5,200.00 Component Description: Transportation Charges on Invoice HMDRQ3065 Amount: $4,500.00 Component Description: WUJA-TV Tower Request for Reimbursement. Sabre Industries Invoice 422588B Freight. Proposal Items VI-A and VI-B. Amount: $12,312.41 Component Description: Transportation charges on WUJA Interim Transmission LIne. RGB Broadcast Services Corp. Invoice HMDRQ3095 Amount: $651.15 Component Description: WUJA tower, and antena delivery to site reimbursement request. Item: Warehouse Handling Out & Delivery to Channel 58 in Aguas Buenas. Amount: $4,200.00 Component Description: Reimbursement request for additional freight charges on WUJA Tower shippment. Amount: $18,665.00
Disposal Costs (for equipment and other waste, net of any salvage value)	Information not provided.
Local Zoning	Component Description: Final Works for the WUJA Tower construction local permit application preparation and filing. Amount: $5,400.00 Component Description: Reimbursement request for the preparation of WUJA tower construction local goverment permit application. Amount: $13,280.00
FCC Filing Fees - Special Temporary Authorization request	Information not provided.
FCC Filing Fees - Form 2100 license to cover application	Information not provided.
DTV Medical Facility Notification	Component Description: WUJA Medical Notifications. DTVNotification Invoice Number INV-001812 Amount: $3,062.00
Employees Time	Information not provided.
Local Service Tax	Component Description: 4% Services Local Sales Tax Amount: $115.50 Component Description: 4% Sales tax on Invoice 1193 Amount: $66.50 Component Description: 4% Sales tax on Invoice 1204 Amount: $140.00 Component Description: 4% Service Sales tax on Invoice 1192 Amount: $112.00 Component Description: Repack Management services 4% local services tax. Amount: $496.00 Component Description: 4% Local Sales tax on invoice 1181 Amount: $198.00 Component Description: 4% Local Service Tax on Invoice 1230 Amount: $136.00 Component Description: 4% Local Sales Tax on invoice 1191 Amount: $99.75

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$1,592,283.97	$1,365,200.30	$1,096,668.29

Reimbursement Status

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

Certification

Section	Question	Response
Submission of Estimated Expenses Statements	WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.
The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD). The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund. The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.	Alejandro Luciano , P.E. . Repack Project Manager 01/09/2023

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.

Alejandro Luciano , P.E. .

Repack Project Manager

01/09/2023

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.	Alejandro Luciano , P.E. . Repack Project Manager 01/09/2023

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.

Alejandro Luciano , P.E. .

Repack Project Manager

01/09/2023

(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

Interim Transmitter

New Transmitter Costs

Interim Transmitter

Other Transmitter Costs

Interim 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

New Transmission Line

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Interim Transmission Line

New Transmission Line

Interim Transmission Line

Other Transmission Line Expenses Not Listed

Tower Equipment And Rigging Costs

Primary Tower

Existing Tower

Primary Tower

Tower Construction Costs

Primary Tower

Tower Rigging Costs

Primary Tower

Other Tower Expenses Not Listed

Outside Professional Services Costs

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Other Expenses

Other Expenses

Other Expenses Not Listed

Cost Information

Transmitters

Components

Cost Information

Antennas

Components

Cost Information

Transmission Line

Components

Cost Information

Tower Equipment and Rigging Costs

Components

Cost Information

Outside Professional Services

Components

Cost Information