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:
53847
Service:
DTV
Call Sign:
KXLN-DT
Channel:
30 (UHF)
File Number:
0000028520
FRN:
0008192015
Date Submitted:
07/12/2017

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

KXLN LICENSE PARTNERSHIP, L.P.

Doing Business As: KXLN LICENSE PARTNERSHIP, L.P.

Christopher G. Wood

5999 CENTER DRIVE

LOS ANGELES, CA 90045

United States

+1 (310) 348-3600 cwood@univision.net Limited Partnership

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

Karl D Lahm , P.E. .

Director RF Systems Engineering

Univision Management Company

Karl D. Lahm

358 Pines Blvd.

Lake Villa, IL 60046

United States

+1 (847) 245-8699 klahm@univision.net

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 Replacement of existing antenna, mask filter, and transmitter at main facility and replacement of channel combiner module, mask filter, and transmitter at auxiliary facility. Latter to be while main antenna is replaced. See attached Implementation Plan.

Transmitters

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

Auxiliary Transmitter

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Add Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Auxiliary (Backup)
Description of Use During maintenance/failure of main unit or when reduced power required for RFE protection on tower
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 DHD-45P2
Year 2002
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 10 kW

Auxiliary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Auxiliary (Backup)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model THU9-8evo
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 13 kW
Justification for New Transmitter Amplifiers of existing are incapable of operation below channel 40, have been discontinued by the manufacturer, and replacements are not otherwise available.

Auxiliary 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 No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Auxiliary Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

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 CD3200P2
Year 2001
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 42 kW

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Manufacturer
Model THU9-24evo
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 33.7 kW
Justification for New Transmitter See attached IOT Replacement Analysis document; existing transmitter incapable of operation below channel 40

Primary 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 480:400V step-down transformer, primary AC wiring to transmitter cabinets, and power/control wiring to ancillary components
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

Antennas

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

Auxiliary Antenna

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Add Antenna Information

Section Question Response
Existing Antenna Description Type of change Retune Existing
Antenna Use Auxiliary (Backup)
Description of Use During maintenance/failure of main unit or when reduced power required for RFE protection on tower
Ownership Leased
Owner American Tower
Site N/A
Is this antenna currently shared with any other stations? Yes
Is this antenna directional? No
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? Yes
Existing Antenna Manufacturer and Type Class Full Power
Mounting Top Mount
Antenna position in stack Bottom
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 6
Number of Panels 80
Design power capacity in use 42.0 %
Lower Limit 470.00 MHz
Upper Limit 860.00 MHz
Other Antenna Type N/A
ERP: 340.0 kW
Manufacturer RFS
Model PHO80U22211E
Year 2002

Facility ID's and Call Signs of all stations with whom the antenna is shared.

Facility ID Call Sign
12895 KETH-TV
17746 KBPX-LD
24436 KLTJ
58835 KPXB-TV
60537 KFTH-DT

Auxiliary Antenna

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Adjustment to Existing Antenna

Section Question Response
Sweep Test of Existing Antenna Do you need a sweep test of existing antenna? No

Auxiliary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? Yes
Type Additional Module
Number of channels supported 1
Frequencies of channels supported RF channel
Frequency N/A

Enter a list of RF channel numbers.

RF Channel Number
30

Auxiliary Antenna

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Other Antenna Cost Not Listed

Information not provided.

Primary Antenna

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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? Yes
Existing Antenna Manufacturer and Type 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 N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 1000.0 kW
Manufacturer
Model ATW27H4-ETCL-45H
Year 2000

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? No
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? Yes
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: 745.0 kW
Manufacturer
Model TFU-24JTT/VP-R S190
Year 2018
Justification for New Antenna Existing antenna has single-channel bandwidth and is not usable on new channel.

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? No
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? N/A
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Single Channel
Feed Line Size 6 1/8 inches inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? 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

Primary 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 Utilize Existing
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer Andrew
Type Rigid
Diameter 8 3/16 inches
Other Diameter N/A
Segment Length 19 3/4 inches
Other Segment Length N/A
Number of parallel runs 1
Length 2094 feet per run

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Line Sweep Test

Determine if existing line is suitable for new channel

Auxiliary Transmission Line

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Add Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Utilize Existing
Use Auxiliary (Backup)
Description of Use During maintenance/failure of main unit or when reduced power required for RFE protection on tower
Ownership Owned
Owner N/A
Site N/A
Is this transmission currently shared with any other stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer Andrew
Type Rigid
Diameter 3 1/8 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 150 feet per run

Auxiliary 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 Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? Candelabra
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users 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 1059622
Coordinates (NAD83) Latitude (NAD83) 29° 33' 45.2" N-
Longitude (NAD83) 095° 30' 35.9" W-
Overall Structure Height 1974.06 feet
Support Structure Height 1844.14 feet
Ground Elevation Above Mean Sea Level (AMSL) 74.15 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner American Towers, LLC.
Date Constructed 08/30/2000

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

Facility ID Call Sign Service
11969 KBXX FM
51569 KTXH DTV
31870 KYAZ DTV
9625 KQBT FM
69531 KZJL DTV
11971 KMJQ FM
22204 KRIV DTV
13200 KUVM-CD DTV
28324 KTBU DTV

Other Types of Users

Users
KUVM-LD
KHLM-LD
KCHV-LD
K236AR
K227BD
K273CW

Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Study needed for tower with candelabra
Tower Reinforcements Please select whether tower reinforcements are needed: Minor Reinforcements needed

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Access Road Repair

The cost associated damage to the access road, driveway caused by trenching (electrical and foundation installations) and equipment mobilization

Tower Permit Drawing Package

Basic drawing package for municipality permitting.

Grading

Cost of preparation and staging of hoists and equipment on the soft soil area around tower site. Due to the heavy weights of the equipment needed to perform the antenna gin pole removals/Installation, the equipment may sink in soft soil conditions.

Fencing

The removal and installation of existing fencing in compound area where the construction and additional equipment is being installed, some of the fencing will require replacement and reconfiguration once all repack construction is completed.

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 520
Explanation Univision stations are only staffed for daily station operations and minor equipment changes, major projects are contracted out externally. The large volume of work associated with repack schedule requires using external project management resources.
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 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 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 No
Quantity N/A
NEPA Section 106 environmental review Yes
Environmental Assessment No
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements Yes
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

American Tower PM Fee

Project management fee for the transition of broadcasters. Scheduling and management of the timelines and schedules occurring during the repack.

Migratory Bird Assesment

Assessment and permitting of impact to bird migration

Tower Construction PM Fee

Tower Modification Project Mgmt

Auxiliary Site RF PM

RF Project Management for reconfiguration of broadband antenna combiner modules

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 Yes
BLM or NFS Coordination No
FCC Construction Permit Minor Change Yes
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? No
Does this relocation require Equipment Storage? No
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? No
Does this relocation require MVPD Notification of a Channel Change? No

Other Expenses

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Other Expenses Not Listed

Name Description

Tower Lessor Administration Fee

Tower lessor's fee for administration of station's changes and lease modification

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 $1,505,000.00 $1,457,500.00 N/A $0.00 N/A
Total for all systems $2,766,944.00 $2,566,554.00 N/A $0.00 N/A
Primary Transmitter THU9-24evo $1,010,500.00 $1,010,500.00 $0.00
Other Electrical Service: 480:400V step-down transformer, primary AC wiring to transmitter cabinets, and power/control wiring to ancillary components $34,000.00 $34,000.00 Please see the attached cost estimate for Electrical Distribution Cost. N/A N/A
UHF - Liquid Cooled Solid State Transmitter 33.7 kW $976,500.00 $976,500.00 N/A N/A N/A
Auxiliary Transmitter THU9-8evo $494,500.00 $447,000.00 $0.00
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW $494,500.00 $447,000.00 N/A N/A N/A

Components

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 $399,460.00 $409,377.00 N/A $0.00 N/A
Total for all systems $2,766,944.00 $2,566,554.00 N/A $0.00 N/A
Primary Antenna TFU-24JTT/VP-R S190 $308,530.00 $291,200.00 $0.00
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $289,500.00 $273,800.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $11,000.00 N/A N/A N/A
Auxiliary Antenna PHO80U22211E $90,930.00 $118,177.00 $0.00
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
UHF - High Power Top Mount Six Station broadband panel antenna horizontally polarized $0.00 $0.00 No modification required. N/A N/A
Adding a module to existing combiner (without antenna) $84,200.00 $111,777.00 Per line(s)# 95 and 110 of American Tower Missouri City auxiliary site implementation proposal. N/A N/A

Components

Information not provided.

Cost Information

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Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $4,150.00 $4,150.00 N/A $0.00 N/A
Total for all systems $2,766,944.00 $2,566,554.00 N/A $0.00 N/A
Primary Transmission Line $4,150.00 $4,150.00 $0.00
Line Sweep Test $4,150.00 $4,150.00 Test line to determine if replacement required. Quote attached. N/A N/A
Auxiliary Transmission Line $0.00 $0.00 $0.00

Components

Information not provided.

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 $613,775.00 $485,863.00 N/A $0.00 N/A
Total for all systems $2,766,944.00 $2,566,554.00 N/A $0.00 N/A
Primary Tower GTOWER $613,775.00 $485,863.00 $0.00
Fencing $1,875.00 $1,875.00 See attached cost estimate for KXLN primary tower, American tower site# 30285 line(s) # 216. N/A N/A
Minor tower reinforcement/modifications $158,000.00 $60,000.00 N/A N/A N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $400,000.00 N/A N/A N/A
Tower Permit Drawing Package $9,400.00 $9,400.00 Engineering drawings for KXLN primary tower per line(s)# 167, 168 of attached American Tower cost estimate for ATC site# 30285. N/A N/A
Structural engineering tower load study for a documented tower with candelabra $20,000.00 $11,088.00 N/A N/A N/A
Access Road Repair $2,500.00 $2,500.00 See attached American Tower cost estimate for KXLN primary tower ATC site# 30285 line(s)# 221. N/A N/A
Grading $1,000.00 $1,000.00 See attached American Tower cost estimate for KXLN primary site, ATC site# 30285, line(s) # 217. N/A N/A

Components

Information not provided.

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $176,604.00 $143,309.00 N/A $0.00 N/A
Total for all systems $2,766,944.00 $2,566,554.00 N/A $0.00 N/A
Outside Professional Services $176,604.00 $143,309.00 $0.00
Project management of the transition $82,160.00 $78,000.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A
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
Perform engineering study for new channel assignment and antenna development $7,360.00 $5,000.00 American Tower configuration planning fee, see attached ATC cost estimates for KXLN auxiliary site, ATC site #30285, line(s) #177. N/A N/A
NEPA Section 106 environmental review, if needed $6,310.00 $1,350.00 N/A N/A N/A
RF Exposure Measurements $21,050.00 $3,750.00 RF Exposure measurements for KXLN primary tower per line(s)# 190 of attached American Tower cost estimate for ATC site# 30285 N/A N/A
American Tower PM Fee $9,480.00 $9,480.00 See attached American Tower cost estimate for KXLN primary site, ATC site# 30285, line(s) #174. N/A N/A
Migratory Bird Assesment $438.00 $438.00 Migratory bird impact assessment for KXLN primary tower per line(s)# 193 of attached American Tower cost estimate for ATC site# 30285 N/A N/A
Tower Construction PM Fee $7,500.00 $7,500.00 See attached American Tower cost estimate for KXLN primary tower site, ATC site# 30285 line(s)# 170. N/A N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $3,750.00 ATC coordination meeting fees for KXLN primary tower per line(s)# 175, 192 of attached American Tower cost estimate for ATC site# 30285. N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A N/A N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application $2,105.00 $2,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
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 N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $2,500.00 N/A N/A N/A
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application $4,210.00 $2,000.00 N/A N/A N/A
Auxiliary Site RF PM $16,791.00 $16,791.00 Pro-rata pass-thru share, per attached ATC Missouri City 282638 cost estimate spreadsheet, line 224. N/A N/A

Components

Information not provided.

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $67,955.00 $66,355.00 N/A $0.00 N/A
Total for all systems $2,766,944.00 $2,566,554.00 N/A $0.00 N/A
Other Expenses $67,955.00 $66,355.00 $0.00
DTV Medical Facility Notification $11,550.00 $10,000.00 N/A N/A N/A
Non-zoning permits $2,500.00 $2,500.00 Building permit costs per attached cost estimate for KXLN auxiliary site #282638 line(s) # 202 and KXLN primary site #30285 line(s) 202, 203. N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 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
Disposal Costs (for equipment and other waste, net of any salvage value) $33,500.00 $33,500.00 AERC quote for removing an identical transmitter, under similar conditions, at KSTR-DT is attached. N/A N/A
Tower Lessor Administration Fee $18,960.00 $18,960.00 Two sites, $9,480 per site per attached ATC price list. N/A N/A

Components

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $2,766,944.00 $2,566,554.00 $0.00

Reimbursement Status

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

Certification

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Section Question Response
Submission of Estimated Expenses Statements

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

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

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

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

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

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

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

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

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

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

CHRISTOPHER G. WOOD

SVP/ASSOC. GEN. COUN.-GOV. & REG. AFF.


07/12/2017

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