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:
66781
Service:
DTV
Call Sign:
KIRO-TV
Channel:
23 (UHF)
File Number:
0000028117
FRN:
0014361620
Date Submitted:
08/15/2017

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

KIRO-TV, INC.

Doing Business As: KIRO-TV, INC.

Chief Engineer

2807 THIRD AVENUE

SEATTLE, WA 98121

United States

+1 (206) 728-7777 dshaw@kiro7.com Corporation

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

Donald Shaw

Director Of Engineering KIRO TV INC

KIRO-TV, Inc.

Don Shaw

2807 Third Avenue

Seattle, WA 98121

United States

+1 (206) 728-8240 dshaw@kirotv.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 Phase 1 requires installation of an Interim TX and antenna. A current transmission line will be extended and antenna raised to help match existing coverage. In Phase 2 KIRO replaces its Main transmitter, filters, antenna and electrical system.

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 Sigma CD-40P1
Year 1999
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 28.2 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 ULXTE-50
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 31.7 kW
Justification for New Transmitter Current transmitter cannot be retuned to channel 23. See attached supporting docs from Gates and Comark to substantiate solid state vs. IOT. See Gates Air Main Transmitter quote(ULXTE-50 Main TX) for cost breakdowns.

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) Yes
Power 150 kVA
Rigid Conduit and Wiring Yes
Size 4 inches
Length 100.0 feet
Other Electrical Service Yes
Description Electrician will remove existing electrical and install new transformer, conduits, and heat exchanger feeds for primary transmitter. See quote from Schneider for cost breakdowns.
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? Yes
Size 200.0 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 Purchase
Manufacturer
Model ULXTE-60
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 38 kW
Justification for New Transmitter Current Aux Transmitter cannot be retuned and does not provide enough power to meet ERP requirements during the transition/interim phase-See Gates Air Interim quote for costs.

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) Yes
Power 150 kVA
Rigid Conduit and Wiring Yes
Size 3 inches
Length 240.0 feet
Other Electrical Service Yes
Description Electrician will remove existing service connections ad dispose. New Transformer, conduits and heat exchanger will be installed for interim Transmitter-See Schneider Proposal, Queen Anne for costs.
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

Information not provided.

Antennas

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

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? 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: 1000.0 kW
Manufacturer
Model TFU-32DSC C164
Year 1999

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? No
New Antenna Manufacturer and Types 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/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 715.0 kW
Manufacturer
Model TFU-26JSC/R C164
Year 2018
Justification for New Antenna Current MAIN antenna cannot be retuned to Ch-23. KIRO will require TFU-26JSC/R C164 to meet repack assignments. See Dielectric MAIN ANT quote for cost details

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? 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

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Other Antenna Cost Not Listed

Name Description

Dielectric Custom Flanges

Custom flanges needed to connect current transmission lines to new main antenna

Main antenna Support Brackets

Custom support brackets needed for new primary antenna installation.

Main Antenna Freight

Primary antenna Freight charges.

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? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New 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/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 715.0 kW
Manufacturer
Model TFU-26JSC/R C164
Year 2018
Justification for New Antenna Existing transmission line will be extended to higher elevation of tower where new interim Antenna will be installed. Higher elevation needed to enable coverage demands while main antenna is 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 6 1/8 inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for an antenna? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? Yes
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Interim Antenna

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Other Antenna Cost Not Listed

Name Description

Antenna Support Brackets

Custom Support Brackets for Interim antenna

Freight Charges

Freight Charges for Interim Antenna

Dielectric Custom Flanges

Flanges and fittings needed to connect current transmission line to extension

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 Dielectric
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 27
Length 20 feet per run

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Interim Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Interim
Description of Use N/A
Change Type Purchase New
Type Rigid
Diameter 6 1/8 inches
Segment Length 20'
Other Segment Length
Number of parallel runs 9
Length 20 feet per run
Justification for New Transmission Line To meet ERP during transition, KIRO will extend existing Aux transmission 9 sections to elevate new Interim antenna.

Interim 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? 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? Yes
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1011408
Coordinates (NAD83) Latitude (NAD83) 47° 37' 58.9" N-
Longitude (NAD83) 122° 21' 23.9" W-
Overall Structure Height 607.93 feet
Support Structure Height 529.85 feet
Ground Elevation Above Mean Sea Level (AMSL) 399.93 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner IWG Towers Assets II, LLC
Date Constructed 07/22/1957


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 documented tower
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 N/A
Helicopter Services Required Are helicopter services required? No

Primary Tower

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Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? No
Number of Hours N/A
Explanation N/A
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 Yes
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 No
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

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Other Professional Services Expenses Not Listed

Name Description

DTV Medical Notifications

Hire external service to conduct Medical Notifications related to repack

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 Yes
Non-zoning permits Yes
BLM or NFS Coordination No
FCC Construction Permit Minor Change No
FCC License to Cover Application Yes
FCC Special Temporary Authority Application 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

Merrill Weiss Group

Perform RF studies pre and post repack. Assist with CPO applications.

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 $2,569,835.00 $2,445,306.00 N/A $0.00 N/A
Total for all systems $3,678,077.50 $3,516,309.00 N/A $0.00 N/A
Interim Transmitter ULXTE-60 $1,522,980.00 $1,400,201.00 $0.00
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW $1,473,000.00 $1,352,191.00 Gates air ULXTE 60 for interim transmission. N/A N/A
Transformer 3 phase/480v - 150 KVA $25,550.00 $24,300.00 N/A N/A N/A
3" Rigid Conduit and Wiring (Cost per foot) $12,480.00 $11,760.00 N/A N/A N/A
Other Electrical Service: Electrician will remove existing service connections ad dispose. New Transformer, conduits and heat exchanger will be installed for interim Transmitter-See Schneider Proposal, Queen Anne for costs. $11,950.00 $11,950.00 Labor to remove existing electrical feeds and install new for interim transmitter N/A N/A
Primary Transmitter ULXTE-50 $1,046,855.00 $1,045,105.00 $0.00
UHF - Liquid Cooled Solid State Transmitter 31.7 kW $989,755.00 $989,755.00 Gates Air ULXTE-50 for primary transmitter. N/A N/A
Other -- Building Addition Size: 200.0 $9,500.00 $9,500.00 Remove existing wall to allow primary install. relocate duct work for aux transmitter room. N/A N/A
Other Electrical Service: Electrician will remove existing electrical and install new transformer, conduits, and heat exchanger feeds for primary transmitter. See quote from Schneider for cost breakdowns. $11,950.00 $11,950.00 Labor to remove existing electrical feeds and install new for primary transmitter. SEE Schneider Proposal Queen Anne for cost details. N/A N/A
4" Rigid Conduit and Wiring (Cost per foot) $10,100.00 $9,600.00 New main conduit runs. See Schneider Proposal Queen Anne for cost details. N/A N/A
Transformer 3 phase/480v - 150 KVA $25,550.00 $24,300.00 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 $410,792.50 $407,800.00 N/A $0.00 N/A
Total for all systems $3,678,077.50 $3,516,309.00 N/A $0.00 N/A
Interim Antenna TFU-26JSC/R C164 $205,396.25 $204,736.25 $0.00
Dielectric Custom Flanges $1,841.25 $1,841.25 Custom flanges and transmission line sections to extend current transmission line for interim antenna-see Dielectric Interim quote (Item 23) for costs and verifications. N/A N/A
Antenna Support Brackets $21,750.00 $21,750.00 N/A N/A N/A
UHF - Lower Power, Side Mount, Class A, basic slot antenna, 715 kW input, directional,, horizontally polarized $145,275.00 $145,275.00 See Dielectric Interim antenna quote for cost details. N/A N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $11,970.00 See attached quote-Dielectric Interim antenna for costs and details N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Freight Charges $17,500.00 $17,500.00 See Dielectric Interim antenna quote for cost details and verifications N/A N/A
Primary Antenna TFU-26JSC/R C164 $205,396.25 $203,063.75 $0.00
Dielectric Custom Flanges $1,841.25 $1,841.25 Custom flanges and transmission lines needed to connect current transmission line to new antenna. See Dielectric Main antenna quote,(Line 23) for costs and verifications. N/A N/A
Main antenna Support Brackets $21,750.00 $21,750.00 See Dielectric MAIN ANT quote for support bracket cost details. N/A N/A
UHF - Lower Power, Side Mount, Class A, basic slot antenna, 715 kW input, directional,, horizontally polarized $145,275.00 $145,275.00 New primary antenna for repack. See Dielectric MAIN ANTENNA quote for cost details. 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 $10,297.50 See Dielectric MAIN ANT quote for elbow cost details. N/A N/A
Main Antenna Freight $17,500.00 $17,500.00 See Dielectric MAIN Antenna quote for cost details on Freight. 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 $36,360.00 $20,973.00 N/A $0.00 N/A
Total for all systems $3,678,077.50 $3,516,309.00 N/A $0.00 N/A
Interim Transmission Line $36,360.00 $20,973.00 $0.00
Rigid Transmission Line - copper, 6 1/8" $36,360.00 $20,973.00 Transmission line extension for interim antenna. see attached Dielectric Interim Trans extension quote for details. N/A N/A
Primary 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 $381,100.00 $370,480.00 N/A $0.00 N/A
Total for all systems $3,678,077.50 $3,516,309.00 N/A $0.00 N/A
Primary Tower GTOWER $381,100.00 $370,480.00 $0.00
Tall Tower (greater than 500') $210,500.00 $200,000.00 Rigging and equipment to remove current Main&Aux antennas, transmission lines. Install new repack antennas and transmission lines. N/A N/A
Structural engineering tower load study for well documented tower $12,600.00 $20,480.00 TEC Engineering repack tower load study-see TEC Quote for details. N/A N/A
Minor tower reinforcement/modifications $158,000.00 $150,000.00 To meet new wind load stress induced by new repack antennas new Mid-Bay horizontals will need to be added to the KIRO Tower. See attached, TEC repack analysis for specifics. 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 $161,930.00 $154,250.00 N/A $0.00 N/A
Total for all systems $3,678,077.50 $3,516,309.00 N/A $0.00 N/A
Outside Professional Services $161,930.00 $154,250.00 $0.00
DTV Medical Notifications $7,500.00 $7,500.00 Hire external company to perform DTV Medical notifications for Repack. N/A 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 $80,000.00 N/A N/A N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase $2,105.00 $2,000.00 N/A N/A N/A
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet $10,520.00 $10,000.00 N/A N/A N/A
NEPA Section 106 environmental review, if needed $6,310.00 $6,000.00 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
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
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 $2,000.00 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 N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 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), Construction Permit Application $5,260.00 $5,000.00 N/A 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 $118,060.00 $117,500.00 N/A $0.00 N/A
Total for all systems $3,678,077.50 $3,516,309.00 N/A $0.00 N/A
Other Expenses $118,060.00 $117,500.00 $0.00
MVPD Notification of Channel Change $11,750.00 $11,750.00 MVPD notifications N/A N/A
Develop and air announcement of upcoming channel change $15,000.00 $15,000.00 Develop internal and external awareness campaign for repack. N/A N/A
Equipment Storage $5,000.00 $5,000.00 up to 8 weeks antenna storage in Dielectric warehouse. N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 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
Local Zoning $2,000.00 $2,000.00 Seattle local zoning-Estimates based on previous projects in this area. N/A N/A
Non-zoning permits $800.00 $800.00 Seattle street closure permits. N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $6,500.00 $6,500.00 Costs to dispose of high voltage cabinets, current transmitters, transmission line and misc. equipment related to repack. N/A N/A
Equipment Delivery and Handling Charges $32,300.00 $32,300.00 N/A N/A N/A
Merrill Weiss Group $32,825.00 $32,825.00 RF studies pre-post repack. See Merrill Weiss group quote for specifics. 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 $3,678,077.50 $3,516,309.00 $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.

Jane Williams

Vice President


08/15/2017

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