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:
42359
Service:
DTV
Call Sign:
KTXD-TV
Channel:
23 (UHF)
File Number:
0000028579
FRN:
0027171693
Date Submitted:
09/19/2017

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

KTXD LICENSE COMPANY, LLC

Doing Business As: KTXD LICENSE COMPANY, LLC

Jonathan Dietz

15455 DALLAS PARKWAY

SUITE 100

ADDISON, TX 75001

United States

+1 (214) 628-9900 jdietz@lbc-texas.com Limited Liability Company

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

David Sanderford

Marsand, Inc.

David Sanderford

1957 Reynolds Dr

Azle, TX 76020

United States

+1 (817) 783-5566 david@marsand.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. Yes
Briefly describe transition plan Please see attached Transition Plan Narrative.

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 Retune Existing
Use Auxiliary (Backup)
Ownership Owned
Owner 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 Harris
Model ULX-4700AT
Year 2009
Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 5 kW

Auxiliary Transmitter

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Retuning Transmitter Costs

Section Question Response
New IOT Tubes Number of Tubes (including accessories) needed N/A
New Mask Filter
Power 7 kW
Other Power N/A
New Exciter Is a new exciter needed? No

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

Name Description

Use as Interim

Move and install existing auxiliary transmitter to interim site then move it back and reinstall.

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 CDP3100P1
Year 2005
Type Inductive Output Tube
IOT Power Type Single
Power Capacity 21 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 THU9-12EVO
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 19 kW
Justification for New Transmitter Existing transmitter is not supported for retuning. Station plans to file for maximization as stated in the filed application for minor modification to better match existing service area.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) Yes
Switchgear (industrial 800 amp) Yes
Transformer (480V) Yes
Power 300 kVA
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service Yes
Description Electrical installation for new transmitter.
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 25 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 550.0 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

Name Description

Ice Shield

Ice Protection over the mechanical slab and the equipment for new HVAC units, heat exchangers and repack broadcasters equipment to be installed.

Move generator

Move existing 300kW generator from the current site to the final site and install. Requires new pad, standalone ice shield and underground electrical.

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 Lease New
Antenna Use Primary (Main)
Description of Use N/A
Ownership Leased
Owner American Tower Corporation
Site N/A
Is the existing antenna shared with another station or stations? Yes
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 Horizontal
Type Broadband Panel
Number of Stations Supported 4
Number of Panels 36
Design power capacity in use 92.5 %
Lower Limit 605.00 MHz
Upper Limit 665.00 MHz
Other Antenna Type N/A
ERP: 600.0 kW
Manufacturer
Model PHP36C
Year 2003

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

Facility ID Call Sign
22201 KDAF
49326 KDTN
67910 KDTX-TV

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 Lease New
Is this a request for upgraded equipment? Yes
Ownership Leased
Owner American Tower Corporation
Is antenna shared? Yes
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 Broadband Panel
Number of Stations Supported 5
Number of Panels/Bays 48
Lower Limit 482.00 MHz
Upper Limit 608.00 MHz
Design power capacity in use 65.0 %
Other Antenna Type N/A
ERP: 377.0 kW
Manufacturer
Model TUM-AP-C4-14/48H-2-B
Year 2017
Justification for New Antenna Please see attached American Tower Corporation Transition Plan

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? Yes
Type New
Number of channels supported 5
Frequencies of channels supported RF channel
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? No
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Broadband
Feed Line Size 7 3/16 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

Enter a list of RF channel numbers.

RF Channel Number
21
18
19
23
29

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Combiner Installation

Installation of the combiner; Dual chain combiner system, Single chain of 2 constant impedance waveguide modules, and/or single chain of 2 directional filter modules per Dielectric layout plus a third low power filter for the wideband port.

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 Lease New
Use Primary (Main)
Description of Use N/A
Ownership Leased
Owner ATC
Site N/A
Is the existing transmission line shared with another station or stations? Yes
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 8 3/16 inches
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 1
Length 1507 feet per run

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

Facility ID Call Sign
67910 KDTX-TV
22201 KDAF
49326 KDTN

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Lease New
Is this a request for upgraded equipment? Yes
Type Rigid
Diameter 7 3/16 inches
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 2
Length 1650 feet per run
Justification for New Transmission Line Please see attached American Tower Corporation Transition Plan

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Transmission Line Bridge

New Ice Bridge required to support new transmission lines from all four repack tenants space to tower, estimated to be 200 linear ft. This cost includes the materials, foundations and installation.

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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Add 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? Unknown
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1055009
Coordinates (NAD83) Latitude (NAD83) 32° 35' 22.0" N-
Longitude (NAD83) 096° 58' 12.9" W-
Overall Structure Height 1550.83 feet
Support Structure Height 1453.07 feet
Ground Elevation Above Mean Sea Level (AMSL) 829.71 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner American Tower, LLC
Date Constructed 11/04/2008

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
47739 KDMX FM
18114 KEGL FM
59702 KKDA-FM FM
35841 KUVN-DT DTV
41380 KLNO FM
23084 KHKS FM
26950 KATA-CD DTV
11451 WRR FM
6378 KZPS FM
14524 KCBI FM
9620 KDGE FM

Other Types of Users

Users
KNAV-LP
KJJM-LD
KHPK-LD
K31GL-D
KVFW-LD

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: Serious 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

Construction Project management Tower Modifications Reinforcements and Facilities

60 hours on Modification project management and RF installation project management.

Ground and Building A and E Permit Drawing Package

The generation of a construction drawing package for one broadcaster.

Tower Permit Drawing Package

The generation of a construction drawing package for one broadcaster.

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Move Equipment
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 No
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1059733
Coordinates (NAD83) Latitude (NAD83) 32° 32' 36.0" N-
Longitude (NAD83) 096° 57' 33.0" W-
Overall Structure Height 1635.15 feet
Support Structure Height 1523.60 feet
Ground Elevation Above Mean Sea Level (AMSL) 813.97 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner American Towers, LLC
Date Constructed 06/18/2000

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
41380 KLNO FM
28624 KVIL FM
67195 KLUV FM
42359 KTXD-TV DTV
49323 KERA FM
63779 KJKK FM
23440 KMVK FM
17037 KDFI DTV
1087 KRLD-FM FM
68834 KPXD-TV DTV
22201 KDAF DTV
23422 KTVT DTV
9627 KBFB FM
67910 KDTX-TV DTV
49324 KERA-TV DTV
60534 KSTR-DT DTV
55768 KKXT FM
49326 KDTN DTV
51517 KTXA DTV

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

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? Yes
Number of Hours 450
Explanation The station will contract for Project Management services to handle the complete project. It does not have personnel available for any of these tasks, nor is the staff trained to provide any of these 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 No
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 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 No
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 2
NEPA Section 106 environmental review Yes
Environmental Assessment Yes
ASR Modification Yes
FAA Consultation (including preparation of FAA Form 7460) Yes
Negotiation of Lease and other Matter for Shared Locations Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study 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

RF System Test

Testing of the combiner to ensure all one (1) frequencies are tuned for optimal patterns.

Migratory Bird Assessment Permitting

Migratory Bird Assessment Permitting

Site Coordination Meeting

Site coordination meetings with all broadcasters, contractors and vendors involved with the site deliveries and construction.

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 No
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? No
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

Tree Clearing

This cost is for the removal of trees and vegetation to ensure the proper clearance of taglines and laydown areas, required for construction.

Construction and Electrical Permits

2% construction cost, excluding the material and equipment for electrical and building permits.

Site Security

Site security for installation and storage of Transmission line and materials for 57 days X 12 hours. The materials are a high risk of theft due to the material makeup such as copper, brass and aluminum.

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 $1,226,770.00 $1,178,360.00 N/A $0.00 N/A
Total for all systems $4,846,057.00 $2,137,127.00 N/A $0.00 N/A
Primary Transmitter THU9-12EVO $1,078,360.00 $1,035,460.00 $0.00
Move generator $64,860.00 $64,860.00 See attached Generator Move Quotation. N/A N/A
Other -- Building Addition Size: 550.0 $83,600.00 $83,600.00 The building upgrade is required to accommodate the repack equipment. The current building configuration will need to be altered. See attached American Tower Corporation quote. N/A N/A
Service entrance 3 phase/800 amp/208 volt $14,400.00 $13,700.00 N/A N/A N/A
Transformer 3 phase/480v - 300 KVA $36,800.00 $35,000.00 N/A N/A N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW $684,000.00 $650,000.00 N/A N/A N/A
Other Electrical Service: Electrical installation for new transmitter. $25,000.00 $25,000.00 Electrical distribution to the new transmitter. Parts and installation. N/A N/A
Ice Shield $40,000.00 $40,000.00 Please see attached ATC Transition Plan N/A N/A
25 Ton system $91,500.00 $87,000.00 Please see attached ATC Transition Plan N/A N/A
Auxiliary Transmitter ULX-4700AT $148,410.00 $142,900.00 $0.00
Use as Interim $37,000.00 $37,000.00 See attached quote for Auxiliary Transmitter - use as interim N/A N/A
UHF and VHF - minor banding issues $105,200.00 $100,000.00 Catalog N/A N/A
7 kW mask filter $6,210.00 $5,900.00 Catalog 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 $248,697.00 $211,167.00 N/A $0.00 N/A
Total for all systems $4,846,057.00 $2,137,127.00 N/A $0.00 N/A
Primary Antenna TUM-AP-C4-14/48H-2-B $248,697.00 $211,167.00 $0.00
Elbow complex, broadband, at antenna input, per 7 3/16. feedline (if needed) $16,850.00 $6,500.00 See attached American Tower Corporation quote. N/A N/A
New combiner, cost per channel (without antenna) $84,200.00 $60,000.00 See attached American Tower Corporation quote N/A N/A
Sweep test of existing antenna $6,730.00 $3,750.00 See attached American Tower Corporation quote. N/A N/A
UHF - High Power Top Mount Five Station broadband panel antenna elliptically or circularly polarized $134,667.00 $134,667.00 This is the portion of the cost of the antenna assigned to KTXD. This antenna will be shared (in the final facility) between KDTN, KDTX and KTXD. See attached American Tower Corporation quote. N/A N/A
Combiner Installation $6,250.00 $6,250.00 See attached American Tower Corporation quote. 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 $1,121,400.00 $224,955.00 N/A $0.00 N/A
Total for all systems $4,846,057.00 $2,137,127.00 N/A $0.00 N/A
Primary Transmission Line $1,121,400.00 $224,955.00 $0.00
Rigid Transmission Line - copper, 7 3/16" broadband $1,098,900.00 $202,455.00 See attached American Tower Corporation quote. N/A N/A
Transmission Line Bridge $22,500.00 $22,500.00 See attached American Tower Corporation quote. N/A N/A

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 $1,930,900.00 $239,615.00 N/A $0.00 N/A
Total for all systems $4,846,057.00 $2,137,127.00 N/A $0.00 N/A
Primary Tower GTOWER $421,000.00 $0.00 $0.00
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $0.00 This appears as a duplicate entry. N/A N/A
Primary Tower GTOWER $1,509,900.00 $239,615.00 $0.00
Structural engineering tower load study for a documented tower with candelabra $20,000.00 $8,870.00 See attached American Tower Corporation quote. ($4,960 - mapping / $3,910 - study) N/A N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $63,845.00 See attached American Tower Corporation quote. N/A N/A
Tower Permit Drawing Package $4,700.00 $4,700.00 See attached American Tower Corporation quote. N/A N/A
Ground and Building A and E Permit Drawing Package $4,700.00 $4,700.00 See attached American Tower Corporation quote. N/A N/A
Construction Project management Tower Modifications Reinforcements and Facilities $7,500.00 $7,500.00 See attached American Tower Corporation quote. N/A N/A
Serious tower reinforcement/modifications $1,052,000.00 $150,000.00 See attached American Tower Corporation quote. 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 $244,890.00 $210,180.00 N/A $0.00 N/A
Total for all systems $4,846,057.00 $2,137,127.00 N/A $0.00 N/A
Outside Professional Services $244,890.00 $210,180.00 $0.00
Site Coordination Meeting $2,500.00 $2,500.00 See attached American Tower Corporation quote. 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
ASR modification (prepare FCC Form 854) $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
Attorney Fees - Prepare and File request for Special Temporary Authorization $7,360.00 $7,000.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $4,000.00 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
Prepare request for Special Temporary Authorization $4,100.00 $3,000.00 N/A N/A N/A
Project management of the transition $71,100.00 $67,500.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 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 engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 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
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A N/A N/A
RF Exposure Measurements $21,050.00 $3,000.00 See attached American Tower Corporation quote. N/A N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A N/A N/A
NEPA Section 106 environmental review, if needed $6,310.00 $1,080.00 See attached American Tower Corporation quote. N/A N/A
Migratory Bird Assessment Permitting $350.00 $350.00 See attached American Tower Corporation quote. N/A N/A
RF System Test $4,000.00 $4,000.00 See attached American Tower Corporation quote. 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 $73,400.00 $72,850.00 N/A $0.00 N/A
Total for all systems $4,846,057.00 $2,137,127.00 N/A $0.00 N/A
Other Expenses $73,400.00 $72,850.00 $0.00
Site Security $8,550.00 $8,550.00 See attached American Tower Corporation quote. N/A N/A
Construction and Electrical Permits $10,000.00 $10,000.00 See attached American Tower Corporation quote. N/A N/A
Tree Clearing $1,600.00 $1,600.00 See attached American Tower Corporation quote. N/A N/A
Develop and air announcement of upcoming channel change $500.00 $500.00 N/A N/A N/A
Equipment Delivery and Handling Charges $5,000.00 $5,000.00 See attached American Tower Corporation quote. N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $16,500.00 $16,500.00 Pre-auction channel transmitter and interior RF system dismantling, removal and disposal including coolant and oil reclamation. N/A N/A
Non-zoning permits $10,000.00 $10,000.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A N/A N/A
Local Zoning $4,700.00 $4,700.00 See attached American Tower Corporation quote. N/A N/A
MVPD Notification of Channel Change $5,000.00 $5,000.00 N/A 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 $4,846,057.00 $2,137,127.00 $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.

David Sanderford

Technical Consultant


09/19/2017

Attachments

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