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:
36607
Service:
DTV
Call Sign:
KJZZ-TV
Channel:
19 (UHF)
File Number:
0000028798
FRN:
0025502048
Date Submitted:
06/11/2018

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

KJZZ LICENSEE, LLC

Doing Business As: KJZZ LICENSEE, LLC

Harvey Arnold

10706 Beaver Dam Road

Cockeysville, MD 21030

United States

+1 (410) 568-1500 harnold@sbgtv.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

Paul A Cicelski

Lerman Senter PLLC

Paul Cicelski

2001 L Street, NW

Suite 400

Washington, DC 20036

United States

+1 (202) 429-8970 pcicelski@lermansenter.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 See Exhibit A.

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 DHD45P2
Year 2001
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 10.5 kW

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Manufacturer
Model ULXTE-16
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 10 kW
Justification for New Transmitter Per the manufacturer, the current transmitter cannot be retuned. See Exhibit B.

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) Yes
Transformer (480V) Yes
Power 300 kVA
Rigid Conduit and Wiring Yes
Size 2 inches
Length 800.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Heating and Cooling
Size 50 tons
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.

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-20
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 12 kW
Justification for New Transmitter This interim transmitter cost will be shared by the eight stations that are collocated on this tower, and will aid all of the stations in transitioning to their new channels considering the terrain and phase time constraints.

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) Yes
Transformer (480V) Yes
Power 300 kVA
Rigid Conduit and Wiring Yes
Size 2 inches
Length 800.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Heating and Cooling
Size 50 tons
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? Yes

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? 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 Top
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 8
Number of Panels 48
Design power capacity in use 77.0 %
Lower Limit 773.00 MHz
Upper Limit 928.00 MHz
Other Antenna Type N/A
ERP: 200.0 kW
Manufacturer
Model 773 928
Year 1999

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

Facility ID Call Sign
69396 KUED
69582 KUEN
1136 KUCW
35823 KUTV
6359 KSL-TV
6823 KBYU-TV
68889 KTVX

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Ownership Owned
Owner N/A
Is antenna shared? 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 Bottom
Polarization Circular
Type Broadband Panel
Number of Stations Supported 8
Number of Panels/Bays 48
Lower Limit 470.00 MHz
Upper Limit 608.00 MHz
Design power capacity in use 90.0 %
Other Antenna Type N/A
ERP: 114.0 kW
Manufacturer
Model 759 25063
Year 2017
Justification for New Antenna FROM MANUFACTURER. These panel antennas are finely tuned to a specific band, but the new repacked channels are not within the specific band, so the current antenna cannot be used for the new repack 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? Yes
Type New
Number of channels supported 8
Frequencies of channels supported Upper and lower frequency
Frequency 470.0 MHz - 608.0 MHz
Do you need a combiner output splitter/switcher for dual feed lines? Yes
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Broadband
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

Name Description

Antenna Installation

Installation of 48 new panels with harness. See Exhibit D.

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? Yes
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 Broadband
Other Segment Length N/A
Number of parallel runs 2
Length 230 feet per run

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

Facility ID Call Sign
68889 KTVX
1136 KUCW
35823 KUTV
6359 KSL-TV
6823 KBYU-TV
69396 KUED
69582 KUEN

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Owned
Is this tower consider Complex? Terrain Constrained
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? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1062408
Coordinates (NAD83) Latitude (NAD83) 40° 39' 33.0" N-
Longitude (NAD83) 112° 12' 10.0" W-
Overall Structure Height 308.40 feet
Support Structure Height 308.40 feet
Ground Elevation Above Mean Sea Level (AMSL) 9035.32 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner DTV UTAH, LC
Date Constructed 10/28/1999

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
69582 KUEN DTV
69396 KUED DTV
6359 KSL-TV DTV
68889 KTVX DTV
35823 KUTV DTV
6823 KBYU-TV DTV
1136 KUCW DTV

Other Types of Users

Users
KPNZ - Telev
Go Go Air

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: Major Reinforcements needed

Primary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower Terrain constrained
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 800
Explanation Outside consulting engineering, legal work, and accounting services, as well as project management for regional and comprehensive repack execution. See Exhibit K.
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 No
Environmental Assessment No
ASR Modification Yes
FAA Consultation (including preparation of FAA Form 7460) Yes
Negotiation of Lease and other Matter for Shared Locations Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study 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

Information not provided.

Other Expenses

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

Other Expenses

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Other Expenses Not Listed

Name Description

DTV Utah Operating Agreement Equity Equalization

Per Operating Agreement signed July 1998. See Exhibit M.

KSTU Mask Filter

Needed for KSTU (channel 28) to protect KUED (channel 27). See Exhibit N.

Road Maintenance

Snow plowing, grading, and repairs to existing road to remote mountaintop site. See Exhibit R.

Temporary Sanitation

For onsite workers. See Exhibit S.

Temporary Storage

For tools and equipment onsite and staging area off-site. See Exhibit P.

Transportation Services

Snow cat and helicopter to move equipment and personnel to remote mountaintop site during winter season. See Exhibit R.

Garbage Disposal

Remove general garbage from mountaintop site (does not include equipment removal). Billed as used.

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 $1,860,100.00 $722,371.50 N/A $55,716.81 N/A
Total for all systems $3,768,838.25 $1,853,304.75 N/A $88,056.04 N/A
Interim Transmitter ULXTE-20 $1,003,800.00 $131,071.50 $55,716.81
Transformer 3 phase/480v - 300 KVA $36,800.00 $4,375.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. $0.00 N/A
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW $494,500.00 $70,534.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. $55,716.81 N/A
UHF inside RF system including switching $147,500.00 $17,500.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. N/A N/A
50 Ton system $266,000.00 $31,625.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. $0.00 N/A
2" Rigid Conduit and Wiring (Cost per foot) $20,800.00 $2,500.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. N/A N/A
Switchgear - industrial 800 amp $38,200.00 $4,537.50 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. N/A N/A
Primary Transmitter ULXTE-16 $856,300.00 $591,300.00 $0.00
50 Ton system $266,000.00 $30,000.00 This cost is shared with eight stations, six of which are repacked, and we estimate $180,000 total for the cost of this HVAC service. N/A N/A
2" Rigid Conduit and Wiring (Cost per foot) $20,800.00 $20,000.00 N/A N/A N/A
Transformer 3 phase/480v - 300 KVA $36,800.00 $35,000.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW $494,500.00 $470,000.00 N/A N/A N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A

Components

Actual Information Description File Name
Transformer 3 phase/480v - 300 KVA Information not provided.
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW

Component Description:
Install station specific transmitter electrical equipment. #717-100
Amount:
$15,222.00

Component Description:
Transmitter downpayment. #9500074989
Amount:
$40,494.81
UHF inside RF system including switching Information not provided.
50 Ton system Information not provided.
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Switchgear - industrial 800 amp Information not provided.
50 Ton system Information not provided.
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Transformer 3 phase/480v - 300 KVA Information not provided.
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW Information not provided.
Switchgear - industrial 800 amp Information not provided.

Cost Information

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Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $436,593.00 $514,713.00 N/A $0.00 N/A
Total for all systems $3,768,838.25 $1,853,304.75 N/A $88,056.04 N/A
Primary Antenna 759 25063 $436,593.00 $514,713.00 $0.00
New combiner, cost per channel (without antenna) $84,200.00 $185,000.00 See Exhibit E. $0.00 N/A
Combiner output splitting/switching for dual feed lines, if applicable $126,000.00 $120,000.00 The station now has an invoice with this cost separated as a line item, and is entering it in the 399 as such. $0.00 N/A
UHF - High Power Top Mount Eight Station broadband panel antenna elliptically or circularly polarized $168,286.00 $168,286.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. See Exhibit D. $0.00 N/A
Sweep test of existing antenna $6,730.00 $2,125.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. N/A N/A
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed) $13,700.00 $1,625.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. N/A N/A
Antenna Installation $37,677.00 $37,677.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. See Exhibit D. 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 $0.00 $0.00 N/A $0.00 N/A
Total for all systems $3,768,838.25 $1,853,304.75 N/A $88,056.04 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 $854,600.00 $101,500.00 N/A $0.00 N/A
Total for all systems $3,768,838.25 $1,853,304.75 N/A $88,056.04 N/A
Primary Tower TOWER $854,600.00 $101,500.00 $0.00
Structural engineering tower load study for well documented tower $12,600.00 $1,500.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. $0.00 N/A
Major tower reinforcement/modifications $421,000.00 $50,000.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. N/A N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $50,000.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. See Exhibit L for partial cost. 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 $276,510.00 $174,250.00 N/A $31,576.73 N/A
Total for all systems $3,768,838.25 $1,853,304.75 N/A $88,056.04 N/A
Outside Professional Services $276,510.00 $174,250.00 $31,576.73
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $2,418.10 N/A
Prepare request for Special Temporary Authorization $4,100.00 $3,000.00 N/A $0.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $2,385.00 N/A
Project management of the transition $126,400.00 $120,000.00 N/A $19,816.71 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A $375.00 N/A
RF Exposure Measurements $21,050.00 $2,500.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. N/A N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $10,000.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. 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
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
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $6,360.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A $221.92 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

Components

Actual Information Description File Name
Prepare and or review reimbursement form

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$152.01

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759
Amount:
$869.30

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289
Amount:
$1,311.48

Component Description:
Legal services cost. #461804
Amount:
$85.31
Prepare request for Special Temporary Authorization Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Consulting engineering cost. #878-74-0001
Amount:
$2,385.00
Project management of the transition

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #1029
Amount:
$20.91

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1039
Amount:
$30.47

Component Description:
Legal services cost. #464698
Amount:
$240.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #453972
Amount:
$716.28

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #1010
Amount:
$86.88

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #1012
Amount:
$20.65

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #1022
Amount:
$32.35

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #1032
Amount:
$43.72

Component Description:
Consulting cost. #1800032
Amount:
$101.15

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1051
Amount:
$105.97

Component Description:
Legal services cost. #453970
Amount:
$172.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1045
Amount:
$185.10

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1058
Amount:
$187.24

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1055
Amount:
$243.38

Component Description:
Legal services cost. #463575
Amount:
$250.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1063
Amount:
$262.29

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #463567
Amount:
$566.48

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #464321
Amount:
$683.07

Component Description:
Legal services cost. #460941
Amount:
$765.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #457851
Amount:
$818.59

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #457331
Amount:
$836.44

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #450412
Amount:
$999.04

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759
Amount:
$29.98

Component Description:
Legal services cost. #464356
Amount:
$1,250.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289
Amount:
$91.50

Component Description:
Legal service cost. #457856
Amount:
$3,745.80

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #463026
Amount:
$801.57

Component Description:
Legal services cost. #464259
Amount:
$575.00

Component Description:
Legal services cost. #463022
Amount:
$5,586.40

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #453686
Amount:
$943.95
Address transition timing and coordination issues w/ other stations and wireless

Component Description:
Legal services cost.
Amount:
$375.00
RF Exposure Measurements Information not provided.
Comprehensive coverage verification via field study, if needed Information not provided.
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase Information not provided.
ASR modification (prepare FCC Form 854) Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
Perform engineering study for new channel assignment and antenna development

Component Description:
Consulting engineering cost. #858-64-0001
Amount:
$3,705.00

Component Description:
Consulting engineering services. #878-74-0001
Amount:
$2,655.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759
Amount:
$99.92

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289
Amount:
$122.00
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application 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 $341,035.25 $340,470.25 N/A $762.50 N/A
Total for all systems $3,768,838.25 $1,853,304.75 N/A $88,056.04 N/A
Other Expenses $341,035.25 $340,470.25 $762.50
Equipment Delivery and Handling Charges $8,125.00 $8,125.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. See Exhibit P. $450.00 N/A
Temporary Storage $4,000.00 $4,000.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. See Exhibit P. $0.00 N/A
Garbage Disposal $1,500.00 $1,500.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. Billed as used, but the estimate is based on past experience at this site. $312.50 N/A
Transportation Services $5,000.00 $5,000.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. To be used during inclement weather. $0.00 N/A
Temporary Sanitation $3,000.00 $3,000.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. See Exhibit S. Estimate is based on past experience at this site. N/A N/A
Road Maintenance $10,000.00 $10,000.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. See Exhibit R. N/A N/A
KSTU Mask Filter $6,756.25 $6,756.25 Mask filter to remedy adjacent channel problem with KSTU. This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. See Exhibit N. N/A N/A
DTV Utah Operating Agreement Equity Equalization $223,083.00 $223,083.00 See Exhibit M. N/A N/A
MVPD Notification of Channel Change $5,000.00 $5,000.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $28,050.00 $28,050.00 See Exhibit T. N/A N/A
Equipment Storage $4,000.00 $4,000.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. See Exhibit Q. N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $28,566.00 $28,566.00 See Exhibit U. N/A N/A
Non-zoning permits $1,875.00 $1,875.00 This cost is shared with all DTV Utah stations and represents 1/8 of the cost of this item. N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Equipment Delivery and Handling Charges

Component Description:
Freight cost. #239058A
Amount:
$450.00
Temporary Storage Information not provided.
Garbage Disposal

Component Description:
Garbage disposal. #10184
Amount:
$312.50
Transportation Services Information not provided.
Temporary Sanitation Information not provided.
Road Maintenance Information not provided.
KSTU Mask Filter Information not provided.
DTV Utah Operating Agreement Equity Equalization Information not provided.
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Non-zoning permits Information not provided.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
DTV Medical Facility Notification Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $3,768,838.25 $1,853,304.75 $88,056.04

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 B Amy

Secretary Sinclair Television Group Inc.


06/11/2018

Certification

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Section Question Response
Submission of Actual Cost Documentation Statements

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

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

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

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

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

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

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

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

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

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

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

David B Amy

Secretary Sinclair Television Group Inc.


06/11/2018

Attachments

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