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:
65681
Service:
DTV
Call Sign:
WTAE-TV
Channel:
27 (UHF)
File Number:
0000026711
FRN:
0001587583
Date Submitted:
11/29/2017

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

Hearst Stations Inc.

Doing Business As: Hearst Stations Inc.

C/O BROOKS, PIERCE, ET. AL.

P.O. BOX 1800

RALEIGH, NC 27602

United States

+1 (919) 839-0300 mprak@brookspierce.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

The Preparer is same as the reimbursement contact.

 

 

 

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 See attached document

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
Year 1999
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 44 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-60
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 38 kW
Justification for New Transmitter Existing IOT transmitter cannot be converted to post-transition channel, see GatesAir EOL and HTV IOT to Solid-State Justification statements. An IOT replacement is more expensive than proposed SS transmitter. See attached Comark IOT Transmitter quote.

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 300 kVA
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service Yes
Description transmitter installation electrical service
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 2000.0 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

RF Accessories

Additional RF components required for transmitter operation and integration into current RF environment.

Shipping

Transmitter shipping

Transmitter de-install

Remove old transmitter

Electrical Accessories

Surge Protection required by manufacturer

Sales Tax

transmitter sales tax

Antennas

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

Auxiliary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Auxiliary (Backup)
Description of Use backup to main antenna
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 Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 207.0 kW
Manufacturer
Model TLP-16-I-C
Year 1999

Auxiliary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Auxiliary (Backup)
Description of Use Interim/Aux
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 Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Slot
Number of Stations Supported 1
Number of Panels/Bays 16
Lower Limit 470.00 MHz
Upper Limit 608.00 MHz
Design power capacity in use 57.8 %
Other Antenna Type N/A
ERP: 628.0 kW
Manufacturer
Model TFU-16WB
Year 2018
Justification for New Antenna Current auxiliary antenna is channel specific. The TFU-16WB is a broadband antenna that can be used for both pre and post transition channels facilitating a smooth and on-time transition to new channel.

Auxiliary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? 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? 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? Yes
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

Auxiliary Antenna

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Other Antenna Cost Not Listed

Name Description

Shipping

Antenna shipping

Sales Tax

antenna sales tax

Impedence Transformer

50 ohm to 75 ohm transformer

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 Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels 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-30DSC-R CT150
Year 2004

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 Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 628.0 kW
Manufacturer
Model TFU-24JSC-R CT150
Year 2019
Justification for New Antenna Current antenna is channel specific (51) and cannot be used on post-transition channel (27). Must be replaced

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? 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

Shipping

Antenna shipping

Feed Through Components

Line sections & elbows

Sales Tax

antenna sales tax

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 1
Length 1030 feet per run

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Auxiliary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Auxiliary (Backup)
Description of Use Backup
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 3 1/8 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 880 feet per run

Auxiliary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Auxiliary (Backup)
Description of Use Interim/Auxiliary
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 1
Length 880 feet per run
Justification for New Transmission Line The current auxiliary line must be replaced with a line capable of handling higher power since station will be operating for extended time on auxiliary antenna on both pre and post transition channels. This helps ensure a smooth and on-time transition.

Auxiliary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Sales Tax

transmission line sales tax

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? 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? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1025144
Coordinates (NAD83) Latitude (NAD83) 40° 16' 49.0" N-
Longitude (NAD83) 079° 48' 10.0" W-
Overall Structure Height 1062.98 feet
Support Structure Height 892.38 feet
Ground Elevation Above Mean Sea Level (AMSL) 982.93 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Hearst Stations Inc.
Date Constructed 08/07/1958


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

Name Description

Tower Consulting

tower consulting and tower project management

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 200
Explanation Additional RF experience needed
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study 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

Transmitter Site Survey

Transmitter planning survey & transmitter building drawings

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 No
BLM or NFS Coordination No
FCC Construction Permit Minor Change Yes
FCC License to Cover Application Yes
FCC Special Temporary Authority Application No
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? No
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? No
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

Information not provided.

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 $1,858,234.00 $1,430,057.00 N/A $334,006.27 N/A
Total for all systems $3,094,130.00 $2,557,802.00 N/A $801,901.61 N/A
Primary Transmitter ULXTE-60 $1,858,234.00 $1,430,057.00 $334,006.27
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW $1,473,000.00 $1,073,150.00 GatesAir quote sections A, B & E. This is the transmitter, mask filter, installation and proof per the FCC "transmitter" definition. $334,006.27 N/A
Transformer 3 phase/480v - 300 KVA $36,800.00 $8,473.00 N/A N/A N/A
Other Electrical Service: transmitter installation electrical service $150,000.00 $150,000.00 required transmitter installation electrical service per attached quote N/A N/A
Other -- Building Addition Size: 2000.0 $3,860.00 $3,860.00 Modifications needed for installation of repack transmitter N/A N/A
Transmitter de-install $22,640.00 $22,640.00 removal of current transmitter to make space for replacement N/A N/A
Electrical Accessories $1,943.00 $1,943.00 Manufacturer required surge protection N/A N/A
RF Accessories $76,222.00 $76,222.00 Additional RF components required for transmitter operation and integration into current RF environment. N/A N/A
Shipping $11,000.00 $11,000.00 Transmitter shipping N/A N/A
Sales Tax $82,769.00 $82,769.00 transmitter sales tax per attached GatesAir quote N/A N/A

Components

Actual Information Description File Name
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW

Component Description:
Transmitter 1st deposit
Amount:
$118,742.08

Component Description:
Transmitter 2nd deposit
Amount:
$215,264.19
Transformer 3 phase/480v - 300 KVA Information not provided.
Other Electrical Service: transmitter installation electrical service Information not provided.
Other -- Building Addition Size: 2000.0 Information not provided.
Transmitter de-install Information not provided.
Electrical Accessories Information not provided.
RF Accessories Information not provided.
Shipping Information not provided.
Sales Tax 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 $383,500.00 $359,358.00 N/A $314,438.67 N/A
Total for all systems $3,094,130.00 $2,557,802.00 N/A $801,901.61 N/A
Primary Antenna TFU-24JSC-R CT150 $216,782.00 $207,725.00 $183,024.00
UHF - High Power, Side Mount, basic slot antenna, 628 kW input, directional,, horizontally polarized $144,825.00 $144,825.00 antenna cost per attached Dielectric quote $133,589.00 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $6,400.00 N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $10,298.00 N/A $10,297.50 N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $16,425.00 N/A $16,425.00 N/A
Feed Through Components $11,693.00 $11,693.00 additional RF components required for antenna installation per attached Dielectric quote $11,692.50 N/A
Shipping $4,620.00 $4,620.00 shipping per Dielectric quote $4,620.00 N/A
Sales Tax $13,464.00 $13,464.00 estimated antenna sales tax based on Pennsylvania state and local sales tax rate of 7% N/A N/A
Auxiliary Antenna TFU-16WB $166,718.00 $151,633.00 $131,414.67
Impedence Transformer $3,685.00 $3,685.00 transformer to match antenna to transmission line $3,685.50 Rounding Error for the difference in cost.
Sales Tax $9,228.00 $9,228.00 estimated antenna sales tax based on Pennsylvania state and local sales tax rate of 7% N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $6,400.00 N/A
UHF - High Power, Side Mount, basic slot antenna, 16 bay,, 628 kW input, directional,, horizontally polarized $106,050.00 $106,050.00 antenna price per attached Dielectric quote $106,050.00 N/A
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed) $13,700.00 $11,970.00 N/A $979.17 N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $10,125.00 N/A $10,125.00 N/A
Shipping $4,175.00 $4,175.00 shipping per attached Dielectric quote $4,175.00 N/A

Components

Actual Information Description File Name
UHF - High Power, Side Mount, basic slot antenna, 628 kW input, directional,, horizontally polarized

Component Description:
WTAE Main Antenna cost. Dielectric; 9.13.2017; $42,077
Amount:
$42,077.00

Component Description:
WTAE Dielectric Main antenna Prepmt 2
Amount:
$91,512.00
Sweep test of existing antenna

Component Description:
WTAE Repack Sweep cost. Dielectric; 9.13.2017; $6,400
Amount:
$6,400.00
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
WTAE Elbow Complex, Dielectric; 9.13.2017; $10,927.50
Amount:
$10,297.50
Side mount brackets for high power antennas (if not included in antenna base cost)

Component Description:
WTAE Main Antenna Side mount bracket cost. Dielectric; 9.13.2017; $16,425
Amount:
$16,425.00
Feed Through Components

Component Description:
WTAE Feed Through Components; Dielectric; 9.13.2017; $11,692.50
Amount:
$11,692.50
Shipping

Component Description:
WTAE Freight/Shipping cost, Dielectric; 9.13.2017; $4,620
Amount:
$4,620.00
Sales Tax Information not provided.
Impedence Transformer

Component Description:
Dielectric. Transformer Charge for WTAE; 9.13.2017; $3,685.50
Amount:
$3,685.50
Sales Tax Information not provided.
Sweep test of existing antenna

Component Description:
Dielectric. WTAE Repack Sweep; 9.13.2017; $6,400
Amount:
$6,400.00
UHF - High Power, Side Mount, basic slot antenna, 16 bay,, 628 kW input, directional,, horizontally polarized

Component Description:
Purchase of Interim Antenna for WTAE Dielectric; 9.13.2017; $106,050
Amount:
$106,050.00
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
WTAE; Auxillary Antenna Elbow complex cost. Dielectric
Amount:
$979.17
Side mount brackets for high power antennas (if not included in antenna base cost)

Component Description:
Dielectric. WTAE Custom Mounts for TFU16WB; 9.13.2017; $10,125
Amount:
$10,125.00
Shipping

Component Description:
WTAE Freight and Shipping cost Dielectric; 9.13.2017; $4,175.
Amount:
$4,175.00

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 $214,804.00 $162,700.00 N/A $131,414.67 N/A
Total for all systems $3,094,130.00 $2,557,802.00 N/A $801,901.61 N/A
Primary Transmission Line $0.00 $0.00 $0.00
Auxiliary Transmission Line $214,804.00 $162,700.00 $131,414.67
Rigid Transmission Line - copper, 6 1/8" broadband $204,160.00 $152,056.00 price per attached Dielectric quote $131,414.67 N/A
Sales Tax $10,644.00 $10,644.00 estimated sales tax based on Pennsylvania state and local sales tax rate of 7% N/A N/A

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 6 1/8" broadband

Component Description:
WTAE; Rigid Transmission Line; Dielectric
Amount:
$131,414.67
Sales Tax 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 $388,600.00 $369,500.00 N/A $0.00 N/A
Total for all systems $3,094,130.00 $2,557,802.00 N/A $801,901.61 N/A
Primary Tower TOWER $388,600.00 $369,500.00 $0.00
Tall Tower (greater than 500') $210,500.00 $200,000.00 N/A $0.00 N/A
Tower Consulting $7,500.00 $7,500.00 tower consulting and tower project management - quote attached N/A N/A
Minor tower reinforcement/modifications $158,000.00 $150,000.00 N/A $0.00 N/A
Structural engineering tower load study for well documented tower $12,600.00 $12,000.00 N/A 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 $197,497.00 $188,292.00 N/A $22,042.00 N/A
Total for all systems $3,094,130.00 $2,557,802.00 N/A $801,901.61 N/A
Outside Professional Services $197,497.00 $188,292.00 $22,042.00
Transmitter Site Survey $22,042.00 $22,042.00 Transmitter planning survey & transmitter building drawings quote attached $22,042.00 N/A
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,500.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application $4,210.00 $4,000.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A N/A N/A
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
Project management of the transition $31,600.00 $30,000.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A
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 request for Special Temporary Authorization $2,050.00 $1,500.00 N/A N/A N/A

Components

Actual Information Description File Name
Transmitter Site Survey

Component Description:
WTAE Field Service, GatesAir 6/30/2016 $22,042
Amount:
$22,042.00
RF Exposure Measurements Information not provided.
Comprehensive coverage verification via field study, if needed Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application Information not provided.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Project management of the transition Information not provided.
Prepare and or review reimbursement form Information not provided.
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Perform engineering study for new channel assignment and antenna development Information not provided.
Prepare request for Special Temporary Authorization 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 $51,495.00 $47,895.00 N/A $0.00 N/A
Total for all systems $3,094,130.00 $2,557,802.00 N/A $801,901.61 N/A
Other Expenses $51,495.00 $47,895.00 $0.00
MVPD Notification of Channel Change $2,500.00 $2,500.00 Attorney assistance in coordinating MVPD notification N/A N/A
Local Zoning $3,000.00 $3,000.00 need quote N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $8,000.00 N/A N/A N/A
Equipment Storage $30,500.00 $30,500.00 Estimate for 1 year of antenna storage. See attached Dielectric document. N/A N/A
Develop and air announcement of upcoming channel change $2,500.00 $2,500.00 Attorney review to ensure FCC compliance 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 $3,094,130.00 $2,557,802.00 $801,901.61

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.

Susan Triana

Sr. Accounting Manager, Projects


11/29/2017

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.

Susan Triana

Sr. Accounting Manager, Projects


11/29/2017

Attachments

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