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:
55644
Service:
DTV
Call Sign:
KYTX
Channel:
15 (UHF)
File Number:
0000027987
FRN:
0001569110
Date Submitted:
05/21/2018

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

LSB BROADCASTING, INC.

Law Department

TEGNA, Inc.

7950 Jones Branch Drive

McLean, VA 22107

United States

+1 (703) 873-6600 LAWDEPT@TEGNA.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

Jeffrey Johnson

TEGNA, Inc.

TEGNA, Inc.

Jeffrey Johnson

TEGNA, Inc.

7950 Jones Branch Drive

McLean, VA 22102

United States

+1 (703) 873-6736 jsjohnson@tegna.com

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan The station will be reusing its existing antenna. We will need to build an interim facility to maintain service during the transition while the main antenna is tested on its new channel and throughout duration of phase.

Transmitters

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

Auxiliary Transmitter

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Add Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Auxiliary (Backup)
Description of Use Lower power Auxiliary transmitter
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 Ranger CZ 100
Year 2004
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1 kW

Auxiliary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Auxiliary (Backup)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model UAXTE 2R37
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1.2 kW
Justification for New Transmitter The current low power Ranger cannot be re-tuned and is no longer supported.

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 Yes
Size 2 inches
Length 100.0 feet
Other Electrical Service Yes
Description Additional electrical services required for transmitter installation.
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Auxiliary Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

Primary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model Innovator HX
Year 2009
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 18 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? No
Manufacturer
Model ULXTE-24
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 16.1 kW
Justification for New Transmitter Transmitter cannot be re-tuned. Station has excess of 10% TPO headroom & is eligible for 1-Step-Up Allowance. Reimbursable TPO is 11.4 kW based on initial 90-day filing CP. This would require a ULXTE-20. 1-Step-Up is ULXTE-24 and is reimbursable.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring Yes
Size 3 inches
Length 100.0 feet
Other Electrical Service Yes
Description Additional electrical services required for transmitter installation, including heat exchangers, transformers, cooling pumps, etc.
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 100.0 square feet
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

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 Retune Existing
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 Top 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: 640.0 kW
Manufacturer Dielectric
Model TUD-32UDA-3/48SP
Year 2004

Primary Antenna

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Adjustment to Existing Antenna

Section Question Response
Sweep Test of Existing Antenna Do you need a sweep test of existing antenna? Yes

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

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

Interim Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Type Class 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: 640.0 kW
Manufacturer
Model TFU-24DSC 3BP260
Year 2018
Justification for New Antenna Interim antenna required while station is testing new channel on main antenna. Pre-transition station cannot go off the air while station and MVPDs conduct tests.

Interim Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? S
Feed Line Size 6 1/8 inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for an antenna? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? Yes
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Interim Antenna

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Other Antenna Cost Not Listed

Name Description

Shipping

$6,800

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 7 3/16 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1400 feet per run

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

TX Line Sweep

Sweep required to verify post-transition channel measures well on existing line.

Interim Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Interim
Description of Use N/A
Change Type Purchase New
Type Rigid
Diameter 6 1/8 inches
Segment Length 20'
Other Segment Length
Number of parallel runs 1
Length 1400 feet per run
Justification for New Transmission Line Line for interim antenna at full power.

Interim Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

TX Line Sweep

Sweep required to verify post-transition channel measures well on new line.

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? No
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1024425
Coordinates (NAD83) Latitude (NAD83) 31° 54' 21.0" N-
Longitude (NAD83) 095° 05' 06.0" W-
Overall Structure Height 1585.94 feet
Support Structure Height 1582.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 331.03 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner KTVK, Inc.
Date Constructed 05/15/2004


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 undocumented/poorly documented tower
Tower Reinforcements Please select whether tower reinforcements are needed: Minor Reinforcements needed

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 300
Explanation It will be necessary to schedule and coordinate multiple vendors, complete progress reports, and update Schedule 399s. Station does not have available personnel or personnel trained in project management for such complex projects.
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 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 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 1
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 Yes
Number of Days 10
Justification $2,500 per site visit including expenses x 10 days. It is necessary to survey the site, plan the equipment, develop specifications for purchasing, & oversee multiple vendor RF projects. Station does not have available personnel trained in such services.

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Pre filling site review

Services to have a third party to review sites prior to 399 filling.

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning Yes
Non-zoning permits Yes
BLM or NFS Coordination No
FCC Construction Permit Minor Change No
FCC License to Cover Application Yes
FCC Special Temporary Authority Application 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

Internal labor

Local and Corporate labor

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 $892,800.00 $817,008.25 N/A $42,304.13 N/A
Total for all systems $2,980,981.00 $2,465,765.55 N/A $312,929.09 N/A
Primary Transmitter ULXTE-24 $739,200.00 $704,900.00 $0.00
Other -- Building Addition Size: 100.0 $25,000.00 $25,000.00 New pad required for heat exchangers, transformers, pumps, etc. Equipment must also be shielded. N/A N/A
3" Rigid Conduit and Wiring (Cost per foot) $5,200.00 $4,900.00 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: Additional electrical services required for transmitter installation, including heat exchangers, transformers, cooling pumps, etc. $25,000.00 $25,000.00 Additional electrical services required for transmitter installation, including heat exchangers, transformers, cooling pumps, etc. N/A N/A
Auxiliary Transmitter UAXTE 2R37 $153,600.00 $112,108.25 $42,304.13
Other Electrical Service: Additional electrical services required for transmitter installation. $25,000.00 $25,000.00 Additional electrical services required for transmitter installation. N/A N/A
2" Rigid Conduit and Wiring (Cost per foot) $2,600.00 $2,500.00 N/A N/A N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $84,608.25 N/A $42,304.13 N/A

Components

Actual Information Description File Name
Other -- Building Addition Size: 100.0 Information not provided.
3" Rigid Conduit and Wiring (Cost per foot) Information not provided.
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW Information not provided.
Other Electrical Service: Additional electrical services required for transmitter installation, including heat exchangers, transformers, cooling pumps, etc. Information not provided.
Other Electrical Service: Additional electrical services required for transmitter installation. Information not provided.
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
Inv JW30004289-DP KYTX UAXTE-2R37 Aux transmitter filter RF accessories 50 percent down payment UL20180427jg v1
Amount:
$42,304.13

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 $755,940.00 $354,341.30 N/A $47,841.30 N/A
Total for all systems $2,980,981.00 $2,465,765.55 N/A $312,929.09 N/A
Interim Antenna TFU-24DSC 3BP260 $488,310.00 $334,741.30 $47,841.30
Shipping $6,800.00 $6,800.00 N/A N/A N/A
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $5,000.00 Per Widelity estimate N/A N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $22,000.00 Per Widelity estimate N/A N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $11,700.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 Per Dielectric N/A N/A
UHF - High Power, Side Mount, basic slot antenna, 640 kW input, directional,, horizontally polarized $235,000.00 $235,000.00 Originally planned on a TFU-WB interim antenna; however, the TFU-WB cadioid will exceed the licensed peanut. Contacting Dielelctric for options. N/A N/A
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed) $9,570.00 $7,408.80 ***System Notice: Estimate adjusted and locked because line has been superseded.*** $7,408.80 N/A
UHF - Lower Power Side Mount, One station - 200-500 kW, horizontally polarized $189,500.00 $40,432.50 ***System Notice: Estimate adjusted and locked because line has been superseded.*** $40,432.50 N/A
Primary Antenna TUD-32UDA-3/48SP $267,630.00 $19,600.00 $0.00
Elbow complex, single channel, at antenna input, per 7 3/16. feedline (if needed) $13,900.00 $13,200.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized $247,000.00 $0.00 Existing antenna to be repurposed N/A N/A

Components

Actual Information Description File Name
Shipping Information not provided.
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) Information not provided.
Side mount brackets for high power antennas (if not included in antenna base cost) Information not provided.
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) Information not provided.
Sweep test of existing antenna Information not provided.
UHF - High Power, Side Mount, basic slot antenna, 640 kW input, directional,, horizontally polarized Information not provided.
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed)

Component Description:
Inv MAN00314 KYTX Elbow Complex 45 percent payment 2 UL20180426jg v1
Amount:
$3,704.40

Component Description:
Inv MAN00226 KYTX Elbow Complex 45 percent down payment UL20180426jg v1
Amount:
$3,704.40
UHF - Lower Power Side Mount, One station - 200-500 kW, horizontally polarized

Component Description:
Inv MAN00314 KYTX Aux antenna 45 percent payment 2 UL20180426jg v1
Amount:
$20,216.25

Component Description:
Inv MAN00226 KYTX Aux antenna 45 percent down payment UL20180426jg v1
Amount:
$20,216.25
Elbow complex, single channel, at antenna input, per 7 3/16. feedline (if needed) Information not provided.
Sweep test of existing antenna Information not provided.
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized 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 $295,600.00 $281,600.00 N/A $222,783.66 N/A
Total for all systems $2,980,981.00 $2,465,765.55 N/A $312,929.09 N/A
Interim Transmission Line $289,200.00 $275,200.00 $222,783.66
Rigid Transmission Line - copper, 6 1/8" $282,800.00 $268,800.00 N/A $222,783.66 N/A
TX Line Sweep $6,400.00 $6,400.00 N/A N/A N/A
Primary Transmission Line $6,400.00 $6,400.00 $0.00
TX Line Sweep $6,400.00 $6,400.00 N/A N/A N/A

Components

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

Component Description:
Inv MAN00314 KYTX Transmission line 45 percent payment 2 UL20180426jg v1
Amount:
$111,391.83

Component Description:
Inv MAN00226 KYTX Transmission line 45 percent down payment UL20180426jg v1
Amount:
$111,391.83
TX Line Sweep Information not provided.
TX Line Sweep 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 $394,800.00 $375,000.00 N/A $0.00 N/A
Total for all systems $2,980,981.00 $2,465,765.55 N/A $312,929.09 N/A
Primary Tower TOWER $394,800.00 $375,000.00 $0.00
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $25,000.00 N/A N/A N/A
Minor tower reinforcement/modifications $158,000.00 $150,000.00 N/A N/A N/A
Tall Tower (greater than 500') $210,500.00 $200,000.00 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 $236,780.00 $226,750.00 N/A $0.00 N/A
Total for all systems $2,980,981.00 $2,465,765.55 N/A $312,929.09 N/A
Outside Professional Services $236,780.00 $226,750.00 $0.00
Pre filling site review $20,000.00 $20,000.00 N/A N/A N/A
Additional Field Engineering Service, 10 Days $25,000.00 $25,000.00 $2,500 per site visit including expenses x 10 days. It is necessary to survey the site, plan the equipment, develop specifications for purchasing, & oversee multiple vendor RF projects. Station does not have available personnel trained in such services. N/A N/A
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A N/A N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase $2,105.00 $2,000.00 N/A N/A N/A
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 $3,680.00 $3,500.00 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
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $2,050.00 $1,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A N/A N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A N/A N/A
Project management of the transition $47,400.00 $45,000.00 It will be necessary to schedule and coordinate multiple vendors, complete progress reports, and update Schedule 399s. Station does not have available personnel or personnel trained in project management for such complex projects. N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A

Components

Information not provided.

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $137,431.00 $136,866.00 N/A $0.00 N/A
Total for all systems $2,980,981.00 $2,465,765.55 N/A $312,929.09 N/A
Other Expenses $137,431.00 $136,866.00 $0.00
Internal labor $22,751.00 $22,751.00 N/A N/A N/A
MVPD Notification of Channel Change $6,000.00 $6,000.00 informational campaign to notify all MVPD's of upcoming changes and testing dates. N/A N/A
Develop and air announcement of upcoming channel change $6,000.00 $6,000.00 Produce informational spot to alert the public of upcoming changes N/A N/A
Equipment Storage $15,000.00 $15,000.00 six months storage on 2 flatbed trailers N/A N/A
Equipment Delivery and Handling Charges $25,000.00 $25,000.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $25,000.00 $25,000.00 N/A N/A N/A
Non-zoning permits $25,000.00 $25,000.00 N/A N/A N/A
Local Zoning $600.00 $600.00 N/A 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

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $2,980,981.00 $2,465,765.55 $312,929.09

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.

William T. Godfrey , Jr. .

Consulting Engineers


05/21/2018

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