Go to the Federal Communications Commission homepage at www.fcc.gov

FCC Form 399: Incentive Auction Relocation Reimbursement Fund System

Approved by OMB 3060-1178
Go to the Federal Communications Commission homepage at www.fcc.gov

(REFERENCE COPY - Not for submission)FCC Form 399: Incentive Auction Relocation Reimbursement Fund System

File Number:
0000028228
FRN:
0019509470
Facility ID:
81458
Repack Channel:
29 (UHF)
Entity:
Broadcaster
Filing Status:
Submitted
Date Submitted:
11/29/2018

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

NBC TELEMUNDO LICENSE LLC

Margaret L. Tobey

300 NEW JERSEY AVE, N.W.

SUITE 700

WASHINGTON, DC 20001

United States

+1 (202) 524-6401 MARGARET.TOBEY@NBCUNI.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

Margaret L Tobey

NBCUniversal, LLC

300 New Jersey Ave. NW

Suite 700

Washington, DC 20001

United States

+1 (202) 524-6401 Margaret.Tobey@nbcuni.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 Use current main antenna as interim, install new antenna in reserved space above it for new channel. Retune transmitter and filter for new channel. Replace no longer supported backup transmitter to use to stay on air during retuning.

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 Retune Existing
Use Primary (Main)
Description of Use  
Ownership Owned
Owner  
Site  
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer Rohde & Schwarz
Model THU9-24
Year 2014
Type Solid state
IOT Power Type  
Description  
Power capacity  
Solid State Cooling Liquid
Solid State Power Capacity 25 kw
Other Transmitter Type  

Primary Transmitter

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Retuning Transmitter Costs

Section Question Response
New IOT Tubes Number of Tubes (including accessories) needed  
New Mask Filter Power 30 kw
Other Power  
New Exciter Is a new exciter needed? No
Exciter Type

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
Rigid Conduit and Wiring No
Size
Length
Other Electrical Service No
Description  
HVAC Service Does the replacement transmitter require HVAC Service? No
Type
Size
Other Size  
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size
Channel 14 Costs Is an RF Consulting Engineer needed?
Is a channel 14 Mask Filer needed?
Is additional field engineering time needed?
Number of Days  

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Primary Transmitter Retune

Retuning, Filter, proofing and reroute of RF for primary transmitter

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 Used to maintain coverage during transiton
Ownership Owned
Owner  
Site  
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model Ultimate
Year 2001
Type Solid state
IOT Power Type  
Description  
Power capacity  
Solid State Cooling Liquid
Solid State Power Capacity 5 kw
Other Transmitter Type  

Auxiliary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Auxiliary (Backup)
Description of Use used to maintain coverage during transiton
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model THU9-12
Transmitter Type Solid state
IOT Power Type  
Other  
Power capacity  
Solid State Cooling Liquid
Solid State Power Capacity 19 kw
Other Transmitter Type  
Justification for New Transmitter Existing transmitter is no longer supported by vendor. See attached notice.

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) Yes
Power 150 kVA
Rigid Conduit and Wiring No
Size
Length
Other Electrical Service Yes
Description Installation costs outlined below include electrical work
HVAC Service Does the replacement transmitter require HVAC Service? No
Type
Size
Other Size  
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size
Channel 14 Costs Is an RF Consulting Engineer needed?
Is a channel 14 Mask Filer needed?
Is additional field engineering time needed?
Number of Days  

Auxiliary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Auxilary Transmitter Installation Costs

Installation, RF, and electrical work associated with auxiliary transmitter install

Antennas

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

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? Yes
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: 550.00 kW
Manufacturer
Model TFU-16JSC C165 SP
Year 2005

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? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? Yes
New Antenna Manufacturer and Type Class Full Power
Mounting Top-mount single
Antenna position in stack Not in Stack
Polarization Elliptical
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: 425.00 kW
Manufacturer
Model TFU-14ETT/VP-R 4C165
Year 2018
Justification for New Antenna Current antenna (ch 39) will not work on new channel (ch 29)

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
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 Mounting Equipment

Adapter and support pole required to mount antenna to tower.

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 Purchase New
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
Type Rigid
Diameter 6 1/8 inches
Segment Length 19 ¾ '
Other Segment Length
Number of parallel runs 1
Length 370 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Rigid
Diameter 6 1/8 inches
Segment Length 19 ½ '
Other Segment Length
Number of parallel runs 1
Length 400 feet per run
Justification for New Transmission Line Current line will not work on the channel (ch 29)

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Line Adapters

Line Adapters

Tower Equipment And Rigging Costs

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

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? No
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users No
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 1204586
Coordinates (NAD83) Latitude (NAD83) 33° 20' 03.2" N-
Longitude (NAD83) 112° 03' 40.5" W-
Overall Structure Height 395.99 feet
Support Structure Height 301.83 feet
Ground Elevation Above Mean Sea Level (AMSL) 2627.92 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner America 51, L.P.
Date Constructed 12/20/1998

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
81458 KTAZ DTV
26655 KPPX-TV DTV

Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Study needed for tower with candelabra
Tower Reinforcements Please select whether tower reinforcements are needed: Serious Reinforcements needed

Primary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower N/A
Helicopter Services Required Are helicopter services required? Yes

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 1040
Explanation Project oversight of transmitter install, electrical connectivity, tower work, and antenna installation. Additional time will be spent tracking financial and legal process and coordinating with other broadcasters.
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development No
Prepare engineering section of Form FCC Construction Permit Application No
For Auxiliary Facility N/A
For Main Facility N/A
Prepare engineering section of Form FCC License to Cover Application No
For Auxiliary Facility N/A
For Main Facility N/A
Prepare request for Special Temporary Authority No
Quantity N/A
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare request for Special Temporary Authority No
Quantity N/A
NEPA Section 106 environmental review 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 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 40
Justification Transmitter and RF design at ground level

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

Removal of interim RF system

Removal of interim RF system upon cutover

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 $1,072,879.45 $495,569.80 N/A $413,980.51 N/A
Total for all systems $3,255,234.13 $2,809,900.39 N/A $1,658,025.96 N/A
Primary Transmitter THU9-24 $215,739.29 $81,589.29 $0.00
Primary Transmitter Retune $81,589.29 $81,589.29 N/A N/A N/A
UHF and VHF - minor banding issues $102,400.00 $0.00 N/A N/A N/A
30 kW mask filter $31,750.00 $0.00 costs included in retune N/A N/A
Auxiliary Transmitter THU9-12 $857,140.16 $413,980.51 $413,980.51
Auxilary Transmitter Installation Costs $166,240.16 $166,240.16 N/A $166,240.16 N/A
Other Electrical Service: Installation costs outlined below include electrical work $0.00 $0.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW $666,000.00 $242,853.35 See attached quote from Rohde and Schwarz. Needed to remain on air during and after transmitter retune before final transition date. Replaces existing backup transmitter. 7.29% tax added $242,853.35 N/A
Transformer 3 phase/480v - 150 KVA $24,900.00 $4,887.00 N/A $4,887.00 N/A

Components

Actual Information Description File Name
Primary Transmitter Retune Information not provided.
UHF and VHF - minor banding issues Information not provided.
30 kW mask filter Information not provided.
Auxilary Transmitter Installation Costs

Component Description:
See line 2 of invoice
Amount:
$83,120.08

Component Description:
See 2nd item of invoice
Amount:
$83,120.08
Other Electrical Service: Installation costs outlined below include electrical work Information not provided.
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW

Component Description:
See line 1 of invoice and a proportional amount of the tax on line 3. See attached explanation of variance for remaining invoice amount.
Amount:
$242,853.35
Transformer 3 phase/480v - 150 KVA

Component Description:
Transformers for 1 cabinet DTV transmitter, 75KVA K13 480/400Y-230, plus AZ sales tax
Amount:
$4,887.00

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 $418,397.00 $306,852.00 N/A $218,602.82 N/A
Total for all systems $3,255,234.13 $2,809,900.39 N/A $1,658,025.96 N/A
Primary Antenna TFU-14ETT/VP-R 4C165 $418,397.00 $306,852.00 $218,602.82
Sweep test of existing antenna $6,550.00 $4,500.00 N/A $4,500.00 N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $281,500.00 $173,707.50 N/A $142,971.76 N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,000.00 $10,297.50 N/A $9,267.76 N/A
Antenna Mounting Equipment $118,347.00 $118,347.00 See lines 1 and 2 in attachment "KTAZ Antenna Additional Proposal", as well as the attachment "KTAZ Mounting Brackets" $61,863.30 N/A

Components

Actual Information Description File Name
Sweep test of existing antenna

Component Description:
See 3rd item of invoice
Amount:
$2,250.00

Component Description:
See 3rd item of invoice.
Amount:
$2,250.00
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
See line 1 of invoice. See attached explanation of variance for line 2.
Amount:
$71,485.88

Component Description:
See line 1 of invoice. See attached explanation of variance for line 2.
Amount:
$71,485.88
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
See line 3 of invoice.
Amount:
$4,633.88

Component Description:
See line 3 of invoice.
Amount:
$4,633.88
Antenna Mounting Equipment

Component Description:
Antenna mounting brackets
Amount:
$8,607.15

Component Description:
Custom mounting brackets to relocate antenna
Amount:
$8,607.15

Component Description:
See lines 1 and 2 of invoice.
Amount:
$44,649.00

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 $149,448.70 $143,281.40 N/A $97,161.36 N/A
Total for all systems $3,255,234.13 $2,809,900.39 N/A $1,658,025.96 N/A
Primary Transmission Line $149,448.70 $143,281.40 $97,161.36
Rigid Transmission Line - copper, 6 1/8" $78,800.00 $72,632.70 N/A $65,369.44 N/A
Line Adapters $70,648.70 $70,648.70 See lines 3-12 in attachment "KTAZ Antenna Additional Proposal" $31,791.92 N/A

Components

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

Component Description:
See line 4 of invoice.
Amount:
$32,684.72

Component Description:
See line 4 of invoice.
Amount:
$32,684.72
Line Adapters

Component Description:
See lines 3-12 of invoice.
Amount:
$31,791.92

Cost Information

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Tower Equipment and Rigging Costs

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $1,125,350.00 $1,439,593.21 N/A $751,160.00 N/A
Total for all systems $3,255,234.13 $2,809,900.39 N/A $1,658,025.96 N/A
Primary Tower TOWER $1,125,350.00 $1,439,593.21 $751,160.00
Short Tower (less than 500') $81,900.00 $397,418.40 Tower crew to install antenna and line (cost includes helicopter lift) $367,980.00 N/A
Serious tower reinforcement/modifications $1,024,000.00 $1,008,994.81 After structural study, more tower modifications necessary. Attached "KTAZ ITI Additional Charges", all tower mod & other charges not included in 1st Marsand proposal. PO to be revised, & Marsand to credit what was paid on "estimated charges" originally $350,000.00 N/A
Tower Helicopter Lift $0.00 $0.00 included in rigging costs N/A N/A
Structural engineering tower load study for a documented tower with candelabra $19,450.00 $33,180.00 Includes structural study and tower mods design study. $33,180.00 N/A

Components

Actual Information Description File Name
Short Tower (less than 500')

Component Description:
See "Tower crew antenna/line install" on invoice
Amount:
$183,990.00

Component Description:
See "Tower crew antenna/line install" on invoice
Amount:
$183,990.00
Serious tower reinforcement/modifications

Component Description:
See "estimated tower modifications" on invoice
Amount:
$175,000.00

Component Description:
See "estimated tower modifications" on invoice
Amount:
$175,000.00
Tower Helicopter Lift Information not provided.
Structural engineering tower load study for a documented tower with candelabra

Component Description:
Broadcast Tower Modification Design. Note that the line mentioning "Add KPPX" only refers to the fact that the vendor added consideration of the KPPX antenna to their designs. These costs are all related to KTAZ
Amount:
$4,660.00

Component Description:
Structural Analysis of an Existing Tower
Amount:
$4,250.00

Component Description:
Broadcast Tower Modification Design
Amount:
$9,864.00

Component Description:
Structural Analysis of existing tower (Add MW Dish)
Amount:
$2,000.00

Component Description:
Broadcast Tower Modification Design
Amount:
$6,576.00

Component Description:
Broadcast Tower Modification Design
Amount:
$4,500.00

Component Description:
Mount Analysis
Amount:
$1,330.00

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 $323,300.00 $266,250.00 N/A $126,188.87 N/A
Total for all systems $3,255,234.13 $2,809,900.39 N/A $1,658,025.96 N/A
Outside Professional Services $323,300.00 $266,250.00 $126,188.87
Additional Field Engineering Service, 40 Days $40,000.00 $40,000.00 Transmitter and RF design at ground level $10,000.00 N/A
RF Exposure Measurements $20,500.00 $20,000.00 N/A N/A N/A
Comprehensive coverage verification via field study, if needed $81,900.00 $30,000.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,095.00 $4,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,305.00 $2,250.00 N/A N/A N/A
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application $4,100.00 $4,000.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,120.00 $5,000.00 N/A $283.50 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,560.00 $2,500.00 N/A N/A N/A
Prepare and or review reimbursement form $2,560.00 $2,500.00 N/A $699.21 N/A
Project management of the transition $160,160.00 $156,000.00 N/A $115,206.16 N/A

Components

Actual Information Description File Name
Additional Field Engineering Service, 40 Days

Component Description:
Engineering site visit, inspection, measurements, drawing and planning for repack transmitter and RF installation, budgeting and planning.
Amount:
$10,000.00
RF Exposure Measurements Information not provided.
Comprehensive coverage verification via field study, if needed Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations 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

Component Description:
See lines 2, 3, and half of line 1, less 10% vendor discount.
Amount:
$245.70

Component Description:
See line 1 of invoice, less 10% vendor discount.
Amount:
$37.80
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form

Component Description:
See line 1 of invoice.
Amount:
$43.65

Component Description:
Review of Form 399
Amount:
$43.65

Component Description:
Review of Form 399
Amount:
$87.30

Component Description:
Review of Form 399
Amount:
$43.65

Component Description:
See lines 2-4 of invoice, less 10% vendor discount.
Amount:
$273.06

Component Description:
Additional information for Form 399.
Amount:
$113.40

Component Description:
See half of line 1, less 10% vendor discount.
Amount:
$94.50
Project management of the transition

Component Description:
October 2018 Project Management
Amount:
$6,000.00

Component Description:
See "Project Management" portion of invoice, itemized with completed work
Amount:
$21,246.30

Component Description:
Project Management Services
Amount:
$3,300.00

Component Description:
Tower elevation verification. Project status meeting participation, Coordination with Point B, KPPX antenna stack verification structural engineering review with Paul J Ford, Conference calls with w PJF and Project team.
Amount:
$617.50

Component Description:
Coordination with Ion/ KPPX and Paul J. Ford on tower modification plan and KTAZ transition plan
Amount:
$699.20

Component Description:
Project Management Services
Amount:
$6,630.00

Component Description:
Coordination with Ion/ KPPX and Paul J. Ford on tower modification plan and KTAZ transition plan
Amount:
$974.70

Component Description:
Jan 2018 Project Management
Amount:
$14,025.00

Component Description:
Project Management Services
Amount:
$348.95

Component Description:
Project Management Services
Amount:
$4,290.00

Component Description:
Coordination with Ion/ KPPX and Paul J. Ford on tower modification plan and KTAZ transition plan
Amount:
$1,299.60

Component Description:
Project Management Services
Amount:
$2,145.00

Component Description:
Project status meeting participation, Coordination with PointB, KPPX antenna stack verification structuralengineering review with Paul J Ford.
Amount:
$600.00

Component Description:
Permitting follow-up with City of Phoenix.
Amount:
$308.75

Component Description:
Project management
Amount:
$10,050.00

Component Description:
Project Management Services
Amount:
$2,145.00

Component Description:
Project Management Services
Amount:
$3,510.00

Component Description:
Permitting follow-up with City of Phoenix. Tower elevation verification. Project status meeting participation.
Amount:
$760.00

Component Description:
April 2018 project management and travel expenses, see attached receipts
Amount:
$8,859.86

Component Description:
See "Project Management" portion of invoice, itemized with completed work
Amount:
$21,246.30

Component Description:
Project management
Amount:
$6,150.00

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 $165,858.98 $158,353.98 N/A $50,932.40 N/A
Total for all systems $3,255,234.13 $2,809,900.39 N/A $1,658,025.96 N/A
Other Expenses $165,858.98 $158,353.98 $50,932.40
Equipment Storage $2,500.00 $2,500.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $50,956.99 $50,956.99 Disposal of Thales Auxiliary Transmitter and associated equipment $47,182.40 N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
Local Zoning $1,500.00 $1,500.00 N/A N/A N/A
DTV Medical Facility Notification $11,250.00 $3,750.00 N/A $3,750.00 N/A
Non-zoning permits $1,500.00 $1,500.00 N/A N/A N/A
BLM or NFS Coordination $0.00 $0.00 N/A N/A N/A
Equipment Delivery and Handling Charges $5,000.00 $5,000.00 antenna shipment and delivery N/A N/A
Develop and air announcement of upcoming channel change $30,000.00 $30,000.00 N/A N/A N/A
MVPD Notification of Channel Change $12,000.00 $12,000.00 N/A N/A N/A
Removal of interim RF system $50,956.99 $50,956.99 N/A N/A N/A

Components

Actual Information Description File Name
Equipment Storage Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
See 1st item of invoice
Amount:
$23,591.20

Component Description:
See 1st item of invoice
Amount:
$23,591.20
FCC Filing Fees - Special Temporary Authorization request Information not provided.
Local Zoning Information not provided.
DTV Medical Facility Notification

Component Description:
Medical Notification Mailing
Amount:
$3,750.00
Non-zoning permits Information not provided.
BLM or NFS Coordination Information not provided.
Equipment Delivery and Handling Charges Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
MVPD Notification of Channel Change Information not provided.
Removal of interim RF system Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $3,255,234.13 $2,809,900.39 $1,658,025.96

Construction Status

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Question Response
Is construction complete? 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.

Margaret L Tobey

Assistant Secretary


11/29/2018

Certification

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Section Question Response
Submission of Actual Cost Documentation 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 and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity acknowledges that all certifications and attached documentation are considered material.

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

  3. 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).

  4. 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.

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

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

  7. 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.

Margaret L Tobey

Assistant Secretary


11/29/2018

Attachments

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