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:
22108
Service:
DTV
Call Sign:
WFWA
Channel:
18 (UHF)
File Number:
0000027861
FRN:
0007158843
Date Submitted:
12/03/2018

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

FORT WAYNE PUBLIC TELEVISION, INC.

Doing Business As: FORT WAYNE PUBLIC TELEVISION, INC.

2501 EAST COLISEUM BOULEVARD

FORT WAYNE, IN 46805

United States

+1 (260) 484-8839 brucehaines@wfwa.org Not-for-Profit

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

Robert Gehman

ConsultingEngineer

Kessler and Gehman Associates, Inc.

Robert Gehman

507 NW 60 Street

Suite D

Gainesville, FL 32607

United States

+1 (352) 332-3157 bob@kesslerandgehman.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 Map & analyze tower; modify if needed. Replace transmitter and antenna. Acquire interim antenna system to keep station on air while replacing antenna and for the duration of the phase. See attached Transition Plan.

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 DTT5CSWU
Year 2013
Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power Capacity 9.6 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 TBD
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 10 kW
Justification for New Transmitter Manufacturer of existing transmitter is out of business and no support is available for the existing transmitter.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) Yes
Transformer (480V) Yes
Power 150 kVA
Rigid Conduit and Wiring Yes
Size 3 inches
Length 100.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Additional Interior RF System

Additional Interior RF System for new transmitter

Standby Exciter and Switch

Standby Exciter with Automatic Change Over Switch

Antennas

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

Primary Antenna

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Add 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 this antenna currently shared with any other stations? No
Is this antenna directional? No
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: 152.8 kW
Manufacturer
Model TFU-28GTH-R 04 DC
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? No
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types 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/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 109.0 kW
Manufacturer
Model TBD
Year 2018
Justification for New Antenna The existing primary antenna is a single channel slotted coaxial which cannot accommodate the assigned channel.

Primary Antenna

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Other Antenna Costs

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

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? No
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: 152.8 kW
Manufacturer
Model TBD
Year 2018
Justification for New Antenna An interim antenna is necessary to keep station on the air during primary antenna replacement and for the duration of the assigned phase.

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

Information not provided.

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 770 feet per run

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Primary Line Sweep

Sweep line to confirm operation on new channel

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
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 770 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 4 1/16 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 775 feet per run
Justification for New Transmission Line A sweep was made of the existing 6-1/8" line, which failed. Station is replacing line with the smallest size that meets the power and attenuation requirements.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

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 Flexible Air
Diameter 3 inches
Segment Length N/A
Other Segment Length
Number of parallel runs 1
Length 550 feet per run
Justification for New Transmission Line An interim transmission line is necessary for the interim antenna to keep station on the air during primary antenna replacement and for the duration of the assigned phase.

Interim Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Owned
Is this tower consider Complex? 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 Yes
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 1030891
Coordinates (NAD83) Latitude (NAD83) 41° 06' 13.0" N-
Longitude (NAD83) 085° 11' 28.0" W-
Overall Structure Height 747.04 feet
Support Structure Height 695.53 feet
Ground Elevation Above Mean Sea Level (AMSL) 813.64 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner FORT WAYNE PUBLIC TELEVISION
Date Constructed 07/01/1988

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
59132 WAJI FM

Other Types of Users

Users
WINM
ATF
DEA
NOAA
INDDC
FBI

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: Major 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

Weather Delays

Delay charges caused by the tower crew not able to work due to inclement weather

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 183
Explanation It will be necessary to schedule and coordinate multiple vendors, complete progress reports, and update Schedule 399. 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 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 No
Additional Field Engineering Service Yes
Number of Days 22
Justification It will be necessary to survey the site, plan the equipment, develop specifications for purchasing, and oversee multiple vendor RF projects. Station does not have available personnel or personnel trained in such services.

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Other Engineering Services

Engineering services related to the repack not already included in predetermined 399 categories

Other Legal Services

Legal services related to the repack not already included in predetermined 399 categories

Other Expenses

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

Bank Fee

Increase and Renew Bank Line of Credit, plus estimate for Interest for a one year period

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 $728,450.00 $700,500.00 N/A $338,750.04 N/A
Total for all systems $2,305,354.00 $2,019,950.10 N/A $999,143.32 N/A
Primary Transmitter TBD $728,450.00 $700,500.00 $338,750.04
Standby Exciter and Switch $25,000.00 $25,000.00 N/A N/A N/A
Additional Interior RF System $140,000.00 $140,000.00 N/A N/A N/A
3" Rigid Conduit and Wiring (Cost per foot) $5,200.00 $4,900.00 N/A $1,460.00 N/A
Transformer 3 phase/480v - 150 KVA $25,550.00 $24,300.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW $494,500.00 $470,000.00 N/A $315,449.20 N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A $21,840.84 N/A

Components

Actual Information Description File Name
Standby Exciter and Switch Information not provided.
Additional Interior RF System Information not provided.
3" Rigid Conduit and Wiring (Cost per foot)

Component Description:
Extend existing concrete pad to accommodate transmitter heat exchanger. Revised to clarify WFWA is also known as PBS39
Amount:
$1,460.00
Transformer 3 phase/480v - 150 KVA Information not provided.
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW

Component Description:
GatesAir inv #US0318728 Primary TX pmt 3 UL20181127jgv1
Amount:
$108,675.74

Component Description:
GatesAir inv #TE10004590-2 Primary TX pmt 2 UL20181128jgv1
Amount:
$103,386.73

Component Description:
One third down payment for transmitter WFWA
Amount:
$103,386.73
Switchgear - industrial 800 amp

Component Description:
Hoagland inv #0018364 Electrical UL20181128jgv1
Amount:
$21,840.84

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 $492,270.00 $325,750.50 N/A $177,217.63 N/A
Total for all systems $2,305,354.00 $2,019,950.10 N/A $999,143.32 N/A
Interim Antenna TBD $226,240.00 $72,650.50 $27,550.50
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $5,000.00 N/A N/A N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $22,000.00 N/A 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
UHF - Lower Power Side Mount, One station antenna - medium power (50-200 kW), horizontally polarized $89,400.00 $13,437.50 ***System Notice: Estimate adjusted and locked because line has been superseded.*** $13,437.50 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $0.00 N/A
UHF - Lower Power Side Mount, One station antenna - medium power (50-200 kW), horizontally polarized $89,400.00 $14,113.00 ***System Notice: Estimate adjusted and locked because line has been superseded.*** $14,113.00 N/A
Primary Antenna TBD $266,030.00 $253,100.00 $149,667.13
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 N/A $3,125.00 N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized $247,000.00 $235,000.00 N/A $146,542.13 N/A

Components

Actual Information Description File Name
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.
UHF - Lower Power Side Mount, One station antenna - medium power (50-200 kW), horizontally polarized

Component Description:
Down Payment for Interim Antenna WFWA
Amount:
$13,437.50
Sweep test of existing antenna Information not provided.
UHF - Lower Power Side Mount, One station antenna - medium power (50-200 kW), horizontally polarized

Component Description:
Balance of purchase price to vendor for Interim Antenna, plus added shipping, WFWA
Amount:
$14,113.00
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) Information not provided.
Sweep test of existing antenna

Component Description:
Sweep tests, which are actually for the new primary antenna. WFWA
Amount:
$3,125.00
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized

Component Description:
Down payment for Primary Antenna WFWA
Amount:
$96,875.00

Component Description:
ERI inv #WFWA-TV-006 Antenna & line installation plus 1 gal aviation orange paint UL20181203jgv1
Amount:
$49,667.13

Component Description:
Dummy to Delete Component
Amount:
N/A

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 $148,750.00 $108,813.10 N/A $64,835.55 N/A
Total for all systems $2,305,354.00 $2,019,950.10 N/A $999,143.32 N/A
Interim Transmission Line $32,450.00 $30,800.00 $22,704.00
Flexible Air Transmission Line - dielectric, 3" $32,450.00 $30,800.00 N/A $22,704.00 N/A
Primary Transmission Line $6,250.00 $6,250.00 $6,250.00
Primary Line Sweep $6,250.00 $6,250.00 ***System Notice: Estimate adjusted and locked because line has been superseded.***Sweep needed to confirm acceptability of existing line on assigned channel. $6,250.00 N/A
Primary Transmission Line $110,050.00 $71,763.10 $35,881.55
Rigid Transmission Line - copper, 4 1/16" $110,050.00 $71,763.10 N/A $35,881.55 N/A

Components

Actual Information Description File Name
Flexible Air Transmission Line - dielectric, 3"

Component Description:
Interim Transmission Line
Amount:
$22,704.00
Primary Line Sweep

Component Description:
Sweep of existing primary line on post transition channel 18
Amount:
$6,250.00
Rigid Transmission Line - copper, 4 1/16"

Component Description:
50% down payment of the new primary line equipment and materials
Amount:
$35,881.55

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 $660,300.00 $627,500.00 N/A $339,489.79 N/A
Total for all systems $2,305,354.00 $2,019,950.10 N/A $999,143.32 N/A
Primary Tower TOWER $660,300.00 $627,500.00 $339,489.79
Tall Tower (greater than 500') $210,500.00 $200,000.00 N/A $99,525.15 N/A
Weather Delays $2,500.00 $2,500.00 N/A $2,500.00 N/A
Major tower reinforcement/modifications $421,000.00 $400,000.00 N/A $226,714.64 N/A
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 $10,750.00 N/A

Components

Actual Information Description File Name
Tall Tower (greater than 500')

Component Description:
Down payment for Primary Antenna Installation WFWA
Amount:
$58,022.65

Component Description:
50% down payment for the installation of new primary transmission line
Amount:
$41,502.50
Weather Delays

Component Description:
Charges for tower crew due to delays caused by inclement weather
Amount:
$2,500.00
Major tower reinforcement/modifications

Component Description:
ERI inv #WFWA-TV-007 Tower reinforcements & modifications UL20181203jgv1
Amount:
$107,253.64

Component Description:
Down Payment for Tower Modification services
Amount:
$108,836.00

Component Description:
Tower Reinforcing Analysis and Design WFWA
Amount:
$4,500.00

Component Description:
Geotechnical survey and report for tower foundation analysis WFWA
Amount:
$6,125.00
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study

Component Description:
Balance due for Tower Structural Analysis. See WFWA Structural Analysis - Quote, attached.
Amount:
$2,000.00

Component Description:
50 percent down payment for Structural Analysis and Report. See WFWA Structural Analysis - Quote, attached.
Amount:
$2,000.00

Component Description:
Tower Mapping and Assessment
Amount:
$6,750.00

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 $202,034.00 $184,386.50 N/A $70,330.82 N/A
Total for all systems $2,305,354.00 $2,019,950.10 N/A $999,143.32 N/A
Outside Professional Services $202,034.00 $184,386.50 $70,330.82
Other Engineering Services $20,000.00 $20,000.00 N/A $8,187.50 N/A
Additional Field Engineering Service, 22 Days $24,000.00 $24,000.00 N/A $6,934.98 N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A $33,486.84 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 $675.00 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 $0.00 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A $0.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $2,095.00 See WFWA_KGA_Service_Purchase_order for list of fixed fees.
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 request for Special Temporary Authorization $2,050.00 $1,686.50 A legal services invoice for STA was inadvertently included in this category, which caused the amount to be exceeded. $1,686.50 Invoice 28037 for legal services was inadvertently entered here, which added to the cost.
ASR modification (prepare FCC Form 854) $2,105.00 $2,000.00 N/A $425.00 N/A
Other Legal Services $10,000.00 $10,000.00 N/A $2,937.50 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $3,500.00 See WFWA_KGA_Service_Purchase_order for list of fixed fees.
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A $151.50 N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $2,500.00 N/A
Project management of the transition $28,914.00 $17,450.00 N/A $7,751.00 N/A

Components

Actual Information Description File Name
Other Engineering Services

Component Description:
Engineering services related to preparation of 399 actual cost invoices and RF design
Amount:
$8,187.50
Additional Field Engineering Service, 22 Days

Component Description:
TPO calculations, layout of transmitter and RF system for WFWA
Amount:
$2,400.00

Component Description:
On Site Equipment Inv and Facility Survey
Amount:
$3,934.98

Component Description:
RF Field Engineering Services, Design of transmitter facilities
Amount:
$600.00

Component Description:
On Site Equipment Inventory and Facilities survey WFWA
Amount:
$3,934.98
Comprehensive coverage verification via field study, if needed

Component Description:
Field Services for WFWA
Amount:
$3,000.00

Component Description:
RF Field Engineering Services
Amount:
$30,486.84
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase

Component Description:
Services related to the preparation of FAA 7460-2
Amount:
$125.00

Component Description:
KGA inv #949-11 FAA 7460-1 filing UL20181128jgv1
Amount:
$550.00
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 - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Form 2100
Amount:
$145.50
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Engineering section of Form FCC Construction Permit Application Main Facility WFWA
Amount:
$2,000.00

Component Description:
Form 2100
Amount:
$95.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare request for Special Temporary Authorization

Component Description:
Planning for STA
Amount:
$151.50

Component Description:
Engineering for STA for WFWA
Amount:
$1,535.00
ASR modification (prepare FCC Form 854)

Component Description:
Preparation and filing of ASR
Amount:
$425.00
Other Legal Services

Component Description:
Other legal services related to the repack of WFWA
Amount:
$2,338.50

Component Description:
Other legal services related to the repack of WFWA
Amount:
$599.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Engineering study for new channel assignment and antenna development WFWA
Amount:
$3,500.00
Address transition timing and coordination issues w/ other stations and wireless

Component Description:
Timing issues related to early transition under T-Mobile agreement
Amount:
$151.50
Prepare and or review reimbursement form

Component Description:
Outside Professional Services and Prepare and Review FCC Form 399 for reimbursement
Amount:
$2,500.00
Project management of the transition

Component Description:
Legal Billing - Progress
Amount:
$1,568.00

Component Description:
Outside Project Management Services, Form 387 Progress Report 4Q2017
Amount:
$225.00

Component Description:
Legal - Re Filing Form 399
Amount:
$1,967.50

Component Description:
Legal advice related to Quarterly progress report
Amount:
$50.50

Component Description:
Legal consultation related to Quarterly Reports for WFWA
Amount:
$50.50

Component Description:
Outside Project Management Services, Form 387 Progress Report
Amount:
$300.00

Component Description:
Review FCC channel assignment and Form 1876
Amount:
$101.00

Component Description:
Legal presentation relating to the FCC reimbursement process
Amount:
$404.00

Component Description:
Email regarding FCC webinar
Amount:
$50.50

Component Description:
Email regarding FCC Auction Closing
Amount:
$50.50

Component Description:
Legal services related to reimbursements
Amount:
$353.50

Component Description:
Review Correspondence re filing date.
Amount:
$39.00

Component Description:
KGA inv #949-25 Form 387 2018 Q2 UL20181116jgv1
Amount:
$150.00

Component Description:
Email regarding TV incentive auction
Amount:
$50.50

Component Description:
Review FCC Public Notice
Amount:
$56.00

Component Description:
Email regarding WFWA channel reassignment
Amount:
$202.00

Component Description:
FCC construction permit
Amount:
$468.00

Component Description:
Prepare and file form 387 progress report WFWA
Amount:
$225.00

Component Description:
Review FCC Procedures
Amount:
$56.00

Component Description:
Legal services - Review Public Notice on reimbursement
Amount:
$112.00

Component Description:
Legal services - announcing the FCC site visit audits
Amount:
$56.00

Component Description:
Review FCC Public Notice
Amount:
$56.00

Component Description:
Review FCC Decision
Amount:
$56.00

Component Description:
Outside Project Management Services, Form 399 Actual Cost information for WFWA
Amount:
$300.00

Component Description:
Review and email re FCC Public Notice
Amount:
$56.00

Component Description:
Project management and preparation and submission of From 387 for 4Q2017 WFWA
Amount:
$1,005.00

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 $73,550.00 $73,000.00 N/A $8,519.49 N/A
Total for all systems $2,305,354.00 $2,019,950.10 N/A $999,143.32 N/A
Other Expenses $73,550.00 $73,000.00 $8,519.49
MVPD Notification of Channel Change $2,000.00 $2,000.00 Research and notify MVPDs of the channel change carrying station programming $125.00 N/A
Develop and air announcement of upcoming channel change $0.00 $0.00 N/A N/A N/A
Equipment Storage $10,000.00 $10,000.00 N/A $434.09 N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A $5,247.50 N/A
Non-zoning permits $5,000.00 $5,000.00 Local building permits for electrical work and tower modification work. N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $15,000.00 $15,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $25,000.00 $25,000.00 Shipping from factory to site for transmitter, primary antenna and interim antenna system. $1,212.90 N/A
Bank Fee $5,000.00 $5,000.00 Item does not have a predetermined cost $1,500.00 N/A

Components

Actual Information Description File Name
MVPD Notification of Channel Change

Component Description:
Review of MVPD notifications
Amount:
$125.00
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage

Component Description:
Storage of antenna and tower parts during rigging and tower modification work for WFWA
Amount:
$434.09
DTV Medical Facility Notification

Component Description:
Medical Facility Notifications for WFWA
Amount:
$3,310.00

Component Description:
Review of Medical notifications
Amount:
$125.00

Component Description:
Preparation and distribution of Medical notifications and certification. Corrected Inv number.
Amount:
$1,812.50
Non-zoning permits Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Equipment Delivery and Handling Charges

Component Description:
Freight charges for shipping the Interim transmission line.
Amount:
$531.59

Component Description:
Offloading and delivery of antenna for WFWA
Amount:
$120.00

Component Description:
Freight for Interim Transmission Line
Amount:
$561.31
Bank Fee

Component Description:
The is the amount of a debit memo to pay the bank fee for WFWA
Amount:
$1,500.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $2,305,354.00 $2,019,950.10 $999,143.32

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.

Jeffrey C Gehman

Engineering Associate


12/03/2018

Certification

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Section Question Response
Submission of Actual Cost Documentation Statements

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

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

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

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

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

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

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

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

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

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

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

Jeffrey C Gehman

Engineering Associate


12/03/2018

Attachments

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