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:
0000027185
FRN:
0003613825
Facility ID:
72145
Repack Channel:
42 (UHF)
Entity:
Broadcaster
Filing Status:
Submitted
Date Submitted:
01/16/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

WHDH-TV

Doing Business As: WHDH-TV

Paul Magnes

GOVERNMENT CENTER

7 BULFINCH PLACE

BOSTON, MA 02114

United States

+1 (617) 725-0710 pmagnes@whdh.com Trust

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

The Preparer is same as the reimbursement contact.

 

 

 

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan Install interim antenna/transmission line. Broadcast on interim antenna while tower structural work is completed. Install new (upgrade) Solid State Transmitter. Go on air with new Transmitter and main antenna during testing window.

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  
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 DCX Paragon
Year 2009
Type Inductive Output Tube
IOT Power Type Three
Description  
Power capacity 75 kw
Solid State Cooling  
Solid State Power Capacity  
Other Transmitter Type  

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Description of Use  
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Manufacturer
Model HPTV-PRLX-U33
Transmitter Type Solid state
IOT Power Type  
Other  
Power capacity  
Solid State Cooling Liquid
Solid State Power Capacity 53 kw
Other Transmitter Type  
Justification for New Transmitter Unlike with WHDH's existing Comark IOT Transmitter, the requested transmitter will permit WHDH to remain on air at full power during the transition

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 Yes
Description Electrician materials and labor to install transmitter
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 15 tons
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

System Design, Site Survey

Transmitter installation site survey

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 stacked
Antenna position in stack Middle
Polarization Horizontal
Type Slotted coaxial
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 1000.00 kW
Manufacturer
Model TFU-24GBH-R 06
Year 1998

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? No
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Type Class Full Power
Mounting Top-mount stacked
Antenna position in stack Top
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: 1000.00 kW
Manufacturer
Model TFU-28JTH/VP-R 06
Year 2017
Justification for New Antenna Current Main antenna cannot be retuned to new frequency

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 8 3/16 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

Feed Through Components

6-1/8" 75 OHM elbows, cut lengths, hangers, and transition to 8-3/16" 75 OHM to extend antenna input through support pole into tower top

Bottom Support Pole

Approximate 50' support pole and wedding cake adapter to support main antenna to maintain overall structure height

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: 1000.00 kW
Manufacturer
Model TFU-16WB
Year 2017
Justification for New Antenna Interim Antenna allows station to broadcast during replacement of Main antenna and during major tower structural modifications

Interim Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? No
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? N/A
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Broadband
Feed Line Size 6 1/8 inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

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 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 8 3/16 inches
Segment Length 19 ½ '
Other Segment Length
Number of parallel runs 1
Length 1045 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 8 3/16 inches
Segment Length 20'
Other Segment Length
Number of parallel runs 1
Length 1085 feet per run
Justification for New Transmission Line Current Transmission line will not work on new Frequency

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 Rigid
Diameter 6 1/8 inches
Segment Length 20'
Other Segment Length
Number of parallel runs 1
Length 910 feet per run
Justification for New Transmission Line To feed Interim Antenna required for transition

Interim Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Nitrogen Generator

N2-Gen TL-1050 for Interim and Main Transmission Lines

3' Waveguide

Custom Waveguide to connect Waveguide switch

Motorized Waveguide Switch

Waveguide Switch allows transmitter output to switch between interim and main antenna

Tower Equipment And Rigging Costs

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

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Owned
Is this tower consider Complex? No
Is this tower currently shared with any other stations? No
One or more FM, AM or TV radio broadcaster(s) N/A
Others Types of Users N/A
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1005862
Coordinates (NAD83) Latitude (NAD83) 42° 18' 41.0" N-
Longitude (NAD83) 071° 12' 58.0" W-
Overall Structure Height 1062.30 feet
Support Structure Height 1009.50 feet
Ground Elevation Above Mean Sea Level (AMSL) 108.60 feet
Structure Type other -
Tower Owner WHDH TV
Date Constructed 04/20/1962


Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Study needed for documented tower
Tower Reinforcements Please select whether tower reinforcements are needed: 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? 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 760
Explanation Internal project management. 760 hours anticipated
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 3
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 3
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers No
RF Field Engineering Services Comprehensive coverage verification via field study Yes
RF exposure measurements Yes
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

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

Other Expenses

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Other Expenses Not Listed

Information not provided.

Cost Information

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Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $1,897,100.00 $1,894,800.00 N/A $885,300.00 N/A
Total for all systems $4,668,404.25 $4,433,505.95 N/A $1,400,448.43 N/A
Primary Transmitter HPTV-PRLX-U33 $1,897,100.00 $1,894,800.00 $885,300.00
System Design, Site Survey $15,300.00 $15,300.00 N/A $15,300.00 N/A
15 Ton system $54,300.00 $53,000.00 N/A N/A N/A
Other Electrical Service: Electrician materials and labor to install transmitter $86,500.00 $86,500.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 52 - 61 kW $1,741,000.00 $1,740,000.00 N/A $870,000.00 N/A

Components

Actual Information Description File Name
System Design, Site Survey

Component Description:
System Design Site Survey Down Payment
Amount:
$2,000.00

Component Description:
System Design, Site Survey final balance
Amount:
$13,300.00
15 Ton system Information not provided.
Other Electrical Service: Electrician materials and labor to install transmitter Information not provided.
UHF - Liquid Cooled Solid State Transmitter 52 - 61 kW

Component Description:
Primary Transmitter 50% deposit due with order
Amount:
$870,000.00

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 $635,510.00 $567,736.00 N/A $241,225.20 N/A
Total for all systems $4,668,404.25 $4,433,505.95 N/A $1,400,448.43 N/A
Interim Antenna TFU-16WB $151,120.00 $133,641.00 $60,138.45
Side mount brackets for high power antennas (if not included in antenna base cost) $22,550.00 $10,312.00 N/A $4,640.40 N/A
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed) $13,300.00 $8,209.00 N/A $3,694.05 N/A
Sweep test of existing antenna $6,550.00 $6,400.00 N/A $2,880.00 N/A
UHF - High Power, Side Mount, basic slot antenna, 1000 kW input, horizontally polarized $108,720.00 $108,720.00 N/A $48,924.00 N/A
Primary Antenna TFU-28JTH/VP-R 06 $484,390.00 $434,095.00 $181,086.75
Bottom Support Pole $156,960.00 $156,960.00 N/A $70,632.00 N/A
Feed Through Components $24,530.00 $24,530.00 Transition from 8-3/16" 70 OHM to 6-1/8" 75 OHM increases costs $11,038.50 N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $281,500.00 $231,717.00 N/A $90,016.65 N/A
Sweep test of existing antenna $6,550.00 $6,400.00 N/A $2,880.00 N/A
Elbow complex, single channel, at antenna input, per 8 3/16. feedline (if needed) $14,850.00 $14,488.00 N/A $6,519.60 N/A

Components

Actual Information Description File Name
Side mount brackets for high power antennas (if not included in antenna base cost)

Component Description:
Antenna Mounting Brackets for Tapered Tower
Amount:
$4,640.40
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
Transition WR1500 X 6-50 UHF System Use Per Rev-E 013A77140
Amount:
$990.00

Component Description:
TRANS WR1500 X 6-50 CH35
Amount:
$990.00

Component Description:
Transition WR1500 X 8-75 CH35
Amount:
$1,714.05
Sweep test of existing antenna

Component Description:
Repack Sweep
Amount:
$2,880.00
UHF - High Power, Side Mount, basic slot antenna, 1000 kW input, horizontally polarized

Component Description:
Interim Antenna- UHF Broadband Side Mount
Amount:
$48,924.00
Bottom Support Pole

Component Description:
Bottom Support Pole
Amount:
$70,632.00
Feed Through Components

Component Description:
Feed Through Components
Amount:
$11,038.50
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
UHF High Power Top Mount Antenna
Amount:
$90,016.65
Sweep test of existing antenna

Component Description:
Repack Sweep
Amount:
$2,880.00
Elbow complex, single channel, at antenna input, per 8 3/16. feedline (if needed)

Component Description:
Elbow Complex-Single Channel
Amount:
$6,519.60

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 $578,851.25 $449,224.95 N/A $202,151.23 N/A
Total for all systems $4,668,404.25 $4,433,505.95 N/A $1,400,448.43 N/A
Interim Transmission Line $212,121.25 $205,553.75 $92,499.19
Rigid Transmission Line - copper, 6 1/8" $179,270.00 $172,702.50 N/A $77,716.12 N/A
Nitrogen Generator $18,273.25 $18,273.25 N/A $8,222.97 N/A
3' Waveguide $800.00 $800.00 N/A $360.00 N/A
Motorized Waveguide Switch $13,778.00 $13,778.00 N/A $6,200.10 N/A
Primary Transmission Line $366,730.00 $243,671.20 $109,652.04
Rigid Transmission Line - copper, 8 3/16" $366,730.00 $243,671.20 N/A $109,652.04 N/A

Components

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

Component Description:
Rigid Transmission Line-Copper 6-1/8" 50 OHM EIA - 800FT (830' V and 80' H)
Amount:
$72,147.37

Component Description:
T/L 6-50 EIA Length 15' To 20' Fixed FLG 1 End/Swivel FLG 1 End
Amount:
$5,568.75
Nitrogen Generator

Component Description:
Dew Point Alarm W/touch screen PLC Upgrade for N2-Gen Nitrogen Generator
Amount:
$2,459.25

Component Description:
Annual Filter Replacement Kit for N2-Gen Nitrogen Generator
Amount:
$42.19

Component Description:
Nitrogen Purity Sensor Sampling Kit for N2-Gen Nitrogen Generator
Amount:
$88.20

Component Description:
Regulator Kit W/low pressure alarm for N2-Gen Nitrogen Generator
Amount:
$365.63

Component Description:
Failure Alarm for N2-Gen Nitrogen Generator
Amount:
$67.05

Component Description:
Installation Plumbing Kit for N2-Gen Nitrogen Generator
Amount:
$67.05

Component Description:
Nitrogen Generator N2-Gen TL-1050. 110V, 15A
Amount:
$4,905.00

Component Description:
Portable Nitrogen Purity Sensor for N2-Gen Nitrogen Generator
Amount:
$228.60
3' Waveguide

Component Description:
W/G Kit WR1500 RF System Use for inside Building Non Pressurized Painted Black
Amount:
$360.00
Motorized Waveguide Switch

Component Description:
Switch WR1150 H Plane 115 VAC 60000
Amount:
$6,200.10
Rigid Transmission Line - copper, 8 3/16"

Component Description:
Rigid Transmission Line- Copper 8-3/16" 75 OHM EIA- 1020 FT (940' V and 80' H)
Amount:
$104,871.24

Component Description:
Transmission Line 8-75 EIA Length 15' to 20' Fixed FLG 1 END/ Swivel FLG 1 END
Amount:
$4,780.80

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 $1,241,300.00 $1,212,500.00 N/A $43,786.00 N/A
Total for all systems $4,668,404.25 $4,433,505.95 N/A $1,400,448.43 N/A
Primary Tower other $1,241,300.00 $1,212,500.00 $43,786.00
Structural engineering tower load study for well documented tower $12,300.00 $12,500.00 Complex self supporting tower. Structural analysis came in higher than $12,000.00 $12,500.00 N/A
Tall Tower (greater than 500') $205,000.00 $200,000.00 N/A N/A N/A
Serious tower reinforcement/modifications $1,024,000.00 $1,000,000.00 N/A $31,286.00 N/A

Components

Actual Information Description File Name
Structural engineering tower load study for well documented tower

Component Description:
Structural engineering tower load study for well documented tower down payment
Amount:
$5,250.00

Component Description:
Structural engineering tower load study for well documented tower progress payment
Amount:
$5,250.00

Component Description:
Structural engineering tower load study for well documented tower final payment
Amount:
$2,000.00
Tall Tower (greater than 500') Information not provided.
Serious tower reinforcement/modifications

Component Description:
Tower Structural Reinforcement materials
Amount:
$31,286.00

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 $264,245.00 $258,110.00 N/A $23,936.00 N/A
Total for all systems $4,668,404.25 $4,433,505.95 N/A $1,400,448.43 N/A
Outside Professional Services $264,245.00 $258,110.00 $23,936.00
Comprehensive coverage verification via field study, if needed $81,900.00 $80,000.00 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 $1,950.00 N/A
Prepare request for Special Temporary Authorization $4,605.00 $4,605.00 N/A $2,647.50 N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application $1,535.00 $1,500.00 N/A $2,617.50 I mistakenly assigned the wrong invoice to the aux construction permit component (029-03-0010)- that invoice should have been assigned here. it too was over the estimated costs- $1,860 vs. the estimate of $1,500. CTJC invoice is higher than the estimate
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,535.00 $1,500.00 N/A $0.00 N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application $2,050.00 $2,000.00 N/A $1,860.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,070.00 $3,000.00 N/A $1,620.00 N/A
Perform engineering study for new channel assignment and antenna development $7,170.00 $7,000.00 N/A $2,962.50 N/A
Project management of the transition $117,040.00 $114,000.00 N/A N/A N/A
Prepare and or review reimbursement form $2,560.00 $2,500.00 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 $3,811.00 Note- New attachment includes cover letter identifying the difference between the requested amount and the invoice as requested by the reviewer
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 - Prepare and File request for Special Temporary Authorization $10,755.00 $10,755.00 N/A $6,467.50 N/A
RF Exposure Measurements $20,500.00 $20,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Comprehensive coverage verification via field study, if needed Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Attorney Fees- Prepare and file FCC form 2100 (main) Construction Permit
Amount:
$1,950.00
Prepare request for Special Temporary Authorization

Component Description:
Additional Engineering information for FCC in support of STA request
Amount:
$547.50

Component Description:
Preparation of engineering in support of a Request for STA and waiver request to transition in Phase 7 instead of Phase 8
Amount:
$2,100.00
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application

Component Description:
Consulting Engineer prepare prepare and submit application for aux antenna construction permit
Amount:
$2,617.50
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application

Component Description:
Preparation of FCC Form 2100 Interim antenna construction permit
Amount:
$1,860.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Preparation of the engineering section, Schedule A, of FCC Form 2100 Construction Permit Application
Amount:
$1,620.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Performance of engineering studies for the new channel assignment and antenna development
Amount:
$2,962.50
Project management of the transition Information not provided.
Prepare and or review reimbursement form Information not provided.
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application

Component Description:
prepare and File Form 2100 Aux Antenna
Amount:
$238.50

Component Description:
Matter 320205.00208 draft and file aux antenna construction permit
Amount:
$2,502.50

Component Description:
FCC filing fee, Aux construction permit. Reimbursable costs 5/3/18
Amount:
$1,070.00
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
Prepare and File request for Special Temporary Authorization
Amount:
$397.50

Component Description:
Attorney Fees- Prepare and File request for Special Temporary Authority
Amount:
$4,445.50

Component Description:
Special Temporary Authorization Filing
Amount:
$1,624.50
RF Exposure Measurements Information not provided.

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $51,398.00 $51,135.00 N/A $4,050.00 N/A
Total for all systems $4,668,404.25 $4,433,505.95 N/A $1,400,448.43 N/A
Other Expenses $51,398.00 $51,135.00 $4,050.00
MVPD Notification of Channel Change $3,500.00 $3,500.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $5,000.00 $5,000.00 N/A N/A N/A
Equipment Storage $7,120.00 $7,120.00 N/A N/A N/A
Equipment Delivery and Handling Charges $9,000.00 $9,000.00 N/A $4,050.00 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $10,000.00 $10,000.00 N/A N/A N/A
Non-zoning permits $5,000.00 $5,000.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $333.00 $325.00 N/A N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
DTV Medical Facility Notification $11,250.00 $11,000.00 N/A N/A N/A

Components

Actual Information Description File Name
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges

Component Description:
Freight, Shipping, and Handling Main Antenna and Transmission Line
Amount:
$2,700.00

Component Description:
Interim Antenna and Transmission line Shipping and Handling to Site
Amount:
$1,350.00
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Non-zoning permits Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
DTV Medical Facility Notification Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $4,668,404.25 $4,433,505.95 $1,400,448.43

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.

James Edmund Shultis

Director of Engineering


01/16/2019

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.

James Edmund Shultis

Director of Engineering


01/16/2019

Attachments

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