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:
54443
Service:
DTV
Call Sign:
WRFB
Channel:
30 (UHF)
File Number:
0000028155
FRN:
0001729847
Date Submitted:
09/15/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

Telecinco, Inc.

Jose A. Vizcarrondo

P.O. Box 43

Mayaguez, PR 00681

United States

+1 (787) 831-0071 Lrosa@telecincoinc.com Corporation

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

Alejandro Luciano , PE .

Repack Coordinator

Alejandro Luciano PE

Alejandro Luciano PE

PO Box 194528

SAN JUAN, PR 00919

United States

+1 (787) 717-6984 aluciano@aluciano.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 File for construction permit, construction of Interim Facility, Tower Modifications, facilities maximization, Antenna, transmission line and transmitter installation, RF systems sweep and test, transition to new channel.

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 AFFINITY
Year 2008
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 2.0 kW

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Manufacturer
Model Maxiva ULXTE-24
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 16.1 kW
Justification for New Transmitter Existing transmitter on channel 51 is not re-tunable to channel 30.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring Yes
Size 2 inches
Length 40.0 feet
Other Electrical Service Yes
Description UPS for Above transmitter
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? Yes
Size 200.0 square feet
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

SURGE PROTECTOR

PARALLEL SURGE PROTECTOR FOR 3PH WYE

Interim Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Interim
Description of Use N/A
Change Type Purchase
Manufacturer
Model SLIM4_03_UHF_SD_PCM-4P-PPT
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2.5 kW
Justification for New Transmitter An small interim transmitter is needed to remain on the air while the existing is removed.

Interim Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring Yes
Size 2 inches
Length 40.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 5 tons
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
Inside RF System Is an additional interior RF system required to support this interim transmitter? No

Interim Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

Antennas

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

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change 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: 16.0 kW
Manufacturer
Model ATC-24H6C2-51
Year 2008

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? Yes
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization 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: 250.0 kW
Manufacturer
Model TFU-24DSBW/VP-R W (C)
Year 2018
Justification for New Antenna The existing antenna on Channel 51 can't be retuned to new repack channel 30.

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? Yes
Type New
Number of channels supported 2
Frequencies of channels supported RF channel
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? No
Elbow Complex Do you require the separate purchase of the Elbow Complex? No
Broadband or Single Channel? N/A
Feed Line Size N/A
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? Yes
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Enter a list of RF channel numbers.

RF Channel Number
29
30

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

Interim Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? Yes
New Antenna Manufacturer and Type Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Other
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 Broadband Panel Array
ERP: 16.0 kW
Manufacturer
Model 75010013
Year 2018
Justification for New Antenna An interim antenna is needed to remain on the air while the repack facilities are built

Interim Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? No
Broadband or Single Channel? N/A
Feed Line Size N/A
Side Mount Brackets Do you require the separate purchase of side mount brackets for an 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

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 Flexible Air
Diameter 3 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 275 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? Yes
Type Flexible Air
Diameter 4 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 300 feet per run
Justification for New Transmission Line The existing line will be used to remain on the air while the new facilities on channel 30 are built.

Primary 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 Construct New
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? No
One or more FM, AM or TV radio broadcaster(s) N/A
Others Types of Users N/A
Is tower documented for structural analysis? No
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1043939
Coordinates (NAD83) Latitude (NAD83) 18° 16' 37.0" N-
Longitude (NAD83) 065° 51' 11.0" W-
Overall Structure Height 333.99 feet
Support Structure Height 300.19 feet
Ground Elevation Above Mean Sea Level (AMSL) 2411.39 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner ESTRADA, JORGE L DBA = COMMUNICATIONS TOWER SERVICES
Date Constructed 01/01/1987


Primary Tower

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Tower Construction Costs

Section Question Response
Construct New Tower Use Primary (Main)
Description of Use N/A
Is this a request for upgraded equipment? No
Height 250.00 feet
Justification for New Tower See Attached tower construction justification document

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Tower Construction Supervision

Structural Engineer Tower Construction Supervision

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 750
Explanation Station lacks personnel to perform the project management.
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 2
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 2
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification Yes
FAA Consultation (including preparation of FAA Form 7460) Yes
Negotiation of Lease and other Matter for Shared Locations Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements Yes
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Quarterly Progress Reports.

Quarterly Repack Progress Report.

Other Expenses

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

State Service Tax

State Service Tax 4 percent

State and City Sales Tax

State and City Sales Tax 11.5 percent

Station Employees Time

Station Employees Time dedicated to the repack functions.

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 $879,344.43 $609,542.67 N/A $245,265.30 N/A
Total for all systems $2,361,209.05 $1,878,113.58 N/A $475,855.56 N/A
Interim Transmitter SLIM4_03_UHF_SD_PCM-4P-PPT $147,290.00 $120,220.40 $99,970.40
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $99,970.40 See attached Broadcast Depot Sales Quote 206231 $99,970.40 N/A
5 Ton system $20,250.00 $19,250.00 N/A N/A N/A
2" Rigid Conduit and Wiring (Cost per foot) $1,040.00 $1,000.00 N/A N/A N/A
Primary Transmitter Maxiva ULXTE-24 $732,054.43 $489,322.27 $145,294.90
Other -- Building Addition Size: 200.0 $20,000.00 $20,000.00 Based on local construction cost of $100.00 per square ft. The addition is necessary to house the new full power transmitter, combining system, aux transmitter and existing transmitters at the site. A quote will be provided as soon as received. N/A N/A
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW $684,000.00 $441,307.84 See Attached RGB Broadcast Services Main Transmitter Proposal HMDRQ3064 Excluding Section 22 Item 23 Parallel surge Protector and RGB HMDRQ3081 2.4KW Baseline Transmitter proposal. $143,280.47 N/A
2" Rigid Conduit and Wiring (Cost per foot) $1,040.00 $1,000.00 N/A N/A N/A
Other Electrical Service: UPS for Above transmitter $25,000.00 $25,000.00 Based on consultations with manufacturer local sales office. N/A N/A
SURGE PROTECTOR $2,014.43 $2,014.43 ***System Notice: Estimate adjusted and locked because line has been superseded.***SEE ATTACHED GATES AIR PROPOSAL ELECTRICAL SECTION. $2,014.43 N/A

Components

Actual Information Description File Name
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
See WRFB Rev-A_Aux Transmitter Inv. 38448
Amount:
$99,970.40
5 Ton system Information not provided.
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Other -- Building Addition Size: 200.0 Information not provided.
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW

Component Description:
See Attached Cover Letter with Baseline Transmitter verified funds excluding Line 15 Item 7401278000.PARALLEL SURGE PROTECTOR and Main transmitter Invoice.
Amount:
$143,280.47
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Other Electrical Service: UPS for Above transmitter Information not provided.
SURGE PROTECTOR

Component Description:
RGB Broadcast Services Corp Invoice HMDRQ3064-02 Electrical Section PARALLEL SURGE PROTECTOR. See Attached Cover Transmiiter Explanation Cover Letter
Amount:
$2,014.43

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 $379,370.00 $192,287.00 N/A $73,178.50 N/A
Total for all systems $2,361,209.05 $1,878,113.58 N/A $475,855.56 N/A
Interim Antenna 75010013 $33,030.00 $31,400.00 $0.00
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $26,300.00 $25,000.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Primary Antenna TFU-24DSBW/VP-R W (C) $346,340.00 $160,887.00 $73,178.50
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 $13,320.00 SEE ATTACHED DIELECTRIC PROPOSAL NUMBER 800111CMZ-1 LINE 2 $6,660.00 N/A
UHF - Lower Power Side Mount, One station antenna -- 200-500 kW, elliptically or circularly polarized $227,000.00 $96,344.00 SEE ATTACHED DIELECTRIC PROPOSAL NUMBER 8000111CMZ-1 LINE 1 $43,372.00 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 SEE ATTACHED DIELECTRIC PROPOSAL NUMBER 800111CMZ-1 LINE 22 $3,200.00 N/A
New combiner, cost per channel (without antenna) $84,200.00 $39,823.00 SEE ATTACHED DIELECTRIC ANTENNA PROPOSAL 800111CMZ-1 LINE 21 $19,946.50 N/A

Components

Actual Information Description File Name
UHF - Lower Power Side Mount, Class A One Station antenna -- basic Information not provided.
Sweep test of existing antenna Information not provided.
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) Information not provided.
Side mount brackets for high power antennas (if not included in antenna base cost)

Component Description:
WRFB Main Antenna 50% Deposit Invoice MAN00551 Line 3 Item 400004695. Custom Antenna Mounting Brackets
Amount:
$6,660.00
UHF - Lower Power Side Mount, One station antenna -- 200-500 kW, elliptically or circularly polarized

Component Description:
Dielectric Deposit Invoice MAN0051 Line 1
Amount:
$43,372.00
Sweep test of existing antenna

Component Description:
WRFB Dielectric Main Antenna Deposit Invoice MAN00551, Line 23, REPACK SWEEP
Amount:
$3,200.00
New combiner, cost per channel (without antenna)

Component Description:
WRFB Main Antenna 50% Deposit Invoice MAN00551 Line 22 Item 400004696 Combiner Adjacent Channel
Amount:
$19,946.50

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 $22,200.00 $19,287.29 N/A $9,643.65 N/A
Total for all systems $2,361,209.05 $1,878,113.58 N/A $475,855.56 N/A
Primary Transmission Line $22,200.00 $19,287.29 $9,643.65
Flexible Air Transmission Line - dielectric, 4" $22,200.00 $19,287.29 SEE ATTACHED DIELECTRIC PROPOSAL NUMBER 800111CMZ-1 LINE 3 $9,643.65 N/A

Components

Actual Information Description File Name
Flexible Air Transmission Line - dielectric, 4"

Component Description:
WRFB Dielectric main antenna 50% Deposit,Invoice MAN00551, Line 4, Item 300006830 FLEXIBLE TRANSMISSION LINE 4" AIR DIELECTRIC 300FT. Includes Items 4-20
Amount:
$9,643.65

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 $635,135.00 $630,935.00 N/A $122,217.50 N/A
Total for all systems $2,361,209.05 $1,878,113.58 N/A $475,855.56 N/A
Primary Tower TOWER $0.00 $0.00 $0.00
Primary Tower $635,135.00 $630,935.00 $122,217.50
Short Tower (less than 500') $84,200.00 $80,000.00 N/A $0.00 N/A
Tower Construction Supervision $28,500.00 $28,500.00 Estimated cost of the Tower construction supervision. N/A N/A
New tower $522,435.00 $522,435.00 See WRFB Tower Invoice explanation cover letter and Final tower proposal attached document $122,217.50 wwwww

Components

Actual Information Description File Name
Short Tower (less than 500') Information not provided.
Tower Construction Supervision Information not provided.
New tower

Component Description:
Returned Payment Credit Memo CM-2019-01-28-WRFB
Amount:
($139,000.00)

Component Description:
50% Deposit as per ERI WRFB-001 Invoice for WRFB TOWER CONSTRUCTION ERECTION AND RIGGING.
Amount:
$261,217.50

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 $194,455.00 $183,900.00 N/A $0.00 N/A
Total for all systems $2,361,209.05 $1,878,113.58 N/A $475,855.56 N/A
Outside Professional Services $194,455.00 $183,900.00 $0.00
Quarterly Progress Reports. $2,150.00 $2,150.00 Quarterly Repack progress Report Documents preparation and filling. N/A N/A
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase $2,105.00 $2,000.00 N/A N/A N/A
ASR modification (prepare FCC Form 854) $2,105.00 $2,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $7,360.00 $7,000.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $4,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application $4,210.00 $4,000.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $4,100.00 $3,000.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A
Project management of the transition $118,500.00 $112,500.00 N/A N/A N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A N/A N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application $2,105.00 $2,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A

Components

Information not provided.

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $250,704.62 $242,161.62 N/A $25,550.61 N/A
Total for all systems $2,361,209.05 $1,878,113.58 N/A $475,855.56 N/A
Other Expenses $250,704.62 $242,161.62 $25,550.61
Station Employees Time $49,986.42 $49,986.42 Estimated amount for Stations Employees time exclusively dedicated to the repack functions. See attached WRFB Station personnel expenses document. N/A N/A
State and City Sales Tax $99,120.00 $99,120.00 State and City Sales Tax 11.5% $17,272.41 N/A
State Service Tax $25,592.00 $25,592.00 State Service Tax 4% N/A N/A
MVPD Notification of Channel Change $316.20 $316.20 See Attached WRFB MVPD DTVNotification EST-001228 estimate document. $316.20 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $4,500.00 $4,500.00 Based on previous experience during the analog to digital transition. N/A N/A
Local Zoning $8,000.00 $8,000.00 Based on previous experience. Estimated fees of the local authority for obtaining permits for the tower work needed. N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $3,062.00 See Attached WRFB Medical DTVNotification Estimate EST-001215. $3,062.00 N/A
Develop and air announcement of upcoming channel change $20,000.00 $20,000.00 Based on previous experience during the analog to digital transition N/A N/A
Equipment Storage $5,000.00 $5,000.00 Based on previous experience during the analog to digital transition N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
Equipment Delivery and Handling Charges $25,000.00 $25,000.00 Based on previous experience during the analog to digital transition $4,900.00 N/A

Components

Actual Information Description File Name
Station Employees Time Information not provided.
State and City Sales Tax

Component Description:
Sales Tax on the Baseline Transmitter. See WRFB Explanation Cover Letter with Transmitter Invoices.
Amount:
$17,272.41
State Service Tax Information not provided.
MVPD Notification of Channel Change

Component Description:
Reibursement Request on DTVNotification Invoice # INV-001807
Amount:
$316.20

Component Description:
See WRFB MVPD Invoice # INV-001807
Amount:
$316.20
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Local Zoning Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
DTV Medical Facility Notification

Component Description:
WRFB Medical Facilities Notification Invoice from DTVNotification. Invoice # INV-001814
Amount:
$3,062.00

Component Description:
See DTV Medical Invoice. Invoice Number INV-001814
Amount:
$3,062.00
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
Equipment Delivery and Handling Charges

Component Description:
Baseline Transmitter Estimated Freight Charges. See WRFB Explanation Cover Letter with Transmitter Invoices.
Amount:
$4,900.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $2,361,209.05 $1,878,113.58 $475,855.56

Reimbursement Status

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Question Response
The facility has ceased operating on its pre-auction channel. Yes
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.

Alejandro Luciano , PE .

Repack Project Manager


09/15/2019

Attachments

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