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:
0000028650
FRN:
0018223693
Facility ID:
35037
Repack Channel:
26 (UHF)
Entity:
Broadcaster
Filing Status:
Submitted
Date Submitted:
05/13/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

GRAY TELEVISION LICENSEE, LLC

KKTV

KKTV

520 E. COLORADO

COLORADO SPRINGS, CO 80903

United States

+1 (719) 634-2844 btomek@kktv.com Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

Samuel Hariton

Widelity

Samuel Hariton

4031 University Dr

Suite 100

Fairfax, VA 22030

United States

+1 (339) 222-8107 sam.hariton@widelity.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 KKTV will be replacing the main antenna, transmitter, and transmission line. KKTV will be installing an interim transmitter, transmission line and side-mount antenna.

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 PowerCD
Year 2009
Type Inductive Output Tube
IOT Power Type Two
Description  
Power capacity 23 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 UAXTE-32R44
Transmitter Type Solid state
IOT Power Type  
Other  
Power capacity  
Solid State Cooling Air
Solid State Power Capacity 16 kw
Other Transmitter Type  
Justification for New Transmitter Upgrading existing IOT transmitter with air cooled solid state transmitter. Per discussions with GatesAir, due to the high altitude of the station's transmitter site, the station will require a 19 kW transmitter to make the power necessary (16 kW).

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 The new transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors.
HVAC Service Does the replacement transmitter require HVAC Service? No
Type
Size
Other Size  
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size
Channel 14 Costs Is an RF Consulting Engineer needed?
Is a channel 14 Mask Filer needed?
Is additional field engineering time needed?
Number of Days  

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Mask Filter

30 KW Mask filter

Building Expansion

Building expansion, electrical expansion, ICE shield expansion.

Interim Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Interim
Description of Use  
Change Type Purchase
Manufacturer
Model TX9
Transmitter Type Solid state
IOT Power Type  
Other  
Power capacity  
Solid State Cooling Air
Solid State Power Capacity 19 kw
Other Transmitter Type  
Justification for New Transmitter It's needed so the station can operate while the main transmitter is replaced. Per discussions with GatesAir, due to the high altitude of the station's transmitter site, the station will require a 19 kW transmitter to make the power necessary (16 kW).

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
Rigid Conduit and Wiring No
Size
Length
Other Electrical Service Yes
Description The new transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors.
HVAC Service Does the replacement transmitter require HVAC Service? No
Type
Size
Other Size  
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size
Channel 14 Costs Is an RF Consulting Engineer needed?
Is a channel 14 Mask Filer needed?
Is additional field engineering time needed?
Number of Days  
Inside RF System Is an additional interior RF system required to support this interim transmitter? Yes

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 Top-mount single
Antenna position in stack Not in Stack
Polarization Elliptical
Type Slotted coaxial
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 550.00 kW
Manufacturer
Model ATW22HS6-ETC170-49H Trasar
Year 2009

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? Yes
Will antenna be located on or in close proximity to an antenna farm? Yes
New Antenna Manufacturer and Type Class Full Power
Mounting Top-mount single
Antenna position in stack Not in Stack
Polarization Elliptical
Type Slotted coaxial
Number of Stations Supported N/A
Number of Panels/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 350.00 kW
Manufacturer
Model ATW17HS6-ETCX-26H
Year 2019
Justification for New Antenna Current antenna is Channel 49, new channel assignment is 26. Current antenna is not re-tunable.

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 4 1/16 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

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 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: 20.00 kW
Manufacturer
Model ATW16H6-ESC170-26L
Year 2019
Justification for New Antenna Interim Antenna needed so that the station can broadcast while the new main antenna is installed.

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? 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? 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 Rigid
Diameter 6 1/8 inches
Segment Length 19 ¾ '
Other Segment Length
Number of parallel runs 1
Length 350 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
Segment Length 19 ½ '
Other Segment Length
Number of parallel runs 1
Length 370 feet per run
Justification for New Transmission Line New Channel 26 Assignment required RF Line sections to be at 19.5' per section, existing RF Line is currently 19.75' per section.

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 4 inches
Segment Length N/A
Other Segment Length
Number of parallel runs 1
Length 300 feet per run
Justification for New Transmission Line Interim transmission line needed so that the station can continue broadcasting while the new transmission line is installed.

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? 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? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1024861
Coordinates (NAD83) Latitude (NAD83) 38° 44' 42.0" N-
Longitude (NAD83) 104° 51' 45.0" W-
Overall Structure Height 353.01 feet
Support Structure Height 299.87 feet
Ground Elevation Above Mean Sea Level (AMSL) 9439.85 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Gray Television Group, Inc.
Date Constructed 06/01/1960


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: No 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

Interim Antenna Rigging

Rigging costs for the interim antenna installation

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 900
Explanation Strategic Planning
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 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 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 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

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

Name Description

Other State and Local Taxes

Other State and Local Taxes on all equipment and services not explicitly stated otherwise.

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 $1,716,202.88 $1,724,252.88 N/A $189,342.92 N/A
Total for all systems $2,714,118.88 $3,380,349.63 N/A $875,949.38 N/A
Interim Transmitter TX9 $630,305.00 $638,355.00 $121,201.25
UHF inside RF system including switching $143,500.00 $151,550.00 State and local taxes added to the cost N/A N/A
UHF - Air Cooled Solid State Transmitter 19 kW $484,805.00 $484,805.00 New interim transmitter required during the transition of the main transmitter to the new repack frequency. $121,201.25 N/A
Other Electrical Service: The new transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors. $2,000.00 $2,000.00 N/A N/A N/A
Primary Transmitter UAXTE-32R44 $1,085,897.88 $1,085,897.88 $68,141.67
Building Expansion $417,208.00 $417,208.00 GE Johnson Construction Co. KKTV Renovations Estimate ($394,468). Keystone Associates Architect Fee quote ($22,740). Combined $417,208. $68,141.67 N/A
Mask Filter $19,800.00 $19,800.00 30 KW Mask filter N/A N/A
UHF - Air Cooled Solid State Transmitter 16 kW $646,889.88 $646,889.88 GatesAir quote GA-00022480r1 $0.00 N/A
Other Electrical Service: The new transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors. $2,000.00 $2,000.00 N/A N/A N/A

Components

Actual Information Description File Name
UHF inside RF system including switching Information not provided.
UHF - Air Cooled Solid State Transmitter 19 kW

Component Description:
25% downpayment UHF 19.0 kw CH26 R&S TX9
Amount:
$121,201.25
Other Electrical Service: The new transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors. Information not provided.
Building Expansion

Component Description:
Architectural and Engineering Services for September 2017
Amount:
$2,362.18

Component Description:
Architectural Services
Amount:
$654.40

Component Description:
Architectural Services for August 2018
Amount:
$2,709.20

Component Description:
KKTV-Digital Transmitter Upgrade
Amount:
$52,565.72

Component Description:
Remove and dispose 6' of existing chain link fence to include one line post.
Amount:
$2,622.00

Component Description:
Professional Services
Amount:
$552.17

Component Description:
Limited Architectural Services
Amount:
$5,200.00

Component Description:
Additional Services/Variance/Nakai
Amount:
$1,476.00
Mask Filter Information not provided.
UHF - Air Cooled Solid State Transmitter 16 kW Information not provided.
Other Electrical Service: The new transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors. Information not provided.

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 $415,168.50 $319,718.75 N/A $165,931.92 N/A
Total for all systems $2,714,118.88 $3,380,349.63 N/A $875,949.38 N/A
Interim Antenna ATW16H6-ESC170-26L $117,798.50 $117,648.50 $94,118.79
Sweep test of existing antenna $6,550.00 $6,400.00 N/A $5,120.00 N/A
UHF - High Power, Side Mount, basic slot antenna, 20 kW input, directional,, elliptically or circularly polarized $111,248.50 $111,248.50 Please see DTVPros quote JEHQ1410-03 this cost includes side mount brackets. $88,998.79 N/A
Primary Antenna ATW17HS6-ETCX-26H $297,370.00 $202,070.25 $71,813.13
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed) $9,320.00 $3,336.25 Please see attached DTVPros quote JEHQ1409-02. $1,834.93 N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $281,500.00 $192,334.00 Please see attached DTVPros quote JEHQ1409-02, this price includes new top plate. $66,458.20 N/A
Sweep test of existing antenna $6,550.00 $6,400.00 N/A $3,520.00 N/A

Components

Actual Information Description File Name
Sweep test of existing antenna

Component Description:
KKTV-280-Sweep test new interim antenna
Amount:
$1,600.00

Component Description:
Sweep test new interim antenna
Amount:
$1,600.00

Component Description:
Sweep test new interim antenna
Amount:
$1,920.00
UHF - High Power, Side Mount, basic slot antenna, 20 kW input, directional,, elliptically or circularly polarized

Component Description:
UHF-high power side mount (200-1000KW) ATW16H-ESC170-26L side mounted elliptically polarized UHF TRASAR television transmitting antenna
Amount:
$27,812.12

Component Description:
UHF-High Power Side Mount (200-1000KW)
Amount:
$33,374.55

Component Description:
UHF- High Power Side Mount (200-1000KW)
Amount:
$27,812.12
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed)

Component Description:
KKTV Elbow Complex New Primary Antenna
Amount:
$834.06

Component Description:
KKTV Elbow Complex new primary antenna
Amount:
$1,000.87
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
UHF-high power top mount (200-1000KW) ATW17H56-ETCX-26H top mounted elliptically polarized UHF TRASAR television transmitting antenna
Amount:
$8,758.00

Component Description:
UHF - High Power Top Mount (200-1000KW) ATW17HS6-ETCX-26H Top Mounted Elliptically Polarized UHF TRASAR Television Transmitting Antenna
Amount:
$57,700.20
Sweep test of existing antenna

Component Description:
KKTV Sweep Test New Primary Antenna
Amount:
$1,600.00

Component Description:
KKTV Sweep Test New Primary Antenna
Amount:
$1,920.00

Cost Information

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Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $72,660.00 $71,286.21 N/A $43,819.74 N/A
Total for all systems $2,714,118.88 $3,380,349.63 N/A $875,949.38 N/A
Interim Transmission Line $21,600.00 $21,741.16 $16,570.04
Flexible Air Transmission Line - dielectric, 4" $21,600.00 $21,741.16 Please see attached DTVPros quote JEHQ1410-03 $16,570.04 N/A
Primary Transmission Line $51,060.00 $49,545.05 $27,249.70
Rigid Transmission Line - copper, 4 1/16" $51,060.00 $49,545.05 Please see attached DTVPros quote JEHQ1409-02 $27,249.70 N/A

Components

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

Component Description:
KKTV-380-New Interim Transmission Line
Amount:
$5,178.13

Component Description:
New Interim Transmission Line
Amount:
$6,213.78

Component Description:
New Interim Transmission Line
Amount:
$5,178.13
Rigid Transmission Line - copper, 4 1/16"

Component Description:
KKTV New Primary Transmission Line
Amount:
$12,386.21

Component Description:
KKTV New Primary Transmission Line
Amount:
$14,863.49

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 $180,800.00 $948,600.00 N/A $411,557.50 N/A
Total for all systems $2,714,118.88 $3,380,349.63 N/A $875,949.38 N/A
Primary Tower TOWER $180,800.00 $948,600.00 $411,557.50
Short Tower (less than 500') $81,900.00 $850,000.00 The tower is on top of Cheyenne Mountain. Thin Air Quote 2838-001-KKTV $409,057.50 N/A
Structural engineering tower load study for well documented tower $12,300.00 $12,000.00 N/A $2,500.00 N/A
Interim Antenna Rigging $86,600.00 $86,600.00 N/A N/A N/A

Components

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

Component Description:
Cheyenne Mountain KKTV Tower Work Antenna & Line-50%Down
Amount:
$409,057.50
Structural engineering tower load study for well documented tower

Component Description:
Structural Analysis and Report
Amount:
$2,500.00
Interim Antenna Rigging Information not provided.

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $190,590.00 $186,075.00 N/A $62,542.30 N/A
Total for all systems $2,714,118.88 $3,380,349.63 N/A $875,949.38 N/A
Outside Professional Services $190,590.00 $186,075.00 $62,542.30
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application $2,050.00 $675.00 Please see the attached invoice from Chesapeake RF Consultants #4962 $675.00 N/A
RF Exposure Measurements $20,500.00 $21,650.00 State and local taxes included $0.00 N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,585.00 $3,500.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,305.00 $2,250.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,120.00 $5,000.00 N/A $0.00 N/A
Prepare and or review reimbursement form $2,560.00 $2,500.00 N/A N/A N/A
Address transition timing and coordination issues w/ other stations and wireless $2,560.00 $2,500.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,170.00 $7,000.00 N/A $4,687.50 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,070.00 $3,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,535.00 $1,500.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $1,535.00 $1,500.00 N/A N/A N/A
Project management of the transition $138,600.00 $135,000.00 N/A $57,179.80 N/A

Components

Actual Information Description File Name
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application

Component Description:
Develop final technical parameters for side-mount antenna on repack Ch-26 for use as interim.
Amount:
$675.00
RF Exposure Measurements Information not provided.
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 Information not provided.
Prepare and or review reimbursement form Information not provided.
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Perform engineering study for new channel assignment and antenna development

Component Description:
Conduct channel study
Amount:
$187.50

Component Description:
Review prospective sub antenna specs
Amount:
$187.50

Component Description:
Consulting Engineer
Amount:
$1,450.00

Component Description:
Perform engineering study for new channel assignment
Amount:
$2,862.50
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare request for Special Temporary Authorization Information not provided.
Project management of the transition

Component Description:
Cost Reconciliation
Amount:
$2,650.20

Component Description:
Project Management
Amount:
$1,706.25

Component Description:
Project Management
Amount:
$2,265.85

Component Description:
Project Mgt, Budget Review, Cost Reconciliation
Amount:
$2,576.05

Component Description:
Project Management
Amount:
$1,820.10

Component Description:
Project Management
Amount:
$3,571.85

Component Description:
Project Management
Amount:
$7,145.65

Component Description:
Project Mgt, Budget Review, Cost Reconciliation
Amount:
$755.80

Component Description:
Project management, cost reconciliation, budget review
Amount:
$2,943.80

Component Description:
Project Management
Amount:
$3,710.65

Component Description:
Project Management
Amount:
$3,481.05

Component Description:
Project Management
Amount:
$3,156.05

Component Description:
Project Management
Amount:
$1,831.65

Component Description:
Project management
Amount:
$2,555.15

Component Description:
Project Management
Amount:
$2,352.40

Component Description:
Project Management
Amount:
$2,751.45

Component Description:
Project managment
Amount:
$1,328.55

Component Description:
Project Management
Amount:
$1,653.10

Component Description:
Project Management
Amount:
$1,783.05

Component Description:
Project Mgt
Amount:
$802.25

Component Description:
Project management
Amount:
$2,539.40

Component Description:
Project Management
Amount:
$1,829.35

Component Description:
Project Management
Amount:
$28.20

Component Description:
Project Management
Amount:
$1,941.95

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 $138,697.50 $130,416.79 N/A $2,755.00 N/A
Total for all systems $2,714,118.88 $3,380,349.63 N/A $875,949.38 N/A
Other Expenses $138,697.50 $130,416.79 $2,755.00
DTV Medical Facility Notification $11,250.00 $2,982.29 N/A $2,755.00 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
Disposal Costs (for equipment and other waste, net of any salvage value) $25,000.00 $25,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $25,000.00 $25,000.00 N/A N/A N/A
Equipment Storage $15,155.00 $15,155.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $5,412.50 $5,412.50 N/A N/A N/A
Other State and Local Taxes $41,053.00 $41,053.00 N/A N/A N/A
Non-zoning permits $14,000.00 $14,000.00 N/A N/A N/A
MVPD Notification of Channel Change $1,299.00 $1,299.00 N/A N/A N/A

Components

Actual Information Description File Name
DTV Medical Facility Notification

Component Description:
Mailing: Print and mail a two page, black and white generically addressed letter with a specifically addressed USPS barcoded route sorted envelope:
Amount:
$2,755.00
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Equipment Delivery and Handling Charges Information not provided.
Equipment Storage Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Other State and Local Taxes Information not provided.
Non-zoning permits Information not provided.
MVPD Notification of Channel Change Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $2,714,118.88 $3,380,349.63 $875,949.38

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.

Robert J. Folliard , III .

Assistant Secretary


05/13/2019

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.

Robert J. Folliard , III .

Assistant Secretary


05/13/2019

Attachments

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