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:
66536
Service:
DTV
Call Sign:
WTIU
Channel:
33 (UHF)
File Number:
0000028550
FRN:
0005268222
Date Submitted:
05/22/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

TRUSTEES OF INDIANA UNIVERSITY

Doing Business As: TRUSTEES OF INDIANA UNIVERSITY

Deborah A. Lemon, Secretary of the Board of Trustees

FRANKLIN HALL 200

601 E. KIRKWOOD AVE.

BLOOMINGTON, IN 47405

United States

+1 (812) 856-3731 DALEMON@IU.EDU Private Not-for-Profit Educational Institution

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

George C. Hopstetter

Director Operation and Engineering

Indiana University

George C. Hopstetter

WTIU, Indiana University

1229 E. 7th Street

Bloomington, IN 47405

United States

+1 (812) 855-3177 GHOPSTET@INDIANA.EDU

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 WTIU will need to replace the current transmitter, exciter with backup, mask filter, combiner, dehydrator and top mount antenna to re-locate to digital Ch. 33. Current transmission line was sweep to verify acceptable RF/VSWR to operate on Ch.33.

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 Diamond DHD45P2
Year 2003
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 10.5 kW

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model ULXTE-30
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 19.2 kW
Justification for New Transmitter Existing transmitter can not be re-channeled to meet the new FCC Ch. assignment, mask filter is channel specific and must be replaced to meet the new assignment channel. Uploaded new TPO recalculations for new requested antenna at Ch.33 lower gain 18.9

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 No
Size N/A
Length N/A
Other Electrical Service Yes
Description New electrical breaker panel is required to facilitate Ch. 33 transmitter and supporting equipment.
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

Primary 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? No
Existing Antenna Manufacturer and Type Class Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 1
Number of Panels 32
Design power capacity in use 35.0 %
Lower Limit 470.00 MHz
Upper Limit 806.00 MHz
Other Antenna Type N/A
ERP: 224.0 kW
Manufacturer
Model TUA-SP4A-8/32H-1-TR
Year 2002

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class Full Power
Mounting Top 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: 384.0 kW
Manufacturer
Model TFU-18GTH/VP-R 6S250
Year 2019
Justification for New Antenna Current broadband antenna is not efficient single channel operations and limited capabilities. Antenna sweep indicated that power divider had a high than desired reflection on assigned channel.Initial Report when installed had a higher than desired VSWR

Primary Antenna

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Other Antenna Costs

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

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

Interim Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? No
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Broadband Panel
Number of Stations Supported 1
Number of Panels/Bays 16
Lower Limit 470.00 MHz
Upper Limit 698.00 MHz
Design power capacity in use 95.0 %
Other Antenna Type N/A
ERP: 132.43 kW
Manufacturer
Model i230ECW-16-14/33
Year 2019
Justification for New Antenna Interim antenna, side mount broadband operation on Ch. 14 during transition of primary top mount antenna to single CH. 33. Dielectric/ERI does not rent or lease interim antennas or transmission line.

Interim Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? S
Feed Line Size 6 1/8 inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for an antenna? 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
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 1
Length 650 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 Flexible Air
Diameter 4 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 0
Length 500 feet per run
Justification for New Transmission Line Flex 4 inch Andrew HJ11-50 for interim side mount antenna feed. To service while primary top mount antenna is removed and replace by new single Ch. 33 antenna.

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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Add Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Owned
Is this tower consider Complex? No
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users Yes
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1234684
Coordinates (NAD83) Latitude (NAD83) 39° 08' 31.0" N-
Longitude (NAD83) 086° 29' 42.9" W-
Overall Structure Height 645.99 feet
Support Structure Height 610.23 feet
Ground Elevation Above Mean Sea Level (AMSL) 806.09 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner Trustees of Indiana University
Date Constructed 12/28/2015

FM, AM or TV radio broadcasters. Facility ID's, Call Signs and Services of other broadcast stations with whom the tower is shared

Facility ID Call Sign Service
68269 WFIU FM

Other Types of Users

Users
Verizon
T-Mobile
New Cingular
Sprint

Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: No study needed
Tower Reinforcements Please select whether tower reinforcements are needed: Minor 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

Lower Guy support upgrade

Lower Guy supports upgraded to handle the added "AUX" Interim antenna loading on tower

Antenna replacement

Costs to remove existing top mounted antenna and install new Ch. 33 top mount antenna

Interim Antenna installation

Cost to install Aux antenna and 500ft of 4" transmission line for Ch. 14 while Primary antenna is removed and replaced.

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? No
Number of Hours N/A
Explanation N/A
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 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 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 1
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification Yes
FAA Consultation (including preparation of FAA Form 7460) Yes
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers No
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements No
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 No
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)? No
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? No
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

Endeavor Communications

New Ch. 33 receive element for provided PR-450 receive antenna feed local cable system programming. Change Ch. 14 element to CH. 33 element on Receive tower

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 $836,350.00 $801,701.92 N/A $214,217.31 N/A
Total for all systems $1,995,757.00 $1,600,811.57 N/A $463,366.81 N/A
Primary Transmitter ULXTE-30 $836,350.00 $801,701.92 $214,217.31
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW $684,000.00 $650,351.92 N/A $214,217.31 N/A
Other Electrical Service: New electrical breaker panel is required to facilitate Ch. 33 transmitter and supporting equipment. $132,100.00 $132,100.00 Requires replacement of Closed Transition Automatic Transfer switch with by-pass isolation ($34,922 additional cost) to wire in new transmitter and addition main breaker and sub panels to connect new transmitter while current transmitter remains on-line. N/A N/A
5 Ton system $20,250.00 $19,250.00 Over estimation on cooling the new liquid cooled transmitter. Upload Technical operating data showing the room heat dissipation of the Gate Air transmitter. New transmitter is to be installed in a separate room with limited HVAC service. Waiting on Quote N/A N/A

Components

Actual Information Description File Name
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW

Component Description:
ULXTE-30 Transmitter per Quote Q-81797 Down Payment
Amount:
$214,217.31
Other Electrical Service: New electrical breaker panel is required to facilitate Ch. 33 transmitter and supporting equipment. Information not provided.
5 Ton system 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 $430,660.00 $387,395.00 N/A $143,972.44 N/A
Total for all systems $1,995,757.00 $1,600,811.57 N/A $463,366.81 N/A
Interim Antenna i230ECW-16-14/33 $122,130.00 $175,981.00 $69,673.54
Sweep test of existing antenna $6,730.00 $6,250.00 N/A $0.00 N/A
UHF - Lower Power Side Mount, One Station antenna . medium power (50-200 kW), elliptically or circularly polarized $103,100.00 $164,563.00 Change in interim antenna, ERI does not rent or lease interim antenna. Requires purchase of new interim antenna. Includes side mounts $9,800 $67,811.30 Cost of ERI Interim side mounted antenna i230ECW-16-14/33, new design and currently the one the manufacture now offers as a interim antenna.
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $5,168.00 6 1/8" 90 degree miter elbow and hardware, $1,862.24 N/A
Primary Antenna TFU-18GTH/VP-R 6S250 $308,530.00 $211,414.00 $74,298.90
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $289,500.00 $198,712.00 ERI Cost is Hpol - Vpol cost of $15,500.00 $68,273.99 N/A
Sweep test of existing antenna $6,730.00 $6,250.00 N/A $3,700.00 N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $6,452.00 90 degree miter elbows and hardware $2,324.91 N/A

Components

Actual Information Description File Name
Sweep test of existing antenna

Component Description:
No existing interim "AUX" antenna exist to sweep test.
Amount:
N/A
UHF - Lower Power Side Mount, One Station antenna . medium power (50-200 kW), elliptically or circularly polarized

Component Description:
Down payment of Interim Antenna "AUX" cost.
Amount:
$67,811.30
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
down payment of Interim antenna "AUX" elbow complex cost.
Amount:
$1,862.24
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
Down payment of ERI ATW18H3-16-14/33 "MAIN" antenna top mount Ch. 33
Amount:
$68,273.99
Sweep test of existing antenna

Component Description:
System Sweep of existing 6.125" line and antenna operating on Ch.14 to determine use on Ch.33. 50% down with order and 50% due NET-30. Sweep.
Amount:
$3,700.00
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
Down payment of Elbow complex for Main antenna system.
Amount:
$2,324.91

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 $0.00 $53,302.65 N/A $15,469.40 N/A
Total for all systems $1,995,757.00 $1,600,811.57 N/A $463,366.81 N/A
Primary Transmission Line $0.00 $53,302.65 $15,469.40
Flexible Air Transmission Line - dielectric, 4" $0.00 $53,302.65 4" flexible transmission line to feed Interim side mount antenna. includes mounting and"O"-rings, mounting hardware. Includes RF transmission line sweep of $6,250.00 after installation. $15,469.40 N/A

Components

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

Component Description:
Interim transmission line system .333 down cost of 4" line requested, but upgrading to 5"-line.
Amount:
$15,469.40

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 $661,997.00 $293,497.00 N/A $82,937.66 N/A
Total for all systems $1,995,757.00 $1,600,811.57 N/A $463,366.81 N/A
Primary Tower GTOWER $661,997.00 $293,497.00 $82,937.66
Antenna replacement $95,251.00 $95,251.00 Cost to remove existing top mounted Ch. 14 antenna replace with Ch. 33 top mounted antenna (TFU-18GTH/VP-R 6S250), hook to existing 6 1/8" line. install and wire top AOL beacon. Installation cost increased since original quotes $33,409.28 N/A
Interim Antenna installation $134,914.00 $134,914.00 Interim aux antenna (i230ECW-16-14/33) installation with 530-ft 5" flexible transmission line. Aux antenna needed to maintain air operations while top antenna is being replaced. Note: Installation cost tripled since original quote. $49,528.38 N/A
Lower Guy support upgrade $63,332.00 $63,332.00 Structural Analysis shows lower guy over stressed with "AUX" Interim antenna added to tower, manufacture recommends lower guy supports be upgraded to elevate over stress points on the lower guy. N/A N/A
Minor tower reinforcement/modifications $158,000.00 $0.00 N/A N/A N/A
Tall Tower (greater than 500') $210,500.00 $0.00 No new tower needed. N/A N/A

Components

Actual Information Description File Name
Antenna replacement

Component Description:
.334 down deposit with order and 50% of $6500 applied for Layout Site survey for installation of Antennas.
Amount:
$33,409.28
Interim Antenna installation

Component Description:
.333 down and includes 50% layout site survey cost of $6,500, .333 of $3250 applied.
Amount:
$49,528.38
Lower Guy support upgrade Information not provided.
Minor tower reinforcement/modifications Information not provided.
Tall Tower (greater than 500') 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 $40,185.00 $38,665.00 N/A $6,770.00 N/A
Total for all systems $1,995,757.00 $1,600,811.57 N/A $463,366.81 N/A
Outside Professional Services $40,185.00 $38,665.00 $6,770.00
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase $2,105.00 $2,050.00 N/A N/A N/A
ASR modification (prepare FCC Form 854) $2,105.00 $2,050.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,585.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,560.00 N/A $900.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,070.00 N/A $1,970.00 N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application $2,105.00 $2,050.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,535.00 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 $1,535.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,170.00 N/A $3,900.00 N/A
Prepare request for Special Temporary Authorization $2,050.00 $1,535.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,120.00 N/A N/A N/A
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application $4,210.00 $4,100.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,305.00 N/A N/A N/A

Components

Actual Information Description File Name
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase Information not provided.
ASR modification (prepare FCC Form 854) Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Prepare and or review reimbursement form

Component Description:
Cost of Review and edit FCC Form 399 Application,
Amount:
$900.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Cost of preparing engineering section of FCC Form 2100 and prepare comprehensive technical exhibits attachment for filing in the initial 90-day window. FCC Construction Permit ApplicationApplication
Amount:
$1,970.00
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application Information not provided.
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, License to Cover Application Information not provided.
Perform engineering study for new channel assignment and antenna development

Component Description:
Cost to conduct technical studies for new UHF channel and replacement directional antenna.
Amount:
$3,900.00
Prepare request for Special Temporary Authorization Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application Information not provided.
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application 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 $26,565.00 $26,250.00 N/A $0.00 N/A
Total for all systems $1,995,757.00 $1,600,811.57 N/A $463,366.81 N/A
Other Expenses $26,565.00 $26,250.00 $0.00
Endeavor Communications $3,985.00 $3,985.00 Uploaded quote for tower crew to change out PR-450 element for Cloverdale (Endeavor Communications) cable headend to receive new Ch. 33. Cost of tower service N/A N/A
DTV Medical Facility Notification $11,550.00 $11,250.00 N/A 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 - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
Equipment Delivery and Handling Charges $6,800.00 $6,800.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $2,500.00 $2,500.00 N/A N/A N/A
MVPD Notification of Channel Change $1,200.00 $1,200.00 N/A N/A N/A

Components

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $1,995,757.00 $1,600,811.57 $463,366.81

Reimbursement Status

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Question Response
The facility has ceased operating on its pre-auction channel. No
Construction of final facilities or all necessary modifications are complete. No
All receipts for reimbursement have been submitted no further costs are expected to be incurred. Note this will lock the Form 399 from further editing and begin close-out procedures with the Fund Administrator. No

Certification

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Section Question Response
Submission of Estimated Expenses Statements

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

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

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

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

  4. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD).

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

  6. The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred.

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

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

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

Deborah A. Lemon

Secretary of the Board of Trustees


05/22/2019

Certification

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Section Question Response
Submission of Actual Cost Documentation Statements

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

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

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

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

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

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

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

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

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

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

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

GEORGE C. HOPSTETTER

Director, Operations and Engineering


05/22/2019

Attachments

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