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:
21656
Service:
DTV
Call Sign:
KOMO-TV
Channel:
30 (UHF)
File Number:
0000028794
FRN:
0023174477
Date Submitted:
09/16/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

SINCLAIR SEATTLE LICENSEE, LLC

Doing Business As: SINCLAIR SEATTLE LICENSEE, LLC

Harvey Arnold

10706 Beaver Dam Road

Cockeysville, MD 21030

United States

+1 (410) 568-1500 harnold@sbgtv.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

Paul A. Cicelski , Esq .

Lerman Senter PLLC

2001 L Street, NW

Suite 400

Washington, DC 20036

United States

+1 (202) 416-6756 pcicelski@lermansenter.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 See Exhibit A.

Transmitters

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Section Question Response
Transmitter Related Expenses Do you have transmitter related expenses? Yes

Auxiliary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Retune Existing
Use Auxiliary (Backup)
Ownership Owned
Owner 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 Rohde & Schwarz
Model NV8608
Year 2006
Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 6 kW

Auxiliary Transmitter

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Retuning Transmitter Costs

Section Question Response
New IOT Tubes Number of Tubes (including accessories) needed N/A
New Mask Filter
Power 7 kW
Other Power N/A
New Exciter Is a new exciter needed? No

Auxiliary 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 No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Auxiliary Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

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 DTT50KWU
Year 2000
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 50 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 THU9evo-48
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 73.5 kW
Justification for New Transmitter The current transmitter cannot be retuned because the company is no longer in business.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) Yes
Transformer (480V) Yes
Power 300 kVA
Rigid Conduit and Wiring Yes
Size 2 inches
Length 1200.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

Antennas

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

Auxiliary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Auxiliary (Backup)
Description of Use KOMO (Backup) Antenna
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? No
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: 40.0 kW
Manufacturer
Model TFU-32DSC C164
Year 1997

Auxiliary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Auxiliary (Backup)
Description of Use BACK UP IN CASE OF FAILURE
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? Yes
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: 851.0 kW
Manufacturer
Model TFU-32DSC/VP-R-C164
Year 2017
Justification for New Antenna Auxiliary antenna is a single frequency antenna that cannot be used on the post-auction channel.

Auxiliary 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? 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

Auxiliary Antenna

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Other Antenna Cost Not Listed

Information not provided.

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? No
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
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: 1000.0 kW
Manufacturer
Model ATW28H3-ETO-38H
Year 2011

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? No
Will antenna be located on or in close proximity to an antenna farm? Yes
New Antenna Manufacturer and Types Class Full Power
Mounting Top Mount
Antenna position in stack Top
Polarization Elliptical
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 851.0 kW
Manufacturer
Model TFU-26JTH/VP-R o6
Year 2017
Justification for New Antenna Old antenna is a single channel antenna that cannot be used for the new post-auction channel.

Primary Antenna

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Other Antenna Costs

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

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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Section Question Response
Transmission Line Related Expenses Do you have transmission line related expenses? No

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?
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 No
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 1032456
Coordinates (NAD83) Latitude (NAD83) 47° 37' 55.0" N-
Longitude (NAD83) 122° 21' 14.0" W-
Overall Structure Height 563.97 feet
Support Structure Height 465.87 feet
Ground Elevation Above Mean Sea Level (AMSL) 450.13 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Sinclair Seattle Licensee, LLC
Date Constructed 01/01/1953

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
4624 KUNS-TV DTV

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: Major Reinforcements needed

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 470
Explanation Outside consulting engineering, legal work, and accounting services, as well as project management for regional and comprehensive repack execution.
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 Yes
Environmental Assessment Yes
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 Yes
RF exposure measurements Yes
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Sinclair Internal Costs

Internal Employee Time Costs

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 Yes
BLM or NFS Coordination No
FCC Construction Permit Minor Change No
FCC License to Cover Application Yes
FCC Special Temporary Authority Application Yes
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? Yes
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Information not provided.

Cost Information

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Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $2,216,610.00 $2,134,318.64 N/A $342,608.12 N/A
Total for all systems $4,112,609.55 $3,905,723.19 N/A $502,605.47 N/A
Primary Transmitter THU9evo-48 $2,105,200.00 $2,028,418.64 $342,608.12
Transformer 3 phase/480v - 300 KVA $36,800.00 $35,000.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 68.5 - 75 kW $1,999,000.00 $1,927,118.64 See Response to August 4 Inquiry. $342,608.12 N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A
2" Rigid Conduit and Wiring (Cost per foot) $31,200.00 $30,000.00 N/A N/A N/A
Auxiliary Transmitter NV8608 $111,410.00 $105,900.00 $0.00
UHF and VHF - minor banding issues $105,200.00 $100,000.00 N/A N/A N/A
7 kW mask filter $6,210.00 $5,900.00 N/A N/A N/A

Components

Actual Information Description File Name
Transformer 3 phase/480v - 300 KVA Information not provided.
UHF - Liquid Cooled Solid State Transmitter 68.5 - 75 kW

Component Description:
Transmitter related cost. #9500100963
Amount:
$342,608.12
Switchgear - industrial 800 amp Information not provided.
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
UHF and VHF - minor banding issues Information not provided.
7 kW mask filter 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 $616,515.00 $564,780.00 N/A $104,075.17 N/A
Total for all systems $4,112,609.55 $3,905,723.19 N/A $502,605.47 N/A
Primary Antenna TFU-26JTH/VP-R o6 $308,530.00 $259,135.00 $8,053.39
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $289,500.00 $241,035.00 See Response to August 4 Inquiry. $1,653.39 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $6,400.00 N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $11,700.00 N/A N/A N/A
Auxiliary Antenna TFU-32DSC/VP-R-C164 $307,985.00 $305,645.00 $96,021.78
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $5,000.00 N/A N/A N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $22,000.00 N/A N/A N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $11,700.00 N/A N/A N/A
UHF - High Power, Side Mount, basic slot antenna, 851 kW input, directional,, elliptically or circularly polarized $260,545.00 $260,545.00 See Response to August 4 Inquiry. $96,021.78 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A

Components

Actual Information Description File Name
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
Total invoice amount reduced by 25.40%. #512026
Amount:
$1,653.39
Sweep test of existing antenna

Component Description:
Sweep test cost. #6139
Amount:
$6,400.00
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) 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) Information not provided.
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) Information not provided.
UHF - High Power, Side Mount, basic slot antenna, 851 kW input, directional,, elliptically or circularly polarized

Component Description:
Antenna related cost. #1910-01
Amount:
$96,021.78
Sweep test of existing antenna Information not provided.

Cost Information

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Transmission Line

Information not provided.

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 $854,600.00 $812,000.00 N/A $24,467.75 N/A
Total for all systems $4,112,609.55 $3,905,723.19 N/A $502,605.47 N/A
Primary Tower TOWER $854,600.00 $812,000.00 $24,467.75
Major tower reinforcement/modifications $421,000.00 $400,000.00 N/A $18,144.00 N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $400,000.00 N/A N/A N/A
Structural engineering tower load study for well documented tower $12,600.00 $12,000.00 N/A $6,323.75 N/A

Components

Actual Information Description File Name
Major tower reinforcement/modifications

Component Description:
Tower related cost. #2844
Amount:
$15,567.75

Component Description:
Tower related cost. #2808
Amount:
$2,576.25
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) Information not provided.
Structural engineering tower load study for well documented tower

Component Description:
Tower load study cost. #2879
Amount:
$1,000.00

Component Description:
Tower load study cost. #Final 2843
Amount:
$5,323.75

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 $249,238.55 $219,543.55 N/A $29,854.43 N/A
Total for all systems $4,112,609.55 $3,905,723.19 N/A $502,605.47 N/A
Outside Professional Services $249,238.55 $219,543.55 $29,854.43
Sinclair Internal Costs $143.55 $143.55 N/A $143.05 N/A
RF Exposure Measurements $21,050.00 $3,500.00 N/A $3,500.00 N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A $0.00 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
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet $10,520.00 $10,000.00 N/A N/A N/A
NEPA Section 106 environmental review, if needed $6,310.00 $6,000.00 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 $122.00 N/A
Prepare request for Special Temporary Authorization $4,100.00 $3,000.00 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
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, Construction Permit Application $2,105.00 $2,000.00 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 $1,575.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $1,920.00 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
Prepare and or review reimbursement form $2,630.00 $2,650.00 Updated cost of estimated amount per FCC requirement. $1,766.39 N/A
Project management of the transition $74,260.00 $70,500.00 N/A $20,827.99 N/A

Components

Actual Information Description File Name
Sinclair Internal Costs

Component Description:
Portion of general repack matter internal time card attributable to this station - divided by 100.
Amount:
$66.55

Component Description:
Internal expense - KOMO - 1-2019
Amount:
$76.50
RF Exposure Measurements

Component Description:
Radio frequency exposure analysis cost. #47444
Amount:
$3,500.00
Comprehensive coverage verification via field study, if needed Information not provided.
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.
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet Information not provided.
NEPA Section 106 environmental review, if needed Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover 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), Construction Permit Application

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$122.35

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289
Amount:
$122.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759
Amount:
$99.92
Prepare request for Special Temporary Authorization Information not provided.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover 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, Construction Permit Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Consulting engineer services.
Amount:
$1,575.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Consulting engineering cost
Amount:
$1,920.00
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form

Component Description:
Legal services cost.
Amount:
$187.90

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759
Amount:
$869.30

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$1,315.27

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289
Amount:
$1,311.48

Component Description:
Legal services.
Amount:
$115.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$152.01
Project management of the transition

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$716.28

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1079
Amount:
$177.14

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 99 stations. #1086
Amount:
$275.35

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$818.59

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$20.91

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #463567
Amount:
$566.48

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #464321
Amount:
$683.07

Component Description:
Legal services cost. #460920
Amount:
$367.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #465001
Amount:
$596.30

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #465173
Amount:
$654.26

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #473506
Amount:
$421.40

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1123
Amount:
$342.14

Component Description:
Legal Service Cost. #472653
Amount:
$163.75

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1114
Amount:
$242.25

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1099
Amount:
$266.93

Component Description:
Legal Service Cost. #470322
Amount:
$497.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1133
Amount:
$307.72

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1117
Amount:
$282.68

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1098
Amount:
$238.07

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 99 stations. #469573
Amount:
$377.14

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1105
Amount:
$216.88

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 99 stations. #468718
Amount:
$349.51

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1093
Amount:
$265.72

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1130
Amount:
$281.49

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #471524
Amount:
$341.18

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #470321
Amount:
$198.52

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1069
Amount:
$246.68

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759
Amount:
$29.98

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #467861
Amount:
$470.30

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #466690
Amount:
$446.87

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1117
Amount:
$282.68

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1090
Amount:
$176.70

Component Description:
Legal Service Cost. #465255
Amount:
$177.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations.
Amount:
$105.97

Component Description:
Legal Service Cost. #467931
Amount:
$50.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1063
Amount:
$262.29

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #461759
Amount:
$999.20

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #470237
Amount:
$436.37

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1072
Amount:
$237.64

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$43.72

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1055
Amount:
$243.38

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$32.35

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. Previous balance of invoice #453686.
Amount:
$999.04

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations.
Amount:
$185.10

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #470923
Amount:
$406.65

Component Description:
Legal Service Cost. #464720
Amount:
$417.90

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 100 stations. #1111
Amount:
$159.58

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1078
Amount:
$215.68

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$86.88

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #463026
Amount:
$801.57

Component Description:
Legal Service Cost. #470899
Amount:
$163.75

Component Description:
Legal services cost #463646
Amount:
$145.20

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$943.95

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$91.76

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #1058
Amount:
$187.24

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$836.44

Component Description:
Legal services cost. #461733
Amount:
$513.20

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations.
Amount:
$20.65

Component Description:
Legal services cost. #464379
Amount:
$145.60

Component Description:
Legal Service Cost. #467458
Amount:
$62.90

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 93 stations. #461289
Amount:
$91.50

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations.
Amount:
$30.47

Component Description:
Legal Service Cost. #466770
Amount:
$240.00

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 98 stations. #467378
Amount:
$576.96

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 $175,646.00 $175,081.00 N/A $0.00 N/A
Total for all systems $4,112,609.55 $3,905,723.19 N/A $502,605.47 N/A
Other Expenses $175,646.00 $175,081.00 $0.00
MVPD Notification of Channel Change $5,000.00 $5,000.00 See Exhibit J. N/A N/A
Develop and air announcement of upcoming channel change $75,000.00 $75,000.00 See Response to August 4 Inquiry. N/A N/A
Equipment Storage $15,000.00 $15,000.00 See Exhibit J. N/A N/A
Equipment Delivery and Handling Charges $10,000.00 $10,000.00 See Exhibit J. N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $28,566.00 $28,566.00 See Response to August 4 Inquiry. N/A N/A
Non-zoning permits $10,000.00 $10,000.00 See Exhibit J. N/A N/A
Local Zoning $20,000.00 $20,000.00 See Exhibit J. N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 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

Components

Actual Information Description File Name
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Non-zoning permits Information not provided.
Local Zoning

Component Description:
Local zoning related cost. #2770
Amount:
$1,600.00
FCC Filing Fees - Special Temporary Authorization request Information not provided.
DTV Medical Facility Notification Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $4,112,609.55 $3,905,723.19 $502,605.47

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.

Lucy Rutishauser

CFO


09/16/2019

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.

Lucy Rutishauser

CFO


09/16/2019

Attachments

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