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:
71297
Service:
DTV
Call Sign:
WCSC-TV
Channel:
19 (UHF)
File Number:
0000024799
FRN:
0018223693
Date Submitted:
10/07/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

GRAY TELEVISION LICENSEE, LLC

Doing Business As: WCSC

4370 PEACHTREE ROAD, NE

ATLANTA, GA 30319

United States

+1 (843) 402-5555 allfcclms@gray.tv 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

The Preparer is same as the reimbursement contact.

 

 

 

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. Yes
Briefly describe transition plan Install interim antenna and connect to existing line Install new 7" EIA tx line and connect to existing antenna Will require new combiner for WCSC and WGWG. WGWG is not repacked.

Transmitters

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

Auxiliary Transmitter

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Add 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 Harris
Model UAX-2000AT
Year 2012
Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2.5 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 3 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 Power CD
Year 2014
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 60 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-50
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 30.1 kW
Justification for New Transmitter The cost of rental main transmitter coupled with the cost to retune the existing main transmitter is more expensive than the purchase of a comparable solid state transmitter. Quotes attached.

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 No
Size N/A
Length N/A
Other Electrical Service Yes
Description Electrical panel, conduit and wire
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? Yes
Size 200.0 square feet
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

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 Retune Existing
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? Yes
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 Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 2
Number of Panels 10
Design power capacity in use 40.0 %
Lower Limit 470.00 MHz
Upper Limit 690.00 MHz
Other Antenna Type N/A
ERP: 1000.0 kW
Manufacturer Dielectric
Model TUP-C3-10-1
Year 2003

Facility ID's and Call Signs of all stations with whom the antenna is shared.

Facility ID Call Sign
21536 WGWG

Primary Antenna

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Adjustment to Existing Antenna

Section Question Response
Sweep Test of Existing Antenna Do you need a sweep test of existing antenna? Yes

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? Yes
Type New
Number of channels supported 2
Frequencies of channels supported RF channel
Frequency N/A

Enter a list of RF channel numbers.

RF Channel Number
34
19

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Combiner installation

Installation of new combiner.

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? Yes
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Slot
Number of Stations Supported 2
Number of Panels/Bays 16
Lower Limit 470.00 MHz
Upper Limit 686.00 MHz
Design power capacity in use 40.0 %
Other Antenna Type N/A
ERP: 1000.0 kW
Manufacturer
Model TFU-WB16
Year 2019
Justification for New Antenna Interim antenna for use while new transmission line is installed and connected to existing panel antenna.

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 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? Yes
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 7 3/16 inches
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 1
Length 1920 feet per run

Facility ID's and Call Signs of all stations with whom the transmission line is shared.

Facility ID Call Sign
21536 WGWG

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 7 3/16 inches
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 1
Length 1920 feet per run
Justification for New Transmission Line Existing line is not true broadband but has selected cut sections to make the line work on current digital channel 47 and analog channel 5. Will not work on channel 19. Sweep data and comments attached. Existing line to serve as interim.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Nitrogen

Tanks to pressurize new line

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? 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? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1051231
Coordinates (NAD83) Latitude (NAD83) 32° 55' 29.0" N-
Longitude (NAD83) 079° 41' 57.0" W-
Overall Structure Height 1999.98 feet
Support Structure Height 1999.98 feet
Ground Elevation Above Mean Sea Level (AMSL) 16.08 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner WCSC, LLC
Date Constructed 10/07/2009

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
60950 WSCI FM
61005 WITV DTV
60039 WIWF FM
21536 WGWG 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 undocumented/poorly 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

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 595
Explanation WCSC-TV requires the aid of outside project management services in order to fulfill the requirements of the repack transition.
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 No
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 No
Address transition timing and coordination issues w/ other stations and wireless providers No
RF Field Engineering Services Comprehensive coverage verification via field study Yes
RF exposure measurements No
Additional Field Engineering Service Yes
Number of Days 1
Justification RF system analysis

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 No
FCC Special Temporary Authority Application No
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? 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

Security

Site Security to deter copper theft

Internal Corporate Project Management

Raycom Media Corp Project management

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 $1,158,178.58 $1,085,136.91 N/A $134,061.53 N/A
Total for all systems $2,569,525.06 $2,190,297.39 N/A $412,774.87 N/A
Primary Transmitter ULXTE-50 $1,048,823.58 $1,072,882.89 $121,807.51
Other -- Building Addition Size: 200.0 $2,492.00 $2,492.00 minor ductwork demolition to allow for new RF system installation. Invoice attached $0.00 N/A
Other Electrical Service: Electrical panel, conduit and wire $24,331.58 $24,331.58 Heat Exchanger disconnect panels, new 480v disconnect, new 400 amp distribution panel. Quote attached Invoices received $24,331.58 a
Transformer 3 phase/480v - 300 KVA $36,800.00 $35,000.00 N/A N/A N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A $0.00 N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW $947,000.00 $974,759.31 Quote attached $97,475.93 N/A
Auxiliary Transmitter UAX-2000AT $109,355.00 $12,254.02 $12,254.02
UHF and VHF - minor banding issues $105,200.00 $12,254.02 GateAir Invoice US0315882 $12,254.02 N/A
3 kW mask filter $4,155.00 $0.00 included in retune quote attached N/A N/A

Components

Actual Information Description File Name
Other -- Building Addition Size: 200.0

Component Description:
Duct Work
Amount:
$2,492.00
Other Electrical Service: Electrical panel, conduit and wire

Component Description:
Clevis Hanger Adjustable Pipe
Amount:
$190.53

Component Description:
Installed new Channel 2 Tower Transmitter Panel
Amount:
$23,922.00

Component Description:
Union, Cast Copper, 1-1/2" Tube, CXC
Amount:
$219.05
Transformer 3 phase/480v - 300 KVA Information not provided.
Switchgear - industrial 800 amp

Component Description:
Copper Strap
Amount:
$429.00
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW

Component Description:
UXLTE-50 Transmitter
Amount:
$408,330.08

Component Description:
1/3 of Liquid Cooled Solid state transmitter due prior to shipment
Amount:
$319,229.69

Component Description:
ULXTE-50 Per quote
Amount:
$97,475.93

Component Description:
15% of Liquid Cooled Solid State Transmitter
Amount:
$143,653.36
UHF and VHF - minor banding issues

Component Description:
15% of channel change and proof
Amount:
$1,663.87

Component Description:
Channel Change UAX-2000 per quote
Amount:
$1,109.24

Component Description:
Channel Change, Quote GA-00020216 11,092.44 Low Pass Filter, Quote Q-77296
Amount:
$9,480.91
3 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 $236,050.70 $151,190.70 N/A $113,972.78 N/A
Total for all systems $2,569,525.06 $2,190,297.39 N/A $412,774.87 N/A
Interim Antenna TFU-WB16 $130,120.70 $129,790.70 $112,242.78
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $0.00 Quote attached
UHF - High Power, Side Mount, basic slot antenna, 16 bay,, 1000 kW input, directional,, horizontally polarized $123,390.70 $123,390.70 Quote 63001 attached $112,242.78 Quote: 123,390.7 Invoice Total: 111,290.92
Primary Antenna TUP-C3-10-1 $105,930.00 $21,400.00 $1,730.00
Combiner installation $15,000.00 $15,000.00 N/A $1,730.00 N/A
New combiner, cost per channel (without antenna) $84,200.00 $0.00 Included in TX line quote 67003 attached N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $0.00 N/A

Components

Actual Information Description File Name
Sweep test of existing antenna

Component Description:
RF sweep testing of two coax transmission lines
Amount:
$3,000.00
UHF - High Power, Side Mount, basic slot antenna, 16 bay,, 1000 kW input, directional,, horizontally polarized

Component Description:
T/L 6-75 EIA Length up to 5' fixed flg 1 end/ swivel flg 1 end
Amount:
$951.86

Component Description:
10% Balance Due
Amount:
$18,747.89

Component Description:
interim antenna
Amount:
$61,695.35

Component Description:
interim antenna
Amount:
$30,847.68
Combiner installation

Component Description:
Electrical Testing
Amount:
$7,362.25

Component Description:
Connect coax output of WGWG-TV transmitter into WCSC-TVs new 2-station RF combiner
Amount:
$1,730.00
New combiner, cost per channel (without antenna) Information not provided.
Sweep test of existing antenna

Component Description:
Engineering Services
Amount:
$2,709.04

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 $639,993.86 $414,902.86 N/A $58,755.25 N/A
Total for all systems $2,569,525.06 $2,190,297.39 N/A $412,774.87 N/A
Primary Transmission Line $639,993.86 $414,902.86 $58,755.25
Nitrogen $633.86 $633.86 Airgas invoices total (attached) $633.24 N/A
Rigid Transmission Line - copper, 7 3/16" broadband $639,360.00 $414,269.00 Quote 67003: 390,816.00 C/O: 2/8/18: 10,015.00 cut sections C/O: 1/23/18: 13,438.00 cut sections Net: 414,269 $58,122.01 N/A

Components

Actual Information Description File Name
Nitrogen

Component Description:
Nitrogen industrial 300
Amount:
$199.31

Component Description:
Nitrogen Industrial 300
Amount:
$234.62

Component Description:
Nitrogen Industrial 300
Amount:
$199.31
Rigid Transmission Line - copper, 7 3/16" broadband

Component Description:
Interim Antenna
Amount:
N/A

Component Description:
Interim Antenna
Amount:
N/A

Component Description:
Rigid Transmission Line 10% Balance Due
Amount:
$39,081.53

Component Description:
Rigid Transmission Line
Amount:
$14,769.15

Component Description:
Reducer, Flange, etc
Amount:
$4,271.33

Component Description:
Elbow, Anchor, Flange quote with change orders attached
Amount:
$8,795.40

Component Description:
Rigid Transmission Line
Amount:
$21,229.11

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 $236,800.00 $248,600.00 N/A $13,100.00 N/A
Total for all systems $2,569,525.06 $2,190,297.39 N/A $412,774.87 N/A
Primary Tower TOWER $236,800.00 $248,600.00 $13,100.00
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $18,600.00 Per invoices received $13,100.00 There is a pre-determined cost that is more than the invoice.
Tall Tower (greater than 500') $210,500.00 $230,000.00 Per Tower King II proposal C-18-001 (uploaded to LMS) $0.00 N/A

Components

Actual Information Description File Name
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study

Component Description:
Tower Service - Mapping of WCSC Facility ID # 71297
Amount:
$5,500.00

Component Description:
Feasibility Structural Analysis
Amount:
$7,600.00

Component Description:
WCSC's portion of tower mapping services
Amount:
$5,500.00
Tall Tower (greater than 500')

Component Description:
Down payment/mobilization for WCSC
Amount:
$50,000.00

Component Description:
Completion of Phase 1a of WCSC
Amount:
$130,000.00

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $203,660.00 $203,425.00 N/A $42,789.28 N/A
Total for all systems $2,569,525.06 $2,190,297.39 N/A $412,774.87 N/A
Outside Professional Services $203,660.00 $203,425.00 $42,789.28
Additional Field Engineering Service, 1 Days $0.00 $0.00 not required N/A N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,500.00 N/A $868.73 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 - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $2,050.00 $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
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $0.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $7,654.66 Estimated cost to be added.
Project management of the transition $94,010.00 $99,675.00 Please see the attached Widelity quote. $34,265.89 N/A

Components

Actual Information Description File Name
Additional Field Engineering Service, 1 Days Information not provided.
Comprehensive coverage verification via field study, if needed Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
Professional legal services
Amount:
$868.73
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 request for Special Temporary Authorization Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Perform engineering study for new channel assignment and antenna development

Component Description:
WCSC-530-RF Eng - Engineering Study for New Channel Assignment
Amount:
$5,279.66

Component Description:
Engineering study and preparation of engineering portion of FCC Form 2100
Amount:
$2,250.00

Component Description:
Engineering study work new channel and antenna development
Amount:
$125.00
Project management of the transition

Component Description:
Project Management
Amount:
$385.01

Component Description:
Project Management
Amount:
$66.73

Component Description:
Project Management
Amount:
$2,064.80

Component Description:
Project Management
Amount:
$3,583.85

Component Description:
Project Management
Amount:
$2,531.70

Component Description:
Project Management LMS 387 Q1 Progress Report - Robert E Thurber, 15 mins @ $154.00/hr
Amount:
$77.00

Component Description:
Project Management
Amount:
$3,960.35

Component Description:
Project Management
Amount:
$2,965.95

Component Description:
Project management
Amount:
$4,861.55

Component Description:
Project Management
Amount:
$3,097.45

Component Description:
Project Management
Amount:
$2,734.60

Component Description:
Project Management
Amount:
$3,320.65

Component Description:
Project Management
Amount:
$2,403.80

Component Description:
Project Management
Amount:
$2,212.45

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 $94,841.92 $87,041.92 N/A $50,096.03 N/A
Total for all systems $2,569,525.06 $2,190,297.39 N/A $412,774.87 N/A
Other Expenses $94,841.92 $87,041.92 $50,096.03
Equipment Storage $20,000.00 $20,000.00 Estimate for Dielectric on site antenna storage Dielectric letter attached N/A N/A
Internal Corporate Project Management $35,000.00 $35,000.00 Estimated internal labor cost Detailed spreadsheet will be attached for each invoice $26,367.11 N/A
Security $7,072.00 $7,072.00 Hours and cost verification attached with initial quote $7,072.00 N/A
MVPD Notification of Channel Change $0.00 $0.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $2,850.00 $2,850.00 estimate for on air rescan announcement production. Quote attached N/A N/A
Equipment Delivery and Handling Charges $18,369.92 $18,369.92 On site forklift rental Per invoice received $12,906.92 N/A
DTV Medical Facility Notification $11,550.00 $3,750.00 Group quote attached $3,750.00 N/A

Components

Actual Information Description File Name
Equipment Storage Information not provided.
Internal Corporate Project Management

Component Description:
Internal Project Management See attachment for details
Amount:
$26,367.11
Security

Component Description:
Security
Amount:
$4,080.00

Component Description:
Security
Amount:
$2,992.00
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Equipment Delivery and Handling Charges

Component Description:
Shooting Boom Forklift
Amount:
$5,013.32

Component Description:
Shooting Boom Forklift Rental
Amount:
$4,772.33

Component Description:
Shooting Boom Forklift
Amount:
$3,040.34

Component Description:
Diesel
Amount:
$80.93

Component Description:
Shooting Boom Forklift
Amount:
$5,463.00
DTV Medical Facility Notification

Component Description:
Medical Notifiaction
Amount:
$3,750.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $2,569,525.06 $2,190,297.39 $412,774.87

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.

Robert Folliard , III .

Assistant Secretary


10/07/2019

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.

Robert Folliard , III .

Assistant Secretary


10/07/2019

Attachments

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