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:
11033
Service:
DTV
Call Sign:
WLLA
Channel:
22 (UHF)
File Number:
0000027855
FRN:
0002940195
Date Submitted:
10/29/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

CHRISTIAN FAITH BROADCAST, INC.

Mr. Clyde R. Yost

3809 MAPLE AVENUE

CASTALIA, OH 44824

United States

+1 (419) 684-5311 rustyy@cfbroadcast.net Corporation

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

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. No
Briefly describe transition plan Must remove existing antenna(s), transmitter, transmission line(s), install interim antenna, transmitter, transmission line - install new transmitter. Must add space to building for heat exchangers, pumps. Must reroute ductwork and install different AC.

Transmitters

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

Primary Transmitter

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Add 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 Sigma Diamond
Year 2008
Type Inductive Output Tube
IOT Power Type Single
Power Capacity 30 kW

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Manufacturer
Model ULXTE-30
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 19.2 kW
Justification for New Transmitter Gates is no longer making IOT transmitters - Existing transmitter cannot be re-tuned. See attached letter from Gates Air.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) Yes
Switchgear (industrial 800 amp) Yes
Transformer (480V) Yes
Power 150 kVA
Rigid Conduit and Wiring Yes
Size 2 inches
Length 100.0 feet
Other Electrical Service Yes
Description remove old and reroute existing conduit and control cabling
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 10 tons
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? Yes
Size 320.0 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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Add 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 this antenna currently shared with any other stations? No
Is this 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 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: 350.0 kW
Manufacturer
Model JSM-10/22
Year 2019

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: 350.0 kW
Manufacturer
Model JSM-10/22
Year 2019
Justification for New Antenna Existing antenna cannot be re-tuned. See Cover Letter included with Invoice - WLLA will cover the cost with the upgrade to elliptical polarization

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?
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?
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

Interim Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? 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 1
Number of Panels/Bays 2
Lower Limit 518.00 MHz
Upper Limit 524.00 MHz
Design power capacity in use 100.0 %
Other Antenna Type N/A
ERP: 384.0 kW
Manufacturer
Model JA/MS-16/22
Year 2019
Justification for New Antenna Need interim antenna while removing old and installing new

Interim Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? No
Broadband or Single Channel? N/A
Feed Line Size N/A
Side Mount Brackets Do you require the separate purchase of side mount brackets for an antenna? No
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? Yes
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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Add 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 this transmission currently shared with any other 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 19 3/4 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1200 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 19 1/2 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1200 feet per run
Justification for New Transmission Line The existing line cannot be used on new frequency.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Interim Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Interim
Description of Use N/A
Change Type Purchase New
Type Flexible Air
Diameter 4 inches
Segment Length N/A
Other Segment Length
Number of parallel runs 1
Length 1100 feet per run
Justification for New Transmission Line will need to operate with interim facility while removing old and installing new

Interim Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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Section Question Response
Tower Equipment or Rigging Costs Changes Do you have tower equipment or rigging costs changes? Yes

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Owned
Is this tower consider Complex? No
Is this tower currently shared with any other stations? No
One or more FM, AM or TV radio broadcaster(s) N/A
Others Types of Users N/A
Is tower documented for structural analysis? Unknown
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1004741
Coordinates (NAD83) Latitude (NAD83) 42° 33' 52.1" N-
Longitude (NAD83) 085° 27' 31.0" W-
Overall Structure Height 1080.04 feet
Support Structure Height 1054.12 feet
Ground Elevation Above Mean Sea Level (AMSL) 872.04 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Christian Broadcasting Ministry
Date Constructed 05/21/2007


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: Major 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

tower rigging

may need to rig tower for interim equipment and re-rig for final install

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 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 Yes
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning No
Non-zoning permits 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)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? Yes
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Name Description

employee expense

must bring in employees from OH and overtime for onsite employees

lodging meals incidentals

OH employees lodging and meals

Tower Road Modifications

Must modify road to tower to allow large trucks etc.

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 $836,240.00 $778,158.42 N/A $663,315.72 N/A
Total for all systems $3,154,538.00 $2,440,537.45 N/A $1,269,595.75 N/A
Primary Transmitter ULXTE-30 $836,240.00 $778,158.42 $663,315.72
Other -- Building Addition Size: 320.0 $32,590.00 $32,590.00 per revised Rick Reed estimate to include Call Letters and Facility ID $32,590.00 This cost is reflected in the transmitter cost originally
10 Ton system $38,900.00 $21,120.00 Revised estimate to include the electrical wiring from Severance Electric. The Severance Electric quote was included in other electrical section - but moving to include here. See attachment (Adams Air - Severance Electric) $21,120.00 Estimated wiring cost was not included on in the Adams Air Quote but was included in the Severance Electric Quote and is reflected elsewhere on Form 399 see attached New PDF
Other Electrical Service: remove old and reroute existing conduit and control cabling $0.00 $0.00 Price reflected elsewhere N/A N/A
2" Rigid Conduit and Wiring (Cost per foot) $2,600.00 $0.00 Price reflected elsewhere N/A N/A
Transformer 3 phase/480v - 150 KVA $25,550.00 $24,300.00 N/A $0.00 N/A
Service entrance 3 phase/800 amp/208 volt $14,400.00 $13,700.00 N/A N/A N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW $684,000.00 $650,148.42 Final Quote from Gates Air includes Mask Filter, Electrical Transformer. Final Engineering determined we need a TPO of 19,200 watts to obtain an ERP of the FCC required 275,000 watts to duplicate the existing coverage. $609,605.72 After Engineering was finished - it was determined the transmitter quoted was too small WLLA will need a minimum of 19,200W to reach our ERP of 275,000W. Includes Mask Filter and Electric Transmformer

Components

Actual Information Description File Name
Other -- Building Addition Size: 320.0

Component Description:
Rick Reed Building Addition Invoice
Amount:
$32,590.00
10 Ton system

Component Description:
Install 2- 5 ton AC units includes 2 condensors and 2 Air handlers. Does not include electrical wiring.
Amount:
$16,120.00

Component Description:
Invoice for Electrical wiring 3 Phase AC Install
Amount:
$5,000.00
Other Electrical Service: remove old and reroute existing conduit and control cabling Information not provided.
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Transformer 3 phase/480v - 150 KVA Information not provided.
Service entrance 3 phase/800 amp/208 volt Information not provided.
Switchgear - industrial 800 amp Information not provided.
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW

Component Description:
Final Payment on transmitter - does not include Install - Proof or shipping
Amount:
$180,106.78

Component Description:
2nd - Payment of total due before shipment
Amount:
$214,749.47

Component Description:
1/3 payment prior to shipment
Amount:
$214,749.47

Component Description:
1/3 Down payment for WLLA transmitter. Includes Mask Filter RF Accessories, Electrical transformer
Amount:
$214,749.47

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 $846,420.00 $308,670.96 N/A $290,870.96 N/A
Total for all systems $3,154,538.00 $2,440,537.45 N/A $1,269,595.75 N/A
Interim Antenna JA/MS-16/22 $290,890.00 $85,020.96 $73,620.96
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
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
UHF - Lower Power Side Mount, One station - 200-500 kW, horizontally polarized $189,500.00 $36,810.48 N/A $36,810.48 Invoice includes multiple antennas and transmission lines
UHF - Lower Power Side Mount, One station antenna - medium power (50-200 kW), horizontally polarized $89,400.00 $36,810.48 ***System Notice: Estimate adjusted and locked because line has been superseded.*** $36,810.48 Invoice includes Main/Interim antennas - and transmission line for both
Primary Antenna JSM-10/22 $555,530.00 $223,650.00 $217,250.00
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $289,500.00 $105,000.00 N/A $105,000.00 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $7,250.00 N/A $7,250.00 Invoice includes Main/Interim antennas - and transmission line for both
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized $247,000.00 $105,000.00 ***System Notice: Estimate adjusted and locked because line has been superseded.*** $105,000.00 Invoice includes Main, Interim antennas, and transmission line for both

Components

Actual Information Description File Name
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) Information not provided.
Sweep test of existing antenna Information not provided.
UHF - Lower Power Side Mount, One station - 200-500 kW, horizontally polarized

Component Description:
Ch 22 Interim Antenna
Amount:
$36,810.48
UHF - Lower Power Side Mount, One station antenna - medium power (50-200 kW), horizontally polarized

Component Description:
Invoice includes Main/Interim antennas - and transmission line for both
Amount:
$36,810.48
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
Invoice includes antennas and transmission lines.
Amount:
$105,000.00
Sweep test of existing antenna Information not provided.
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
Invoice includes Main/Interim Antennas and transmission line
Amount:
$7,250.00
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized

Component Description:
Invoice includes Main/Interim antennas and transmission line
Amount:
$105,000.00

Cost Information

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Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $323,800.00 $251,177.07 N/A $251,177.07 N/A
Total for all systems $3,154,538.00 $2,440,537.45 N/A $1,269,595.75 N/A
Interim Transmission Line $81,400.00 $37,426.27 $37,426.27
Flexible Air Transmission Line - dielectric, 4" $81,400.00 $37,426.27 N/A $37,426.27 Invoice includes Main/Interim antennas - and transmission line for both
Primary Transmission Line $242,400.00 $213,750.80 $213,750.80
Rigid Transmission Line - copper, 6 1/8" $242,400.00 $213,750.80 Per Widelity Catalog Pg 17 tables 1 & 2 Ch 22 requires a 20ft section and we are presently using a 19-3/4ft section transmission line. We will need to replace the existing 6-1/8 line. Includes mounting hdwe and tuning sections $213,750.80 Invoice includes Main/Interim antennas - and transmission line for both

Components

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

Component Description:
Invoice includes Main/Interim antennas and transmission line for both
Amount:
$37,426.27
Rigid Transmission Line - copper, 6 1/8"

Component Description:
Invoice includes Main/Interim antennas and transmission line
Amount:
$213,750.80

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 $857,800.00 $825,000.00 N/A $0.00 N/A
Total for all systems $3,154,538.00 $2,440,537.45 N/A $1,269,595.75 N/A
Primary Tower TOWER $857,800.00 $825,000.00 $0.00
tower rigging $200,000.00 $200,000.00 Interim Facility install and existing line removal. We will most likely need to rig the tower twice, once for the removal of equipment and install interim equipment. Then a 2nd time to install the primary antenna and transmission line. If Needed N/A N/A
Tall Tower (greater than 500') $210,500.00 $200,000.00 Install new line and antenna. 2nd rigging for installation of new equipment N/A N/A
Major tower reinforcement/modifications $421,000.00 $400,000.00 N/A N/A N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $25,000.00 N/A N/A N/A

Components

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 $130,700.00 $123,750.00 N/A $0.00 N/A
Total for all systems $3,154,538.00 $2,440,537.45 N/A $1,269,595.75 N/A
Outside Professional Services $130,700.00 $123,750.00 $0.00
RF Exposure Measurements $21,050.00 $20,000.00 N/A 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 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 - 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
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A

Components

Information not provided.

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $159,578.00 $153,781.00 N/A $64,232.00 N/A
Total for all systems $3,154,538.00 $2,440,537.45 N/A $1,269,595.75 N/A
Other Expenses $159,578.00 $153,781.00 $64,232.00
Tower Road Modifications $55,475.00 $55,475.00 N/A $55,475.00 N/A
lodging meals incidentals $12,672.00 $12,672.00 See Attached Employee Expense Exhibit N/A N/A
employee expense $31,362.00 $31,362.00 Must take employee off regular duty for the re-pack and project manage. Plus maintain day to day responsibilities. See Attached Employee Expense Exihibit N/A N/A
MVPD Notification of Channel Change $2,989.00 $2,989.00 N/A $2,989.00 N/A
Develop and air announcement of upcoming channel change $5,000.00 $5,000.00 N/A N/A N/A
Equipment Storage $8,000.00 $8,000.00 3 - 45ft containers for temp storage approx. 6 months rental plus drop-off / pick-up N/A N/A
DTV Medical Facility Notification $11,550.00 $5,768.00 N/A $5,768.00 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
Disposal Costs (for equipment and other waste, net of any salvage value) $15,000.00 $15,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $17,000.00 $17,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Tower Road Modifications

Component Description:
Modifications to tower rd to allow large trucks etc.
Amount:
$55,475.00
lodging meals incidentals Information not provided.
employee expense Information not provided.
MVPD Notification of Channel Change

Component Description:
MVPD Notification for WLLA 11033
Amount:
$2,989.00
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
DTV Medical Facility Notification

Component Description:
Medical Notification WLLA 11033
Amount:
$5,768.00
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Equipment Delivery and Handling Charges Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $3,154,538.00 $2,440,537.45 $1,269,595.75

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.

Richard Hawkins

GM


10/29/2019

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