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:
3660
Service:
DTV
Call Sign:
KLBK-TV
Channel:
31 (UHF)
File Number:
0000028778
FRN:
0009961889
Date Submitted:
11/05/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

NEXSTAR BROADCASTING, INC.

Elizabeth Ryder

545 E. JOHN CARPENTER FREEWAY

SUITE 700

IRVING, TX 75062

United States

+1 (972) 373-8800 eryder@nexstar.tv 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

Elizabeth Ryder

General Counsel

Nexstar Broadcasting, Inc.

Elizabeth Ryder

545 E. John Carpenter Freeway

Suite 700

Irving, TX 75062

United States

+1 (972) 373-8800 eryder@nexstar.tv

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 new antenna. Higher COR reduces ERP to 400 kW for initial CP and will save repack costs. Operate on pre-repack channel on STA using interim side mount.

Question Response
Sharee Station Facility ID 40820
Call Sign KAMC
Type Commercial
Licensee Name MISSION BROADCASTING, INC.
Status LICENSED
DTS No
Community of License LUBBOCK, TX
Pre-auction RF Channel 27
Post-auction RF Channel 27
Neilsen DMA Lubbock
Network Affiliation

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 Purchase New
Use Auxiliary (Backup)
Description of Use backup
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 Ranger
Year 2002
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1 kW

Auxiliary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Auxiliary (Backup)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model TLU9
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 0.1 kW
Justification for New Transmitter Existing transmitter cannot be converted to repacked channel and is not longer supported per manufacturer.

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) Yes
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring Yes
Size 2 inches
Length 50.0 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

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 DCX2
Year 2008
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? Yes
Manufacturer
Model THU9evo/16
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 25.5 kW
Justification for New Transmitter Existing transmitter cannot be converted to repacked channel per manufacturer.

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) No
Power N/A
Rigid Conduit and Wiring Yes
Size 3 inches
Length 100.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 5 tons
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? Yes
Size 100.0 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 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? Yes
Is the existing antenna directional? No
Is antenna in operating condition? No
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 24
Design power capacity in use 100.0 %
Lower Limit 470.00 MHz
Upper Limit 600.00 MHz
Other Antenna Type N/A
ERP: 2000.0 kW
Manufacturer
Model 9551516
Year 2008

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

Facility ID Call Sign
40820 KAMC

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? Yes
Is antenna directional? No
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 Horizontal
Type Broadband Panel
Number of Stations Supported 2
Number of Panels/Bays 64
Lower Limit 470.00 MHz
Upper Limit 700.00 MHz
Design power capacity in use 50.0 %
Other Antenna Type N/A
ERP: 400.0 kW
Manufacturer
Model TFU-31ETT/VP-R O6
Year 2017
Justification for New Antenna Antenna purchased is top-mount, single-channel slot as approved by FCC Review. Antenna component in "Cost" Section locks if 399 is revised to show "Slotted Coaxial"; therefore, 399 still indicates antenna is broadband; however, it is single-channel slot.

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
Do you need a combiner output splitter/switcher for dual feed lines? No
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Broadband
Feed Line Size 8 3/16 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

Enter a list of RF channel numbers.

RF Channel Number
31
27

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? 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 8 3/16 inches
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 1
Length 725 feet per run

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

Facility ID Call Sign
40820 KAMC

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 8 3/16 inches
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 1
Length 925 feet per run
Justification for New Transmission Line Line purchased is 6 in 20 ft section as approved by FCC Review. Transmission Line component in "Cost Section" locks if 399 is revised to show actual line purchased; therefore, 399 still indicates line is 8 in broadband; however, it is 6 in 20 ft line.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Leased
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? No
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1054347
Coordinates (NAD83) Latitude (NAD83) 33° 31' 33.8" N-
Longitude (NAD83) 101° 52' 08.6" W-
Overall Structure Height 916.98 feet
Support Structure Height 836.93 feet
Ground Elevation Above Mean Sea Level (AMSL) 3228.96 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner American Towers, LLC.
Date Constructed 07/06/1998

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
40820 KAMC 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: 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 Load Study

Structural Analysis

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 1000
Explanation It will be necessary to schedule and coordinate multiple vendors, complete progress reports, and update Schedule 399. Station does not have available personnel or personnel trained in project management for such complex projects.
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 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 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 2
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification Yes
FAA Consultation (including preparation of FAA Form 7460) Yes
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers No
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements No
Additional Field Engineering Service Yes
Number of Days 20
Justification It is necessary to survey the site, plan the equipment, develop specifications for purchasing, & oversee multiple vendor RF projects. Station does not have available personnel trained in such services.

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 Yes
Non-zoning permits No
BLM or NFS Coordination No
FCC Construction Permit Minor Change Yes
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

Sales and Use Tax

Sales and Use Tax

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 $1,083,550.00 $804,795.00 N/A $725,995.00 N/A
Total for all systems $3,075,550.38 $2,500,387.18 N/A $1,750,716.10 N/A
Primary Transmitter THU9evo/16 $1,030,050.00 $752,345.00 $711,995.00
Other -- Building Addition Size: 100.0 $5,000.00 $5,000.00 N/A N/A N/A
5 Ton system $20,250.00 $19,700.00 N/A N/A N/A
3" Rigid Conduit and Wiring (Cost per foot) $5,200.00 $5,000.00 N/A $3,400.00 N/A
Switchgear - industrial 800 amp $38,200.00 $37,150.00 N/A $37,150.00 N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW $947,000.00 $671,445.00 See Rohde & Schwarz quote 105694.0 $663,950, additional parts 137833.0 $5,495 and 131892.0 Transformer stacking stand $2,000 $671,445.00 N/A
Service entrance 3 phase/800 amp/208 volt $14,400.00 $14,050.00 N/A N/A N/A
Auxiliary Transmitter TLU9 $53,500.00 $52,450.00 $14,000.00
2" Rigid Conduit and Wiring (Cost per foot) $1,300.00 $1,300.00 N/A N/A N/A
UHF - Air Cooled Solid State Transmitter 0.1 kW $14,000.00 $14,000.00 See Rohde & Schwarz quote 105683.1 attached. $14,000.00 N/A
Switchgear - industrial 800 amp $38,200.00 $37,150.00 N/A N/A N/A

Components

Actual Information Description File Name
Other -- Building Addition Size: 100.0 Information not provided.
5 Ton system Information not provided.
3" Rigid Conduit and Wiring (Cost per foot)

Component Description:
Electrical services
Amount:
$3,400.00
Switchgear - industrial 800 amp

Component Description:
Electrical services
Amount:
$37,150.00
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW

Component Description:
Transmitter, installment #3
Amount:
$165,987.50

Component Description:
Transmitter, installment #2
Amount:
$331,975.00

Component Description:
Transmitter, installment #1
Amount:
$165,987.50

Component Description:
Additional transmitter parts
Amount:
$5,495.00

Component Description:
Transformer stacking stand
Amount:
$2,000.00
Service entrance 3 phase/800 amp/208 volt Information not provided.
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
UHF - Air Cooled Solid State Transmitter 0.1 kW

Component Description:
Aux transmitter, installment #2
Amount:
$10,500.00

Component Description:
Aux transmitter, installment #1
Amount:
$3,500.00
Switchgear - industrial 800 amp 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 $656,880.00 $332,306.50 N/A ($80,106.16) N/A
Total for all systems $3,075,550.38 $2,500,387.18 N/A $1,750,716.10 N/A
Primary Antenna TFU-31ETT/VP-R O6 $656,880.00 $332,306.50 ($80,106.16)
Elbow complex, broadband, at antenna input, per 8 3/16. feedline (if needed) $18,950.00 $10,298.00 N/A $6,439.50 N/A
UHF - High Power Top Mount (200-1000 kW), Two Station broadband panel antenna, horizontally polarized $547,000.00 $297,151.00 Antenna purchased is a top-mount, single-channel slot antenna as approved by an FCC Review. A broadband antenna was not purchased. See attached cover letter with explanation (Dielectric Antenna Cover Letter). ($111,253.16) N/A
New combiner, cost per channel (without antenna) $84,200.00 $18,307.50 Cost revised down from $80,000 to $18,307.50. Total cost of combiner is $36,615 per Dielectric quote 800062CMZ attached. The combiner also benefits KAMC which is a non-repack station, so KLBK will seek reimbursement for 50% of the cost. $18,307.50 N/A
Sweep test of existing antenna $6,730.00 $6,550.00 N/A $6,400.00 N/A

Components

Actual Information Description File Name
Elbow complex, broadband, at antenna input, per 8 3/16. feedline (if needed)

Component Description:
Reverse request
Amount:
$6,439.50

Component Description:
Credit memo - antenna order changed
Amount:
($6,439.50)

Component Description:
Elbow component - line 3 of invoice
Amount:
$6,439.50
UHF - High Power Top Mount (200-1000 kW), Two Station broadband panel antenna, horizontally polarized

Component Description:
Credit memo - antenna order changed
Amount:
($21,733.65)

Component Description:
Credit memo - antenna order changed
Amount:
($350,147.81)

Component Description:
Reverse request
Amount:
$21,733.65

Component Description:
Reverse request
Amount:
$217,161.00

Component Description:
Credit memo - antenna order changed
Amount:
($217,161.00)

Component Description:
Antenna component - line 1 of invoice.
Amount:
$217,161.00

Component Description:
Antenna component - line 2 of invoice
Amount:
$21,733.65
New combiner, cost per channel (without antenna)

Component Description:
KLBK 50% share of combiner cost, installment #2
Amount:
$8,238.38

Component Description:
KLBK 50% share of combiner cost, installment #1
Amount:
$8,238.38

Component Description:
KLBK 50% share of combiner cost, balance due
Amount:
$1,830.74
Sweep test of existing antenna

Component Description:
Sweep test
Amount:
$6,400.00

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 $369,075.00 $134,593.90 N/A $104,813.66 N/A
Total for all systems $3,075,550.38 $2,500,387.18 N/A $1,750,716.10 N/A
Primary Transmission Line $369,075.00 $134,593.90 $104,813.66
Rigid Transmission Line - copper, 8 3/16" broadband $369,075.00 $134,593.90 Transmission Line purchased is 6 inch 20 ft section line as approved by an FCC Review. 8 inch Broadband transmission line was not purchased. See attached cover letter with explanation (Dielectric Transmission Line Cover Letter). $104,813.66 N/A

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 8 3/16" broadband

Component Description:
Credit memo - antenna order changed
Amount:
($104,813.66)

Component Description:
Reverse request
Amount:
$104,813.66

Component Description:
Transmission line - line 4 of invoice
Amount:
$104,813.66

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 $669,800.00 $944,958.40 N/A $923,478.40 N/A
Total for all systems $3,075,550.38 $2,500,387.18 N/A $1,750,716.10 N/A
Primary Tower GTOWER $669,800.00 $944,958.40 $923,478.40
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $41,475.00 See American Tower quote attached. Increased due to antenna design changes. Added cost $10400. See American Tower revised quote. $41,475.00 N/A
Major tower reinforcement/modifications $421,000.00 $241,980.00 See American Tower PO request (excludes structural analysis) $232,500.00 N/A
Tall Tower (greater than 500') $210,500.00 $649,503.40 See Tower Consultants Proposal TCI-18-235A; and Tower Consultants change order 1 $649,503.40 N/A
Tower Load Study $12,000.00 $12,000.00 N/A N/A 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:
Structural analysis
Amount:
$10,475.00

Component Description:
Structural analysis
Amount:
$5,200.00

Component Description:
Structural analysis
Amount:
$5,200.00

Component Description:
Tower Mapping
Amount:
$20,600.00
Major tower reinforcement/modifications

Component Description:
Tower Modifications, installment #2
Amount:
$155,000.00

Component Description:
Tower Modifications, installment #1
Amount:
$77,500.00
Tall Tower (greater than 500')

Component Description:
Tower work, installment #1
Amount:
$319,105.00

Component Description:
Tower work, installment #2
Amount:
$191,463.00

Component Description:
Tower work, balance due
Amount:
$138,935.40
Tower Load Study 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 $244,020.00 $238,100.00 N/A $47,414.50 N/A
Total for all systems $3,075,550.38 $2,500,387.18 N/A $1,750,716.10 N/A
Outside Professional Services $244,020.00 $238,100.00 $47,414.50
Additional Field Engineering Service, 20 Days $48,000.00 $48,000.00 N/A N/A N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase $2,105.00 $2,050.00 N/A N/A N/A
ASR modification (prepare FCC Form 854) $2,105.00 $2,050.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $7,360.00 $7,170.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,305.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,120.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $4,100.00 $3,070.00 N/A $1,500.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,535.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,070.00 N/A $2,500.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,170.00 N/A $3,850.00 N/A
Prepare and or review reimbursement form $2,630.00 $2,560.00 N/A N/A N/A
Project management of the transition $158,000.00 $154,000.00 N/A $39,564.50 N/A

Components

Actual Information Description File Name
Additional Field Engineering Service, 20 Days 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.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application Information not provided.
Prepare request for Special Temporary Authorization

Component Description:
STA to operate FCC Repack post-transition interim facilty
Amount:
$1,500.00
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

Component Description:
Prepare engineering section of FCC Form 2100, item 4 from invoice summary
Amount:
$2,500.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Revise and update 399 form
Amount:
$175.00

Component Description:
Revise storyboard, interference study, create CP and recalculate ERP if COR changed, transition plan document, create 399, coverage maps, and upload draft docs to ASANA. Engineering analysis for new KLBK antenna, creation of exhibits and prep of STA
Amount:
$2,712.50

Component Description:
Review pre and post repack use of TFUWB antenna, MCI Panel Analysis
Amount:
$962.50
Prepare and or review reimbursement form Information not provided.
Project management of the transition

Component Description:
Project management services 10.27.18 through 11.30.18
Amount:
$900.00

Component Description:
Project management services 3.2.19 through 3.29.19, items 1 and 2 from invoice summary
Amount:
$8,000.00

Component Description:
Project management services March 2019
Amount:
$338.00

Component Description:
Project management services July 2019
Amount:
$100.00

Component Description:
Project management services June 2019
Amount:
$50.00

Component Description:
Project management services May 2019
Amount:
$1,430.00

Component Description:
Project management services April 2019
Amount:
$123.50

Component Description:
Prepare FCC Schedule 387, item 2 from invoice summary
Amount:
$300.00

Component Description:
Project management services 12.1.18 through 12.31.18
Amount:
$375.00

Component Description:
Project management services, item 1 from invoice summary
Amount:
$10,050.00

Component Description:
Project management services various, item 5 from invoice summary
Amount:
$1,288.00

Component Description:
Project management services March 2019
Amount:
$75.00

Component Description:
Project management services November 2018
Amount:
$50.00

Component Description:
Project management services 6.30.18 through 7.27.18
Amount:
$825.00

Component Description:
Project management services 9.29.18 through 10.26.18
Amount:
$1,375.00

Component Description:
Project management services 1.1.19 through 1.31.19
Amount:
$1,250.00

Component Description:
Prepare FCC Schedule 387, item 3 from invoice summary
Amount:
$150.00

Component Description:
Project management services 2.1.19 through 3.1.19
Amount:
$300.00

Component Description:
Project management services January 2019
Amount:
$65.00

Component Description:
Project management services 7.28.18 through 9.28.18
Amount:
$3,250.00

Component Description:
Project management services January 2019
Amount:
$120.00

Component Description:
Project management services 3.30.19 through 4.26.19
Amount:
$300.00

Component Description:
Project management services October 2018
Amount:
$75.00

Component Description:
Project management services 5.26.18 through 6.29.18
Amount:
$4,750.00

Component Description:
Project Management for Structural Analysis and Tower Modifications. Services 10/27/17 through 12/31/17.
Amount:
$1,725.00

Component Description:
Project Management for Structural Analysis and Tower Modifications including consultants Kessler and Gehman Associates. Services from January 27, 2018 through February 23, 2018.
Amount:
$1,875.00

Component Description:
Project management services September 2018
Amount:
$50.00

Component Description:
Project management services December 2018
Amount:
$150.00

Component Description:
Project management services 6.1.19 through 6.28.19
Amount:
$225.00

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 $52,225.38 $45,633.38 N/A $29,120.70 N/A
Total for all systems $3,075,550.38 $2,500,387.18 N/A $1,750,716.10 N/A
Other Expenses $52,225.38 $45,633.38 $29,120.70
Equipment Delivery and Handling Charges $25,000.00 $25,000.00 N/A $20,861.32 N/A
Sales and Use Tax $3,345.38 $3,345.38 Tax due on installation services; see R&S invoice 9500086784 $3,345.38 N/A
MVPD Notification of Channel Change $2,500.00 $2,500.00 N/A $0.00 N/A
Develop and air announcement of upcoming channel change $1,500.00 $1,500.00 Develop and produce spots and crawls for viewer notification. N/A N/A
Equipment Storage $3,190.00 $3,190.00 See Dielectric invoice 570008 $3,190.00 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $2,500.00 $2,500.00 N/A N/A N/A
Local Zoning $1,000.00 $1,000.00 N/A N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $195.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $333.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $5,000.00 N/A $1,724.00 N/A

Components

Actual Information Description File Name
Equipment Delivery and Handling Charges

Component Description:
Antenna freight and shipping
Amount:
$20,861.32
Sales and Use Tax

Component Description:
Tax due on installation services
Amount:
$3,345.38
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage

Component Description:
Antenna storage costs
Amount:
$3,190.00
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Local Zoning Information not provided.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
DTV Medical Facility Notification

Component Description:
Notification of medical facilities
Amount:
$1,724.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $3,075,550.38 $2,500,387.18 $1,750,716.10

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.

Elizabeth Ryder

General Counsel


11/05/2019

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.

Elizabeth Ryder

General Counsel


11/05/2019

Attachments

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