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:
35906
Service:
DTV
Call Sign:
KXLT-TV
Channel:
26 (UHF)
File Number:
0000027878
FRN:
0013392477
Date Submitted:
05/05/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

SAGAMOREHILL OF MINNESOTA LICENSES, LLC

Louis Wall

525 Blackburn Drive

AUGUSTA, GA 30907

United States

+1 (706) 922-5644 louis@shbtv.com Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

Tony zumMallen

QCommunications, LLC

Tony zumMallen

705B SE Melody LN #314

Lees Summit, MO 64063

United States

+1 (816) 729-1177 tony@qcom1.com

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan To transition from ch 46 to ch 26, tests by Resonant Results, LTD say TX line can be refurbished and the antenna can be retuned. New TX and associated systems are needed. An interim system (ant, TX and line) is required to operate during the transition.

Transmitters

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

Primary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model Diamond
Year 2001
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 7.25 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-10
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 6.6 kW
Justification for New Transmitter Transmitter is not tunable per the 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) Yes
Power 300 kVA
Rigid Conduit and Wiring Yes
Size 2 inches
Length 500.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 15 tons
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Site Survey - TX

Site survey and report are required to be performed before the new transmitter and components installation plan can be finalized.

Shipping of TX and comp to staging or station

Shipping of TX and comp to staging or station

Transmitter Sales Tax est

KXLT Sales Tax estimate for Transmitter

Transmitter - Training

Transmitter training - offsite - 1 week in duration at mfg site.

Disconnect existing Transmitter

Disconnect transmitter and components from existing configuration and move within building to make way for new facilities.

Transmitter Site Preparation

Duties to prepare the transmitter site ready for the Gates installation crew that are not covered by Gates SOW.

RF Switch Installation

TX configuration requires 2nd RF switch to be installed not covered in any other PO.

Interim Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Interim
Description of Use N/A
Change Type Purchase
Manufacturer
Model UAXTE-4R37
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2.4 kW
Justification for New Transmitter Interim facility is required to avoid prolonged period of station silence during transition, and station currently has no aux facility to use for interim operation. Extended silent period during transition to new channel is unreasonable.

Interim 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 400.0 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
Inside RF System Is an additional interior RF system required to support this interim transmitter? Yes

Interim Transmitter

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Other Transmitter Cost Not Listed

Name Description

Shipping of TX and comp to staging or station

Shipping of TX and comp from MFG to station or staging area

Transmitter Site Preparation

Site prep for installation of the interim and main transmitters and RF components not part of Gates SOW.

Sales Tax est for Interim Transmitter

Est Sales tax for Interim Transmitter

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? No
Is the existing antenna directional? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type Class Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 1
Number of Panels 6
Design power capacity in use 50.0 %
Lower Limit 470.00 MHz
Upper Limit 698.00 MHz
Other Antenna Type N/A
ERP: 220.0 kW
Manufacturer Dielectric
Model TUP-C2-6-1
Year 1998

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? No
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Retune Antenna

Retune Antenna per Resonant Results field report 2-15-17

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 Panel
Number of Stations Supported 1
Number of Panels/Bays 8
Lower Limit 470.00 MHz
Upper Limit 698.00 MHz
Design power capacity in use 50.0 %
Other Antenna Type N/A
ERP: 10.0 kW
Manufacturer
Model TFU-8WB
Year 2017
Justification for New Antenna Interim facility is required to avoid prolonged period of station silence during transition, and station currently has no aux facility to use for interim operation. Extended silent period during transition to new channel is unreasonable.

Interim Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? B
Feed Line Size 3 1/8 inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for an antenna? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? Yes
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Interim Antenna

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Other Antenna Cost Not Listed

Name Description

Freight- Interim ANT

Freight from MFG to staging or station

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 Utilize Existing
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer Dielectric
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length Other
Other Segment Length 19 feet
Number of parallel runs 1
Length 1162 feet per run

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Disconnect existing Interior RF components

Disconnect interior RF transmission line and filters from existing configuration and move within the building to make way for new facilities.

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 Rigid
Diameter 3 1/8 inches
Segment Length 20'
Other Segment Length
Number of parallel runs 1
Length 1075 feet per run
Justification for New Transmission Line Interim facility is required to avoid prolonged period of station silence during transition, and station currently has no aux facility to use for interim operation. Extended silent period during transition to new channel is unreasonable.

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 Move Equipment
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? 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? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1063897
Coordinates (NAD83) Latitude (NAD83) 43° 38' 34.0" N-
Longitude (NAD83) 092° 31' 36.0" W-
Overall Structure Height 1148.94 feet
Support Structure Height 1118.75 feet
Ground Elevation Above Mean Sea Level (AMSL) 1350.05 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner KTTC Television, Inc.
Date Constructed 09/01/1998


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

STRUCTURAL ANALYSIS

Structural Analysis of tower for antenna system

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 728
Explanation Scope & significance of project (SH has multiple stations repacked) require outside management services to augment existing internal personnel to assist turnkey management of and ensure timely and safe execution of channel relocation.
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 4
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 4
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 Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study Yes
RF exposure measurements No
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Quarterly reporting -Atty

Preparation and submittal of the FCC required quarterly report 387 by attorney.

Vendor Travel Expenses

Reimbursable Vendor Travel expenses for working in the field on behalf of the station for the Repack project - see quote for estimated expenses. QC-17001

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

Information not provided.

Cost Information

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Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $890,190.10 $687,758.89 N/A $463,682.59 N/A
Total for all systems $1,696,054.10 $1,454,701.39 N/A $687,756.56 N/A
Interim Transmitter UAXTE-4R37 $341,740.60 $200,640.60 $139,440.28
Shipping of TX and comp to staging or station $4,640.60 $4,640.60 est shipping from factory per Q-59827 $4,640.60 N/A
Transmitter Site Preparation $5,000.00 $5,000.00 Site prep for installation of the interim and main transmitters and RF components not part of Gates SOW. $4,000.00 N/A
UHF inside RF system including switching $147,500.00 $14,700.00 release of majority of component. Billed elsewhere in Transmitter cost components. $1,942.49 N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A $12,652.75 N/A
Sales Tax est for Interim Transmitter $10,000.00 $10,000.00 Est sales tax for KXLT interim transmitter equipment $9,356.04 N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $120,000.00 N/A $106,848.40 N/A
2" Rigid Conduit and Wiring (Cost per foot) $10,400.00 $10,000.00 N/A N/A N/A
Primary Transmitter ULXTE-10 $548,449.50 $487,118.29 $324,242.31
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW $273,500.00 $219,868.79 ***System Notice: Estimate adjusted and locked because line has been superseded.*** $199,204.27 N/A
RF Switch Installation $12,000.00 $12,000.00 RF Switch installation not covered in standard installation. RF config required an additional 2nd RF switch for the interim cut-over. $12,000.00 N/A
Transmitter Site Preparation $10,000.00 $10,000.00 Site prep for installation of the interim and main transmitters and RF components not part of Gates SOW. $4,000.00 N/A
Disconnect existing Transmitter $20,000.00 $20,000.00 Disconnect transmitter and components from existing configuration and move within building to make way for new facilities. $18,500.00 N/A
Transmitter - Training $3,300.00 $3,300.00 Transmitter training - offsite - 1 week in duration at mfg site. N/A N/A
Transmitter Sales Tax est $20,080.25 $20,080.25 est sales tax for KXLT Main transmitter $18,492.86 N/A
Shipping of TX and comp to staging or station $5,704.73 $5,704.73 est Freight or Shipping per quote Q-59825 for TX and components. $5,364.13 N/A
Site Survey - TX $25,000.00 $25,000.00 Site survey and report are required to be performed before the new transmitter and components installation plan can be finalized. $10,500.00 N/A
UHF - Liquid Cooled Solid State Transmitter 6.6 kW $20,664.52 $20,664.52 Amount unreimbursed on transmitter per invoices from GatesAir. $20,664.52 N/A
15 Ton system $55,800.00 $53,000.00 the 399 default for 20 tons is zero. entered 10 tons to reserve the funds N/A N/A
2" Rigid Conduit and Wiring (Cost per foot) $13,000.00 $12,500.00 N/A N/A N/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 $31,958.57 N/A
Service entrance 3 phase/800 amp/208 volt $14,400.00 $13,700.00 N/A $3,557.96 N/A

Components

Actual Information Description File Name
Shipping of TX and comp to staging or station

Component Description:
Gates - Int Tx - Remaining Freight - Final Invoice US0320866 - PO 19968 - Q-59827
Amount:
$340.60

Component Description:
KXLT-FREIGHT-INT- INV-US0314131
Amount:
$4,300.00
Transmitter Site Preparation

Component Description:
KXLT-INT-PREP-INV-QC-035
Amount:
$4,000.00
UHF inside RF system including switching

Component Description:
KXLT-GATES-INT-LINE D BALANCE - INV-US0314131
Amount:
$647.49

Component Description:
KXLT-Gates- INT TX quote 59827 - Line D 2nd payment due
Amount:
$647.50

Component Description:
KXLT-Gates- INT TX quote 59827 - Line D 33percent inv
Amount:
$647.50
Switchgear - industrial 800 amp

Component Description:
KXLT-GATES INV -US0314131-LINE C BALANCE
Amount:
$4,217.59

Component Description:
KXLT-Gates INT TX -RF COMP - 2nd payment- quote 59827 - line C
Amount:
$4,217.58

Component Description:
KXLT-Gates INT TX - quote 59827 - line C
Amount:
$4,217.58
Sales Tax est for Interim Transmitter

Component Description:
KXLT- Sales tax est 33 percent inv see quote Q 59827 attached
Amount:
$2,567.79

Component Description:
Gates - Int Tx - remaining tax - Final INV US0320866 - PO 19968 - Q-59827
Amount:
$1,587.37

Component Description:
KXLT-INT-SALES TAX BALANCE-INV-US0314131
Amount:
$2,633.09

Component Description:
KXLT- Sales tax est 2nd payment- inv see quote Q 59827 attached
Amount:
$2,567.79
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
KXLT - Gates - Int TX final invoice - INV US0320866 - Lines A,B, E and Change order Q-59827-1 - PO 19968 - Q-59827 -
Amount:
$20,405.99

Component Description:
KXLT-MAIN-TX-2nd payment due-Lines A B and E - see Gates quote-Q-59827
Amount:
$32,484.62

Component Description:
KXLT-GATES-INV-US0314131 LINE A-B- BALANCE
Amount:
$21,473.17

Component Description:
KXLT-MAIN-TX-33percent down-Lines A B and E - see Gates quote 59827 attached
Amount:
$32,484.62
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW

Component Description:
KXLT - Gates - Main Transmitter - 3rd Invoice - INV US0315947 - PO 19968 - Q-59825 -
Amount:
$53,848.85

Component Description:
KXLT - GatesAir - Main TX - Lines A, B, & E and Change order Q-79575, PO 20500. INV US0320865
Amount:
N/A

Component Description:
MAIN TX DEPOSIT INV FOR KXLT 1.3 DEPOSIT see Q-59825 Lines A B and E
Amount:
$72,677.71

Component Description:
KXLT-MAIN-TX-2nd payment-LINES A B and E see QTE-Q-59825
Amount:
$72,677.71
RF Switch Installation

Component Description:
KXLT- RF SWITCH INSTALL - QCOMM - INV QC18-060
Amount:
$12,000.00
Transmitter Site Preparation

Component Description:
KXLT-MAIN-PREP-INV-QC18-035
Amount:
$4,000.00
Disconnect existing Transmitter

Component Description:
KXLT- DECOMM TX - INV QC18-080
Amount:
$18,500.00
Transmitter - Training Information not provided.
Transmitter Sales Tax est

Component Description:
KXLT - GatesAir - Main tx - remaining tax - INV US0320865 - PO 19968 - Q-59825
Amount:
$7,325.82

Component Description:
KXLT-MAIN-TX-2nd inv-Sales Tax see Quote - Q-59825
Amount:
$5,583.52

Component Description:
KXLT-Gates- Sales Tax for Main TX est. see Q-59825 attached 33 percent
Amount:
$5,583.52
Shipping of TX and comp to staging or station

Component Description:
Revised 1-30-20 GatesAir - Main tx - Remaining freight - INV0320865 - PO 19968 - Q-59825
Amount:
$3,864.13

Component Description:
KXLT- Main TX- Shipping - 2nd inv see Q-59825
Amount:
$1,500.00

Component Description:
KXLT- FORKLIFT-FOR UNLOADING EQ -INV-15814264-001
Amount:
$737.34
Site Survey - TX

Component Description:
KXLT-SURVEY-INV-QC18-032
Amount:
$10,500.00
UHF - Liquid Cooled Solid State Transmitter 6.6 kW

Component Description:
KXLT - Gates - Main tx - INV US0320865
Amount:
$20,664.52
15 Ton system Information not provided.
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Transformer 3 phase/480v - 300 KVA Information not provided.
Switchgear - industrial 800 amp

Component Description:
KXLT - GatesAir - Switch - INV US0322871 - PO 20516 - Q-79743; Includes Tax and Freight
Amount:
$9,905.32

Component Description:
Revised 1/30/20 GatesAir - Main Tx- Lines C & D on Q-59825 - INV 0320865
Amount:
$8,537.07

Component Description:
KXLT-Gates- 2nd inv-RF comp for Main TX est. see Q-59825 attached Line C
Amount:
$6,758.09

Component Description:
KXLT-Gates- RF comp for Main TX est. see Q-59825 attached Line C
Amount:
$6,758.09
Service entrance 3 phase/800 amp/208 volt

Component Description:
KXLT-MAIN-TX- ELEC- 2nd INV - see quote Q-59825 line D
Amount:
$1,778.98

Component Description:
KXLT-Gates- Elec for Main TX see Q-59825 attached Line D
Amount:
$1,778.98

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 $124,470.00 $119,590.00 N/A $27,755.10 N/A
Total for all systems $1,696,054.10 $1,454,701.39 N/A $687,756.56 N/A
Interim Antenna TFU-8WB $95,340.00 $90,790.00 $27,755.10
Elbow complex, broadband, at antenna input, per 3 1/8. feedline (if needed) $9,340.00 $8,880.00 N/A $4,028.85 N/A
UHF . Broadband Panel, Side Mount Auxiliary/Interim, 10 kW input, low gain, horizontally polarized $47,350.00 $45,000.00 N/A $20,216.25 3-19-18-Uploaded - PO19964 and Confirmation Order 407001
Freight- Interim ANT $3,510.00 $3,510.00 Freight to ship Interim ant. INV 93020 $3,510.00 N/A
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $5,000.00 N/A N/A N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $22,000.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Primary Antenna TUP-C2-6-1 $29,130.00 $28,800.00 $0.00
Retune Antenna $22,400.00 $22,400.00 per PCI quote e17456-5 KXLT - EX-B N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A

Components

Actual Information Description File Name
Elbow complex, broadband, at antenna input, per 3 1/8. feedline (if needed)

Component Description:
INTERIM ELBOW FOR ANT-KXLT-DEPOSIT LINE #17 AND 18
Amount:
$4,028.85

Component Description:
KXLT-INT ELBOW -INV MAN00113-LINE #17 AND 18
Amount:
$4,028.85
UHF . Broadband Panel, Side Mount Auxiliary/Interim, 10 kW input, low gain, horizontally polarized

Component Description:
INTERIM ANTENNA LINE #1 KXLT
Amount:
$20,216.25

Component Description:
KXLT-INT ANTENNA LINE #1 INV-MAN-00113
Amount:
$20,216.25
Freight- Interim ANT

Component Description:
KXLT-Frieght- INT ant/line to staging per INV 93020
Amount:
$3,510.00
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) Information not provided.
Side mount brackets for high power antennas (if not included in antenna base cost) Information not provided.
Sweep test of existing antenna Information not provided.
Retune Antenna Information not provided.
Sweep test of existing antenna Information not provided.

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 $124,300.00 $118,925.00 N/A $54,802.67 N/A
Total for all systems $1,696,054.10 $1,454,701.39 N/A $687,756.56 N/A
Interim Transmission Line $111,800.00 $106,425.00 $43,302.67
Rigid Transmission Line - copper, 3 1/8" $111,800.00 $106,425.00 N/A $43,302.67 N/A
Primary Transmission Line $12,500.00 $12,500.00 $11,500.00
Disconnect existing Interior RF components $12,500.00 $12,500.00 Disconnect interior RF transmission line and filters from existing configuration and move within the building to make way for new facilities. $11,500.00 N/A

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 3 1/8"

Component Description:
KXLT - Dielectric - T/L 33.5" long - INV 246018 - PO 20361
Amount:
$974.30

Component Description:
Dielectric - Transmission Line - INV 261007 - PO 20359. See cover sheet.
Amount:
$2,499.45

Component Description:
KXLT-INT-LINE-INV-MAN00113- LINES 2 AND 20
Amount:
$40,699.58

Component Description:
TX LINE INTERIM KXLT DEPOSIT 45% LINE #2
Amount:
$39,828.92
Disconnect existing Interior RF components

Component Description:
KXLT - DECOMM RF - INV QC18-080
Amount:
$11,500.00

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 $221,500.00 $211,000.00 N/A $2,700.00 N/A
Total for all systems $1,696,054.10 $1,454,701.39 N/A $687,756.56 N/A
Primary Tower GTOWER $221,500.00 $211,000.00 $2,700.00
STRUCTURAL ANALYSIS $11,000.00 $11,000.00 Structural Analysis of existing tower for new antenna system $2,700.00 N/A
Tall Tower (greater than 500') $210,500.00 $200,000.00 N/A $0.00 N/A

Components

Actual Information Description File Name
STRUCTURAL ANALYSIS

Component Description:
KXLT-FORD ANALYSIS-INV-202031
Amount:
$2,700.00
Tall Tower (greater than 500')

Component Description:
KXLT - PCI - INV 7268 - Amount due on proposal acceptance per PO 20087
Amount:
$95,000.00

Component Description:
KXLT - PCI - INV 7406 - PO 20087 - Amount due upon crew's arrival 39965.00 PLUS $2500 for Weather days per Exhibit A, Line 2 (a). See cover sheet.
Amount:
$39,465.00

Component Description:
PCI - Line Refurbish - INV 7503 - includes outstanding freight charge per addendum 18317-5.
Amount:
$40,117.60

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 $273,514.00 $255,912.50 N/A $130,278.86 N/A
Total for all systems $1,696,054.10 $1,454,701.39 N/A $687,756.56 N/A
Outside Professional Services $273,514.00 $255,912.50 $130,278.86
Vendor Travel Expenses $12,420.00 $12,420.00 VENDOR TRAVEL EXPENSE REIMBURSEMENT EST PER QUOTE QC17001- ITEMS 1010-1015- CO PO 20392 ADDED $2,808.00 $10,393.86 N/A
Quarterly reporting -Atty $4,500.00 $4,500.00 Preparation and submittal of the FCC required quarterly report 387 by attorney. We estimate $750/qtr over 6 qtr's. N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $1,970.00 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 FCC Form 2100 (main), Construction Permit Application $5,260.00 $2,470.00 ***System Notice: Estimate adjusted and locked because line has been superseded.*** $205.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $2,400.00 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A
Project management of the transition $115,024.00 $109,200.00 CO PO 20392 - TO ACCOUNT FOR THE INTERIM FACILITIES AND OTHER ENGINEERING AND DESIGN ITEMS REQUIRED TO BE PERFORMED TO TRANSITION TO THE REPACK CHANNEL ARE IDENTIFIED IN ATTACHED CO/PO. $109,087.50 N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $14,720.00 $14,000.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $4,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $8,200.00 $6,000.00 N/A $1,125.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A $525.00 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $4,572.50 ***System Notice: Estimate adjusted and locked because line has been superseded.*** $4,572.50 N/A

Components

Actual Information Description File Name
Vendor Travel Expenses

Component Description:
KXLT-QCOMM-PM-INV QC17-150- ITEMS - 1010-1015 TRAVEL
Amount:
$1,576.26

Component Description:
KXLT-QCOMM-PM-INV QC19-019- ITEMS - 1010 TRAVEL TIME TO/FRO -OFFICE TO STATION
Amount:
$6,720.00

Component Description:
KXLT-PM-TRAVEL- JAN THUR MAR 18 INV - QC18-045- RFAS CORRECTED ZIP CODE FOR PER DIEM CALC AT $64/DAY
Amount:
$2,097.60
Quarterly reporting -Atty Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
ENGR CP INV FOR KXLT
Amount:
$1,970.00

Component Description:
KXLT - LOHNES- CP -INV 201707-0275-16-35906
Amount:
$1,970.00
Comprehensive coverage verification via field study, if needed Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
LEGAL JULY17 KXLT - CP 399
Amount:
$2,265.00

Component Description:
LEGAL KXLT APRIL17, CP 399
Amount:
$205.00
Perform engineering study for new channel assignment and antenna development

Component Description:
KXLT- LOHNES- CA -INV 201707-0275-16-35906
Amount:
$2,400.00

Component Description:
NEW CHANNEL ENGR - KXLT INV
Amount:
$2,400.00
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form Information not provided.
Project management of the transition

Component Description:
KXLT- PM FOR AUG-NOV 18 -PM- INV QC19-019 -
Amount:
$34,350.00

Component Description:
KXLT-PM-8THRU12 17 - INV QC18-016
Amount:
$11,752.50

Component Description:
KXLT- PM- 1THRU3-1- INV QC18-045 - RFAS - CORRECTED ZIP CODE FOR PER DIEM
Amount:
$17,137.50

Component Description:
KXLT- PM FOR APR-JULY 18 - INV QC17-070
Amount:
$26,572.50

Component Description:
KXLT-QCOMM-PM-INV QC17-150
Amount:
$19,275.00
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare request for Special Temporary Authorization

Component Description:
KXLT- LOHNES STA - INV 201809-0275-16
Amount:
$1,125.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
KXLT- LOHNES - LICENCE TO COVER INV 201811-0275-16
Amount:
$525.00
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
KXLT - CP Atty Fees INV June 17
Amount:
$2,307.50

Component Description:
KXLT - CP Atty Fees INV JULY 17
Amount:
$2,265.00

Component Description:
KXLT- CP Atty fees
Amount:
$205.00

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 $62,080.00 $61,515.00 N/A $8,537.34 N/A
Total for all systems $1,696,054.10 $1,454,701.39 N/A $687,756.56 N/A
Other Expenses $62,080.00 $61,515.00 $8,537.34
Disposal Costs (for equipment and other waste, net of any salvage value) $10,000.00 $10,000.00 Rent 40 yard disposal bin on site to capture all waste from on site system integration and tower vendors with multiple pickups. Est 6 months on site with potential hazardous waste. $0.00 N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A $2,450.00 N/A
MVPD Notification of Channel Change $5,000.00 $5,000.00 Required FCC notification. N/A N/A
Develop and air announcement of upcoming channel change $15,000.00 $15,000.00 Required FCC announcements and good will public relations must we upheld. The production airing and disseminating of these announcements are fundamental to our operations. N/A N/A
Equipment Storage $10,000.00 $10,000.00 Expecting multiple staggered equipment deliveries from different vendors and need to store and stage new equipment prior to installation date. Anticipate from 6-24 months of storage time. $3,600.00 N/A
Equipment Delivery and Handling Charges $10,000.00 $10,000.00 Transport, forklift rental and handling fees from staging area to transmitter site. $2,487.34 N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A

Components

Actual Information Description File Name
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
KXLT-DISPOSAL-SUNSHINE-INV0000398983
Amount:
$494.99
FCC Filing Fees - Form 2100 license to cover application Information not provided.
DTV Medical Facility Notification

Component Description:
KXLT-RF - MED- INV 1030
Amount:
$2,450.00
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage

Component Description:
KXLT - STORAGE 3RD QTR 18 - INV 1013
Amount:
$1,800.00

Component Description:
KXLT - CASEY STORAGE 4TH QTR 18 - INV 1022
Amount:
$1,800.00
Equipment Delivery and Handling Charges

Component Description:
KLXT- CASEY -EQ DELIVERY FROM STAGING AREA TO STATION FOR INSTALL - INV 1017
Amount:
$1,750.00

Component Description:
KXLT-FORKLIFT TO UNLOAD TX EQ FROM TRUCK INTO STATION. INV 158142464-001
Amount:
$737.34
FCC Filing Fees - Special Temporary Authorization request Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $1,696,054.10 $1,454,701.39 $687,756.56

Reimbursement Status

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Question Response
The facility has ceased operating on its pre-auction channel. Yes
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.

BRADY DREASLER

CORPORATE DIRECTOR OF ENGINEERING


05/05/2020

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.

BRADY DREASLER

CORPORATE DIRECTOR OF ENGINEERING


05/05/2020

Attachments

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