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:
257
Service:
DCA
Call Sign:
WWAT-CD
Channel:
29 (UHF)
File Number:
0000028694
FRN:
0024413338
Date Submitted:
03/10/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

FIFTH STREET ENTERPRISES, LLC

Doing Business As: FIFTH STREET ENTERPRISES, LLC

Ron Bruno

975 Greentree Rd.

Pittsburgh, PA 15220

United States

+1 (412) 921-7577 ron@thevideohouse.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

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 The plan is for WWAT is to replace it's transmitter and mask filter. The transmission line and antenna will be reused.

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 830 Digital ITS/Axcera
Year 1995
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 0.25 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 TMU9-1
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 0.6 kW
Justification for New Transmitter This transmitter is a like-for-like transmitter swap. The difference in power level is due to 600 watts being the smallest size transmitter capable of driving the system.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring Yes
Size 2 inches
Length 20.0 feet
Other Electrical Service Yes
Description The new main transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors.
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Mask Filter

Mask Filter UT8D7F-4K Dielectric Full 4KW 1-50 in/out with 115VAC blowers

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? 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? Yes
Existing Antenna Manufacturer and Type Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 1
Number of Panels 2
Design power capacity in use 12.0 %
Lower Limit 470.00 MHz
Upper Limit 698.00 MHz
Other Antenna Type N/A
ERP: 0.558 kW
Manufacturer
Model TUA-C2
Year 2015

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? Yes
New Antenna Manufacturer and Types Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Circular
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: 15.0 kW
Manufacturer
Model DLP-8B
Year 2019
Justification for New Antenna Channel change - existing antenna not able to be retuned.

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

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? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Flexible Foam
Diameter 7/8 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 0
Length 150 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 Flexible Foam
Diameter 1 5/8 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 300 feet per run
Justification for New Transmission Line The new system is 100 ft higher than the existing one and the existing transmission line is not long enough and can not support the transmitter power output

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 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? Yes
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1025878
Coordinates (NAD83) Latitude (NAD83) 39° 48' 39.65" N-
Longitude (NAD83) 079° 41' 30.4" W-
Overall Structure Height 220.00 feet
Support Structure Height 236.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 2736.00 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner Crown Castle
Date Constructed 09/17/1992


Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 2000
Explanation WWAT-CD does not have sufficient resource capacity and expertise in house to handle all of the Project Management related tasks necessary to facility on-time completion of the station's build by the Construction Deadline
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 No
Quantity N/A
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 No
Quantity N/A
NEPA Section 106 environmental review Yes
Environmental Assessment Yes
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 Yes
Number of Days 8
Justification Justification? RF Project management of tower and transmitter installs

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 Yes
BLM or NFS Coordination No
FCC Construction Permit Minor Change Yes
FCC License to Cover Application Yes
FCC Special Temporary Authority Application No
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? 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

Vehicle Rental

Required for equipment delivery.

Antenna Parts

Cables and Connectors for Antenna Installation

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 $140,020.00 $140,000.00 N/A $7,495.00 N/A
Total for all systems $897,535.00 $854,148.00 N/A $94,152.21 N/A
Primary Transmitter TMU9-1 $140,020.00 $140,000.00 $7,495.00
UHF - Air Cooled Solid State Transmitter 0.6 kW $120,000.00 $120,000.00 N/A $0.00 N/A
Other Electrical Service: The new main transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors. $15,000.00 $15,000.00 N/A $2,995.00 N/A
Mask Filter $4,500.00 $4,500.00 N/A $4,500.00 N/A
2" Rigid Conduit and Wiring (Cost per foot) $520.00 $500.00 N/A N/A N/A

Components

Actual Information Description File Name
UHF - Air Cooled Solid State Transmitter 0.6 kW

Component Description:
Pro Service Inc - Transmitter Install - WWAT-CD - Jan 2020
Amount:
$16,850.03

Component Description:
Pro Service Inc - Mask Filter - WWAT-CD 1-28-20
Amount:
N/A
Other Electrical Service: The new main transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors.

Component Description:
Patton Electric - WWAT-CD Electric Install - 1-29-20
Amount:
$2,995.00
Mask Filter

Component Description:
Pro Service Inc - Mask Filter - WWAT-CD
Amount:
$4,500.00
2" Rigid Conduit and Wiring (Cost per foot) 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 $26,300.00 $11,693.00 N/A $3,848.00 N/A
Total for all systems $897,535.00 $854,148.00 N/A $94,152.21 N/A
Primary Antenna DLP-8B $26,300.00 $11,693.00 $3,848.00
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $26,300.00 $11,693.00 N/A $3,848.00 Shipping and Freight was TBD at time of Antenna Quote. That is the reason the subtotal is greater than the estimated cost. - moved to Other Expenses

Components

Actual Information Description File Name
UHF - Lower Power Side Mount, Class A One Station antenna -- basic

Component Description:
MultiComm - WWAT-CD- Antenna Cable, Connectors and Shipping 1-27-20
Amount:
N/A

Component Description:
WWAT-CD - Freight and Shipping for Dielectric Antenna. - Moved to Other Expenses
Amount:
N/A

Component Description:
Dielectric Invoice, Cover Letter, Quote and Purchase Order - Antenna -WWAT-CD 12-16-19
Amount:
$3,848.00

Component Description:
Wireless Services Inc- Invoice and Proposal - Antenna Install for WWAT-CD 1-28-20
Amount:
N/A

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 $7,200.00 $7,000.00 N/A $4,372.76 N/A
Total for all systems $897,535.00 $854,148.00 N/A $94,152.21 N/A
Primary Transmission Line $7,200.00 $7,000.00 $4,372.76
Flexible Foam Transmission Line - dielectric, 1 5/8" $7,200.00 $7,000.00 N/A $4,372.76 N/A

Components

Actual Information Description File Name
Flexible Foam Transmission Line - dielectric, 1 5/8"

Component Description:
RF Specialties Invoice and Quote - WWAT-CD Dec 2019
Amount:
$4,372.76

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 $84,200.00 $84,200.00 N/A $10,000.00 N/A
Total for all systems $897,535.00 $854,148.00 N/A $94,152.21 N/A
Primary Tower GTOWER $84,200.00 $84,200.00 $10,000.00
Short Tower (less than 500') $84,200.00 $84,200.00 N/A $10,000.00 N/A

Components

Actual Information Description File Name
Short Tower (less than 500')

Component Description:
Crown Castle - Structural Letter Invoice and POR - WWAT 1-7-20
Amount:
$1,000.00

Component Description:
Decommission Antenna - WWAT- CD 10-29-18
Amount:
$2,500.00

Component Description:
Wireless Services Inc - WWAT- CD V.2 2-19-20
Amount:
$6,500.00

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $462,220.00 $439,750.00 N/A $52,295.70 N/A
Total for all systems $897,535.00 $854,148.00 N/A $94,152.21 N/A
Outside Professional Services $462,220.00 $439,750.00 $52,295.70
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 $5,000.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $650.00 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
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet $10,520.00 $10,000.00 N/A N/A N/A
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
Project management of the transition $316,000.00 $300,000.00 N/A $45,620.70 N/A
Additional Field Engineering Service, 8 Days $16,000.00 $16,000.00 N/A $3,625.00 N/A
NEPA Section 106 environmental review, if needed $6,310.00 $6,000.00 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
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $2,400.00 N/A

Components

Actual Information Description File Name
Comprehensive coverage verification via field study, if needed Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application Information not provided.
Perform engineering study for new channel assignment and antenna development

Component Description:
Interference study of repack Channel 29
Amount:
$650.00
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form Information not provided.
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet 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.
Project management of the transition

Component Description:
Project Management - March 2018
Amount:
$1,301.65

Component Description:
Project Management - Feb 2018
Amount:
$1,649.85

Component Description:
Project Management - Jan 2018
Amount:
$1,818.40

Component Description:
CTA Media Productions - Oct 2019 Project Management WWAT- CD
Amount:
$862.50

Component Description:
CTA Media - WWAT September 2019- Project Management
Amount:
$900.00

Component Description:
Davis Project Management- Inv 2007
Amount:
$150.00

Component Description:
Project Management - Inv 2005
Amount:
$484.00

Component Description:
CTA Media Productions - WWAT -CD Project Managment- Feb 2020
Amount:
$937.50

Component Description:
Project Management - November 2019 - CTA Media Productions
Amount:
$1,012.50

Component Description:
Project Management - August 2019
Amount:
$1,087.50

Component Description:
Project Management - June 2019
Amount:
$1,312.50

Component Description:
Project Management - July 2019
Amount:
$1,050.00

Component Description:
Project Management - Revised Invoice 7-22-19
Amount:
$20.00

Component Description:
Project Management March 2019
Amount:
$2,332.50

Component Description:
Project Management - May 2018
Amount:
$1,258.55

Component Description:
Project Management - Aug 2018
Amount:
$1,582.05

Component Description:
Project Management Dec 2018
Amount:
$3,787.20

Component Description:
CTA Media Productions - Project Management - Dec 2019 WWAT-CD - UPDATED
Amount:
$975.00

Component Description:
Project Management - Nov 2018
Amount:
$4,205.10

Component Description:
Project Management - April 2019
Amount:
$1,950.00

Component Description:
Project Management - April 2018
Amount:
$1,109.85

Component Description:
Project Management
Amount:
$1,692.45

Component Description:
Project Management - May 2019
Amount:
$1,710.00

Component Description:
Project Management - February 2019
Amount:
$2,784.80

Component Description:
Project Management - Jan 2019
Amount:
$3,619.70

Component Description:
Project Management
Amount:
$3,155.15

Component Description:
CTA Media Productions - Jan 2020 Project Management - WWAT-CD
Amount:
$1,275.00

Component Description:
Project Management - June 2018
Amount:
$1,596.95
Additional Field Engineering Service, 8 Days

Component Description:
Pro Service Proposal and Invoice - Re-Channel to CH 29 WWAT 8-26-19
Amount:
$3,625.00
NEPA Section 106 environmental review, if needed Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Preparation of engineering portion of initial FCC Application Construction Permit for repack facility.
Amount:
$1,750.00

Component Description:
Preparation of revised engineering portion of initial FCC Application for Construction Permit for repack facility
Amount:
$650.00

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 $60,095.00 $59,505.00 N/A $16,140.75 N/A
Total for all systems $897,535.00 $854,148.00 N/A $94,152.21 N/A
Other Expenses $60,095.00 $59,505.00 $16,140.75
Antenna Parts $100.00 $100.00 N/A $81.50 N/A
Vehicle Rental $5,000.00 $5,000.00 N/A $0.00 N/A
MVPD Notification of Channel Change $2,000.00 $2,000.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $15,000.00 $15,000.00 N/A $1,500.00 N/A
Equipment Storage $5,000.00 $5,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $5,000.00 $5,000.00 N/A $3,346.25 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $10,000.00 $10,000.00 N/A N/A N/A
Non-zoning permits $2,500.00 $2,500.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A $10,878.00 N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $335.00 N/A $335.00 N/A
Local Zoning $2,500.00 $2,500.00 N/A N/A N/A

Components

Actual Information Description File Name
Antenna Parts

Component Description:
MultiComm Inc- WWAT- CD Antenna parts ($81.50) and shipping ($710) - Jan 2020
Amount:
$81.50
Vehicle Rental Information not provided.
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change

Component Description:
Videohouse invoice- and Estimate - Develop and air announcement of channel change - Aug 2019
Amount:
$1,500.00
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges

Component Description:
Freight and Shipping for Antenna - WWAT-CD
Amount:
$1,586.25

Component Description:
Pro Service Inc. Shipping Cost of Mask Filter - WWAT-CD 1-28-20
Amount:
$350.00

Component Description:
Procopio - Labor & Delivery of parts - WWAT-CD 2-10-20
Amount:
$350.00

Component Description:
MultiComm - Shipping Costs to Deliver Antenna, etc to Tower WWAT-CD 1-27-20
Amount:
$710.00

Component Description:
Pandl - WWAT - Labor & Delivery Charges - V.2
Amount:
$350.00
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Non-zoning permits Information not provided.
DTV Medical Facility Notification

Component Description:
DTV Notification- Revised estimate and invoice- Additional work was completed- therefore the estimate and invoice have been revised to reflect that.
Amount:
$10,878.00
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
FCC Filing Fees - Form 2100 license to cover application

Component Description:
The Videohouse - License to Cover Fee- WWAT-CD 1-30-20
Amount:
$335.00
Local Zoning Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $897,535.00 $854,148.00 $94,152.21

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. Yes
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.

Dawn Azua

Production Manager


03/10/2020

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.

Dawn Azua

Production Manager


03/10/2020

Certification

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Section Question Response
Submission of Final Allocation or Accounting Information 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 and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

  2. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.

  3. The above-named entity certifies that all costs identified as "actual costs" herein accurately represent the costs actually paid by the above-named entity, including any discounts, refunds, or rebates.

  4. 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.

  5. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.

  6. 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.

Dawn Azua

Production Manager


03/10/2020

Attachments

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