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:
168750
Service:
DCA
Call Sign:
KSBS-CD
Channel:
19 (UHF)
File Number:
0000024837
FRN:
0002710192
Date Submitted:
04/23/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

CHANNEL 3 TV COMPANY, LLC

Doing Business As: KCDO-TV/KSBS-CD

Greg Armstrong

3001 S Jamaica Ct.

Ste 210

Aurora, CO 80014

United States

+1 (303) 925-0303 garmstrong@ch3tv.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. Yes
Briefly describe transition plan A Project Manager has been hired to work under station supervision to design and build a replacement facility on reassigned channel 19 and includes a new transmitter, antenna and flash transition with no interim facilities.

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 Dynamar
Year 2012
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity .7 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 EC 702-HP
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1.7 kW
Justification for New Transmitter In order to do a flash cut to avoid an extended off air period a new transmitter is required as the station has no current standby facility. This is a higher powered transmitter, but broadcaster does not seek reimbursement for the upgrade costs.

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 No
Size N/A
Length N/A
Other Electrical Service Yes
Description Modify 50 amp 240 volt service to support additional transmitter and HVAC load. Install 12 kVA generator and supporting infrastructure. This description replaces earlier description to conform to work actually required.
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size Other
Other Size 1 tons
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? Yes
Size 400.0 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

Name Description

Proof and Test

Cost of outside engineer and rental equipment to proof and test transmitter in output switching.

Inside RF System

Materials to adapt output load switching.

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? No
Existing Antenna Manufacturer and Type Class Class A
Mounting Side Mount
Antenna position in stack Middle
Polarization Elliptical
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 15.0 kW
Manufacturer
Model PSILP 8CRC-41-CP Custom
Year 2012

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? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class Class A
Mounting Side Mount
Antenna position in stack Middle
Polarization Elliptical
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 13.8 kW
Manufacturer
Model TLP-8M/VP-R BB
Year 2018
Justification for New Antenna Current antenna is slotted single channel on channel 41 and reassigned channel is 19. Initially proposed replacement was panel with wind-load issues. This replacement is slot design.

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 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? Yes

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Side Mount Brackets

It has been found that it will be necessary to create custom brackets to mount the antenna.

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 1 5/8 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 59 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 66 feet per run
Justification for New Transmission Line Increased line length to meet new construction permit height of new antenna.

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) No
Others Types of Users Yes
Is tower documented for structural analysis? No
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? No
ASR Number
Coordinates (NAD83) Latitude (NAD83) 39° 43' 45.9" N-
Longitude (NAD83) 105° 14' 09.9" W-
Overall Structure Height 66.10 feet
Support Structure Height 50.50 feet
Ground Elevation Above Mean Sea Level (AMSL) 7358.90 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner Mauna Towers, LLC
Date Constructed 01/01/1980


Other Types of Users

Users
4 LPTV stations
6 FM stations

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: Minor Reinforcements needed

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 520
Explanation Station lacks an experienced person on its small staff to execute this transition so a contract with a Project Manager is necessary.
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 No
Environmental Assessment No
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement 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 Yes
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning No
Non-zoning permits No
BLM or NFS Coordination No
FCC Construction Permit Minor Change No
FCC License to Cover Application Yes
FCC Special Temporary Authority Application 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

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 $172,100.00 $110,100.00 N/A $75,377.78 N/A
Total for all systems $716,989.00 $333,710.00 N/A $250,687.09 N/A
Primary Transmitter EC 702-HP $172,100.00 $110,100.00 $75,377.78
Other Electrical Service: Modify 50 amp 240 volt service to support additional transmitter and HVAC load. Install 12 kVA generator and supporting infrastructure. This description replaces earlier description to conform to work actually required. $15,600.00 $15,600.00 At installation, AC voltage at transmitter site was measured higher than allowed by transmitter specifications. Step-down transformer was necessary. $3,242.96 AC voltage was measured over limits for transmitter specifications and step-down transformer was needed.
Inside RF System $6,500.00 $6,500.00 N/A N/A N/A
Proof and Test $12,000.00 $12,000.00 N/A $6,727.50 N/A
Other -- Building Addition Size: 400.0 $6,000.00 $6,000.00 Building modifications found to be necessary to support the installation of the repack transmitter. $729.08 N/A
Other -- HVAC Service Type: C Size:1 (Other) $6,000.00 $6,000.00 Bids for the necessary air conditioning to support the repack transmitter were higher than the initial estimate. $767.64 N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $64,000.00 N/A $63,910.60 N/A

Components

Actual Information Description File Name
Other Electrical Service: Modify 50 amp 240 volt service to support additional transmitter and HVAC load. Install 12 kVA generator and supporting infrastructure. This description replaces earlier description to conform to work actually required.

Component Description:
Electrical system modification and generator installation.
Amount:
$11,400.00

Component Description:
Invoice for step-down transformer to correct AC voltage; Cover Letter attached.
Amount:
$3,242.96

Component Description:
Credit Memo for Tice Electric invoice 19-001 (included generator)
Amount:
($11,400.00)

Component Description:
Installation of propane tank and lines for generator.
Amount:
$885.82
Inside RF System Information not provided.
Proof and Test

Component Description:
At the time the new transmitter was installed, a voltage problem prevented proof by the vendor. A second site visit was necessary and a flat fee was negotiated and billed for this. There was no written quote or proposal. See attached letter.
Amount:
$6,727.50
Other -- Building Addition Size: 400.0

Component Description:
Transmitter building modifications.
Amount:
$729.08
Other -- HVAC Service Type: C Size:1 (Other)

Component Description:
Air conditioning unit for transmitter building. Home Depot receipt added.
Amount:
$767.64
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
This is the second and final payment for the transmitter (there are two invoices, both for $31955.30). This does not include the cost of the transmitter upgrade.
Amount:
$31,955.30

Component Description:
50% downpayment of replication transmitter; does not include upgrade. See attached explanation.
Amount:
$31,955.30

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 $36,030.00 $37,400.00 N/A $28,528.00 N/A
Total for all systems $716,989.00 $333,710.00 N/A $250,687.09 N/A
Primary Antenna TLP-8M/VP-R BB $36,030.00 $37,400.00 $28,528.00
Side Mount Brackets $3,000.00 $3,000.00 It has been found that it will be necessary to create custom brackets to mount the antenna. N/A N/A
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $26,300.00 $28,000.00 Current antenna is "slot" design; initially proposed replacement was panel, which would cause wind load issues. New replacement, Dielectric TLP=8M/VP-R-BB is slot design. $22,128.00 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $6,400.00 N/A

Components

Actual Information Description File Name
Side Mount Brackets Information not provided.
UHF - Lower Power Side Mount, Class A One Station antenna -- basic

Component Description:
This down-payment Invoice is also for transmission line and sweep. Portion of antenna cost not requested is for upgrade. See attached explanation.
Amount:
$11,064.00

Component Description:
Second payment, does not include extra cost of upgraded antenna. Invoice also contains charge for transmission line.
Amount:
$11,064.00
Sweep test of existing antenna

Component Description:
Second payment, half of total.
Amount:
$3,200.00

Component Description:
This down-payment invoice also includes charges for antenna and transmission line.
Amount:
$3,200.00

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 $1,584.00 $6,200.00 N/A $5,935.21 N/A
Total for all systems $716,989.00 $333,710.00 N/A $250,687.09 N/A
Primary Transmission Line $1,584.00 $6,200.00 $5,935.21
Flexible Foam Transmission Line - dielectric, 1 5/8" $1,584.00 $6,200.00 Catalog of Estimated Cost price of $23/foot appears to be based on 1,000 ft. lengths and does not scale down to 66 fee with hangers, other accessories, and installation costs. $5,935.21 N/A

Components

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

Component Description:
Additional transmission line parts purchased by Project Manager from Pasternack and Eupen. Charges passed through without additions.
Amount:
$704.44

Component Description:
Second payment. Invoice also includes charge for antenna.
Amount:
$2,615.38

Component Description:
This down-payment invoice also includes charges for antenna and sweep.
Amount:
$2,615.39

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 $268,500.00 $23,500.00 N/A $6,982.01 N/A
Total for all systems $716,989.00 $333,710.00 N/A $250,687.09 N/A
Primary Tower GTOWER $268,500.00 $23,500.00 $6,982.01
Minor tower reinforcement/modifications $158,000.00 $6,000.00 N/A N/A N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $8,500.00 N/A N/A N/A
Short Tower (less than 500') $84,200.00 $9,000.00 Additional costs related to weather during install and the recommendation of the manufacturer to remove the old antenna from the tower after the transition to channel 19. $6,982.01 N/A

Components

Actual Information Description File Name
Minor tower reinforcement/modifications Information not provided.
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study Information not provided.
Short Tower (less than 500')

Component Description:
Labor, materials, equipment rental, and mileage for tower rigging and antenna installation.
Amount:
$6,982.01

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 $212,390.00 $136,250.00 N/A $117,527.59 N/A
Total for all systems $716,989.00 $333,710.00 N/A $250,687.09 N/A
Outside Professional Services $212,390.00 $136,250.00 $117,527.59
RF Exposure Measurements $21,050.00 $6,000.00 N/A N/A N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $28,500.00 Quote from Meintel Sgrignoli & Wallace, plus additional necessary equipment. $27,673.00 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A $720.00 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A $5,000.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A $500.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $0.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $3,500.00 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 $2,500.00 N/A
Project management of the transition $82,160.00 $78,000.00 Project Management costs were increased due to weather, incomplete deliveries by vendors, delays on the part of adjacent channels, and power company issues. $77,634.59 N/A

Components

Actual Information Description File Name
RF Exposure Measurements Information not provided.
Comprehensive coverage verification via field study, if needed

Component Description:
Final payment on completion of KSBS-CD coverage study and signal verification
Amount:
$20,500.00

Component Description:
Advance retainer for field measurement project
Amount:
$7,000.00

Component Description:
Portable receive antennas for coverage study.
Amount:
$173.00
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
Legal review of application for License to Cover and new license.
Amount:
$720.00
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Attorney Fees: prepare for Construction Permit application
Amount:
$50.00

Component Description:
Attorney Fees: prepare and file Construction Permit Application
Amount:
$4,950.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
Engineering preparation of application for License to Cover
Amount:
$500.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Perform engineering study for new channel assignment and antenna development

Component Description:
Engineering study work for new channel assignment and antenna development
Amount:
$375.00

Component Description:
Engineering study work for new channel assignment and antenna development
Amount:
$1,875.00

Component Description:
Engineering study work for new channel assignment
Amount:
$500.00

Component Description:
Engineering study work for new channel assignment and antenna development
Amount:
$750.00
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form

Component Description:
Attorney fees: prepare for reimbursement form
Amount:
$880.00

Component Description:
Attorney fees: Prepare and review reimbursement form.
Amount:
$1,620.00
Project management of the transition

Component Description:
Project Management Services: January-February 2019
Amount:
$18,476.40

Component Description:
Project management charges 5/29/2018 - 12/26/2018
Amount:
$9,475.23

Component Description:
Project Management Charges for June 2019
Amount:
$3,963.49

Component Description:
Project Management Fees, September 2019
Amount:
$5,550.88

Component Description:
Project management services for May 2019
Amount:
$5,133.01

Component Description:
Project Management Fees, July & August
Amount:
$4,887.00

Component Description:
Project Management Services April, 2019
Amount:
$7,832.70

Component Description:
Project Management 5/3-5/26/17
Amount:
$2,622.92

Component Description:
Project Management Fees for October 2019
Amount:
$6,980.96

Component Description:
Project management charges for March 2019
Amount:
$9,610.79

Component Description:
Blair engineering project management 7-11/2017
Amount:
$3,101.21

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 $26,385.00 $20,260.00 N/A $16,336.50 N/A
Total for all systems $716,989.00 $333,710.00 N/A $250,687.09 N/A
Other Expenses $26,385.00 $20,260.00 $16,336.50
MVPD Notification of Channel Change $200.00 $200.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $2,000.00 $2,000.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $5,425.00 N/A $5,425.00 N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $335.00 Current FCC filing fee $335.00 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $0.00 $0.00 N/A N/A N/A
Equipment Delivery and Handling Charges $11,000.00 $11,000.00 Original equipment delivery costs were underestimated. $10,576.50 N/A
Equipment Storage $1,300.00 $1,300.00 N/A N/A N/A

Components

Actual Information Description File Name
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
DTV Medical Facility Notification

Component Description:
Notification of facility changes to health care facilities
Amount:
$5,425.00
FCC Filing Fees - Form 2100 license to cover application

Component Description:
FCC Filing Fee
Amount:
$335.00
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Equipment Delivery and Handling Charges

Component Description:
Snow plowing and road treatment to allow delivery of transmitter to Lookout Mountain site.
Amount:
$1,690.00

Component Description:
Snow plowing and road treatment to allow delivery of antenna to Lookout Mountain site.
Amount:
$2,390.00

Component Description:
Transport of antenna & line up mountainside and removal of packing material. Paid by Project Manager and passed through without additions.
Amount:
$434.00

Component Description:
Shipping and handling for antenna
Amount:
$6,062.50
Equipment Storage Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $716,989.00 $333,710.00 $250,687.09

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. Yes

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.

Greg Armstrong

President and General Manager


04/23/2020

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.

David H Pawlik

Legal Counsel


04/23/2020

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.

Greg Armstrong

President and General Manager


04/23/2020

Attachments

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