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:
68911
Service:
DCA
Call Sign:
W18BL-D
Channel:
32 (UHF)
File Number:
0000027695
FRN:
0023829625
Date Submitted:
05/27/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

George G. Duncan

Doing Business As: GEORGE DUNCAN

George G. Duncan

PO Box 10

SAVANAH, TN 38372

United States

+1 (731) 926-7191 GEORGEGDUNCAN@YAHOO.COM Individual

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 erect new tower, install new building, install new transmitter and antenna cut traffic over to new transmitter, take old transmitter off air

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 DTV1000
Year 2012
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1 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 DTV-32
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1 kW
Justification for New Transmitter Old transmitter cannot be retuned

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 1.5 inches
Length 30.0 feet
Other Electrical Service Yes
Description 200 amp service entrance
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Heating and Cooling
Size 5 tons
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? Yes
Size 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

Information not provided.

Antennas

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Section Question Response
Antenna Related Expenses Do you have antenna related expenses? Yes

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? No
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 Top Mount
Antenna position in stack Top
Polarization Circular
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 DTV-15
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? No
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 Top
Polarization Horizontal
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 PSILP8OI
Year 2020
Justification for New Antenna Cannot retune old antenna

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna?
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? N/A
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Single Channel
Feed Line Size 3 1/8 inches inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? No
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

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 240 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 225 feet per run
Justification for New Transmission Line required to stay on the air during transition

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 Construct New
Tower Use Primary (Main)
Description of Use N/A
Ownership Owned
Is this tower consider Complex? No
Is this tower currently shared with any other stations? No
One or more FM, AM or TV radio broadcaster(s) N/A
Others Types of Users N/A
Is tower documented for structural analysis? Unknown
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? No
ASR Number
Coordinates (NAD83) Latitude (NAD83) 35° 14' 05.0" N-
Longitude (NAD83) 088° 22' 35.0" W-
Overall Structure Height 198.00 feet
Support Structure Height 198.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 609.00 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner George Duncan
Date Constructed 01/01/1996


Primary Tower

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Tower Construction Costs

Section Question Response
Construct New Tower Use Primary (Main)
Description of Use N/A
Is this a request for upgraded equipment? No
Height 298.00 feet
Justification for New Tower required to remain on air during transition.

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

Site Survey

Site Survey for new tower and foundations.

Rigging of Antenna

Installation of Antenna and ancillary antennas/dish

Freight and Sales Tax

Freight and Sales Tax for tower steel

Removal of old tower

Dismantle old tower upon completion of facilities to new tower.

Installation of cable on tower

Installation of 200 ft of cable

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 120
Explanation Project management to coordinate installing new tower, antenna, line and remove old tower.
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development No
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 No
RF exposure measurements No
Additional Field Engineering Service Yes
Number of Days 10
Justification Install, test, debug new transmitter and antenna, retire old equipment.

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? No
Permit and Filing Costs Local Zoning Yes
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? No

Other Expenses

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Other Expenses Not Listed

Name Description

Digital Encoder

Not included as part of Transmitter

STL

STL link from studio to new transmitter building

generator

Generator for new building during transition

internet and phone

lines to new building

site prep

pad and gravel drive for new building

Interior Wiring for new building

interior wiring, receptacles, a/c and transmitter wiring, 200 amp service entrance

1 58 90 deg elbow

90 degree elbow 1 5/8 inch

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 $144,092.21 $138,092.21 N/A $89,737.21 N/A
Total for all systems $398,310.63 $381,058.63 N/A $266,075.29 N/A
Primary Transmitter DTV-32 $144,092.21 $138,092.21 $89,737.21
1.5" Rigid Conduit and Wiring $500.00 $500.00 N/A N/A N/A
Other -- Building Addition Size: 400.0 $7,826.66 $7,826.66 See GT Communications Building Quote Invoice.pdf for quote. $7,826.66 N/A
Other -- HVAC Service Type: H Size:5 (Other) $9,265.55 $9,265.55 Actual cost of 5 ton package unit with labor. Quote attached with Invoice SwanCOHVACQuote_Invoice Existing facility not large enough to house new transmitter, new cooling equipment required. $9,265.55 Actual cost.
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $120,000.00 N/A $72,645.00 N/A
Other Electrical Service: 200 amp service entrance $500.00 $500.00 N/A N/A N/A

Components

Actual Information Description File Name
1.5" Rigid Conduit and Wiring Information not provided.
Other -- Building Addition Size: 400.0

Component Description:
Building materials, exterior / interior walls, roof and labor to construct.
Amount:
$7,826.66
Other -- HVAC Service Type: H Size:5 (Other)

Component Description:
HVAC - actual cost
Amount:
$9,265.55

Component Description:
HVAC System
Amount:
$9,265.55
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
Factory training and transmitter delivery
Amount:
$3,760.00

Component Description:
Ch 32 Transmitter
Amount:
$68,885.00

Component Description:
Transmitter, unable to retune existing transmitter
Amount:
$68,885.00
Other Electrical Service: 200 amp service entrance 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 $40,630.00 $24,650.00 N/A $11,550.00 N/A
Total for all systems $398,310.63 $381,058.63 N/A $266,075.29 N/A
Primary Antenna PSILP8OI $40,630.00 $24,650.00 $11,550.00
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $26,300.00 $12,550.00 Quoted price $11,550 plus $1000 allocation for freight $11,550.00 N/A
Elbow complex, single channel, at antenna input, per 3 1/8. feedline (if needed) $7,600.00 $7,600.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $4,500.00 See attachment: new W18BL SIDE MOUNT 090617.pdf N/A N/A

Components

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

Component Description:
Cost of HPOL Ch 32 Antenna
Amount:
$11,550.00
Elbow complex, single channel, at antenna input, per 3 1/8. feedline (if needed) 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 $5,400.00 $5,520.00 N/A $2,908.35 N/A
Total for all systems $398,310.63 $381,058.63 N/A $266,075.29 N/A
Primary Transmission Line $5,400.00 $5,520.00 $2,908.35
Flexible Foam Transmission Line - dielectric, 1 5/8" $5,400.00 $5,520.00 N/A $2,908.35 N/A

Components

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

Component Description:
Cost of cable, not including freight
Amount:
$2,908.35

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 $118,828.60 $120,156.60 N/A $120,156.60 N/A
Total for all systems $398,310.63 $381,058.63 N/A $266,075.29 N/A
Primary Tower TOWER $0.00 $0.00 $0.00
Primary Tower $118,828.60 $120,156.60 $120,156.60
New tower $0.00 $0.00 N/A $0.00 N/A
Short Tower (less than 500') $84,200.00 $85,528.00 Existing tower will not support a second antenna for the transition to the new channel. A new tower will be required to remain on the air during the transition. Updated 2019 cost. $85,528.00 N/A
Site Survey $9,820.49 $9,820.49 Site Survey for placement of new tower foundation and guy wire foundations, building placement and coordination around existing tower. See ClearChoiceEng Site Survey Proposal.pdf $9,820.49 N/A
Installation of cable on tower $2,000.00 $2,000.00 Install 200 ft of transmission line. See EXCEL Tower Quote $2,000.00 N/A
Removal of old tower $16,575.00 $16,575.00 Dismantle old tower, see EXCEL Tower quote $16,575.00 N/A
Rigging of Antenna $3,000.00 $3,000.00 Installation of new Ch 32 antenna, move 911 antenna See EXCEL Tower Quote $3,000.00 N/A
Freight and Sales Tax $3,233.11 $3,233.11 Freight and Sales Tax for tower steel $3,233.11 N/A

Components

Actual Information Description File Name
New tower Information not provided.
Short Tower (less than 500')

Component Description:
Steel for 200 ft of tower to replace existing tower.
Amount:
$37,228.00

Component Description:
Invoice for soil study for tower base. Invoice and Proposal attached.
Amount:
$4,400.00

Component Description:
Total of lines 1thru 5 EXCEL Invoice W18BL2020
Amount:
$43,900.00
Site Survey

Component Description:
Site Survey for tower and foundations
Amount:
$9,820.49
Installation of cable on tower

Component Description:
Total of line 12 EXCEL Tower Invoice W18BL2020
Amount:
$2,000.00
Removal of old tower

Component Description:
Total of line 9 EXCEL Invoice W18BL2020
Amount:
$16,575.00
Rigging of Antenna

Component Description:
Total of lines 10 and 11 EXCEL Tower Invoice W18BL2020
Amount:
$3,000.00
Freight and Sales Tax

Component Description:
Freight and Sales Tax for tower steel
Amount:
$3,233.11

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 $41,580.00 $44,875.00 N/A $8,401.31 N/A
Total for all systems $398,310.63 $381,058.63 N/A $266,075.29 N/A
Outside Professional Services $41,580.00 $44,875.00 $8,401.31
Additional Field Engineering Service, 10 Days $5,000.00 $5,000.00 N/A $0.00 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A N/A N/A
Prepare 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 N/A 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 $901.31 N/A
Project management of the transition $18,960.00 $23,125.00 Non on site engineer to oversee project transition from Ch 18 to Ch 32 See Clear Choice Project Management Quote $7,000.00 N/A

Components

Actual Information Description File Name
Additional Field Engineering Service, 10 Days

Component Description:
Engineering Support
Amount:
$273.17
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
engineering service for new contour calculations
Amount:
$500.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form

Component Description:
Log into LMS set up CORES, submit costs
Amount:
$273.12

Component Description:
Call vendors, get email quotes, convert to pdf, upload to database, call help desk
Amount:
$437.00

Component Description:
Inventory equip needed for repack and start contacting vendors
Amount:
$191.19

Component Description:
N/A
Amount:
N/A
Project management of the transition

Component Description:
Project Management Aug-Mar
Amount:
$7,000.00

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 $47,779.82 $47,764.82 N/A $33,321.82 N/A
Total for all systems $398,310.63 $381,058.63 N/A $266,075.29 N/A
Other Expenses $47,779.82 $47,764.82 $33,321.82
1 58 90 deg elbow $400.00 $400.00 required to exit top of transmitter through wall of building insufficient ceiling height to make bend $0.00 N/A
site prep $6,595.50 $6,595.50 See GT Comm Building Quote Invoice.pdf TN sales tax was not included. $6,595.50 N/A
internet and phone $500.00 $500.00 N/A N/A N/A
generator $9,000.00 $9,000.00 A new building is required due to limited space, the current generator will not support two buildings with transmitters and hvac during the repack, we would risk being off air during power a failure. See attachment LindseyGeneratorQuote.pdf. $9,000.00 N/A
STL $8,100.00 $8,100.00 Cannot reuse old tower/transmitter/building, new building requires new STL from studio to transmitter in order to remain on the air during the transition. See attachment: GEORGE DUNCAN FIBER PROPOSAL 9-6-2017.pdf and Thor_Estimate_TV-18_2018-11-24.pdf $3,300.00 N/A
Digital Encoder $2,495.00 $2,495.00 Not included as part of transmitter, see attachment: Thor_Estimate_TV-18 pt2_2018-11-24.pdf $2,495.00 $2995 is the actual cost
Develop and air announcement of upcoming channel change $1,000.00 $1,000.00 N/A N/A N/A
Equipment Storage $100.00 $100.00 N/A N/A N/A
Equipment Delivery and Handling Charges $2,000.00 $2,000.00 Antenna Estimated shipping, see attachment: new W18BL SIDE MOUNT 090617.pdf $72.00 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $10,000.00 $10,000.00 Removal of old tower after repack, limited ground space requires co-mingling guy wires for new tower, unsafe if not removed. See attachment, TV18 Remove Old Tower Qoute.pdf $5,000.00 N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
Interior Wiring for new building $6,859.32 $6,859.32 interior wiring for new building, a/c and 200 amp service, parts & labor. See GT Comm Building Quote Invoice.pdf $6,859.32 Building interior costs were not included when it was determined that a new building was required.
Local Zoning $200.00 $200.00 N/A N/A N/A

Components

Actual Information Description File Name
1 58 90 deg elbow Information not provided.
site prep

Component Description:
Materials for interior wiring receptacles, air conditioning and transmitter wiring, 200 amp service entrance and labor to install.
Amount:
$6,595.50
internet and phone Information not provided.
generator

Component Description:
generator
Amount:
$9,000.00

Component Description:
Generator complete installation and materials.
Amount:
$9,000.00
STL

Component Description:
STL Component Media Converter
Amount:
$3,300.00

Component Description:
Part of STL, media converters on this invoice pn F-1ASI-RX and TX cost $995 each
Amount:
$3,980.00
Digital Encoder

Component Description:
Cost for Encoder on this invoice for $2995
Amount:
$3,064.57

Component Description:
Encoder
Amount:
$2,495.00
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges

Component Description:
Encoder shipping
Amount:
$28.00

Component Description:
STL component shipping
Amount:
$44.00
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
Total of line 13 EXCEL Tower Invoice W18BL2020
Amount:
$5,000.00
FCC Filing Fees - Special Temporary Authorization request Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
Interior Wiring for new building

Component Description:
Interior wiring and 200 amp service for new building.
Amount:
$6,859.32
Local Zoning Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $398,310.63 $381,058.63 $266,075.29

Reimbursement Status

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Question Response
The facility has ceased operating on its pre-auction channel. No
Construction of final facilities or all necessary modifications are complete. No
All receipts for reimbursement have been submitted no further costs are expected to be incurred. Note this will lock the Form 399 from further editing and begin close-out procedures with the Fund Administrator. No

Certification

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Section Question Response
Submission of Estimated Expenses Statements

WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.

  1. The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.

  2. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

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

  4. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD).

  5. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

  6. The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred.

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

  8. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.

I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Susan Hansen

Consultant


05/27/2020

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.

George Duncan

Applicant


05/27/2020

Attachments

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