TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
COMMUNITY TELEVISION EDUCATORS OF DFW, INC. Doing Business As: COMMUNITY TELEVISION EDUCATORS OF DFW, INC.	Arnold Torres 3901 HIGHWAY 121 SOUTH BEDFORD, TX 76021 United States	+1 (817) 571-1229	ARNOLD.TORRES@DAYSTAR.COM	Private Not-for-Profit Educational Institution

Applicant

Address

Phone

Applicant Type

COMMUNITY TELEVISION EDUCATORS OF DFW, INC.

Doing Business As: COMMUNITY TELEVISION EDUCATORS OF DFW, INC.

Arnold Torres

3901 HIGHWAY 121 SOUTH

BEDFORD, TX 76021

United States

+1 (817) 571-1229

ARNOLD.TORRES@DAYSTAR.COM

Private Not-for-Profit Educational Institution

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant	Address	Phone	Email
[Confidential]

Preparer Contact Information

Preparer Contact Name and Information

Applicant	Address	Phone	Email
Henry Turner Engineer COMMUNITY TELEVISION EDUCATORS OF DFW, INC.	Henry Turner 3901 HIGHWAY 121 SOUTH Bedford, TX 76021 United States	+1 (817) 571-1229	HENRY.TURNER@DAYSTAR.COM

Applicant

Address

Phone

Henry Turner

Engineer

COMMUNITY TELEVISION EDUCATORS OF DFW, INC.

Henry Turner

3901 HIGHWAY 121 SOUTH

Bedford, TX 76021

United States

+1 (817) 571-1229

HENRY.TURNER@DAYSTAR.COM

Broadcaster Information and Transition Plan

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	See attached narrative describing KDTN's transition plan.

Transmitters

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

Primary Transmitter

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	Vissionary
	Year	2004
	Type	Inductive Output Tube
	IOT Power Type	Two
	Power Capacity	26 kW

Primary Transmitter

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	TXUD40000ALC
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	40 kW
	Justification for New Transmitter	Transmitter is not capable if the power level that will be needed. Current transmitter cannot be retuned to new antenna due to banding issues. Current transmitter will remain on air transmitting pre auction channel during transition.

Primary Transmitter

Other Transmitter Costs

Section	Question	Response
Electrical Service	Service Entrance (3 phases 800A 208V)	Yes
	Switchgear (industrial 800 amp)	Yes
	Transformer (480V)	Yes
	Power	500 kVA
	Rigid Conduit and Wiring	No
	Size	N/A
	Length	N/A
	Other Electrical Service	Yes
	Description	Minimal electric services not listed above will be needed to implement new facility.
HVAC Service	Does the replacement transmitter require HVAC Service?	Yes
	Type	Cooling Only
	Size	25 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	550.0 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

Other Transmitter Cost Not Listed

Name	Description
Ice Shield	ice Shield for HVAC equipment
Mask Filter	Mask Filter
Transmitter Installation	Installation of primary transmitter

Antennas

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

Primary Antenna

Existing Antenna Information

Section	Question	Response
Existing Antenna Description	Type of change	Lease New
	Antenna Use	Primary (Main)
	Description of Use	N/A
	Ownership	Leased
	Owner	American Tower Corporation
	Site	N/A
	Is the existing antenna shared with another station or stations?	Yes
	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	Full Power
	Mounting	Top Mount
	Antenna position in stack	Not in Stack
	Polarization	Horizontal
	Type	Broadband Panel
	Number of Stations Supported	4
	Number of Panels	36
	Design power capacity in use	90.0 %
	Lower Limit	605.00 MHz
	Upper Limit	665.00 MHz
	Other Antenna Type	N/A
	ERP:	1000.0 kW
	Manufacturer
	Model	PHP36C
	Year	2003

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

Facility ID	Call Sign
22201	KDAF
67910	KDTX-TV
42359	KTXD-TV

Primary Antenna

New Antenna Costs

Section	Question	Response
New Antenna Description	Use	Primary (Main)
	Description of Use	N/A
	Change Type	Lease New
	Is this a request for upgraded equipment?	Yes
	Ownership	Leased
	Owner	American Tower Corporation
	Is antenna shared?	Yes
	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	Top Mount
	Antenna position in stack	Not in Stack
	Polarization	Elliptical
	Type	Broadband Panel
	Number of Stations Supported	5
	Number of Panels/Bays	54
	Lower Limit	482.00 MHz
	Upper Limit	608.00 MHz
	Design power capacity in use	14.0 %
	Other Antenna Type	N/A
	ERP:	757.0 kW
	Manufacturer
	Model	TUM-AP-C4-14/48H-2-R-B
	Year	2017
	Justification for New Antenna	Current Broadband antenna is in a frequency range outside of new transition channel's frequency.

Primary Antenna

Other Antenna Costs

Section	Question	Response
Combiner for Shared Antenna	Do you need a Combiner for a Shared Antenna?	Yes
	Type	New
	Number of channels supported	5
	Frequencies of channels supported	RF channel
	Frequency	N/A
	Do you need a combiner output splitter/switcher for dual feed lines?	No
Elbow Complex	Do you require the separate purchase of the Elbow Complex?	Yes
	Broadband or Single Channel?	Broadband
	Feed Line Size	7 3/16 inches inches
Side Mount Brackets	Do you require the separate purchase of side mount brackets for a high power antenna?
Pattern Scatter Analysis	Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna?	No
Sweep Test	Do you require the sweep testing of transmission line and antenna?	Yes

Enter a list of RF channel numbers.

RF Channel Number
21
18
19
23
29

Primary Antenna

Other Antenna Cost Not Listed

Name	Description
Combiner Installation	Installation of the combiner; Dual chain combiner system, Single chain of 2 constant impedance waveguide modules, and or single chain of 2 directional filter modules per Dielectric layout plus a third low power filter for the wideband port.

Transmission Line

Section	Question	Response
Transmission Line Related Expenses	Do you have transmission line related expenses?	Yes

Primary Transmission Line

Existing Transmission Line

Section	Question	Response
Existing Transmission Line Description	Type of change	Lease New
	Use	Primary (Main)
	Description of Use	N/A
	Ownership	Leased
	Owner	American Tower Corporation
	Site	N/A
	Is the existing transmission line shared with another station or stations?	Yes
	Is Transmission Line in operating condition?	Yes
Existing Transmission Line Manufacturer and Type	Manufacturer
	Type	Rigid
	Diameter	8 3/16 inches
	Other Diameter	N/A
	Segment Length	Broadband
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	1675 feet per run

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

Facility ID	Call Sign
22201	KDAF
42359	KTXD-TV
67910	KDTX-TV

Primary Transmission Line

New Transmission Line

Section	Question	Response
New Transmission Line Costs	Use	Primary (Main)
	Description of Use	N/A
	Change Type	Lease New
	Is this a request for upgraded equipment?	Yes
	Type	Rigid
	Diameter	7 3/16 inches
	Other Diameter	N/A
	Segment Length	Broadband
	Other Segment Length	N/A
	Number of parallel runs	2
	Length	1650 feet per run
	Justification for New Transmission Line	New line runs for new line feeding new broadband array at new tower site.

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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

Primary Tower

Add 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?	Candelabra
	Is this tower currently shared with any other stations?	Yes
	One or more FM, AM or TV radio broadcaster(s)	Yes
	Others Types of Users	Yes
	Is tower documented for structural analysis?	Unknown
	Is tower compliant with Rev G?	Unknown
Existing Tower Structure Registration	Do you have a tower registration number?	Yes
Existing Tower Structure Registration	ASR Number	1055009
Coordinates (NAD83)	Latitude (NAD83)	32° 35' 22.0" N-
	Longitude (NAD83)	096° 58' 12.9" W-
	Overall Structure Height	1550.83 feet
	Support Structure Height	1453.07 feet
	Ground Elevation Above Mean Sea Level (AMSL)	829.71 feet
	Structure Type	GTOWER - Guyed Structure Used for Communication Purposes
	Tower Owner	American Tower, LLC
	Date Constructed	11/04/2008

FM, AM or TV radio broadcasters. Facility ID's, Call Signs and Services of other broadcast stations with whom the tower is shared

Facility ID	Call Sign	Service
6378	KZPS	FM
11451	WRR	FM
35841	KUVN-DT	DTV
47739	KDMX	FM
9620	KDGE	FM
41380	KLNO	FM
18114	KEGL	FM
14524	KCBI	FM
26950	KATA-CD	DTV
23084	KHKS	FM
59702	KKDA-FM	FM

Other Types of Users

Users
KODF-LD
KNAV-LP
KJJM-LD
KHPK-LD
K31GL-D
KVFW-LD

Primary Tower

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:	Serious Reinforcements needed

Primary Tower

Tower Rigging Costs

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

Primary Tower

Other Tower Expenses Not Listed

Name	Description
Ground and Building A and E Permit Drawing Package	Ground and Building A and E Permit Drawing Package
Tower Load Study	Rigorous analysis to access the structural capacity and modifications needed to accommodate the repack equipment.
Tower Permit Drawing package	The generation of a construction drawing package for one broadcaster.
Construction project management Tower Modification reinforcements and facilties	60 hours on Modification project management and RF installation project management

Primary Tower

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?	Candelabra
	Is this tower currently shared with any other stations?	Yes
	One or more FM, AM or TV radio broadcaster(s)	Yes
	Others Types of Users	No
	Is tower documented for structural analysis?	Yes
	Is tower compliant with Rev G?	Unknown
Existing Tower Structure Registration	Do you have a tower registration number?	Yes
Existing Tower Structure Registration	ASR Number	1059733
Coordinates (NAD83)	Latitude (NAD83)	32° 32' 36.0" N-
	Longitude (NAD83)	096° 57' 33.0" W-
	Overall Structure Height	1635.15 feet
	Support Structure Height	1523.60 feet
	Ground Elevation Above Mean Sea Level (AMSL)	813.97 feet
	Structure Type	GTOWER - Guyed Structure Used for Communication Purposes
	Tower Owner	American Towers, LLC
	Date Constructed	06/18/2000

FM, AM or TV radio broadcasters. Facility ID's, Call Signs and Services of other broadcast stations with whom the tower is shared

Facility ID	Call Sign	Service
17037	KDFI	DTV
49323	KERA	FM
60534	KSTR-DT	DTV
67195	KLUV	FM
49326	KDTN	DTV
49324	KERA-TV	DTV
55768	KKXT	FM
9627	KBFB	FM
23422	KTVT	DTV
42359	KTXD-TV	DTV
22201	KDAF	DTV
68834	KPXD-TV	DTV
1087	KRLD-FM	FM
41380	KLNO	FM
28624	KVIL	FM
51517	KTXA	DTV
63779	KJKK	FM
23440	KMVK	FM
67910	KDTX-TV	DTV

Primary Tower

Tower Rigging Costs

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

Primary Tower

Other Tower Expenses Not Listed

Name	Description
Tower Permit Drawing Package	The generation of a construction drawing package for one broadcasters/customers.
Ground and Building A and E Permit Drawing Package	The generation of a construction drawing package for one broadcasters/customers.

Outside Professional Services Costs

Section	Question	Response
Outside Project Management Services	Do you require outside project management services?	Yes
	Number of Hours	595
	Explanation	KDTN lacks sufficient resources in house to handle all activities for on-time completion of build and requires the aid of outside project management services to fulfill repack requirements. KDTN will hire an outside firm to support KDTN's transition.
Outside RF consulting Engineering Services	Perform engineering study for new channel assignment and antenna development	Yes
	Prepare engineering section of Form FCC Construction Permit Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare engineering section of Form FCC License to Cover Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare request for Special Temporary Authority	Yes
	Quantity	2
	Do you have Distributed Transmission System engineering services?	N/A
	Critical Facility	N/A
	Terrain-Shielded Facility	N/A
Attorney and Other Outside Consulting Services	Prepare and file Form FCC Construction Permit Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare and file Form FCC License to Cover Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare request for Special Temporary Authority	Yes
	Quantity	2
	NEPA Section 106 environmental review	Yes
	Environmental Assessment	Yes
	ASR Modification	Yes
	FAA Consultation (including preparation of FAA Form 7460)	Yes
	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	No
	RF exposure measurements	Yes
	Additional Field Engineering Service	Yes
	Number of Days	10
	Justification	Installation of transmitter and supervision of antenna installation.

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Name	Description
Site Coordination Meeting	Site coordination meetings with all broadcasters, contractors and vendors involved with the site deliveries and construction.
RF System Test	Testing of the combiner to ensure all, but specifically this broadcaster frequencies are tuned for optimal patterns.
Migratory Bird Assessment Permitting if needed	Migratory Bird Assessment Permitting if needed

Other Expenses

Section	Question	Response
AM Pattern Disturbance	Is an Impact Study needed?	No
AM Pattern Disturbance	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	Yes
Other Miscellaneous Expenses	Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)?	Yes
	Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs?	Yes
	Does this relocation require Equipment Storage?	Yes
	Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change?	Yes
	Does this relocation require MVPD Notification of a Channel Change?	Yes

Other Expenses

Other Expenses Not Listed

Name	Description
Cost of Construction and Electrical permits	2% construction cost, excluding the material and equipment for electrical and building permits.
Site Secuirty Company during construction for theft prevention and vandalism	Site security for installation and storage of Transmission line and materials for 57 days X 12 hours. The materials are a high risk of theft due to the material makeup such as copper, brass and aluminum.
Tree Clearing Tag Alley	This cost is for the removal of trees and vegetation to ensure the proper clearance of taglines and laydown areas, required for construction.
Transmission Line Bridge	New Ice Bridge required to support new transmission lines from all four repack tenants space to tower, estimated to be 200 linear ft. This cost includes the materials, foundations and installation.

Cost Information

Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$1,952,521.34	$1,418,257.31	N/A	$1,150,792.61	N/A
Total for all systems	$5,588,473.67	$2,596,307.83	N/A	$1,878,992.93	N/A
Primary Transmitter TXUD40000ALC	$1,952,521.34	$1,418,257.31		$1,150,792.61
Service entrance 3 phase/800 amp/208 volt	$14,400.00	$13,700.00	N/A	$0.00	N/A
Mask Filter	$67,500.00	$67,500.00	See attached price quote.	$913.96	N/A
Switchgear - industrial 800 amp	$38,200.00	$36,300.00	N/A	$0.00	N/A
Other Electrical Service: Minimal electric services not listed above will be needed to implement new facility.	$5,000.00	$5,000.00	N/A	$2,454.09	N/A
Other -- Building Addition Size: 550.0	$134,342.25	$134,342.25	see Estimated Cost Justification KDTN-110-1st Primary Transmitter - Building Addition, 550 Sq. Ft. v0	$67,927.79	N/A
Transmitter Installation	$25,546.09	$25,546.09	Please see KDTN Primary Transmitter Installation Revision Justification Cover Letter	$25,546.09	N/A
Ice Shield	$54,633.00	$54,633.00	see Estimated Cost Justification KDTN-110-1st Primary Transmitter - Ice Shield v0	$30,000.00	N/A
25 Ton system	$91,500.00	$46,400.00	N/A	$35,114.71	N/A
Transformer 3 phase/480v - 500 KVA	$48,400.00	$46,000.00	N/A	$0.00	N/A
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW	$1,473,000.00	$988,835.97	Please see KDTN Primary Transmitter Installation Revision Justification Cover Letter	$988,835.97	N/A

Components

Actual Information Description	File Name
Service entrance 3 phase/800 amp/208 volt	Information not provided.
Mask Filter	Component Description: 1/2X100 H/C PEX Tube Amount: $867.02 Component Description: LF 1 ID X 1 MIP Amount: $46.94
Switchgear - industrial 800 amp	Information not provided.
Other Electrical Service: Minimal electric services not listed above will be needed to implement new facility.	Component Description: EMT Amount: $424.54 Component Description: 508 2-1/2 MI Beam Clamp 1/2-13 Amount: $1,031.28 Component Description: Welding on rack at TV Tower Cedar Hill, TX Amount: $812.50 Component Description: Belden Wire & Cable Amount: $185.77
Other -- Building Addition Size: 550.0	Component Description: ITEM: Pluming Material Amount: $4,087.79 Component Description: Weld Stands Amount: $1,140.00 Component Description: 1. KDTN-110-1st Primary Transmitter - Building Addition, 550 Sq. Ft. Amount: $20,900.00 Component Description: KDTN-110-1st Primary Transmitter - Building Addition, 550 Sq. Ft. Amount: $41,800.00
Transmitter Installation	Component Description: Labor Amount: $696.34 Component Description: Repack Travel Expenses Amount: $37.89 Component Description: Labor Amount: $536.37 Component Description: Repack Travel Expenses Amount: $481.40 Component Description: Labor Transport Amount: $569.66 Component Description: Labor Amount: $686.95 Component Description: 1-5/8" to type N female plate Amount: $966.00 Component Description: Labor Amount: $150.56 Component Description: Repack Travel Expenses Amount: $274.92 Component Description: Professional Fees Amount: $21,146.00
Ice Shield	Component Description: 2. KDTN-110-1st Primary Transmitter - Ice Shield Amount: $10,000.00 Component Description: KDTN-110-1st Primary Transmitter - Ice Shield Amount: $20,000.00
25 Ton system	Component Description: 5/8-11 X 2" Hex Amount: $314.71 Component Description: CAPITAL CONTRIBUTION - MILTON/CEDAR HILL Amount: $11,600.00 Component Description: Capital Contribution Amount: $23,200.00
Transformer 3 phase/480v - 500 KVA	Information not provided.
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW	Component Description: Elettronika TXUD40.000ALC UHF Digital TV Transmitter. Amount: $981,566.30 Component Description: Shipping and Handling Amount: $7,269.67 Component Description: Invoice moved to correct budget category per RFI. Amount: N/A Component Description: Invoice moved to correct budget category per RFI. Amount: N/A Component Description: Invoice moved to correct budget category per RFI. Amount: N/A Component Description: Invoice moved to correct budget category per RFI. Amount: N/A Component Description: Invoice moved to correct budget category per RFI. Amount: N/A

Cost Information

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	$278,996.43	$287,416.68	N/A	$206,839.60	N/A
Total for all systems	$5,588,473.67	$2,596,307.83	N/A	$1,878,992.93	N/A
Primary Antenna TUM-AP-C4-14/48H-2-R-B	$278,996.43	$287,416.68		$206,839.60
Elbow complex, broadband, at antenna input, per 7 3/16. feedline (if needed)	$16,850.00	$9,166.25	see Estimated Cost Justification KDTN-210-Primary Antenna - 7 3_16 Broadband Elbow Complex v0	$4,875.00	N/A
Sweep test of existing antenna	$6,730.00	$6,400.00	N/A	$5,312.50	N/A
UHF - Lower Power, Top Mount, Class A, broadband panel, 54 bay,, 757 kW input, directional,, elliptically or circularly polarized	$157,847.43	$157,847.43	see Estimated Cost Justification KDTN-210-Primary Antenna - UHF Lower Power Top Mount Broadband E-POL v0	$101,000.10	N/A
New combiner, cost per channel (without antenna)	$84,200.00	$100,634.00	Please see KDTN American Towers Cost Estimation and KDTN Main 75253 Dallas Milton Repack Cost Estimates	$85,634.00	N/A
Combiner Installation	$13,369.00	$13,369.00	see Estimated Cost Justification KDTN-210-Primary Antenna - Combiner Installation v0	$10,018.00	N/A

Components

Actual Information Description	File Name
Elbow complex, broadband, at antenna input, per 7 3/16. feedline (if needed)	Component Description: KDTN-210-Primary Antenna - 7 3/16" Broadband Elbow Complex Amount: $3,250.00 Component Description: 6. KDTN-210-Primary Antenna - 7 3/16" Broadband Elbow Complex Amount: $1,625.00
Sweep test of existing antenna	Component Description: 5. KDTN-210-Primary Antenna - Sweep Test Amount: $937.50 Component Description: KDTN-210-Primary Antenna - Sweep Test Amount: $1,875.00 Component Description: KDTN-210-Primary Antenna - Sweep Test Amount: $2,500.00
UHF - Lower Power, Top Mount, Class A, broadband panel, 54 bay,, 757 kW input, directional,, elliptically or circularly polarized	Component Description: KDTN-210-Primary Antenna - UHF Lower Power Top Mount Broadband E-POL Amount: $67,333.40 Component Description: 3. KDTN-210-Primary Antenna - UHF Lower Power Top Mount Broadband E-POL Amount: $33,666.70
New combiner, cost per channel (without antenna)	Component Description: 4. KDTN-210-Primary Antenna - Combiner Amount: $15,000.00 Component Description: KDTN-210-Primary Antenna - Combiner Amount: $30,000.00 Component Description: CAPITAL CONTRIBUTION Amount: $40,634.00
Combiner Installation	Component Description: 7. KDTN-210-Primary Antenna - Combiner Installation Amount: $1,562.50 Component Description: KDTN-210-Primary Antenna - Combiner Installation Amount: $5,330.50 Component Description: KDTN-210-Primary Antenna - Combiner Installation Amount: $3,125.00

Cost Information

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	$1,098,900.00	$332,459.44	N/A	$188,437.07	N/A
Total for all systems	$5,588,473.67	$2,596,307.83	N/A	$1,878,992.93	N/A
Primary Transmission Line	$1,098,900.00	$332,459.44		$188,437.07
Rigid Transmission Line - copper, 7 3/16" broadband	$1,098,900.00	$332,459.44	see Estimated Cost Justification KDTN-310-Primary Transmission Line - 7 3_16 Broadband Rigid Copper v0	$188,437.07	N/A

Components

Actual Information Description	File Name
Rigid Transmission Line - copper, 7 3/16" broadband	Component Description: 6-1/8" EIA 50 ohm fixed flanged rigid line section Amount: $30,631.68 Component Description: 4-1/2" IEC flange male to 4-1/16" flange female Amount: $1,033.89 Component Description: 6-1/8" 50 ohm fixed flanged Amount: $4,930.25 Component Description: 8. KDTN-310-Primary Transmission Line - 7 3/16" Broadband Rigid Copper Amount: $50,613.75 Component Description: Comb Invoice KDTN-310-Primary Transmission Line - 7 3-16in Broadband Rigid Copper American Towers LLC 460203772 Amount: $101,227.50

Actual Information Description

File Name

Rigid Transmission Line - copper, 7 3/16" broadband

Component Description:: 6-1/8" EIA 50 ohm fixed flanged rigid line section
Amount:: $30,631.68

Component Description:: 4-1/2" IEC flange male to 4-1/16" flange female
Amount:: $1,033.89

Component Description:: 6-1/8" 50 ohm fixed flanged
Amount:: $4,930.25

Component Description:: 8. KDTN-310-Primary Transmission Line - 7 3/16" Broadband Rigid Copper
Amount:: $50,613.75

Component Description:: Comb Invoice KDTN-310-Primary Transmission Line - 7 3-16in Broadband Rigid Copper American Towers LLC 460203772
Amount:: $101,227.50

Cost Information

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	$1,948,260.40	$246,765.40	N/A	$179,711.40	N/A
Total for all systems	$5,588,473.67	$2,596,307.83	N/A	$1,878,992.93	N/A
Primary Tower GTOWER	$421,000.00	$0.00		$0.00
Tower Permit Drawing Package	$0.00	$0.00	This appears as a duplicate entry	N/A	N/A
Ground and Building A and E Permit Drawing Package	$0.00	$0.00	This appears as a duplicate entry.	N/A	N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)	$421,000.00	$0.00	This appears as a duplicate entry.	N/A	N/A
Primary Tower GTOWER	$1,527,260.40	$246,765.40		$179,711.40
Construction project management Tower Modification reinforcements and facilties	$14,650.40	$14,650.40	see Estimated Cost Justification KDTN-410-Existing Primary Tower - Construction Project Management, Tower and Facilities v0	$5,625.00	N/A
Tower Load Study	$3,910.00	$3,910.00	Please see 75253 Dallas Milton Repack Cost Estimates	$2,932.50	N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study	$26,300.00	$4,960.00	Please see 75253 Dallas Milton Repack Cost Estimates	$3,720.00	N/A
Tower Permit Drawing package	$4,700.00	$4,700.00	See attached AMT quote.	$3,525.00	N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)	$421,000.00	$63,845.00	N/A	$47,883.90	N/A
Serious tower reinforcement/modifications	$1,052,000.00	$150,000.00	N/A	$112,500.00	N/A
Ground and Building A and E Permit Drawing Package	$4,700.00	$4,700.00	See attached AMT quote.	$3,525.00	N/A

Components

Actual Information Description	File Name
Tower Permit Drawing Package	Information not provided.
Ground and Building A and E Permit Drawing Package	Information not provided.
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)	Information not provided.
Construction project management Tower Modification reinforcements and facilties	Component Description: 16. KDTN-410-Existing Primary Tower - Construction Project Management, Tower and Facilities Amount: $1,875.00 Component Description: KDTN-410-Existing Primary Tower - Construction Project Management, Tower and Facilities Amount: $3,750.00
Tower Load Study	Component Description: 11. KDTN-410-Existing Primary Tower - Tower Load Study, Documented Tower Amount: $977.50 Component Description: KDTN-410-Existing Primary Tower - Tower Load Study, Documented Tower Amount: $1,955.00
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study	Component Description: 10. KDTN-410-Existing Primary Tower - Tower Mapping Amount: $1,240.00 Component Description: KDTN-410-Existing Primary Tower - Tower Study Amount: $2,480.00
Tower Permit Drawing package	Component Description: 14. KDTN-410-Existing Primary Tower - Tower Permit Drawing Package Amount: $1,175.00 Component Description: KDTN-410-Existing Primary Tower - Tower Permit Drawing Package Amount: $2,350.00
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)	Component Description: 13. KDTN-410-Existing Primary Tower - Tower Rigging, Complex Tower Amount: $15,961.30 Component Description: KDTN-410-Existing Primary Tower - Tower Rigging, Complex Tower Amount: $31,922.60
Serious tower reinforcement/modifications	Component Description: KDTN-410-Existing Primary Tower - Serious Tower Reinforcement/Modifications Amount: $75,000.00 Component Description: 12. KDTN-410-Existing Primary Tower - Serious Tower Reinforcement/Modifications Amount: $37,500.00
Ground and Building A and E Permit Drawing Package	Component Description: KDTN-410-Existing Primary Tower - Ground and Building Permit Drawing Package Amount: $2,350.00 Component Description: 15. KDTN-410-Existing Primary Tower - Ground and Building Permit Drawing Package Amount: $1,175.00

Cost Information

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	$208,600.00	$212,578.50	N/A	$101,948.75	N/A
Total for all systems	$5,588,473.67	$2,596,307.83	N/A	$1,878,992.93	N/A
Outside Professional Services	$208,600.00	$212,578.50		$101,948.75
Project management of the transition	$94,010.00	$118,635.00	see Estimated Cost Justification KDTN-510-Project Management v0	$70,582.75	invoices
Migratory Bird Assessment Permitting if needed	$350.00	$350.00	See attached AMT quote.	$262.50	N/A
RF System Test	$9,000.00	$9,000.00	Please see KDTN American Towers Cost Estimation and KDTN Main 75253 Dallas Milton Repack Cost Estimates	$8,000.00	N/A
Site Coordination Meeting	$2,500.00	$2,500.00	See attached AMT quote.	$1,875.00	N/A
Additional Field Engineering Service, 10 Days	$20,000.00	$20,000.00	N/A	$0.00	N/A
RF Exposure Measurements	$21,050.00	$3,000.00	N/A	$2,250.00	N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase	$2,105.00	$2,000.00	N/A	$0.00	N/A
ASR modification (prepare FCC Form 854)	$2,105.00	$2,000.00	N/A	$0.00	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	$0.00	N/A
NEPA Section 106 environmental review, if needed	$6,310.00	$1,800.00	N/A	$810.00	N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization	$7,360.00	$7,000.00	N/A	$1,043.00	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), Construction Permit Application	$3,155.00	$3,000.00	N/A	N/A	N/A
Perform engineering study for new channel assignment and antenna development	$7,360.00	$10,000.00	Please see KDTN American Towers Cost Estimation and KDTN Main 75253 Dallas Milton Repack Cost Estimates	$8,750.00	N/A
Address transition timing and coordination issues w/ other stations and wireless	$2,630.00	$2,500.00	N/A	$1,875.00	N/A
Prepare and or review reimbursement form	$2,630.00	$5,043.50	Estimated Cost Justification KDTN-590-Prepare and_or Review Reimbursement v0	$5,043.50	N/A
Attorney Fees - Negotiation of lease and other matters for shared locations	$4,210.00	$4,000.00	N/A	$712.00	N/A
Prepare request for Special Temporary Authorization	$4,100.00	$3,000.00	N/A	$0.00	N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	$1,580.00	$1,500.00	N/A	$745.00	N/A

Components

Actual Information Description	File Name
Project management of the transition	Component Description: Project Management Amount: $1,620.15 Component Description: Project Management Amount: $3,518.70 Component Description: Project Management Amount: $1,514.90 Component Description: Project Management Amount: $2,543.65 Component Description: Project Management Amount: $10,323.90 Component Description: Project Management Amount: $4,937.95 Component Description: Project Management Amount: $1,803.40 Component Description: Project Management Amount: $4,724.35 Component Description: Project Management Amount: $6,804.60 Component Description: Project Management Amount: $3,385.70 Component Description: Project Management Amount: $1,519.30 Component Description: 17. KDTN-510-Project Management Amount: $2,370.00 Component Description: KDTN-510-Project Management Amount: $9,480.00 Component Description: KDTN-510-Project Management Amount: $4,740.00 Component Description: Project Management Amount: $93.90 Component Description: Project Management Amount: $1,528.75 Component Description: Project Management Amount: $9,673.50
Migratory Bird Assessment Permitting if needed	Component Description: KDTN-590-Migratory Bird Assessment and Permitting Amount: $175.00 Component Description: 23. KDTN-590-Migratory Bird Assessment and Permitting Amount: $87.50
RF System Test	Component Description: 24. KDTN-580-Field Engineering Service - RF System Test Amount: $1,000.00 Component Description: KDTN-580-Field Engineering Service - RF System Test Amount: $5,000.00 Component Description: KDTN-580-Field Engineering Service - RF System Test Amount: $2,000.00
Site Coordination Meeting	Component Description: KDTN-590-Site Coordination Meeting Amount: $1,250.00 Component Description: 22. KDTN-590-Site Coordination Meeting Amount: $625.00
Additional Field Engineering Service, 10 Days	Information not provided.
RF Exposure Measurements	Component Description: KDTN-580-Field Engineering Service - RF Exposure Measurements Amount: $1,500.00 Component Description: 21. KDTN-580-Field Engineering Service - RF Exposure Measurements Amount: $750.00
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase	Information not provided.
ASR modification (prepare FCC Form 854)	Information not provided.
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet	Information not provided.
NEPA Section 106 environmental review, if needed	Component Description: 20. KDTN-590-NEPA Section 106 Review Amount: $270.00 Component Description: KDTN-590-NEPA Section 106 Review Amount: $540.00
Attorney Fees - Prepare and File request for Special Temporary Authorization	Component Description: Total Professional Services Amount: $1,043.00
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), Construction Permit Application	Information not provided.
Perform engineering study for new channel assignment and antenna development	Component Description: 19. KDTN-530-RF Eng - Engineering Study for New Channel Assignment Amount: $1,250.00 Component Description: KDTN-530-RF Eng - Engineering Study for New Channel Assignment Amount: $2,500.00 Component Description: KDTN-530-RF Eng - Engineering Study for New Channel Assignment Amount: $5,000.00
Address transition timing and coordination issues w/ other stations and wireless	Component Description: 18. KDTN-590-Transition Timing and Coordination Amount: $625.00 Component Description: KDTN-590-Transition Timing and Coordination Amount: $1,250.00
Prepare and or review reimbursement form	Component Description: Total Professional Services Amount: $786.00 Component Description: Total Professional Services Amount: $4,257.50
Attorney Fees - Negotiation of lease and other matters for shared locations	Component Description: Total Professional Services Amount: $69.50 Component Description: Total Professional Services Amount: $223.50 Component Description: Total Professional Services Amount: $74.50 Component Description: Total Professional Services Amount: $69.50 Component Description: Total Professional Services Amount: $131.00 Component Description: Total Professional Services Amount: $74.50 Component Description: Total Professional Services Amount: $69.50
Prepare request for Special Temporary Authorization	Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	Component Description: Total Professional Services Amount: $745.00

Cost Information

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	$101,195.50	$98,830.50	N/A	$51,263.50	N/A
Total for all systems	$5,588,473.67	$2,596,307.83	N/A	$1,878,992.93	N/A
Other Expenses	$101,195.50	$98,830.50		$51,263.50
Non-zoning permits	$10,000.00	$10,000.00	N/A	N/A	N/A
Local Zoning	$4,700.00	$4,700.00	See attached AMT quote.	$3,525.00	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	$335.00	see Estimated Cost Justification KDTN-610-FCC Filing Fees - License to Cover Application v0	$335.00	N/A
Transmission Line Bridge	$36,241.50	$36,241.50	see Estimated Cost Justification KDTN-610-Transmission Line Bridge v0	$16,875.00	N/A
Site Secuirty Company during construction for theft prevention and vandalism	$8,500.00	$8,500.00	See attached AMT quote.	$6,412.50	N/A
Cost of Construction and Electrical permits	$10,000.00	$10,000.00	See attached AMT quote.	$7,500.00	N/A
MVPD Notification of Channel Change	$2,964.00	$2,964.00	see Estimated Cost Justification KDTN-610-MVPD Notifications v0	$2,964.00	N/A
Develop and air announcement of upcoming channel change	$500.00	$500.00	N/A	N/A	N/A
Equipment Storage	$3,500.00	$3,500.00	See attached AMT quote.	N/A	N/A
Equipment Delivery and Handling Charges	$5,000.00	$5,000.00	See attached AMT quote.	$3,750.00	N/A
Disposal Costs (for equipment and other waste, net of any salvage value)	$5,000.00	$5,000.00	N/A	N/A	N/A
Tree Clearing Tag Alley	$1,600.00	$1,600.00	See attached AMT quote.	$1,200.00	N/A
DTV Medical Facility Notification	$11,550.00	$9,230.00	N/A	$8,702.00	N/A
FCC Filing Fees - Form 2100 minor change CP application	$1,110.00	$1,070.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
Non-zoning permits	Information not provided.
Local Zoning	Component Description: 25. KDTN-610-Local Zoning Amount: $1,175.00 Component Description: KDTN-610-Local Zoning Amount: $2,350.00
FCC Filing Fees - Special Temporary Authorization request	Information not provided.
FCC Filing Fees - Form 2100 license to cover application	Component Description: KDTN-610-FCC Filing Fee - License to Cover Application Amount: $335.00
Transmission Line Bridge	Component Description: 9. KDTN-610-Transmission Line Bridge Amount: $5,625.00 Component Description: KDTN-610-Transmission Line Bridge Amount: $11,250.00
Site Secuirty Company during construction for theft prevention and vandalism	Component Description: KDTN-610-Site Security Amount: $4,275.00 Component Description: 27. KDTN-610-Site Security Amount: $2,137.50
Cost of Construction and Electrical permits	Component Description: 28. KDTN-610-Construction and Electrical Permits Amount: $2,500.00 Component Description: KDTN-610-Construction and Electrical Permits Amount: $5,000.00
MVPD Notification of Channel Change	Component Description: MVPD Notification Services Amount: $2,964.00
Develop and air announcement of upcoming channel change	Information not provided.
Equipment Storage	Information not provided.
Equipment Delivery and Handling Charges	Component Description: 26. KDTN-610-Equipment Delivery and Handling Amount: $1,250.00 Component Description: KDTN-610-Equipment Delivery and Handling Amount: $2,500.00
Disposal Costs (for equipment and other waste, net of any salvage value)	Information not provided.
Tree Clearing Tag Alley	Component Description: 29. KDTN-610-Tree Clearing Tag Alley Amount: $400.00 Component Description: KDTN-610-Tree Clearing Tag Alley Amount: $800.00
DTV Medical Facility Notification	Component Description: DTV Notification Service Amount: $8,702.00
FCC Filing Fees - Form 2100 minor change CP application	Information not provided.

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$5,588,473.67	$2,596,307.83	$1,878,992.93

Reimbursement Status

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

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.
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. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. 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). 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. 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. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. 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.	Arnold Torres Business Administrator 06/24/2020

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.

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.
The above-named entity acknowledges that all certifications and attached documentation are considered material representations.
The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.
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).
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.
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.
The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.
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.

Arnold Torres

Business Administrator

06/24/2020

Certification

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).

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 certifies that the statements in this form and attached documentation are true, complete, and correct.
The above-named entity acknowledges that all certifications and attached documentation are considered material representations.
The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.
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) .
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.
The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred.
The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.
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.

Arnold Torres

Business Administrator

06/24/2020

Certification

Section

Question

Response

Submission of Final Allocation or Accounting Information Statements

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.
The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.
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.
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.
The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.
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.

Arnold Torres

Business Administrator

06/24/2020

(REFERENCE COPY - Not for submission) FCC Form 399: Reimbursement Request

Applicant Information

Applicant Name, Type, and Contact Information

Reimbursement Contact Information

Reimbursement Contact Name and Information

Preparer Contact Information

Preparer Contact Name and Information

Broadcaster Information and Transition Plan

Transmitters

Primary Transmitter

Existing Transmitter Information

Primary Transmitter

New Transmitter Costs

Primary Transmitter

Other Transmitter Costs

Primary Transmitter

Other Transmitter Cost Not Listed

Antennas

Primary Antenna

Existing Antenna Information

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

Primary Antenna

New Antenna Costs

Primary Antenna

Other Antenna Costs

Enter a list of RF channel numbers.

Primary Antenna

Other Antenna Cost Not Listed

Transmission Line

Primary Transmission Line

Existing Transmission Line

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

Primary Transmission Line

New Transmission Line

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Tower Equipment And Rigging Costs

Primary Tower

Add Tower

FM, AM or TV radio broadcasters. Facility ID's, Call Signs and Services of other broadcast stations with whom the tower is shared

Other Types of Users

Primary Tower

Tower Modification Costs

Primary Tower

Tower Rigging Costs

Primary Tower

Other Tower Expenses Not Listed

Primary Tower

Existing Tower

FM, AM or TV radio broadcasters. Facility ID's, Call Signs and Services of other broadcast stations with whom the tower is shared

Primary Tower

Tower Rigging Costs

Primary Tower

Other Tower Expenses Not Listed

Outside Professional Services Costs

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Other Expenses

Other Expenses

Other Expenses Not Listed

Cost Information

Transmitters

Components

Cost Information

Antennas

Components

Cost Information

Transmission Line

Components

Cost Information

Tower Equipment and Rigging Costs

Components

Cost Information

Outside Professional Services

Components