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:
20566
Service:
LPA
Call Sign:
KSAA-LD
Channel:
10 (High VHF)
File Number:
0000086317
FRN:
0026907329
Eligibility Status:
Eligible
Date Submitted:
09/21/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

HC2 LPTV HOLDINGS, INC.

RENEE ILHARDT

450 PARK AVENUE

30TH FLOOR

NEW YORK, NY 10022

United States

+1 (954) 606-5486 RILHARDT@HC2BROADCASTING.COM Corporation

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 This displaced facility is currently in the process of complying with it is new displacement construction permit as part of the repack program.

Question Response
Sharee Station Facility ID 58786
Call Sign KISA-LD
Type
Licensee Name HC2 LPTV HOLDINGS, INC.
Status LICENSED
DTS No
Community of License SAN ANTONIO, TX
Pre-auction RF Channel 22
Post-auction RF Channel
Neilsen DMA
Network Affiliation
Question Response
Sharee Station Facility ID 67304
Call Sign KSSJ-LD
Type
Licensee Name DTV AMERICA CORPORATION
Status LICENSED
DTS No
Community of License SAN ANTONIO, TX
Pre-auction RF Channel 33
Post-auction RF Channel
Neilsen DMA
Network Affiliation

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)
Ownership Owned
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model ATU500LD
Year 2002
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity .5 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 LPTV-5000-1000V3
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1 kW
Justification for New Transmitter The applicant plans on replacing the existing transmitter because of its age and lack of current support. Facility is also moving from UHF band to VHF band.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Other Transmitter Costs
Does the transmitter installation require a Transmitter Building Site Survey/Installation? Yes
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Rigid Conduit and Wiring Yes
Size 2 inches
Length 10.0 feet
Other Electrical Service Yes
Description Minor electrical work
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 5 tons
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Additional Field Engineering Time

Additional Field Engineering Time

UHF Inside RF System Including Switching

UHF Inside RF System Including 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)
Ownership Owned
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
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Other
Other Antenna Type Panel
ERP: 14.5 kW
Manufacturer
Model SCA 4DR-16-4HO
Year 2002

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Change Type Purchase New
Ownership Owned
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
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Circular
Type Broadband Slot
Number of Stations Supported 1
Number of Panels/Bays 4
Lower Limit 174.00 MHz
Upper Limit 216.00 MHz
Design power capacity in use 100.0 %
ERP: 3.0 kW
Manufacturer
Model PSIVLP6OI-10-CP
Year 2019
Justification for New Antenna The applicant plans on replacing the existing antenna to support the new displacement construction permit. Proposed antenna.

Primary Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? No
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

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)
Ownership Owned
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 Air
Diameter 3 inches
Number of parallel runs 1
Length 1502 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Flexible Foam
Diameter 1 5/8 inches
Number of parallel runs 1
Length 460 feet per run
Justification for New Transmission Line Antenna placement due to size of the VHF antenna on the tower/leg had to be adjusted to accommodate the new larger antenna. Due to age of the existing line, the outer jacket was failing in many areas so it had to be replaced.
Interior RF Systems Does the Installation of the Transmission Line require an additional or replacement Inside RF system including switching, patch panels, and dehydrators? Yes

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)
Ownership Leased
Is this tower consider Complex? No
Is this tower currently shared with any other stations? No
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1214327
Coordinates (NAD83) Latitude (NAD83) 29° 26' 29.9" N-
Longitude (NAD83) 098° 30' 22.8" W-
Overall Structure Height 498.68 feet
Support Structure Height 498.68 feet
Ground Elevation Above Mean Sea Level (AMSL) 679.78 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner American Towers LLC
Date Constructed 07/12/2001


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 need for guyed or free-standing tower
Tower Reinforcements Please select whether tower reinforcements are needed: No 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 150
Explanation Outside consulting engineering, legal work, and accounting services, as well as project management for regional and comprehensive repack execution.
Outside RF consulting Engineering Services Perform engineering study for displacement application No
Prepare engineering section of Form FCC Construction Permit Application No
Prepare engineering section of Form FCC License to Cover Application No
Prepare request for Special Temporary Authority No
Prepare Form 601 No
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application No
Prepare and file Form FCC License to Cover Application No
Prepare request for Special Temporary Authority No
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement Yes
Form 399 assistance or other program management costs Yes
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements No
Additional Field Engineering Service No

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
Permit and Filing Costs FCC Construction Permit Major Change No
FCC Construction Permit Minor Change Yes
FCC License to Cover Application Yes
FCC Special Temporary Authority Application No
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? No
Point to Point Microwave (STL/ICR) Frequency Coordination for Unidirection System No
Frequency Coordination for Bi-Direction System No
New Point to Point Microwave System No

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 $66,390.82 $36,731.82 N/A $1,481.82 N/A
Total for all systems $217,380.82 $136,538.13 N/A $59,417.30 N/A
Primary Transmitter LPTV-5000-1000V3 $66,390.82 $36,731.82 $1,481.82
UHF Inside RF System Including Switching $457.33 $457.33 N/A $457.33 N/A
Additional Field Engineering Time $423.49 $423.49 N/A $423.49 N/A
Transmitter Building Site Survey/Installation $10,000.00 $10,000.00 N/A N/A N/A
5 Ton system $20,250.00 $20,250.00 N/A N/A N/A
Other Electrical Service: Minor electrical work $5,000.00 $5,000.00 N/A N/A N/A
2" Rigid Conduit and Wiring (Cost per foot) $260.00 $601.00 Please see attached invoice from Hill Eletric. $601.00 N/A
High VHF - Air Cooled Solid State Transmitter 400 - 1000 Watts $30,000.00 $0.00 N/A N/A N/A

Components

Actual Information Description File Name
UHF Inside RF System Including Switching

Component Description:
1-5/8'' EIA flange. #20116
Amount:
$457.33
Additional Field Engineering Time

Component Description:
Turndown/turnup TX for antenna install. #2003
Amount:
$423.49
Transmitter Building Site Survey/Installation Information not provided.
5 Ton system Information not provided.
Other Electrical Service: Minor electrical work Information not provided.
2" Rigid Conduit and Wiring (Cost per foot)

Component Description:
Conduit related cost. #31315
Amount:
$601.00
High VHF - Air Cooled Solid State Transmitter 400 - 1000 Watts 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 $37,580.00 $36,458.45 N/A $26,533.45 N/A
Total for all systems $217,380.82 $136,538.13 N/A $59,417.30 N/A
Primary Antenna PSIVLP6OI-10-CP $37,580.00 $36,458.45 $26,533.45
Power Dividers (each, for panel antenna system, if not included in antenna cost) $1,300.00 $1,300.00 N/A N/A N/A
Side Mount antenna brackets $4,625.00 $4,625.00 N/A N/A N/A
Sweep test of transmission line and antenna $5,730.00 $1,608.45 N/A $1,608.45 N/A
High VHF-Low Power, Side Mount, Broadband Slot, 4 bay, 3.0kW input, Circular $24,925.00 $24,925.00 N/A $24,925.00 N/A
Cable harness (each, for panel antenna system, if not included in antenna cost) $1,000.00 $4,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Power Dividers (each, for panel antenna system, if not included in antenna cost) Information not provided.
Side Mount antenna brackets Information not provided.
Sweep test of transmission line and antenna

Component Description:
Perform RF testing. #993330106665857
Amount:
$1,608.45
High VHF-Low Power, Side Mount, Broadband Slot, 4 bay, 3.0kW input, Circular

Component Description:
Antenna cost, 50% balance. #2112
Amount:
$12,462.50

Component Description:
Antenna cost, 50% down. #2112DP
Amount:
$12,462.50
Cable harness (each, for panel antenna system, if not included in antenna cost) 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 $21,040.00 $14,669.50 N/A $4,669.50 N/A
Total for all systems $217,380.82 $136,538.13 N/A $59,417.30 N/A
Primary Transmission Line $21,040.00 $14,669.50 $4,669.50
Interior RF Systems: Inside RF system including switching, patch panels and dehydrators $10,000.00 $10,000.00 N/A N/A N/A
Flexible Foam Transmission Line - dielectric, 1 5/8" $11,040.00 $4,669.50 N/A $4,669.50 N/A

Components

Actual Information Description File Name
Interior RF Systems: Inside RF system including switching, patch panels and dehydrators Information not provided.
Flexible Foam Transmission Line - dielectric, 1 5/8"

Component Description:
TL cost, 50% down. #2112DP
Amount:
$2,334.75

Component Description:
TL cost, 50% balance. #2112
Amount:
$2,334.75

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 $64,890.00 $21,198.36 N/A $21,198.36 N/A
Total for all systems $217,380.82 $136,538.13 N/A $59,417.30 N/A
Primary Tower GTOWER $64,890.00 $21,198.36 $21,198.36
Study needed for guyed or free-standing tower $8,700.00 $1,200.00 N/A $1,200.00 N/A
Tower Rigging Short Tower (less than 500') $56,190.00 $19,998.36 N/A $19,998.36 N/A

Components

Actual Information Description File Name
Study needed for guyed or free-standing tower

Component Description:
Customer structural. #A204937
Amount:
$1,200.00
Tower Rigging Short Tower (less than 500')

Component Description:
Tower work, down payment. #993330106665295
Amount:
$9,999.21

Component Description:
Tower work, balance. #993330106665856
Amount:
$9,999.15

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 $20,035.00 $20,035.00 N/A $2,549.54 N/A
Total for all systems $217,380.82 $136,538.13 N/A $59,417.30 N/A
Outside Professional Services $20,035.00 $20,035.00 $2,549.54
Project management of the transition $15,825.00 $15,825.00 N/A $2,549.54 N/A
Form 399 assistance or other Program Management costs $2,500.00 $2,500.00 N/A N/A N/A
Prepare/ Review 399 reimbursement form $1,710.00 $1,710.00 N/A N/A N/A

Components

Actual Information Description File Name
Project management of the transition

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 29 stations. #188
Amount:
$656.55

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 40 stations. #477015
Amount:
$406.37

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 23 stations. #174
Amount:
$551.95

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 40 stations. #1149
Amount:
$302.67

Component Description:
Portion of general repack matter invoice attributable to this station - divided by 25 stations. #181
Amount:
$632.00
Form 399 assistance or other Program Management costs Information not provided.
Prepare/ Review 399 reimbursement form Information not provided.

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 $7,445.00 $7,445.00 N/A $2,984.63 N/A
Total for all systems $217,380.82 $136,538.13 N/A $59,417.30 N/A
Other Expenses $7,445.00 $7,445.00 $2,984.63
Equipment Delivery and Handling Charges $3,000.00 $3,000.00 N/A $2,984.63 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $3,000.00 $3,000.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $335.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,110.00 N/A N/A N/A

Components

Actual Information Description File Name
Equipment Delivery and Handling Charges

Component Description:
Antenna and TL freight. #2112
Amount:
$1,962.83

Component Description:
Centracast rack shipment. #05609533046
Amount:
$229.42

Component Description:
Transmitter freight. #13514
Amount:
$792.38
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Form 2100 minor change CP application Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $217,380.82 $136,538.13 $59,417.30

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.

Kurt Hanson

CTO


09/21/2020

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.

Kurt Hanson

CTO


09/21/2020

Attachments

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