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:
24977
Service:
DCA
Call Sign:
KBTR-CD
Channel:
36 (UHF)
File Number:
0000028441
FRN:
0001714344
Date Submitted:
10/20/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

LOUISIANA TELEVISION BROADCASTING, L.L.C.

Doing Business As: LOUISIANA TELEVISION BROADCASTING, L.L.C.

Robert Bernard

P. O. BOX 2906

BATON ROUGE, LA 70821

United States

+1 (225) 387-2222 Programs@WBRZ.COM Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

Arthur M Hoover , III .

President Technical Consultant

Technical Services Group, Inc.

12015 Cloverland Court

Baton Rouge, LA 70809

United States

+1 (225) 751-9800 amh@tsgcom.com

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 See attached Narrative

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 UAXT-2R37 Maxiva
Year 2014
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1.8 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 UAXT-2.5R37
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2.5 kW
Justification for New Transmitter KBTR is installing a new lower gain antenna for structural reasons. A higher TPO transmitter will be needed to meet the necessary ERP.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring Yes
Size 2 inches
Length 100.0 feet
Other Electrical Service Yes
Description Panel board expansion for operation of interim and replacement transmitters, and installation of new circuit breaker panel
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
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? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Primary Transmitter - Surge Suppressor

Surge suppressor for primary transmitter

Primary transmitter- Other Parts

Other transmitter parts required for repack

Antennas

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

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
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: 13.6 kW
Manufacturer
Model PSILP120I
Year 2009

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
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: 13.6 kW
Manufacturer
Model TLP-8
Year 2017
Justification for New Antenna KBTR current antenna is a single frequency Ch. 41 and is not capable of operating on the new 36 assignment

Primary Antenna

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Other Antenna Costs

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

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Interim Sweep tests

After the existing main antenna is moved to new interim position and reconnected to existing main line, sweep tests will be necessary.

Interim Side Mount Brackets

New side mount brackets will be necessary to install the existing main antenna to it's interim position on the tower.

Interim Pattern Scatter Analysis

After the existing main antenna is moved to new interim position and reconnected to existing main line, A pattern scatter analysis will benecessary.

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 Air
Diameter 1 5/8 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 680 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 Air
Diameter 1 5/8 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 685 feet per run
Justification for New Transmission Line KBTRs request for new main transmission line is required to facilitate installation of the new antenna while the old line remains on the tower for interim operation on current frequency.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Owned
Is this tower consider Complex? No
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) No
Others Types of Users Yes
Is tower documented for structural analysis? No
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1019301
Coordinates (NAD83) Latitude (NAD83) 30° 25' 57.0" N-
Longitude (NAD83) 091° 11' 07.0" W-
Overall Structure Height 769.02 feet
Support Structure Height 768.04 feet
Ground Elevation Above Mean Sea Level (AMSL) 47.90 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner LOUISIANA TELEVISION BROADCASTING CORP DBA = WBRZ TV
Date Constructed 01/01/1954


Other Types of Users

Users
Public Safety
Many 2-way pagi
K249DV FX

Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Study needed for undocumented/poorly documented tower
Tower Reinforcements Please select whether tower reinforcements are needed: Minor Reinforcements needed

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Structural Analysis

After the tower mapping is complete, the structural analysis will need to be run.

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 1192
Explanation Current internal personnel insufficient to ensure safe, timely transition for project of this scope. As such, KBTR will hire an outside firm to facilitate and support KBTR in these tasks and others to ensure a timely and well managed 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 1
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 1
NEPA Section 106 environmental review Yes
Environmental Assessment Yes
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements Yes
Additional Field Engineering Service Yes
Number of Days 8
Justification planning, design, and field verification

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

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

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Other Expenses Not Listed

Name Description

Non-Catalog Legal Services such as review of quarterly transition status reports and other miscellan

Non-Catalog Legal Services such as review of quarterly transition status reports and other miscellaneous non-catalog legal fees

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 $176,288.63 $170,288.63 N/A $15,498.62 N/A
Total for all systems $1,086,949.63 $1,038,452.38 N/A $192,157.90 N/A
Primary Transmitter UAXT-2.5R37 $176,288.63 $170,288.63 $15,498.62
Primary Transmitter - Surge Suppressor $2,373.09 $2,373.09 Please see Estimated Cost Justification KBTR-110-1st Primary Transmitter - Surge Suppressor v0 $2,373.08 N/A
Primary transmitter- Other Parts $65.54 $65.54 Please see TSG KBTR Primary Transmitter- other parts Budget Justification Cover Letter $65.54 N/A
5 Ton system $20,250.00 $20,250.00 N/A $11,460.00 N/A
Other Electrical Service: Panel board expansion for operation of interim and replacement transmitters, and installation of new circuit breaker panel $25,000.00 $25,000.00 N/A $1,050.00 N/A
2" Rigid Conduit and Wiring (Cost per foot) $2,600.00 $2,600.00 N/A $550.00 N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $120,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Primary Transmitter - Surge Suppressor

Component Description:
Parallel Surge Suppressor, for 3-Phase
Amount:
$2,373.08

Component Description:
Category 1.0 Main/Primary Transmitter 1.3 Other Electrical Service
Amount:
$1,984.00
Primary transmitter- Other Parts

Component Description:
Pressure Guage, Test
Amount:
$65.54
5 Ton system

Component Description:
HVAC Installation according to Lambert's Heating and Air Conditioning INC
Amount:
$9,710.00

Component Description:
Materials and Labor for installation of air conditioning in KBTR-CD Transmitter room.
Amount:
$1,750.00
Other Electrical Service: Panel board expansion for operation of interim and replacement transmitters, and installation of new circuit breaker panel

Component Description:
Flat Price Labor Group
Amount:
$1,050.00
2" Rigid Conduit and Wiring (Cost per foot)

Component Description:
Materials and Labor for reconfiguration for two (2) 110 vold ciruits for KBTR-CD Transmitter room.
Amount:
$550.00
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW 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 $56,430.00 $49,487.92 N/A $22,213.91 N/A
Total for all systems $1,086,949.63 $1,038,452.38 N/A $192,157.90 N/A
Primary Antenna TLP-8 $56,430.00 $49,487.92 $22,213.91
Interim Pattern Scatter Analysis $5,000.00 $5,000.00 N/A N/A N/A
Interim Sweep tests $6,400.00 $6,400.00 N/A $0.00 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $6,400.00 N/A
Interim Side Mount Brackets $12,000.00 $12,000.00 N/A $1,125.99 N/A
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $26,300.00 $19,687.92 Please see Estimated Cost Justification KBTR-210-Primary Antenna - UHF Lower Power Side Mount, Class A Station V0 $14,687.92 N/A

Components

Actual Information Description File Name
Interim Pattern Scatter Analysis Information not provided.
Interim Sweep tests

Component Description:
Sweep test of existing antenna
Amount:
$6,400.00
Sweep test of existing antenna

Component Description:
Interim Sweep test
Amount:
$6,400.00
Interim Side Mount Brackets

Component Description:
Alive Telecom ATC-BCE312M-V3-24 Side Mounts
Amount:
$1,125.99
UHF - Lower Power Side Mount, Class A One Station antenna -- basic

Component Description:
"Alive Telecom ATC-BCH312M-23 H-POL Coaxial Slot Antenna Side Mounted"
Amount:
$14,687.92

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 $22,605.00 $21,235.00 N/A $21,025.42 N/A
Total for all systems $1,086,949.63 $1,038,452.38 N/A $192,157.90 N/A
Primary Transmission Line $22,605.00 $21,235.00 $21,025.42
Flexible Air Transmission Line - dielectric, 1 5/8" $22,605.00 $21,235.00 N/A $21,025.42 N/A

Components

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

Component Description:
"HJ7-50A HELIAX standard air dielectric coaxial cable, 1-5/8 inch, 50 ohm (wideband from 0.5-2700 MHz)."
Amount:
$21,025.42

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 $406,800.00 $387,000.00 N/A $90,378.87 N/A
Total for all systems $1,086,949.63 $1,038,452.38 N/A $192,157.90 N/A
Primary Tower TOWER $406,800.00 $387,000.00 $90,378.87
Tall Tower (greater than 500') $210,500.00 $200,000.00 N/A $71,003.87 N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $25,000.00 N/A $9,375.00 N/A
Structural Analysis $12,000.00 $12,000.00 N/A $10,000.00 N/A
Minor tower reinforcement/modifications $158,000.00 $150,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Tall Tower (greater than 500')

Component Description:
"TS3.25/3-6 tower leg stand-off kit, 3.25"" stand-off, 3/8"" tapped hole, formed 1/8"" stainless steel, screw clamp arch reinforced, 3/8-16 x 3/4"" hex head nut, 3/8"" split-lockwasher"
Amount:
$2,875.89

Component Description:
Invoice moved to correct budget category.
Amount:
N/A

Component Description:
KBTR-410-Existing Primary Tower - Tower Rigging, Tall Tower
Amount:
$4,449.55

Component Description:
Tower Work: Install Sidemount Antenna @ 630'
Amount:
$63,678.43
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study

Component Description:
"By a three-man crew of the 770 guyed tower and above ground base foundation"
Amount:
$9,375.00
Structural Analysis

Component Description:
LEVEL I CORROSION RISK ANALYSIS
Amount:
$10,000.00
Minor tower reinforcement/modifications Information not provided.

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 $277,136.00 $263,355.83 N/A $31,206.33 N/A
Total for all systems $1,086,949.63 $1,038,452.38 N/A $192,157.90 N/A
Outside Professional Services $277,136.00 $263,355.83 $31,206.33
Additional Field Engineering Service, 8 Days $16,000.00 $16,000.00 N/A N/A N/A
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,500.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $3,309.43 see Estimated Cost Justification KBTR-550-Attorney - Other Matters v0 $3,309.43 x
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 $762.40 N/A
Prepare request for Special Temporary Authorization $2,050.00 $1,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 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 $2,996.40 see Estimated Cost Justification KBTR-590-Prepare and_or Review Reimbursement Form v0 $2,996.40 N/A
Project management of the transition $188,336.00 $178,800.00 N/A $24,138.10 N/A
NEPA Section 106 environmental review, if needed $6,310.00 $6,000.00 N/A N/A N/A
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet $10,520.00 $10,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Additional Field Engineering Service, 8 Days Information not provided.
RF Exposure Measurements Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations

Component Description:
Professional Services
Amount:
$98.00

Component Description:
Professional Services
Amount:
$49.00

Component Description:
Professional Services
Amount:
$784.80

Component Description:
Professional Services
Amount:
$89.00

Component Description:
Professional Services
Amount:
$384.30

Component Description:
Professional Services
Amount:
$392.00

Component Description:
Professional Services
Amount:
$72.63

Component Description:
Professional Services
Amount:
$44.50

Component Description:
Professional Services
Amount:
$44.50

Component Description:
Professional Services
Amount:
$89.00

Component Description:
Professional Services
Amount:
$44.50

Component Description:
Professional Services
Amount:
$686.80

Component Description:
Professional Services
Amount:
$42.70

Component Description:
Professional Services
Amount:
$133.50

Component Description:
Professional Services
Amount:
$85.40

Component Description:
Professional Services
Amount:
$42.70

Component Description:
Professional Services
Amount:
$42.70

Component Description:
Professional Services
Amount:
$85.40

Component Description:
Legal Services
Amount:
$98.00
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

Component Description:
KBTR-550-Attorney - Construction Permit Application (Main)
Amount:
$42.70

Component Description:
KBTR-550-Attorney - Construction Permit Application (Main)
Amount:
$719.70
Prepare request for Special Temporary Authorization Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Perform engineering study for new channel assignment and antenna development 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:
KBTR-590-Prepare and/or Review Reimbursement Form
Amount:
$1,800.80

Component Description:
Professional Services
Amount:
$42.70

Component Description:
KBTR-590-Prepare and/or Review Reimbursement Form
Amount:
$469.70

Component Description:
KBTR-590-Prepare and/or Review Reimbursement Form
Amount:
$341.60

Component Description:
Professional Services
Amount:
$341.60
Project management of the transition

Component Description:
Project Management
Amount:
$4,100.75

Component Description:
Project Management
Amount:
$102.50

Component Description:
Project Management
Amount:
$5,434.40

Component Description:
Project Management
Amount:
$2,417.95

Component Description:
Project Management
Amount:
$1,286.25

Component Description:
Project Management
Amount:
$1,160.00

Component Description:
Project Management
Amount:
$3,243.70

Component Description:
Project Management
Amount:
$5,992.55

Component Description:
Project Management
Amount:
$268.75

Component Description:
Project Management
Amount:
$28.75

Component Description:
Project Management
Amount:
$51.25

Component Description:
Project Management
Amount:
$51.25
NEPA Section 106 environmental review, if needed Information not provided.
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet 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 $147,690.00 $147,085.00 N/A $11,834.75 N/A
Total for all systems $1,086,949.63 $1,038,452.38 N/A $192,157.90 N/A
Other Expenses $147,690.00 $147,085.00 $11,834.75
Non-Catalog Legal Services such as review of quarterly transition status reports and other miscellan $0.00 $0.00 N/A N/A N/A
MVPD Notification of Channel Change $2,000.00 $2,000.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $15,000.00 $15,000.00 N/A N/A N/A
Equipment Storage $30,000.00 $30,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $35,000.00 $35,000.00 N/A $6,650.00 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $37,500.00 $37,500.00 N/A N/A N/A
Non-zoning permits $5,000.00 $5,000.00 N/A N/A N/A
Local Zoning $10,000.00 $10,000.00 N/A N/A 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
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A $5,184.75 N/A

Components

Actual Information Description File Name
Non-Catalog Legal Services such as review of quarterly transition status reports and other miscellan Information not provided.
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges

Component Description:
Equipment Delivery
Amount:
$6,650.00
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Non-zoning permits Information not provided.
Local Zoning Information not provided.
FCC Filing Fees - Special Temporary Authorization request 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.
DTV Medical Facility Notification

Component Description:
Medical Facility Notification
Amount:
$5,184.75

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $1,086,949.63 $1,038,452.38 $192,157.90

Reimbursement Status

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Question Response
The facility has ceased operating on its pre-auction channel. Yes
Construction of final facilities or all necessary modifications are complete. 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.

Jason P White

Chief Engineer


10/20/2020

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.

Jason P White

Chief Engineer


10/20/2020

Attachments

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