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:
69946
Service:
DTV
Call Sign:
WVER
Channel:
9 (High VHF)
File Number:
0000028408
FRN:
0005067830
Date Submitted:
11/16/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

VERMONT ETV, INC.

Doing Business As: Vermont PBS

Jack Efromson

10 East Allen street

Suite 202

Winooski, VT 05404

United States

+1 (802) 654-3682 Jefromson@vermontpbs.org Not-for-Profit

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

The Preparer is same as the reimbursement contact.

 

 

 

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan Replace transmitter and mask filter. Replace unused UHF antenna on top with new Channel 10 antenna. Operate on channels 9 & 10 through test phase.

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 Platinum
Year 2005
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 3.5 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? No
Manufacturer
Model VAXTE-4R37
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 3.2 kW
Justification for New Transmitter Harris/GatesAir classifies existing transmitter as not retunable.

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 90.0 feet
Other Electrical Service No
Description N/A
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

Mask Filter

FCC required

Primary Transmitter - Site Survey

Primary Transmitter - Site Survey

Factory Training

3 people at 1895.00 tuition 3 people hotel total $800

Internal Transmission Line

Internal Transmission Line

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? Yes
Existing Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Other
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 THV-6A9/VP-R C160 SM
ERP: 15.0 kW
Manufacturer
Model THV-6A9/VP-R C160 SM
Year 2005

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? Yes
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? Yes
New Antenna Manufacturer and Types Class Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Other
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 THV-6A10-/VP-R C160
ERP: 15.0 kW
Manufacturer
Model THV-6A10-/VP-R C160
Year 2020
Justification for New Antenna Present antenna is single channel (9) only.

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna?
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? N/A
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Single Channel
Feed Line Size 3 1/8 inches inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna?
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.

Interim Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
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? Yes
New 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/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 15.0 kW
Manufacturer
Model TLS-V4M-R
Year 2020
Justification for New Antenna Interim equipment required to remain on air during transition

Interim Antenna

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Other Antenna Costs

Section Question Response
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 an 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

Interim Antenna

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Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Flexible 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 240 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Flexible 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 410 feet per run
Justification for New Transmission Line New antenna will be atop tower, replacing unused analog antenna.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Interim Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Interim
Description of Use N/A
Change Type Purchase New
Type Flexible Air
Diameter 1 5/8 inches
Segment Length N/A
Other Segment Length
Number of parallel runs 1
Length 280 feet per run
Justification for New Transmission Line Interim equipment required to remain on air during transition

Interim 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? No
One or more FM, AM or TV radio broadcaster(s) N/A
Others Types of Users N/A
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1210439
Coordinates (NAD83) Latitude (NAD83) 43° 39' 31.4" N-
Longitude (NAD83) 073° 06' 23.6" W-
Overall Structure Height 310.04 feet
Support Structure Height 245.08 feet
Ground Elevation Above Mean Sea Level (AMSL) 1975.04 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Vermont ETV, Inc.
Date Constructed 03/06/2000


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 documented 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? Yes

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Primary Tower - Road Repair

Road repairs required for repack work

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 595
Explanation WVER requires the aid of outside project management services in order to fulfill the requirements of the repack. WVER does not have sufficient resource capacity and expertise in house to handle all of the repack responsibilities.
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 No
Environmental Assessment No
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 No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning Yes
Non-zoning permits Yes
BLM or NFS Coordination No
FCC Construction Permit Minor Change No
FCC License to Cover Application No
FCC Special Temporary Authority Application No
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? Yes
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Name Description

Lease Agreement

Payment to temporarily use Cornwell-Friese land

UAX-VAX-INSTALL

GatesAir Installation of Transmitter and Mask Filter

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 $220,900.23 $161,190.04 N/A $145,020.67 N/A
Total for all systems $1,085,227.93 $1,150,119.31 N/A $823,197.83 N/A
Primary Transmitter VAXTE-4R37 $220,900.23 $161,190.04 $145,020.67
Primary Transmitter - Site Survey $7,296.00 $7,296.00 Please see WVER GatesAir PO C19923 and Quote Q-86026 $7,296.00 N/A
Factory Training $8,085.00 $8,085.00 Factory training cost ($1895 each), hotel and airfare ($800) on transmitter for 3 engineers. N/A N/A
5 Ton system $20,250.00 $15,000.00 Manufacturer strongly recommends air conditioning for this transmitter $13,778.00 N/A
High VHF - Air Cooled Solid State Transmitter 1.1 . 4.4 kW $152,500.00 $98,079.81 Please see WVER GatesAir quote Q86004 $95,705.00 N/A
Internal Transmission Line $17,289.04 $17,289.04 Please see Quote GatesAir Q-87384 VAXTE-4R37 Change Order 1 $15,101.48 N/A
2" Rigid Conduit and Wiring (Cost per foot) $2,340.00 $2,300.00 2250 for wiring and conduit $1510.82 for 3-phase surge suppressor N/A N/A
Mask Filter $13,140.19 $13,140.19 Please see Estimated Cost Justification WVER-110-1st Primary Transmitter - Mask Filter V0 $13,140.19 N/A

Components

Actual Information Description File Name
Primary Transmitter - Site Survey

Component Description:
SITE SURVEY, BASIC
Amount:
$7,296.00
Factory Training Information not provided.
5 Ton system

Component Description:
Contract Billing
Amount:
$13,778.00
High VHF - Air Cooled Solid State Transmitter 1.1 . 4.4 kW

Component Description:
VHF Transmitter Mask Filter SFN Software and GPS Surge Suppression Installation
Amount:
$28,262.26

Component Description:
VHF Transmitter
Amount:
$34,138.69

Component Description:
VAXTE-4R37
Amount:
$32,693.27

Component Description:
VHF Transmitter Mask Filter SFN Software and GPS Surge Suppression Installation
Amount:
$610.78
Internal Transmission Line

Component Description:
WVER-110-1st Primary Transmitter - Internal Transmission Line
Amount:
$8,251.22

Component Description:
WVER-110-1st Primary Transmitter - Internal Transmission Line
Amount:
$6,850.26
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Mask Filter

Component Description:
WVER-110-1st Primary Transmitter - Mask Filter
Amount:
$4,240.73

Component Description:
WVER-110-1st Primary Transmitter - Mask Filter
Amount:
$4,240.73

Component Description:
WVER-110-1st Primary Transmitter - Mask Filter
Amount:
$4,658.73

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 $466,240.00 $442,230.00 N/A $360,342.00 N/A
Total for all systems $1,085,227.93 $1,150,119.31 N/A $823,197.83 N/A
Interim Antenna TLS-V4M-R $86,910.00 $63,430.00 $57,030.00
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $0.00 not needed N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 Please see Dielectric Quote 200045CMZ-1 N/A N/A
High VHF - High Power Side Mount One Station horizontally polarized $57,030.00 $57,030.00 Please see Dielectric Quote 200045CMZ-1, plus actual shipping costs on invoice 841008 $57,030.00 N/A
Primary Antenna THV-6A10-/VP-R C160 $379,330.00 $378,800.00 $303,312.00
Elbow complex, single channel, at antenna input, per 3 1/8. feedline (if needed) $7,600.00 $7,400.00 N/A $0.00 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 see Justifying Quote WVER Dielectric Quote 800325CMZ-1 $5,760.00 N/A
High VHF - High Power Top Mount One Station elliptically or circularly polarized $365,000.00 $365,000.00 N/A $297,552.00 N/A

Components

Actual Information Description File Name
Side mount brackets for high power antennas (if not included in antenna base cost) Information not provided.
Sweep test of existing antenna Information not provided.
High VHF - High Power Side Mount One Station horizontally polarized

Component Description:
VHF-Side Mount AUX/Interim
Amount:
$57,030.00
Elbow complex, single channel, at antenna input, per 3 1/8. feedline (if needed) Information not provided.
Sweep test of existing antenna

Component Description:
WVER-210-Primary Antenna - Sweep Test
Amount:
$2,880.00

Component Description:
HIGH-VHF ONE STATION ANTENNA - TOP MOUNT
Amount:
$2,880.00
High VHF - High Power Top Mount One Station elliptically or circularly polarized

Component Description:
HIGH-VHF ONE STATION ANTENNA - TOP MOUNT
Amount:
$133,898.40

Component Description:
WVER-210-Primary Antenna
Amount:
$133,898.40

Component Description:
High-VHF one station antenna - top mount
Amount:
$29,755.20

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 $22,770.00 $23,796.08 N/A $20,841.67 N/A
Total for all systems $1,085,227.93 $1,150,119.31 N/A $823,197.83 N/A
Interim Transmission Line $9,240.00 $11,086.08 $9,769.83
Flexible Air Transmission Line - dielectric, 1 5/8" $9,240.00 $11,086.08 Please see Dielectric Quote 200045CMZ-1, plus actual shipping costs on invoice 841008 $9,769.83 N/A
Primary Transmission Line $13,530.00 $12,710.00 $11,071.84
Flexible Air Transmission Line - dielectric, 1 5/8" $13,530.00 $12,710.00 Installed cost $11,071.84 N/A

Components

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

Component Description:
WVER-380-Interim Transmission Line - 1 5/8" Flexible Air Dielectric
Amount:
$9,769.83
Flexible Air Transmission Line - dielectric, 1 5/8"

Component Description:
WVER-310-Primary Transmission Line - 1 5/8" Flexible Air Dielectric
Amount:
$4,982.33

Component Description:
WVER-310-Primary Transmission Line
Amount:
$4,982.33

Component Description:
WVER-310-Primary Transmission Line - 1 5/8" Flexible Air Dielectric
Amount:
$1,107.18

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 $144,150.00 $277,042.24 N/A $203,942.24 N/A
Total for all systems $1,085,227.93 $1,150,119.31 N/A $823,197.83 N/A
Primary Tower TOWER $144,150.00 $277,042.24 $203,942.24
Tower Helicopter Lift $0.00 $0.00 N/A $0.00 N/A
Structural engineering tower load study for well documented tower $12,600.00 $12,000.00 N/A $0.00 N/A
Primary Tower - Road Repair $47,350.00 $47,350.00 Please see WVER Kevin C. Spencer LLC estimate dated 5-11-20 $16,452.24 N/A
Short Tower (less than 500') $84,200.00 $217,692.24 see Estimated Cost Justification WVER-410- Existing Primary Tower - Tower Rigging, Short Tower V2 $187,490.00 N/A

Components

Actual Information Description File Name
Tower Helicopter Lift Information not provided.
Structural engineering tower load study for well documented tower Information not provided.
Primary Tower - Road Repair

Component Description:
Remaining due for completion of Grandpa's Knob project
Amount:
$2,600.00

Component Description:
Grandpa's Knob West Side
Amount:
$2,650.00

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

Component Description:
Grass seed for crane pad restoration
Amount:
$52.24

Component Description:
Bill to date for work completed on Grandpa's Knob
Amount:
$13,800.00
Short Tower (less than 500')

Component Description:
Short Tower
Amount:
$2,650.00

Component Description:
Grandpa's Knob Castleton, VT Provide dual led lighting system
Amount:
$11,840.00

Component Description:
JobVT
Amount:
$120,400.00

Component Description:
JobVT
Amount:
$51,600.00

Component Description:
This fee is for the turnaround of trucks at the area
Amount:
$1,000.00

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 $154,190.00 $169,433.25 N/A $46,398.00 N/A
Total for all systems $1,085,227.93 $1,150,119.31 N/A $823,197.83 N/A
Outside Professional Services $154,190.00 $169,433.25 $46,398.00
Perform engineering study for new channel assignment and antenna development $7,360.00 $10,809.70 The estimated cost has been adjusted to include all invoices submitted for reimbursement at this time. $10,809.70 Please see submitted invoices.
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $5,152.30 The estimated cost has been adjusted to include all invoices submitted for reimbursement at this time. $5,152.30 Please see submitted invoices.
RF Exposure Measurements $21,050.00 $20,000.00 N/A $0.00 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 $1,100.00 N/A
ASR modification (prepare FCC Form 854) $2,105.00 $2,000.00 N/A $0.00 N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $4,657.20 Please see WVER Attorney STA Budget Justification cover letter $162.00 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A $0.00 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A $0.00 N/A
Prepare request for Special Temporary Authorization $2,050.00 $8,389.05 The estimated cost has been adjusted to include all invoices submitted for reimbursement at this time. $8,389.05 Please see submitted invoices.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A $0.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $0.00 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A $117.00 N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $483.00 N/A
Project management of the transition $94,010.00 $99,675.00 Please see Widelity Services Quote labeled "WVER Strategic support quote 7-25-19" $20,184.95 N/A

Components

Actual Information Description File Name
Perform engineering study for new channel assignment and antenna development

Component Description:
Consultation on interference study IMD for Grandpas Knob
Amount:
$1,050.00

Component Description:
Professional Fees
Amount:
$7,862.20

Component Description:
Consultation on WVER temporary antenna.
Amount:
$1,897.50
Attorney Fees - Negotiation of lease and other matters for shared locations

Component Description:
Commence work on request for letter to send
Amount:
$500.00

Component Description:
WVER-550-Attorney- Negotiation of lease and other matters
Amount:
$241.50

Component Description:
Review and filing of WVER
Amount:
$117.00

Component Description:
WVER-550-Attorney- Negotiation of lease and other matters
Amount:
$810.00

Component Description:
For Services rendered
Amount:
$200.00

Component Description:
Repacking - WVER
Amount:
$600.00

Component Description:
Professional Services Rendered
Amount:
$195.00

Component Description:
Repacking WVER
Amount:
$150.00

Component Description:
Email communications regarding COVID-19
Amount:
$864.00

Component Description:
WVER-550-Attorney- Negotiation of lease and other matters
Amount:
$270.00

Component Description:
Professional Services Rendered
Amount:
$172.80

Component Description:
Professional services rendered
Amount:
$486.00

Component Description:
Repacking - WVER
Amount:
$39.00

Component Description:
Repacking- WVER
Amount:
$507.00
RF Exposure Measurements Information not provided.
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase

Component Description:
Consultation on FAA filings for WVER.
Amount:
$1,100.00
ASR modification (prepare FCC Form 854) Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
Review FCC grant of construction permit extension.
Amount:
$162.00
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 request for Special Temporary Authorization

Component Description:
Services Rendered
Amount:
$43.75

Component Description:
WVER-530-RF Eng STA
Amount:
$1,171.10

Component Description:
Repacking WVER
Amount:
$405.00

Component Description:
WVER-550-Attorney- STA
Amount:
$2,131.20

Component Description:
WVER-550-Attorney- STA
Amount:
$312.00

Component Description:
Repacking - WVER
Amount:
$330.00

Component Description:
Professional Services Rendered
Amount:
$2,322.00

Component Description:
Review draft DTS construction
Amount:
$1,674.00
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.
Address transition timing and coordination issues w/ other stations and wireless

Component Description:
Repacking WVER
Amount:
$117.00
Prepare and or review reimbursement form

Component Description:
For services rendered
Amount:
$483.00
Project management of the transition

Component Description:
Project Management
Amount:
$2,081.15

Component Description:
Project Management
Amount:
$820.00

Component Description:
Project Management
Amount:
$3,009.10

Component Description:
Project Management
Amount:
$3,813.15

Component Description:
Project Management
Amount:
$3,305.45

Component Description:
Project Management
Amount:
$2,279.60

Component Description:
Project Management
Amount:
$351.45

Component Description:
Project Management
Amount:
$2,384.85

Component Description:
Project Management
Amount:
$644.75

Component Description:
Project Management
Amount:
$1,495.45

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 $76,977.70 $76,427.70 N/A $46,653.25 N/A
Total for all systems $1,085,227.93 $1,150,119.31 N/A $823,197.83 N/A
Other Expenses $76,977.70 $76,427.70 $46,653.25
Lease Agreement $19,000.00 $19,000.00 Please see Cornwell Friese Herberg Signed Lease Agreement 070120 $19,000.00 N/A
MVPD Notification of Channel Change $2,000.00 $2,000.00 N/A $0.00 N/A
Develop and air announcement of upcoming channel change $500.00 $500.00 N/A $0.00 N/A
Equipment Storage $10,000.00 $10,000.00 N/A $0.00 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $4,800.00 $4,800.00 see Estimated Cost Justification WVER-610-Disposal Costs v0 $4,800.00 N/A
Non-zoning permits $1,500.00 $1,500.00 N/A $0.00 N/A
Local Zoning $750.00 $750.00 N/A $0.00 N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A $5,400.00 N/A
UAX-VAX-INSTALL $11,011.45 $11,011.45 Installation & commissioning of transmitter, mask filter. $8,862.00 N/A
Equipment Delivery and Handling Charges $15,866.25 $15,866.25 see Estimated Cost Justification WVER-610-Equipment Delivery and Handling v0 $8,591.25 N/A

Components

Actual Information Description File Name
Lease Agreement

Component Description:
This is for the Lease for the area outlined
Amount:
$6,750.00

Component Description:
This is the lease for the area outlined in lease agreement
Amount:
$8,250.00

Component Description:
WVER - Land use for Crane to install antenna on Grandpa Knob
Amount:
$4,000.00
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
Men 4 VT
Amount:
$4,800.00
Non-zoning permits Information not provided.
Local Zoning Information not provided.
DTV Medical Facility Notification

Component Description:
Medical Notification
Amount:
$2,950.00

Component Description:
Medical Notification 2nd Mailing Complete
Amount:
$2,450.00
UAX-VAX-INSTALL

Component Description:
WVER-610-GatesAir UAX-VAX Transmitter Installation
Amount:
$4,431.00

Component Description:
WVER-610-GatesAir UAX-VAX Transmitter Installation
Amount:
$4,431.00
Equipment Delivery and Handling Charges

Component Description:
WVER-610-Equipment Delivery and Handling
Amount:
$2,900.00

Component Description:
WVER-610-Equipment Delivery and Handling
Amount:
$4,375.00

Component Description:
Freight and shipping
Amount:
$1,316.25

Component Description:
Invoice to be resubmitted.
Amount:
N/A

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $1,085,227.93 $1,150,119.31 $823,197.83

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.

Jack Efromson

CTO


11/16/2020

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.

Jack Efromson

CTO


11/16/2020

Attachments

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