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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:
81594
Service:
DTV
Call Sign:
WBIF
Channel:
26 (UHF)
File Number:
0000028066
FRN:
0001843697
Date Submitted:
03/04/2021

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

WORD OF GOD FELLOWSHIP, INC.

Doing Business As: WORD OF GOD FELLOWSHIP, INC.

Arnold Torres

3901 HIGHWAY 121 SOUTH

BEDFORD, TX 76021

United States

 +1 (817) 571-1229 arnold.torres@DAYSTAR.COM 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

Samuel Hariton

Widelity, Inc.

Samuel Hariton

4031 University Drive

Ste 100

Fairfax, VA 22030

United States

 +1 (339) 222-8107 sam.hariton@widelity.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. Yes
Briefly describe transition plan Coordinate with tower owner and other Broadcasters; transition during assigned phase. WBIF will change sites and change antenna and transmitter.

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 CTT-V-CXIC
Year 2002
Type Inductive Output Tube
IOT Power Type Single
Power Capacity 25 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 TXUD6000AAC
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 5 kW
Justification for New Transmitter Current transmitter cannot be retuned to new antenna at reduced TPO power level.

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 No
Size N/A
Length N/A
Other Electrical Service Yes
Description Minimal electric services will be needed to implement new facility.
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
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

Mask Filter

Primary Transmitter - Proof and Performance

Primary Transmitter- Other Expenses- Proof and Performance

Transmitter Installation

Transmitter Installation Costs

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: 50.0 kW
Manufacturer
Model SWFPS24OI/51
Year 2002

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? No
New Antenna Manufacturer and Types Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
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: 50.0 kW
Manufacturer
Model SWEDL16EC/26-EP
Year 2017
Justification for New Antenna Existing antenna is non-tunable to new channel.

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? No
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 7 3/16 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 900 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 3 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 765 feet per run
Justification for New Transmission Line Line for new tower site

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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Add Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? No
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users No
Is tower documented for structural analysis? No
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? No
ASR Number
Coordinates (NAD83) Latitude (NAD83) 30° 26' 00.01" N-
Longitude (NAD83) 085° 24' 51.0" W-
Overall Structure Height 812.00 feet
Support Structure Height 812.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 138.12 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner Gray Television Group
Date Constructed 01/01/1962

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

Facility ID Call Sign Service
73136 WJHG-TV DTV

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: 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.

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Move Equipment
Tower Use Primary (Main)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? No
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users No
Is tower documented for structural analysis? Unknown
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1057617
Coordinates (NAD83) Latitude (NAD83) 30° 30' 42.7" N-
Longitude (NAD83) 085° 29' 16.9" W-
Overall Structure Height 1147.95 feet
Support Structure Height 1142.05 feet
Ground Elevation Above Mean Sea Level (AMSL) 137.14 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Pinnacle Towers LLC
Date Constructed 04/26/1988

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

Facility ID Call Sign Service
66667 WFSY FM
61252 WPAP FM
25412 WYYX FM

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

Tower mapping

Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study

Structural engineering tower load study for documented tower

Structural engineering tower load study for documented tower

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 Pre-construction services, including initial antenna placement and RF compatibility review, zoning and permitting requirements review; leasing application services, to support the transition of a single broadcaster.
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 Yes
FAA Consultation (including preparation of FAA Form 7460) Yes
Negotiation of Lease and other Matter for Shared Locations Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements Yes
Additional Field Engineering Service Yes
Number of Days 7
Justification Engineer performing the installation of transmitter and supervision of antenna installation.

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

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 $260,223.60 $178,806.23 N/A $174,752.85 N/A
Total for all systems $1,092,345.28 $561,212.10 N/A $382,805.31 N/A
Primary Transmitter TXUD6000AAC $260,223.60 $178,806.23 $174,752.85
Transmitter Installation $10,648.60 $10,648.60 Please see Estimated Cost Justification WBIF-110-1st Primary Transmitter - Installation V1 $10,260.08 N/A
Primary Transmitter - Proof and Performance $3,075.00 $3,075.00 Please see ELETTRONIKA AMERICA USA CORP Estimate 6511 $3,075.00 N/A
Mask Filter $0.00 $0.00 This cost has been included in the transmitter equipment category $0.00 N/A
Other Electrical Service: Minimal electric services will be needed to implement new facility. $10,000.00 $10,000.00 N/A $7,338.80 N/A
UHF - Air Cooled Solid State Transmitter 4 - 6 kW $236,500.00 $155,082.63 see Estimated Cost Justification WBIF-110-1st Primary Transmitter - UHF - Air-Cooled Solid State Transmitter 4 - 6 kW V1 $154,078.97 N/A

Components

Actual Information Description File Name
Transmitter Installation

Component Description:
Repack travel expenses
Amount:
$442.54

Component Description:
HELPED JOHN WITH NEW TRANSMITTER INSTALL
Amount:
$780.00

Component Description:
Repack Travel expenses
Amount:
$534.12

Component Description:
Incorporate coaxial switch
Amount:
$8,503.42
Primary Transmitter - Proof and Performance

Component Description:
Professional Visit to Site
Amount:
$3,075.00
Mask Filter Information not provided.
Other Electrical Service: Minimal electric services will be needed to implement new facility.

Component Description:
Provided 200amp three phase service and installed 125amp three circuits for transmitter. Installed (4) 120V quad outlets
Amount:
$7,264.00

Component Description:
ELECTRONIC TEMP CONTROL
Amount:
$74.80
UHF - Air Cooled Solid State Transmitter 4 - 6 kW

Component Description:
Disassembled old transmitter
Amount:
$520.00

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

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

Component Description:
SHIPPING AND HANDLING
Amount:
$2,187.97

Component Description:
UHF Digital TV Transmitter
Amount:
$151,371.00

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 $109,830.00 $43,973.54 N/A $6,400.00 N/A
Total for all systems $1,092,345.28 $561,212.10 N/A $382,805.31 N/A
Primary Antenna SWEDL16EC/26-EP $109,830.00 $43,973.54 $6,400.00
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $6,400.00 N/A
UHF - Lower Power Side Mount, One Station antenna . medium power (50-200 kW), elliptically or circularly polarized $103,100.00 $37,573.54 Per SWR Quote 19552-05 (includes freight est) $0.00 N/A

Components

Actual Information Description File Name
Sweep test of existing antenna

Component Description:
WBIF-210-Primary Antenna - Sweep Test
Amount:
$6,400.00
UHF - Lower Power Side Mount, One Station antenna . medium power (50-200 kW), elliptically or circularly polarized

Component Description:
low power digital TV transmit antenna
Amount:
$32,027.46

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 $45,135.00 $30,593.71 N/A $0.00 N/A
Total for all systems $1,092,345.28 $561,212.10 N/A $382,805.31 N/A
Primary Transmission Line $45,135.00 $30,593.71 $0.00
Flexible Air Transmission Line - dielectric, 3" $45,135.00 $30,593.71 see Estimated Cost Justification WBIF-Primary Transmission Line V0. Quote calls for a 2 1/4" line but due to LMS limitations 3" was selected. $0.00 N/A

Components

Actual Information Description File Name
Flexible Air Transmission Line - dielectric, 3"

Component Description:
WBIF-310-Primary Transmission Line
Amount:
$30,593.71

Component Description:
Invoice moved to Primary Tower - Tower Mapping
Amount:
N/A

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 $447,300.00 $84,361.94 N/A $84,361.94 N/A
Total for all systems $1,092,345.28 $561,212.10 N/A $382,805.31 N/A
Primary Tower GTOWER $236,800.00 $78,150.00 $78,150.00
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $5,500.00 see Estimated Cost Justification WBIF-410-New Primary Tower - Tower Mapping v0 $5,500.00 N/A
Tall Tower (greater than 500') $210,500.00 $72,650.00 Please see Estimated Cost Justification WBIF-410-New Primary Tower - Tower Rigging, Tall Tower v0 $72,650.00 N/A
Primary Tower TOWER $210,500.00 $6,211.94 $6,211.94
Tall Tower (greater than 500') $210,500.00 $6,211.94 WBIF did not incur any tower rigging expenses related to the removal of pre-transition equipment from pre-transition Pinnacle Tower site. Two invoices were already submitted for payment before the new tower was added to the station's 399. $6,211.94 N/A
Tower mapping $0.00 $0.00 Deemed non-reimbursable due to move $0.00 N/A
Structural engineering tower load study for documented tower $0.00 $0.00 Deemed non-reimbursable due to move $0.00 N/A

Components

Actual Information Description File Name
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study

Component Description:
Engineering Evaluation, New Primary Tower - Tower Mapping:
Amount:
$5,500.00
Tall Tower (greater than 500')

Component Description:
Antenna installation
Amount:
$18,162.50

Component Description:
Tower Equipment and Rigging
Amount:
$54,487.50
Tall Tower (greater than 500')

Component Description:
3-1/8" EIA flange, male to 1-5/8" EIA flange
Amount:
$2,890.84

Component Description:
Tower stand-off, 4.0" stand-off, 3/8" tapped hole
Amount:
$3,321.10
Tower mapping Information not provided.
Structural engineering tower load study for documented tower 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 $195,166.68 $196,571.68 N/A $113,872.53 N/A
Total for all systems $1,092,345.28 $561,212.10 N/A $382,805.31 N/A
Outside Professional Services $195,166.68 $196,571.68 $113,872.53
Project management of the transition $94,010.00 $99,675.00 see Estimated Cost Justification WBIF-510-Project Management v0 $86,000.35 N/A
Additional Field Engineering Service, 7 Days $24,146.68 $24,146.68 The estimated cost has been adjusted to include all invoices submitted for reimbursement at this time. $24,146.68 Please see submitted invoices.
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A 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 N/A N/A
ASR modification (prepare FCC Form 854) $2,105.00 $2,000.00 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
NEPA Section 106 environmental review, if needed $6,310.00 $6,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,500.00 N/A $139.00 N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $4,000.00 N/A $2,800.50 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A N/A N/A
Prepare 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 $2,500.00 N/A $786.00 N/A

Components

Actual Information Description File Name
Project management of the transition

Component Description:
Project Management
Amount:
$8,176.70

Component Description:
Project Management
Amount:
$7,370.45

Component Description:
Project Management
Amount:
$1,620.15

Component Description:
Project Management
Amount:
$4,476.50

Component Description:
Project management
Amount:
$3,759.25

Component Description:
Project Management
Amount:
$5,092.20

Component Description:
Project management
Amount:
$2,867.90

Component Description:
Project Management
Amount:
$3,539.75

Component Description:
Project Management
Amount:
$2,982.40

Component Description:
Project Management
Amount:
$3,647.45

Component Description:
Project Management
Amount:
$3,828.20

Component Description:
Project Management
Amount:
$26.40

Component Description:
Project Management
Amount:
$1,514.90

Component Description:
Project Management
Amount:
$5,349.20

Component Description:
Project Management
Amount:
$5,976.10

Component Description:
Project Management
Amount:
$4,520.85

Component Description:
Project Management
Amount:
$1,803.40

Component Description:
Project Management
Amount:
$3,179.35

Component Description:
Project Management
Amount:
$1,519.30

Component Description:
Project Management
Amount:
$1,528.75

Component Description:
Project Management
Amount:
$3,114.80

Component Description:
Project Management
Amount:
$5,916.40

Component Description:
Project Management
Amount:
$4,189.95
Additional Field Engineering Service, 7 Days

Component Description:
Accept delivery of 3 transmitter crates
Amount:
$7,665.64

Component Description:
Powered up tx into dummy load
Amount:
$5,175.56

Component Description:
Swept line and antenna after placed tower
Amount:
$11,305.48
RF Exposure Measurements Information not provided.
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase Information not provided.
ASR modification (prepare FCC Form 854) Information not provided.
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet Information not provided.
NEPA Section 106 environmental review, if needed Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
WBIF-550-Attorney - Special Temporary Authorization
Amount:
$139.00
Attorney Fees - Negotiation of lease and other matters for shared locations

Component Description:
Total Professional Services
Amount:
$139.00

Component Description:
Total Professional Services
Amount:
$232.00

Component Description:
Total Professional Services
Amount:
$834.00

Component Description:
Total Professional Services
Amount:
$834.00

Component Description:
WBIF-550-Attorney - Negotiate Lease and Other Matters
Amount:
$208.50

Component Description:
Total Professional Services
Amount:
$69.50

Component Description:
Total Professional Services
Amount:
$131.00

Component Description:
Total Professional Services
Amount:
$278.00

Component Description:
Total Professional Services
Amount:
$74.50
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 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:
Total Professional Services
Amount:
$786.00

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $34,690.00 $26,905.00 N/A $3,417.99 N/A
Total for all systems $1,092,345.28 $561,212.10 N/A $382,805.31 N/A
Other Expenses $34,690.00 $26,905.00 $3,417.99
MVPD Notification of Channel Change $5,000.00 $5,000.00 N/A $2,007.99 N/A
Develop and air announcement of upcoming channel change $500.00 $500.00 N/A N/A N/A
Equipment Storage $3,500.00 $3,500.00 N/A N/A N/A
Equipment Delivery and Handling Charges $2,500.00 $2,500.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $5,000.00 $5,000.00 N/A $100.00 N/A
Non-zoning permits $2,500.00 $2,500.00 N/A N/A N/A
Local Zoning $2,500.00 $2,500.00 N/A N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $200.00 Per Estimated Cost Justification WBIF-610-FCC Filing Fee - Special Temporary Authorization v0 $200.00 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 $2,180.00 see Estimated Cost Justification WBIF-610-FCC Filing Fee - Construction Permit Application v1 $1,110.00 N/A
DTV Medical Facility Notification $11,550.00 $2,700.00 N/A N/A N/A

Components

Actual Information Description File Name
MVPD Notification of Channel Change

Component Description:
Total Professional Services
Amount:
$2,007.99
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
WBIF-610-Disposal Costs - $100.00
Amount:
$100.00
Non-zoning permits Information not provided.
Local Zoning Information not provided.
FCC Filing Fees - Special Temporary Authorization request

Component Description:
WBIF-610-FCC Filing Fee - Special Temporary Authorization
Amount:
$200.00
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Form 2100 minor change CP application

Component Description:
Total Professional Services
Amount:
$1,110.00
DTV Medical Facility Notification Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate 		Estimated Cost Actual Cost
Total for all systems $1,092,345.28 $561,212.10 $382,805.31

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. Yes
All receipts for reimbursement have been submitted no further costs are expected to be incurred. Note this will lock the Form 399 from further editing and begin close-out procedures with the Fund Administrator. No

Certification

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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.

Arnold Torres

Business Administrator


03/04/2021

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.

Arnold Torres

Business Administrator


03/04/2021

Certification

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Section Question Response
Submission of Final Allocation or Accounting Information 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 and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

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

  3. The above-named entity certifies that all costs identified as "actual costs" herein accurately represent the costs actually paid by the above-named entity, including any discounts, refunds, or rebates.

  4. 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.

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

  6. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Arnold Torres

Business Administrator


03/04/2021

Attachments

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