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:
68058
Service:
DTV
Call Sign:
WHSG-TV
Channel:
22 (UHF)
File Number:
0000028012
FRN:
0004346060
Date Submitted:
05/27/2021

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

TRINITY BROADCASTING OF TEXAS, INC.

Doing Business As: TRINITY BROADCASTING NETWORKs

13600 Heritage Parkway

Suite 200

Fort Worth, TX 76177

United States

+1 (855) 826-2255 CMMAY@MAYLAWOFFICES.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

The Preparer is same as the reimbursement contact.

 

 

 

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. Yes
Briefly describe transition plan Reduce TPO to 50% and remove 1/2 of the xmitter system. Install new SS xmitter system. Add AUX antenna & line to the tower & feed it with a reduced signal from the current xmitter. Remove & replace antenna. Test.

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 DCX 2
Year 2004
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 50 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 HPTV PRLX U24
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 40 kW
Justification for New Transmitter See Atachment

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 500.0 feet
Other Electrical Service Yes
Description Labor, Disconnects, breakers...
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Heating and Cooling
Size 10 tons
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? Yes
Size 1000.0 square feet
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

install

xmitter installation

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 Leased
Owner American Tower
Site N/A
Is the existing antenna shared with another station or stations? Yes
Is the existing antenna directional? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type Class Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Circular
Type Broadband Panel
Number of Stations Supported 4
Number of Panels 14
Design power capacity in use 80.0 %
Lower Limit 470.00 MHz
Upper Limit 800.00 MHz
Other Antenna Type N/A
ERP: 1000.0 kW
Manufacturer
Model TUD-05-14/70U-2-B
Year 2000

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

Facility ID Call Sign
48813 WUVG-DT
64033 WPCH-TV
72120 WGCL-TV

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 Leased
Owner aMERICAN tOWER
Is antenna shared? Yes
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 Top Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Broadband Panel
Number of Stations Supported 4
Number of Panels/Bays 12
Lower Limit 470.00 MHz
Upper Limit 800.00 MHz
Design power capacity in use 80.0 %
Other Antenna Type N/A
ERP: 1000.0 kW
Manufacturer
Model PEPL48D-C170-2-6
Year 2017
Justification for New Antenna aMERICAN tOWER

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? Yes
Type Additional Module
Number of channels supported 1
Frequencies of channels supported RF channel
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? No
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Broadband
Feed Line Size 8 3/16 inches inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna?
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Enter a list of RF channel numbers.

RF Channel Number
22

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Connection to Combiner

to connect the xmitter output to the combiner input.

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 Leased
Owner American Tower
Site N/A
Is the existing transmission line shared with another station or stations? Yes
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 8 3/16 inches
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 1
Length 2000 feet per run

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

Facility ID Call Sign
64033 WPCH-TV
48813 WUVG-DT
6900 WUPA

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 Rigid
Diameter 8 3/16 inches
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 1
Length 2000 feet per run
Justification for New Transmission Line American tower

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

combiner install

installation

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 Leased
Is this tower consider Complex? Candelabra
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users No
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1223132
Coordinates (NAD83) Latitude (NAD83) 33° 48' 26.4" N-
Longitude (NAD83) 084° 20' 21.5" W-
Overall Structure Height 1182.07 feet
Support Structure Height 1056.09 feet
Ground Elevation Above Mean Sea Level (AMSL) 867.12 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner American Tower, LLC
Date Constructed 03/27/2002

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
72120 WGCL-TV DTV
48813 WUVG-DT DTV
22819 WATL DTV
6900 WUPA DTV
64033 WPCH-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: Minor Reinforcements needed

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

drawing

permit

structural

load study

ground

package

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 95
Explanation American Tower
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 Yes
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 2
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 2
NEPA Section 106 environmental review No
Environmental Assessment Yes
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations No
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 No
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

Name Description

site

meeting

RF System

testing

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 No
Non-zoning permits Yes
BLM or NFS Coordination No
FCC Construction Permit Minor Change No
FCC License to Cover Application Yes
FCC Special Temporary Authority Application No
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? No
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? No
Does this relocation require MVPD Notification of a Channel Change? No

Other Expenses

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Other Expenses Not Listed

Name Description

ATC Tower rental

One time tower rental during repack

Compound fencing

fence

Nitrogen gen

Nitrogen generator

FM moving

FM move / rigging

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 $1,686,500.00 $1,633,250.00 N/A $1,158,676.85 N/A
Total for all systems $4,637,350.00 $2,739,034.00 N/A $2,065,620.57 N/A
Primary Transmitter HPTV PRLX U24 $1,686,500.00 $1,633,250.00 $1,158,676.85
Other Electrical Service: Labor, Disconnects, breakers... $69,000.00 $69,000.00 updated quote $65,925.08 N/A
install $35,000.00 $35,000.00 installation quote $35,000.00 N/A
Other -- Building Addition Size: 1000.0 $36,000.00 $36,000.00 American Tower $22,500.00 N/A
10 Ton system $60,500.00 $87,000.00 ATC $43,125.00 N/A
2" Rigid Conduit and Wiring (Cost per foot) $13,000.00 $6,250.00 N/A $4,687.50 N/A
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW $1,473,000.00 $1,400,000.00 N/A $987,439.27 N/A

Components

Actual Information Description File Name
Other Electrical Service: Labor, Disconnects, breakers...

Component Description:
xmitter electrical
Amount:
$58,240.00

Component Description:
sub panel cap 2a
Amount:
$1,875.00

Component Description:
final 2
Amount:
$2,500.00

Component Description:
surge for new suite
Amount:
$2,372.58

Component Description:
25% deposit, see attached Cap Con
Amount:
$937.50

Component Description:
25% deposit, see attached Cap Con
Amount:
$937.50
install

Component Description:
xmitter installation
Amount:
$35,000.00
Other -- Building Addition Size: 1000.0

Component Description:
bldg cap 2 a
Amount:
$15,000.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$7,500.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$7,500.00
10 Ton system

Component Description:
ac cap 2a
Amount:
$28,750.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$14,375.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$14,375.00
2" Rigid Conduit and Wiring (Cost per foot)

Component Description:
conduit cap 2a
Amount:
$3,125.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$1,562.50

Component Description:
25% deposit, see attached CAP CON
Amount:
$1,562.50
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW

Component Description:
30% 7 days prior to shipping
Amount:
$296,231.78

Component Description:
5% proof
Amount:
$49,371.96

Component Description:
30% 60 days
Amount:
$296,231.78

Component Description:
35% deposit
Amount:
$345,603.75

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 $1,279,880.00 $356,693.00 N/A $269,083.12 N/A
Total for all systems $4,637,350.00 $2,739,034.00 N/A $2,065,620.57 N/A
Primary Antenna PEPL48D-C170-2-6 $1,279,880.00 $356,693.00 $269,083.12
Connection to Combiner $80,000.00 $80,000.00 materials to connect the transmitter to the combiner. $65,071.02 N/A
Elbow complex, broadband, at antenna input, per 8 3/16. feedline (if needed) $18,950.00 $11,100.00 N/A $10,895.60 N/A
Adding a module to existing combiner (without antenna) $84,200.00 $66,500.00 N/A $45,967.90 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $3,000.00 N/A
UHF - High Power Top Mount (200-1000 kW), Four Station broadband panel antenna, elliptically or circularly polarized $1,090,000.00 $192,693.00 N/A $144,148.60 N/A

Components

Actual Information Description File Name
Connection to Combiner

Component Description:
combiner input
Amount:
$1,452.25

Component Description:
combiner input
Amount:
$6,492.41

Component Description:
combiner input
Amount:
$45,256.08

Component Description:
misc
Amount:
$4,694.25

Component Description:
field cut
Amount:
$7,176.03
Elbow complex, broadband, at antenna input, per 8 3/16. feedline (if needed)

Component Description:
elbow cap 2a
Amount:
$2,700.00

Component Description:
final 2
Amount:
$6,845.60

Component Description:
25% deposit, see attached Cap Con
Amount:
$1,350.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$1,350.00
Adding a module to existing combiner (without antenna)

Component Description:
combiner cap 2a
Amount:
$26,250.00

Component Description:
final 2
Amount:
$6,592.90

Component Description:
25% deposit, see attached Cap Con
Amount:
$13,125.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$13,125.00
Sweep test of existing antenna

Component Description:
sweep cap 2a
Amount:
$1,250.00

Component Description:
final 2
Amount:
$1,125.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$625.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$625.00
UHF - High Power Top Mount (200-1000 kW), Four Station broadband panel antenna, elliptically or circularly polarized

Component Description:
antenna cap 2
Amount:
$61,346.25

Component Description:
final
Amount:
$52,129.22

Component Description:
25% deposit, see attached Cap Con
Amount:
$30,673.13

Component Description:
25% deposit, see attached Cap Con
Amount:
$30,673.13

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 $811,500.00 $211,116.00 N/A $185,734.60 N/A
Total for all systems $4,637,350.00 $2,739,034.00 N/A $2,065,620.57 N/A
Primary Transmission Line $811,500.00 $211,116.00 $185,734.60
combiner install $13,500.00 $13,500.00 ATC quote $11,600.00 N/A
Rigid Transmission Line - copper, 8 3/16" broadband $798,000.00 $197,616.00 N/A $174,134.60 N/A

Components

Actual Information Description File Name
combiner install

Component Description:
combiner install cap 2a
Amount:
$3,750.00

Component Description:
final 2
Amount:
$5,975.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$1,875.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$1,875.00
Rigid Transmission Line - copper, 8 3/16" broadband

Component Description:
field cuts
Amount:
$4,529.60

Component Description:
line cap 2a
Amount:
$53,808.25

Component Description:
final 2
Amount:
$88,892.63

Component Description:
25% deposit, see attached Cap Con
Amount:
$26,904.13

Component Description:
25% deposit, see attached Cap Con
Amount:
$26,904.12

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 $620,700.00 $314,360.00 N/A $275,610.50 N/A
Total for all systems $4,637,350.00 $2,739,034.00 N/A $2,065,620.57 N/A
Primary Tower GTOWER $620,700.00 $314,360.00 $275,610.50
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $165,000.00 N/A $146,374.00 N/A
Minor tower reinforcement/modifications $158,000.00 $125,000.00 N/A $109,046.50 N/A
drawing $4,700.00 $4,700.00 Tower permit drawing package, American Tower $3,525.00 N/A
ground $4,700.00 $4,700.00 American Tower $3,525.00 N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $8,960.00 N/A $7,440.00 N/A
structural $6,000.00 $6,000.00 American Tower $5,700.00 q

Components

Actual Information Description File Name
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)

Component Description:
complex tower cap 2a
Amount:
$52,500.00

Component Description:
final 2
Amount:
$67,624.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$26,250.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$26,250.00
Minor tower reinforcement/modifications

Component Description:
tower mod cap 2a
Amount:
$17,500.00

Component Description:
install coax
Amount:
$48,775.00

Component Description:
final 2
Amount:
$34,021.50

Component Description:
25% deposit, see attached Cap Con
Amount:
$8,750.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$8,750.00
drawing

Component Description:
drawing cap 2a
Amount:
$2,350.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$1,175.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$1,175.00
ground

Component Description:
ground cap 2a
Amount:
$2,350.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$1,175.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$1,175.00
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study

Component Description:
Tower map cap 2a
Amount:
$2,480.00

Component Description:
final 2
Amount:
$3,720.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$1,240.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$1,240.00
structural

Component Description:
structural cap 2a
Amount:
$1,955.00

Component Description:
final 2
Amount:
$2,767.50

Component Description:
25% deposit, see attached Cap Con
Amount:
$977.50

Component Description:
25% deposit, see attached Cap Con
Amount:
$977.50

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 $78,865.00 $69,180.00 N/A $27,105.00 N/A
Total for all systems $4,637,350.00 $2,739,034.00 N/A $2,065,620.57 N/A
Outside Professional Services $78,865.00 $69,180.00 $27,105.00
RF System $6,000.00 $6,000.00 Quoted by ATC $5,000.00 N/A
site $3,000.00 $3,000.00 American Tower $3,000.00 N/A
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet $10,520.00 $10,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $7,360.00 $7,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,200.00 N/A N/A N/A
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application $4,210.00 $4,000.00 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 $4,100.00 $3,000.00 N/A N/A N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,000.00 N/A $750.00 N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application $2,105.00 $2,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $1,750.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $6,300.00 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A $2,500.00 N/A
Project management of the transition $15,010.00 $9,480.00 N/A $7,805.00 N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A

Components

Actual Information Description File Name
RF System

Component Description:
test cap 2a
Amount:
$2,500.00

Component Description:
final 2
Amount:
$1,250.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$1,250.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$1,250.00
site

Component Description:
site cap 2a
Amount:
$1,000.00

Component Description:
final 2
Amount:
$1,500.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$500.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$500.00
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License 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.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
license
Amount:
$750.00
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Engineering for 2100 CP
Amount:
$1,750.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Interference study for CP
Amount:
$650.00

Component Description:
antenna dev cap 2a
Amount:
$2,500.00

Component Description:
final 2
Amount:
$1,250.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$1,250.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$1,250.00

Component Description:
Further interference study for CP
Amount:
$650.00
Address transition timing and coordination issues w/ other stations and wireless

Component Description:
time cap 2a
Amount:
$1,250.00

Component Description:
final 2
Amount:
$625.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$625.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$625.00
Project management of the transition

Component Description:
management cap 2a
Amount:
$4,740.00

Component Description:
final 2
Amount:
$695.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$2,370.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$2,370.00
Prepare and or review reimbursement form Information not provided.

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $159,905.00 $154,435.00 N/A $149,410.50 N/A
Total for all systems $4,637,350.00 $2,739,034.00 N/A $2,065,620.57 N/A
Other Expenses $159,905.00 $154,435.00 $149,410.50
FM moving $43,000.00 $43,000.00 ATC Quote $42,004.00 N/A
Nitrogen gen $7,000.00 $7,000.00 ATC Quote $6,693.50 N/A
Compound fencing $500.00 $500.00 ATC Quote $495.75 N/A
ATC Tower rental $57,600.00 $57,600.00 American Tower rental $57,600.00 N/A
Equipment Delivery and Handling Charges $12,500.00 $12,500.00 American Tower $9,375.00 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $26,670.00 $26,670.00 It is required by ATC that the old suite be empty of all transmitter equipment. $26,670.00 N/A
Non-zoning permits $750.00 $750.00 American Tower $666.65 N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $222.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $6,193.00 N/A $5,905.60 N/A

Components

Actual Information Description File Name
FM moving

Component Description:
final 2
Amount:
$42,004.00
Nitrogen gen

Component Description:
final 2
Amount:
$6,693.50
Compound fencing

Component Description:
final 2
Amount:
$495.75
ATC Tower rental

Component Description:
rental cap 2a
Amount:
$28,800.00

Component Description:
final 2
Amount:
$14,400.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$14,400.00
Equipment Delivery and Handling Charges

Component Description:
delivery cap 2a
Amount:
$6,250.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$3,125.00

Component Description:
25% deposit, see attached Cap Con
Amount:
$3,125.00
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
DTV xmitter removal
Amount:
$26,670.00
Non-zoning permits

Component Description:
permits cap 2a
Amount:
$375.00

Component Description:
final 2
Amount:
$104.15

Component Description:
25% deposit, see attached Cap Con
Amount:
$187.50

Component Description:
25% deposit, see attached Cap Con
Amount:
$187.50
FCC Filing Fees - Form 2100 license to cover application Information not provided.
DTV Medical Facility Notification

Component Description:
med
Amount:
$5,905.60

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $4,637,350.00 $2,739,034.00 $2,065,620.57

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.

Steve Hastings

Network RF Manager


05/27/2021

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.

Steve Hastings

Network RF Manager


05/27/2021

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.

Steve Hastings

Network RF Manager


05/27/2021

Attachments

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