Skip to main content Skip to footer and contact information
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:
33778
Service:
DTV
Call Sign:
KDTV-DT
Channel:
51 (UHF)
File Number:
0000028006
FRN:
0001531425
Date Submitted:
09/02/2021

Applicant Information

Back to Top ↑

Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

KDTV LICENSE PARTNERSHIP, G.P.

Doing Business As: KDTV LICENSE PARTNERSHIP, G.P.

CHRISTOPHER G. WOOD

5999 CENTER DRIVE

LOS ANGELES, CA 90045

United States

 +1 (310) 348-3600 CWOOD@UNIVISION.NET General Partnership

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 

Preparer Contact Information

Back to Top ↑

Preparer Contact Name and Information

Applicant Address Phone Email

Theodore Stoner

VP Distribution Technology Strategy

Univision Communications Inc.

Theodore Stoner

9405 NW 41st Street

Miami, FL 31378

United States

 +1 (513) 608-0308 tstoner@univision.net

Broadcaster Information and Transition Plan

Back to Top ↑
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 Install new wideband antenna and combiner for temporary, pre-cutover use by KDTV and KSTS. Replace existing antennas and acquire/install new transmitter and mask filters. See attached Implementation Plan for details.

Transmitters

Back to Top ↑
Section Question Response
Transmitter Related Expenses Do you have transmitter related expenses? Yes

Auxiliary Transmitter

Back to Top ↑

Add Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Auxiliary (Backup)
Description of Use Auxiliary
Ownership Owned
Owner N/A
Site N/A
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? No
Existing Transmitter Manufacturer and Type Manufacturer
Model NV-7600
Year 2005
Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power Capacity 7.8 kW

Auxiliary Transmitter

Back to Top ↑

New Transmitter Costs

Section Question Response
New Transmitter Use Auxiliary (Backup)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model THU9-4 Evo
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 6.5 kW
Justification for New Transmitter Replacing old transmitter requireing minor repairs. Station is seeking reimb for retuning an existing primary transmitter and the purchase of a new aux transmitter. These expenditures prove more cost effective than purchasing a new primary transmitter.

Auxiliary Transmitter

Back to Top ↑

Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) Yes
Power 150 kVA
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service Yes
Description Installation of conduits, wiring, and other equipment for Primary Transmitter
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

Auxiliary Transmitter

Back to Top ↑

Other Transmitter Cost Not Listed

Information not provided.

Primary Transmitter

Back to Top ↑

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 DHD45P2
Year 2002
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 10.5 kW

Primary Transmitter

Back to Top ↑

New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Manufacturer
Model THU9-16evo
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 25.5 kW
Justification for New Transmitter Current Harris Diamond transmitter is not capable of operation on below channel 42, is no longer supported and parts necessary for re-channeling are not available. See attached Transmitter Power Analysis document.

Primary Transmitter

Back to Top ↑

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 Installation of conduits, wiring, and other equipment for Primary Transmitter
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

Back to Top ↑

Other Transmitter Cost Not Listed

Name Description

Primary Transmitter - Transmitter Removal

Primary Transmitter-Transmitter Removal

Transmitter Installation

Transmitter Installation

Antennas

Back to Top ↑
Section Question Response
Antenna Related Expenses Do you have antenna related expenses? Yes

Primary Antenna

Back to Top ↑

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 Top Mount
Antenna position in stack Not in Stack
Polarization Elliptical
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: 476.3 kW
Manufacturer
Model ATW25H4-ETP-51H
Year 2001

Primary Antenna

Back to Top ↑

New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? Yes
New Antenna Manufacturer and Types Class Full Power
Mounting Top 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: 475.0 kW
Manufacturer
Model SAA20-KDTV-E600-ET5R-20
Year 2019
Justification for New Antenna Existing KDTV channel 51 slotted coaxial antenna is incapable of operation on post auction channel 20.

Primary Antenna

Back to Top ↑

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 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

Primary Antenna

Back to Top ↑

Other Antenna Cost Not Listed

Information not provided.

Interim Antenna

Back to Top ↑

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? Yes
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 Elliptical
Type Broadband Slot
Number of Stations Supported 2
Number of Panels/Bays 16
Lower Limit 470.00 MHz
Upper Limit 698.00 MHz
Design power capacity in use 80.0 %
Other Antenna Type N/A
ERP: 300.0 kW
Manufacturer
Model i230ECW-24-X
Year 2019
Justification for New Antenna Maintain continuity of operation during replacement of KDTV and KSTS antennas atop the tower candelabra, limit rigger exposure to RF energy.

Interim Antenna

Back to Top ↑

Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? Yes
Type New
Number of channels supported 2
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? B
Feed Line Size 4 1/16 inches
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? Yes
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Enter a list of RF channel numbers.

RF Channel Number
49
51

Interim Antenna

Back to Top ↑

Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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

Primary Transmission Line

Back to Top ↑

Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Utilize Existing
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 Andrew
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 460 feet per run

Primary Transmission Line

Back to Top ↑

Other Transmission Line Expenses Not Listed

Name Description

Transmission Line Expenses

Line Sweep & Retune

Tower Equipment And Rigging Costs

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

Primary Tower

Back to Top ↑

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? 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 1044718
Coordinates (NAD83) Latitude (NAD83) 37° 29' 57.0" N-
Longitude (NAD83) 121° 52' 20.0" W-
Overall Structure Height 442.91 feet
Support Structure Height 392.06 feet
Ground Elevation Above Mean Sea Level (AMSL) 2605.94 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Univision Television Group, Inc.
Date Constructed 02/25/1998

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
64987 KSTS DTV

Primary Tower

Back to Top ↑

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: Minor Reinforcements needed

Primary Tower

Back to Top ↑

Tower Rigging Costs

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

Primary Tower

Back to Top ↑

Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

Back to Top ↑
Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 595
Explanation Univision stations are only staffed for daily station operations and minor equipment changes, major projects are contracted out externally. The large volume of work associated with repack schedule requires using external project management resources.
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 No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers No
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

Back to Top ↑

Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

Back to Top ↑
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 No
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? No
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

Back to Top ↑

Other Expenses Not Listed

Name Description

Notification Management

Notification Management

Internal Labor

Internal Univision Labor directly associated with Repack

Cost Information

Back to Top ↑

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 $1,304,963.59 $703,031.85 N/A $356,350.11 N/A
Total for all systems $2,821,622.46 $2,085,736.71 N/A $1,433,897.02 N/A
Primary Transmitter THU9-16evo $984,408.59 $392,408.59 $117,500.59
Transmitter Installation $2,261.09 $2,261.09 Please see Estimated Cost Justification KDTV-DT-110-1st Primary Transmitter - Transmitter Installation v0 $2,261.09 N/A
Primary Transmitter - Transmitter Removal $7,100.00 $7,100.00 Please see GCB Wireless quote dated 6-3-20 $7,100.00 N/A
Other Electrical Service: Installation of conduits, wiring, and other equipment for Primary Transmitter $28,047.50 $28,047.50 Please see Estimated Cost Justification KDTV-DT-110-1st Primary Transmitter - Other Electrical - Installation of Conduits v0 $28,047.50 N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW $947,000.00 $355,000.00 N/A $80,092.00 N/A
Auxiliary Transmitter THU9-4 Evo $320,555.00 $310,623.26 $238,849.52
Other Electrical Service: Installation of conduits, wiring, and other equipment for Primary Transmitter $21,505.00 $21,505.00 Please see Total Environmental Power Systems quote 20195298 (costs split between primary and auxiliary transmitter) N/A N/A
Transformer 3 phase/480v - 150 KVA $25,550.00 $4,945.00 Please see attached Rohde & Schwarz Quote 125481.3. Transformer is 75 kVA, documented at 150 kVA due to LMS limitations N/A N/A
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW $273,500.00 $284,173.26 see Estimated Cost Justification KDTV-DT-110-1st Auxiliary Transmitter - UHF Liquid Cooled Solid State v0 $238,849.52 N/A

Components

Actual Information Description File Name
Transmitter Installation

Component Description:
Inventory materials
Amount:
$312.59

Component Description:
KDTV-DT-110-1st Primary Transmitter - Transmitter Installation
Amount:
$1,948.50
Primary Transmitter - Transmitter Removal

Component Description:
Removal of broadcast equipment
Amount:
$7,100.00
Other Electrical Service: Installation of conduits, wiring, and other equipment for Primary Transmitter

Component Description:
Install 200A, 600V panel; install conduit, wire, jct boxes.
Amount:
$28,047.50
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW

Component Description:
KDTV-DT Transmitter instllation
Amount:
$80,092.00
Other Electrical Service: Installation of conduits, wiring, and other equipment for Primary Transmitter Information not provided.
Transformer 3 phase/480v - 150 KVA Information not provided.
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW

Component Description:
35% Final Payment PO# 59987 Line 1
Amount:
$113,977.25

Component Description:
30% Downpayment PO# 59987 Line 1 Transmitter - THU9-4evo 6.5 kW ATSC Rohde & Schwarz
Amount:
$57,549.00

Component Description:
KDTV-DT-110-1st Auxiliary Transmitter-UHF Liquid Cooled Solid State
Amount:
$182.77

Component Description:
35% Due Upon FAT PO# 59987 Line 1
Amount:
$67,140.50

Cost Information

Back to Top ↑

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 $689,753.17 $590,840.41 N/A $477,290.40 N/A
Total for all systems $2,821,622.46 $2,085,736.71 N/A $1,433,897.02 N/A
Interim Antenna i230ECW-24-X $378,273.17 $367,866.66 $266,066.65
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $5,000.00 N/A N/A N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $18,083.49 see Estimated Cost Justification KDTV-DT-280-Interim Antenna - Side Mount Brackets - High Power Antenna v1 $18,083.49 N/A
Elbow complex, broadband, at antenna input, per 4 1/16. feedline (if needed) $10,950.00 $10,400.00 N/A N/A N/A
New combiner, cost per channel (without antenna) $84,200.00 $80,000.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
UHF - High Power, Side Mount, basic slot antenna, 16 bay,, 300 kW input, directional,, elliptically or circularly polarized $247,983.17 $247,983.17 see Estimated Cost Justification KDTV-DT-280-Interim Antenna - UHF High Power Side Mount, H-POL v2 $247,983.16 N/A
Primary Antenna SAA20-KDTV-E600-ET5R-20 $311,480.00 $222,973.75 $211,223.75
Sweep test of existing antenna $6,730.00 $6,555.00 Please see Estimated Cost Justification KDTV-DT-210-Primary Antenna - Sweep Test V0 $6,555.00 N/A
Elbow complex, single channel, at antenna input, per 8 3/16. feedline (if needed) $15,250.00 $14,500.00 N/A $2,750.00 N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $289,500.00 $201,918.75 Please see Estimated Cost Justification KDTV-DT-210-Primary Antenna - UHF High Power Top Mount, E-POL V0 $201,918.75 N/A

Components

Actual Information Description File Name
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) Information not provided.
Side mount brackets for high power antennas (if not included in antenna base cost)

Component Description:
KDTV-DT-280-Interim Antenna - Side Mount Brackets - High Power Antenna
Amount:
$2,410.05

Component Description:
KDTV-DT-280-Interim Antenna - Side Mount Brackets - High Power Antenna
Amount:
$4,776.00

Component Description:
KDTV-DT-280-Interim Antenna - Side Mount Brackets - High Power Antenna
Amount:
$6,121.44

Component Description:
KDTV-DT-280-Interim Antenna - Side Mount Brackets - High Power Antenna
Amount:
$4,776.00
Elbow complex, broadband, at antenna input, per 4 1/16. feedline (if needed) Information not provided.
New combiner, cost per channel (without antenna) Information not provided.
Sweep test of existing antenna Information not provided.
UHF - High Power, Side Mount, basic slot antenna, 16 bay,, 300 kW input, directional,, elliptically or circularly polarized

Component Description:
PER PROPOSAL AGREEMENT: 20180605-334 REV A
Amount:
$30,007.49

Component Description:
KDTV-DT Main Transmitter Additional Part
Amount:
$20,109.66

Component Description:
ETU TV Antenna
Amount:
$50,358.15

Component Description:
KDTV-DT-280-Interim Antenna - UHF High Power Side Mount, H-POL
Amount:
$14,248.80

Component Description:
Antenna, custom mounts
Amount:
$69,398.26

Component Description:
DP Line #8 on PO
Amount:
$1,980.70

Component Description:
ETU TV Antenna
Amount:
$50,358.15

Component Description:
PO LI#7 R&S QT# 269679.1 Additional
Amount:
$9,336.50

Component Description:
POLI#4 KDTV-DT Aux transmitter materials
Amount:
$2,185.45
Sweep test of existing antenna

Component Description:
KDTV-DT-210-Primary Antenna - Sweep Test
Amount:
$1,155.00

Component Description:
KDTV-DT-210-Primary Antenna - Sweep Test
Amount:
$1,800.00

Component Description:
KDTV-DT-210-Primary Antenna - Sweep Test
Amount:
$1,800.00

Component Description:
KDTV-DT-210-Primary Antenna - Sweep Test: $1,800.00
Amount:
$1,800.00
Elbow complex, single channel, at antenna input, per 8 3/16. feedline (if needed)

Component Description:
KDTV-DT Labor to measure an existing 8" elbow complex
Amount:
$2,750.00
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
20 bay top mounted
Amount:
$53,250.00

Component Description:
20 bay top mounted
Amount:
$53,250.00

Component Description:
SAA20-KDTV-E600-ET5R-20 | 20 bay top mounted
Amount:
$53,250.00

Component Description:
SAA20-KDTV-E600-ET5R-20 | 20 bay top mounted, elliptically polarized, Channel 20 UHF antenna
Amount:
$42,168.75

Cost Information

Back to Top ↑

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 $20,326.72 $20,326.72 N/A $18,880.79 N/A
Total for all systems $2,821,622.46 $2,085,736.71 N/A $1,433,897.02 N/A
Primary Transmission Line $20,326.72 $20,326.72 $18,880.79
Transmission Line Expenses $20,326.72 $20,326.72 see Estimated Cost Justification KDTV-DT-310-Primary Transmission Line - Other Expenses Not Listed - Transmission Line Expenses v0 $18,880.79 N/A

Components

Actual Information Description File Name
Transmission Line Expenses

Component Description:
Per quotation
Amount:
$1,869.08

Component Description:
MACXLINE 6 1/8" 75 OHM CUSTOM SECTION
Amount:
$1,669.03

Component Description:
KDTV-DT-530-RF Eng - Engineering Study for New Channel Assignment
Amount:
$562.50

Component Description:
6-1/8" UNEQUAL ELBOW
Amount:
$12,017.49

Component Description:
6 1/8" 75 OHM EQUAL LEG ELBOW
Amount:
$2,762.69

Cost Information

Back to Top ↑

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 $591,600.00 $456,000.00 N/A $296,253.21 N/A
Total for all systems $2,821,622.46 $2,085,736.71 N/A $1,433,897.02 N/A
Primary Tower TOWER $591,600.00 $456,000.00 $296,253.21
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $400,000.00 N/A $296,253.21 N/A
Minor tower reinforcement/modifications $158,000.00 $50,000.00 N/A N/A N/A
Structural engineering tower load study for well documented tower $12,600.00 $6,000.00 N/A $0.00 N/A

Components

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

Component Description:
KDTV-DT Provide electrician to assist with installation of new tower lighting controller
Amount:
$780.00

Component Description:
MATERIALS:LABOR
Amount:
$41,600.00

Component Description:
MATERIALS:LABOR KDTV-DT New lighting system installation
Amount:
$14,360.00

Component Description:
Infrastructure Services
Amount:
$23,200.00

Component Description:
LABOR
Amount:
$5,800.00

Component Description:
Antenna System Installation
Amount:
$62,400.00

Component Description:
AC HZN L864/865 24/40FPM W/GPS
Amount:
$8,903.21

Component Description:
Services rendered by Tower Consultants
Amount:
$6,210.00

Component Description:
"50% deposit of KDTV Mt. Allison Auxillary Antenna System Installation"
Amount:
$29,000.00

Component Description:
"50% deposit invoice for KDTV Mt Allison PERM Antenna System Installation"
Amount:
$104,000.00
Minor tower reinforcement/modifications Information not provided.
Structural engineering tower load study for well documented tower Information not provided.

Cost Information

Back to Top ↑

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 $147,350.00 $250,463.75 N/A $226,158.39 N/A
Total for all systems $2,821,622.46 $2,085,736.71 N/A $1,433,897.02 N/A
Outside Professional Services $147,350.00 $250,463.75 $226,158.39
RF Exposure Measurements $21,050.00 $10,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,500.00 N/A $71.10 N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $2,000.00 N/A $1,047.60 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A $826.20 N/A
Prepare request for Special Temporary Authorization $2,050.00 $1,500.00 N/A $687.50 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 $4,043.75 The estimated cost has been adjusted to include all invoices submitted for reimbursement at this time. $4,043.75 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $3,500.00 N/A $2,250.00 N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $62.50 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $2,500.00 N/A N/A N/A
Project management of the transition $94,010.00 $217,170.00 The estimated cost has been adjusted to include all invoices submitted for reimbursement at this time. $217,169.74 see submitted invoices

Components

Actual Information Description File Name
RF Exposure Measurements Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
KDTV-DT-550-Attorney - Special Temporary Authorization
Amount:
$71.10
Attorney Fees - Negotiation of lease and other matters for shared locations

Component Description:
"Credit Memo - Station requested reimbursement for channel sharing expenses that are not reimbursable under program guidelines."
Amount:
($177.75)

Component Description:
Legal Services
Amount:
$225.00

Component Description:
Legal Services
Amount:
$319.95

Component Description:
KDTV-DT-550-Attorney - Negotiate Lease and Other Matters
Amount:
$449.10

Component Description:
KDTV-DT-550-Attorney - Negotiate Lease and Other Matters
Amount:
$195.75

Component Description:
Legal Services
Amount:
$35.55
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
Legal Services
Amount:
$520.20

Component Description:
Legal Services
Amount:
$306.00
Prepare request for Special Temporary Authorization

Component Description:
KDTV-DT-530-RF Eng - Special Temporary Authorization
Amount:
$625.00

Component Description:
KDTV-DT-530-RF Eng - Special Temporary Authorization
Amount:
$62.50
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

Component Description:
Prepare engineering section of FCC Form 2100
Amount:
$2,981.25

Component Description:
KDTV-DT-530-RF Eng - Construction Permit Application (Main)
Amount:
$1,000.00

Component Description:
KDTV-DT-530-RF Eng - Construction Permit Application (Main)
Amount:
$62.50
Perform engineering study for new channel assignment and antenna development

Component Description:
Antenna Sharing evaluation
Amount:
$125.00

Component Description:
Project management consultations
Amount:
$62.50

Component Description:
K. Lahm -Evaluation of temp antenna VSWR issues and their resolution
Amount:
$812.50

Component Description:
Pre-cutover temporary antenna study & configuration
Amount:
$875.00

Component Description:
Discussion of recently granted STA and CP authorizations
Amount:
$62.50

Component Description:
K. Lahm - Antenna aperture review - 3/28/2019
Amount:
$125.00

Component Description:
KDTV-DT-590-Prepare and/or Review Reimbursement Form- $62.50
Amount:
$187.50
Prepare and or review reimbursement form

Component Description:
Transmitter reimbursement discussion
Amount:
$62.50
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application Information not provided.
Project management of the transition

Component Description:
Project Management Services
Amount:
$1,493.88

Component Description:
Project Management Services
Amount:
$2,737.80

Component Description:
Project Management Services
Amount:
$260.00

Component Description:
Project management Services
Amount:
$316.55

Component Description:
Project management Services
Amount:
$275.60

Component Description:
Project management Services
Amount:
$227.50

Component Description:
Project Management
Amount:
$124.50

Component Description:
Project management services
Amount:
$603.75

Component Description:
Project management Services
Amount:
$485.55

Component Description:
Project management Services
Amount:
$282.75

Component Description:
KDTV-DT-510-Project Management
Amount:
$75.00

Component Description:
Project Management
Amount:
$3,135.80

Component Description:
Project Management Services
Amount:
$1,751.12

Component Description:
Project Management Services
Amount:
$331.25

Component Description:
Project Management
Amount:
$4,111.20

Component Description:
Project Management Services
Amount:
$428.35

Component Description:
Project Management Services
Amount:
$52.50

Component Description:
Project management Services
Amount:
$217.75

Component Description:
Project Management Services, including: supervision
Amount:
$928.66

Component Description:
Project management Services
Amount:
$207.50

Component Description:
Project management Services
Amount:
$205.40

Component Description:
Project Management Services
Amount:
$912.14

Component Description:
Project Management Services
Amount:
$719.80

Component Description:
Project Management Services
Amount:
$156.00

Component Description:
Project management Services
Amount:
$357.50

Component Description:
Project management Services
Amount:
$213.85

Component Description:
Project Management
Amount:
$40.50

Component Description:
Project Management Services
Amount:
$1,554.06

Component Description:
Project Management Services
Amount:
$117.00

Component Description:
Project management
Amount:
$5,849.65

Component Description:
Project Management Services
Amount:
$9.00

Component Description:
Project Management
Amount:
$7,345.95

Component Description:
Project Management Services
Amount:
$313.95

Component Description:
Project management Services
Amount:
$1,200.00

Component Description:
KDTV-DT-510-Project Management
Amount:
$150.00

Component Description:
Project Management Services
Amount:
$825.00

Component Description:
Project Management Services
Amount:
$1,227.20

Component Description:
Project management Services
Amount:
$92.95

Component Description:
Project management services
Amount:
$282.50

Component Description:
Project Management
Amount:
$742.22

Component Description:
KDTV-DT-510-Project Management
Amount:
$112.50

Component Description:
Project Management Services
Amount:
$2,197.16

Component Description:
Project Management Services
Amount:
$76.50

Component Description:
Project Management Services
Amount:
$112.50

Component Description:
Project Management
Amount:
$102.00

Component Description:
Project management Services
Amount:
$927.50

Component Description:
Project Management
Amount:
$10,296.85

Component Description:
Project management services
Amount:
$1,726.34

Component Description:
Project management Services
Amount:
$437.50

Component Description:
Project Management Services
Amount:
$181.50

Component Description:
Project Management Services
Amount:
$3,270.45

Component Description:
Project management Services
Amount:
$211.90

Component Description:
Project management Services
Amount:
$368.75

Component Description:
Project Management Services
Amount:
$785.00

Component Description:
Project Management Services including: coordinate tower rigging projects with local engineers
Amount:
$132.00

Component Description:
Project management Services
Amount:
$542.50

Component Description:
Project Management Services including: coordinate tower rigging projects with local engineers
Amount:
$85.50

Component Description:
Project Management Services
Amount:
$42.00

Component Description:
Project Management
Amount:
$2,263.20

Component Description:
Project Management Services including: coordinate tower rigging projects with local engineers
Amount:
$126.00

Component Description:
Project Management
Amount:
$2,149.50

Component Description:
Project Management
Amount:
$2,623.40

Component Description:
Project management Services
Amount:
$806.25

Component Description:
Project Management
Amount:
$3,505.90

Component Description:
Project management Services
Amount:
$681.25

Component Description:
Project management Services
Amount:
$218.40

Component Description:
KDTV-DT: Anthony Flores provided project management services for KDTV
Amount:
$2,175.00

Component Description:
Project management Services
Amount:
$717.50

Component Description:
K. Lahm - Antenna aperture plan reviews -
Amount:
$112.50

Component Description:
Project Management Services
Amount:
$1,353.40

Component Description:
Project management Services
Amount:
$437.50

Component Description:
Invoice revisions to meet FCC submittal requirements
Amount:
$30.00

Component Description:
Project management Services
Amount:
$83.85

Component Description:
Project Management Services
Amount:
$84.00

Component Description:
Project Management Services including: coordinate tower rigging projects with local engineers
Amount:
$115.50

Component Description:
Project Management Services
Amount:
$808.50

Component Description:
Project Management Services including: coordinate tower rigging projects with local engineers
Amount:
$21.00

Component Description:
Project management Services
Amount:
$321.10

Component Description:
Project Management Services including: coordinate tower rigging projects with local engineers
Amount:
$244.50

Component Description:
Project Management
Amount:
$3,417.50

Component Description:
KDTV-DT Anthony Flores February
Amount:
$1,500.00

Component Description:
Project management services
Amount:
$374.40

Component Description:
Project Management
Amount:
$3,540.55

Component Description:
Project Management Services
Amount:
$217.50

Component Description:
Project management Services
Amount:
$747.50

Component Description:
Project management Services
Amount:
$272.35

Component Description:
Project mgt
Amount:
$2,636.30

Component Description:
Project Management Services
Amount:
$1,044.30

Component Description:
Project Management Services
Amount:
$814.20

Component Description:
Project Management Services
Amount:
$48.00

Component Description:
Project management Services
Amount:
$352.30

Component Description:
Project management
Amount:
$3,555.55

Component Description:
Project management Services
Amount:
$138.75

Component Description:
Project management
Amount:
$416.65

Component Description:
Inventory materials
Amount:
$500.00

Component Description:
Project management Services
Amount:
$288.75

Component Description:
Project Management Services
Amount:
$148.50

Component Description:
Project Management
Amount:
$1,048.30

Component Description:
Project Management Services
Amount:
$660.80

Component Description:
Coordination for AUX antenna
Amount:
$600.00

Component Description:
Project Management
Amount:
$3,020.20

Component Description:
Project management Services
Amount:
$392.50

Component Description:
Project Management Services
Amount:
$57.00

Component Description:
Project Management
Amount:
$183.00

Component Description:
Project Management Services including: coordinate tower rigging projects with local engineers
Amount:
$217.50

Component Description:
Project management Services
Amount:
$83.85

Component Description:
Project Management Services
Amount:
$21.00

Component Description:
Project Management Services
Amount:
$367.50

Component Description:
Project Management
Amount:
$1,829.40

Component Description:
Project Management
Amount:
$34.50

Component Description:
Project Management Services
Amount:
$37.50

Component Description:
Project Management Services
Amount:
$388.22

Component Description:
Project Management Services
Amount:
$75.00

Component Description:
Project management Services
Amount:
$209.30

Component Description:
Project Management
Amount:
$988.50

Component Description:
Project Management
Amount:
$3,070.85

Component Description:
Project Management Services
Amount:
$590.00

Component Description:
Project Management Services
Amount:
$865.00

Component Description:
Project Management
Amount:
$1,023.06

Component Description:
Project Management
Amount:
$5,951.65

Component Description:
Project management
Amount:
$820.30

Component Description:
Project management Services
Amount:
$795.00

Component Description:
Project Management Services
Amount:
$5,617.05

Component Description:
Project management Services
Amount:
$252.20

Component Description:
Project Management
Amount:
$6,662.80

Component Description:
Project Management Services
Amount:
$361.25

Component Description:
Project Management
Amount:
$4,373.10

Component Description:
Project Management Services including: coordinate tower rigging projects with local engineers
Amount:
$102.00

Component Description:
Project management Services
Amount:
$287.30

Component Description:
Project management
Amount:
$360.75

Component Description:
Project management Services
Amount:
$269.75

Component Description:
Project Management Services
Amount:
$236.25

Component Description:
Project management Services
Amount:
$218.40

Component Description:
Project Management Services
Amount:
$313.95

Component Description:
Project management Services
Amount:
$451.75

Component Description:
Project Management
Amount:
$4,071.60

Component Description:
Project management services
Amount:
$2,249.08

Component Description:
Project Management Services
Amount:
$1,362.90

Component Description:
Project Management Services
Amount:
$787.06

Component Description:
Project Management Services
Amount:
$49.50

Component Description:
Project Management Services
Amount:
$456.25

Component Description:
Project Management
Amount:
$4,603.25

Component Description:
Project Management
Amount:
$1,483.60

Component Description:
Project Management
Amount:
$2,832.80

Component Description:
Project Management Services
Amount:
$118.50

Component Description:
Project Management
Amount:
$3,974.20

Component Description:
Project management Services
Amount:
$1,126.25

Component Description:
Project Management
Amount:
$52.50

Component Description:
Project management Services
Amount:
$428.34

Component Description:
Project Management
Amount:
$1,237.30

Component Description:
Project management Services
Amount:
$247.50

Component Description:
Project management Services
Amount:
$581.25

Component Description:
Project management Services
Amount:
$272.35

Component Description:
Project Management
Amount:
$5,378.70

Component Description:
K. Lahm - Transmitter size analysis review; Transmission line reconfiguration analysis
Amount:
$250.00

Component Description:
Project management Services, including: invoice processing
Amount:
$461.50

Component Description:
Project management Services
Amount:
$228.75

Component Description:
Project Management Services
Amount:
$535.72

Component Description:
Project Management Services
Amount:
$484.98

Component Description:
Project management Services
Amount:
$588.75

Component Description:
Services to Coordinate Tower
Amount:
$1,500.00

Component Description:
Project Management
Amount:
$22.50

Component Description:
Project management services
Amount:
$223.75

Component Description:
Project Management Services including: coordinate tower rigging projects with local engineers
Amount:
$139.50

Component Description:
Project Management Services
Amount:
$1,703.75

Component Description:
Project management Services
Amount:
$32.50

Component Description:
Project Management
Amount:
$6,576.75

Component Description:
Project Management Services
Amount:
$84.00

Component Description:
Project Management Services including: coordinate tower rigging projects with local engineers
Amount:
$204.00

Component Description:
Project Management
Amount:
$9,043.65

Component Description:
Project Management Services
Amount:
$235.50

Component Description:
Project Management Services
Amount:
$1,250.80

Component Description:
Project Management Services
Amount:
$373.10

Component Description:
Project Management Services
Amount:
$66.00

Component Description:
Project Management Services
Amount:
$444.86

Component Description:
Project Management Services
Amount:
$111.00

Component Description:
Project management Services
Amount:
$335.00

Component Description:
Project management Services
Amount:
$560.00

Component Description:
Project Management
Amount:
$2,345.60

Component Description:
"AFF Consulting to provide project management services in connection with the TV Repack of Univision KDTV."
Amount:
$2,700.00

Component Description:
Project management Services
Amount:
$1,096.25

Component Description:
Project management Services
Amount:
$392.50

Component Description:
Project management Services
Amount:
$280.00

Component Description:
Project management Services
Amount:
$933.75

Component Description:
Project management Services
Amount:
$269.75

Component Description:
Project Management
Amount:
$6,953.90

Component Description:
Project Management
Amount:
$1,443.14

Component Description:
Project management Services
Amount:
$253.50

Component Description:
Project management Services
Amount:
$431.25

Component Description:
Project management Services
Amount:
$447.20

Cost Information

Back to Top ↑

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 $67,628.98 $65,073.98 N/A $58,964.12 N/A
Total for all systems $2,821,622.46 $2,085,736.71 N/A $1,433,897.02 N/A
Other Expenses $67,628.98 $65,073.98 $58,964.12
Internal Labor $27,283.68 $27,283.68 N/A $27,283.68 N/A
Notification Management $486.00 $486.00 Please see KDTV-DT Notification Management Budget Revision Justification Letter $486.00 N/A
MVPD Notification of Channel Change $594.00 $594.00 Please see attached justification document for MVPD Notifications and Covington & Burling Invoice #60793358 $594.00 N/A
Equipment Storage $2,487.75 $2,487.75 Please see Estimated Cost Justification KDTV-DT-610-Storage V0 $2,487.75 N/A
Equipment Delivery and Handling Charges $3,291.16 $3,291.16 Please see Estimated Cost Justification KDTV-DT-610-Equipment Delivery V1 $3,291.16 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $2,271.39 $2,271.39 Please see Estimated Cost Justification KDTV-DT-610-Disposal Costs v0 $2,271.39 N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $200.00 The FCC Special Temporary Authorization fee was greater than the Predetermined Estimated Cost set by the FCC $200.00 N/A
DTV Medical Facility Notification $11,550.00 $9,000.00 N/A $4,250.00 N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,110.00 N/A $1,110.00 N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
Local Zoning $18,025.00 $18,025.00 Please see KDTV Block AFF Consulting Proposal 160247 and Change Order 160263 $16,990.14 N/A

Components

Actual Information Description File Name
Internal Labor

Component Description:
Internal Labor 2019
Amount:
$9,793.97

Component Description:
Internal Labor 2020
Amount:
$7,542.56

Component Description:
Internal Labor 2016
Amount:
$43.58

Component Description:
Internal Labor 2021
Amount:
$8,412.52

Component Description:
Internal Labor 2017
Amount:
$778.28

Component Description:
Internal Labor 2018
Amount:
$712.77
Notification Management

Component Description:
Legal Services
Amount:
$486.00
MVPD Notification of Channel Change

Component Description:
Legal Services
Amount:
$594.00
Equipment Storage

Component Description:
KDTV-DT-610-Storage: $1425.00
Amount:
$1,425.00

Component Description:
KDTV-DT-610-Storage
Amount:
$1,062.75
Equipment Delivery and Handling Charges

Component Description:
PO LI#10 KDTV-DT Consolidation
Amount:
$1,116.16

Component Description:
Trucking- regular time hourly charge
Amount:
$2,175.00
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
Dumpster - Debris removal
Amount:
$701.06

Component Description:
Date move tendered & bill issued: Tuesday, December 10th, 2019
Amount:
$1,500.00

Component Description:
Dumpster - Debris removal
Amount:
$70.33
FCC Filing Fees - Special Temporary Authorization request

Component Description:
KDTV-DT-FCC Filing Fee -STA
Amount:
$200.00
DTV Medical Facility Notification

Component Description:
Medical Notification
Amount:
$4,250.00
FCC Filing Fees - Form 2100 minor change CP application

Component Description:
KDTV-DT-FilingFee-Minor Modification
Amount:
$1,110.00
FCC Filing Fees - Form 2100 license to cover application Information not provided.
Local Zoning

Component Description:
Permitting Submittal to Planning/Zoning
Amount:
$16,990.14

Cost Information

Back to Top ↑

Grand Total

Predetermined
Cost Estimate 		Estimated Cost Actual Cost
Total for all systems $2,821,622.46 $2,085,736.71 $1,433,897.02

Reimbursement Status

Back to Top ↑
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

Back to Top ↑
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.

Jose Franchi , Franchi .

VP Finance


09/02/2021

Certification

Back to Top ↑
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.

Jose Franchi , Franchi .

VP Finance


09/02/2021

Attachments

Back to Top ↑