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:
18148
Service:
DCA
Call Sign:
KDTV-CD
Channel:
21 (UHF)
File Number:
0000028201
FRN:
0001531425
Date Submitted:
10/04/2021

Applicant Information

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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

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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 33178

United States

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

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan Antenna and mask filter will be replaced, see attached Implementation Plan.

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 Retune Existing
Use Primary (Main)
Ownership Owned
Owner 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 Rohde and Schwarz
Model SCV8000
Year 2009
Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 0.3 kW

Primary Transmitter

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Retuning Transmitter Costs

Section Question Response
New IOT Tubes Number of Tubes (including accessories) needed N/A
New Mask Filter
Power 1.5 kW
Other Power N/A
New Exciter Is a new exciter needed? No

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

Antennas

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

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 3.7 kW
Manufacturer
Model B16UA
Year 1996

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Broadband Slot
Number of Stations Supported 1
Number of Panels/Bays 8
Lower Limit 488.00 MHz
Upper Limit 608.00 MHz
Design power capacity in use 10.0 %
Other Antenna Type N/A
ERP: 11.0 kW
Manufacturer
Model TLP-12H/VP-R
Year 2019
Justification for New Antenna Current Bogner B16UA antenna is not capable of operation on post auction channel 21.

Primary Antenna

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Other Antenna Costs

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

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Antenna - Ice Shield

Antenna - Ice Shield required for repack antenna

Transmission Line

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Section Question Response
Transmission Line Related Expenses Do you have transmission line related expenses? No

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? No
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users No
Is tower documented for structural analysis? Unknown
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? No
ASR Number
Coordinates (NAD83) Latitude (NAD83) 38° 39' 22.68" N-
Longitude (NAD83) 122° 36' 57.9" W-
Overall Structure Height 100.00 feet
Support Structure Height 80.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 3972.00 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner American Tower Corporation
Date Constructed 06/16/1986

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
5310 KBBF FM

Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Study needed for documented tower
Tower Reinforcements Please select whether tower reinforcements are needed: No reinforcements needed

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 595
Explanation 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 No
Quantity N/A
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 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

Information not provided.

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning No
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)? No
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

Internal Labor

Internal Univision Labor directly associated with Repack

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 $108,230.00 $22,667.71 N/A $22,133.08 N/A
Total for all systems $404,717.65 $337,679.96 N/A $262,690.59 N/A
Primary Transmitter SCV8000 $108,230.00 $22,667.71 $22,133.08
1.5 kW mask filter $3,030.00 $2,800.00 N/A $2,306.95 N/A
UHF and VHF - minor banding issues $105,200.00 $19,867.71 see Estimated Cost Justification KDTV-CD-110-1st Primary Transmitter - Retune Existing Transmitter - Minor Banding Issues v0 $19,826.13 N/A

Components

Actual Information Description File Name
1.5 kW mask filter

Component Description:
8PPXX110E Filter Tuned Pack 7-16S DIN Female Connector
Amount:
$2,306.95
UHF and VHF - minor banding issues

Component Description:
K. Lahm - Travel time
Amount:
$1,078.50

Component Description:
Trans. Line Assy. 1 5/8
Amount:
$3,424.23

Component Description:
4Ch. ASI to IP/IP to ASI converter
Amount:
$15,323.40

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 $41,354.00 $54,313.00 N/A $36,238.52 N/A
Total for all systems $404,717.65 $337,679.96 N/A $262,690.59 N/A
Primary Antenna TLP-12H/VP-R $41,354.00 $54,313.00 $36,238.52
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $26,300.00 $39,589.00 Dielectric Quote 900108CMZ $27,914.52 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $0.00 N/A
Antenna - Ice Shield $8,324.00 $8,324.00 Please see GCB Wireless Services, Inc. quote dated May 28, 2020 $8,324.00 N/A

Components

Actual Information Description File Name
UHF - Lower Power Side Mount, Class A One Station antenna -- basic

Component Description:
UHF- High Power Side Mount
Amount:
$4,756.70

Component Description:
UHF HIGH POWER SIDE MOUNT
Amount:
$3,033.40

Component Description:
UHF HIGH POWER SIDE MOUNT
Amount:
$9,088.45

Component Description:
UHF - High Power Side Mount
Amount:
$9,088.45

Component Description:
Credit Memo - Dielectric credit for the sales tax on the antenna Vpol upgrade.
Amount:
($361.65)

Component Description:
CA Sales Tax -Invoice 689018
Amount:
$2,309.17
Sweep test of existing antenna

Component Description:
KDTV-210-Primary Antenna - Sweep Test
Amount:
$2,240.00

Component Description:
KDTV-CD-210-Primary Antenna - Sweep Test
Amount:
$2,240.00

Component Description:
"Credit Memo - Requested reimbursement on MAN01453 and MAN01515 for a sweep test that was removed/ wasn't charged on the final order conformation 1929577."
Amount:
($4,480.00)

Component Description:
Vendor Credit to be replaced with credit memo
Amount:
N/A
Antenna - Ice Shield

Component Description:
KDTV-CD Remaining 50% billing for Ice shield
Amount:
$4,162.00

Component Description:
KDTV-CD 50% billing for Ice shield
Amount:
$4,162.00

Cost Information

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Transmission Line

Information not provided.

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 $96,800.00 $60,475.00 N/A $15,897.00 N/A
Total for all systems $404,717.65 $337,679.96 N/A $262,690.59 N/A
Primary Tower TOWER $96,800.00 $60,475.00 $15,897.00
Structural engineering tower load study for well documented tower $12,600.00 $10,475.00 N/A $1,350.00 N/A
Short Tower (less than 500') $84,200.00 $50,000.00 N/A $14,547.00 N/A

Components

Actual Information Description File Name
Structural engineering tower load study for well documented tower

Component Description:
Structural Analysis
Amount:
$1,350.00

Component Description:
Invoice moved to correct budget category
Amount:
N/A
Short Tower (less than 500')

Component Description:
KDTV-CDTLP ANTENNA MOUNT MATERIAL PROCUREMENT FABRICATION AND RE-MOBILIZATION FOR INSTALLATION
Amount:
$2,068.50

Component Description:
KDTV-CDTLP ANTENNA MOUNT
Amount:
$2,068.50

Component Description:
KDTV-CD Antenna installation
Amount:
$5,205.00

Component Description:
KDTV-CD Antenna installation
Amount:
$5,205.00

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $124,250.00 $177,300.10 N/A $166,593.68 N/A
Total for all systems $404,717.65 $337,679.96 N/A $262,690.59 N/A
Outside Professional Services $124,250.00 $177,300.10 $166,593.68
Project management of the transition $94,010.00 $164,010.00 The estimated cost has been adjusted to include all invoices submitted for reimbursement at this time. $164,009.23 x
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $437.50 see Estimated Cost Justification KDTV-CD-590-New Channel Study v0 $437.50 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $1,575.00 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
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $2,500.00 N/A $102.60 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $1,000.00 N/A $366.75 N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $102.60 Please see KDTV-CD Attorney - Special Temporary Authorization Budget Revision Justification Letter $102.60 N/A

Components

Actual Information Description File Name
Project management of the transition

Component Description:
Project Management Services
Amount:
$181.50

Component Description:
Project Management
Amount:
$1,533.30

Component Description:
Project management Services
Amount:
$1,293.75

Component Description:
Project management
Amount:
$349.05

Component Description:
Project management Services
Amount:
$172.90

Component Description:
Project Management
Amount:
$1,005.36

Component Description:
Project management Services
Amount:
$455.65

Component Description:
Project Management Services
Amount:
$75.00

Component Description:
Project Management
Amount:
$40.50

Component Description:
Project management Services
Amount:
$234.00

Component Description:
Project management Services
Amount:
$227.50

Component Description:
Project Management Services
Amount:
$9.00

Component Description:
Project Management
Amount:
$3,686.85

Component Description:
Project management Services
Amount:
$442.50

Component Description:
Project management Services
Amount:
$430.00

Component Description:
Project Management
Amount:
$34.50

Component Description:
Project Management Services
Amount:
$1,181.18

Component Description:
Project Management
Amount:
$1,097.50

Component Description:
Project management Services
Amount:
$176.80

Component Description:
Project Management
Amount:
$1,829.40

Component Description:
Project management Services
Amount:
$209.30

Component Description:
Project management Services
Amount:
$266.50

Component Description:
Project management Services
Amount:
$683.75

Component Description:
Project Management Services
Amount:
$76.50

Component Description:
Project management Services
Amount:
$518.75

Component Description:
Project Management
Amount:
$775.26

Component Description:
Project management Services
Amount:
$595.00

Component Description:
Project management services
Amount:
$578.20

Component Description:
Medical Notification
Amount:
$2,000.00

Component Description:
Project Management Services
Amount:
$208.86

Component Description:
Project Management Services
Amount:
$57.00

Component Description:
Project management Services
Amount:
$125.45

Component Description:
Project Management
Amount:
$3,747.80

Component Description:
Project Management Services
Amount:
$248.95

Component Description:
Project Management
Amount:
$183.00

Component Description:
Project Management
Amount:
$444.86

Component Description:
Project Management
Amount:
$2,998.30

Component Description:
Project Management
Amount:
$2,802.85

Component Description:
Project Management Services
Amount:
$37.50

Component Description:
Project Management Services
Amount:
$428.35

Component Description:
Project management Services
Amount:
$212.50

Component Description:
Project Management
Amount:
$214.50

Component Description:
Project Management Services
Amount:
$706.82

Component Description:
Project management
Amount:
$3,361.80

Component Description:
Project management Services
Amount:
$372.50

Component Description:
Project Management
Amount:
$3,769.05

Component Description:
Project Management
Amount:
$763.50

Component Description:
Project Management Services
Amount:
$49.50

Component Description:
Project Management Services
Amount:
$1,411.28

Component Description:
Project management
Amount:
$3,925.90

Component Description:
Project management Services
Amount:
$195.00

Component Description:
Project Management
Amount:
$3,505.15

Component Description:
Project Management
Amount:
$1,483.60

Component Description:
Project management Services
Amount:
$272.50

Component Description:
Project Management Services
Amount:
$1,103.30

Component Description:
Project management Services
Amount:
$217.50

Component Description:
Project management Services
Amount:
$392.50

Component Description:
Project Management
Amount:
$2,450.90

Component Description:
Project management Services
Amount:
$269.75

Component Description:
Project management Services
Amount:
$403.75

Component Description:
Invoice is a duplicate in LMS
Amount:
N/A

Component Description:
Project Management
Amount:
$102.00

Component Description:
Project management Services
Amount:
$213.85

Component Description:
Project Management
Amount:
$3,033.25

Component Description:
Project Mgt
Amount:
$2,452.55

Component Description:
Project Management
Amount:
$2,056.95

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

Component Description:
Project Management
Amount:
$3,042.80

Component Description:
Project Management Services
Amount:
$367.50

Component Description:
Project Management Services
Amount:
$428.34

Component Description:
Project Management Services
Amount:
$223.02

Component Description:
Project Management Services
Amount:
$117.00

Component Description:
Invoice is a duplicate in LMS.
Amount:
N/A

Component Description:
Project Management Services
Amount:
$85.50

Component Description:
Project management Services
Amount:
$309.40

Component Description:
Project Management Services
Amount:
$808.30

Component Description:
Project Management
Amount:
$5,263.45

Component Description:
Project Management Services
Amount:
$741.04

Component Description:
Project Management
Amount:
$115.50

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

Component Description:
Project Management Services
Amount:
$156.00

Component Description:
Project management Services
Amount:
$592.50

Component Description:
Project management
Amount:
$5,497.45

Component Description:
Project Management Services
Amount:
$610.06

Component Description:
Project Management
Amount:
$1,445.90

Component Description:
Project management Services
Amount:
$271.25

Component Description:
Project Management Services
Amount:
$75.00

Component Description:
K. Lahm - ERP-TPO-APO Update - 6/12/2019
Amount:
$125.00

Component Description:
Project management Services
Amount:
$318.50

Component Description:
Project Management Services
Amount:
$392.50

Component Description:
Project management Services
Amount:
$297.50

Component Description:
Project management Services
Amount:
$468.75

Component Description:
Project Management
Amount:
$4,160.60

Component Description:
Project management Services
Amount:
$306.25

Component Description:
Invoice is a duplicate in LMS
Amount:
N/A

Component Description:
Invoice is a duplicate in LMS
Amount:
N/A

Component Description:
Project Management Services
Amount:
$316.25

Component Description:
Project management Services
Amount:
$145.00

Component Description:
Project Management Services
Amount:
$67.50

Component Description:
Project management Services
Amount:
$165.75

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

Component Description:
Project Management Services
Amount:
$111.00

Component Description:
Project management Services
Amount:
$288.75

Component Description:
Project Management
Amount:
$3,489.90

Component Description:
Project management Services
Amount:
$572.50

Component Description:
Project Management Services
Amount:
$788.24

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

Component Description:
Project Management Services
Amount:
$48.00

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

Component Description:
Project management Services
Amount:
$307.50

Component Description:
Project Management Services
Amount:
$66.00

Component Description:
Project management
Amount:
$302.90

Component Description:
Project management Services
Amount:
$223.60

Component Description:
Project Management Services
Amount:
$1,004.18

Component Description:
Project Management Services
Amount:
$575.84

Component Description:
Project Management
Amount:
$5,355.45

Component Description:
Project Management Services
Amount:
$590.00

Component Description:
RX Interference.
Amount:
$450.00

Component Description:
Project management Services
Amount:
$51.35

Component Description:
Project Management Services
Amount:
$977.04

Component Description:
Project management Services
Amount:
$451.25

Component Description:
Project Management Services
Amount:
$389.35

Component Description:
Project Management Services
Amount:
$21.00

Component Description:
Project Management Service
Amount:
$973.50

Component Description:
Invoice revisions to meet FCC submittal requirements
Amount:
$15.00

Component Description:
Project Management
Amount:
$3,006.25

Component Description:
Project Management
Amount:
$2,740.45

Component Description:
Project Management Services
Amount:
$1,117.46

Component Description:
Project Management Services
Amount:
$73.50

Component Description:
Project Management
Amount:
$3,566.75

Component Description:
Project Management
Amount:
$2,112.00

Component Description:
Project Management Services
Amount:
$1,323.96

Component Description:
Project management Services
Amount:
$337.50

Component Description:
Project Management
Amount:
$3,953.05

Component Description:
Invoice is a duplicate in LMS
Amount:
N/A

Component Description:
Project management Services
Amount:
$138.75

Component Description:
Project management Services
Amount:
$78.00

Component Description:
Project Management
Amount:
$2,572.10

Component Description:
Project Management Services including: coordinate tower rigging projects with local engineers
Amount:
$123.00

Component Description:
Project Management Services
Amount:
$42.00

Component Description:
Project Management
Amount:
$2,861.45

Component Description:
Project management Services
Amount:
$260.00

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

Component Description:
Project management Services
Amount:
$252.50

Component Description:
Project Management
Amount:
$2,593.10

Component Description:
Project management Services
Amount:
$202.15

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

Component Description:
Project Management
Amount:
$4,071.20

Component Description:
Project management Services
Amount:
$292.50

Component Description:
Project management Services
Amount:
$187.20

Component Description:
Project management Services
Amount:
$392.50

Component Description:
Project Management
Amount:
$3,197.90

Component Description:
Project Management Services including: coordinate tower rigging projects with local engineers
Amount:
$129.00

Component Description:
Project management Services
Amount:
$272.35

Component Description:
Project management Services
Amount:
$222.30

Component Description:
Project Management Services
Amount:
$217.50

Component Description:
Project Management Services
Amount:
$248.95

Component Description:
Project management Services, including: invoice processing
Amount:
$347.75

Component Description:
Project Management Services
Amount:
$236.25

Component Description:
Project Management Services including: coordinate tower rigging projects with local engineers
Amount:
$100.50

Component Description:
Project Management Services
Amount:
$1,244.90

Component Description:
Project management Services
Amount:
$173.55

Component Description:
Project Management
Amount:
$3,258.30

Component Description:
Project management Services
Amount:
$331.25

Component Description:
Project management Services
Amount:
$337.50

Component Description:
Project management Services
Amount:
$220.00

Component Description:
Project management Services
Amount:
$300.95

Component Description:
Project management Services
Amount:
$228.75

Component Description:
Project Management Services
Amount:
$1,718.08

Component Description:
Project Management
Amount:
$124.50

Component Description:
Project Management
Amount:
$1,319.80

Component Description:
Project management services
Amount:
$1,525.74

Component Description:
Project Management
Amount:
$22.50

Component Description:
Project Management
Amount:
$3,860.90

Component Description:
Project management Services
Amount:
$247.50

Component Description:
Project Management Services
Amount:
$458.75

Component Description:
K. Lahm - Field work scheduling - 2/7/19
Amount:
$37.50

Component Description:
Invoice is a duplicate in LMS
Amount:
N/A

Component Description:
Project Management Services
Amount:
$206.25

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

Component Description:
Project Management Services
Amount:
$418.75

Component Description:
Project management Services
Amount:
$259.35

Component Description:
Project Management Services, including: supervision
Amount:
$822.46

Component Description:
Project management Services
Amount:
$202.80
Prepare and or review reimbursement form Information not provided.
Perform engineering study for new channel assignment and antenna development

Component Description:
K. Lahm - Antenna proposal specification review
Amount:
$312.50

Component Description:
Antenna elevation & Mask filter specifications
Amount:
$125.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Professional Services
Amount:
$1,575.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Legal Services
Amount:
$102.60
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations

Component Description:
Legal Services
Amount:
$224.55

Component Description:
Legal Services
Amount:
$142.20
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
Legal Services
Amount:
$102.60

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $34,083.65 $22,924.15 N/A $21,828.31 N/A
Total for all systems $404,717.65 $337,679.96 N/A $262,690.59 N/A
Other Expenses $34,083.65 $22,924.15 $21,828.31
Internal Labor $15,324.90 $15,324.90 N/A $15,324.56 N/A
DTV Medical Facility Notification $11,550.00 $25.50 Please see KDTV-CD DTV Medical Notifications Budget Revision Justification Letter (one third of quoted costs) N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $335.00 N/A $335.00 N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $600.00 3 FCC Special Temporary Authorizations were required for this station. $600.00 N/A
Equipment Delivery and Handling Charges $5,568.75 $5,568.75 Please see Dielectric quote 900108CMZ $5,568.75 N/A

Components

Actual Information Description File Name
Internal Labor

Component Description:
Internal Labor 2017
Amount:
$1,217.88

Component Description:
Internal Labor 2019
Amount:
$4,447.66

Component Description:
Internal Labor 2018
Amount:
$844.75

Component Description:
Internal Labor 2021_Revised
Amount:
$6,357.58

Component Description:
Internal Labor 2020
Amount:
$2,413.11

Component Description:
Internal Labor 2016
Amount:
$43.58
DTV Medical Facility Notification Information not provided.
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
FCC Filing Fees - Form 2100 license to cover application

Component Description:
License to Cover
Amount:
$335.00
FCC Filing Fees - Special Temporary Authorization request

Component Description:
KDTV-CD- Filing Fee -STA Dec. 10, 2018
Amount:
$200.00

Component Description:
STA Extension June 6, 2019
Amount:
$200.00

Component Description:
KDTV-CD- Filing Fee -STA Extension Dec. 11, 2019
Amount:
$200.00
Equipment Delivery and Handling Charges

Component Description:
Freight and Shipping PAF Van Delivery
Amount:
$5,568.75

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $404,717.65 $337,679.96 $262,690.59

Reimbursement Status

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Question Response
The facility has ceased operating on its pre-auction channel. No
Construction of final facilities or all necessary modifications are complete. No
All receipts for reimbursement have been submitted no further costs are expected to be incurred. Note this will lock the Form 399 from further editing and begin close-out procedures with the Fund Administrator. No

Certification

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Section Question Response
Submission of Estimated Expenses Statements

WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.

  1. The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.

  2. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

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

  4. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD).

  5. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

  6. The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred.

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

  8. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.

I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Jose Franchi , Franchi .

VP Finance


10/04/2021

Certification

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Section Question Response
Submission of Actual Cost Documentation Statements

WILLFUL FALSE, FRAUDULENT, OR FICTITIOUS STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISIONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE AND/OR FRAUDULENT STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT (U.S. CODE, TITLE 31, SECTIONS 3729-3733).

  1. The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.

  2. The above-named entity certifies that the statements in this form and attached documentation are true, complete, and correct.

  3. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

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

  5. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (full power and Class A stations) and/or otherwise modify a television station’s facility as a result of the spectrum repack (LPTV/TV Translator stations); or to minimize service disruption resulting from a repacked television station (FM stations); or to continue to carry the signal of a broadcaster that changes channels (MVPD) .

  6. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

  7. The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred.

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

  9. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a prerequisite for obtaining the payments herein requested.

I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Jose Franchi , Franchi .

VP Finance


10/04/2021

Attachments

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