TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
PRAIRIE PUBLIC BROADCASTING, INC. Doing Business As: PRAIRIE PUBLIC BROADCASTING, INC.	Jack Anderson PO Box 3240 FARGO, ND 58108 United States	+1 (701) 241-6900	janderson@prairiepublic.org	Not-for-Profit

Applicant

Address

Phone

Applicant Type

PRAIRIE PUBLIC BROADCASTING, INC.

Doing Business As: PRAIRIE PUBLIC BROADCASTING, INC.

Jack Anderson

PO Box 3240

FARGO, ND 58108

United States

+1 (701) 241-6900

janderson@prairiepublic.org

Not-for-Profit

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant	Address	Phone	Email
[Confidential]

Preparer Contact Information

Preparer Contact Name and Information

Applicant	Address	Phone	Email
The Preparer is same as the reimbursement contact.

Broadcaster Information and Transition Plan

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	Total replacement of existing single channel RF system consisting of 942 ft guyed tower, side-mounted antenna and 3-1/8 rigid line with new equal height tower, line size and top-mounted antenna. See attached.

Transmitters

Section	Question	Response
Transmitter Related Expenses	Do you have transmitter related expenses?	Yes

Primary Transmitter

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	DHD20P1
	Year	2003
	Type	Solid State
	Solid State Cooling	Air Cooled
	Solid State Power Capacity	5.5 kW

Primary Transmitter

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	Maxiva UAXTE-8R37
	Transmitter Type	Solid State
	Solid State Cooling	Air Cooled
	Solid State Power capacity	4.8 kW
	Justification for New Transmitter	The existing transmitter and mast filter is channel-specific and must be replaced to accommodate the channel change. Proposed KW size based on top-mounted antenna and 3-1/8 rigid transmission line. TX upgraded from 3.6KW to 4.8K for coverage maximization.

Primary Transmitter

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	Relocation of main building transformer.
HVAC Service	Does the replacement transmitter require HVAC Service?	Yes
	Type	Cooling Only
	Size	5 tons
	Other Size	N/A tons
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

Other Transmitter Cost Not Listed

Name	Description
Electrician - TX	Funding for labor and materials to install new transmitter and associated surge suppressor.

Antennas

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

Primary Antenna

Existing Antenna Information

Section	Question	Response
Existing Antenna Description	Type of change	Purchase New
	Antenna Use	Primary (Main)
	Description of Use	N/A
	Ownership	Owned
	Owner	N/A
	Site	N/A
	Is the existing antenna shared with another station or stations?	No
	Is the existing antenna directional?	Yes
	Is antenna in operating condition?	Yes
	Is antenna located on or in close proximity to an antenna farm?	No
Existing Antenna Manufacturer and Type	Class	Full Power
	Mounting	Side Mount
	Antenna position in stack	Not in Stack
	Polarization	Horizontal
	Type	Slotted Coaxial
	Number of Stations Supported	N/A
	Number of Panels	N/A
	Design power capacity in use	N/A
	Lower Limit	N/A
	Upper Limit	N/A
	Other Antenna Type	N/A
	ERP:	146.0 kW
	Manufacturer
	Model	881-24
	Year	2003

Primary Antenna

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?	No
New Antenna Manufacturer and Types	Class	Full Power
	Mounting	Top Mount
	Antenna position in stack	Not in Stack
	Polarization	Horizontal
	Type	Slotted Coaxial
	Number of Stations Supported	N/A
	Number of Panels/Bays	N/A
	Lower Limit	N/A
	Upper Limit	N/A
	Design power capacity in use	N/A
	Other Antenna Type	N/A
	ERP:	36.2 kW
	Manufacturer
	Model	TFU-15JTH-R-C250
	Year	2017
	Justification for New Antenna	The existing side mounted antenna is channel-specific and must be replaced to accommodate the channel change. Proposed top mounted antenna allows for minimal outage times during testing and transition periods.

Primary Antenna

Other Antenna Costs

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

Primary Antenna

Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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

Primary Transmission Line

Existing Transmission Line

Section	Question	Response
Existing Transmission Line Description	Type of change	Purchase New
	Use	Primary (Main)
	Description of Use	N/A
	Ownership	Owned
	Owner	N/A
	Site	N/A
	Is the existing transmission line shared with another station or stations?	No
	Is Transmission Line in operating condition?	Yes
Existing Transmission Line Manufacturer and Type	Manufacturer
	Type	Rigid
	Diameter	3 1/8 inches
	Other Diameter	N/A
	Segment Length	20 inches
	Other Segment Length	N/A
	Number of parallel runs	0
	Length	800 feet per run

Primary Transmission Line

New Transmission Line

Section	Question	Response
New Transmission Line Costs	Use	Primary (Main)
	Description of Use	N/A
	Change Type	Purchase New
	Is this a request for upgraded equipment?	No
	Type	Rigid
	Diameter	3 1/8 inches
	Other Diameter	N/A
	Segment Length	20 inches
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	1000 feet per run
	Justification for New Transmission Line	Proposed rigid transmission line allows for minimal outage times during testing and transition periods. Line and antenna will be installed concurrently with replacement tower.

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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

Primary Tower

Existing Tower

Section	Question	Response
Existing Tower Description	Type of change	Construct New
	Tower Use	Primary (Main)
	Description of Use	N/A
	Ownership	Owned
	Is this tower consider Complex?	No
	Is this tower currently shared with any other stations?	No
	One or more FM, AM or TV radio broadcaster(s)	N/A
	Others Types of Users	N/A
	Is tower documented for structural analysis?	Yes
	Is tower compliant with Rev G?	No
Existing Tower Structure Registration	Do you have a tower registration number?	Yes
Existing Tower Structure Registration	ASR Number	1037968
Coordinates (NAD83)	Latitude (NAD83)	48° 03' 02.0" N-
	Longitude (NAD83)	101° 23' 27.0" W-
	Overall Structure Height	1030.83 feet
	Support Structure Height	943.89 feet
	Ground Elevation Above Mean Sea Level (AMSL)	2118.08 feet
	Structure Type	TOWER - Free Standing or Guyed Structure
	Tower Owner	PRAIRIE PUBLIC BROADCASTING INC
	Date Constructed	11/08/1983

Primary Tower

Tower Construction Costs

Section	Question	Response
Construct New Tower	Use	Primary (Main)
	Description of Use	N/A
	Is this a request for upgraded equipment?	No
	Height	944.00 feet
	Justification for New Tower	Results of structural analysis of the existing tower built in 1983 determined it was not feasible to perform upgrades necessary to comply with the EIA/TIA 222-G national standard. Best-case antenna loading was used, with removal of the top mounted antenna

Primary Tower

Tower Rigging Costs

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

Primary Tower

Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

Section	Question	Response
Outside Project Management Services	Do you require outside project management services?	No
	Number of Hours	N/A
	Explanation	N/A
Outside RF consulting Engineering Services	Perform engineering study for new channel assignment and antenna development	Yes
	Prepare engineering section of Form FCC Construction Permit Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare engineering section of Form FCC License to Cover Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare request for Special Temporary Authority	Yes
	Quantity	1
	Do you have Distributed Transmission System engineering services?	N/A
	Critical Facility	N/A
	Terrain-Shielded Facility	N/A
Attorney and Other Outside Consulting Services	Prepare and file Form FCC Construction Permit Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare and file Form FCC License to Cover Application	Yes
	For Auxiliary Facility	No
	For Main Facility	Yes
	Prepare request for Special Temporary Authority	Yes
	Quantity	1
	NEPA Section 106 environmental review	No
	Environmental Assessment	No
	ASR Modification	Yes
	FAA Consultation (including preparation of FAA Form 7460)	Yes
	Negotiation of Lease and other Matter for Shared Locations	No
	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

Other Professional Services Expenses Not Listed

Name	Description
Project Management	Consideration for Inside project management labor cost.
Tower Soil Analysis	Soil testing performed to determine type and design of replacement tower foundations.
Tower Structural Analysis	Tower analysis performed on existing tower to determine if upgrading structure was feasible.

Other Expenses

Section	Question	Response
AM Pattern Disturbance	Is an Impact Study needed?	No
AM Pattern Disturbance	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	No
	FCC License to Cover Application	No
	FCC Special Temporary Authority Application	No
Other Miscellaneous Expenses	Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)?	No
	Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs?	No
	Does this relocation require Equipment Storage?	No
	Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change?	Yes
	Does this relocation require MVPD Notification of a Channel Change?	Yes

Other Expenses

Other Expenses Not Listed

Information not provided.

Cost Information

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	$448,675.12	$211,175.12	N/A	$205,835.60	N/A
Total for all systems	$3,801,345.12	$3,498,653.12	N/A	$3,478,580.37	N/A
Primary Transmitter Maxiva UAXTE-8R37	$448,675.12	$211,175.12		$205,835.60
UHF - Air Cooled Solid State Transmitter 3.6 kW	$172,925.12	$172,925.12	*System Notice: Estimate adjusted and locked because line has been superseded.*	$172,925.12	N/A
Electrician - TX	$4,000.00	$4,000.00	N/A	$743.07	N/A
5 Ton system	$20,250.00	$19,250.00	N/A	$17,192.41	N/A
UHF - Air Cooled Solid State Transmitter 4 - 6 kW	$236,500.00	$0.00	N/A	N/A	N/A
Other Electrical Service: Relocation of main building transformer.	$15,000.00	$15,000.00	N/A	$14,975.00	N/A

Components

Actual Information Description	File Name
UHF - Air Cooled Solid State Transmitter 3.6 kW	Component Description: Transmitter 3rd Payment -Adjusted For Upgraded Equipment Amount: $39,451.82 Component Description: Transmitter Initial Payment -Adjusted For Upgraded Equipment Amount: $57,244.83 Component Description: Transmitter 2nd Payment -Adjusted For Upgraded Equipment Amount: $57,244.83 Component Description: Initial down-payment for transmitter package. Amount: $58,402.32 Component Description: Transmitter 4th Payment, Updated 12/27/18 Amount: $18,983.64
Electrician - TX	Component Description: KSRE Electrical Materials Amount: $375.48 Component Description: KSRE Electrical Materials Amount: $166.86 Component Description: KSRE Electrical Materials Amount: $200.73
5 Ton system	Component Description: KSRE HVAC Materials Amount: $5,970.00 Component Description: KSRE HVAC Materials Amount: $111.74 Component Description: KSRE HVAC Materials Amount: $126.84 Component Description: KSRE HVAC Materials Amount: $217.49 Component Description: KSRE HVAC Materials Amount: $1,567.10 Component Description: KSRE HVAC Materials Amount: $478.85 Component Description: KSRE HVAC Materials Amount: $1,441.44 Component Description: KSRE HVAC Materials Amount: $79.20 Component Description: KSRE HVAC Components Amount: $193.63 Component Description: KSRE HVAC Materials Amount: $467.82 Component Description: KSRE HVAC Materials Amount: $83.32 Component Description: KSRE HVAC Materials Amount: $1,728.45 Component Description: KSRE HVAC Materials Amount: $67.66 Component Description: KSRE HVAC (No Tax, Added Material Cost Added) Amount: $1,748.75 Component Description: KSRE HVAC Materials Amount: $50.17 Component Description: HVAC Materials Amount: $2,586.29 Component Description: KSRE HVAC Materials Amount: $164.00 Component Description: KSRE HVAC Materials Amount: $109.66
UHF - Air Cooled Solid State Transmitter 4 - 6 kW	Information not provided.
Other Electrical Service: Relocation of main building transformer.	Component Description: Building transformer relocation electrical labor/materials. Amount: $10,175.00 Component Description: Site leveling around building electrical transformer. Amount: $800.00 Component Description: Main electrical transformer utility cost. Amount: $4,000.00

Cost Information

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	$261,330.00	$214,845.00	N/A	$214,047.53	N/A
Total for all systems	$3,801,345.12	$3,498,653.12	N/A	$3,478,580.37	N/A
Primary Antenna TFU-15JTH-R-C250	$261,330.00	$214,845.00		$214,047.53
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized	$247,000.00	$201,069.00	The existing side mounted antenna is channel-specific and must be replaced to accommodate the channel change. Proposed top mounted antenna allows for minimal outage times during testing and transition periods.	$200,381.52	N/A
Sweep test of existing antenna	$6,730.00	$6,400.00	N/A	$6,347.94	N/A
Elbow complex, single channel, at antenna input, per 3 1/8. feedline (if needed)	$7,600.00	$7,376.00	N/A	$7,318.07	N/A

Components

Actual Information Description	File Name
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized	Component Description: Request partial payment that represents % of total antenna cost. Amount: $1,345.11 Component Description: Request partial payment that represents % of total antenna cost. Amount: $4,120.36 Component Description: Request partial payment that represents % of total antenna cost. Updated 12/27/18. Amount: $3,347.11 Component Description: North Dakota Use Tax on antenna. Updated 1/15/19. Amount: $8,684.40 Component Description: Request partial payment that represents approx. 5.26% of total antenna and shipping cost. Amount: $10,088.40 Component Description: Request partial payment that represents 45% of total antenna and shipping cost. Amount: $86,360.85 Component Description: Request partial payment that represents 45% of total antenna and shipping cost. Amount: $86,360.85 Component Description: Request partial payment that represents % of total antenna cost. Amount: $74.44
Sweep test of existing antenna	Component Description: Request partial payment that represents approx. 5.26% of total sweep test cost. Amount: $336.43 Component Description: Request partial payment that represents % of total sweep test cost. Amount: $2.48 Component Description: Request partial payment that represents % of total sweep test cost. Amount: $137.41 Component Description: Request partial payment that represents 45% of total sweep test cost. Amount: $2,880.00 Component Description: Request partial payment that represents % of total sweep test cost. Amount: N/A Component Description: Request partial payment that represents 45% of total sweep test cost. Amount: $2,880.00 Component Description: Request partial payment that represents % of total sweep test cost. Updated 12/27/18. Amount: $111.62
Elbow complex, single channel, at antenna input, per 3 1/8. feedline (if needed)	Component Description: Request partial payment that represents % of total elbow complex cost. Amount: $2.73 Component Description: Request partial payment that represents % of total elbow complex cost. Amount: $150.80 Component Description: Request partial payment that represents 45% of total elbow complex cost. Amount: $3,160.80 Component Description: Request partial payment that represents % of total elbow complex cost. Amount: N/A Component Description: Request partial payment that represents % of total elbow complex cost. Updated 12/27/18. Amount: $122.50 Component Description: Request partial payment that represents approx. 5.26% of total elbow complex cost. Amount: $369.24 Component Description: North Dakota Use Tax on elbow complex. Updated 1/15/19. Amount: $351.20 Component Description: Request partial payment that represents 45% of total elbow complex cost. Amount: $3,160.80

Cost Information

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	$104,000.00	$98,383.00	N/A	$97,514.70	N/A
Total for all systems	$3,801,345.12	$3,498,653.12	N/A	$3,478,580.37	N/A
Primary Transmission Line	$104,000.00	$98,383.00		$97,514.70
Rigid Transmission Line - copper, 3 1/8"	$104,000.00	$98,383.00	Shipping and 5% Use Tax included in pricing.	$97,514.70	N/A

Components

Actual Information Description	File Name
Rigid Transmission Line - copper, 3 1/8"	Component Description: Request partial payment that represents % of total line pkg cost. Amount: $35.98 Component Description: Request partial payment that represents % of total line pkg cost. Amount: $1,264.00 Component Description: Request partial payment that represents % of total line pkg cost. Amount: $1,991.43 Component Description: Request partial payment that represents 45% of total transmission line package cost. Amount: $41,739.48 Component Description: North Dakota Use Tax on line package. Updated 1/15/19. Amount: $4,250.76 Component Description: Request partial payment that represents 45% of total transmission line package cost. Amount: $41,739.48 Component Description: Request partial payment that represents % of total line pkg cost. Updated 12/27/18. Amount: $1,617.70 Component Description: Request partial payment that represents approx. 5.26% of total transmission line cost. Amount: $4,875.87

Actual Information Description

File Name

Rigid Transmission Line - copper, 3 1/8"

Component Description:: Request partial payment that represents % of total line pkg cost.
Amount:: $35.98

Component Description:: Request partial payment that represents % of total line pkg cost.
Amount:: $1,264.00

Component Description:: Request partial payment that represents % of total line pkg cost.
Amount:: $1,991.43

Component Description:: Request partial payment that represents 45% of total transmission line package cost.
Amount:: $41,739.48

Component Description:: North Dakota Use Tax on line package. Updated 1/15/19.
Amount:: $4,250.76

Component Description:: Request partial payment that represents 45% of total transmission line package cost.
Amount:: $41,739.48

Component Description:: Request partial payment that represents % of total line pkg cost. Updated 12/27/18.
Amount:: $1,617.70

Component Description:: Request partial payment that represents approx. 5.26% of total transmission line cost.
Amount:: $4,875.87

Cost Information

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	$2,890,500.00	$2,880,000.00	N/A	$2,879,956.19	N/A
Total for all systems	$3,801,345.12	$3,498,653.12	N/A	$3,478,580.37	N/A
Primary Tower TOWER	$0.00	$0.00		$0.00
Primary Tower	$2,890,500.00	$2,880,000.00		$2,879,956.19
New tower	$2,680,000.00	$2,680,000.00	N/A	$2,679,956.19	N/A
Tall Tower (greater than 500')	$210,500.00	$200,000.00	N/A	$200,000.00	N/A

Components

Actual Information Description	File Name
New tower	Component Description: Partial payment #3 to continue tower fabrication. Amount: $200,000.00 Component Description: Tower partial payment request #4. Amount: $103,248.77 Component Description: Tower and foundation design cost. Resubmitted invoice to include PO/Quote/Invoice. Amount: $7,500.00 Component Description: Tower site leveling and restoration. Amount: $5,200.00 Component Description: Tower mounting brackets. Amount: $20,068.70 Component Description: Tower Hardware Package Amount: $294.02 Component Description: Tower fencing installation. Amount: $10,000.00 Component Description: Tower Erection Payment Request #3 Amount: $354,814.50 Component Description: Partial Shipping Payment Amount: $27,834.95 Component Description: Partial payment to begin tower fabrication. (Ehresmann Quotation & PO Uploaded as separate files) Amount: $75,000.00 Component Description: Tower foundation guy anchor bolts and base pin. Resubmitted invoice to include PO/Quote/Invoice. Amount: $15,045.00 Component Description: Tower rest platforms. Amount: $6,000.00 Component Description: North Dakota Use Tax on tower. Updated 1/15/19. Amount: $30,676.29 Component Description: Tower erection payment request #2. Amount: $354,814.50 Component Description: Partial payment to continue tower fabrication. Amount: $200,000.00 Component Description: Old tower foundation removal cost. Amount: $34,814.50 Component Description: New tower foundation installation. (Steeplejacks Quotations & PO Uploaded as separate files) Amount: $693,500.00 Component Description: Tower foundation site marking supplies. Resubmitted invoice to include PO & Invoice. Amount: $28.18 Component Description: On-site drone to provide independent video tower inspection and allow field verification of installation work performed during construction. Amount: $2,949.00 Component Description: KSRE Tower Materials Amount: $1,201.41 Component Description: KSRE Tower Materials Amount: $299.92 Component Description: Tower guy wire inspection scale required to field verify guy tensions. Amount: $3,931.14 Component Description: Tower Partial Shipping#2(Final) Amount: $23,850.00 Component Description: Tower materials. Amount: $1,532.00 Component Description: Old broadcast tower removal cost. Amount: $110,000.00 Component Description: Tower erection payment request #4. Amount: $354,814.50 Component Description: Tower ice bridge foundation materials and design. Amount: $14,232.00 Component Description: Tower erection down payment request #1. Amount: $35,000.00 Component Description: Tower-Junction Box Amount: $186.95
Tall Tower (greater than 500')	Component Description: KSRE Antenna Rigging Amount: $200,000.00

Actual Information Description

File Name

New tower

Component Description:: Partial payment #3 to continue tower fabrication.
Amount:: $200,000.00

Component Description:: Tower partial payment request #4.
Amount:: $103,248.77

Component Description:: Tower and foundation design cost. Resubmitted invoice to include PO/Quote/Invoice.
Amount:: $7,500.00

Component Description:: Tower site leveling and restoration.
Amount:: $5,200.00

Component Description:: Tower mounting brackets.
Amount:: $20,068.70

Component Description:: Tower Hardware Package
Amount:: $294.02

Component Description:: Tower fencing installation.
Amount:: $10,000.00

Component Description:: Tower Erection Payment Request #3
Amount:: $354,814.50

Component Description:: Partial Shipping Payment
Amount:: $27,834.95

Component Description:: Partial payment to begin tower fabrication. (Ehresmann Quotation & PO Uploaded as separate files)
Amount:: $75,000.00

Component Description:: Tower foundation guy anchor bolts and base pin. Resubmitted invoice to include PO/Quote/Invoice.
Amount:: $15,045.00

Component Description:: Tower rest platforms.
Amount:: $6,000.00

Component Description:: North Dakota Use Tax on tower. Updated 1/15/19.
Amount:: $30,676.29

Component Description:: Tower erection payment request #2.
Amount:: $354,814.50

Component Description:: Partial payment to continue tower fabrication.
Amount:: $200,000.00

Component Description:: Old tower foundation removal cost.
Amount:: $34,814.50

Component Description:: New tower foundation installation. (Steeplejacks Quotations & PO Uploaded as separate files)
Amount:: $693,500.00

Component Description:: Tower foundation site marking supplies. Resubmitted invoice to include PO & Invoice.
Amount:: $28.18

Component Description:: On-site drone to provide independent video tower inspection and allow field verification of installation work performed during construction.
Amount:: $2,949.00

Component Description:: KSRE Tower Materials
Amount:: $1,201.41

Component Description:: KSRE Tower Materials
Amount:: $299.92

Component Description:: Tower guy wire inspection scale required to field verify guy tensions.
Amount:: $3,931.14

Component Description:: Tower Partial Shipping#2(Final)
Amount:: $23,850.00

Component Description:: Tower materials.
Amount:: $1,532.00

Component Description:: Old broadcast tower removal cost.
Amount:: $110,000.00

Component Description:: Tower erection payment request #4.
Amount:: $354,814.50

Component Description:: Tower ice bridge foundation materials and design.
Amount:: $14,232.00

Component Description:: Tower erection down payment request #1.
Amount:: $35,000.00

Component Description:: Tower-Junction Box
Amount:: $186.95

Tall Tower (greater than 500')

Component Description:: KSRE Antenna Rigging
Amount:: $200,000.00

Cost Information

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	$81,290.00	$79,250.00	N/A	$74,385.35	N/A
Total for all systems	$3,801,345.12	$3,498,653.12	N/A	$3,478,580.37	N/A
Outside Professional Services	$81,290.00	$79,250.00		$74,385.35
Tower Structural Analysis	$3,000.00	$3,000.00	N/A	$3,000.00	N/A
Tower Soil Analysis	$9,600.00	$9,600.00	N/A	$9,557.50	N/A
Project Management	$36,400.00	$36,400.00	Consideration for inside project management labor.	$36,390.00	N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase	$2,105.00	$2,000.00	N/A	$1,739.00	N/A
ASR modification (prepare FCC Form 854)	$2,105.00	$2,000.00	N/A	$1,544.30	N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization	$3,680.00	$3,500.00	N/A	$3,500.00	N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	$2,365.00	$2,250.00	N/A	$2,086.80	N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	$5,260.00	$5,000.00	N/A	$4,891.00	N/A
Prepare request for Special Temporary Authorization	$2,050.00	$1,500.00	N/A	N/A	N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	$1,580.00	$1,500.00	N/A	N/A	N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	$3,155.00	$3,000.00	N/A	N/A	N/A
Perform engineering study for new channel assignment and antenna development	$7,360.00	$7,000.00	N/A	$9,197.25	A percentage of these costs could be allocated for FAA engineering services as noted on invoice.
Prepare and or review reimbursement form	$2,630.00	$2,500.00	N/A	$2,479.50	The budgeted KSRE legal review cost were estimated. The actual legal costs are more than was anticipated.

Components

Actual Information Description	File Name
Tower Structural Analysis	Component Description: Tower structural analysis on existing tower. Resubmitted to include PO/Quote/Invoice. Amount: $3,000.00
Tower Soil Analysis	Component Description: Soils analysis for foundation design. Amount: $9,557.50
Project Management	Component Description: Inside project management labor. Amount: $19,380.00 Component Description: Inside project management labor request #3, including time sheets, pay stubs and letter. Amount: $2,916.00 Component Description: Inside project management labor request #2, including time sheets, pay stubs and letter. Amount: $14,094.00
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase	Component Description: Legal costs associated with FAA issues. Amount: $1,161.50 Component Description: KSRE FAA filing (Includes Quote and PO) Amount: $577.50
ASR modification (prepare FCC Form 854)	Component Description: FAA & FCC License Services Amount: $786.80 Component Description: Legal costs associated with ASR issues. Amount: $757.50
Attorney Fees - Prepare and File request for Special Temporary Authorization	Component Description: Legal/STA Amount: $3,500.00
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	Component Description: Legal Services Amount: $957.00 Component Description: Legal Services Amount: $343.00 Component Description: FAA & FCC License Services Amount: $786.80
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	Component Description: Legal Review Amount: $35.00 Component Description: Legal costs associated with construction permit. Amount: $773.50 Component Description: Legal Review Amount: $202.00 Component Description: Legal costs associated with construction permit. Amount: $2,015.00 Component Description: Legal Review Amount: $202.00 Component Description: Legal Review Amount: $738.50 Component Description: Legal costs associated with construction permit. Amount: $151.50 Component Description: Legal Review Amount: $672.50 Component Description: Legal Services Amount: $101.00
Prepare request for Special Temporary Authorization	Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	Information not provided.
Perform engineering study for new channel assignment and antenna development	Component Description: Engineering consultant cost for construction permit. Amount: $9,197.25
Prepare and or review reimbursement form	Component Description: Legal Services Amount: $151.50 Component Description: Legal Services Amount: $252.50 Component Description: Project FCC legal review costs. Amount: $50.50 Component Description: Legal review costs. Amount: $151.00 Component Description: Legal Review Amount: $50.50 Component Description: Project FCC legal review costs. Amount: $303.00 Component Description: Legal Costs Amount: N/A Component Description: Legal review costs. Amount: $409.50 Component Description: Legal costs. Amount: $50.50 Component Description: Legal repack services. Amount: $909.00 Component Description: Project FCC legal review costs. Amount: $151.50

Cost Information

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	$15,550.00	$15,000.00	N/A	$6,841.00	N/A
Total for all systems	$3,801,345.12	$3,498,653.12	N/A	$3,478,580.37	N/A
Other Expenses	$15,550.00	$15,000.00		$6,841.00
MVPD Notification of Channel Change	$2,000.00	$2,000.00	N/A	$1,175.00	N/A
DTV Medical Facility Notification	$11,550.00	$11,000.00	N/A	$4,136.50	N/A
Develop and air announcement of upcoming channel change	$2,000.00	$2,000.00	N/A	$1,529.50	N/A

Components

Actual Information Description	File Name
MVPD Notification of Channel Change	Component Description: MVPD Notification Amount: $1,175.00
DTV Medical Facility Notification	Component Description: Legal review costs. Amount: $1,186.50 Component Description: Medical facility notifications. Amount: $2,950.00
Develop and air announcement of upcoming channel change	Component Description: Legal/Consumer Notices Amount: $944.00 Component Description: Legal/Consumer Notices Amount: $585.50

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$3,801,345.12	$3,498,653.12	$3,478,580.37

Reimbursement Status

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

Certification

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.
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. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. 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). 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. 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. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.	Jack William Anderson Director of Engineering 10/07/2021

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.

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.
The above-named entity acknowledges that all certifications and attached documentation are considered material representations.
The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.
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).
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.
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.
The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.
The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.

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

Jack William Anderson

Director of Engineering

10/07/2021

Certification

Section	Question	Response
Submission of Final Allocation or Accounting Information Statements	WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.
The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. The above-named entity certifies that all costs identified as "actual costs" herein accurately represent the costs actually paid by the above-named entity, including any discounts, refunds, or rebates. 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. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.	Jack William Anderson Director of Engineering 10/07/2021

Section

Question

Response

Submission of Final Allocation or Accounting Information Statements

The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.
The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.
The above-named entity certifies that all costs identified as "actual costs" herein accurately represent the costs actually paid by the above-named entity, including any discounts, refunds, or rebates.
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.
The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.
The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.

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

Jack William Anderson

Director of Engineering

10/07/2021

(REFERENCE COPY - Not for submission) FCC Form 399: Reimbursement Request

Applicant Information

Applicant Name, Type, and Contact Information

Reimbursement Contact Information

Reimbursement Contact Name and Information

Preparer Contact Information

Preparer Contact Name and Information

Broadcaster Information and Transition Plan

Transmitters

Primary Transmitter

Existing Transmitter Information

Primary Transmitter

New Transmitter Costs

Primary Transmitter

Other Transmitter Costs

Primary Transmitter

Other Transmitter Cost Not Listed

Antennas

Primary Antenna

Existing Antenna Information

Primary Antenna

New Antenna Costs

Primary Antenna

Other Antenna Costs

Primary Antenna

Other Antenna Cost Not Listed

Transmission Line

Primary Transmission Line

Existing Transmission Line

Primary Transmission Line

New Transmission Line

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Tower Equipment And Rigging Costs

Primary Tower

Existing Tower

Primary Tower

Tower Construction Costs

Primary Tower

Tower Rigging Costs

Primary Tower

Other Tower Expenses Not Listed

Outside Professional Services Costs

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Other Expenses

Other Expenses

Other Expenses Not Listed

Cost Information

Transmitters

Components

Cost Information

Antennas

Components

Cost Information

Transmission Line

Components

Cost Information

Tower Equipment and Rigging Costs

Components