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:
30429
Service:
DCA
Call Sign:
WEPT-CD
Channel:
28 (UHF)
File Number:
0000028224
FRN:
0003768876
Date Submitted:
03/01/2022

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

VENTURE TECHNOLOGIES GROUP, LLC

5670 WILSHIRE BLVD., SUITE 1620

LOS ANGELES, CA 90036

United States

+1 (323) 965-5400 ROGOW@LOOP.COM Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

The Preparer is same as the reimbursement contact.

 

 

 

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan The plan is for WEPT is to replace the existing channel 22 system with a new channel 28 antenna, new 3" line and new transmitter.

Transmitters

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

Primary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model NX8306
Year 2012
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1.9 kW

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Manufacturer
Model TMU9-5
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 3.0 kW
Justification for New Transmitter A new transmitter is necessary because the existing transmitter does not have sufficient output power to drive the new, lower gain, antenna necessary due to tower structural limitations.

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) Yes
Transformer (480V) Yes
Power 150 kVA
Rigid Conduit and Wiring Yes
Size 2 inches
Length 20.0 feet
Other Electrical Service Yes
Description A new transmitter is necessary because the existing transmitter does not have sufficient output power to drive the lower gain antenna, which is necessary due to tower structural limitations.
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? Yes
Size 100.0 square feet
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

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 Circular
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: 15.0 kW
Manufacturer
Model ALP12M6-CSOC
Year 2014

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 Circular
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: 15.0 kW
Manufacturer
Model TFU-16DSB/VP-B-R
Year 2019
Justification for New Antenna The existing antenna is a single channel slotted Coaxial antenna. It is not capable of operating on the new channel.

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? 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? No
Broadband or Single Channel? N/A
Feed Line Size N/A
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? No
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? Yes
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Flexible Foam
Diameter 1 5/8 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 350 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Type Flexible Air
Diameter 3 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 860 feet per run
Justification for New Transmission Line The power handling of 1-5/8" line is insufficient to generate the required ERP.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Interim Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Interim
Description of Use N/A
Change Type Purchase New
Type Flexible Foam
Diameter -- inches
Segment Length N/A
Other Segment Length
Number of parallel runs 1
Length 140 feet per run
Justification for New Transmission Line WEPT-CD needs to install an interim facility because delivery of the main antenna was delayed.

Interim Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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

Primary Tower

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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? Terrain Constrained
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) No
Others Types of Users Yes
Is tower documented for structural analysis? No
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? No
ASR Number
Coordinates (NAD83) Latitude (NAD83) 42° 05' 06.0" N-
Longitude (NAD83) 074° 06' 00.0" W-
Overall Structure Height 298.55 feet
Support Structure Height 298.55 feet
Ground Elevation Above Mean Sea Level (AMSL) 2919.91 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner TAYLOR , C POWERS
Date Constructed 07/01/1985


Other Types of Users

Users
WQXE274
KUQ874
WPHS611
WQGU980
WQPU574
WQUG258

Primary Tower

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Tower Modification Costs

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

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Structural Analysis

After the tower mapping is complete, the structural analysis will need to be run.

Antenna Painting

Antenna must be painted gray due to local regulation.

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 2000
Explanation WEPT-CD does not have sufficient resource capacity and expertise in house to handle all of the Project Management related tasks necessary to facility on-time completion of the station's build by the Construction Deadline
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 No
Quantity N/A
NEPA Section 106 environmental review Yes
Environmental Assessment Yes
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 Yes
RF Field Engineering Services Comprehensive coverage verification via field study Yes
RF exposure measurements Yes
Additional Field Engineering Service Yes
Number of Days 8
Justification RF Project management of tower and transmitter installs

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning Yes
Non-zoning permits Yes
BLM or NFS Coordination Yes
FCC Construction Permit Minor Change Yes
FCC License to Cover Application Yes
FCC Special Temporary Authority Application No
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? Yes
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Name Description

Vehicle Rentals

Required for equipment delivery.

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 $253,473.75 $253,473.75 N/A $114,502.81 N/A
Total for all systems $1,372,948.75 $857,609.03 N/A $426,185.06 N/A
Primary Transmitter TMU9-5 $253,473.75 $253,473.75 $114,502.81
Other -- Building Addition Size: 100.0 $1,000.00 $1,000.00 N/A N/A N/A
Other Electrical Service: A new transmitter is necessary because the existing transmitter does not have sufficient output power to drive the lower gain antenna, which is necessary due to tower structural limitations. $5,000.00 $5,000.00 N/A $4,087.80 N/A
2" Rigid Conduit and Wiring (Cost per foot) $520.00 $520.00 N/A N/A N/A
Transformer 3 phase/480v - 150 KVA $25,550.00 $25,550.00 N/A N/A N/A
Switchgear - industrial 800 amp $38,200.00 $38,200.00 N/A N/A N/A
UHF - Air Cooled Solid State Transmitter 2.501 - 3.999 kW $155,600.00 $155,600.00 N/A $82,811.26 N/A
UHF - Air Cooled Solid State Transmitter 3.0 kW $27,603.75 $27,603.75 ***System Notice: Estimate adjusted and locked because line has been superseded.*** $27,603.75 N/A

Components

Actual Information Description File Name
Other -- Building Addition Size: 100.0 Information not provided.
Other Electrical Service: A new transmitter is necessary because the existing transmitter does not have sufficient output power to drive the lower gain antenna, which is necessary due to tower structural limitations.

Component Description:
Electrical Installation work for new transmitter.
Amount:
$4,087.80
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Transformer 3 phase/480v - 150 KVA Information not provided.
Switchgear - industrial 800 amp Information not provided.
UHF - Air Cooled Solid State Transmitter 2.501 - 3.999 kW

Component Description:
75% payment on transmitter.
Amount:
$82,811.26
UHF - Air Cooled Solid State Transmitter 3.0 kW

Component Description:
25% deposit on new transmitter.
Amount:
$27,603.75

Cost Information

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Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $33,030.00 $37,618.75 N/A $33,856.86 N/A
Total for all systems $1,372,948.75 $857,609.03 N/A $426,185.06 N/A
Primary Antenna TFU-16DSB/VP-B-R $33,030.00 $37,618.75 $33,856.86
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $26,300.00 $31,218.75 See cost estimate for comparable antenna. $28,096.86 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $5,760.00 N/A

Components

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

Component Description:
45% Payment on Antenna.
Amount:
$14,048.43

Component Description:
45% Deposit on Antenna
Amount:
$14,048.43
Sweep test of existing antenna

Component Description:
45% Deposit on Antenna Sweep
Amount:
$2,880.00

Component Description:
45% Payment on Sweep Test.
Amount:
$2,880.00

Cost Information

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Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $51,230.00 $20,530.97 N/A $4,867.27 N/A
Total for all systems $1,372,948.75 $857,609.03 N/A $426,185.06 N/A
Interim Transmission Line $490.00 $930.97 $930.97
Flexible Foam Transmission Line - dielectric, 1/2" $490.00 $930.97 Additional cost for 7/8" flanges $930.97 N/A
Primary Transmission Line $50,740.00 $19,600.00 $3,936.30
Flexible Air Transmission Line - dielectric, 3" $50,740.00 $19,600.00 N/A $3,936.30 N/A

Components

Actual Information Description File Name
Flexible Foam Transmission Line - dielectric, 1/2"

Component Description:
Interim Transmission Line
Amount:
$930.97
Flexible Air Transmission Line - dielectric, 3"

Component Description:
45% payment on transmission line.
Amount:
$1,968.15

Component Description:
45% Deposit on Transmission Line
Amount:
$1,968.15

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 $464,300.00 $280,195.40 N/A $240,695.40 N/A
Total for all systems $1,372,948.75 $857,609.03 N/A $426,185.06 N/A
Primary Tower TOWER $464,300.00 $280,195.40 $240,695.40
Antenna Painting $5,000.00 $5,000.00 N/A N/A N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $25,000.00 N/A N/A N/A
Structural Analysis $12,000.00 $12,000.00 N/A $2,500.00 N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $238,195.40 N/A $238,195.40 N/A

Components

Actual Information Description File Name
Antenna Painting Information not provided.
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study Information not provided.
Structural Analysis

Component Description:
Structural Analysis
Amount:
$2,500.00
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)

Component Description:
DISREGARD
Amount:
N/A

Component Description:
DISREGARD
Amount:
N/A

Component Description:
DISREGARD
Amount:
N/A

Component Description:
Removal of old antenna.
Amount:
$10,130.40

Component Description:
Tower Crew: Install antenna and line.
Amount:
$228,065.30

Component Description:
Credit Memo.
Amount:
($0.30)

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 $468,420.00 $163,895.16 N/A $24,456.61 N/A
Total for all systems $1,372,948.75 $857,609.03 N/A $426,185.06 N/A
Outside Professional Services $468,420.00 $163,895.16 $24,456.61
Additional Field Engineering Service, 8 Days $1,150.00 $1,150.00 N/A $1,150.00 N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A N/A N/A
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet $10,520.00 $10,000.00 N/A N/A N/A
NEPA Section 106 environmental review, if needed $6,310.00 $6,000.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $4,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A N/A N/A
Prepare 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 $2,400.00 N/A
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $850.00 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $1,061.45 N/A
Project management of the transition $316,000.00 $18,995.16 N/A $18,995.16 N/A

Components

Actual Information Description File Name
Additional Field Engineering Service, 8 Days

Component Description:
Onsite engineering Svcs.
Amount:
$1,150.00
Comprehensive coverage verification via field study, if needed Information not provided.
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet Information not provided.
NEPA Section 106 environmental review, if needed Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application Information not provided.
Prepare 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:
Preparation of revised engineering portion of initial FCC Application for Construction Permit for repack facility on Channel 28 for WEPT-CD in Newburgh, NY; e-filing
Amount:
$650.00

Component Description:
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application
Amount:
$1,750.00
RF Exposure Measurements Information not provided.
Perform engineering study for new channel assignment and antenna development

Component Description:
Interference study of repack Channel 28 for WEPT-CD in Newburgh, NY; email report; preparation of engineering portion of initial FCC Application for Construction Permit for repack facility; e-filing
Amount:
$850.00
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form

Component Description:
Budget Review.
Amount:
$110.25

Component Description:
Budget Review, Budget Form Prep and Submission.
Amount:
$450.85

Component Description:
Budget Review, Budget Form Prep and Submission.
Amount:
$500.35
Project management of the transition

Component Description:
Project Management
Amount:
$1,582.05

Component Description:
Technical , Consultation and Planning Services. Review and answering technical questions through a telephone conference call for the follow up report for the Re-pack.
Amount:
$75.00

Component Description:
Project Management
Amount:
$1,547.30

Component Description:
Project Management
Amount:
$2,140.90

Component Description:
Project Management
Amount:
$859.05

Component Description:
Project Management
Amount:
$2,318.90

Component Description:
Credit Memo
Amount:
($20.44)

Component Description:
Project Management
Amount:
$1,109.85

Component Description:
Technical , Consultation and Planning Services.
Amount:
$54.60

Component Description:
Technical , Consultation and Planning Services. Technical , Consultation and Planning Services with Sam Hariton (Widelity).
Amount:
$75.00

Component Description:
Technical , Consultation and Planning Services. Attended a conference at Rohde and Schwartz on 3/6/2017 concerning the 399 re-pack documentation.
Amount:
$75.00

Component Description:
Project Management
Amount:
$1,334.05

Component Description:
Project Management
Amount:
$1,301.65

Component Description:
Project Management.
Amount:
$210.00

Component Description:
Re-pack consulting and updating.
Amount:
$75.00

Component Description:
Project Management
Amount:
$2,011.20

Component Description:
Technical Consultation and planning services.
Amount:
$54.60

Component Description:
Technical Consultation and planning services.
Amount:
$5.46

Component Description:
Project Management
Amount:
$684.20

Component Description:
Technical Consultation and Planning Services
Amount:
$54.60

Component Description:
Project Management
Amount:
$1,477.35

Component Description:
Technical , Consultation and Planning Services. Attended conference at Rohde and Swartz concerning the re-pack Form 399.
Amount:
$189.00

Component Description:
Project Management
Amount:
$760.70

Component Description:
Project Management
Amount:
$1,450.85

Component Description:
Project Management
Amount:
$557.75

Component Description:
Technical consultation and planning services.
Amount:
$136.50

Component Description:
Technical , Consultation and Planning Services. Three conference calls
Amount:
$75.00

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $102,495.00 $101,895.00 N/A $7,806.11 N/A
Total for all systems $1,372,948.75 $857,609.03 N/A $426,185.06 N/A
Other Expenses $102,495.00 $101,895.00 $7,806.11
Vehicle Rentals $5,000.00 $5,000.00 N/A N/A N/A
MVPD Notification of Channel Change $2,000.00 $2,000.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $15,000.00 $15,000.00 N/A N/A N/A
Equipment Storage $10,000.00 $10,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $15,000.00 $15,000.00 N/A $421.25 N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A $5,798.00 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 $325.00 N/A N/A N/A
Local Zoning $20,000.00 $20,000.00 N/A N/A N/A
Non-zoning permits $2,500.00 $2,500.00 N/A N/A N/A
BLM or NFS Coordination $10,000.00 $10,000.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $10,000.00 $10,000.00 N/A $1,586.86 N/A

Components

Actual Information Description File Name
Vehicle Rentals Information not provided.
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges

Component Description:
Freight and shipping fees.
Amount:
$421.25
DTV Medical Facility Notification

Component Description:
Medical Facility Notification
Amount:
$5,798.00
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
Local Zoning Information not provided.
Non-zoning permits Information not provided.
BLM or NFS Coordination Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
Removal of old transmission equipment.
Amount:
$1,586.86

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $1,372,948.75 $857,609.03 $426,185.06

Reimbursement Status

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

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.

Andy Wilcoxson

General Manager


03/01/2022

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.

Andy Wilcoxson

General Manager


03/01/2022

Certification

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Section Question Response
Submission of Final Allocation or Accounting Information Statements

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

  1. The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

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

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

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

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

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

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

Andy Wilcoxson

General Manager


03/01/2022

Attachments

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