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:
37689
Service:
DCA
Call Sign:
KAXT-CD
Channel:
42 (UHF)
File Number:
0000027888
FRN:
0028887503
Date Submitted:
03/18/2022

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

KAXT-TV LLC

Doing Business As: KAXT-TV LLC

Norman H. Shapiro

26 NORTH HALSTED STREET

CHICAGO, IL 60661

United States

+1 (312) 705-2600 nshapiro@wciu.com Corporation

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

The Preparer is same as the reimbursement contact.

 

 

 

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. Yes
Briefly describe transition plan See attached Transition Plan Narrative.

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 AT71K0-1
Year 2009
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1 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 THU9evo-3
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 4.9 kW
Justification for New Transmitter Please see attached Transition Plan Narrative.

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 Yes
Description Establish new 480V/200A service with meter at the new location.
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 10 tons
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? 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

Name Description

Transmitter Installation

Installation of the new Primary transmitter

Remove Existing Equipment

Landlord requires the removal of abandoned equipment in the leased space before installation of new.

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? Yes
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 PSILPD12AXT-42-CP
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? No
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? Yes
New Antenna Manufacturer and Types Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Circular
Type Broadband Panel
Number of Stations Supported 1
Number of Panels/Bays 2
Lower Limit 518.00 MHz
Upper Limit 524.00 MHz
Design power capacity in use 100.0 %
Other Antenna Type N/A
ERP: 15.0 kW
Manufacturer
Model TUM-C2-2/4M-1 SM
Year 2018
Justification for New Antenna See attached Transition Plan Narrative.

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? 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 Air
Diameter 1 5/8 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 178 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? No
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 525 feet per run
Justification for New Transmission Line Please see attached Transition Plan Narrative.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Dehydrator

Dry Air Dehydrator for new Primary transmission line

Reducer

A 3" to 1-5/8" reducer required at the output of the Primary transmitter RF system to the input of the Primary transmission line

Elbow

A elbow required for the transition at the base of the tower

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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Add Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? Candelabra
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users No
Is tower documented for structural analysis? Unknown
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1044718
Coordinates (NAD83) Latitude (NAD83) 37° 29' 57.0" N-
Longitude (NAD83) 121° 52' 20.0" W-
Overall Structure Height 442.91 feet
Support Structure Height 392.06 feet
Ground Elevation Above Mean Sea Level (AMSL) 2605.94 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Univision Television Group, Inc.
Date Constructed 02/25/1998

FM, AM or TV radio broadcasters. Facility ID's, Call Signs and Services of other broadcast stations with whom the tower is shared

Facility ID Call Sign Service
64987 KSTS DTV
33778 KDTV-DT DTV

Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Study needed for tower with candelabra
Tower Reinforcements Please select whether tower reinforcements are needed: Minor Reinforcements needed

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Remove existing equipment

Remove existing antenna and transmission line from the current tower after the transition.

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 350
Explanation Please see attached Transition Plan Narrative.
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements Yes
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Site Survey

Required for specifying the final equipment needs and installation planning.

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

Other Expenses

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Other Expenses Not Listed

Name Description

Studio to Transmitter Link

Additional microwave equipment to facilitate the transition to the new tower site while maintaining operations at the existing site during the interim.

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 $369,195.00 $149,971.61 N/A $149,971.61 N/A
Total for all systems $1,166,618.17 $318,387.72 N/A $318,387.72 N/A
Primary Transmitter THU9evo-3 $369,195.00 $149,971.61 $149,971.61
Remove Existing Equipment $0.00 $0.00 A technician from Harmonic, Inc took the transmitter and related components, free of charge. N/A N/A
Transmitter Installation $30,000.00 $30,000.00 Installation of the KAXT Primary transmitter $30,000.00 N/A
10 Ton system $38,900.00 $12,637.50 N/A $12,637.50 N/A
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW $273,500.00 $80,539.11 N/A $80,539.11 N/A
Other Electrical Service: Establish new 480V/200A service with meter at the new location. $26,795.00 $26,795.00 This is the cost for the material and installation for the electrical related to the Primary transmitter installation. This new space had no electrical infrastructure. As a result, a new build-out from the meter to the transmitter was required. $26,795.00 Total

Components

Actual Information Description File Name
Remove Existing Equipment Information not provided.
Transmitter Installation

Component Description:
KAXT Primary transmitter installation downpayment
Amount:
$15,000.00

Component Description:
KAXT Primary transmitter installation final payment
Amount:
$15,000.00
10 Ton system

Component Description:
KAXT Primary transmitter HVAC material and installation
Amount:
$12,637.50
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW

Component Description:
KAXT Primary Transmitter Shipping Invoice
Amount:
$5,000.00

Component Description:
KAXT Primary Transmitter and Sales Tax Invoice
Amount:
$75,539.11

Component Description:
KAXT Primary Transmitter Payment. This amount represents the total eligible amount.
Amount:
$75,539.11

Component Description:
KAXT Primary transmitter shipping
Amount:
$5,000.00
Other Electrical Service: Establish new 480V/200A service with meter at the new location.

Component Description:
KAXT Primary Transmitter Electrical Invoice
Amount:
$26,795.00

Component Description:
KAXT Primary transmitter electrical material and installation
Amount:
$26,795.00

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 $35,550.00 $51,112.00 N/A $51,112.00 N/A
Total for all systems $1,166,618.17 $318,387.72 N/A $318,387.72 N/A
Primary Antenna TUM-C2-2/4M-1 SM $35,550.00 $51,112.00 $51,112.00
UHF - Lower Power Side Mount, Class A broadband panel (cost per panel) $2,520.00 $0.00 This is included in the cost of the Primary antenna N/A N/A
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $26,300.00 $44,712.00 This is for the Primary antenna, including shipping and mounts. This is a circularly polarized antenna. $44,712.00 Test
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $6,400.00 N/A

Components

Actual Information Description File Name
UHF - Lower Power Side Mount, Class A broadband panel (cost per panel) Information not provided.
UHF - Lower Power Side Mount, Class A One Station antenna -- basic

Component Description:
KAXT Primary antenna final payment
Amount:
$4,813.52

Component Description:
KAXT Primary Antenna Shipping Invoice
Amount:
$5,865.00

Component Description:
KAXT Primary Antenna Downpayment Invoice
Amount:
$34,033.48

Component Description:
KAXT Primary antenna shipping
Amount:
$5,865.00

Component Description:
KAXT Primary antenna downpayment
Amount:
$34,033.48
Sweep test of existing antenna

Component Description:
KAXT Primary antenna system sweep
Amount:
$6,400.00

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 $35,913.17 $26,843.17 N/A $26,843.17 N/A
Total for all systems $1,166,618.17 $318,387.72 N/A $318,387.72 N/A
Primary Transmission Line $35,913.17 $26,843.17 $26,843.17
Elbow $1,504.13 $1,504.13 A elbow required for the transition at the base of the tower $1,504.13 N/A
Reducer $660.04 $660.04 A 3" to 1-5/8" reducer required at the output of the Primary transmitter RF system to the input of the Primary transmission line $660.04 N/A
Dehydrator $2,774.00 $2,774.00 Dry Air Dehydrator for new Primary transmission line $2,774.00 N/A
Flexible Air Transmission Line - dielectric, 3" $30,975.00 $21,905.00 N/A $21,905.00 N/A

Components

Actual Information Description File Name
Elbow

Component Description:
KAXT Primary transmission line elbow shipping
Amount:
$343.35

Component Description:
KAXT Primary transmission line elbow
Amount:
$1,062.50

Component Description:
KAXT Primary transmission line elbow sales tax
Amount:
$98.28
Reducer

Component Description:
KAXT Primary transmission line reducer shipping
Amount:
$158.58

Component Description:
KAXT Primary transmission line reducer sales tax
Amount:
$42.46

Component Description:
KAXT Primary transmission line reducer
Amount:
$459.00
Dehydrator

Component Description:
KAXT Primary transmission line dehydrator downpayment
Amount:
$1,402.00

Component Description:
KAXT Primary transmission line dehydrator downpayment
Amount:
$1,372.00
Flexible Air Transmission Line - dielectric, 3"

Component Description:
KAXT Primary transmission line final payment
Amount:
$12,615.00

Component Description:
KAXT Primary transmission line downpayment
Amount:
$9,290.00

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 $599,000.00 $66,418.74 N/A $66,418.74 N/A
Total for all systems $1,166,618.17 $318,387.72 N/A $318,387.72 N/A
Primary Tower TOWER $599,000.00 $66,418.74 $66,418.74
Remove existing equipment $0.00 $0.00 Remove existing antenna and transmission line from the current tower after the transition. N/A N/A
Structural engineering tower load study for a documented tower with candelabra $20,000.00 $0.00 This was included as part of another analysis prior to Weigel's acquisition of KAXT. N/A N/A
Minor tower reinforcement/modifications $158,000.00 $0.00 No tower work was needed. Only the antenna and line installation was required, which was covered under the Complex Tower line item. N/A N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $66,418.74 N/A $66,418.74 N/A

Components

Actual Information Description File Name
Remove existing equipment Information not provided.
Structural engineering tower load study for a documented tower with candelabra Information not provided.
Minor tower reinforcement/modifications Information not provided.
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)

Component Description:
KAXT Primary tower complex tower downpayment
Amount:
$28,250.00

Component Description:
KAXT Primary tower, complex tower, additional costs
Amount:
$9,918.74

Component Description:
KAXT Primary tower complex tower downpayment
Amount:
$28,250.00

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 $111,270.00 $18,592.20 N/A $18,592.20 N/A
Total for all systems $1,166,618.17 $318,387.72 N/A $318,387.72 N/A
Outside Professional Services $111,270.00 $18,592.20 $18,592.20
Site Survey $0.00 $0.00 Weigel managed this in-house. $0.00 N/A
RF Exposure Measurements $21,050.00 $0.00 This was not needed, as it was conducted by the tower owner. N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $8,208.00 KAXT was scheduled for Phase 9. However, due to delays caused by the COVID pandemic, KAXT was not able to complete the buildout. As a result, a waiver and related STA was requested and granted to move to Phase 10. $8,208.00 Test
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $0.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $1,122.00 N/A $1,122.00 N/A
Prepare request for Special Temporary Authorization $2,050.00 $0.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $125.00 N/A $125.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $2,250.00 N/A $2,250.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $3,150.00 N/A $3,150.00 The engineering study requirements were more than originally estimated.
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $0.00 The San Francisco market conducted a coordinated effort led by KGO. All of the local broadcasters participated and coordinated among themselves. N/A N/A
Prepare and or review reimbursement form $2,630.00 $3,312.70 N/A $3,312.70 The estimated cost was for the work of our consulting engineers and did not include attorney's fees.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $387.00 N/A $387.00 N/A
Project management of the transition $55,300.00 $37.50 N/A $37.50 N/A

Components

Actual Information Description File Name
Site Survey

Component Description:
Please refer to line 5 of the invoice for details
Amount:
$1,796.01
RF Exposure Measurements Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
KAXT Attorney fees, STA
Amount:
$1,782.00

Component Description:
KAXT Attorney fees, STA
Amount:
$2,520.00

Component Description:
KAXT Attorney fees, STA
Amount:
$3,906.00
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

Component Description:
KAXT Attorney fees, license to cover
Amount:
$1,122.00
Prepare request for Special Temporary Authorization Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
KAXT Engineering fees, license to cover
Amount:
$125.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Please see line 1 of the invoice - Prepare engineering section of FCC form 2100, construction permit application.
Amount:
$2,250.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Please refer to line 4 of the invoice for details
Amount:
$1,693.75

Component Description:
Please refer to line 6 of the invoice for details
Amount:
$887.50

Component Description:
Please refer to line 3 of the invoice for details
Amount:
$1,598.81

Component Description:
Please see line 3 of the invoice - Perform engineering study for new channel assignment and antenna development.
Amount:
$1,800.00

Component Description:
Please refer to line three of the invoice - KAXT-CD Perform engineering study for new channel assignment and antenna development
Amount:
$1,350.00
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form

Component Description:
Please see line 2 of the invoice - Prepare and or review reimbursement form
Amount:
$2,500.00

Component Description:
Please refer to lines 1,2,5 and 6 of the attached invoice totaling $903. Less the 10% discount received the amount due is $812.70. Please note the hours and rates are provided at the bottom of the invoice.
Amount:
$812.70
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Please see lines 3 and 4 of the attached invoice totaling $430. Less the 10% discount received the amount due is $387. Please note the hours and rates are provided at the bottom of the invoice.
Amount:
$387.00
Project management of the transition

Component Description:
Please refer to line 3 of the invoice for details
Amount:
$37.50

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 $15,690.00 $5,450.00 N/A $5,450.00 N/A
Total for all systems $1,166,618.17 $318,387.72 N/A $318,387.72 N/A
Other Expenses $15,690.00 $5,450.00 $5,450.00
Studio to Transmitter Link $0.00 $0.00 N/A N/A N/A
MVPD Notification of Channel Change $0.00 $0.00 Weigel handled this in-house. N/A N/A
Develop and air announcement of upcoming channel change $0.00 $0.00 This was handled by Weigel in-house at no cost N/A N/A
Equipment Storage $0.00 $0.00 Equipment was stored on site at no cost. N/A N/A
Equipment Delivery and Handling Charges $0.00 $0.00 Equipment was offloaded on site as part of the shipping costs already submitted. N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $0.00 $0.00 The tower owner provided dumpster services for KAXT at no cost. N/A N/A
Non-zoning permits $2,500.00 $2,500.00 Permits were required for the Primary antenna installation. $2,500.00 N/A
Local Zoning $0.00 $0.00 Local zoning was not required. N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $0.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $0.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $0.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $2,950.00 N/A $2,950.00 N/A

Components

Actual Information Description File Name
Studio to Transmitter Link 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 Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Non-zoning permits

Component Description:
KAXT Primary tower permit
Amount:
$2,500.00
Local Zoning Information not provided.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
DTV Medical Facility Notification

Component Description:
KAXT DTV Medical Notification
Amount:
$2,950.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $1,166,618.17 $318,387.72 $318,387.72

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.

Kyle Walker

VP, Technology


03/18/2022

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.

Kyle Walker

VP, Technology


03/18/2022

Attachments

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