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:
41398
Service:
DTV
Call Sign:
WNPT
Channel:
7 (High VHF)
File Number:
0000028087
FRN:
0005423389
Date Submitted:
05/03/2022

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

NASHVILLE PUBLIC TELEVISION, INC.

Daniel Tidwell

161 RAINS AVENUE

NASHVILLE, TN 37203

United States

+1 (615) 259-9325 DTIDWELL@WNPT.ORG Not-for-Profit

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

Dale Howard

Dale Howard & Associates

Dale Howard

4949 Lakeridge Drive

Old Hickory, TN 37138

United States

+1 (615) 202-3253 dale@multiwavelengths.com

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 Station will be replacing a top mounted antenna on a tower that no other television entity is co-located on.

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 PTCD5P1-i
Year 2008
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 2.0 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? No
Manufacturer
Model TMU9C
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2.9 kW
Justification for New Transmitter Per GatesAir, they"will continue to provide service support for this system through 2022 we will not be able to provide channel change assistance for this transmitter due to all the frequency change components involved.

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 Install EMT conduit and wiring to circuit breaker box.
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

Antennas

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

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? No
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 Top Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Other
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 Panel
ERP: 17.65 kW
Manufacturer
Model TAD-12HD-4/24
Year 1997

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? No
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 Elliptical
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 20.0 kW
Manufacturer
Model ATW12V5-ETO-7H
Year 2020
Justification for New Antenna Current antenna was originally purchased for analog channel 8. Used for channel 8 digital and response is flat across the channel. At channel 7, the response drops 10 dB from the upper side of the channel to the lower side.

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? Yes
Broadband or Single Channel? Single Channel
Feed Line Size 6 1/8 inches inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna?
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

TV System Sweep

Sweep for new main antenna after installed

Custom Pedestal

For primary antenna

Antenna Tuning

Additional Labor needed for antenna system tuning issues

Interim Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? No
Will antenna be located on or in close proximity to an antenna farm? No
New 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/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 20.0 kW
Manufacturer
Model ALV2V0-HSOC-8
Year 2020
Justification for New Antenna Interim antenna was necessary as to not interrupt the station being on air during transition - Equipment needed to be removed prior to install of new antenna

Interim Antenna

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Other Antenna Costs

Section Question Response
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 an 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

Interim 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 Utilize Existing
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer Dielectric
Type Rigid
Diameter Other
Other Diameter 6 inches
Segment Length 19 1/2 inches
Other Segment Length N/A
Number of parallel runs 1
Length 25 feet per run

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Interim Antenna Section

ERI - Additional 110' section necessary because side-mount antenna being placed lower than originally planned

Main Antenna Section

ERI - Additional Sections needed to connect to main antenna

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 Owned
Is this tower consider Complex? No
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users No
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? No
ASR Number
Coordinates (NAD83) Latitude (NAD83) 36° 02' 50.0" N-
Longitude (NAD83) 086° 49' 49.0" W-
Overall Structure Height 943.89 feet
Support Structure Height 943.89 feet
Ground Elevation Above Mean Sea Level (AMSL) 1104.97 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Young Broadcasting of Nashville LLC
Date Constructed 01/01/1973

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
59815 WSIX-FM FM

Primary Tower

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Tower Modification Costs

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

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Mobilization No.2

Main Antenna installation

Electronics Research Inc

Gin Pole Support Assembly

Mobilization No.1

Install Interim antenna

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 120
Explanation Station doesn't employ anyone with the necessary RF expertise.
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development No
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 No
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 No
Additional Field Engineering Service Yes
Number of Days 3
Justification Testing of temporary antenna and testing of system after installation

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Administrative

Admin details

Form 399 Assistance

Assist with Form 399 preparation

Legal Fees

Legal Fees associated with transition

Other Expenses

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

Other Expenses

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Other Expenses Not Listed

Name Description

Installation

Dale Howard Invoice 05252021- Installation Services

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 $157,500.00 $110,046.30 N/A $107,258.43 N/A
Total for all systems $1,390,840.06 $1,328,791.36 N/A $1,047,769.73 N/A
Primary Transmitter TMU9C $157,500.00 $110,046.30 $107,258.43
High VHF - Air Cooled Solid State Transmitter 1.1 . 4.4 kW $152,500.00 $105,046.30 N/A $105,046.30 N/A
Other Electrical Service: Install EMT conduit and wiring to circuit breaker box. $5,000.00 $5,000.00 N/A $2,212.13 N/A

Components

Actual Information Description File Name
High VHF - Air Cooled Solid State Transmitter 1.1 . 4.4 kW

Component Description:
Parts for transmitter
Amount:
$1,932.80

Component Description:
Balance of transmitter
Amount:
$77,335.12

Component Description:
25% down payment for transmitter
Amount:
$25,778.38
Other Electrical Service: Install EMT conduit and wiring to circuit breaker box.

Component Description:
Electrical parts and labor
Amount:
$2,212.13

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 $343,516.16 $343,186.16 N/A $322,708.36 N/A
Total for all systems $1,390,840.06 $1,328,791.36 N/A $1,047,769.73 N/A
Interim Antenna ALV2V0-HSOC-8 $38,875.50 $38,875.50 $32,145.50
High VHF - High Power Side Mount One Station horizontally polarized $32,145.50 $32,145.50 N/A $32,145.50 N/A
Sweep test of existing antenna $6,730.00 $6,730.00 N/A $0.00 N/A
Primary Antenna ATW12V5-ETO-7H $304,640.66 $304,310.66 $290,562.86
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $1,200.00 N/A
Antenna Tuning $1,800.00 $1,800.00 N/A $1,800.00 N/A
Custom Pedestal $45,620.00 $45,620.00 N/A $45,620.00 N/A
TV System Sweep $6,250.00 $6,250.00 N/A $6,250.00 N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $12,300.00 N/A $3,752.20 N/A
High VHF - High Power Top Mount One Station elliptically or circularly polarized $231,940.66 $231,940.66 N/A $231,940.66 N/A

Components

Actual Information Description File Name
High VHF - High Power Side Mount One Station horizontally polarized

Component Description:
50% balance due for interim antenna
Amount:
$9,073.75

Component Description:
50% deposit for interim antenna
Amount:
$9,073.75

Component Description:
Balance Due - interim antenna install
Amount:
$6,999.00

Component Description:
50% deposit Antenna Install
Amount:
$6,999.00
Sweep test of existing antenna Information not provided.
Sweep test of existing antenna

Component Description:
Sweep test of existing antenna
Amount:
$1,200.00
Antenna Tuning

Component Description:
Additional Labor need to address antenna tuning issues
Amount:
$1,800.00
Custom Pedestal

Component Description:
50% Balance due for custom pedestal
Amount:
$22,810.00

Component Description:
50% deposit for custom pedestal
Amount:
$22,810.00
TV System Sweep

Component Description:
50% deposit for Sweep
Amount:
$3,125.00

Component Description:
40% of Sweep
Amount:
$2,500.00

Component Description:
Balance due (10% ) for sweep
Amount:
$625.00
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
Dielectric elbows for main antenna
Amount:
$3,752.20
High VHF - High Power Top Mount One Station elliptically or circularly polarized

Component Description:
Remaining 50% for main antenna
Amount:
$113,485.00

Component Description:
50% Deposit for main antenna
Amount:
$113,485.00

Component Description:
Round Member Adaptors
Amount:
$45.66

Component Description:
Balance due for Custom Exit platform
Amount:
$2,462.50

Component Description:
50% deposit for custom exit platform
Amount:
$2,462.50

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 $32,846.51 $32,846.51 N/A $32,846.50 N/A
Total for all systems $1,390,840.06 $1,328,791.36 N/A $1,047,769.73 N/A
Primary Transmission Line $32,846.51 $32,846.51 $32,846.50
Interim Antenna Section $6,723.96 $6,723.96 N/A $6,723.96 N/A
Main Antenna Section $26,122.55 $26,122.55 N/A $26,122.54 N/A

Components

Actual Information Description File Name
Interim Antenna Section

Component Description:
50% deposit - trans line interim antenna
Amount:
$3,361.98

Component Description:
Balance due - trans line- interim antenna
Amount:
$3,361.98
Main Antenna Section

Component Description:
50% balance due for trans line -main antenna
Amount:
$13,473.94

Component Description:
50% deposit for trans line- main antenna
Amount:
$13,473.95

Component Description:
Credits for 2 line items, part 40392-4 (page 6 of proposal) and MAX650-10 (page 7 of proposal)
Amount:
($1,659.20)

Component Description:
Custom Section of Trans Line - Main Antenna
Amount:
$833.85

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 $747,068.38 $735,968.38 N/A $528,468.37 N/A
Total for all systems $1,390,840.06 $1,328,791.36 N/A $1,047,769.73 N/A
Primary Tower TOWER $747,068.38 $735,968.38 $528,468.37
Mobilization No.1 $89,418.00 $89,418.00 N/A $89,418.00 N/A
Electronics Research Inc $11,791.38 $11,791.38 N/A $11,791.38 N/A
Tall Tower (greater than 500') $210,500.00 $200,000.00 N/A N/A N/A
Structural engineering tower load study for well documented tower $12,600.00 $12,000.00 N/A $4,500.00 N/A
Mobilization No.2 $422,759.00 $422,759.00 N/A $422,758.99 N/A

Components

Actual Information Description File Name
Mobilization No.1

Component Description:
40% due for services - interim antenna intall
Amount:
$35,767.20

Component Description:
50% deposit for services -interim antenna install -
Amount:
$44,709.00

Component Description:
Balance Due (10%) for services - interim antenna install
Amount:
$8,941.80
Electronics Research Inc

Component Description:
Gin Pole Support assembly
Amount:
$11,791.38
Tall Tower (greater than 500') Information not provided.
Structural engineering tower load study for well documented tower

Component Description:
Analysis of tower
Amount:
$4,500.00
Mobilization No.2

Component Description:
40% due for services - main antenna
Amount:
$169,103.60

Component Description:
50% deposit for services - Main Antenna
Amount:
$211,379.49

Component Description:
Balance due (10%) for services - main antenna
Amount:
$42,275.90

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 $56,984.75 $54,424.75 N/A $23,224.75 N/A
Total for all systems $1,390,840.06 $1,328,791.36 N/A $1,047,769.73 N/A
Outside Professional Services $56,984.75 $54,424.75 $23,224.75
Legal Fees $6,602.25 $6,602.25 N/A $6,602.25 N/A
Form 399 Assistance $3,487.50 $3,487.50 N/A $3,487.50 N/A
Administrative $210.00 $210.00 N/A $210.00 N/A
Additional Field Engineering Service, 3 Days $4,375.00 $4,375.00 N/A $4,375.00 N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,500.00 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 request for Special Temporary Authorization $2,050.00 $1,500.00 N/A $112.50 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A $150.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $112.50 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 $900.00 N/A
Project management of the transition $18,960.00 $18,000.00 N/A $7,275.00 N/A

Components

Actual Information Description File Name
Legal Fees

Component Description:
Services thru Nov 2020
Amount:
$1,023.00

Component Description:
Services thru Oct 202
Amount:
$1,528.55

Component Description:
Services thru Feb 2018
Amount:
$217.00

Component Description:
Services thru July 31, 2020
Amount:
$889.35

Component Description:
Services thru June 2017
Amount:
$558.95

Component Description:
Services thru Oct 2017
Amount:
$406.00

Component Description:
Services thru Sept 202
Amount:
$634.00

Component Description:
Services thru July 2017
Amount:
$1,345.40
Form 399 Assistance

Component Description:
Form 399 assistance
Amount:
$3,487.50
Administrative

Component Description:
Admin Duties 7-15-20
Amount:
$70.00

Component Description:
Admin Duties July 3-4 2020
Amount:
$140.00
Additional Field Engineering Service, 3 Days

Component Description:
40% Due for engineering climbing inspection
Amount:
$1,700.00

Component Description:
50% deposit for engineering climbing inspection
Amount:
$2,125.00

Component Description:
Balance Due (10%) for engineering climbing inspection
Amount:
$425.00

Component Description:
Engineering Support
Amount:
$125.00
Attorney Fees - Prepare and File request for Special Temporary Authorization 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 request for Special Temporary Authorization

Component Description:
Prep STA Request
Amount:
$112.50
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
Engineering Section of License to Cover
Amount:
$150.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Engineering Section of Construction Permit
Amount:
$112.50
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form

Component Description:
Reimbursement Analysis
Amount:
$900.00
Project management of the transition

Component Description:
Project Management
Amount:
$3,225.00

Component Description:
Project Mgmt
Amount:
$4,050.00

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 $52,924.26 $52,319.26 N/A $33,263.32 N/A
Total for all systems $1,390,840.06 $1,328,791.36 N/A $1,047,769.73 N/A
Other Expenses $52,924.26 $52,319.26 $33,263.32
Equipment Delivery and Handling Charges $17,059.26 $17,059.26 N/A $17,059.26 N/A
Installation $9,675.00 $9,675.00 N/A $9,675.00 N/A
MVPD Notification of Channel Change $5,000.00 $5,000.00 N/A $1,950.00 N/A
Develop and air announcement of upcoming channel change $5,000.00 $5,000.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $3,000.00 $3,000.00 N/A $829.06 N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 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
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A $3,750.00 N/A

Components

Actual Information Description File Name
Equipment Delivery and Handling Charges

Component Description:
Custom Hauling - main antenna, & Gin Pole
Amount:
$10,072.20

Component Description:
Additional cost to transport Gin Pole off site
Amount:
$1,410.00

Component Description:
Shipping on Dale's invoice 05252021
Amount:
$230.31

Component Description:
Freight
Amount:
$9.42

Component Description:
Freight to include invoices WNPT-6000, WNPT-38051, WNPT-38051-1
Amount:
$5,337.33
Installation

Component Description:
Installation Services throughout project
Amount:
$9,675.00
MVPD Notification of Channel Change

Component Description:
MVPD Channel Change notification
Amount:
$1,950.00
Develop and air announcement of upcoming channel change Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
40yd flat Disposal
Amount:
$580.89

Component Description:
Delivery of 40yd open top
Amount:
$248.17
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:
Medical Notification Mailing
Amount:
$3,750.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $1,390,840.06 $1,328,791.36 $1,047,769.73

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. No

Certification

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Section Question Response
Submission of Estimated Expenses Statements

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

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

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

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

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

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

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

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

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

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

Kathy Jo McElroy

Senior VP & CFO


05/03/2022

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.

Kathy Jo McElroy

Senior VP & CFO


05/03/2022

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.

Kathy Jo McElroy

Senor VP & CFO


05/03/2022

Attachments

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