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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:
51609
Service:
LPT
Call Sign:
K14RF-D
Channel:
14 (UHF)
File Number:
0000089293
FRN:
0002710192
Eligibility Status:
Eligible
Date Submitted:
06/14/2022

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

SCRIPPS BROADCASTING HOLDINGS LLC

Doing Business As: KTVQ COMMUNICATIONS, LLC

David Giles

312 Walnut St

28th Floor

Cincinnati, OH 45202

United States

 +1 (513) 977-3891 DAVE.GILES@SCRIPPS.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

Ray Thurber

Scripps Broadcasting Holdings LLC

Ray Thurber

312 Walnut St.

Suite 2800

Cincinnati, OH 45202

United States

 +1 (513) 898-4050 ray.thurber@scripps.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. Yes
Briefly describe transition plan Retune existing translator, fed into combiner and shared antenna

Transmitters

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Section Question Response
Transmitter Related Expenses Do you have transmitter related expenses? No

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)
Ownership Owned
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
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
ERP: 5.0 kW
Manufacturer
Model SL-8
Year 1990

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Change Type Purchase New
Ownership Owned
Is antenna shared? Yes
Is antenna directional? No
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Other
Other Antenna Type Broadband Superturnstile
ERP: 5.0 kW
Manufacturer
Model UTV-11/4
Year 2018
Justification for New Antenna Old antenna was cut channel 43.

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? Yes
Type New
Number of channels supported 5
Frequencies of channels supported RF channel
Elbow Complex Do you require the separate purchase of the Elbow Complex? 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? No

Enter a list of RF channel numbers.

RF Channel Number
40
14
19
25
30

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Primary Antenna - Custom Mounting Assembly

Primary Antenna - Custom Mounting Assembly

Transmission Line

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

Tower Equipment And Rigging Costs

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Section Question Response
Tower Equipment or Rigging Costs Changes Do you have tower equipment or rigging costs changes? No

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 194
Explanation K14RF-D requires the aid of outside project management services in order to fulfill the requirements of the repack. K14RF-D does not have sufficient resource capacity and expertise in house to handle all tasks associated with the repack.
Outside RF consulting Engineering Services Perform engineering study for displacement application 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
Prepare Form 601 No
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
Negotiation of Lease and other Matter for Shared Locations Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Form 399 assistance or other program management costs Yes
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements No
Additional Field Engineering Service No

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
Permit and Filing Costs FCC Construction Permit Major Change No
FCC Construction Permit Minor Change No
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)? No
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? No
Point to Point Microwave (STL/ICR) Frequency Coordination for Unidirection System No
Frequency Coordination for Bi-Direction System No
New Point to Point Microwave System No

Other Expenses

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Other Expenses Not Listed

Name Description

Combiner

Combiner for shared antenna

Cost Information

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Transmitters

Information not provided.

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 $2,057.66 $2,057.66 N/A $2,057.66 N/A
Total for all systems $71,898.47 $53,837.80 N/A $32,043.53 N/A
Primary Antenna UTV-11/4 $2,057.66 $2,057.66 $2,057.66
UHF-Low Power, Top Mount, Other, 5.0kW input, Horizontal $1,795.00 $1,795.00 N/A $1,795.00 N/A
Primary Antenna - Custom Mounting Assembly $262.66 $262.66 Please see K14RF-D Primary Antenna - Custom Mounting Assembly Budget Revision Justification Letter $262.66 N/A

Components

Actual Information Description File Name
UHF-Low Power, Top Mount, Other, 5.0kW input, Horizontal

Component Description:
Invoice to be resubmitted.
Amount:
N/A

Component Description:
1 EA KATHREIN UTV-11/4/LP UHF OMNI
Amount:
$1,795.00
Primary Antenna - Custom Mounting Assembly

Component Description:
Fabricate and supply custom Kathrein SIRA UTV-11/4/LP antenna mount assembly to fit the existing 4" Pipe leg on the frestanding tower
Amount:
$262.66

Cost Information

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Transmission Line

Information not provided.

Cost Information

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Tower Equipment and Rigging Costs

Information not provided.

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 $67,007.00 $49,111.33 N/A $27,317.06 N/A
Total for all systems $71,898.47 $53,837.80 N/A $32,043.53 N/A
Outside Professional Services $67,007.00 $49,111.33 $27,317.06
Attorney Fees - Negotiation of lease and other matters for shared locations $3,262.50 $1,533.58 K14RF-D Attorney Fees - Other Matters Budget Revision Justification Letter. The estimated cost has been adjusted to include all invoices submitted for reimbursement at this time. $1,533.58 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $3,025.00 $1,207.25 N/A $0.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,052.50 $0.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $2,102.50 $6,152.02 All consulting engineering fees combined. $0.00 N/A
Perform engineering study for displacement application $1,800.00 $6,151.98 The estimated cost has been adjusted to include all invoices submitted for reimbursement at this time. $6,151.98 .
Form 399 assistance or other Program Management costs $32,010.00 $32,010.00 Please see Estimated Cost Justification K14RF-D-510-Project Management v0 $19,285.00 N/A
Prepare/ Review 399 reimbursement form $1,710.00 $1,710.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $1,577.50 $346.50 The estimated cost has been adjusted to include all invoices submitted for reimbursement at this time. $346.50 N/A
Project management of the transition $20,467.00 $0.00 PM invoices are being applied to the Form 399 Assistance or Other Program Management Costs budget category. $0.00 N/A

Components

Actual Information Description File Name
Attorney Fees - Negotiation of lease and other matters for shared locations

Component Description:
K14RF-D-550-Attorney - Other Matters
Amount:
$128.33

Component Description:
For services rendered through September 30, 2018
Amount:
$269.50

Component Description:
Fees
Amount:
$808.50

Component Description:
Fees
Amount:
$327.25
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Invoice to be resubmitted
Amount:
N/A
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:
Invoice to be resubmitted
Amount:
N/A
Perform engineering study for displacement application

Component Description:
Consulting engineering services
Amount:
$1,912.88

Component Description:
Consulting engineering services
Amount:
$630.26

Component Description:
Consulting engineering services
Amount:
$537.13

Component Description:
Consulting engineering services
Amount:
$3,071.71
Form 399 assistance or other Program Management costs

Component Description:
Project Management
Amount:
$341.00

Component Description:
Project Management
Amount:
$873.15

Component Description:
Project Management
Amount:
$1,425.90

Component Description:
Project Management
Amount:
$68.20

Component Description:
Project Management
Amount:
$92.90

Component Description:
Project Management
Amount:
$57.35

Component Description:
Project Management
Amount:
$3,875.00

Component Description:
Project Management
Amount:
$1,324.70

Component Description:
Project Management
Amount:
$1,117.25

Component Description:
Project Management
Amount:
$162.75

Component Description:
Project Management
Amount:
$332.60

Component Description:
Project Management
Amount:
$207.70

Component Description:
Project Management
Amount:
$128.45

Component Description:
Project Management
Amount:
$1,697.25

Component Description:
Project Management
Amount:
$2,170.05

Component Description:
Project Management
Amount:
$466.85

Component Description:
Project Management
Amount:
$1,070.00

Component Description:
Project Management
Amount:
$820.00

Component Description:
Project Management
Amount:
$295.50

Component Description:
Project management
Amount:
$1,225.55

Component Description:
Project Management
Amount:
$213.80

Component Description:
Project Management
Amount:
$66.65

Component Description:
Project Management
Amount:
$258.85

Component Description:
Project Management
Amount:
$90.00

Component Description:
Project Management
Amount:
$255.75

Component Description:
Project Management
Amount:
$647.80
Prepare/ Review 399 reimbursement form Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
For services rendered through October 31, 2018
Amount:
$346.50
Project management of the transition

Component Description:
Invoice moved to correct budget category.
Amount:
N/A

Component Description:
Invoice moved to correct budget category.
Amount:
N/A

Component Description:
Invoice moved to correct budget category.
Amount:
N/A

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 $2,833.81 $2,668.81 N/A $2,668.81 N/A
Total for all systems $71,898.47 $53,837.80 N/A $32,043.53 N/A
Other Expenses $2,833.81 $2,668.81 $2,668.81
Combiner $2,298.80 $2,298.80 N/A $2,298.80 N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $170.00 Please see K14RF-D FCC Filing Fee - LTC Budget Revision Justification Letter $170.00 N/A
Equipment Delivery and Handling Charges $200.01 $200.01 Please see K14RF-D Equipment Delivery and Handling Budget Revision Justification Letter $200.01 N/A

Components

Actual Information Description File Name
Combiner

Component Description:
1 EA Kathrein 5 Ch Combiner
Amount:
$2,298.80

Component Description:
Invoice to be resubmitted
Amount:
N/A
FCC Filing Fees - Form 2100 license to cover application

Component Description:
For services rendered through November 30, 2018
Amount:
$170.00
Equipment Delivery and Handling Charges

Component Description:
Shipping Charge on invoice 120449
Amount:
$200.01

Cost Information

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Grand Total

Predetermined
Cost Estimate 		Estimated Cost Actual Cost
Total for all systems $71,898.47 $53,837.80 $32,043.53

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.

Sravan Reddy

Senior Director, General Accounting


06/14/2022

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.

Sravan Reddy

Senior Director, General Accounting


06/14/2022

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.

Sravan Reddy

Senior Director, General Accounting


06/14/2022

Attachments

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