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:
66170
Service:
DTV
Call Sign:
KTIV
Channel:
14 (UHF)
File Number:
0000027507
FRN:
0018223693
Date Submitted:
08/14/2017

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

KTIV LICENSE, LLC

Doing Business As: KTIV LICENSE, LLC

Brady Dreasler

PO Box 909

QUINCY, IL 62306

United States

+1 (217) 223-5100 bdreasler@quincymedia.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

Tony zumMallen

QCommunications

Tony zumMallen

705B SE Melody LN #314

Lees Summit, MO 64063

United States

+1 (816) 729-1177 tony@qcom1.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 The transition from channel 41 to channel 14 requires shared interim systems with KMEG and KPTH through a combiner. KTIV will require a new antenna, line and transmitter to complete the transition.

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 PowerCD
Year 2006
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 60 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 ULXTE-100
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 56.7 kW
Justification for New Transmitter IOT Transmitter is not tunable per the manufacturer. Special Case- Channel 14 requirements. Per engineering consultant new TPO required is 56.7kw.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) Yes
Switchgear (industrial 800 amp) Yes
Transformer (480V) Yes
Power 300 kVA
Rigid Conduit and Wiring Yes
Size 2 inches
Length 500.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 25 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 10

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Disconnect existing Transmitter

Disconnect transmitter and components from existing configuration and move within building to make way for new facilities.

Securirty - Site

This site requires security once the new transmission line and equipment arrive on site to be installed. Estimated length of 4-6 weeks.

Site Survey - TX

Site survey and report are required to be performed before the new transmitter and components installation plan can be finalized.

Transmitter - Training

Transmitter training - offsite - 1 week in duration at mfg site.

Channel 14 remediation

After working with the NAB and our consulting engineer a LM remediation budget needs to be added to cover these estimated costs of operating in CH 14.

Interim Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Interim
Description of Use N/A
Change Type Purchase
Manufacturer
Model ULXTE-30
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 20 kW
Justification for New Transmitter Interim facility is required to avoid prolonged period of station silence during transition, and station currently has no aux facility to use for interim operation. Extended silent period during transition to new channel is unreasonable.

Interim Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) Yes
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring Yes
Size 2 inches
Length 500.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 25 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
Inside RF System Is an additional interior RF system required to support this interim transmitter? Yes

Interim 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? Yes
Existing Antenna Manufacturer and Type Class Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 873.0 kW
Manufacturer
Model TFU-30JTH-R-04
Year 2006

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? Yes
New Antenna Manufacturer and Types Class Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Broadband Panel
Number of Stations Supported 1
Number of Panels/Bays 24
Lower Limit 470.00 MHz
Upper Limit 698.00 MHz
Design power capacity in use 100.0 %
Other Antenna Type N/A
ERP: 873.0 kW
Manufacturer
Model TFU-24GTH
Year 2017
Justification for New Antenna Required to operate on the new channel assignment. Ch14 special case. FAA height restrictions.

Primary Antenna

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Other Antenna Costs

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

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

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? Yes
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? Yes
New Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Broadband Slot
Number of Stations Supported 3
Number of Panels/Bays 24
Lower Limit 470.00 MHz
Upper Limit 698.00 MHz
Design power capacity in use 50.0 %
Other Antenna Type N/A
ERP: 300.0 kW
Manufacturer
Model TFU-24WB-1-R
Year 2017
Justification for New Antenna Interim facility is required to avoid prolonged period of station silence during transition, and station currently has no aux facility to use for interim operation. Shared with KPTH and KMEG. Paid from the KPTH deal.

Interim 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 3
Frequencies of channels supported RF channel
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? No
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? B
Feed Line Size 6 1/8 inches
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

Enter a list of RF channel numbers.

RF Channel Number
30
32
14

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 Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 7 3/16 inches
Other Diameter N/A
Segment Length 19 1/2 inches
Other Segment Length N/A
Number of parallel runs 1
Length 2298 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 Rigid
Diameter 7 3/16 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 2140 feet per run
Justification for New Transmission Line Required to make the channel assignment relocation from CH41 to CH14

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Disconnect existing Interior RF components

Disconnect interior RF transmission line and filters from existing configuration and move within the building to make way for new facilities.

Tower Equipment And Rigging Costs

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

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? 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? Yes
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1057963
Coordinates (NAD83) Latitude (NAD83) 42° 35' 12.0" N-
Longitude (NAD83) 096° 13' 19.0" W-
Overall Structure Height 1987.84 feet
Support Structure Height 1847.09 feet
Ground Elevation Above Mean Sea Level (AMSL) 1332.99 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Heartland Tower Company, L.L.C.
Date Constructed 02/22/2007

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
77451 KPTH DTV
39665 KMEG 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: Major 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

Information not provided.

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 933
Explanation Scope & significance of project (QMI has multiple stations repacked) require outside management services to augment existing internal personnel to assist turnkey management of and ensure timely and safe execution of channel relocation.
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 4
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 4
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 Yes
RF exposure measurements No
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

Quarterly reporting

Preparation and submittal of the FCC required quarterly report 387 by PM and attorney.

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 No
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

Information not provided.

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 $3,784,760.00 $3,626,100.00 N/A $0.00 N/A
Total for all systems $6,096,724.00 $5,812,855.00 N/A $0.00 N/A
Interim Transmitter ULXTE-30 $974,200.00 $925,800.00 $0.00
UHF inside RF system including switching $147,500.00 $140,000.00 N/A N/A N/A
25 Ton system $91,500.00 $87,000.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW $684,000.00 $650,000.00 N/A N/A N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A
2" Rigid Conduit and Wiring (Cost per foot) $13,000.00 $12,500.00 N/A N/A N/A
Primary Transmitter ULXTE-100 $2,810,560.00 $2,700,300.00 $0.00
UHF - Liquid Cooled Solid State Transmitter 52 - 61 kW $1,788,000.00 $1,700,000.00 N/A N/A N/A
Channel 14 remediation $500,000.00 $500,000.00 After consulting further with The NAB and the consulting engineer it has been determined that a land-mobile receivers remediation budget needs to be added to cover these estimated remediation costs of transitioning to CH 14. N/A N/A
Site Survey - TX $25,000.00 $25,000.00 Site survey and report are required to be performed before the new transmitter and components installation plan can be finalized. N/A N/A
Additional field engineering time, 10-30 days $63,100.00 $60,000.00 N/A N/A N/A
Channel 14 Mask Filter $189,500.00 $180,000.00 N/A N/A N/A
RF Consulting Engineer $5,260.00 $5,000.00 N/A N/A N/A
25 Ton system $91,500.00 $87,000.00 We reviewed the transmitter transition plans and with an additional 25 tons of HVAC installed in the new section of the transmitter room it is estimated that the required environmental conditions to operate the new transmitter config can be obtained. N/A N/A
2" Rigid Conduit and Wiring (Cost per foot) $13,000.00 $12,500.00 N/A N/A N/A
Transformer 3 phase/480v - 300 KVA $36,800.00 $35,000.00 N/A N/A N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A
Service entrance 3 phase/800 amp/208 volt $14,400.00 $13,700.00 N/A N/A N/A
Securirty - Site $17,500.00 $17,500.00 This site requires security once the new transmission line and equipment arrive on site to be installed. Estimated length of 4-6 weeks. N/A N/A
Disconnect existing Transmitter $25,000.00 $25,000.00 Disconnect transmitter and components from existing configuration and move within building to make way for new facilities. N/A N/A
Transmitter - Training $3,300.00 $3,300.00 Transmitter training - offsite - 1 week in duration at mfg site. N/A N/A

Components

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 $414,560.00 $380,800.00 N/A $0.00 N/A
Total for all systems $6,096,724.00 $5,812,855.00 N/A $0.00 N/A
Interim Antenna TFU-24WB-1-R $104,630.00 $86,400.00 $0.00
New combiner, cost per channel (without antenna) $84,200.00 $80,000.00 each station requires a combiner to make the interim shared line and antenna work. N/A N/A
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed) $13,700.00 $0.00 This cost will be shared with KPTH and KTIV, and KPTH is purchasing this equipment. N/A N/A
UHF - High Power, Side Mount, basic slot antenna, 24 bay,, 300 kW input, directional,, elliptically or circularly polarized $0.00 $0.00 Cost of antenna is included in the KPTH deal. Shared with KTIV, KPTH and KMEG. N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Primary Antenna TFU-24GTH $309,930.00 $294,400.00 $0.00
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $289,500.00 $275,000.00 N/A N/A N/A
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed) $13,700.00 $13,000.00 N/A N/A N/A

Components

Information not provided.

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 $635,600.00 $605,640.00 N/A $0.00 N/A
Total for all systems $6,096,724.00 $5,812,855.00 N/A $0.00 N/A
Primary Transmission Line $635,600.00 $605,640.00 $0.00
Rigid Transmission Line - copper, 7 3/16" $620,600.00 $590,640.00 N/A N/A N/A
Disconnect existing Interior RF components $15,000.00 $15,000.00 Disconnect interior RF transmission line and filters from existing configuration and move within the building to make way for new facilities. N/A N/A

Components

Information not provided.

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 $862,000.00 $819,000.00 N/A $0.00 N/A
Total for all systems $6,096,724.00 $5,812,855.00 N/A $0.00 N/A
Primary Tower TOWER $862,000.00 $819,000.00 $0.00
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $400,000.00 N/A N/A N/A
Structural engineering tower load study for a documented tower with candelabra $20,000.00 $19,000.00 N/A $0.00 N/A
Major tower reinforcement/modifications $421,000.00 $400,000.00 N/A N/A N/A

Components

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 $288,724.00 $272,700.00 N/A $0.00 N/A
Total for all systems $6,096,724.00 $5,812,855.00 N/A $0.00 N/A
Outside Professional Services $288,724.00 $272,700.00 $0.00
Quarterly reporting $5,000.00 $5,000.00 Preparation and submittal of the FCC required quarterly report 387 by PM and attorney. N/A N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $14,720.00 $14,000.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $4,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A N/A N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A N/A N/A
Project management of the transition $147,414.00 $139,950.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $8,200.00 $6,000.00 N/A N/A N/A

Components

Information not provided.

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 $60,080.00 $59,515.00 N/A $0.00 N/A
Total for all systems $6,096,724.00 $5,812,855.00 N/A $0.00 N/A
Other Expenses $60,080.00 $59,515.00 $0.00
Equipment Storage $10,000.00 $10,000.00 Expecting multiple staggered equipment deliveries from different vendors and need to store and stage new equipment prior to installation date. Anticipate from 6-24 months of storage time. N/A N/A
Develop and air announcement of upcoming channel change $15,000.00 $15,000.00 Required FCC announcements and good will public relations must we upheld. The production airing and disseminating of these announcements are fundamental to our operations. N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $10,000.00 $10,000.00 Rent 40 yard dumpster with multiple pickups. Estimated 6- months on site. Potential hazardous waste management issues. N/A N/A
Equipment Delivery and Handling Charges $8,000.00 $8,000.00 Transport and handling fees from staging area to transmitter site. N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 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 - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
MVPD Notification of Channel Change $5,000.00 $5,000.00 Required FCC notifications. N/A N/A

Components

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $6,096,724.00 $5,812,855.00 $0.00

Reimbursement Status

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Question Response
The facility has ceased operating on its pre-auction channel. No
Construction of final facilities or all necessary modifications are complete. No
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.

Brady Dreasler

Corporate Director of Engineering


08/14/2017

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