Go to the Federal Communications Commission homepage at www.fcc.gov

FCC Form 399: Incentive Auction Relocation Reimbursement Fund System

Approved by OMB 3060-1178
Go to the Federal Communications Commission homepage at www.fcc.gov

(REFERENCE COPY - Not for submission)FCC Form 399: Incentive Auction Relocation Reimbursement Fund System

File Number:
0000028424
FRN:
0018223693
Facility ID:
46728
Repack Channel:
20 (UHF)
Entity:
Broadcaster
Filing Status:
Submitted
Date Submitted:
02/15/2018

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

GRAY TELEVISION LICENSEE, LLC

Doing Business As: GRAY TELEVISION LICENSEE, LLC

WCAX

4370 PEACHTREE ROAD, NE

ATLANTA, GA 30319

United States

+1 (202) 750-1585 Robert.Folliard@gray.tv 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

Samuel Harington

Widelity

4031 University Dr

Ste. 100

Fairfax, VA 22030

United States

+1 (339) 222-8107 sam.hariton@widelity.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 WCAX-TV will transition from Channel 22 to the newly assigned Channel 20. This will impact WPTZ which shares the tower and antenna

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  
Ownership Owned
Owner  
Site  
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model PWR60D2
Year 2006
Type Inductive Output Tube
IOT Power Type Two
Description  
Power capacity 60 kw
Solid State Cooling  
Solid State Power Capacity  
Other Transmitter Type  

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Description of Use  
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Manufacturer
Model ULXTE-60
Transmitter Type Solid state
IOT Power Type  
Other  
Power capacity  
Solid State Cooling Liquid
Solid State Power Capacity 38.4 kw
Other Transmitter Type  
Justification for New Transmitter There is no room available to perform a retune of the existing IOT transmitter.

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
Rigid Conduit and Wiring No
Size
Length
Other Electrical Service Yes
Description The new transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors.
HVAC Service Does the replacement transmitter require HVAC Service? No
Type
Size
Other Size  
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size
Channel 14 Costs Is an RF Consulting Engineer needed?
Is a channel 14 Mask Filer needed?
Is additional field engineering time needed?
Number of Days  

Primary Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

Interim Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Interim
Description of Use  
Change Type Purchase
Manufacturer
Model ULXTE-30
Transmitter Type Solid state
IOT Power Type  
Other  
Power capacity  
Solid State Cooling Liquid
Solid State Power Capacity 19.2 kw
Other Transmitter Type  
Justification for New Transmitter Needed to broadcast during transition period because the existing IOT must be removed to allow for the installation of the interim transmitter.

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) No
Transformer (480V) No
Power
Rigid Conduit and Wiring No
Size
Length
Other Electrical Service Yes
Description The new transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors.
HVAC Service Does the replacement transmitter require HVAC Service? No
Type
Size
Other Size  
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size
Channel 14 Costs Is an RF Consulting Engineer needed?
Is a channel 14 Mask Filer needed?
Is additional field engineering time needed?
Number of Days  
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

Name Description

UHF Inside RF System

UHF Inside RF System including switching

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 Retune Existing
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? Yes
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 Full Power
Mounting Top-mount stacked
Antenna position in stack Bottom
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 2
Number of Panels 40
Design power capacity in use 100.0 %
Lower Limit 470.00 MHz
Upper Limit 710.00 MHz
Other Antenna Type N/A
ERP: 443.00 kW
Manufacturer Dielectric
Model TUP-04/C4SP-10/40H-2-R
Year 2006

Facility ID's and Call Signs of all stations with whom the antenna is shared.

Facility ID Call Sign
57476 WPTZ

Primary Antenna

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Adjustment to Existing Antenna

Section Question Response
Sweep Test of Existing Antenna Do you need a sweep test of existing antenna? Yes

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 3
Frequencies of channels supported upper and lower frequency
Frequency 470.0 MHz - 698.0 MHz

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Lower Power Elbow Complex

3 1/8" line feed, broadband

Auxiliary Antenna

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Add Antenna Information

Section Question Response
Existing Antenna Description Type of change Retune Existing
Antenna Use Auxiliary (Backup)
Description of Use Backup
Ownership Owned
Owner N/A
Site N/A
Is this antenna currently shared with any other stations? Yes
Is this 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 stacked
Antenna position in stack Top
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 2
Number of Panels 8
Design power capacity in use 100.0 %
Lower Limit 470.00 MHz
Upper Limit 710.00 MHz
Other Antenna Type N/A
ERP: 76.60 kW
Manufacturer Dielectric
Model TUP-04-2/8U-1-R
Year 2006

Facility ID's and Call Signs of all stations with whom the antenna is shared.

Facility ID Call Sign
57476 WPTZ

Auxiliary Antenna

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Adjustment to Existing Antenna

Section Question Response
Sweep Test of Existing Antenna Do you need a sweep test of existing antenna? Yes

Auxiliary 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 upper and lower frequency
Frequency 470.0 MHz - 698.0 MHz

Auxiliary 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

Auxiliary Transmission Line

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Add Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Auxiliary (Backup)
Description of Use Backup
Ownership Owned
Owner N/A
Site N/A
Is this transmission currently shared with any other stations? Yes
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 4 1/16 inches
Segment Length Broadband
Other Segment Length
Number of parallel runs 1
Length 500 feet per run

Facility ID's and Call Signs of all stations with whom the transmission line is shared.

Facility ID Call Sign
57476 WPTZ

Auxiliary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Auxiliary (Backup)
Description of Use Backup
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Rigid
Diameter 4 1/16 inches
Segment Length Broadband
Other Segment Length
Number of parallel runs 1
Length 500 feet per run
Justification for New Transmission Line Line sweep determined that flange summing occurs in band for repacked channel 20 eliminating chances to reuse any of the existing lines

Auxiliary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

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? Yes
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 6 1/8 inches
Segment Length Broadband
Other Segment Length
Number of parallel runs 1
Length 450 feet per run

Facility ID's and Call Signs of all stations with whom the transmission line is shared.

Facility ID Call Sign
57476 WPTZ

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 6 1/8 inches
Segment Length Broadband
Other Segment Length
Number of parallel runs 1
Length 450 feet per run
Justification for New Transmission Line Line sweep determined that flange summing occurs in band for repacked channel 20 eliminating chances to reuse any of the existing lines

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Primary Transmission Line

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Add 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 this transmission currently shared with any other stations? Yes
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 3 1/8 inches
Segment Length Broadband
Other Segment Length
Number of parallel runs 1
Length 450 feet per run

Facility ID's and Call Signs of all stations with whom the transmission line is shared.

Facility ID Call Sign
57476 WPTZ

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 3 1/8 inches
Segment Length Broadband
Other Segment Length
Number of parallel runs 1
Length 450 feet per run
Justification for New Transmission Line Line sweep determined that flange summing occurs in band for repacked channel 20 eliminating chances to reuse any of the existing lines

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Sweep Existing Transmission Line

Sweep test of existing transmission line

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? Terrain Constrained
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 Yes
Is tower documented for structural analysis? No
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? No
ASR Number
Coordinates (NAD83) Latitude (NAD83) 44° 31' 32.19" N-
Longitude (NAD83) 072° 48' 56.4" W-
Overall Structure Height 185.00 feet
Support Structure Height 130.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 4166.67 feet
Structure Type MTOWER - Monopole
Tower Owner WCAX-TV
Date Constructed 01/01/2005

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
57476 WPTZ DTV

Other Types of Users

Users
WVPS FM
WEZF 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 undocumented/poorly documented tower
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 Terrain constrained
Helicopter Services Required Are helicopter services required? Yes

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Corrosion analysis

Corrosion analysis

Tower structural analysis

Structural analysis of existing tower

Move Equipment

Replace transmission lines

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 900
Explanation Strategic Support
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 Yes
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare request for Special Temporary Authority No
Quantity N/A
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
NEPA Section 106 environmental review No
Environmental Assessment Yes
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 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

Information not provided.

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning No
Non-zoning permits Yes
BLM or NFS Coordination Yes
FCC Construction Permit Minor Change Yes
FCC License to Cover Application Yes
FCC Special Temporary Authority Application 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

Taxes

State and Local Taxes

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 $2,411,728.00 $2,036,517.00 N/A $0.00 N/A
Total for all systems $5,014,063.00 $3,578,797.00 N/A $43,702.25 N/A
Interim Transmitter ULXTE-30 $952,728.00 $845,852.00 $0.00
UHF Inside RF System $70,000.00 $70,000.00 N/A N/A N/A
UHF inside RF system including switching $143,500.00 $140,000.00 N/A N/A N/A
Other Electrical Service: The new transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors. $73,228.00 $73,228.00 See quote, amended to be added to this document per FCC request dated 8/14/17 (complete response narrative attached as well). The physical build for the interim/permanent transmitter solution drove the cost of quote. N/A N/A
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW $666,000.00 $562,624.00 N/A N/A N/A
Primary Transmitter ULXTE-60 $1,459,000.00 $1,190,665.00 $0.00
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW $1,434,000.00 $1,165,665.00 N/A N/A N/A
Other Electrical Service: The new transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors. $25,000.00 $25,000.00 N/A 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 $1,265,985.00 $513,872.00 N/A $0.00 N/A
Total for all systems $5,014,063.00 $3,578,797.00 N/A $43,702.25 N/A
Primary Antenna TUP-04/C4SP-10/40H-2-R $636,785.00 $261,652.00 $0.00
New combiner, cost per channel (without antenna) $80,000.00 $240,000.00 Catalog cost listed as 80k per channel N/A N/A
UHF - High Power Top Mount (200-1000 kW), Two Station broadband panel antenna, horizontally polarized $532,000.00 $0.00 Ghost antenna inserted by form, cannot remove. This is a bug. N/A N/A
Sweep test of existing antenna $6,550.00 $6,400.00 N/A N/A N/A
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed) $13,300.00 $10,317.00 N/A N/A N/A
Lower Power Elbow Complex $4,935.00 $4,935.00 N/A N/A N/A
Auxiliary Antenna TUP-04-2/8U-1-R $629,200.00 $252,220.00 $0.00
Elbow complex, broadband, at antenna input, per 4 1/16. feedline (if needed) $10,650.00 $5,820.00 N/A N/A N/A
UHF - High Power Top Mount (200-1000 kW), Two Station broadband panel antenna, horizontally polarized $532,000.00 $0.00 Ghost antenna, cannot be removed. This is a bug. N/A N/A
Sweep test of existing antenna $6,550.00 $6,400.00 N/A N/A N/A
New combiner, cost per channel (without antenna) $80,000.00 $240,000.00 Catalog cost listed as 80k per channel 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 $237,350.00 $198,961.00 N/A $3,490.25 N/A
Total for all systems $5,014,063.00 $3,578,797.00 N/A $43,702.25 N/A
Primary Transmission Line $101,700.00 $82,542.00 $0.00
Rigid Transmission Line - copper, 6 1/8" broadband $101,700.00 $82,542.00 N/A N/A N/A
Primary Transmission Line $56,150.00 $49,708.00 $3,490.25
Sweep Existing Transmission Line $3,500.00 $3,500.00 See invoice $3,490.25 N/A
Rigid Transmission Line - copper, 3 1/8" broadband $52,650.00 $46,208.00 N/A N/A N/A
Auxiliary Transmission Line $79,500.00 $66,711.00 $0.00
Rigid Transmission Line - copper, 4 1/16" broadband $79,500.00 $66,711.00 N/A N/A N/A

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 6 1/8" broadband Information not provided.
Sweep Existing Transmission Line

Component Description:
Sweep test of all transmission lines
Amount:
$3,490.25
Rigid Transmission Line - copper, 3 1/8" broadband Information not provided.
Rigid Transmission Line - copper, 4 1/16" broadband 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 $639,240.00 $292,640.00 N/A $9,750.00 N/A
Total for all systems $5,014,063.00 $3,578,797.00 N/A $43,702.25 N/A
Primary Tower MTOWER $639,240.00 $292,640.00 $9,750.00
Corrosion analysis $1,500.00 $1,500.00 See invoice $750.00 N/A
Tower structural analysis $2,500.00 $2,500.00 See invoice $1,250.00 N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $25,600.00 $12,000.00 N/A $7,750.00 N/A
Move Equipment $0.00 $0.00 N/A N/A N/A
Tower Helicopter Lift $46,640.00 $46,640.00 May require helicopter to delivery equipment and transmission line to transmitter site. N/A N/A
Minor tower reinforcement/modifications $153,500.00 $150,000.00 N/A N/A N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $409,500.00 $80,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Corrosion analysis

Component Description:
Level 1 Corrosion Risk Analysis
Amount:
$750.00
Tower structural analysis

Component Description:
Engineering Evaluation
Amount:
$1,250.00
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study

Component Description:
Tower Mapping
Amount:
$2,875.00

Component Description:
Tower Mapping
Amount:
$4,875.00
Move Equipment Information not provided.
Tower Helicopter Lift Information not provided.
Minor tower reinforcement/modifications Information not provided.
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) 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 $204,930.00 $289,750.00 N/A $30,462.00 N/A
Total for all systems $5,014,063.00 $3,578,797.00 N/A $43,702.25 N/A
Outside Professional Services $204,930.00 $289,750.00 $30,462.00
RF Exposure Measurements $20,500.00 $20,000.00 N/A $5,355.00 N/A
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet $10,240.00 $100,000.00 potential if tower requires reinforcement State of Vermont N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,585.00 $3,500.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,305.00 $2,250.00 N/A N/A N/A
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application $4,100.00 $4,000.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,120.00 $5,000.00 N/A $1,250.00 N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application $1,535.00 $1,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,535.00 $1,500.00 N/A N/A N/A
Prepare and or review reimbursement form $2,560.00 $2,500.00 N/A N/A N/A
Address transition timing and coordination issues w/ other stations and wireless $2,560.00 $2,500.00 N/A N/A N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application $2,050.00 $2,000.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,170.00 $7,000.00 N/A $1,700.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,070.00 $3,000.00 N/A $187.50 N/A
Project management of the transition $138,600.00 $135,000.00 N/A $21,969.50 N/A

Components

Actual Information Description File Name
RF Exposure Measurements

Component Description:
Provide 2 RF Specialists from GTI to attend the WCAX Mt. Mansfield tower site & Perform RF measurements to identify OET 65 issues.
Amount:
$5,355.00
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet Information not provided.
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 - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Email re: lifting of anti-collusion rule, time of FCC letter; emails re: FCC letter, next steps; Email re: WPTZ
Amount:
$600.00

Component Description:
Emails, review draft 2100, send draft to Gray. File 2100.
Amount:
$650.00
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare and or review reimbursement form Information not provided.
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application Information not provided.
Perform engineering study for new channel assignment and antenna development

Component Description:
Perform engineering study for new channel assignment
Amount:
$1,500.00

Component Description:
Email duTreil re issues in repacking application
Amount:
$200.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
review engineering portions and related exhibits of "90 day" FCC CP application
Amount:
$187.50
Project management of the transition

Component Description:
Project Mgt
Amount:
$3,763.95

Component Description:
Project management
Amount:
$2,951.90

Component Description:
Project Mgt
Amount:
$718.30

Component Description:
Project management
Amount:
$2,330.15

Component Description:
Project Management
Amount:
$1,857.60

Component Description:
Project Mgt
Amount:
$802.25

Component Description:
Project Mgt
Amount:
$2,507.30

Component Description:
Project management
Amount:
$1,328.55

Component Description:
Project Mgt
Amount:
$28.20

Component Description:
Project Mgt
Amount:
$2,381.30

Component Description:
Transition Related Project Management Costs
Amount:
$3,300.00

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 $254,830.00 $247,057.00 N/A $0.00 N/A
Total for all systems $5,014,063.00 $3,578,797.00 N/A $43,702.25 N/A
Other Expenses $254,830.00 $247,057.00 $0.00
Taxes $171,482.00 $171,482.00 N/A N/A N/A
MVPD Notification of Channel Change $1,000.00 $1,000.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $10,000.00 $10,000.00 N/A N/A N/A
DTV Medical Facility Notification $11,250.00 $3,490.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,070.00 $1,070.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $333.00 $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
Non-zoning permits $2,500.00 $2,500.00 N/A N/A N/A
BLM or NFS Coordination $10,000.00 $10,000.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $25,000.00 $25,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $10,000.00 $10,000.00 N/A N/A N/A
Equipment Storage $12,000.00 $12,000.00 N/A 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 $5,014,063.00 $3,578,797.00 $43,702.25

Construction Status

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Question Response
Is construction complete? 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.

Robert Folliard

Assistant Secretary


02/15/2018

Certification

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Section Question Response
Submission of Actual Cost Documentation 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.

  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 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).

  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 certifies that the cost information/documents submitted reflect costs actually incurred.

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

  7. 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.

Robert Folliard

Assistant Secretary


02/15/2018

Attachments

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