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:
37808
Service:
DTV
Call Sign:
WLFG
Channel:
14 (UHF)
File Number:
0000028111
FRN:
0002058089
Date Submitted:
10/12/2018

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

Living Faith Ministries, Inc.

Doing Business As: Living Faith Ministries, Inc.

P.O. Box 1867

Abingdon, VA 24210

United States

+1 (276) 676-3806 mike@livingfaithtv.com Corporation

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

Timothy Z Sawyer

Technical Consultant

Mullaney Engineering, Inc.

4937 G - Green Valley Road

Monrovia, MD 21770

United States

+1 (301) 921-0115 mullaney@mullengr.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 Please see attached exhibit titled "WLFG Exhibit for Modified Transition Plan (August 2018)".

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 QXD2
Year 2001
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 60.0 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 ULXTE-50
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 31.7 kW
Justification for New Transmitter Existing tx cannot be rechanneled -210 MHz change in frequency. IOT operation not available, manufacturer no longer in business. See attached letter from manufacturer dated January 1, 2017.

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) Yes
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring Yes
Size 3 inches
Length 200.0 feet
Other Electrical Service Yes
Description Transmitter disconnect service panel
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

Name Description

Mask Filter System

See GatesAir Proposal Q-77816

Install Ch 14 filter and Mask

Install Ch 14 filter and transmitter mask filter

Transmitter Building Modification

See GatesAir Proposal Q-75623

RF Accessories

See GatesAir Proposal Q-77816

Old Transmitter Removal

Remove old transmitter from site

RF Components for Install

RF components and installation for main transmitter

Electrical

See GatesAir Proposal Q-77816

Channel 14 Cost Not Listed

Additional Engineering

Installation and Proof

See GatesAir Proposal Q-77816

RF Consultant

Provide installation support services and review of associated systems during the installation of the primary transmitter

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 Side 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: 1000.0 kW
Manufacturer
Model 2050-32BT(1.25)
Year 1998

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 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: 479.0 kW
Manufacturer
Model ATW22H5-HTO12-14H
Year 2018
Justification for New Antenna EXISTING ANTENNA CAN NOT BE RETUNED - CURRENTLY CH 49 - MOVING TO CH 14, 210 MHZ CHANGE IN FREQ.

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? 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? 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? 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: 120.0 kW
Manufacturer
Model AL120-49-PM
Year 2018
Justification for New Antenna Interim Antenna will be necessary if expense for new tower is not approved in time for timely construction of new tower by Phase 2 deadline.

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

Name Description

Transmission Line Connectors

Transmission line interior interconnect segments and RF components (couplers/flanges)

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 6 1/8 inches
Other Diameter N/A
Segment Length 19 3/4 inches
Other Segment Length N/A
Number of parallel runs 1
Length 250 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 6 1/8 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 250 feet per run
Justification for New Transmission Line NEW LINE SEGMENT LENGTH REQUIRED FOR CHANNEL CHANGE FROM CH 49 (OLD 19-3/4' SEGMENTS) TO CHANNEL 14 (NEW 20' SEGMENTS).

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Transmission Line Bridge

Cost estimated; actual length will determine actual cost.

Interim Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Interim
Description of Use N/A
Change Type Purchase New
Type Flexible Air
Diameter 4 inches
Segment Length N/A
Other Segment Length
Number of parallel runs 1
Length 150 feet per run
Justification for New Transmission Line Transmission line for required interim antenna operation.

Interim Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

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 Construct New
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? No
One or more FM, AM or TV radio broadcaster(s) N/A
Others Types of Users N/A
Is tower documented for structural analysis? No
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? No
ASR Number
Coordinates (NAD83) Latitude (NAD83) 36° 49' 47.3" N-
Longitude (NAD83) 082° 04' 44.4" W-
Overall Structure Height 200.00 feet
Support Structure Height 200.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 4180.00 feet
Structure Type LTOWER - Lattice Tower
Tower Owner LIVING FAITH MINISTRIES, INC.
Date Constructed 01/01/1995


Primary Tower

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Tower Construction Costs

Section Question Response
Construct New Tower Use Primary (Main)
Description of Use N/A
Is this a request for upgraded equipment? No
Height 143.10 feet
Justification for New Tower Please see attached exhibit titled "WLFG - Exhibit for New Tower Justification (September 2018)"

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

Weather Conditions

Winter weather conditions restricting access and crew working conditions

Soil Conditions

Actual Soil Conditions versus assumed standard soil conditions

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 100
Explanation CONSULTING SERVICES DURING TRANSITION STATION DOES NOT HAVE RESOURCES ON STAFF
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers No
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements Yes
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Additional Repack Legal Services Not Otherwise Specified in Form 399

Non-catalog legal services such as review of quarterly transition status reports and other miscellaneous non-catalog legal fees.

Interim Antenna Considerations

Consulting Engineer Interim Antenna Operations Analysis

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 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

Land Mobile Mitigation Group E Stations

Preliminary Estimate of LM Filters/RF Traps/Mitigation Expenses Group E Stations

Land Mobile Mitigation Group F Stations

Preliminary Estimate of LM Filters/RF Traps/Mitigation Expenses Group F Stations

Land Mobile Mitigation Group B Stations

Preliminary Estimate of LM Filters/RF Traps/Mitigation Expenses Group B Stations

AC Line Conditioners

Electrical Surge Suppressor - for Solid State Transmitter

Land Mobile Mitigation Expenses Engineering Evaluation

Preliminary Estimate of LM Filters/RF Traps/Mitigation Engineering Evaluation

Land Mobile Mitigation Group A Stations

Preliminary Estimate of LM Filters/RF Traps/Mitigation Expenses Group A Stations

Site Security

Site security service for tower location while construction is underway

Land Mobile Mitigation Group C Stations

Preliminary Estimate of LM Filters/RF Traps/Mitigation Expenses Group C Stations

Land Mobile Mitigation Group D Stations

Preliminary Estimate of LM Filters/RF Traps/Mitigation Expenses Group D Stations

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 $1,108,800.37 $1,106,300.37 N/A $340,673.54 N/A
Total for all systems $2,681,254.12 $2,558,495.12 N/A $838,583.41 N/A
Primary Transmitter ULXTE-50 $1,108,800.37 $1,106,300.37 $340,673.54
RF Consultant $10,000.00 $10,000.00 N/A $2,250.00 N/A
Installation and Proof $58,543.75 $58,543.75 N/A $19,319.43 N/A
Channel 14 Cost Not Listed $2,500.00 $2,500.00 N/A $550.70 N/A
UHF - Liquid Cooled Solid State Transmitter 31.7 kW $818,624.12 $818,624.12 N/A $270,145.95 N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A
3" Rigid Conduit and Wiring (Cost per foot) $10,400.00 $9,800.00 N/A $0.00 N/A
Other Electrical Service: Transmitter disconnect service panel $3,500.00 $3,500.00 N/A N/A N/A
Electrical $9,007.62 $9,007.62 N/A $2,972.51 N/A
Transmitter Building Modification $7,866.00 $7,866.00 N/A N/A N/A
RF Accessories $63,987.22 $63,987.22 N/A $21,115.78 N/A
Old Transmitter Removal $4,500.00 $4,500.00 N/A N/A N/A
RF Components for Install $6,000.00 $6,000.00 N/A N/A N/A
Mask Filter System $71,421.66 $71,421.66 N/A $23,569.17 N/A
Install Ch 14 filter and Mask $3,500.00 $3,500.00 N/A N/A N/A
Channel 14 -- Additional field engineering time, 2 days $750.00 $750.00 ***System Notice: Estimate adjusted and locked because line has been superseded.***FIELD TUNING OF SPECIAL CHANNEL 14 FILTER AND PROOF 2-ON-SITE DAYS $750.00 N/A

Components

Actual Information Description File Name
RF Consultant

Component Description:
Repack Channel 14 transmission RF system review; RF power calculations for transmitter sizing.
Amount:
$2,250.00
Installation and Proof

Component Description:
Installation and Proof for ULXTE-50 Transmitter per Quote Q-77816
Amount:
$19,319.43
Channel 14 Cost Not Listed

Component Description:
Additional cost information not listed
Amount:
$342.10

Component Description:
Additional cost information not listed
Amount:
$208.60
UHF - Liquid Cooled Solid State Transmitter 31.7 kW

Component Description:
New ULXTE-50 Transmitter per Quote Q-77816
Amount:
$270,145.95
Switchgear - industrial 800 amp Information not provided.
3" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Other Electrical Service: Transmitter disconnect service panel Information not provided.
Electrical

Component Description:
Electrical for ULXTE-50 Transmitter per Quote Q-77816
Amount:
$2,972.51
Transmitter Building Modification Information not provided.
RF Accessories

Component Description:
RF Accessories for ULXTE-50 Transmitter per Quote Q-77816
Amount:
$21,115.78
Old Transmitter Removal Information not provided.
RF Components for Install Information not provided.
Mask Filter System

Component Description:
Mask Filter System for ULXTE-50 Transmitter per Quote Q-77816
Amount:
$23,569.17
Install Ch 14 filter and Mask Information not provided.
Channel 14 -- Additional field engineering time, 2 days

Component Description:
Engineering consulting services directly related to repack DTV Channel 14 minimum transmitter power output requirements, system loss calculations, land mobile channel filter, and system gains worksheet.
Amount:
$750.00

Cost Information

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Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $387,160.00 $266,386.00 N/A $131,886.00 N/A
Total for all systems $2,681,254.12 $2,558,495.12 N/A $838,583.41 N/A
Interim Antenna AL120-49-PM $121,130.00 $116,400.00 $0.00
UHF - Lower Power Side Mount, One station antenna - medium power (50-200 kW), horizontally polarized $89,400.00 $85,000.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Transmission Line Connectors $25,000.00 $25,000.00 N/A N/A N/A
Primary Antenna ATW22H5-HTO12-14H $266,030.00 $149,986.00 $131,886.00
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized $247,000.00 $131,886.00 N/A $131,886.00 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $11,700.00 N/A N/A N/A

Components

Actual Information Description File Name
UHF - Lower Power Side Mount, One station antenna - medium power (50-200 kW), horizontally polarized Information not provided.
Sweep test of existing antenna Information not provided.
Transmission Line Connectors Information not provided.
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized

Component Description:
ERI Top-Mount Antenna ATW22H5-HTO12-14H
Amount:
$131,886.00
Sweep test of existing antenna Information not provided.
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) 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 $86,600.00 $83,500.00 N/A $43,792.60 N/A
Total for all systems $2,681,254.12 $2,558,495.12 N/A $838,583.41 N/A
Interim Transmission Line $11,100.00 $10,500.00 $0.00
Flexible Air Transmission Line - dielectric, 4" $11,100.00 $10,500.00 N/A N/A N/A
Primary Transmission Line $75,500.00 $73,000.00 $43,792.60
Transmission Line Bridge $25,000.00 $25,000.00 N/A N/A N/A
Rigid Transmission Line - copper, 6 1/8" $50,500.00 $48,000.00 N/A $43,792.60 N/A

Components

Actual Information Description File Name
Flexible Air Transmission Line - dielectric, 4" Information not provided.
Transmission Line Bridge Information not provided.
Rigid Transmission Line - copper, 6 1/8"

Component Description:
Transmission Line System
Amount:
$43,792.60

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 $646,873.75 $644,573.75 N/A $256,336.87 N/A
Total for all systems $2,681,254.12 $2,558,495.12 N/A $838,583.41 N/A
Primary Tower LTOWER $0.00 $0.00 $0.00
Primary Tower $646,873.75 $644,573.75 $256,336.87
New tower $512,673.75 $512,673.75 N/A $256,336.87 N/A
Weather Conditions $25,000.00 $25,000.00 N/A N/A N/A
Soil Conditions $25,000.00 $25,000.00 N/A N/A N/A
Short Tower (less than 500') $84,200.00 $81,900.00 N/A N/A N/A

Components

Actual Information Description File Name
New tower

Component Description:
Custom Tower and Foundation and Tower Installation
Amount:
$256,336.87
Weather Conditions Information not provided.
Soil Conditions Information not provided.
Short Tower (less than 500') 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 $94,930.00 $103,750.00 N/A $60,231.90 N/A
Total for all systems $2,681,254.12 $2,558,495.12 N/A $838,583.41 N/A
Outside Professional Services $94,930.00 $103,750.00 $60,231.90
Interim Antenna Considerations $5,000.00 $5,000.00 N/A $3,581.25 N/A
Additional Repack Legal Services Not Otherwise Specified in Form 399 $25,000.00 $25,000.00 Additional expenses were incurred as indicated in the attached invoices. $17,307.15 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $3,000.00 N/A
Project management of the transition $15,800.00 $15,000.00 N/A $2,025.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $7,000.00 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 $2,050.00 $1,500.00 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 $2,541.40 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 request for Special Temporary Authorization $3,680.00 $3,500.00 N/A N/A N/A
RF Exposure Measurements $21,050.00 $10,000.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $25,000.00 Additional expenses were incurred as indicated in the attached invoices. $24,777.10 Additional expenses were incurred as indicated in the attached invoices.

Components

Actual Information Description File Name
Interim Antenna Considerations

Component Description:
Interim Antenna operation review of possible reduced power operation; considerations with regards to tower loading.
Amount:
$1,950.00

Component Description:
Design parameters and antenna mounting elevations optimization of interim antenna
Amount:
$1,631.25
Additional Repack Legal Services Not Otherwise Specified in Form 399

Component Description:
Non-Catalog Legal Services such as review of quarterly transition status reports and other miscellaneous non-catalog legal fees
Amount:
$5,391.70

Component Description:
Non-Catalog Legal Services such as review of quarterly transition status reports and other miscellaneous non-catalog legal fees
Amount:
$1,711.70

Component Description:
Non-Catalog Legal Services such as review of quarterly transition status reports and other miscellaneous non-catalog legal fees
Amount:
$1,106.25

Component Description:
Non-Catalog Legal Services such as review of quarterly transition status reports and other miscellaneous non-catalog legal fees
Amount:
$581.00

Component Description:
Non-Catalog Legal Services such as review of quarterly transition status reports and other miscellaneous non-catalog legal fees.
Amount:
$518.50

Component Description:
Non-Catalog Legal Services such as review of quarterly transition status reports and other miscellaneous non-catalog legal fees
Amount:
$114.20

Component Description:
Non-Catalog Legal Services such as review of quarterly transition status reports and other miscellaneous non-catalog legal fees
Amount:
$1,501.90

Component Description:
Non-Catalog Legal Services such as review of quarterly transition status reports and other miscellaneous non-catalog legal fees.
Amount:
$940.30

Component Description:
Non-Catalog Legal Services such as review of quarterly transition status reports and other miscellaneous non-catalog legal fees
Amount:
$5,441.60
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Prepare engineering section of FCC Form 2100 CP Application
Amount:
$3,000.00
Project management of the transition

Component Description:
Project status, tower analysis, vendor selection
Amount:
$2,025.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Perform engineering digital channel study for new channel assignment and antenna development for selected channel.
Amount:
$7,000.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare request for Special Temporary Authorization Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Attorney Fees - Prepare and File FCC Form 2100 CP.
Amount:
$173.60

Component Description:
Attorney Fees - Prepare and File FCC Form 2100 CP.
Amount:
$2,367.80
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
RF Exposure Measurements Information not provided.
Prepare and or review reimbursement form

Component Description:
Prepare and or review reimbursement form
Amount:
$14,561.80

Component Description:
Prepare and or review reimbursement form
Amount:
$354.70

Component Description:
Prepare budget for FCC Form 399 including reimbursement for expenses including vendor review and technical justification.
Amount:
$2,500.00

Component Description:
Prepare and or review reimbursement form.
Amount:
$2,121.40

Component Description:
Prepare and or review reimbursement form.
Amount:
$2,334.90

Component Description:
Prepare and or review reimbursement form
Amount:
$1,414.60

Component Description:
Prepare and or review reimbursement form.
Amount:
$1,133.70

Component Description:
Prepare and or review reimbursement form
Amount:
$356.00

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 $272,690.00 $272,085.00 N/A $5,662.50 N/A
Total for all systems $2,681,254.12 $2,558,495.12 N/A $838,583.41 N/A
Other Expenses $272,690.00 $272,085.00 $5,662.50
Land Mobile Mitigation Group D Stations $25,000.00 $25,000.00 Please see attachment. N/A N/A
Land Mobile Mitigation Group C Stations $25,000.00 $25,000.00 Please see attachment. N/A N/A
Site Security $8,500.00 $8,500.00 N/A N/A N/A
Land Mobile Mitigation Group A Stations $25,000.00 $25,000.00 Please see attachment. N/A N/A
Land Mobile Mitigation Expenses Engineering Evaluation $25,000.00 $25,000.00 Please see attachment. $5,662.50 N/A
AC Line Conditioners $25,000.00 $25,000.00 N/A N/A N/A
Land Mobile Mitigation Group B Stations $25,000.00 $25,000.00 Please see attachment. N/A N/A
Land Mobile Mitigation Group F Stations $25,000.00 $25,000.00 Please see attachment. N/A N/A
Land Mobile Mitigation Group E Stations $25,000.00 $25,000.00 Please see attachment. 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 $2,500.00 $2,500.00 N/A N/A N/A
Equipment Delivery and Handling Charges $25,000.00 $25,000.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $20,000.00 $20,000.00 N/A N/A N/A
Non-zoning permits $2,500.00 $2,500.00 LOCAL ELECTRICAL PERMITS AND DRAWINGS N/A 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 N/A N/A

Components

Actual Information Description File Name
Land Mobile Mitigation Group D Stations Information not provided.
Land Mobile Mitigation Group C Stations Information not provided.
Site Security Information not provided.
Land Mobile Mitigation Group A Stations Information not provided.
Land Mobile Mitigation Expenses Engineering Evaluation

Component Description:
Land Mobile and Mask Filter design review
Amount:
$4,612.50

Component Description:
Channel 14 Land Mobile adjacent filter protection research.
Amount:
$1,050.00
AC Line Conditioners Information not provided.
Land Mobile Mitigation Group B Stations Information not provided.
Land Mobile Mitigation Group F Stations Information not provided.
Land Mobile Mitigation Group E Stations Information not provided.
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Equipment Delivery and Handling Charges Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Non-zoning permits Information not provided.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
DTV Medical Facility Notification Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $2,681,254.12 $2,558,495.12 $838,583.41

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.

Michael Smith

President


10/12/2018

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.

Michael Smith

President


10/12/2018

Attachments

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