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:
68519
Service:
DTV
Call Sign:
WJKT
Channel:
21 (UHF)
File Number:
0000028516
FRN:
0009961889
Date Submitted:
01/30/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

NEXSTAR BROADCASTING, INC.

Elizabeth Ryder

545 E. JOHN CARPENTER FREEWAY

SUITE 700

IRVING, TX 75062

United States

+1 (972) 373-8800 eryder@nexstar.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

Elizabeth Ryder

General Counsel

Nexstar Broadcasting, Inc.

Elizabeth Ryder

545 E. John Carpenter Freeway

Suite 700

Irving, TX 75062

United States

+1 (972) 373-8800 eryder@nexstar.tv

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 Replace transmitter, antenna and add new line. Acquire temporary antenna and line for continued operation during construction. Use existing line and antenna throughout phase. Map, analyze tower; design and implement modifications if required. See attached

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 IOX
Year 2000
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? No
Manufacturer
Model TBD
Transmitter Type Inductive Output Tube
IOT Power Type Two
Power capacity 50 kW
Justification for New Transmitter The manufacturer of the existing IOT transmitter advises that the transmitter cannot be re-tuned to the assigned channel. A new Comark Paragon MSDC IOT transmitter is the basis for a replacement as suggested by the FCC. See attachment.

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) Yes
Power 300 kVA
Rigid Conduit and Wiring Yes
Size 3 inches
Length 100.0 feet
Other Electrical Service No
Description N/A
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

Additional Interior RF System

Interior RF System Existing Transmitter to Interim Transmission line

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: 392.0 kW
Manufacturer
Model ATL25H3-HSO-39
Year 2000

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: 193.0 kW
Manufacturer
Model TFU-23ETT/VP-R 04 (SP)
Year 2018
Justification for New Antenna The existing primary antenna is a single channel slotted coaxial which cannot accommodate the assigned channel.The main antenna is moving from side to top mount. The existing antenna will serve as interim throughout the phase.

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: 392.0 kW
Manufacturer
Model TFU-8WB-R C160
Year 2018
Justification for New Antenna A temporary antenna is necessary to keep station on the air during primary antenna work. Station will attempt to rent if renting is available at time of acquisition.

Interim Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? S
Feed Line Size 3 1/8 inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for an antenna? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? Yes
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Interim Antenna

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Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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Section Question Response
Transmission Line Related Expenses Do you have transmission line related expenses? Yes

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change 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 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1130 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? Yes
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 19 1/2 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1090 feet per run
Justification for New Transmission Line The existing primary transmission line is rigid with section lengths that cannot accommodate the assigned channel. The main antenna is moving from side to top mount so new line is needed for the new main antenna. Existing line will serve as Interim

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

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 3 inches
Segment Length N/A
Other Segment Length
Number of parallel runs 1
Length 1000 feet per run
Justification for New Transmission Line A temporary transmission line is necessary for the temporary antenna to keep station on the air during primary antenna work. Station will attempt to rent if renting is available at time of acquisition

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 Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Owned
Is this tower consider Complex? No
Is this tower currently shared with any other stations? 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? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1049754
Coordinates (NAD83) Latitude (NAD83) 35° 47' 27.0" N-
Longitude (NAD83) 089° 05' 58.0" W-
Overall Structure Height 1040.01 feet
Support Structure Height 1037.06 feet
Ground Elevation Above Mean Sea Level (AMSL) 376.96 feet
Structure Type LTOWER - Lattice Tower
Tower Owner Nexstar Broadcasting, Inc.
Date Constructed 10/10/1991


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: Serious Reinforcements needed

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Tower Foundation Modifications

Phase I: Tower-base foundation GPR survey to interpret the lateral dimensions of a potential, subgrade footing. Phase II: Mobilize GeoProbe rig for field testing. Phase III: Foundation reinforcement steel. Phase IV: Install Helical piers.

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 500
Explanation Schedule and coordinate multiple vendors, complete progress reports, and update Schedule 399. Station does not have available personnel or personnel trained in project management for such complex projects. Internal accounting and Project management.
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 Yes
FAA Consultation (including preparation of FAA Form 7460) Yes
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements No
Additional Field Engineering Service Yes
Number of Days 20
Justification It will be necessary to survey the site, plan the equipment, develop specifications for purchasing, and oversee multiple vendor RF projects. Station does not have available personnel or personnel trained in such services.

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? Yes
Is Remediation needed? Yes
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 No
FCC License to Cover Application No
FCC Special Temporary Authority Application No
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? 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

Sales Tax

Sales and use tax on goods and services

Cost Information

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Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $1,174,200.00 $1,606,470.00 N/A $495,005.00 N/A
Total for all systems $4,112,489.00 $4,458,399.00 N/A $2,404,231.91 N/A
Primary Transmitter TBD $1,174,200.00 $1,606,470.00 $495,005.00
Additional Interior RF System $140,000.00 $140,000.00 N/A N/A N/A
3" Rigid Conduit and Wiring (Cost per foot) $5,200.00 $5,000.00 N/A $2,990.16 N/A
Transformer 3 phase/480v - 300 KVA $36,800.00 $35,850.00 N/A $21,358.27 N/A
Switchgear - industrial 800 amp $38,200.00 $37,150.00 N/A $22,151.57 N/A
Two IOT system (50 kW) $954,000.00 $1,388,470.00 The purchase price of the new transmitter is based on a Proposal from Comark for a 50 kW MSDC IOT as suggested by the FCC. See attachment. $448,505.00 N/A

Components

Actual Information Description File Name
Additional Interior RF System Information not provided.
3" Rigid Conduit and Wiring (Cost per foot)

Component Description:
Electrical Services - prorated to 3" Rigid Conduit
Amount:
$2,990.16
Transformer 3 phase/480v - 300 KVA

Component Description:
Electrical services - prorated to Transformer
Amount:
$21,358.27
Switchgear - industrial 800 amp

Component Description:
Electrical services - prorated to Switchgear
Amount:
$22,151.57
Two IOT system (50 kW)

Component Description:
final 25% milestone due at commissioning 5.29.18; remaining invoice amount $43,729.24 to sales tax
Amount:
$112,126.25

Component Description:
50% milestone payment due at delivery 4.17.18
Amount:
$224,252.50

Component Description:
25% milestone billing Transmitter system
Amount:
$112,126.25

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 $498,270.00 $485,350.00 N/A $242,683.04 N/A
Total for all systems $4,112,489.00 $4,458,399.00 N/A $2,404,231.91 N/A
Interim Antenna TFU-8WB-R C160 $232,240.00 $226,300.00 $55,827.54
UHF - Lower Power Side Mount, One station - 200-500 kW, horizontally polarized $189,500.00 $184,500.00 N/A $55,827.54 N/A
Sweep test of existing antenna $6,730.00 $6,550.00 N/A N/A N/A
Elbow complex, single channel, at antenna input, per 3 1/8. feedline (if needed) $7,600.00 $7,580.00 N/A N/A N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $22,550.00 N/A N/A N/A
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $5,120.00 N/A N/A N/A
Primary Antenna TFU-23ETT/VP-R 04 (SP) $266,030.00 $259,050.00 $186,855.50
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized $247,000.00 $240,500.00 N/A $176,362.50 N/A
Sweep test of existing antenna $6,730.00 $6,550.00 N/A $195.00 N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $12,000.00 N/A $10,298.00 N/A

Components

Actual Information Description File Name
UHF - Lower Power Side Mount, One station - 200-500 kW, horizontally polarized

Component Description:
Lines 1-7 of invoice; see also Equipment Delivery
Amount:
$55,827.54
Sweep test of existing antenna Information not provided.
Elbow complex, single channel, at antenna input, per 3 1/8. feedline (if needed) Information not provided.
Side mount brackets for high power antennas (if not included in antenna base cost) Information not provided.
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) Information not provided.
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized

Component Description:
Main antenna, line 1 of invoice, 10% balance due (see cover letter)
Amount:
$17,636.26

Component Description:
Payment 2 for UHF High Power Top Mount
Amount:
$79,363.12

Component Description:
Payment 1 for UHF High Power Top Mount
Amount:
$79,363.12
Sweep test of existing antenna

Component Description:
Sweep test not provided by Dielectric, credit against previously submitted cost; see cover letter
Amount:
($2,880.00)

Component Description:
Sweep test not provided by Dielectric, credit against previously submitted cost; see cover letter
Amount:
($2,880.00)

Component Description:
Study of Transmission Line Length
Amount:
$195.00

Component Description:
Payment 2 for Sweep Test
Amount:
$2,880.00

Component Description:
Payment 1 for Sweep Test
Amount:
$2,880.00
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
Elbow complex, line 2 of invoice, 10% balance due (see cover letter)
Amount:
$1,029.80

Component Description:
Payment 2 for Elbow complex
Amount:
$4,634.10

Component Description:
Payment 1 for Elbow Complex
Amount:
$4,634.10

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 $279,180.00 $271,730.00 N/A $172,998.60 N/A
Total for all systems $4,112,489.00 $4,458,399.00 N/A $2,404,231.91 N/A
Interim Transmission Line $59,000.00 $57,000.00 $30,841.20
Flexible Air Transmission Line - dielectric, 3" $59,000.00 $57,000.00 N/A $30,841.20 N/A
Primary Transmission Line $220,180.00 $214,730.00 $142,157.40
Rigid Transmission Line - copper, 6 1/8" $220,180.00 $214,730.00 N/A $142,157.40 N/A

Components

Actual Information Description File Name
Flexible Air Transmission Line - dielectric, 3"

Component Description:
Line 1 of invoice. Installment #2 Transmission Line.
Amount:
$15,420.60

Component Description:
Line 1 of invoice. Installment #1 of Transmission Line.
Amount:
$15,420.60
Rigid Transmission Line - copper, 6 1/8"

Component Description:
Transmission line costs, see cover letter
Amount:
$9,575.78

Component Description:
Payment 1 for Rigid Transmission Line
Amount:
$63,970.83

Component Description:
Payment 1 for Rigid Transmission Line
Amount:
$2,319.98

Component Description:
Payment 2 for Rigid Transmission Line
Amount:
$63,970.83

Component Description:
Payment 2 for Rigid Transmission Line
Amount:
$2,319.98

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 $1,541,929.00 $1,480,379.00 N/A $1,318,034.00 N/A
Total for all systems $4,112,489.00 $4,458,399.00 N/A $2,404,231.91 N/A
Primary Tower LTOWER $1,541,929.00 $1,480,379.00 $1,318,034.00
Serious tower reinforcement/modifications $1,052,000.00 $996,650.00 See attached quote from PCI, Inc. Quote # 18821-5 $996,650.00 N/A
Tower Foundation Modifications $253,129.00 $253,129.00 See attached Kermit B. Buck & Son, Inc. Quote for Geotechnical and Tower Foundation Modifications $210,484.00 N/A
Tall Tower (greater than 500') $210,500.00 $205,000.00 N/A $110,900.00 N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $25,600.00 N/A N/A N/A

Components

Actual Information Description File Name
Serious tower reinforcement/modifications

Component Description:
Tower mods, amount due on acceptance and amount due on crew arrival; see also sales tax on materials 26,185.67
Amount:
$664,420.00

Component Description:
Tower modifications, balance due on completion; see also delivery freight
Amount:
$332,230.00
Tower Foundation Modifications

Component Description:
Install helical piers to reinforce foundations to add support to tower additions
Amount:
$210,484.00
Tall Tower (greater than 500')

Component Description:
Interim Antenna Installment #1
Amount:
$36,100.00

Component Description:
Amount due on completion; see also freight.
Amount:
$38,700.00

Component Description:
Amount due on crew arrival
Amount:
$36,100.00
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study 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 $221,920.00 $218,540.00 N/A $74,026.60 N/A
Total for all systems $4,112,489.00 $4,458,399.00 N/A $2,404,231.91 N/A
Outside Professional Services $221,920.00 $218,540.00 $74,026.60
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,535.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $2,050.00 $1,535.00 N/A $1,500.00 N/A
Project management of the transition $79,000.00 $77,000.00 N/A $57,401.60 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,120.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,305.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,585.00 N/A $1,500.00 N/A
ASR modification (prepare FCC Form 854) $2,105.00 $2,050.00 N/A N/A N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase $2,105.00 $2,050.00 N/A $1,125.00 N/A
Additional Field Engineering Service, 20 Days $108,000.00 $108,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,070.00 N/A $3,000.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,170.00 N/A $7,000.00 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,560.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,560.00 N/A $2,500.00 N/A

Components

Actual Information Description File Name
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare request for Special Temporary Authorization

Component Description:
Item 10 from invoice summary
Amount:
$1,500.00
Project management of the transition

Component Description:
Item 5 from invoice summary
Amount:
$150.00

Component Description:
Project Management for Structural Analysis and Tower Modifications including consultants Kessler and Gehman Associates. Services from May 27, 2017 through June 30, 2017.
Amount:
$1,000.00

Component Description:
Items 12 and 13 from invoice summary
Amount:
$4.00

Component Description:
Project Management for Structural Analysis and Tower Modifications including consultants Kessler and Gehman Associates. Services from October 27, 2017 through December 31, 2017.
Amount:
$7,800.00

Component Description:
Project management services, item 1 from invoice summary
Amount:
$13,755.00

Component Description:
Project Management for Structural Analysis and Tower Modifications. Services from January 1, 2018 through January 26, 2018.
Amount:
$7,878.20

Component Description:
Project management services 7.28.18 through 9.28.18 included consulting services provided by Kessler and Gehman Associates.
Amount:
$9,815.00

Component Description:
Item 6 from invoice summary
Amount:
$2,383.00

Component Description:
Project management services 5.26.18 through 6.29.18
Amount:
$4,920.00

Component Description:
Project management services 6.30.18 through 7.27.18
Amount:
$196.40

Component Description:
Project Management for Structural Analysis and Tower Modifications including consultants Kessler and Gehman Associates. Services from January 27, 2018 through February 23, 2018.
Amount:
$10,500.00

Component Description:
Vendor has issued a revised invoice
Amount:
($1,000.00)
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application Information not provided.
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

Component Description:
Item 9 from invoice summary
Amount:
$1,500.00
ASR modification (prepare FCC Form 854) Information not provided.
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase

Component Description:
Item 8 from invoice summary
Amount:
$550.00

Component Description:
Item 7 from invoice summary
Amount:
$575.00
Additional Field Engineering Service, 20 Days Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Vendor has issued a revised invoice
Amount:
($3,000.00)

Component Description:
Kessler & Gehman subcontractor invoice line 3
Amount:
$3,000.00

Component Description:
Item 4 from invoice summary
Amount:
$3,000.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Item 3 from invoice summary
Amount:
$7,000.00

Component Description:
Vendor has issued a revised invoice
Amount:
($7,000.00)

Component Description:
Kessler & Gehman subcontractor invoice line 2
Amount:
$7,000.00
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form

Component Description:
Vendor has issued a revised invoice
Amount:
($2,500.00)

Component Description:
Item 2 from invoice summary
Amount:
$2,500.00

Component Description:
Kessler & Gehman Subcontractor invoice line 1
Amount:
$2,500.00

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 $396,990.00 $395,930.00 N/A $101,484.67 N/A
Total for all systems $4,112,489.00 $4,458,399.00 N/A $2,404,231.91 N/A
Other Expenses $396,990.00 $395,930.00 $101,484.67
Sales Tax $263,000.00 $263,000.00 N/A $73,824.30 N/A
MVPD Notification of Channel Change $2,000.00 $2,000.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $1,500.00 $1,500.00 N/A N/A N/A
Equipment Storage $20,000.00 $20,000.00 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 $18,000.00 N/A
Non-zoning permits $25,000.00 $25,000.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $11,250.00 N/A $1,928.00 N/A
AM Pattern Disturbance -- Remedy $21,050.00 $20,500.00 N/A N/A N/A
AM Pattern Disturbance -- Impact study $7,890.00 $7,680.00 N/A N/A N/A
Equipment Delivery and Handling Charges $25,000.00 $25,000.00 N/A $7,732.37 N/A

Components

Actual Information Description File Name
Sales Tax

Component Description:
Sales tax due on 1st Installment
Amount:
$417.89

Component Description:
Sales tax due on Electrical services
Amount:
$3,491.50

Component Description:
Sales tax on materials for Tower Mods
Amount:
$26,185.67

Component Description:
sales tax due on Transmitter system
Amount:
$43,729.24
MVPD Notification of Channel Change

Component Description:
Notification of medical facilities
Amount:
$1,928.00
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
30% advance for Full Transmitter site cleanout
Amount:
$5,400.00

Component Description:
Balance due Full Transmitter site cleanout
Amount:
$12,600.00
Non-zoning permits Information not provided.
DTV Medical Facility Notification

Component Description:
WJKT Transmitter Medical Facility Notification
Amount:
$1,928.00
AM Pattern Disturbance -- Remedy Information not provided.
AM Pattern Disturbance -- Impact study Information not provided.
Equipment Delivery and Handling Charges

Component Description:
Freight costs per invoice
Amount:
$5,721.00

Component Description:
Line 8 of invoice; See also Antenna Interim.
Amount:
$1,798.37

Component Description:
Freight per invoice.
Amount:
$213.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $4,112,489.00 $4,458,399.00 $2,404,231.91

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.

Elizabeth Ryder

General Counsel


01/30/2019

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.

Elizabeth Ryder

General Counsel


01/30/2019

Attachments

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