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FCC Form 399: Reimbursement Request

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

(REFERENCE COPY - Not for submission) FCC Form 399: Reimbursement Request

Facility ID:
12793
Service:
DTV
Call Sign:
WAXN-TV
Channel:
32 (UHF)
File Number:
0000027845
FRN:
0001842491
Date Submitted:
03/04/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

WSOC TELEVISION, LLC

Doing Business As: WSOC TELEVISION, LLC.

Ted Hand

PO BOX 34665

CHARLOTTE, NC 28234

United States

 +1 (704) 335-4700 ted.hand@wsoc-tv.com Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 

Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

Ted Hand

Director of Engineering Operations

WSOC Television, LLC

Ted Hand

1901 North Tryon Street

Charlotte, NC 28206

United States

 +1 (704) 335-4732 ted.hand@coxinc.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 WAXN will install the auxiliary transmitter first. It will transmit on that system while the main transmitter is installed. There are separate antennas for main and auxiliary.

Transmitters

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Section Question Response
Transmitter Related Expenses Do you have transmitter related expenses? Yes

Auxiliary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Auxiliary (Backup)
Description of Use backup to main
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 DCD20PL3 Diamond CD
Year 1999
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 6 kW

Auxiliary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Auxiliary (Backup)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model ULXTE-10
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 6 kW
Justification for New Transmitter Current auxiliary transmitter is tuned to channel 50 and can not be tuned below channel 36

Auxiliary 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 N/A
Rigid Conduit and Wiring Yes
Size 2 inches
Length 250.0 feet
Other Electrical Service Yes
Description Wiring for water pumps and mask filter blowers
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

Auxiliary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Combiner

Combiner used to combine WAXN Aux and WSOC Aux in to one T/L. Cost is shared with WSOC-TV

Coaxial Switch

Coaxial switch for Main to Aux switching

RF Hanging Supplies

Equipment used to hang RF filters and waveguide in main room

Plumbing Supplies

Plumbing pipe and adapters for liquid cooled transmitter

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 DHD15P1 Diamond CD
Year 1999
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 8 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-12
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 8 kW
Justification for New Transmitter Current transmitter is tuned to channel 50 and can not be tuned below channel 36.

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) Yes
Power 300 kVA
Rigid Conduit and Wiring Yes
Size 2 inches
Length 250.0 feet
Other Electrical Service Yes
Description Wiring for water pumps and mask filter blowers.
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 15 tons
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? Yes
Size 320.0 square feet
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

Distilled Water

Distilled water for cooling transmitter

RF Equipment

Elbows, hangers, hardware kits, flanges

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? Yes
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 Top Mount
Antenna position in stack Top
Polarization Elliptical
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: 150.0 kW
Manufacturer
Model TFU-25ETT-V/R 4C160
Year 2009

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? No
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class Full Power
Mounting Top Mount
Antenna position in stack Top
Polarization Elliptical
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: 150.0 kW
Manufacturer
Model TFU-25ETT-V/R 4C160
Year 2009
Justification for New Antenna Current antenna is a single channel slot tuned to channel 50. It can not be retuned.

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.

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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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Auxiliary (Backup)
Description of Use backup to main
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
Other Diameter N/A
Segment Length 19 1/2 inches
Other Segment Length N/A
Number of parallel runs 1
Length 585 feet per run

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

Facility ID Call Sign
74070 WSOC-TV

Auxiliary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Auxiliary (Backup)
Description of Use backup to main
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 585 feet per run
Justification for New Transmission Line Current line is 19 1/2' sections. New assigned channel will not pass in it.

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? 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 1/2 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1070 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 1070 feet per run
Justification for New Transmission Line Current transmission line is 19 1/2' and will not pass the new assigned channel.

Primary 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 Move Equipment
Tower Use Primary (Main)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? No
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users No
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1004745
Coordinates (NAD83) Latitude (NAD83) 35° 15' 42.0" N-
Longitude (NAD83) 080° 43' 37.0" W-
Overall Structure Height 1082.01 feet
Support Structure Height 970.13 feet
Ground Elevation Above Mean Sea Level (AMSL) 855.96 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner IWG Towers Assets II, LLC
Date Constructed 01/31/2000

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
74070 WSOC-TV DTV

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

Information not provided.

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 25
Explanation Project manager hired to coordinate crews and materials.
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 No
Quantity N/A
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 Yes
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 No
BLM or NFS Coordination No
FCC Construction Permit Minor Change Yes
FCC License to Cover Application Yes
FCC Special Temporary Authority Application No
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? Yes
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Information not provided.

Cost Information

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Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $837,659.41 $727,622.55 N/A $437,799.64 N/A
Total for all systems $1,853,039.41 $1,652,587.55 N/A $622,776.90 N/A
Primary Transmitter ULXTE-12 $522,559.41 $449,809.41 $357,098.22
RF Equipment $10,000.00 $10,000.00 RF equipment needed to move WAXN aux transmitter to make room for new transmitter. $3,331.58 N/A
Distilled Water $1,300.00 $1,300.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 8 kW $359,759.41 $359,759.41 N/A $311,568.33 N/A
Transformer 3 phase/480v - 300 KVA $36,800.00 $6,100.00 Actual cost lower than estimated. $6,100.00 N/A
2" Rigid Conduit and Wiring (Cost per foot) $6,500.00 $6,250.00 N/A N/A N/A
Other Electrical Service: Wiring for water pumps and mask filter blowers. $31,800.00 $31,800.00 N/A $7,482.00 N/A
15 Ton system $55,800.00 $14,000.00 Cost to move current unit. Shared cost with WSOC-TV 74070 $13,288.00 N/A
Other -- Building Addition Size: 320.0 $20,600.00 $20,600.00 N/A $15,328.31 N/A
Auxiliary Transmitter ULXTE-10 $315,100.00 $277,813.14 $80,701.42
Plumbing Supplies $3,500.00 $3,500.00 N/A N/A N/A
RF Hanging Supplies $8,000.00 $8,000.00 N/A $1,880.37 N/A
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW $273,500.00 $236,463.14 N/A $78,821.05 N/A
2" Rigid Conduit and Wiring (Cost per foot) $6,500.00 $6,250.00 N/A N/A N/A
Other Electrical Service: Wiring for water pumps and mask filter blowers $11,600.00 $11,600.00 N/A N/A N/A
Combiner $7,300.00 $7,300.00 This is half the cost. Shared with WSOC-TV N/A N/A
Coaxial Switch $4,700.00 $4,700.00 N/A N/A N/A

Components

Actual Information Description File Name
RF Equipment

Component Description:
RF elbows, insulators, reducers
Amount:
$3,331.58
Distilled Water Information not provided.
UHF - Liquid Cooled Solid State Transmitter 8 kW

Component Description:
WAXN Main 3rd payment
Amount:
$77,660.67

Component Description:
WAXN Main 2nd payment
Amount:
$113,987.86

Component Description:
1/3 Down payment for WAXN MAIN transmitter
Amount:
$119,919.80

Component Description:
Re-submit with PO & Invoice together
Amount:
$119,919.80
Transformer 3 phase/480v - 300 KVA

Component Description:
480 VAC to 240 VAC, 300KVA transformer for WAXN
Amount:
$6,100.00
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Other Electrical Service: Wiring for water pumps and mask filter blowers.

Component Description:
Partial Electrical work done for WAXN transmitter install.
Amount:
$7,482.00
15 Ton system

Component Description:
Cost to move condenser includes new concrete pad and ice bridge. Shared cost with WSOC-TV 74070
Amount:
$13,288.00
Other -- Building Addition Size: 320.0

Component Description:
Building Addition Shared cost with WSOC-TV 74070
Amount:
$13,507.20

Component Description:
Metal Outside Doors for building addition - WAXN costs
Amount:
$1,821.11
Plumbing Supplies Information not provided.
RF Hanging Supplies

Component Description:
this submission is a correction for grainger invoice 9851514712 ADDS WAXN 12793 to invoice
Amount:
$359.94

Component Description:
Unistrut washer, end caps, connect plates, 1/1/2" pipe clamps CORRECTED WAXN-TV
Amount:
$1,029.05

Component Description:
Correction to Grainger invoice 9847490431 ADDS WAXN-TV FRN 12793 replaces
Amount:
$97.81

Component Description:
Unistrut parts: Post Base, Connect Plates
Amount:
$359.94

Component Description:
Galvanized Unistrut to mount cooling fans outdoors plus shipping ADDED WAXN-TV
Amount:
$393.57
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW

Component Description:
1/3 down payment on WAXN AUX Transmitter
Amount:
$78,821.05

Component Description:
Re-submit with PO & Invoice together
Amount:
$78,821.05
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Other Electrical Service: Wiring for water pumps and mask filter blowers Information not provided.
Combiner Information not provided.
Coaxial Switch 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 $308,530.00 $293,100.00 N/A $96,869.25 N/A
Total for all systems $1,853,039.41 $1,652,587.55 N/A $622,776.90 N/A
Primary Antenna TFU-25ETT-V/R 4C160 $308,530.00 $293,100.00 $96,869.25
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $289,500.00 $275,000.00 N/A $93,906.00 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 $2,963.25 N/A

Components

Actual Information Description File Name
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
Antenna, wedding cake, feed-thru (Item 1,2,3) (45% down)
Amount:
$93,906.00
Sweep test of existing antenna Information not provided.
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
Elbow complex (Item 4) (45% down)
Amount:
$2,963.25

Component Description:
N/A
Amount:
N/A

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 $334,310.00 $269,320.00 N/A $70,279.61 N/A
Total for all systems $1,853,039.41 $1,652,587.55 N/A $622,776.90 N/A
Primary Transmission Line $216,140.00 $157,000.00 $70,279.61
Rigid Transmission Line - copper, 6 1/8" $216,140.00 $157,000.00 N/A $70,279.61 N/A
Auxiliary Transmission Line $118,170.00 $112,320.00 $0.00
Rigid Transmission Line - copper, 6 1/8" $118,170.00 $112,320.00 This is half the cost. The other half in on WSOC-TV's Form 399. N/A N/A

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 6 1/8"

Component Description:
Transmission Line, hangers, field service (45% down)
Amount:
$70,279.61
Rigid Transmission Line - copper, 6 1/8" 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 $210,500.00 $200,000.00 N/A $0.00 N/A
Total for all systems $1,853,039.41 $1,652,587.55 N/A $622,776.90 N/A
Primary Tower TOWER $210,500.00 $200,000.00 $0.00
Tall Tower (greater than 500') $210,500.00 $200,000.00 This is half the cost. The other half is on WSOC-TV's Form 399. N/A N/A

Components

Information not provided.

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $139,445.00 $140,550.00 N/A $17,828.40 N/A
Total for all systems $1,853,039.41 $1,652,587.55 N/A $622,776.90 N/A
Outside Professional Services $139,445.00 $140,550.00 $17,828.40
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A $0.00 N/A
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application $4,210.00 $4,000.00 N/A $2,549.70 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A $4,755.70 N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application $2,105.00 $2,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A N/A N/A
Project management of the transition $3,950.00 $3,750.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $15,050.00 Actual Engineering Cost. See attached. $10,523.00 N/A

Components

Actual Information Description File Name
RF Exposure Measurements Information not provided.
Comprehensive coverage verification via field study, if needed 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

Component Description:
Full payment of invoice for legal services for WAXN-TV repack.
Amount:
$2,549.70
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Full payment of invoice for legal services for WAXN-TV repack
Amount:
$1,392.10

Component Description:
Full payment of invoice fro legal services for WAXN-TV repack.
Amount:
$1,933.50

Component Description:
Full payment for invoice fro legal services for WAXN-TV repack.
Amount:
$1,047.20

Component Description:
Full payment of invoice for legal services for WAXN-TV repack.
Amount:
$74.80

Component Description:
Full payment of invoice for legal services for WAXN-TV repack.
Amount:
$308.10
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.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Project management of the transition Information not provided.
Prepare and or review reimbursement form Information not provided.
Perform engineering study for new channel assignment and antenna development

Component Description:
Requesting 50% for WAXN...I filed for the other 50% under WSOC
Amount:
$10,523.00

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 $22,595.00 $21,995.00 N/A $0.00 N/A
Total for all systems $1,853,039.41 $1,652,587.55 N/A $622,776.90 N/A
Other Expenses $22,595.00 $21,995.00 $0.00
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 $2,600.00 $2,600.00 N/A N/A N/A
Equipment Delivery and Handling Charges $0.00 $0.00 N/A $0.00 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $3,500.00 $3,500.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 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

Components

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate 		Estimated Cost Actual Cost
Total for all systems $1,853,039.41 $1,652,587.55 $622,776.90

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.

Ted Hand

Director of Engineering/Operations


03/04/2019

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.

Ted Hand

Director of Engineering/Operations


03/04/2019

Attachments

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