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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:
12033
Service:
DTV
Call Sign:
WWAY
Channel:
24 (UHF)
File Number:
0000028249
FRN:
0014489892
Date Submitted:
03/04/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

WWAY-TV, LLC

Doing Business As: WWAY-TV, LLC

Bobby Berry

301 Poplar Street

MACON, GA 31201

United States

 +1 (478) 745-4141 bberry@morrisnetwork.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

Ray Luke

Project Manager

Custom Specialty Services, LLC

Ray Luke

17363 Carlton Cuebas Road

Gulfport, MS 39503

United States

 +1 (228) 297-2500 ray.css@att.net

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 WWAY will work with WECT and WSFX-TV to repack the current shared combiner, antenna and transmission line. Each station will supply its own transmitter. WWAY and WECT own tower, RF Line, combiner, antenna and building 50/50.

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 Sigma
Year 2003
Type Inductive Output Tube
IOT Power Type Single
Power Capacity 32 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-40
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 25.3 kW
Justification for New Transmitter Old transmitter not supported and will not re-tune to new channel. While the Form 399 FAQ's instruct to list this as an upgrade, it actually is not, but rather a simple replacement. See attachment.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) Yes
Switchgear (industrial 800 amp) Yes
Transformer (480V) Yes
Power 150 kVA
Rigid Conduit and Wiring Yes
Size 3 inches
Length 150.0 feet
Other Electrical Service Yes
Description electrical power installation of transmitter, heat exchanger, pumps, transformer and breaker panels
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 10 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 2000.0 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

STL Wave-Guide

STL must be moved to new transmitter room and wave-guide replaced

ice-bridge

ice bridge must have apx. 800sqf added to cover heat exchangers and HVAC equipment

site survey

site survey for electrical drawing and floor plan

Antennas

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Section Question Response
Antenna Related Expenses Do you have antenna related expenses? Yes

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Retune Existing
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? Yes
Is the existing antenna directional? 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 Top Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 3
Number of Panels 56
Design power capacity in use 95.0 %
Lower Limit 400.00 MHz
Upper Limit 600.00 MHz
Other Antenna Type N/A
ERP: 1000.0 kW
Manufacturer Andrew
Model ABBP14H4-HTWC4-30?54
Year 2003

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

Facility ID Call Sign
72871 WSFX-TV
48666 WECT

Primary Antenna

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Adjustment to Existing Antenna

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

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? Yes
Type New
Number of channels supported 3
Frequencies of channels supported RF channel
Frequency N/A

Enter a list of RF channel numbers.

RF Channel Number
29
23
24

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

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Utilize Existing
Use Primary (Main)
Description of Use N/A
Ownership
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations?
Is Transmission Line in operating condition?
Existing Transmission Line Manufacturer and Type Manufacturer
Type
Diameter
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs
Length

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

RF line components

RF line and components for connecting transmitter to combiner

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
Is this tower consider Complex? No
Is this tower currently shared with any other stations?
One or more FM, AM or TV radio broadcaster(s) N/A
Others Types of Users N/A
Is tower documented for structural analysis?
Is tower compliant with Rev G?
Existing Tower Structure Registration Do you have a tower registration number?
ASR Number
Coordinates (NAD83) Latitude (NAD83) - -
Longitude (NAD83) - -
Overall Structure Height
Support Structure Height
Ground Elevation Above Mean Sea Level (AMSL)
Structure Type -
Tower Owner
Date Constructed


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

instalation of STL wave-guide

install wave-guide for STL link

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 1050
Explanation station is one of a group of co-owned stations all of which are subject to repack, there is no director of engineering and station has only IT engineer on staff. Co-ordination is needed for the entire group's Transition in different phases of repack
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 Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study Yes
RF exposure measurements Yes
Additional Field Engineering Service Yes
Number of Days 7
Justification field testing on combined system

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Additional legal fees

Additional legal fees for 399 forms and progress reports

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 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

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 $1,131,079.40 $1,034,363.83 N/A $569,814.13 N/A
Total for all systems $1,651,660.10 $1,579,888.53 N/A $705,574.49 N/A
Primary Transmitter ULXTE-40 $1,131,079.40 $1,034,363.83 $569,814.13
site survey $0.00 $0.00 N/A N/A N/A
ice-bridge $9,437.40 $9,437.40 ice-bridge needed to protect new heat exchanger and HVAC equipment from falling ice $8,820.00 N/A
STL Wave-Guide $17,000.00 $17,000.00 STL must be moved to new transmitter room and wave-guide replaced including state taxes $15,885.35 N/A
Other -- Building Addition Size: 2000.0 $14,792.00 $14,792.00 THIS IS REMODEL OF EXISTING ROOM AT TRANSMITTER SITE APX. 2000sf TO BE SHARED WITH WECT $7,396.00 N/A
10 Ton system $38,900.00 $18,484.43 HVAC SYSTEM WITH STATE TAX ADDED $17,275.17 N/A
Other Electrical Service: electrical power installation of transmitter, heat exchanger, pumps, transformer and breaker panels $18,000.00 $18,000.00 Electrical Service: electrical power installation of transmitter, heat exchanger, pumps, transformer and breaker panels N/A N/A
3" Rigid Conduit and Wiring (Cost per foot) $7,800.00 $7,350.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW $947,000.00 $875,000.00 N/A $520,437.61 N/A
Service entrance 3 phase/800 amp/208 volt $14,400.00 $13,700.00 N/A N/A N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A
Transformer 3 phase/480v - 150 KVA $25,550.00 $24,300.00 N/A N/A N/A

Components

Actual Information Description File Name
site survey Information not provided.
ice-bridge

Component Description:
WWAY IS A COMBINED SITE AND WECT WILL PAY OTHER HALF OF INVOICE
Amount:
$8,820.00
STL Wave-Guide

Component Description:
Wave-guide to move STL to new transmitter location
Amount:
$15,885.35
Other -- Building Addition Size: 2000.0

Component Description:
BUILDING MODS SPLIT WITH WECT with letter from THTV added
Amount:
$7,396.00
10 Ton system

Component Description:
10 ton HVAC system installed
Amount:
$17,275.17
Other Electrical Service: electrical power installation of transmitter, heat exchanger, pumps, transformer and breaker panels Information not provided.
3" Rigid Conduit and Wiring (Cost per foot) Information not provided.
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW

Component Description:
Quote from Gates and station PO
Amount:
N/A

Component Description:
1/3 payment due to ship transmitter this is 2nd transmitter payment
Amount:
$257,837.85

Component Description:
1/3 down payment on transmitter
Amount:
$262,599.76
Service entrance 3 phase/800 amp/208 volt Information not provided.
Switchgear - industrial 800 amp Information not provided.
Transformer 3 phase/480v - 150 KVA 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 $96,190.00 $137,559.00 N/A $60,616.22 N/A
Total for all systems $1,651,660.10 $1,579,888.53 N/A $705,574.49 N/A
Primary Antenna ABBP14H4-HTWC4-30?54 $96,190.00 $137,559.00 $60,616.22
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $5,000.00 N/A N/A N/A
New combiner, cost per channel (without antenna) $84,200.00 $126,159.00 This cost is above catalog because the channel combiner,mask filter and load are shared by 3 stations, but owned by 2, and by contract cost for 3 is split 2 ways. Tax and shipping still to be added See attached ERI letter of explanation. $60,616.22 You will see that the repack combiner, building, and tower expense estimates for stations WWAY and WECT are split two ways. These two stations are partners in Brunswick Tower LLC which owns the tower, building, antennas, line,
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
UHF - High Power Top Mount Three Station broadband panel antenna horizontally polarized $0.00 $0.00 N/A N/A N/A

Components

Actual Information Description File Name
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) Information not provided.
New combiner, cost per channel (without antenna)

Component Description:
50% down payment for combiner hardware
Amount:
$1,897.47

Component Description:
ERI Justification letter for Invoice # WWAY-001
Amount:
N/A

Component Description:
ERI proposal for 3 station combiner cost paid by WWAY and WECT 50/50 split each station
Amount:
N/A

Component Description:
3-Channel Combiner, Please see ERI letter of explanation of cost, attached hereto. Total cost for 3 stations is divided 2 ways by contractual obligation. WWAY is responsible $117,437.50 this invoice is for WWAY 50% deposit tax and shipping added at end
Amount:
$58,718.75

Component Description:
Tower Lease agreement
Amount:
N/A

Component Description:
WSFX lease Agreement with WWAY and WECT
Amount:
N/A

Component Description:
ERI Technical Proposal for WWAY, WECT and WSFX
Amount:
N/A
Sweep test of existing antenna Information not provided.
UHF - High Power Top Mount Three Station broadband panel antenna horizontally polarized 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 $38,030.70 $38,030.70 N/A $19,015.35 N/A
Total for all systems $1,651,660.10 $1,579,888.53 N/A $705,574.49 N/A
Primary Transmission Line $38,030.70 $38,030.70 $19,015.35
RF line components $38,030.70 $38,030.70 RF LINE COMPONENTS NEEDED TO CONNECT TRANSMITTERS TO COMBINER. INVOICE WILL BE SPLIT WITH WECT $19,015.35 N/A

Components

Actual Information Description File Name
RF line components

Component Description:
INVOICE TO CONNECT TRANSMITTERS TO COMBINER .this is 50% of WWAY'S down payment due with order
Amount:
$19,015.35

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 $19,500.00 $19,500.00 N/A $0.00 N/A
Total for all systems $1,651,660.10 $1,579,888.53 N/A $705,574.49 N/A
Primary Tower $19,500.00 $19,500.00 $0.00
instalation of STL wave-guide $19,500.00 $19,500.00 TOWER CREW TO INSTALL EW63 WAVE-GUIDE FOR STL LINK 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 $323,570.00 $307,750.00 N/A $56,128.79 N/A
Total for all systems $1,651,660.10 $1,579,888.53 N/A $705,574.49 N/A
Outside Professional Services $323,570.00 $307,750.00 $56,128.79
Additional legal fees $8,500.00 $8,500.00 N/A N/A N/A
Additional Field Engineering Service, 7 Days $9,000.00 $9,000.00 Additional Field Engineering Service, 7 Days for tuning of combiner N/A N/A
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 request for Special Temporary Authorization $3,680.00 $3,500.00 N/A $1,226.25 N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $4,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A $675.00 N/A
Prepare request for Special Temporary Authorization $2,050.00 $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
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A N/A N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $1,769.99 N/A
Project management of the transition $165,900.00 $157,500.00 N/A $52,457.55 N/A

Components

Actual Information Description File Name
Additional legal fees Information not provided.
Additional Field Engineering Service, 7 Days Information not provided.
RF Exposure Measurements Information not provided.
Comprehensive coverage verification via field study, if needed Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
Legal fees in connection with preparation and filing of STA request for change in transition phase. Prior month's charges and courtesy discount omitted from reimbursement request.
Amount:
$1,113.75

Component Description:
Provided legal information and advise regarding grant of STA for transition phase change.
Amount:
$112.50
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Provided legal advice as to required preparation of Form 2100 and required timing of same.
Amount:
$112.50

Component Description:
Legal advice and assistance in preparing and filing FCC Form 2100; fees billed in prior months and service charges omitted from this reimbursement request and reimbursement for other elements requested separately.
Amount:
$562.50
Prepare request for Special Temporary Authorization Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Perform engineering study for new channel assignment and antenna development Information not provided.
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form

Component Description:
Provided legal advice as to information needed and timing required for cost reimbursement forms.
Amount:
$112.50

Component Description:
Legal fees and costs for preparing and submitting FCC Form 1876 to obtain reimbursement of expenses.
Amount:
$464.99

Component Description:
Legal fees for preparation and filing of Schedule 399 and obtaining necessary information; fees billed in prior months and service charges omitted from this reimbursement request.
Amount:
$652.50

Component Description:
Legal services in connection with providing further information related to FCC Form 1876 and figuring out apparently inconsistent information; fees billed in prior months and service charges omitted from this reimbursement request.
Amount:
$540.00
Project management of the transition

Component Description:
CSS PROJECT MANAGEMENT INVOICE APRIL 2017 REV.
Amount:
$2,662.50

Component Description:
Project Management invoice Dec. 2018
Amount:
$2,025.00

Component Description:
MAY 2018 PROJECT MANAGEMENT INVOICE
Amount:
$562.50

Component Description:
PROJECT MANAGEMENT INVOICE SEPT 2018
Amount:
$262.50

Component Description:
PROJECT MANAGEMENT INVOICE
Amount:
$1,800.00

Component Description:
NOV. 2017 invoice for project management hours
Amount:
$8,325.00

Component Description:
Project Management invoice Nov. 2018
Amount:
$1,312.50

Component Description:
PROJECT MANAGEMENT INVOICE
Amount:
$1,933.50

Component Description:
project management invoice Oct .2018
Amount:
$1,237.50

Component Description:
DEC. 2017 for project management hours
Amount:
$1,687.50

Component Description:
OCT. 2017 invoice for project management hours
Amount:
$2,475.00

Component Description:
Jan. 2018 invoice for project management hours
Amount:
$1,575.00

Component Description:
PROJECT MANAGEMENT INVOICE
Amount:
$862.50

Component Description:
JULY 2017 PROJECT MANAGEMENT INVOICE
Amount:
$2,133.00

Component Description:
AUG 2017 PROJECT MANAGEMENT INVOICE
Amount:
$799.50

Component Description:
REVISED CSS PROJECT MANAGEMENT INVOICE JUNE 2017
Amount:
$5,101.05

Component Description:
MAR 2018 PROJECT MANAGEMENT INVOICE
Amount:
$3,637.50

Component Description:
APR 2018 PROJECT MANAGEMENT INVOICE
Amount:
$1,462.50

Component Description:
CSS PROJECT MANAGEMENT INVOICE MAY 2017
Amount:
$3,235.50

Component Description:
FEB 2018 INVOICE FOR PROJECT MANAGEMENT HOURS
Amount:
$7,425.00

Component Description:
PROJECT MANAGEMENT INVOICE
Amount:
$1,537.50

Component Description:
SEPT 2017 PROJECT MANAGEMENT INVOICE
Amount:
$405.00

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 $43,290.00 $42,685.00 N/A $0.00 N/A
Total for all systems $1,651,660.10 $1,579,888.53 N/A $705,574.49 N/A
Other Expenses $43,290.00 $42,685.00 $0.00
MVPD Notification of Channel Change $300.00 $300.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $300.00 $300.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $10,000.00 $10,000.00 N/A 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
Equipment Delivery and Handling Charges $19,500.00 $19,500.00 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 $1,651,660.10 $1,579,888.53 $705,574.49

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.

Bobby Berry

Chief Operating Officer


03/04/2019

Attachments

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