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

FCC Form 399: Incentive Auction Relocation Reimbursement Fund System

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

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

File Number:
0000028238
FRN:
0021781422
Facility ID:
14050
Repack Channel:
33 (UHF)
Entity:
Broadcaster
Filing Status:
Submitted
Date Submitted:
03/12/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

TRIBUNE BROADCASTING HARTFORD, LLC

Doing Business As: TRIBUNE BROADCASTING HARTFORD, LLC

Dean Maluski

285 BROAD STREET

HARTFORD, CT 06115

United States

+1 (860) 527-6161 dmaluski@tribunemedia.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

Bill Vanduynhoven , Vanduynhov .

Director of Engineering operations

Tribune broadcasting

Bill Vanduynhoven

2211 Rabbit Hill Cir

Dacula, GA 30019

United States

+1 (404) 312-8693 BillV@Tribunemedia.com

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan Replace antenna and replace shared Transmission line with new transmission line. Replace transmitter

Transmitters

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

Auxiliary Transmitter

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Add Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Auxiliary (Backup)
Description of Use Auxiliary
Ownership Owned
Owner  
Site  
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model Ultimate 8K8
Year 2010
Type Solid state
IOT Power Type  
Description  
Power capacity  
Solid State Cooling Liquid
Solid State Power Capacity 6 kw
Other Transmitter Type  

Auxiliary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Auxiliary (Backup)
Description of Use Auxiliary
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model ULXTE-10
Transmitter Type Solid state
IOT Power Type  
Other  
Power capacity  
Solid State Cooling Liquid
Solid State Power Capacity 6.2 kw
Other Transmitter Type  
Justification for New Transmitter Current transmitter is not supported or re-tunable as stated by the manufacturer

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
Rigid Conduit and Wiring No
Size
Length
Other Electrical Service Yes
Description Electrical Install
HVAC Service Does the replacement transmitter require HVAC Service? No
Type
Size
Other Size  
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size
Channel 14 Costs Is an RF Consulting Engineer needed?
Is a channel 14 Mask Filer needed?
Is additional field engineering time needed?
Number of Days  

Auxiliary Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

Primary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Primary (Main)
Description of Use  
Ownership Owned
Owner  
Site  
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model DCX-2
Year 2000
Type Inductive Output Tube
IOT Power Type Two
Description  
Power capacity 40 kw
Solid State Cooling  
Solid State Power Capacity  
Other Transmitter Type  

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Description of Use  
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Manufacturer
Model ULXTE-30
Transmitter Type Solid state
IOT Power Type  
Other  
Power capacity  
Solid State Cooling Liquid
Solid State Power Capacity 18 kw
Other Transmitter Type  
Justification for New Transmitter Current transmitter can not be re-tuned as stated by Manufacturer

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) No
Power
Rigid Conduit and Wiring Yes
Size 2 inches
Length 100.0 feet
Other Electrical Service No
Description  
HVAC Service Does the replacement transmitter require HVAC Service? No
Type
Size
Other Size  
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size
Channel 14 Costs Is an RF Consulting Engineer needed?
Is a channel 14 Mask Filer needed?
Is additional field engineering time needed?
Number of Days  

Primary Transmitter

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Other Transmitter Cost Not Listed

Information not provided.

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 Top-mount single
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: 50.00 kW
Manufacturer
Model TFU-10JTH/VP-R O4
Year 2008

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? No
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Type Class Full Power
Mounting Top-mount single
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: 70.00 kW
Manufacturer
Model TFU-11JTH/VP-R 04
Year 2019
Justification for New Antenna Current antenna will not work on assigned frequency

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 4 1/16 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? Yes
Is antenna directional? Yes
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 Broadband Slot
Number of Stations Supported 3
Number of Panels/Bays 16
Lower Limit 470.00 MHz
Upper Limit 665.00 MHz
Design power capacity in use 95.0 %
Other Antenna Type N/A
ERP: 500.00 kW
Manufacturer
Model TFU -WB16
Year 2019
Justification for New Antenna Temporary antenna to use during construction and transition.

Interim 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
Do you need a combiner output splitter/switcher for dual feed lines? No
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Broadband
Feed Line Size 6 1/8 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

Enter a list of RF channel numbers.

RF Channel Number
45
20
31

Interim Antenna

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Other Antenna Cost Not Listed

Name Description

Lease Cost

Tower lease cost for adding temporary antenna per station

Combiner connection

Interim antenna combiner connection and mounting

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? Yes
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 7 3/16 inches
Segment Length 19 ½ '
Other Segment Length
Number of parallel runs 1
Length 1375 feet per run

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

Facility ID Call Sign
14050 WCCT-TV
147 WTIC-TV

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Rigid
Diameter 6 1/8 inches
Segment Length 19 ½ '
Other Segment Length
Number of parallel runs 1
Length 1420 feet per run
Justification for New Transmission Line Current shared line is not supported and will not work on new channel. Also tower will not support heavier line. With the new channel assignments WCCT and WTIC cannot share a transmission line.

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 Rigid
Diameter 6 1/8 inches
Segment Length Broadband
Other Segment Length
Number of parallel runs 1
Length 1200 feet per run
Justification for New Transmission Line Transmission line for temporary operation Will be installed by WTIC.

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 Leased
Is this tower consider Complex? Candelabra
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? No
ASR Number
Coordinates (NAD83) Latitude (NAD83) 41° 42' 13.0" N-
Longitude (NAD83) 072° 49' 55.0" W-
Overall Structure Height 1338.89 feet
Support Structure Height 1291.98 feet
Ground Elevation Above Mean Sea Level (AMSL) 709.97 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner COMMUNICATIONS SITE MANAGEMENT, LLC
Date Constructed 09/01/1984

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
1900 WZMX FM
147 WTIC-TV DTV
13602 WEDH DTV
66465 WTIC-FM FM
1910 WRCH FM

Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Study needed for documented tower
Tower Reinforcements Please select whether tower reinforcements are needed: Minor Reinforcements needed

Primary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower Candelabra
Helicopter Services Required Are helicopter services required? Yes

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Weather delays

Delays in construction due to weather

Additional Insurance

Insurance increase required by Site owner

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 100
Explanation Landlord management of project
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 2
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 No
For Auxiliary Facility N/A
For Main Facility N/A
Prepare and file Form FCC License to Cover Application No
For Auxiliary Facility N/A
For Main Facility N/A
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 No
Address transition timing and coordination issues w/ other stations and wireless providers No
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements Yes
Additional Field Engineering Service Yes
Number of Days 10
Justification Intermodulation study

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 No
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? 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 $1,010,800.00 $947,500.00 N/A $531,013.04 N/A
Total for all systems $2,805,435.00 $2,109,020.00 N/A $840,578.58 N/A
Primary Transmitter ULXTE-30 $719,800.00 $692,500.00 $418,280.20
Service entrance 3 phase/800 amp/208 volt $14,050.00 $13,700.00 N/A N/A N/A
Switchgear - industrial 800 amp $37,150.00 $36,300.00 N/A N/A N/A
2" Rigid Conduit and Wiring (Cost per foot) $2,600.00 $2,500.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW $666,000.00 $640,000.00 N/A $418,280.20 N/A
Auxiliary Transmitter ULXTE-10 $291,000.00 $255,000.00 $112,732.84
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW $266,000.00 $230,000.00 N/A $112,732.84 N/A
Other Electrical Service: Electrical Install $25,000.00 $25,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Service entrance 3 phase/800 amp/208 volt Information not provided.
Switchgear - industrial 800 amp Information not provided.
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW

Component Description:
3rd Payment ULXTE-30
Amount:
$132,969.13

Component Description:
Deposit for Primary Transmitter ULXTE-30
Amount:
$140,620.08

Component Description:
Second payment for ULXTE-30
Amount:
$144,690.99
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW

Component Description:
2nd payment for ULXTE-10
Amount:
$55,911.19

Component Description:
Deposit for Aux Antenna ULXTE-10
Amount:
$56,821.65
Other Electrical Service: Electrical Install 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 $469,220.00 $234,720.00 N/A $139,902.74 N/A
Total for all systems $2,805,435.00 $2,109,020.00 N/A $840,578.58 N/A
Interim Antenna TFU -WB16 $171,850.00 $72,000.00 $0.00
Combiner connection $7,000.00 $7,000.00 N/A N/A N/A
Lease Cost $65,000.00 $65,000.00 N/A N/A N/A
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed) $13,300.00 $0.00 N/A N/A N/A
New combiner, cost per channel (without antenna) $80,000.00 $0.00 N/A N/A N/A
Sweep test of existing antenna $6,550.00 $0.00 N/A N/A N/A
UHF - High Power, Side Mount, basic slot antenna, 16 bay,, 500 kW input, directional,, horizontally polarized $0.00 $0.00 N/A N/A N/A
Primary Antenna TFU-11JTH/VP-R 04 $297,370.00 $162,720.00 $139,902.74
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $281,500.00 $147,000.00 N/A $124,875.00 N/A
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed) $9,320.00 $9,320.00 N/A $9,267.74 N/A
Sweep test of existing antenna $6,550.00 $6,400.00 N/A $5,760.00 N/A

Components

Actual Information Description File Name
Combiner connection Information not provided.
Lease Cost Information not provided.
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed) Information not provided.
New combiner, cost per channel (without antenna) Information not provided.
Sweep test of existing antenna Information not provided.
UHF - High Power, Side Mount, basic slot antenna, 16 bay,, 500 kW input, directional,, horizontally polarized Information not provided.
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
deposit - VPOL Components
Amount:
$5,973.75

Component Description:
INPUT COMPLEX 4-50 EHT
Amount:
$7,526.25

Component Description:
VPOL Components
Amount:
$5,973.75

Component Description:
deposit ANT TFU- 11JTH/VP-R 04 (SP) CH 33
Amount:
$48,937.50

Component Description:
ANT TFU- 11JTH/VP-R 04 (SP) CH 33
Amount:
$48,937.50

Component Description:
deposit - INPUT COMPLEX 4-50 EHT
Amount:
$7,526.25
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed)

Component Description:
elbow complex
Amount:
$4,633.87

Component Description:
deposit - elbow complex
Amount:
$4,633.87
Sweep test of existing antenna

Component Description:
deposit - Eng on site
Amount:
$2,880.00

Component Description:
Eng on site
Amount:
$2,880.00

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 $550,940.00 $205,000.00 N/A $169,662.80 N/A
Total for all systems $2,805,435.00 $2,109,020.00 N/A $840,578.58 N/A
Interim Transmission Line $271,200.00 $0.00 $0.00
Rigid Transmission Line - copper, 6 1/8" broadband $271,200.00 $0.00 N/A N/A N/A
Primary Transmission Line $279,740.00 $205,000.00 $169,662.80
Rigid Transmission Line - copper, 6 1/8" $279,740.00 $205,000.00 N/A $169,662.80 N/A

Components

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

Component Description:
6-1-8" 75 OHM - 1443 FT
Amount:
$82,511.42

Component Description:
deposit - T/L 6-75 EIA LENGTH 15' TO 20' FIXED FLG 1 END/ SWIVEL FLG 1
Amount:
$2,319.98

Component Description:
deposit - 6-1-8" 75 OHM - 1443 FT
Amount:
$82,511.42

Component Description:
T/L 6-75 EIA LENGTH 15' TO 20' FIXED FLG 1 END/ SWIVEL FLG 1
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 $628,300.00 $586,800.00 N/A $0.00 N/A
Total for all systems $2,805,435.00 $2,109,020.00 N/A $840,578.58 N/A
Primary Tower TOWER $628,300.00 $586,800.00 $0.00
Additional Insurance $19,000.00 $19,000.00 Included in tower quote N/A N/A
Weather delays $34,000.00 $34,000.00 Actual costs N/A N/A
Tower Helicopter Lift $0.00 $0.00 Included in Tower quote N/A N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $409,500.00 $521,800.00 As quoted by Vendor. Includes Helicopter lift N/A N/A
Minor tower reinforcement/modifications $153,500.00 $0.00 Included in tower quote N/A N/A
Structural engineering tower load study for well documented tower $12,300.00 $12,000.00 N/A 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 $55,745.00 $45,500.00 N/A $0.00 N/A
Total for all systems $2,805,435.00 $2,109,020.00 N/A $840,578.58 N/A
Outside Professional Services $55,745.00 $45,500.00 $0.00
Project management of the transition $15,400.00 $15,000.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,170.00 $7,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,070.00 $3,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,535.00 $1,500.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $3,070.00 $3,000.00 N/A N/A N/A
RF Exposure Measurements $20,500.00 $11,000.00 N/A N/A N/A
Additional Field Engineering Service, 10 Days $5,000.00 $5,000.00 N/A N/A N/A

Components

Information not provided.

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 $90,430.00 $89,500.00 N/A $0.00 N/A
Total for all systems $2,805,435.00 $2,109,020.00 N/A $840,578.58 N/A
Other Expenses $90,430.00 $89,500.00 $0.00
MVPD Notification of Channel Change $11,000.00 $11,000.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $0.00 $0.00 N/A N/A N/A
Equipment Delivery and Handling Charges $15,000.00 $15,000.00 N/A N/A N/A
AM Pattern Disturbance -- Impact study $7,680.00 $7,500.00 N/A N/A N/A
AM Pattern Disturbance -- Remedy $20,500.00 $20,000.00 N/A N/A N/A
DTV Medical Facility Notification $11,250.00 $11,000.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $25,000.00 $25,000.00 N/A N/A N/A

Components

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $2,805,435.00 $2,109,020.00 $840,578.58

Construction Status

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Question Response
Is construction complete? No

Certification

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Section Question Response
Submission of Estimated Expenses Statements

WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.

  1. The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.

  2. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

  3. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.

  4. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD).

  5. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

  6. The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred.

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

  8. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.

I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Bill VanDuynhoven

Director Engineering Operations


03/12/2019

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