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

FCC Form 399: Reimbursement Request

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

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

Facility ID:
18283
Service:
DTV
Call Sign:
KODE-TV
Channel:
23 (UHF)
File Number:
0000028335
FRN:
0004284899
Date Submitted:
08/16/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

Mission Broadcasting, Inc.

30400 DETROIT ROAD

SUITE 304

WESTLAKE, OH 44145

United States

+1 (440) 526-2227 missionbroadcasting@gmail.com Corporation

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

Henry Gola

Wiley Rein LLP

1776 K Street, N.W.

Washington, DC 20006

United States

+1 (202) 719-7561 hgola@wileyrein.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 KODE is moving 1.5 km from its licensed site to collocate with KSNF so that both stations can share antennas & transmission line. Since KODE can operate at its existing site during the buildout, it will not need a new interim antenna or new interim line.

Question Response
Sharee Station Facility ID 67766
Call Sign KSNF
Type Commercial
Licensee Name Nexstar Broadcasting, Inc.
Status LICENSED
DTS No
Community of License JOPLIN, MO
Pre-auction RF Channel 46
Post-auction RF Channel 17
Neilsen DMA Joplin-Pittsburg
Network Affiliation

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 Quantum QXD-2
Year 2008
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 60 kW

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model PRLX U24 D23
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 40 kW
Justification for New Transmitter Baseline ERP is 720 kW. Based on an RMS gain of 28.7, a line loss of 0.797, a filter loss of 0.931 and a combiner loss of 0.933, the H-pol only TPO required is 36.2 kW.

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 300 kVA
Rigid Conduit and Wiring Yes
Size 3 inches
Length 500.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Heating and Cooling
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 720.0 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

Additional Interior RF System

Interior RF System for combining with KSNF

Remove Interim Transmitter

Remove existing transmitter from transmitter building when no longer in use as an interim transmitter

Antennas

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

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? No
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 1000.0 kW
Manufacturer
Model TFU-34JSC-R 03
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? Yes
Ownership Owned
Owner N/A
Is antenna shared? Yes
Is antenna directional? No
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Broadband Panel
Number of Stations Supported 2
Number of Panels/Bays 16
Lower Limit 491.00 MHz
Upper Limit 527.00 MHz
Design power capacity in use 66.0 %
Other Antenna Type N/A
ERP: 1000.0 kW
Manufacturer
Model TUM25-04-16/64H-R-1-T
Year 2018
Justification for New Antenna The existing primary antenna is a single channel slotted coaxial which cannot accommodate the assigned channel. It is considered an upgrade but should be fully reimbursable since it will be a shared antenna with KSNF.

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 2
Frequencies of channels supported Upper and lower frequency
Frequency 491.0 MHz - 527.0 MHz
Do you need a combiner output splitter/switcher for dual feed lines? Yes
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Broadband
Feed Line Size 8 3/16 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

Name Description

Antenna Removal

Remove existing antenna from current tower once it is no longer needed for interim operation

Top Plate Mods

The existing top plate will need to be studied and possibly modified to support and interface with the new top-mount antenna

Transmission Line

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

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 930 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Type Rigid
Diameter 8 3/16 inches
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 1
Length 1090 feet per run
Justification for New Transmission Line Transmission line will be shared with the KSNF post-auction facility which will result in an overall system savings for the FCC since the stations will collocate instead of build-out independently at separate sites.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

TX Line Removal

Remove existing transmission line from current tower once it is no longer needed for interim operation.

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? 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? No
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1012933
Coordinates (NAD83) Latitude (NAD83) 37° 04' 34.9" N-
Longitude (NAD83) 094° 32' 16.4" W-
Overall Structure Height 981.94 feet
Support Structure Height 980.96 feet
Ground Elevation Above Mean Sea Level (AMSL) 1042.97 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner SpectraSite Communications, LLC. through American Towers, LLC.
Date Constructed 01/01/1965

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
51101 KOZJ DTV

Primary Tower

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Tower Modification Costs

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

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

KSNF Tower

The modifications noted in the 399 are for the KSNF tower (not existing tower) since KODE will be collocating at that site with KSNF.

Weather Delays

Weather delays

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 750
Explanation Schedule and coordinate multiple vendors, complete progress reports, and update Schedule 399. Station does not have available personnel or personnel trained in project management for such complex projects. Internal accounting and Project management.
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification Yes
FAA Consultation (including preparation of FAA Form 7460) Yes
Negotiation of Lease and other Matter for Shared Locations 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 No
RF exposure measurements No
Additional Field Engineering Service Yes
Number of Days 25
Justification It will be necessary to survey the site, plan the equipment, develop specifications for purchasing, and oversee multiple vendor RF projects. Station does not have available personnel or personnel trained in such services.

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? Yes
Is Remediation needed? Yes
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning No
Non-zoning permits Yes
BLM or NFS Coordination No
FCC Construction Permit Minor Change No
FCC License to Cover Application No
FCC Special Temporary Authority Application 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? Yes
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Name Description

Sales Tax

Sales and use tax on goods and services

Interim Facility Disposal

Interim antenna, transmission line, transmitter and associated equipment must be removed from existing site once assigned phase is complete

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 $1,880,611.00 $1,467,668.00 N/A $1,168,168.00 N/A
Total for all systems $4,693,016.00 $3,027,305.13 N/A $1,774,795.27 N/A
Primary Transmitter PRLX U24 D23 $1,880,611.00 $1,467,668.00 $1,168,168.00
Remove Interim Transmitter $25,000.00 $25,000.00 N/A N/A N/A
Additional Interior RF System $140,000.00 $140,000.00 N/A N/A N/A
Other -- Building Addition Size: 720.0 $66,711.00 $66,711.00 Costs: 1) Electrical for new bldg is $42,500; 2) New 24x30 building is $49,672; & 3) New Ice Shield is $41,250. Total cost of $133,422.Since these are shared expenses with KSNF, the shared cost is $66,711. See attached Fagan Electric, MSBI & PCI quotes. $66,711.00 N/A
10 Ton system $60,500.00 $25,000.00 N/A N/A N/A
3" Rigid Conduit and Wiring (Cost per foot) $26,000.00 $24,500.00 N/A N/A N/A
Transformer 3 phase/480v - 300 KVA $36,800.00 $35,000.00 N/A N/A N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A
Service entrance 3 phase/800 amp/208 volt $14,400.00 $13,700.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW $1,473,000.00 $1,101,457.00 Cost reduced from $1,400,000 to $1,101,457; see Hitachi quote P#3811PRLXU24-KODE-080718 $1,101,457.00 N/A

Components

Actual Information Description File Name
Remove Interim Transmitter Information not provided.
Additional Interior RF System Information not provided.
Other -- Building Addition Size: 720.0

Component Description:
Transmitter building, installment #3, shared cost with KSNF FAC ID 67766
Amount:
$4,668.80

Component Description:
Concrete pad & Ice shield, balance due
Amount:
$6,875.00

Component Description:
Concrete pad and ice shield, installment #1; see also sales & use tax.
Amount:
$13,750.00

Component Description:
Transmitter building, installment #1, shared cost with KSNF FAC ID 67766
Amount:
$4,967.20

Component Description:
Transmitter building, installment #2, shared cost with KSFN FAC ID 67766
Amount:
$15,200.00

Component Description:
Electrical service to transmitter building, installment #2, 50% of invoice, shared cost with KSNF FAC ID 67766
Amount:
$10,000.00

Component Description:
Electrical service to transmitter building, installment #3, 50% of invoice, shared cost with KSNF FAC ID 67766
Amount:
$5,250.00

Component Description:
Electrical service, installment #1, 50% of invoice, shared cost with KSNF FAC ID 67766
Amount:
$6,000.00
10 Ton system Information not provided.
3" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Transformer 3 phase/480v - 300 KVA Information not provided.
Switchgear - industrial 800 amp Information not provided.
Service entrance 3 phase/800 amp/208 volt Information not provided.
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW

Component Description:
Transmitter, installment #1
Amount:
$550,728.50

Component Description:
Transmitter, installment #3
Amount:
$55,072.85

Component Description:
Transmitter, installment #2
Amount:
$495,655.65

Component Description:
Transmitter, installment #3
Amount:
$55,072.85

Component Description:
Transmitter, installment #2
Amount:
$495,655.65

Component Description:
Transmitter, installment #1
Amount:
$550,728.50

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 $1,041,380.00 $389,310.00 N/A $259,816.50 N/A
Total for all systems $4,693,016.00 $3,027,305.13 N/A $1,774,795.27 N/A
Primary Antenna TUM25-04-16/64H-R-1-T $1,041,380.00 $389,310.00 $259,816.50
Top Plate Mods $12,500.00 $12,500.00 Cost will be in excess of $25,000. Shared expense with KSNF; therefore, budgeting for $12,500 for each station. N/A N/A
Antenna Removal $25,000.00 $25,000.00 N/A N/A N/A
Elbow complex, broadband, at antenna input, per 8 3/16. feedline (if needed) $18,950.00 $8,250.00 Elbow complex cost is $16,500 (see Dielectric Quote); however, it is a shared expense with KSNF. Therefore, the cost for KODE is $8,250. $7,492.50 N/A
Combiner output splitting/switching for dual feed lines, if applicable $126,000.00 $60,000.00 Shared expense with KSNF; therefore, budgeting for $60,000 for each station. N/A N/A
New combiner, cost per channel (without antenna) $84,200.00 $31,285.00 Shared expense with KSNF; therefore, budgeting for $40,000 for each station. Cost reduced from $40,000 to $31,285; see Dielectric quote 800172CMZ $28,156.50 N/A
UHF - High Power Top Mount (200-1000 kW), Two Station broadband panel antenna, elliptically or circularly polarized $768,000.00 $249,075.00 Antenna cost is $627,000, less VPOL $128,850 for net cost of $498,150 (see attached Dielectric Quote); however, it is a shared expense with KSNF. Therefore, the cost for KODE is $249,075. $224,167.50 N/A
Sweep test of existing antenna $6,730.00 $3,200.00 Shared expense with KSNF; therefore, budgeting for $3,200 for each station. N/A N/A

Components

Actual Information Description File Name
Top Plate Mods Information not provided.
Antenna Removal Information not provided.
Elbow complex, broadband, at antenna input, per 8 3/16. feedline (if needed)

Component Description:
KODE share of elbow cost, installment #2; see also KSNF FAC ID 67766.
Amount:
$3,746.25

Component Description:
KODE share of elbow cost, installment #1; see also KSNF FAC ID 67766.
Amount:
$3,746.25
Combiner output splitting/switching for dual feed lines, if applicable Information not provided.
New combiner, cost per channel (without antenna)

Component Description:
Combiner, installment #1, shared cost with KSNF FAC ID 67766
Amount:
$14,078.25

Component Description:
Combiner, installment #2, shared cost with KSNF FAC ID 67766
Amount:
$14,078.25
UHF - High Power Top Mount (200-1000 kW), Two Station broadband panel antenna, elliptically or circularly polarized

Component Description:
KODE share of antenna cost, installment #1; see also KSNF FAC ID 67766.
Amount:
$112,083.75

Component Description:
KODE share of antenna cost, installment #2; see also KSNF FAC ID 67766.
Amount:
$112,083.75
Sweep test of existing antenna 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 $459,910.00 $159,887.13 N/A $121,398.40 N/A
Total for all systems $4,693,016.00 $3,027,305.13 N/A $1,774,795.27 N/A
Primary Transmission Line $459,910.00 $159,887.13 $121,398.40
TX Line Removal $25,000.00 $25,000.00 N/A N/A N/A
Rigid Transmission Line - copper, 8 3/16" broadband $434,910.00 $134,887.13 Transmission Line cost is $269,774.25 (see Dielectric Quote); however, it is a shared expense with KSNF. Therefore, the cost for KODE is $134,887.13. The shared expense for larger line is less than each station independently purchasing 6-1/8" rigid line. $121,398.40 N/A

Components

Actual Information Description File Name
TX Line Removal Information not provided.
Rigid Transmission Line - copper, 8 3/16" broadband

Component Description:
KODE share of transmission line cost, installment #2; see also KSNF FAC ID 67766.
Amount:
$1,680.75

Component Description:
KODE share of transmission line cost, installment #1; see also KSNF FAC ID 67766.
Amount:
$59,018.45

Component Description:
KODE share of transmission line cost, installment #2; see also KSNF FAC ID 67766.
Amount:
$59,018.45

Component Description:
KODE share of transmission line cost, installment #1; see also KSNF FAC ID 67766.
Amount:
$1,680.75

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 $682,400.00 $337,100.00 N/A $213,749.88 N/A
Total for all systems $4,693,016.00 $3,027,305.13 N/A $1,774,795.27 N/A
Primary Tower GTOWER $682,400.00 $337,100.00 $213,749.88
Weather Delays $24,600.00 $24,600.00 Weather delays per Coast to Coast, $300 per day per person $24,600.00 N/A
Major tower reinforcement/modifications $421,000.00 $200,000.00 Shared with KSNF $142,326.00 N/A
KSNF Tower $0.00 $0.00 This was only added as a note. N/A N/A
Tall Tower (greater than 500') $210,500.00 $100,000.00 Shared with KSNF $46,823.88 N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $12,500.00 Shared with KSNF N/A N/A

Components

Actual Information Description File Name
Weather Delays

Component Description:
Weather delays 1.28.19 to 2.11.19
Amount:
$10,200.00

Component Description:
Weather delays 12.31.18 to 1.22.19
Amount:
$14,400.00
Major tower reinforcement/modifications

Component Description:
Tower modifications, installment #3
Amount:
$52,511.90

Component Description:
Tower modifications, balance due on completion
Amount:
$15,000.00

Component Description:
Tower modifications, installment #2
Amount:
$25,000.00

Component Description:
Tower Modification Services, installment #1
Amount:
$49,814.10
KSNF Tower Information not provided.
Tall Tower (greater than 500')

Component Description:
Antenna system replacement services, installment #1
Amount:
$46,823.88
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study Information not provided.

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $220,130.00 $211,750.00 N/A $9,300.00 N/A
Total for all systems $4,693,016.00 $3,027,305.13 N/A $1,774,795.27 N/A
Outside Professional Services $220,130.00 $211,750.00 $9,300.00
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $0.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $0.00 N/A
Project management of the transition $118,500.00 $112,500.00 N/A $9,300.00 N/A
Additional Field Engineering Service, 25 Days $62,500.00 $62,500.00 Flat fee $2,500 per site visit including expenses. N/A N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase $2,105.00 $2,000.00 N/A N/A N/A
ASR modification (prepare FCC Form 854) $2,105.00 $2,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,500.00 N/A N/A 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 N/A 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
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 $0.00 N/A

Components

Actual Information Description File Name
Perform engineering study for new channel assignment and antenna development

Component Description:
Perform engineering study for new channel assignment, item 3 from invoice summary
Amount:
$7,000.00

Component Description:
See item 3 from invoice summary
Amount:
$7,000.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Prepare engineering section of Form 2100, item 4 from invoice summary
Amount:
$3,000.00

Component Description:
See item 4 on the invoice summary
Amount:
$3,000.00
Project management of the transition

Component Description:
Prepare Schedule 387, item 5 from invoice summary
Amount:
$300.00

Component Description:
Prepare Schedule 387, item 6 from invoice summary
Amount:
$150.00

Component Description:
Prepare Schedule 387, item 8 from invoice summary
Amount:
$150.00

Component Description:
Update reimbursement form, item 7 from invoice summary
Amount:
$1,200.00

Component Description:
Project management services, item 1 from invoice summary
Amount:
$10,500.00

Component Description:
Project Management for Structural Analysis and Tower Modifications. Services Osborn invoice from Sept. 29, 2018 through Oct 26, 2018. Includes contractor invoice from Kessler and Gehman Assoc for Progress Report prep October 2018.
Amount:
$300.00

Component Description:
Project Management for Structural Analysis and Tower Modifications. Services from June 30, 2018 through July 27, 2018.
Amount:
$1,125.00

Component Description:
Project Mgt for Structural Analysis and Tower Modifications.Services from Osborn October 27, 2018 through November 30, 2018 invoice also includes contractor invoice from Kessler and Gehman Assoc services February 15, 2018 through October 26, 2018.
Amount:
$5,550.00

Component Description:
Project management services, item 1 from invoice summary
Amount:
$10,500.00

Component Description:
Project Management for Structural Analysis and Tower Modifications. Services from December 1, 2018 through December 31, 2018.
Amount:
$450.00

Component Description:
Project Management services from July 28,2018 through September 28, 2018.
Amount:
$1,200.00

Component Description:
Project Management for Structural Analysis and Tower Modifications to including services provided by consultant Kessler and Gehman Associates from May 26, 2018 through June 29, 2018.
Amount:
$675.00
Additional Field Engineering Service, 25 Days Information not provided.
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase Information not provided.
ASR modification (prepare FCC Form 854) Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
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 Information not provided.
Prepare request for Special Temporary Authorization Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application 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:
Prepare reimbursement form, item 2 from invoice summary
Amount:
$2,500.00

Component Description:
See item 2 from invoice summary
Amount:
$2,500.00

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $408,585.00 $461,590.00 N/A $2,362.49 N/A
Total for all systems $4,693,016.00 $3,027,305.13 N/A $1,774,795.27 N/A
Other Expenses $408,585.00 $461,590.00 $2,362.49
Interim Facility Disposal $25,000.00 $25,000.00 N/A N/A N/A
Sales Tax $237,900.00 $237,900.00 N/A $396.09 N/A
MVPD Notification of Channel Change $3,500.00 $3,500.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $1,500.00 $1,500.00 Costs to develop and produce spots and crawls for viewer notification. N/A N/A
Equipment Storage $25,000.00 $25,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $25,000.00 $25,000.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $25,000.00 $25,000.00 N/A N/A N/A
Non-zoning permits $25,000.00 $25,000.00 N/A N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A $1,966.40 N/A
AM Pattern Disturbance -- Impact study $7,890.00 $22,500.00 Three AM stations within 3.28 kM N/A N/A
AM Pattern Disturbance -- Remedy $21,050.00 $60,000.00 Three AM stations within 3.28 kM N/A N/A

Components

Actual Information Description File Name
Interim Facility Disposal Information not provided.
Sales Tax

Component Description:
Tax on materials
Amount:
$396.09
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Non-zoning permits Information not provided.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
DTV Medical Facility Notification

Component Description:
Notification of medical facilities
Amount:
$1,966.40
AM Pattern Disturbance -- Impact study Information not provided.
AM Pattern Disturbance -- Remedy Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $4,693,016.00 $3,027,305.13 $1,774,795.27

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.

Dennis P. Thatcher

President


08/16/2019

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.

Dennis P. Thatcher

President


08/16/2019

Attachments

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