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:
60026
Service:
DCA
Call Sign:
KHTV-CD
Channel:
27 (UHF)
File Number:
0000027965
FRN:
0034811976
Date Submitted:
05/07/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

VENTURE TECHNOLOGIES GROUP, LLC

5670 WILSHIRE BLVD STE 1620

LOS ANGELES, CA 90036

United States

+1 (323) 965-5400 form399@LOOP.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

The Preparer is same as the reimbursement contact.

 

 

 

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 The proposed plan is for KHTV to replace the existing channel 27 transmitter with a new solid-state transmitter, replace the existing channel 27 mask filter with a new channel 22 mask filter, and replace the existing segmented 2 1/4" foam dielectric line

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 Innovator LX 2000U
Year 2004
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 2 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? Yes
Manufacturer
Model THU9EVO4
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 6.5 kW
Justification for New Transmitter KHTV is planning on replacing the existing Axcera transmitter because the manufacturer has gone out of business and there is no support for retuning the transmitter.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring Yes
Size 2 inches
Length 20.0 feet
Other Electrical Service Yes
Description The new main transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors.
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Mask Filter

KHTV will require a new mask filter designed for channel 22 operation. The existing Myat channel 27 mask filter cannot be retuned or adapted for operation on channel 22. There is space in the existing transmitter room to accommodate the new mask

Interim Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Interim
Description of Use N/A
Change Type Purchase
Manufacturer
Model TMU9
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1.8 kW
Justification for New Transmitter The interim antenna is located within the same compound but on different tower. American Tower indicated that a new Transmitter will be required to feed this interim antenna.

Interim 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 N/A
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A
Inside RF System Is an additional interior RF system required to support this interim transmitter? No

Interim 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? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? Yes
Existing Antenna Manufacturer and Type Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 1
Number of Panels 4
Design power capacity in use 4.5 %
Lower Limit 470.00 MHz
Upper Limit 800.00 MHz
Other Antenna Type N/A
ERP: 8.1 kW
Manufacturer
Model MCI20064
Year 2012

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? No
Will antenna be located on or in close proximity to an antenna farm? Yes
New Antenna Manufacturer and Types Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Circular
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: 15.0 kW
Manufacturer
Model TFU-DSB-6B/VP
Year 2018
Justification for New Antenna Existing antenna does not have combiner or line switch. New antenna is the only way we can avoid prolonged off-air time. This system is the most efficient plan.

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? No
Broadband or Single Channel? N/A
Feed Line Size N/A
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? Yes
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

Interim Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? Yes
New Antenna Manufacturer and Type Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 15.0 kW
Manufacturer
Model DLP8M
Year 2018
Justification for New Antenna American Tower has advised that an interim transmitter and antenna are necessary because KHTV must temporarily vacate the tower on which it is currently located

Interim Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? No
Broadband or Single Channel? N/A
Feed Line Size N/A
Side Mount Brackets Do you require the separate purchase of side mount brackets for an 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

Interim Antenna

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Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Flexible Foam
Diameter Other
Other Diameter 2 1/4 inches
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 300 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Flexible Air
Diameter 3 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 300 feet per run
Justification for New Transmission Line Existing transmission line does not have combiner or line switch. New line is the only way we can avoid prolonged off-air time. This system is the most efficient method.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Interim Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Interim
Description of Use N/A
Change Type Purchase New
Type Flexible Air
Diameter 3 inches
Segment Length N/A
Other Segment Length
Number of parallel runs 1
Length 232 feet per run
Justification for New Transmission Line The interim transmission line is necessary because KHTV must move to a temporary tower location while work on the main tower is conducted.

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

Auxiliary Tower

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Add Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Auxiliary (Backup)
Description of Use Interim
Ownership Leased
Is this tower consider Complex? No
Is this tower currently shared with any other stations? No
One or more FM, AM or TV radio broadcaster(s) N/A
Others Types of Users N/A
Is tower documented for structural analysis? 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) 34° 12' 46.15" N-
Longitude (NAD83) 118° 03' 44.8" W-
Overall Structure Height 199.00 feet
Support Structure Height 199.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 5425.00 feet
Structure Type LTOWER - Lattice Tower
Tower Owner American Tower Corp
Date Constructed 06/19/2000


Auxiliary 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: No reinforcements needed

Auxiliary 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

Auxiliary Tower

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Other Tower Expenses Not Listed

Information not provided.

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? No
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1213941
Coordinates (NAD83) Latitude (NAD83) 34° 12' 47.9" N-
Longitude (NAD83) 118° 03' 44.3" W-
Overall Structure Height 199.80 feet
Support Structure Height 199.80 feet
Ground Elevation Above Mean Sea Level (AMSL) 5428.08 feet
Structure Type LTOWER - Lattice Tower
Tower Owner SpectraSite Communications, LLC. through American Towers, LLC.
Date Constructed 07/01/2000

FM, AM or TV radio broadcasters. Facility ID's, Call Signs and Services of other broadcast stations with whom the tower is shared

Facility ID Call Sign Service
63865 KILM DTV
60026 KHTV-CD DTV
22161 KRCA DTV
56384 KBEH DTV
35608 KSCI DTV
26231 KWHY-TV DTV
19783 KVEA 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: 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? No

Primary Tower

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Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 2000
Explanation KHTV will need outside project management services. KHTV anticipates needing 2,000 hours of Project management services.
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 No
Quantity N/A
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility 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 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 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 8
Justification Project Management

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning Yes
Non-zoning permits Yes
BLM or NFS Coordination No
FCC Construction Permit Minor Change Yes
FCC License to Cover Application Yes
FCC Special Temporary Authority Application No
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? Yes
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Name Description

Vehicle Rentals

Required for equipment delivery.

Interim Antenna Rental

ATC rental cost for the interim antenna

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 $612,570.00 $466,087.89 N/A $293,882.64 N/A
Total for all systems $1,980,853.00 $1,729,604.53 N/A $555,072.71 N/A
Interim Transmitter TMU9 $178,600.00 $139,760.22 $88,560.22
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $88,560.22 N/A $83,610.22 N/A
Service entrance 3 phase/800 amp/208 volt $14,400.00 $14,050.00 N/A $4,950.00 N/A
Switchgear - industrial 800 amp $38,200.00 $37,150.00 N/A N/A N/A
Primary Transmitter THU9EVO4 $433,970.00 $326,327.67 $205,322.42
Mask Filter $3,950.00 $3,950.00 N/A $0.00 N/A
Other Electrical Service: The new main transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors. $30,000.00 $30,000.00 N/A $8,500.00 N/A
2" Rigid Conduit and Wiring (Cost per foot) $520.00 $500.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW $273,500.00 $250,600.00 N/A $155,544.75 N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $41,277.67 ***System Notice: Estimate adjusted and locked because line has been superseded.*** $41,277.67 N/A

Components

Actual Information Description File Name
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
75% Final Payment on Interim Transmitter
Amount:
$63,560.97

Component Description:
Re-tune mask filter for Interim facility.
Amount:
$711.75

Component Description:
Transmitter Installation/Electrical Work
Amount:
$4,950.00

Component Description:
25% down payment on interim transmitter
Amount:
$19,337.50
Service entrance 3 phase/800 amp/208 volt

Component Description:
Electrical Installation Work. USE THIS SUBMISSION, DISREGARD DUPLICATE SUBMISSION OF SAME INVOICE.
Amount:
$4,950.00
Switchgear - industrial 800 amp Information not provided.
Mask Filter Information not provided.
Other Electrical Service: The new main transmitter will require reconfiguration of the electrical service on site. The electrical work cost has been estimated based on verbal guidance from local electrical contractors.

Component Description:
Transmitter Electrical Installation Expenses. USE THIS SUBMISSION & DISREGARD THE OTHER SUBMISSION OF INVOICE 8039
Amount:
$8,500.00

Component Description:
Electrical Work For Transmitter Installation
Amount:
$8,500.00
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW

Component Description:
25% down payment on KHTV main transmitter.
Amount:
N/A

Component Description:
75% payment for KHTV-CD main transmitter.
Amount:
$155,544.75
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
Disregard
Amount:
N/A

Component Description:
zeroed out on 12/18/18, wrong section invoice added under the interim transmitter section.
Amount:
N/A

Component Description:
R&S ETLTV Analyser
Amount:
$41,277.67

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 $66,060.00 $42,190.00 N/A $3,926.25 N/A
Total for all systems $1,980,853.00 $1,729,604.53 N/A $555,072.71 N/A
Interim Antenna DLP8M $33,030.00 $12,950.00 $0.00
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $26,300.00 $6,450.00 N/A $0.00 N/A
Sweep test of existing antenna $6,730.00 $6,500.00 N/A N/A N/A
Primary Antenna TFU-DSB-6B/VP $33,030.00 $29,240.00 $3,926.25
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $26,300.00 $22,840.00 N/A $3,926.25 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A

Components

Actual Information Description File Name
UHF - Lower Power Side Mount, Class A One Station antenna -- basic Information not provided.
Sweep test of existing antenna Information not provided.
UHF - Lower Power Side Mount, Class A One Station antenna -- basic

Component Description:
KHTV-CD Main Antenna
Amount:
$3,926.25
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 $31,388.00 $24,881.64 N/A $24,881.64 N/A
Total for all systems $1,980,853.00 $1,729,604.53 N/A $555,072.71 N/A
Interim Transmission Line $13,688.00 $6,670.24 $6,670.24
Flexible Air Transmission Line - dielectric, 3" $13,688.00 $6,670.24 N/A $6,670.24 There were unanticipated costs associated with the transmission line.
Primary Transmission Line $17,700.00 $18,211.40 $18,211.40
Flexible Air Transmission Line - dielectric, 3" $17,700.00 $18,211.40 Sales tax was not included in original estimate. $18,211.40 N/A

Components

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

Component Description:
Various transmission line accessories.
Amount:
$1,620.80

Component Description:
O-Rings
Amount:
$94.20

Component Description:
Transmission Line Jumper
Amount:
$2,009.64

Component Description:
Various Transmission Line Accessories.
Amount:
$2,945.60
Flexible Air Transmission Line - dielectric, 3"

Component Description:
Transmission line and associated hardware.
Amount:
$5,700.29

Component Description:
Transmission Line
Amount:
$12,511.11

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 $722,100.00 $671,000.00 N/A $178,834.00 N/A
Total for all systems $1,980,853.00 $1,729,604.53 N/A $555,072.71 N/A
Auxiliary Tower LTOWER $96,800.00 $83,900.00 $52,934.00
Short Tower (less than 500') $84,200.00 $81,900.00 N/A $52,934.00 N/A
Structural engineering tower load study for well documented tower $12,600.00 $2,000.00 N/A N/A N/A
Primary Tower LTOWER $625,300.00 $587,100.00 $125,900.00
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $400,000.00 N/A $104,100.00 N/A
Minor tower reinforcement/modifications $158,000.00 $150,000.00 N/A N/A N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $25,600.00 N/A $10,300.00 N/A
Structural engineering tower load study for a documented tower with candelabra $20,000.00 $11,500.00 ***System Notice: Estimate adjusted and locked because line has been superseded.***Per invoice $11,500.00 N/A

Components

Actual Information Description File Name
Short Tower (less than 500')

Component Description:
Scaffolding and Misc. Hardware needed to Rig Tower.
Amount:
$1,407.15

Component Description:
Tower Rigging / Interim Antenna Installation (Final Payment)
Amount:
$21,525.00

Component Description:
Tower equipment/Rigging
Amount:
$5,765.00

Component Description:
Tower Rigging / Interim Antenna Installation (50% deposit)
Amount:
$23,544.00

Component Description:
Scaffolding & misc. hardware needed to rig interim tower.
Amount:
$2,100.00
Structural engineering tower load study for well documented tower Information not provided.
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)

Component Description:
Scaffolding & Misc. Hardware needed to rig tower.
Amount:
$708.41

Component Description:
Scaffolding & Misc. Hardware needed to rig tower less $75.89 credit.
Amount:
$632.52

Component Description:
30% Mobilization Payment on Tower Work.
Amount:
$28,860.00

Component Description:
50% Down Payment on Tower Work.
Amount:
$48,100.00

Component Description:
20% Payment on Completion of Tower Work.
Amount:
$19,240.00

Component Description:
Disregard
Amount:
N/A

Component Description:
Disregard
Amount:
N/A

Component Description:
Disregard
Amount:
N/A

Component Description:
Scaffolding & misc. hardware needed to rig main tower.
Amount:
$7,900.00
Minor tower reinforcement/modifications Information not provided.
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study

Component Description:
Broadcast Tower Mapping
Amount:
$10,300.00
Structural engineering tower load study for a documented tower with candelabra

Component Description:
Broadcast Structural
Amount:
$9,500.00

Component Description:
Tower Mapping. Proper cost category not available in form 399.
Amount:
N/A

Component Description:
Broadcast Structural
Amount:
$2,000.00

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 $466,440.00 $443,750.00 N/A $44,893.18 N/A
Total for all systems $1,980,853.00 $1,729,604.53 N/A $555,072.71 N/A
Outside Professional Services $466,440.00 $443,750.00 $44,893.18
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 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
Project management of the transition $316,000.00 $300,000.00 N/A $35,622.25 N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $1,468.60 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
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $0.00 See: S&F FCC Repack Consulting Engineering Proposal.pdf
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $3,050.00 See: S&F FCC Repack Consulting Engineering Proposal.pdf
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Additional Field Engineering Service, 8 Days $16,000.00 $16,000.00 N/A $4,752.33 N/A
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Comprehensive coverage verification via field study, if needed 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.
Project management of the transition

Component Description:
Project Management Fees
Amount:
$684.20

Component Description:
Technical , Consultation and Planning Services. Review and answering technical questions through a telephone conference call for the follow up report for the Re-pack.
Amount:
$75.00

Component Description:
Technical , Consultation and Planning Services. Three conference calls .
Amount:
$75.00

Component Description:
Site coordination and transition planning.
Amount:
$5,000.00

Component Description:
Project Management
Amount:
$1,450.85

Component Description:
Project Management
Amount:
$1,794.80

Component Description:
Technical Consultation and Planning Services.
Amount:
$54.60

Component Description:
Technical , Consultation and Planning Services. Attended a conference at Rohde and Schwartz on 3/6/2017 concerning the 399 re-pack documentation.
Amount:
$75.00

Component Description:
Project Management
Amount:
$6,709.40

Component Description:
Project management
Amount:
$1,311.85

Component Description:
Project Management
Amount:
$1,706.25

Component Description:
Technical Consultation and Planning Services
Amount:
$54.60

Component Description:
Technical Consultation and Planning Services.
Amount:
$54.60

Component Description:
Project Management
Amount:
$1,818.40

Component Description:
Project Management
Amount:
$1,582.05

Component Description:
Project Management
Amount:
$1,705.30

Component Description:
Re-pack consulting and updating
Amount:
$75.00

Component Description:
Technical , Consultation and Planning Services. Technical , Consultation and Planning Services with Sam Hariton (Widelity).
Amount:
$75.00

Component Description:
Project Management
Amount:
$1,109.85

Component Description:
Project Management
Amount:
$1,537.35

Component Description:
Technical , Consultation and Planning Services.
Amount:
$136.50

Component Description:
Project Managment
Amount:
$6,144.60

Component Description:
Technical Consultation and Planning Services
Amount:
$54.60

Component Description:
Project Management
Amount:
$1,301.65

Component Description:
Please deny this invoice, it is a duplicate
Amount:
N/A

Component Description:
Project Management Fees
Amount:
$1,060.70

Component Description:
Project Management
Amount:
$330.00
Prepare and or review reimbursement form

Component Description:
Budget Review/Form Prep
Amount:
$522.75

Component Description:
Budget Review/Form Prep
Amount:
$945.85

Component Description:
Please Disregard.
Amount:
N/A
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Perform engineering study for new channel assignment and antenna development

Component Description:
Interference study of repack Channel 22 for KHTV-CD in Los Angeles, California; e-mail report ($650); preparation of engineering portion of initial FCC Application for Construction Permit for repack facility; e-filing ($1750)
Amount:
$1,200.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Interference study of repack Channel 22 for KHTV-CD in Los Angeles, California; e-mail report ($650); preparation of engineering portion of initial FCC Application for Construction Permit for repack facility; e-filing ($1750)
Amount:
$2,400.00

Component Description:
Prepare engineering section of FCC Form 2100, Construction Permit Application. Resubmitted to show invoice matches proposal.
Amount:
N/A

Component Description:
Preparation of revised engineering portion of initial FCC Application for Construction Permit for repack facility on Channel 22 for KHTV-CD in Los Angeles, California; e-filing ($650)
Amount:
$650.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Additional Field Engineering Service, 8 Days

Component Description:
Travel expenses for field service engineers.
Amount:
$4,752.33
RF Exposure Measurements 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 $82,295.00 $81,695.00 N/A $8,655.00 N/A
Total for all systems $1,980,853.00 $1,729,604.53 N/A $555,072.71 N/A
Other Expenses $82,295.00 $81,695.00 $8,655.00
Interim Antenna Rental $12,800.00 $12,800.00 Please see the project estimation form from ATC N/A N/A
Vehicle Rentals $5,000.00 $5,000.00 N/A N/A N/A
MVPD Notification of Channel Change $2,000.00 $2,000.00 N/A N/A N/A
Equipment Storage $2,000.00 $2,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $15,000.00 $15,000.00 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
Non-zoning permits $2,500.00 $2,500.00 N/A N/A N/A
Local Zoning $5,000.00 $5,000.00 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 $8,655.00 N/A
Develop and air announcement of upcoming channel change $15,000.00 $15,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Interim Antenna Rental Information not provided.
Vehicle Rentals Information not provided.
MVPD Notification of 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.
Local Zoning Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
DTV Medical Facility Notification

Component Description:
Notification of Medical Facilities
Amount:
$8,655.00
Develop and air announcement of upcoming channel change Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $1,980,853.00 $1,729,604.53 $555,072.71

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.

Andy Wilcoxson

General Manager


05/07/2019

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.

Andy Wilcoxson

General Manager


05/07/2019

Attachments

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