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:
23302
Service:
DTV
Call Sign:
KGMC
Channel:
27 (UHF)
File Number:
0000028681
FRN:
0019509470
Date Submitted:
05/17/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

Cocola Broadcasting Companies, LLC

Doing Business As: Cocola Broadcasting Companies, LLC

Gary M. Cocola

706 W. Herndon Ave.

Fresno, CA 93650

United States

+1 (559) 435-7000 garyc@cocolatv.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

Greg Best

Consulting Engineer

Greg Best Consulting, Inc.

16100 Outlook Avenue

Stilwell, KS 66085

United States

+1 (816) 792-2913 gbconsulting54@gmail.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 Station will install a temporary transmitter and antenna for operation on the new repack channel by the transition date with operation authorized via STA. New xmtr and antenna will be delivered after the Phase transition date and will be installed ASAP.

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
Year 1996
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 10 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 THU9EVO-6
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 9.8 kW
Justification for New Transmitter Existing transmitter cannot be modified and mfgr. is no longer in business. See attachment for description of transmitter and reason for upgrade selection.

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) Yes
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring Yes
Size 3 inches
Length 50.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Heating and Cooling
Size 5 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 100.0 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

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 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: 283.0 kW
Manufacturer
Model ALP24HSOC
Year 1996

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? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
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: 205.0 kW
Manufacturer
Model TFU-24DSB/VP-N-R
Year 2018
Justification for New Antenna Existing antenna is a slot design and will not function on post repack channel. Applicant understands that it will be responsible for the upgrade costs for Vpol operation.

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 inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? Yes
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.

Transmission Line

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Section Question Response
Transmission Line Related Expenses Do you have transmission line related expenses? No

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 Owned
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? No
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? No
ASR Number
Coordinates (NAD83) Latitude (NAD83) 36° 44' 45.8" N-
Longitude (NAD83) 119° 17' 00.4" W-
Overall Structure Height 160.00 feet
Support Structure Height 135.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 1024.00 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Cocola Broadcasting
Date Constructed 09/11/1992


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 N/A
Helicopter Services Required Are helicopter services required? No

Primary Tower

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Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 600
Explanation Station personnel to do not have time or expertise to address all technical and logistic issues.
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers No
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements No
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning Yes
Non-zoning permits No
BLM or NFS Coordination No
FCC Construction Permit Minor Change Yes
FCC License to Cover Application Yes
FCC Special Temporary Authority Application Yes
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? No
Does this relocation require Equipment Storage? Yes
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? No
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 $564,550.00 $388,700.00 N/A $277,050.00 N/A
Total for all systems $1,245,330.00 $990,322.00 N/A $471,855.63 N/A
Primary Transmitter THU9EVO-6 $564,550.00 $388,700.00 $277,050.00
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW $494,500.00 $319,850.00 New KGMC(DT) channel 27 transmitter. $277,050.00 N/A
Switchgear - industrial 800 amp $38,200.00 $37,150.00 N/A N/A N/A
3" Rigid Conduit and Wiring (Cost per foot) $2,600.00 $2,450.00 N/A N/A N/A
Other -- HVAC Service Type: H Size:5 (Other) $19,250.00 $19,250.00 N/A N/A N/A
Other -- Building Addition Size: 100.0 $10,000.00 $10,000.00 N/A N/A N/A

Components

Actual Information Description File Name
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW

Component Description:
Invoice for the new KGMC(DT) R&S transmitter w/ cover letter attached to end of invoice
Amount:
$272,350.00

Component Description:
50% upfront cost to install the new transmitter for KGMC(DT) displacement project
Amount:
$15,000.00

Component Description:
Electrical work for the new transmitter installation for the KGMC(DT) displacement project at 50% of estimate.
Amount:
$4,700.00
Switchgear - industrial 800 amp Information not provided.
3" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Other -- HVAC Service Type: H Size:5 (Other) Information not provided.
Other -- Building Addition Size: 100.0 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 $271,710.00 $212,287.00 N/A $145,016.00 N/A
Total for all systems $1,245,330.00 $990,322.00 N/A $471,855.63 N/A
Primary Antenna TFU-24DSB/VP-N-R $271,710.00 $212,287.00 $145,016.00
UHF - Lower Power Side Mount, One station antenna -- 200-500 kW, elliptically or circularly polarized $227,000.00 $180,000.00 Applicant acknowledges it will be responsible for the upgrade cost to add eliptically polarized signal capability. Cost indicated here is for Hpol antenna only. See attached quotes and antenna cover letter. $112,729.00 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 This sweep is for existing line with new antenna. $6,400.00 N/A
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed) $9,570.00 $8,899.00 See Attached quote. $8,899.00 N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $16,988.00 See attached antenna quotes. The quotes include the cost of the scattering analysis. $16,988.00 The Custom Mount Kit for the KGMC(DT) antenna was higher than anticipated to comply with Rev G standards as engineered by Dielectric; this cost also includes the scatter analysis.
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $0.00 Cost is included as part of custom mounts. N/A N/A

Components

Actual Information Description File Name
UHF - Lower Power Side Mount, One station antenna -- 200-500 kW, elliptically or circularly polarized

Component Description:
Final 10% invoice for Dielectric Antenna plus shipping costs as provided by Dielectric
Amount:
$15,205.00

Component Description:
KGMC(DT) Antenna - final invoice
Amount:
$48,762.00

Component Description:
New UHF antenna for the KGMC(DT) transition to rf channel 27.
Amount:
$48,762.00
Sweep test of existing antenna

Component Description:
Sweep / testing of the UHF antenna for KGMC(DT) rf channel 27 transition.
Amount:
$2,880.00

Component Description:
Final 10% invoice for Repack Sweep
Amount:
$640.00

Component Description:
KGMC(DT) Antenna sweep - final invoice
Amount:
$2,880.00
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed)

Component Description:
Elbow Complex Kit for the UHF Antenna for KGMC(DT) rf transition to channel 27
Amount:
$4,004.55

Component Description:
KGMC(DT) Antenna Elbow Kit - final invoice
Amount:
$4,004.55

Component Description:
Final 10% invoice for Elbow Complex for Dielectric Antenna
Amount:
$889.90
Side mount brackets for high power antennas (if not included in antenna base cost)

Component Description:
KGMC(DT) antenna mounting kit - final invoice
Amount:
$7,644.60

Component Description:
Final 10% for Mounting
Amount:
$1,698.80

Component Description:
Custom mounting kit for the UHF antenna for KGMC(DT) transition to rf channel 27.
Amount:
$7,644.60
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) Information not provided.

Cost Information

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Transmission Line

Information not provided.

Cost Information

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Tower Equipment and Rigging Costs

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $268,500.00 $255,000.00 N/A $15,000.00 N/A
Total for all systems $1,245,330.00 $990,322.00 N/A $471,855.63 N/A
Primary Tower TOWER $268,500.00 $255,000.00 $15,000.00
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 $25,000.00 N/A N/A N/A
Short Tower (less than 500') $84,200.00 $80,000.00 N/A $15,000.00 N/A

Components

Actual Information Description File Name
Minor tower reinforcement/modifications Information not provided.
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study Information not provided.
Short Tower (less than 500')

Component Description:
50% down-payment for the Dielectric antenna installation for the KGMC(DT) displacement project.
Amount:
$15,000.00

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 $122,880.00 $121,250.00 N/A $33,018.00 N/A
Total for all systems $1,245,330.00 $990,322.00 N/A $471,855.63 N/A
Outside Professional Services $122,880.00 $121,250.00 $33,018.00
Project management of the transition $94,800.00 $90,000.00 N/A $16,000.00 N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,500.00 N/A $0.00 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 $217.00 N/A
Prepare request for Special Temporary Authorization $2,050.00 $1,500.00 N/A $1,976.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $7,500.00 Increased expense to coordinate vendor invoices / work associated with the STA transition and CP Ext and reconciliation of same. $7,100.00 The coordination, upload and processing of 399 invoices from various entities for the KGMC(DT) transition has exceeded the pre-determined cost estimate for this project.
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $5,800.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $1,925.00 N/A

Components

Actual Information Description File Name
Project management of the transition

Component Description:
Q4 Progress Report
Amount:
$87.50

Component Description:
Q1 2018 Progress Report
Amount:
$87.50

Component Description:
Project Management costs for KGMC(DT) displacement.
Amount:
$2,325.00

Component Description:
Project Management of the KGMC(DT) displacement project
Amount:
$1,200.00

Component Description:
Various project management costs for the KGMC(DT) displacement transition; CP extended to May 29, 2019. Working to finalize permanent facilities.
Amount:
$700.00

Component Description:
Project management work for the KGMC transition
Amount:
$175.00

Component Description:
Project Management support for the KGMC(DT) displacement transition.
Amount:
$2,625.00

Component Description:
Project management for the KGMC(DT) digital transition to rf channel 27.
Amount:
$1,450.00

Component Description:
Engineering services for the transition to rf channel 27 under the STA granted by the FCC
Amount:
$2,500.00

Component Description:
Project management expenses for the KGMC(DT) displacement to channel 27; CP EXT May 29, 2019
Amount:
$1,600.00

Component Description:
Project Management work for the KGMC transition project.
Amount:
$1,950.00

Component Description:
Project management for the KGMC(DT) displacement, including equipment orders and coordination
Amount:
$1,125.00

Component Description:
Work on progress report
Amount:
$175.00

Component Description:
Project management and accounting work for the displacement transition.
Amount:
$116.25
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
Attorney Fees for preparation and filing of STA for the KGMC displacement.
Amount:
$576.00
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Attorney Fees for CP application / extension.
Amount:
$217.00

Component Description:
Attorney Fees to prepare and file FCC Form 2100 for the CP application
Amount:
$477.00
Prepare request for Special Temporary Authorization

Component Description:
Prepare / review STA filing
Amount:
$576.00

Component Description:
Engineering and file STA for the KGMC(DT) displacement transition
Amount:
$875.00

Component Description:
Engineering for KGMC STA
Amount:
$525.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare and or review reimbursement form

Component Description:
Prepare, submit and manage various 399 invoices for KGMC(DT) displacement transition.
Amount:
$1,300.00

Component Description:
399 invoice prep, submit & revise for the KGMC(DT) displacement project.
Amount:
$650.00

Component Description:
Prepare 399 invoices for the KGMC(DT) digital transition.
Amount:
$1,025.00

Component Description:
Update 399 with new engineering / equipment information for the transition.
Amount:
$962.50

Component Description:
Prepare / review 399
Amount:
$87.50

Component Description:
Prepare / review 399 for updates submitted for the displacement project
Amount:
$900.00

Component Description:
Prepare / update 399 to reflect new equipment engineering.
Amount:
$525.00

Component Description:
Coordination of invoicing / reimbursement for the KGMC(DT) displacement project
Amount:
$1,150.00

Component Description:
Expense / invoice coordination for the KGMC(DT) transition by way of the 399 process.
Amount:
$500.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Revised engineering for displacement transition.
Amount:
$875.00

Component Description:
Engineering for KGMC(DT) displacement channel
Amount:
$875.00

Component Description:
Engineering work for the KGMC(DT) displacement
Amount:
$1,050.00

Component Description:
New channel engineering work
Amount:
$525.00

Component Description:
Engineering for new channel assignment
Amount:
$1,225.00

Component Description:
Engineering for new channel assignment.
Amount:
$525.00

Component Description:
KGMC(DT) repack engineering
Amount:
$200.00

Component Description:
KGMC(DT) Displacement engineering; antenna
Amount:
$525.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Engineering Form 2100 CP for KGMC displacement work
Amount:
$1,050.00

Component Description:
Engineering for Form 2100 CP for KGMC displacement
Amount:
$700.00

Component Description:
Engineering for CP Application.
Amount:
$175.00

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 $17,690.00 $13,085.00 N/A $1,771.63 N/A
Total for all systems $1,245,330.00 $990,322.00 N/A $471,855.63 N/A
Other Expenses $17,690.00 $13,085.00 $1,771.63
DTV Medical Facility Notification $11,550.00 $7,000.00 N/A $335.63 N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 N/A $96.00 N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A $190.00 N/A
Local Zoning $500.00 $500.00 Building permits, licenses, etc. N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $1,000.00 $1,000.00 N/A N/A N/A
Equipment Storage $500.00 $500.00 N/A N/A N/A
MVPD Notification of Channel Change $2,500.00 $2,500.00 N/A $1,150.00 N/A

Components

Actual Information Description File Name
DTV Medical Facility Notification

Component Description:
Medical notifications for the KGMC(DT) displacement transitions.
Amount:
$235.63

Component Description:
Prepare displacement medical notice for the KGMC(DT) Public File per FCC rules
Amount:
$100.00
FCC Filing Fees - Form 2100 minor change CP application

Component Description:
FCC Filing Fee for CP Application
Amount:
$96.00
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Special Temporary Authorization request

Component Description:
KGMC(DT) STA Filing Fee
Amount:
$190.00
Local Zoning Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Equipment Storage Information not provided.
MVPD Notification of Channel Change

Component Description:
MVPD communications and updates
Amount:
$200.00

Component Description:
MVPD notifications for KGMC(DT) displacement transition
Amount:
$650.00

Component Description:
KGMC(DT) repack MVPD viewer notifications.
Amount:
$150.00

Component Description:
Follow-up MVPD communications on around displacement date.
Amount:
$300.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $1,245,330.00 $990,322.00 $471,855.63

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.

Gary M Cocola

Managing Member


05/17/2019

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.

Gary M Cocola

Managing Member


05/17/2019

Attachments

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