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:
53734
Service:
DTV
Call Sign:
WCNY-TV
Channel:
20 (UHF)
File Number:
0000028114
FRN:
0003409299
Date Submitted:
08/10/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

PUBLIC BROADCASTING COUNCIL OF CENTRAL NEW YORK

Doing Business As: PUBLIC BROADCASTING COUNCIL OF CENTRAL NEW YORK

Mindy Caporin

PO BOX 2400

SYRACUSE, NY 13220

United States

+1 (315) 453-2424 mindy.caporin@wcny.org Not-for-Profit

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. Yes
Briefly describe transition plan WCNY is sharing bottom stack antenna with WSTM on candelabra. The top stack antenna is an unused channel 54. The entire stack will be replaced with a single channel top mount for WCNY. Also replace transmitter, which cannot be retuned.

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 TDU2 6K00LV
Year 2002
Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power Capacity 6 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 THU9evo-5
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 8.2 kW
Justification for New Transmitter Manufacturer cannot retune existing 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) Yes
Transformer (480V) Yes
Power 150 kVA
Rigid Conduit and Wiring Yes
Size 3 inches
Length 100.0 feet
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

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Additional Interior RF System

Interior RF System Existing Transmitter to Interim Transmission line

Standby Exciter and Switch

Standby Exciter with Automatic Change Over Switch

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? Yes
Is the existing antenna directional? No
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? Yes
Existing Antenna Manufacturer and Type Class Full Power
Mounting Top Mount
Antenna position in stack Bottom
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: 97.0 kW
Manufacturer
Model TFU-26GBH-R 06 DC
Year 2002

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

Facility ID Call Sign
21252 WSTM-TV

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 Full Power
Mounting Top Mount
Antenna position in stack Top
Polarization Elliptical
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 86.5 kW
Manufacturer
Model TFU-28GTH/VP-R O6 DC
Year 2018
Justification for New Antenna Existing slot antenna is dual channel. It will not accommodate the assigned channel 20.

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? No
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

Interim Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? No
Will antenna be located on or in close proximity to an antenna farm? Yes
New 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/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 97.0 kW
Manufacturer
Model TBD
Year 2018
Justification for New Antenna To keep station on the air while replacing the primary antenna and throughout the duration of the assigned phase.

Interim Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? S
Feed Line Size 4 1/16 inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for an 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

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 Utilize Existing
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? Yes
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer Dielectric
Type Rigid
Diameter 8 3/16 inches
Other Diameter N/A
Segment Length 19 3/4 inches
Other Segment Length N/A
Number of parallel runs 1
Length 910 feet per run

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

Facility ID Call Sign
21252 WSTM-TV

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Sweep

Sweep line to confirm acceptable performance on assigned channel

Interim Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Interim
Description of Use N/A
Change Type Purchase New
Type Rigid
Diameter 4 1/16 inches
Segment Length 19 ½ '
Other Segment Length
Number of parallel runs 1
Length 790 feet per run
Justification for New Transmission Line To support an interim antenna for the duration of the assigned phase

Interim Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Sweep

Sweep line and antenna before applying power

Tower Equipment And Rigging Costs

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Section Question Response
Tower Equipment or Rigging Costs Changes Do you have tower equipment or rigging costs changes? Yes

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? Candelabra
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users Yes
Is tower documented for structural analysis? Unknown
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1233154
Coordinates (NAD83) Latitude (NAD83) 42° 56' 41.8" N-
Longitude (NAD83) 076° 07' 06.2" W-
Overall Structure Height 932.08 feet
Support Structure Height 804.78 feet
Ground Elevation Above Mean Sea Level (AMSL) 1416.98 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner WSTQ Licensee, LLC
Date Constructed 09/05/2003

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
21252 WSTM-TV DTV

Other Types of Users

Users
WCNY-FM STL
WSTM STL
WYYY RPU

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: Serious 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 37
Explanation Fewer Project Management "PM" tasks are required & Other Engineering Services "OES" are required, therefore the PM total has been reduced to 37 hrs ($5,550 at $150/hr), & a new OES category has been created & funded with the money removed from PM.
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study Yes
RF exposure measurements No
Additional Field Engineering Service Yes
Number of Days 14
Justification Station does not have available personnel or personnel trained in planning, purchasing and vendor oversight for complex multiple vendor RF projects

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Other Engineering Services

Other Engineering Services

Other Legal Services

Other Legal Services

Other Expenses

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

Miscellaneous Items

Miscellaneous Items

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 $728,450.00 $602,123.25 N/A $90,361.69 N/A
Total for all systems $3,079,347.50 $2,824,797.75 N/A $354,446.73 N/A
Primary Transmitter THU9evo-5 $728,450.00 $602,123.25 $90,361.69
Standby Exciter and Switch $25,000.00 $25,000.00 N/A $0.00 N/A
Additional Interior RF System $140,000.00 $140,000.00 N/A N/A N/A
3" Rigid Conduit and Wiring (Cost per foot) $5,200.00 $4,900.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW $494,500.00 $371,623.25 N/A $90,361.69 N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A
Transformer 3 phase/480v - 150 KVA $25,550.00 $24,300.00 N/A N/A N/A

Components

Actual Information Description File Name
Standby Exciter and Switch Information not provided.
Additional Interior RF System Information not provided.
3" Rigid Conduit and Wiring (Cost per foot) Information not provided.
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW

Component Description:
R&S 9500097263 TX 25 pct dp v190604jgv1
Amount:
$90,361.69
Switchgear - industrial 800 amp Information not provided.
Transformer 3 phase/480v - 150 KVA Information not provided.

Cost Information

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Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $439,910.00 $367,733.00 N/A $216,209.70 N/A
Total for all systems $3,079,347.50 $2,824,797.75 N/A $354,446.73 N/A
Interim Antenna TBD $134,110.00 $127,500.00 $0.00
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $5,000.00 N/A N/A N/A
UHF - Lower Power Side Mount, One station antenna - medium power (50-200 kW), horizontally polarized $89,400.00 $85,000.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed) $9,570.00 $9,100.00 N/A N/A N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $22,000.00 N/A N/A N/A
Primary Antenna TFU-28GTH/VP-R O6 DC $305,800.00 $240,233.00 $216,209.70
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed) $9,570.00 $10,298.00 Elbow Complex Kit for 2 Channel, broadband at antenna input for 6 1/8" $9,268.20 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $5,760.00 N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $289,500.00 $223,535.00 See Dielectric quote 700281CMZ-2 attached to inv MAN01098 $201,181.50 N/A

Components

Actual Information Description File Name
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) Information not provided.
UHF - Lower Power Side Mount, One station antenna - medium power (50-200 kW), horizontally polarized Information not provided.
Sweep test of existing antenna Information not provided.
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed) Information not provided.
Side mount brackets for high power antennas (if not included in antenna base cost) Information not provided.
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed)

Component Description:
Die MAN01098 Elbow v190610jgv4
Amount:
$4,634.10

Component Description:
Die MAN01153 Elbow Complex 45 pct pmt 2 v190610jgv3
Amount:
$4,634.10
Sweep test of existing antenna

Component Description:
Die MAN01098 Sweep v190610jgv4
Amount:
$2,880.00

Component Description:
Die MAN01153 Sweep 45 pct pmt 2 v190610jgv3
Amount:
$2,880.00
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
Die MAN01153 Antenna 45 pct pmt 2 v190610jgv3
Amount:
$100,590.75

Component Description:
Die MAN01098 Antenna v190610jgv4
Amount:
$100,590.75

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 $124,980.00 $119,450.00 N/A $0.00 N/A
Total for all systems $3,079,347.50 $2,824,797.75 N/A $354,446.73 N/A
Interim Transmission Line $118,580.00 $113,050.00 $0.00
Rigid Transmission Line - copper, 4 1/16" $112,180.00 $106,650.00 N/A N/A N/A
Sweep $6,400.00 $6,400.00 N/A N/A N/A
Primary Transmission Line $6,400.00 $6,400.00 $0.00
Sweep $6,400.00 $6,400.00 N/A N/A N/A

Components

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 $1,499,300.00 $1,425,000.00 N/A $0.00 N/A
Total for all systems $3,079,347.50 $2,824,797.75 N/A $354,446.73 N/A
Primary Tower TOWER $1,499,300.00 $1,425,000.00 $0.00
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
Serious tower reinforcement/modifications $1,052,000.00 $1,000,000.00 Assumes station will be solely responsible for candelabra tower upgrades, N/A N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $400,000.00 Bottom Stack antenna on a Candelabra will be replaced using existing transmission line. Interim antenna will be installed with rigid line to achieve licensed power, and removed at the end of the phase. N/A N/A

Components

Information not provided.

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $188,966.00 $213,300.00 N/A $26,028.00 N/A
Total for all systems $3,079,347.50 $2,824,797.75 N/A $354,446.73 N/A
Outside Professional Services $188,966.00 $213,300.00 $26,028.00
Prepare and or review reimbursement form $2,630.00 $12,500.00 The cost estimate includes the initial 399 amendment, anticipated subsequent 399 amendments, and Actual Cost invoice prep and submission by KGA. $7,470.00 N/A
Project management of the transition $5,846.00 $26,550.00 N/A $1,650.00 N/A
Other Legal Services $15,000.00 $15,000.00 Other Legal Services related to the station's Repack. $9,983.00 N/A
Other Engineering Services $21,000.00 $21,000.00 Fewer Project Management "PM" tasks are required & Other Engineering Services "OES" are required, therefore the PM total has been reduced to 37 hrs ($5,550 at $150/hr), & a new OES category has been created & funded with the money removed from PM. $1,675.00 N/A
Additional Field Engineering Service, 14 Days $28,000.00 $28,000.00 N/A $0.00 N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,500.00 N/A 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
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $3,250.00 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 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), Construction Permit Application $3,155.00 $3,000.00 N/A $2,000.00 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

Components

Actual Information Description File Name
Prepare and or review reimbursement form

Component Description:
KGA 951-17 v190810jgv1
Amount:
$1,300.00

Component Description:
KGA 951-16 v190810jgv1
Amount:
$3,670.00

Component Description:
KGA 951-02 Form 399 v190521jgv2
Amount:
$2,500.00

Component Description:
Prepare FCC Form 399 for Reimbursement
Amount:
$2,500.00
Project management of the transition

Component Description:
KGA 951-18 v190810jgv1
Amount:
$150.00

Component Description:
KGA 951-14 v190810jgv1
Amount:
$300.00

Component Description:
KGA 951-08 v190522pmv1
Amount:
$150.00

Component Description:
Preparation of FCC Schedule 387 Progress Report
Amount:
$300.00

Component Description:
KGA 951-12 v190522pmv1
Amount:
$150.00

Component Description:
KGA 951-07 v190522pmv1
Amount:
$150.00

Component Description:
KGA 951-04 Form 387 2017 Q3 v190521jgv2
Amount:
$300.00

Component Description:
KGA 951-06 v190522pmv1
Amount:
$225.00

Component Description:
KGA 951-05 v190522pmv1
Amount:
$225.00
Other Legal Services

Component Description:
GMP 30655 v190810jgv1
Amount:
$5,157.00

Component Description:
GMP 30308 v190810jgv1
Amount:
$373.50

Component Description:
GMP 29808 v190810jgv1
Amount:
$252.50

Component Description:
GMP 29310 v190810jgv1
Amount:
$50.50

Component Description:
GMP 28681 v190810jgv1
Amount:
$50.50

Component Description:
GMP 29989 v190810jgv1
Amount:
$35.00

Component Description:
GMP 30480 v190810jgv1
Amount:
$4,064.00
Other Engineering Services

Component Description:
KGA 951-15 v190810jgv1
Amount:
$1,250.00

Component Description:
KGA 951-13 OES v190604jgv2
Amount:
$125.00

Component Description:
KGA 951-09 OES v190604jgv2
Amount:
$300.00
Additional Field Engineering Service, 14 Days Information not provided.
Comprehensive coverage verification via field study, if needed 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.
Perform engineering study for new channel assignment and antenna development

Component Description:
Perform engineering study for new channel assignment and antenna development
Amount:
$3,250.00

Component Description:
KGA 951-01 Eng study v190521jgv2
Amount:
$3,250.00
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare request for Special Temporary Authorization Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
KGA 951-01 CP App v190521jgv2
Amount:
$2,000.00

Component Description:
Prepare engineering section of Form FCC Construction Permit
Amount:
$2,000.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application 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 $97,741.50 $97,191.50 N/A $21,847.34 N/A
Total for all systems $3,079,347.50 $2,824,797.75 N/A $354,446.73 N/A
Other Expenses $97,741.50 $97,191.50 $21,847.34
Equipment Storage $15,000.00 $15,000.00 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
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A $2,990.00 N/A
Equipment Delivery and Handling Charges $25,000.00 $25,000.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $0.00 $0.00 N/A N/A N/A
MVPD Notification of Channel Change $2,000.00 $2,000.00 N/A $1,585.00 N/A
Miscellaneous Items $19,191.50 $19,191.50 Items 3-8 on attached Dielectric Quote 700281CMZ-2 $17,272.34 N/A

Components

Actual Information Description File Name
Equipment Storage Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
DTV Medical Facility Notification

Component Description:
KGA 951-10 v190522pmv1
Amount:
$2,990.00
Equipment Delivery and Handling Charges Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
MVPD Notification of Channel Change

Component Description:
KGA 951-11 v190522pmv1
Amount:
$1,585.00
Miscellaneous Items

Component Description:
Die MAN01153 Test Transition 8-75 45 pct pmt 2 v190610jgv3
Amount:
$2,315.25

Component Description:
Die MAN01098 Silicone Lubricant v190610jgv4
Amount:
$17.32

Component Description:
Die MAN01098 Rigid Transmission Line v190610jgv4
Amount:
$1,827.00

Component Description:
Die MAN01153 Rigid Transmission Line 45 pct pmt 2 v190610jgv3
Amount:
$1,827.00

Component Description:
Die MAN01153 Rigid Transmission Line 45 pct pmt 2 v190610jgv3
Amount:
$1,120.50

Component Description:
Die MAN01153 Elbow 6-75 ASSY Digit 9 x 18 45 pct pmt 2 v190610jgv3
Amount:
$2,268.00

Component Description:
Die MAN01153 Silicone Lubricant 45 pct pmt 2 v190610jgv3
Amount:
$17.32

Component Description:
Die MAN01098 Test Transition 8-75 v190610jgv4
Amount:
$2,315.25

Component Description:
Die MAN01153 Reducer 8-75 x 6-75 45 pct pmt 2 v190610jgv3
Amount:
$1,088.10

Component Description:
Die MAN01098 Reducer 8-75 x 6-75 v190610jgv4
Amount:
$1,088.10

Component Description:
Die MAN01098 Rigid Transmission Line v190610jgv4
Amount:
$1,120.50

Component Description:
Die MAN01098 Elbow 6-75 ASSY Digit 9 x 18 v190610jgv4
Amount:
$2,268.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $3,079,347.50 $2,824,797.75 $354,446.73

Reimbursement Status

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Question Response
The facility has ceased operating on its pre-auction channel. Yes
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.

Jeffrey C Gehman

Engineering Associate


08/10/2019

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.

Jeffrey C Gehman

Engineering Associate


08/10/2019

Attachments

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