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:
74464
Service:
DCA
Call Sign:
WPHY-CD
Channel:
22 (UHF)
File Number:
0000028194
FRN:
0021167069
Date Submitted:
08/30/2019

Applicant Information

Back to Top

Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

NRJ TV PHILLY LICENSE CO., LLC

Robert Andrews

722 S. DENTON TAP ROAD

SUITE 130

COPPELL, TX 75019

United States

+1 (972) 947-3391 bob@nrjventures.com Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

Back to Top

Preparer Contact Name and Information

Applicant Address Phone Email

The Preparer is same as the reimbursement contact.

 

 

 

Broadcaster Information and Transition Plan

Back to Top
Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan Replace non retuneable transmitter, replace antenna. Building new channel 22 facility at different tower, which avoids need for an interim facility.

Transmitters

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

Primary Transmitter

Back to Top

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 TXUD400LD
Year 2007
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity .5 kW

Primary Transmitter

Back to Top

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 UAXTE-4R37
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2.4 kW
Justification for New Transmitter Elettronika is not capable of re-tuning existing transmitter due to missing documentation and software for original unit.

Primary Transmitter

Back to Top

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 1 inches
Length 50.0 feet
Other Electrical Service Yes
Description Additional 208 Service for transmitter. Surge Suppressor
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

Back to Top

Other Transmitter Cost Not Listed

Name Description

Temporary Electric Circuit

Due to delay in delivery of new transformer, a temporary power supply from an adjacent suite was installed to allow transmitter installation and testing to be completed

Antennas

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

Primary Antenna

Back to Top

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 Elliptical
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 5.55 kW
Manufacturer
Model ATC-BCE66BP-50
Year 2011

Primary Antenna

Back to Top

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? Yes
New Antenna Manufacturer and Types Class Class A
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Circular
Type Broadband Panel
Number of Stations Supported 1
Number of Panels/Bays 4
Lower Limit 470.00 MHz
Upper Limit 806.00 MHz
Design power capacity in use 100.0 %
Other Antenna Type N/A
ERP: 15.0 kW
Manufacturer
Model ATC-BPC4C2-U
Year 2018
Justification for New Antenna Existing antenna is single frequency and will not work on new assigned channel 22.

Primary Antenna

Back to Top

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 6 1/8 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

Back to Top

Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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

Primary Transmission Line

Back to Top

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 Air
Diameter 1 5/8 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 135 feet per run

Primary Transmission Line

Back to Top

New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 10 feet per run
Justification for New Transmission Line Station is building channel 22 facility at a different tower site, avoiding need for interim facility. At new site using existing dormant trans line at no cost. Station only seeking reimb.for fine matcher, adapters, and elbows to tie in to existing line

Primary Transmission Line

Back to Top

Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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

Primary Tower

Back to Top

Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? No
Is this tower currently shared with any other stations? 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? Yes
ASR Number 1060096
Coordinates (NAD83) Latitude (NAD83) 40° 04' 24.0" N-
Longitude (NAD83) 075° 11' 27.0" W-
Overall Structure Height 289.69 feet
Support Structure Height 289.69 feet
Ground Elevation Above Mean Sea Level (AMSL) 350.06 feet
Structure Type B - Building
Tower Owner MORGAN TOWER, INC.
Date Constructed 01/01/1985


Primary Tower

Back to Top

Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: No study needed
Tower Reinforcements Please select whether tower reinforcements are needed: No reinforcements needed

Primary Tower

Back to Top

Tower Rigging Costs

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

Primary Tower

Back to Top

Other Tower Expenses Not Listed

Name Description

Tower Crew Expenses

Lodging, Per Diem, Travel for tower and antenna crew

Primary Tower

Back to Top

Add 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 1231524
Coordinates (NAD83) Latitude (NAD83) 40° 02' 30.1" N-
Longitude (NAD83) 075° 14' 10.1" W-
Overall Structure Height 1254.91 feet
Support Structure Height 1124.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 292.98 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner Global Tower, LLC. through American Towers, LLC
Date Constructed 11/02/2011

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
74216 WFPA-CD DTV
65190 WRTI FM
30572 WPHI-FM FM
28628 WIP-FM FM
28480 WPPT DTV
51434 WTDY-FM FM
74213 WXTU FM
72278 WPHA-CD DTV
9622 WOGL FM
23142 WWSI DTV
60850 WBPH-TV DTV
1283 WDPN-TV DTV
60560 WUVP-DT DTV
12499 WPSG DTV
12211 WPPZ-FM FM
51984 WPPX-TV DTV
7623 WGTW-TV DTV
63153 WCAU DTV

Primary Tower

Back to Top

Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Study needed for tower with candelabra
Tower Reinforcements Please select whether tower reinforcements are needed: No reinforcements needed

Primary Tower

Back to Top

Tower Rigging Costs

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

Primary Tower

Back to Top

Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

Back to Top
Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 60
Explanation Project co-ordination of logistics, and vendors to support installation and test of system. 60 hrs at $100 hr
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 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 No
RF exposure measurements Yes
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

Back to Top

Other Professional Services Expenses Not Listed

Name Description

Project Management expenses

Travel, Per Diem, Lodging for project management

Other Expenses

Back to Top
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 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? No
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

Back to Top

Other Expenses Not Listed

Information not provided.

Cost Information

Back to Top

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 $136,837.00 $83,675.15 N/A $83,285.15 N/A
Total for all systems $798,332.00 $227,489.71 N/A $132,820.19 N/A
Primary Transmitter UAXTE-4R37 $136,837.00 $83,675.15 $83,285.15
Temporary Electric Circuit $1,527.00 $1,527.00 Transmitter installation and testing would have been delayed without this temporary circuit $1,527.00 N/A
Other Electrical Service: Additional 208 Service for transmitter. Surge Suppressor $8,510.00 $8,510.00 Actual cost per invoice $8,510.00 N/A
1" Rigid Conduit and Wiring $800.00 $800.00 N/A $410.00 N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $72,838.15 8/30/2019: ~$30 upward revision to cover actual invoices $72,838.15 N/A

Components

Actual Information Description File Name
Temporary Electric Circuit

Component Description:
Temporary Transmitter Power Circuit
Amount:
$1,527.00
Other Electrical Service: Additional 208 Service for transmitter. Surge Suppressor

Component Description:
Transmitter Power incl new transformer, panel, and associated labor
Amount:
$8,510.00
1" Rigid Conduit and Wiring

Component Description:
Conduit and Wiring
Amount:
$410.00
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
Reimbursable portion of final invoice for 50% of cost of primary transmitter, plus freight and sales tax
Amount:
$40,850.39

Component Description:
Misc hardware for transmitter installation
Amount:
$364.79

Component Description:
Reimbursable portion of 1st invoice (50% downpayment) of new primary transmitter
Amount:
$31,622.97

Cost Information

Back to Top

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 $45,630.00 $35,850.00 N/A $1,364.00 N/A
Total for all systems $798,332.00 $227,489.71 N/A $132,820.19 N/A
Primary Antenna ATC-BPC4C2-U $45,630.00 $35,850.00 $1,364.00
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $3,000.00 N/A N/A N/A
UHF - Lower Power, Top Mount, Class A, broadband panel, 4 bay,, 15 kW input, directional,, elliptically or circularly polarized $26,600.00 $26,600.00 See actual quote from Alive Telecom included with invoice 2004-A. Estimate includes $21,000 base price plus 8% tax plus freight at $3,920. $0.00 N/A
Sweep test of existing antenna $6,730.00 $6,250.00 N/A $1,364.00 N/A

Components

Actual Information Description File Name
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) Information not provided.
UHF - Lower Power, Top Mount, Class A, broadband panel, 4 bay,, 15 kW input, directional,, elliptically or circularly polarized Information not provided.
Sweep test of existing antenna

Component Description:
Line Sweep
Amount:
$1,364.00

Cost Information

Back to Top

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 $2,020.00 $1,970.00 N/A $0.00 N/A
Total for all systems $798,332.00 $227,489.71 N/A $132,820.19 N/A
Primary Transmission Line $2,020.00 $1,970.00 $0.00
Rigid Transmission Line - copper, 6 1/8" $2,020.00 $1,970.00 N/A N/A N/A

Components

Information not provided.

Cost Information

Back to Top

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 $530,425.00 $39,825.01 N/A $14,600.00 N/A
Total for all systems $798,332.00 $227,489.71 N/A $132,820.19 N/A
Primary Tower B $89,425.00 $25,225.00 $0.00
Short Tower (less than 500') $84,200.00 $20,000.00 N/A N/A N/A
Tower Crew Expenses $5,225.00 $5,225.00 On site expenses for tower and antenna installation crews. N/A N/A
Primary Tower GTOWER $441,000.00 $14,600.01 $14,600.00
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $0.01 This is a placeholder figure until quotes for required work are finalized. N/A N/A
Structural engineering tower load study for a documented tower with candelabra $20,000.00 $14,600.00 N/A $14,600.00 N/A

Components

Actual Information Description File Name
Short Tower (less than 500') Information not provided.
Tower Crew Expenses Information not provided.
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) Information not provided.
Structural engineering tower load study for a documented tower with candelabra

Component Description:
Structural engineering tower load study - Resubmission with cover letter
Amount:
$6,333.33

Component Description:
Tower Mapping - Resubmission with cover letter
Amount:
$8,266.67

Cost Information

Back to Top

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 $65,880.00 $49,298.55 N/A $19,570.54 N/A
Total for all systems $798,332.00 $227,489.71 N/A $132,820.19 N/A
Outside Professional Services $65,880.00 $49,298.55 $19,570.54
Project Management expenses $2,480.00 $2,480.00 On site expenses for project management. $1,045.49 N/A
RF Exposure Measurements $21,050.00 $4,500.00 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 $1,192.00 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 engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $1,750.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $650.00 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A $670.50 N/A
Project management of the transition $9,480.00 $14,068.55 8/30/2019 revised up from $9,000 to match actual invoices received $14,068.55 kj
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $125.00 N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $500.00 N/A $69.00 N/A

Components

Actual Information Description File Name
Project Management expenses

Component Description:
Travel Expenses Dallas to Philadelphia for project management
Amount:
$1,045.49
RF Exposure Measurements 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

Component Description:
File Repack CP Modification
Amount:
$894.00

Component Description:
Re-file CP Modification
Amount:
$298.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Prep of engineering portion of initial FCC App for Construction Permit
Amount:
$1,750.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Interference Study of Repack Channel 22
Amount:
$650.00
Address transition timing and coordination issues w/ other stations and wireless

Component Description:
Attorney Fees regarding handling of AM radio condition on repack construction permit
Amount:
$670.50
Project management of the transition

Component Description:
Project Management
Amount:
$4,740.00

Component Description:
Travel Expenses Dallas to Philadelphia for Transmitter Installation
Amount:
$1,202.15

Component Description:
Address Transition Timing and Coordination Issues
Amount:
$2,500.00

Component Description:
Project Management
Amount:
$125.00

Component Description:
Project Management
Amount:
$2,648.90

Component Description:
Project Management
Amount:
$352.50

Component Description:
Site Coordination Meeting
Amount:
$2,500.00
Prepare and or review reimbursement form

Component Description:
Prepare and/or Review Reimbursement Form
Amount:
$125.00
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
Prepare Special Temporary Authorization
Amount:
$69.00

Cost Information

Back to Top

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 $17,540.00 $16,871.00 N/A $14,000.50 N/A
Total for all systems $798,332.00 $227,489.71 N/A $132,820.19 N/A
Other Expenses $17,540.00 $16,871.00 $14,000.50
MVPD Notification of Channel Change $2,400.00 $2,400.00 N/A $904.50 N/A
Develop and air announcement of upcoming channel change $450.00 $450.00 Contractor to produce announcement N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $1,500.00 $1,500.00 Disposal of old transmitter and antenna $900.00 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
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,110.00 FCC raised the fee $1,110.00 N/A
DTV Medical Facility Notification $11,550.00 $10,896.00 updated 6/2/2019 to reflect actual cost $10,896.00 N/A

Components

Actual Information Description File Name
MVPD Notification of Channel Change

Component Description:
MVPD notifications
Amount:
$904.50
Develop and air announcement of upcoming channel change Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
Contract labor for removal of channel 50 transmitters
Amount:
$900.00
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Special Temporary Authorization request

Component Description:
FCC Filing Fee - Special Temporary Authorization
Amount:
$190.00
FCC Filing Fees - Form 2100 minor change CP application

Component Description:
CP minor mod filing fee
Amount:
$1,110.00
DTV Medical Facility Notification

Component Description:
Medical Facility Notifications
Amount:
$10,896.00

Cost Information

Back to Top

Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $798,332.00 $227,489.71 $132,820.19

Reimbursement Status

Back to Top
Question Response
The facility has ceased operating on its pre-auction channel. Yes
Construction of final facilities or all necessary modifications are complete. Yes
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

Back to Top
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.

Jeff Hazelrigg

CFO


08/30/2019

Certification

Back to Top
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.

Jeff Hazelrigg

CFO


08/30/2019

Certification

Back to Top
Section Question Response
Submission of Final Allocation or Accounting Information 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 and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

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

  3. The above-named entity certifies that all costs identified as "actual costs" herein accurately represent the costs actually paid by the above-named entity, including any discounts, refunds, or rebates.

  4. 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.

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

  6. 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.

Jeff Hazelrigg

CFO


08/30/2019

Attachments

Back to Top