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:
73107
Service:
DTV
Call Sign:
WITI
Channel:
33 (UHF)
File Number:
0000028241
FRN:
0005795067
Date Submitted:
02/18/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

WITI LICENSE, LLC

Doing Business As: WITI LICENSE, LLC

Bob Karlinsey

9001 N. GREEN BAY ROAD

MILWAUKEE, WI 53209

United States

+1 (414) 355-6666 bkalrinsey@nexstar.tv 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

Bill Vanduynhoven , Vanduynhov .

Sr Director of Engineering RF Systems

Nexstar Broadcasting Inc.

Bill Vanduynhoven

2211 Rabbit Hill Cir

Dacula, GA 30019

United States

+1 (404) 312-8693 bvanduynhoven@nexstar.tv

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 Replace Main antenna with shared antenna Replace Aux antenna with shared antenna Replace transmitter

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 Paragon DCXP3
Year 2004
Type Inductive Output Tube
IOT Power Type Three
Power Capacity 75 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 ULXTE-90
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 53 kW
Justification for New Transmitter WITI has no Standby transmitter. Replacement transmitter is more cost effective then re-tuneing existing with rental of a Interim tranmitter

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) Yes
Switchgear (industrial 800 amp) Yes
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring Yes
Size 2 inches
Length 200.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Heating and Cooling
Size 30 tons
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

Asbestos abatment

Replace flooring in transmitter room

Cooling Pads

Exterior cooling pads with Ice shield

Demo

Remove old transmitter and repair damage after removal

Space Modification

Remove door and replace with larger door to be able to accommodate new equipment

Antennas

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

Auxiliary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Auxiliary (Backup)
Description of Use Auxiliary
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? No
Existing Antenna Manufacturer and Type 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 N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 1000.0 kW
Manufacturer
Model TFU-24JSC/VP-R 4C160
Year 2001

Auxiliary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Auxiliary (Backup)
Description of Use Auxiliary
Change Type Purchase New
Is this a request for upgraded equipment? No
Ownership Owned
Owner N/A
Is antenna shared? Yes
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 Horizontal
Type Broadband Slot
Number of Stations Supported 16
Number of Panels/Bays 16
Lower Limit 470.00 MHz
Upper Limit 670.00 MHz
Design power capacity in use 90.0 %
Other Antenna Type N/A
ERP: 500.0 kW
Manufacturer
Model TFU-WB16
Year 2017
Justification for New Antenna Current antenna will not support assigned channel Replacement will support 2 stations.

Auxiliary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? Yes
Type New
Number of channels supported 2
Frequencies of channels supported RF channel
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? No
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Broadband
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

Enter a list of RF channel numbers.

RF Channel Number
40
33
30
31

Auxiliary Antenna

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Other Antenna Cost Not Listed

Name Description

RF Transformer

Special reducer from 75-50 ohm

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type Class Full Power
Mounting Top 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: 1000.0 kW
Manufacturer
Model TFU-23ETT/VP-R 4C160
Year 2009

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? No
Ownership Owned
Owner N/A
Is antenna shared? Yes
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 Top Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Broadband Slot
Number of Stations Supported 2
Number of Panels/Bays 22
Lower Limit 570.00 MHz
Upper Limit 575.00 MHz
Design power capacity in use 90.0 %
Other Antenna Type N/A
ERP: 1700.0 kW
Manufacturer
Model TFU-22ETT/VP-R 4C160
Year 2019
Justification for New Antenna Current antenna will not work on assigned channel.

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? Yes
Type New
Number of channels supported 2
Frequencies of channels supported RF channel
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? No
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Broadband
Feed Line Size 7 3/16 inches inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna?
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

Enter a list of RF channel numbers.

RF Channel Number
31
30

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Combiner Install

Install for both station combiner by WITI

Transmission Line

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

Auxiliary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Auxiliary (Backup)
Description of Use Auliliary
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
Type Rigid
Diameter 7 3/16 inches
Other Diameter N/A
Segment Length 19 1/2 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1200 feet per run

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

Facility ID Call Sign
73107 WITI
37104 WPXE-TV

Auxiliary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Auxiliary (Backup)
Description of Use Auxiliary
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Rigid
Diameter 7 3/16 inches
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 1
Length 1100 feet per run
Justification for New Transmission Line Current line will not support assigned channels

Auxiliary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 7 3/16 inches
Other Diameter N/A
Segment Length 19 1/2 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1362 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Rigid
Diameter 8 3/16 inches
Other Diameter N/A
Segment Length Broadband
Other Segment Length N/A
Number of parallel runs 1
Length 1462 feet per run
Justification for New Transmission Line Current line will not support the channels assigned or the power required

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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

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? Terrain Constrained
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? Yes
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1056835
Coordinates (NAD83) Latitude (NAD83) 43° 05' 26.0" N-
Longitude (NAD83) 087° 53' 50.0" W-
Overall Structure Height 1080.70 feet
Support Structure Height 993.43 feet
Ground Elevation Above Mean Sea Level (AMSL) 630.57 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner WITI License, LLC
Date Constructed 03/29/1974

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
4285 WUWM FM
42669 WYMS FM
21010 WMWK FM

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 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 Terrain constrained
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 170
Explanation Project manager required to coordinate numerous vendors and Road closures with the city during tower work.
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 Yes
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 2
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 No
For Auxiliary Facility N/A
For Main Facility N/A
Prepare and file Form FCC License to Cover Application No
For Auxiliary Facility N/A
For Main Facility N/A
Prepare request for Special Temporary Authority No
Quantity N/A
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement No
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 Yes
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

Name Description

Equipment Rental

Heavy equipment required during construction

Landscaping

Repair after rigging (Public Park)

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning Yes
Non-zoning permits Yes
BLM or NFS Coordination No
FCC Construction Permit Minor Change 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

Road closure fees

Road Closure for Public Saftey

Security

Site security during construction

Repair of Landscape

Repair of Landscape destroyed by Tower work. Site is entrance to Public park and must be maintained

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 $2,051,485.61 $1,560,745.61 N/A $1,326,912.80 N/A
Total for all systems $4,054,473.61 $2,007,337.21 N/A $1,389,563.58 N/A
Primary Transmitter ULXTE-90 $2,051,485.61 $1,560,745.61 $1,326,912.80
2" Rigid Conduit and Wiring (Cost per foot) $5,200.00 $5,000.00 N/A $2,000.00 N/A
Space Modification $4,685.61 $4,685.61 N/A $4,685.61 N/A
Demo $25,000.00 $25,000.00 N/A $14,485.00 N/A
30 Ton system $166,000.00 $166,000.00 N/A N/A N/A
Cooling Pads $5,000.00 $5,000.00 N/A N/A N/A
Asbestos abatment $5,000.00 $5,000.00 N/A N/A N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A $36,140.00 N/A
Service entrance 3 phase/800 amp/208 volt $14,400.00 $13,760.00 N/A $13,760.00 N/A
UHF - Liquid Cooled Solid State Transmitter 52 - 61 kW $1,788,000.00 $1,300,000.00 N/A $1,255,842.19 N/A

Components

Actual Information Description File Name
2" Rigid Conduit and Wiring (Cost per foot)

Component Description:
electrical work
Amount:
$2,000.00
Space Modification

Component Description:
larger door to accommodate new equipment
Amount:
$4,685.61
Demo

Component Description:
demo
Amount:
$6,900.00

Component Description:
demo
Amount:
$7,585.00
30 Ton system Information not provided.
Cooling Pads Information not provided.
Asbestos abatment Information not provided.
Switchgear - industrial 800 amp

Component Description:
electrical work
Amount:
$31,140.00

Component Description:
electrical work
Amount:
$5,000.00
Service entrance 3 phase/800 amp/208 volt

Component Description:
electrical work
Amount:
$13,760.00
UHF - Liquid Cooled Solid State Transmitter 52 - 61 kW

Component Description:
2nd payment for ULXTE-90
Amount:
$415,803.39

Component Description:
3rd payment for ULXTE-90
Amount:
$386,967.36

Component Description:
4th payment for ULXTE-90
Amount:
$31,118.01

Component Description:
site survey
Amount:
$6,150.04

Component Description:
Deposit for ULXTE-90
Amount:
$415,803.39

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 $230,410.00 $98,000.00 N/A $17,141.76 N/A
Total for all systems $4,054,473.61 $2,007,337.21 N/A $1,389,563.58 N/A
Primary Antenna TFU-22ETT/VP-R 4C160 $125,780.00 $18,000.00 $17,141.76
Combiner Install $18,000.00 $18,000.00 N/A $17,141.76 N/A
Elbow complex, broadband, at antenna input, per 7 3/16. feedline (if needed) $16,850.00 $0.00 WPXE N/A N/A
New combiner, cost per channel (without antenna) $84,200.00 $0.00 WPXE will purchase Combiner for both channels N/A N/A
Sweep test of existing antenna $6,730.00 $0.00 WPXE N/A N/A
UHF - High Power Top Mount Two Station antenna elliptically or circularly polarized $0.00 $0.00 WPXE will purchase the antenna N/A N/A
Auxiliary Antenna TFU-WB16 $104,630.00 $80,000.00 $0.00
RF Transformer $0.00 $0.00 N/A N/A N/A
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed) $13,700.00 $0.00 N/A N/A N/A
New combiner, cost per channel (without antenna) $84,200.00 $80,000.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $0.00 N/A N/A N/A
UHF - High Power, Side Mount, basic slot antenna, 16 bay,, 500 kW input, directional,, horizontally polarized $0.00 $0.00 N/A N/A N/A

Components

Actual Information Description File Name
Combiner Install

Component Description:
combiner install
Amount:
$17,141.76
Elbow complex, broadband, at antenna input, per 7 3/16. feedline (if needed) Information not provided.
New combiner, cost per channel (without antenna) Information not provided.
Sweep test of existing antenna Information not provided.
UHF - High Power Top Mount Two Station antenna elliptically or circularly polarized Information not provided.
RF Transformer Information not provided.
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed) Information not provided.
New combiner, cost per channel (without antenna) Information not provided.
Sweep test of existing antenna Information not provided.
UHF - High Power, Side Mount, basic slot antenna, 16 bay,, 500 kW input, directional,, horizontally polarized Information not provided.

Cost Information

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Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $949,638.00 $2,091.60 N/A $2,091.60 N/A
Total for all systems $4,054,473.61 $2,007,337.21 N/A $1,389,563.58 N/A
Primary Transmission Line $583,338.00 $2,091.60 $2,091.60
Rigid Transmission Line - copper, 8 3/16" broadband $583,338.00 $2,091.60 WPXE will provide shared antenna, we did need some cut pieces and a tuner piece. $2,091.60 N/A
Auxiliary Transmission Line $366,300.00 $0.00 $0.00
Rigid Transmission Line - copper, 7 3/16" broadband $366,300.00 $0.00 N/A N/A N/A

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 8 3/16" broadband

Component Description:
cut pieces
Amount:
$2,091.60
Rigid Transmission Line - copper, 7 3/16" broadband 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 $591,600.00 $129,500.00 N/A $17,500.00 N/A
Total for all systems $4,054,473.61 $2,007,337.21 N/A $1,389,563.58 N/A
Primary Tower TOWER $591,600.00 $129,500.00 $17,500.00
Structural engineering tower load study for well documented tower $12,600.00 $12,000.00 N/A N/A N/A
Minor tower reinforcement/modifications $158,000.00 $100,000.00 N/A N/A N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $17,500.00 WPXE will install shared antenna, we are splitting the cost of taking the standby antennas. $17,500.00 N/A

Components

Actual Information Description File Name
Structural engineering tower load study for well documented tower Information not provided.
Minor tower reinforcement/modifications Information not provided.
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)

Component Description:
our portion of taking the standby antennas down
Amount:
$17,500.00

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 $87,790.00 $74,000.00 N/A $21,547.51 N/A
Total for all systems $4,054,473.61 $2,007,337.21 N/A $1,389,563.58 N/A
Outside Professional Services $87,790.00 $74,000.00 $21,547.51
Equipment Rental $10,000.00 $10,000.00 N/A N/A N/A
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $4,100.00 $3,000.00 N/A N/A N/A
Project management of the transition $26,860.00 $16,000.00 N/A $11,756.25 N/A
Landscaping $10,000.00 $10,000.00 Repair of Landscape destroyed by Tower work. Site is entrance to Public park and must be maintained $9,791.26 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A N/A N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application $2,105.00 $2,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Equipment Rental Information not provided.
RF Exposure Measurements Information not provided.
Prepare request for Special Temporary Authorization Information not provided.
Project management of the transition

Component Description:
Project Management
Amount:
$3,586.25

Component Description:
Project Management
Amount:
$1,733.75

Component Description:
Project Management
Amount:
$2,375.00

Component Description:
Project Management
Amount:
$1,401.25

Component Description:
Project Management
Amount:
$2,992.50

Component Description:
Project Management
Amount:
$3,253.75
Landscaping

Component Description:
landscaping and repairs
Amount:
$9,791.26
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application Information not provided.
Perform engineering study for new channel assignment and antenna development 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 $143,550.00 $143,000.00 N/A $4,369.91 N/A
Total for all systems $4,054,473.61 $2,007,337.21 N/A $1,389,563.58 N/A
Other Expenses $143,550.00 $143,000.00 $4,369.91
Road closure fees $12,000.00 $12,000.00 N/A N/A N/A
MVPD Notification of Channel Change $5,000.00 $5,000.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $0.00 $0.00 N/A N/A N/A
Equipment Storage $10,000.00 $10,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $25,000.00 $25,000.00 N/A $619.91 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $15,000.00 $15,000.00 N/A N/A N/A
Non-zoning permits $15,000.00 $15,000.00 N/A N/A N/A
Local Zoning $15,000.00 $15,000.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A $3,750.00 N/A
Repair of Landscape $0.00 $0.00 N/A N/A N/A
Security $35,000.00 $35,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Road closure fees Information not provided.
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges

Component Description:
freight charges
Amount:
$619.91
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Non-zoning permits Information not provided.
Local Zoning Information not provided.
DTV Medical Facility Notification

Component Description:
medical testing
Amount:
$3,750.00
Repair of Landscape Information not provided.
Security Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $4,054,473.61 $2,007,337.21 $1,389,563.58

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.

Teri Ann Guillory

Broadcasting Operations


02/18/2020

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.

Teri Ann Guillory

Broadcasting Operations


02/18/2020

Attachments

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