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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:
23939
Service:
FM
Call Sign:
WMUM-FM
File Number:
0000083473
FRN:
0001844976
Eligibility Status:
Eligible
Date Submitted:
02/19/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

GEORGIA PUBLIC TELECOMMUNICATIONS COMMISSION

Doing Business As: GEORGIA PUBLIC TELECOMMUNICATIONS COMMISSION

Elizabeth Laprade

260 14TH ST NW

ATLANTA, GA 30318

United States

+1 (404) 685-2619 elaprade@gpb.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

Robert Gehman

Consulting Engineer

Kessler and Gehman Associates, Inc.

Robert Gehman

507 NW 60 St, #D

Gainesville, FL 32607

United States

+1 (352) 332-3157 bob@kesslerandgehman.com

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. Yes
Briefly describe transition plan An interim antenna will be used to prevent turning off the station while tower workers are in close proximity of the main antenna performing modifications and working on the repacked TV station's antenna systems.

Transmitters

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Section Question Response
Transmitter Related Expenses Do you have transmitter related expenses? No

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)
Ownership Owned
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? No
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Cross Dipole
ERP: 100.0 kW
Manufacturer
Model DCRC12CHV
Year 2008

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Change Type Purchase New
Ownership Owned
Is antenna shared? No
Is antenna directional? No
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Circular
Type Other
Other Antenna Type Circularly polarized dipoles
ERP: 100.0 kW
Manufacturer
Model JSCP-10
Year 2019
Justification for New Antenna An interim antenna will be used to prevent turning off the station while tower workers are in close proximity of the main antenna performing modifications and working on the repacked TV station's antenna systems.

Primary Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? No
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes
FM Band Pass Filters Do you require an FM band pass filter? No
Notch Filter Do you require a Notch filter? No
De-Icers Do you require De-Icers? No
Radomes Do you require Radomes? Yes
Number of bays 9

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Primary (Main)
Ownership Owned
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 3 inches
Number of parallel runs 1
Length 1000 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Flexible Air
Diameter 3 inches
Number of parallel runs 1
Length 720 feet per run
Justification for New Transmission Line An interim line will be used to prevent turning off the station while tower workers are in close proximity of the main antenna performing modifications and working on the repacked TV station's antenna systems.
Interior RF Systems Does the Installation of the Transmission Line require an additional or replacement Inside RF system including switching, patch panels, and dehydrators? Yes
Does the Installation of the Transmission Line require additional or replacement Inside RF system elbows, fitting, hangers, etc.? Yes

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)
Ownership Owned
Is this tower consider Complex? No
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? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1018798
Coordinates (NAD83) Latitude (NAD83) 32° 28' 12.2" N-
Longitude (NAD83) 083° 15' 18.0" W-
Overall Structure Height 1168.95 feet
Support Structure Height 1109.89 feet
Ground Elevation Above Mean Sea Level (AMSL) 398.95 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner GEORGIA PUBLIC TELECOMMUNICATIONS COMMISSION
Date Constructed 03/02/2016

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
23935 WMUM-TV DTV

Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Tower mapping and report for structural engineer
Tower Reinforcements Please select whether tower reinforcements are needed: Major Reinforcements needed

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? No
Outside RF consulting Engineering Services Prepare engineering section of Form FCC Construction Permit Application No
Prepare engineering section of Form FCC License to Cover Application No
Prepare request for Special Temporary Authority Yes
Quantity 1
Prepare Form 601 No
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application No
Prepare and file Form FCC License to Cover Application No
Prepare request for Special Temporary Authority Yes
Quantity 1
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement Yes
Form 399 assistance or other program management costs Yes
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements No
Additional Field Engineering Service No

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Actual Cost Invoice

Actual Cost reimbursement invoice prep & submit

Other Engineering Services

Design, plan, specify, review approve, and oversee all work for this project

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
Permit and Filing Costs FCC Construction Permit Major Change 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)? No
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? No
Point to Point Microwave (STL/ICR) Frequency Coordination for Unidirection System No
Frequency Coordination for Bi-Direction System No
New Point to Point Microwave System No
1 pair IP-only Codecs for fiber, internet or IP microwave systems No

Other Expenses

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Other Expenses Not Listed

Information not provided.

Cost Information

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Transmitters

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 $27,480.00 $0.00 N/A $0.00 N/A
Total for all systems $263,490.50 $248,380.50 N/A $6,040.50 N/A
Primary Antenna JSCP-10 $27,480.00 $0.00 $0.00
Radomes (per bay) $12,150.00 $0.00 N/A N/A N/A
Side Mount antenna brackets $0.00 $0.00 Included in Antenna Cost N/A N/A
Sweep test of existing antenna $5,730.00 $0.00 Included in Antenna Cost N/A N/A
High Power 51 - 100 kW Circularly-polarized $9,600.00 $0.00 N/A N/A N/A

Components

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 $42,480.00 $0.00 N/A $0.00 N/A
Total for all systems $263,490.50 $248,380.50 N/A $6,040.50 N/A
Primary Transmission Line $42,480.00 $0.00 $0.00
Flexible Air Transmission Line - dielectric, 3" $42,480.00 $0.00 Included in Antenna Cost N/A N/A
Interior RF Systems: Inside RF system including switching, patch panels and dehydrators $0.00 $0.00 N/A N/A N/A
Interior RF Systems: Elbows, fitting, hangers, etc. $0.00 $0.00 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 $157,750.00 $210,500.00 N/A $0.00 N/A
Total for all systems $263,490.50 $248,380.50 N/A $6,040.50 N/A
Primary Tower GTOWER $157,750.00 $210,500.00 $0.00
Tower Rigging Tall Tower (greater than 500') $157,750.00 $210,500.00 N/A N/A N/A
Major tower reinforcement/modifications $0.00 $0.00 N/A 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 $25,780.50 $27,880.50 N/A $6,040.50 N/A
Total for all systems $263,490.50 $248,380.50 N/A $6,040.50 N/A
Outside Professional Services $25,780.50 $27,880.50 $6,040.50
Other Legal Services $555.50 $555.50 See attached / uploaded PDF files titled "GMP 31100 v200218jgv1.pdf" and "GMP 31275 v200218jgv1.pdf" $555.50 N/A
Other Engineering Services $10,000.00 $10,000.00 N/A $1,675.00 N/A
Actual Cost Invoice $10,000.00 $10,000.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $1,280.00 $1,280.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $2,235.00 $2,235.00 N/A N/A N/A
Form 399 assistance or other Program Management costs $0.00 $0.00 N/A N/A N/A
Prepare/ Review 399 reimbursement form $1,710.00 $3,810.00 See attached / uploaded PDF files titled "KGA 554-745 v200218jgv1.pdf" and "KGA 554-746 v200218jgv1.pdf" $3,810.00 N/A

Components

Actual Information Description File Name
Other Legal Services

Component Description:
GMP 31100 v200218jgv1
Amount:
$252.50

Component Description:
GMP 31275 v200218jgv1
Amount:
$303.00
Other Engineering Services

Component Description:
KGA 554-724 v200219jgv1
Amount:
$1,075.00

Component Description:
KGA 554-742 v200219jgv1
Amount:
$600.00
Actual Cost Invoice Information not provided.
Prepare request for Special Temporary Authorization Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Form 399 assistance or other Program Management costs Information not provided.
Prepare/ Review 399 reimbursement form

Component Description:
KGA 554-745 v200218jgv1
Amount:
$2,560.00

Component Description:
KGA 554-746 v200218jgv1
Amount:
$1,250.00

Cost Information

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Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $10,000.00 $10,000.00 N/A $0.00 N/A
Total for all systems $263,490.50 $248,380.50 N/A $6,040.50 N/A
Other Expenses $10,000.00 $10,000.00 $0.00
Equipment Delivery and Handling Charges $10,000.00 $10,000.00 N/A N/A N/A

Components

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $263,490.50 $248,380.50 $6,040.50

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.

Jeffrey C Gehman

Engineering Associate


02/19/2020

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.

Jeffrey C Gehman

Engineering Associate


02/19/2020

Attachments

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