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:
35091
Service:
DCA
Call Sign:
WMKE-CD
Channel:
36 (UHF)
File Number:
0000028322
FRN:
0023962665
Date Submitted:
06/29/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

MILWAUKEE MEDIA LLC

Doing Business As: MILWAUKEE MEDIA LLC

Randy Nonberg

15200 SUNSET BOULEVARD

SUITE 202

PACIFIC PALISADES, CA 90272

United States

+1 (310) 573-1600 randynonberg@cnzcommunications.com Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

Greg Best

Consulting Engineer

Greg Best Consulting Inc.

16100 Outlook Ave.

Stilwell, KS 66085

United States

+1 (816) 792-2913 gbconsulting54@gmail.com

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. Yes
Briefly describe transition plan The transition plan consists of installing a new transmitter, antenna & transmission line at a new height on existing tower.

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 ACT-2XU-2000-A-C
Year 2014
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 2 kW

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model TRN-U-2000-FA
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2.2 kW
Justification for New Transmitter Existing transmitter is no longer supported. See attachment regarding the 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) No
Power N/A
Rigid Conduit and Wiring Yes
Size 2 inches
Length 50.0 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

Information not provided.

Antennas

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

Primary Antenna

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Add 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 this antenna currently shared with any other stations? No
Is this 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 Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 15.0 kW
Manufacturer
Model ATC-BC8C1
Year 2014

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class 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/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 15.0 kW
Manufacturer
Model ALP16L4-ESW-36
Year 2020
Justification for New Antenna Existing coaxial slot antenna is not designed to operate on repacked 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?
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? No
Broadband or Single Channel? N/A
Feed Line Size N/A
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? Yes
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Custom mounts

This item covers custom mounts for the new antenna required because of the antenna location on the tower.

Ice shield

This item replaces the existing ice shield that is too small for the new antenna.

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)
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 Foam
Diameter 1 5/8 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 400 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 Flexible Foam
Diameter 1 5/8 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 50 feet per run
Justification for New Transmission Line Additional transmission line needed to reach antenna.

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 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? Yes
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1057482
Coordinates (NAD83) Latitude (NAD83) 43° 05' 46.2" N-
Longitude (NAD83) 087° 54' 15.0" W-
Overall Structure Height 1212.91 feet
Support Structure Height 1098.74 feet
Ground Elevation Above Mean Sea Level (AMSL) 627.95 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner Milwaukee Area Technical College District Board
Date Constructed 05/27/2015

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
42663 WMVS DTV
74174 WVTV DTV
72342 WVCY-TV DTV
60571 WIWN DTV
42665 WMVT 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: 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 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 200
Explanation Station does not have in-house staff or experience to manage this activity and requires outside project management services.
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 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 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 No
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

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

Other Expenses

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Other Expenses Not Listed

Information not provided.

Cost Information

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Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $165,500.00 $152,300.00 N/A $27,930.00 N/A
Total for all systems $882,115.00 $656,345.00 N/A $202,284.16 N/A
Primary Transmitter TRN-U-2000-FA $165,500.00 $152,300.00 $27,930.00
2" Rigid Conduit and Wiring (Cost per foot) $1,300.00 $1,300.00 N/A N/A N/A
Switchgear - industrial 800 amp $38,200.00 $25,000.00 N/A N/A N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $126,000.00 N/A $27,930.00 N/A

Components

Actual Information Description File Name
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Switchgear - industrial 800 amp Information not provided.
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
Downpayment for WMKE repack transmitter.
Amount:
$27,930.00

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 $37,030.00 $52,900.00 N/A $43,942.80 N/A
Total for all systems $882,115.00 $656,345.00 N/A $202,284.16 N/A
Primary Antenna ALP16L4-ESW-36 $37,030.00 $52,900.00 $43,942.80
Ice shield $3,000.00 $3,000.00 See antenna quote for $2700. Some allowance is made for shipping. $2,700.00 N/A
Sweep test of existing antenna $6,730.00 $8,900.00 Please see attached quote for antenna. ERI cost of system sweep is $6,250.00. And also $2,572.80 cost of line sweep by Dielectric. $8,197.80 N/A
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $26,300.00 $40,000.00 See attached quote for antenna. Licensee accepts responsibility for cost of upgrading to Epol antenna. Cost of equivalent Hpol antenna is contained in the quote. Since antenna is side-mounted, scattering analysis is included. $32,345.00 N/A
Custom mounts $1,000.00 $1,000.00 Cost per quote is $700 and some allowance is added for shipping. $700.00 N/A

Components

Actual Information Description File Name
Ice shield

Component Description:
15% deposit with order
Amount:
$405.00

Component Description:
35% of cost after receipt of order.
Amount:
$945.00

Component Description:
50% balance of cost prior to shipment.
Amount:
$1,350.00

Component Description:
35% cost of ice shield.
Amount:
$945.00

Component Description:
15% downpayment on ice shield.
Amount:
$405.00

Component Description:
50% cost of ice shield.
Amount:
$1,350.00
Sweep test of existing antenna

Component Description:
40% of system sweep cost prior to mobilization.
Amount:
$2,500.00

Component Description:
15% deposit with order.
Amount:
$937.50

Component Description:
35% cost after receipt of order.
Amount:
$2,187.50

Component Description:
15% of system sweep.
Amount:
$937.50

Component Description:
Cost of WMKE line sweep.
Amount:
$2,572.80

Component Description:
35% cost of system sweep.
Amount:
$2,187.50
UHF - Lower Power Side Mount, Class A One Station antenna -- basic

Component Description:
35% of cost of comparable replacement antenna.
Amount:
$11,320.75

Component Description:
15% cost of comparable replacement antenna; deposit with order.
Amount:
$4,851.75

Component Description:
50% balance of comparable replacement antenna cost; payment prior to shipment.
Amount:
$16,172.50

Component Description:
Moved to new line item.
Amount:
N/A

Component Description:
Moved to new line item
Amount:
N/A

Component Description:
Moved to new line item.
Amount:
N/A

Component Description:
15% cost of antenna. ERI did not provide a discount for the Hpol antenna.
Amount:
$4,851.75

Component Description:
35% cost of comparable antenna. ERI did not provide a discount for the Hpol antenna.
Amount:
$11,320.75

Component Description:
Moved to new line item.
Amount:
N/A

Component Description:
50% cost of replacement antenna.
Amount:
$16,172.50
Custom mounts

Component Description:
35% of cost after receipt of order.
Amount:
$245.00

Component Description:
50% balance of cost prior to shipment.
Amount:
$350.00

Component Description:
50% cost of custom mounts.
Amount:
$350.00

Component Description:
15% downpayment for custom mounts.
Amount:
$105.00

Component Description:
35% cost of custom mounts.
Amount:
$245.00

Component Description:
15% deposit with order.
Amount:
$105.00

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 $1,200.00 $5,000.00 N/A $4,138.68 N/A
Total for all systems $882,115.00 $656,345.00 N/A $202,284.16 N/A
Primary Transmission Line $1,200.00 $5,000.00 $4,138.68
Flexible Foam Transmission Line - dielectric, 1 5/8" $1,200.00 $5,000.00 The transmission line requires extra connectors and adapters. $4,138.68 N/A

Components

Actual Information Description File Name
Flexible Foam Transmission Line - dielectric, 1 5/8"

Component Description:
15% deposit with order.
Amount:
$583.81

Component Description:
50% balance of cost before shipment.
Amount:
$1,946.04

Component Description:
35% of cost after receipt of order.
Amount:
$1,362.22

Component Description:
Cost of two inner connectors.
Amount:
$246.61

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 $369,000.00 N/A $111,313.10 N/A
Total for all systems $882,115.00 $656,345.00 N/A $202,284.16 N/A
Primary Tower GTOWER $591,600.00 $369,000.00 $111,313.10
Minor tower reinforcement/modifications $158,000.00 $150,000.00 N/A $92,313.10 N/A
Structural engineering tower load study for well documented tower $12,600.00 $19,000.00 Cost quote from ATC. $19,000.00 N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $200,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Minor tower reinforcement/modifications

Component Description:
40% of scattering study prior to mobilization.
Amount:
$1,920.00

Component Description:
40% of TV installation cost prior to mobilization.
Amount:
$25,863.60

Component Description:
Tower mapping and preparation of documentation necessary for tower load study.
Amount:
$24,800.00

Component Description:
Constribution costs associated with tower modifications required to accommodated installation of equipment.
Amount:
$5,000.00

Component Description:
Scattering study; 35% after receipt of order.
Amount:
$1,680.00

Component Description:
15% cost of scattering study.
Amount:
$720.00

Component Description:
TV installation; 35% after receipt of order.
Amount:
$22,630.65

Component Description:
35% cost of TV installation.
Amount:
$22,630.65

Component Description:
TV Installation;15% deposit with order.
Amount:
$9,698.85

Component Description:
Scattering study; 15% deposit with order.
Amount:
$720.00

Component Description:
35% cost of scattering study.
Amount:
$1,680.00

Component Description:
15% cost of TV installation.
Amount:
$9,698.85
Structural engineering tower load study for well documented tower

Component Description:
Structural engineering tower load study.
Amount:
$19,000.00
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) 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 $60,790.00 $57,750.00 N/A $12,959.58 N/A
Total for all systems $882,115.00 $656,345.00 N/A $202,284.16 N/A
Outside Professional Services $60,790.00 $57,750.00 $12,959.58
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $1,180.08 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 $74.50 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 N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $5,125.00 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A $617.50 N/A
Project management of the transition $31,600.00 $30,000.00 N/A $5,962.50 N/A

Components

Actual Information Description File Name
Prepare and or review reimbursement form

Component Description:
Update 399 form.
Amount:
$450.00

Component Description:
Engineering services: filled out Collocation Application for WMKE Repack.
Amount:
$68.58

Component Description:
Repack consulting services: 399 application update, MOD application, interference issues
Amount:
$877.00

Component Description:
Consulting/Discussion regarding communication from FCC.
Amount:
$211.50

Component Description:
Update 399 form.
Amount:
$450.00

Component Description:
Review WMKE repack minor application.
Amount:
$250.00
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:
Attorney fee: review construction deadline for WMKE.
Amount:
$74.50
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 Information not provided.
Perform engineering study for new channel assignment and antenna development

Component Description:
Engineering repack services: 2/1/20 to 2/28/20, investigation of antenna pattern options and transmission line options; obtain new quote for updated antenna.
Amount:
$900.00

Component Description:
Repack engineering services: 1/1/20 to 1/31/20, quarterly progress report, review of transmitter specs to match antenna, review of antenna specs; services to determine antenna location, performance requirements and elliptical power ratio.
Amount:
$1,575.00

Component Description:
Repack engineering services: quarterly report, channel search and maximization application.
Amount:
$1,137.50

Component Description:
Repack engineering services: quarterly progress reports.
Amount:
$87.50

Component Description:
Engineering repack services: 02/01/20 to 02/28/20 investigation of antenna pattern and transmission line options, obtain new guote from ERI.
Amount:
$900.00

Component Description:
Repack engineering services: quarterly reports.
Amount:
$175.00

Component Description:
Redesign of transmission line system; obtain and review/review installation proposal.
Amount:
$1,687.50

Component Description:
Repack engineering services for August 2019: investigate facilities needed to replicate existing pre-repack population on new channel 36.
Amount:
$700.00
Address transition timing and coordination issues w/ other stations and wireless

Component Description:
Repack engineering services: coordination with FCC to correct issue with WMKE displacement of WMVS; quarterly reports.
Amount:
$437.50

Component Description:
Consultation regarding FCC and transition reporting.
Amount:
$180.00
Project management of the transition

Component Description:
Engineering services: CP mod for higher RCAGL and project coordination.
Amount:
$787.50

Component Description:
Engineering repack services: quarterly progress report, 04-01-2019 to 05-31-2019.
Amount:
$87.50

Component Description:
Engineering repack services: for 11/1/19 to 11/30/19; evaluate coverage options and transmitter requirements.
Amount:
$1,500.00

Component Description:
Engineering repack services from 6/1 to 6/30/2019 including quarterly progress report.
Amount:
$262.50

Component Description:
Engineering repack services: 3/29 to 5/1/2020; review transmitter proposal, revise transmission line design and incorporate all antenna system changes.
Amount:
$2,137.50

Component Description:
Repack engineering services: from 12/1/19 to 1/4/2020; coordinate with vendor to specify correct transmitter model and obtain letter of non-support of existing transmitter; creation and submittal of quarterly progress report.
Amount:
$1,000.00

Component Description:
Repack engineering services from 10/1/19 to 11/1/19; quarterly DTV progress report
Amount:
$100.00

Component Description:
Engineering repack services for the period 10/1/18 to 11/2/18; Q3 quarterly progress report.
Amount:
$87.50

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 $25,995.00 $19,395.00 N/A $2,000.00 N/A
Total for all systems $882,115.00 $656,345.00 N/A $202,284.16 N/A
Other Expenses $25,995.00 $19,395.00 $2,000.00
Develop and air announcement of upcoming channel change $2,500.00 $2,500.00 N/A N/A N/A
Equipment Storage $2,000.00 $2,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $2,000.00 $2,000.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $2,000.00 $2,000.00 N/A N/A N/A
Non-zoning permits $2,500.00 $2,500.00 N/A N/A N/A
Local Zoning $2,000.00 $2,000.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $5,000.00 N/A $2,000.00 N/A

Components

Actual Information Description File Name
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges Information not provided.
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.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
DTV Medical Facility Notification

Component Description:
Cost of required medical notification mailing.
Amount:
$2,000.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $882,115.00 $656,345.00 $202,284.16

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.

Randy E Nonberg

Manager


06/29/2020

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.

Randy E Nonberg

Manager


06/29/2020

Attachments

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