Skip to main content Skip to footer and contact information
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:
69753
Service:
DCA
Call Sign:
KVER-CD
Channel:
27 (UHF)
File Number:
0000028330
FRN:
0001529627
Date Submitted:
09/24/2020

Applicant Information

Back to Top ↑

Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

ENTRAVISION HOLDINGS, LLC

Doing Business As: ENTRAVISION HOLDINGS, LLC

Entravision Communications

SUITE 6000W

2425 OLYMPIC BLVD

SANTA MONICA, CA 90404

United States

 +1 (310) 447-3870 mboelke@entravision.com Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 

Preparer Contact Information

Back to Top ↑

Preparer Contact Name and Information

Applicant Address Phone Email

Samuel Hariton

Widelity

4031 University Dr

Suite 100

Fairfax, VA 22030

United States

 +1 (339) 222-8107 sam.hariton@widelity.com

Broadcaster Information and Transition Plan

Back to Top ↑
Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan The plan is for KVER-CD to replace the existing Channel 41 system with a new Channel 27 antenna, new 1-5/8" line, and a new transmitter.

Transmitters

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

Primary Transmitter

Back to Top ↑

Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model UAX-1000ATRK37D
Year 2014
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1.25 kW

Primary Transmitter

Back to Top ↑

New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model UAXTE-2R37
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1.2 kW
Justification for New Transmitter New transmitter is necessary because the existing transmitter is not capable of being economically retuned as because doing so requires shipping the transmitter back to the manufacturer

Primary Transmitter

Back to Top ↑

Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service Yes
Description The new main transmitter will require reconfiguration of the electrical service on site. Based on verbal guidance from local electrical contractors, KVER-CD estimated the electrical work cost.
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

Back to Top ↑

Other Transmitter Cost Not Listed

Information not provided.

Antennas

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

Primary Antenna

Back to Top ↑

Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? Yes
Existing Antenna Manufacturer and Type Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization 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 ALP12L3-HSW-41
Year 2014

Primary Antenna

Back to Top ↑

New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? Yes
New Antenna Manufacturer and Types Class Class A
Mounting 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 TLP-12/VP-R C160
Year 2017
Justification for New Antenna A new antenna is necessary because the existing antenna cannot be retuned to the new channel and is not capable of broadcasting on channel 25.

Primary Antenna

Back to Top ↑

Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? No
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? N/A
Elbow Complex Do you require the separate purchase of the Elbow Complex? 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? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

Back to Top ↑

Other Antenna Cost Not Listed

Name Description

Side Mount Brackets

Bug in Cost section. Including Side Mount Brackets here.

Transmission Line

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

Primary Transmission Line

Back to Top ↑

Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Flexible Air
Diameter 1 5/8 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 120 feet per run

Primary Transmission Line

Back to Top ↑

New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Flexible Air
Diameter 1 5/8 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 120 feet per run
Justification for New Transmission Line Buying new transmission line allows KVER to install and power the new antenna on the new transmitter without an extended period of time off-air.

Primary Transmission Line

Back to Top ↑

Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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

Primary Tower

Back to Top ↑

Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? No
Is this tower currently shared with any other stations? 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? Yes
Existing Tower Structure Registration Do you have a tower registration number? No
ASR Number
Coordinates (NAD83) Latitude (NAD83) 33° 51' 56.7" N-
Longitude (NAD83) 116° 26' 01.4" W-
Overall Structure Height 114.00 feet
Support Structure Height 94.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 1542.00 feet
Structure Type LTOWER - Lattice Tower
Tower Owner Insite Wireless Group
Date Constructed 01/01/1996

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
11747 KEZN FM

Primary Tower

Back to Top ↑

Tower Modification Costs

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

Primary Tower

Back to Top ↑

Tower Rigging Costs

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

Primary Tower

Back to Top ↑

Other Tower Expenses Not Listed

Name Description

Structural Analysis

Structural Analysis to be completed after mapping complete.

Outside Professional Services Costs

Back to Top ↑
Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 595
Explanation KVER-CD does not have sufficient resource capacity and expertise in house to handle all of the reimbursement filing by the construction deadline of Phase 3 on June 21, 2019. KVER-CD will hire an outside firm to ensure a timely and well managed transition
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 Yes
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

Back to Top ↑

Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

Back to Top ↑
Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning 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 Yes
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? No
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

Back to Top ↑

Other Expenses Not Listed

Information not provided.

Cost Information

Back to Top ↑

Transmitters

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $146,000.00 $140,000.00 N/A $102,933.27 N/A
Total for all systems $532,930.00 $547,397.02 N/A $269,774.67 N/A
Primary Transmitter UAXTE-2R37 $146,000.00 $140,000.00 $102,933.27
Other Electrical Service: The new main transmitter will require reconfiguration of the electrical service on site. Based on verbal guidance from local electrical contractors, KVER-CD estimated the electrical work cost. $20,000.00 $20,000.00 N/A N/A N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $120,000.00 N/A $102,933.27 N/A

Components

Actual Information Description File Name
Other Electrical Service: The new main transmitter will require reconfiguration of the electrical service on site. Based on verbal guidance from local electrical contractors, KVER-CD estimated the electrical work cost. Information not provided.
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
A. Transmitter
Amount:
$2,250.00

Component Description:
UAXTE-2R37 Transmitter
Amount:
$53,962.49

Component Description:
Transmitter
Amount:
$46,720.78

Cost Information

Back to Top ↑

Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $55,030.00 $76,870.00 N/A $32,153.00 N/A
Total for all systems $532,930.00 $547,397.02 N/A $269,774.67 N/A
Primary Antenna TLP-12/VP-R C160 $55,030.00 $76,870.00 $32,153.00
Side Mount Brackets $22,000.00 $22,000.00 N/A N/A N/A
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $26,300.00 $48,370.00 Dielectric Quote Attached $31,203.00 N/A
Sweep test of existing antenna $6,730.00 $6,500.00 Quote from Chuck Britt attached $950.00 N/A

Components

Actual Information Description File Name
Side Mount Brackets Information not provided.
UHF - Lower Power Side Mount, Class A One Station antenna -- basic

Component Description:
UHF Low-Medium Power Side Mount
Amount:
$14,041.35

Component Description:
UHF - Low-medium power side mount; Other VPOL components; Flexible transmission line; etc.
Amount:
$3,120.30

Component Description:
UHF-Low-Medium Power Side Mount Antenna
Amount:
$14,041.35
Sweep test of existing antenna

Component Description:
Provide technician, network analyzer and associated equipment
Amount:
$950.00

Cost Information

Back to Top ↑

Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $3,960.00 $3,594.52 N/A $3,594.51 N/A
Total for all systems $532,930.00 $547,397.02 N/A $269,774.67 N/A
Primary Transmission Line $3,960.00 $3,594.52 $3,594.51
Flexible Air Transmission Line - dielectric, 1 5/8" $3,960.00 $3,594.52 Based on quote from Manufacturer. $3,594.51 N/A

Components

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

Component Description:
KVER-310-New Primary Transmission Line
Amount:
$1,617.53

Component Description:
KVER-310-New Primary Transmission Line
Amount:
$359.45

Component Description:
New Transmission Line
Amount:
$1,617.53

Cost Information

Back to Top ↑

Tower Equipment and Rigging Costs

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $122,500.00 $118,360.00 N/A $32,006.99 N/A
Total for all systems $532,930.00 $547,397.02 N/A $269,774.67 N/A
Primary Tower LTOWER $122,500.00 $118,360.00 $32,006.99
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $25,000.00 N/A $10,940.59 N/A
Structural Analysis $12,000.00 $12,000.00 N/A $2,081.40 N/A
Short Tower (less than 500') $84,200.00 $81,360.00 Based on quote by Tower installation firm. $18,985.00 N/A

Components

Actual Information Description File Name
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study

Component Description:
Tower mapping and prep of doc necessary for tower load study
Amount:
$10,940.59
Structural Analysis

Component Description:
Broadcast Tower Structural Analysis-KVER
Amount:
$2,081.40
Short Tower (less than 500')

Component Description:
Per Proposal#071118JS1, Balance due upon completion.
Amount:
$9,492.50

Component Description:
50% due
Amount:
$9,492.50

Cost Information

Back to Top ↑

Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $144,250.00 $147,987.50 N/A $92,539.40 N/A
Total for all systems $532,930.00 $547,397.02 N/A $269,774.67 N/A
Outside Professional Services $144,250.00 $147,987.50 $92,539.40
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 $0.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A $500.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,562.50 See invoices. Cost overrun due to station changing antenna manufacturer after initial CP work by consulting engineers. $3,562.50 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $437.50 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A
Project management of the transition $94,010.00 $99,675.00 Per Widelity quote "KVER-CD Strategic Support" dated 11/26/2018 $88,039.40 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
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A

Components

Actual Information Description File Name
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:
Invoice moved to correct budget category
Amount:
N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
Services
Amount:
$500.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Preparation of the engineering section of FCC Form 2100
Amount:
$1,937.50

Component Description:
Preparation of the engineering section of FCC Form 2100
Amount:
$1,625.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Engineering study work for new channel assignment including antenna development
Amount:
$437.50
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form Information not provided.
Project management of the transition

Component Description:
Project Management
Amount:
$2,230.15

Component Description:
Project management
Amount:
$93.75

Component Description:
Project Management
Amount:
$3,235.70

Component Description:
Project management
Amount:
$2,034.20

Component Description:
Project management
Amount:
$1,053.15

Component Description:
Project management
Amount:
$1,310.85

Component Description:
Project Management
Amount:
$1,970.45

Component Description:
Project Management
Amount:
$3,411.60

Component Description:
Project Management
Amount:
$3,291.25

Component Description:
Project Management
Amount:
$2,642.90

Component Description:
Project Management
Amount:
$2,061.80

Component Description:
Project Management
Amount:
$1,586.85

Component Description:
Project Management
Amount:
$2,261.85

Component Description:
Project Management
Amount:
$2,394.75

Component Description:
Project Management
Amount:
$2,570.10

Component Description:
Project Management
Amount:
$2,466.70

Component Description:
Project Management
Amount:
$2,496.90

Component Description:
Project Management
Amount:
$1,608.80

Component Description:
Project Management
Amount:
$1,637.85

Component Description:
Project Management
Amount:
$2,416.40

Component Description:
Project Management
Amount:
$1,398.40

Component Description:
Project Management
Amount:
$2,690.90

Component Description:
Project management
Amount:
$1,193.70

Component Description:
Project Management
Amount:
$2,467.85

Component Description:
Project Management
Amount:
$1,709.10

Component Description:
Project Management
Amount:
$1,721.30

Component Description:
Project Management
Amount:
$2,927.35

Component Description:
Project Management
Amount:
$2,855.45

Component Description:
Project Management
Amount:
$3,326.90

Component Description:
Project Management
Amount:
$2,703.80

Component Description:
Project management
Amount:
$1,821.95

Component Description:
Project management
Amount:
$778.60

Component Description:
Project Management
Amount:
$3,053.25

Component Description:
Project management
Amount:
$148.20

Component Description:
Project Management
Amount:
$3,022.00

Component Description:
Project Management
Amount:
$1,874.25

Component Description:
Project Management
Amount:
$3,626.50

Component Description:
Project Management
Amount:
$2,492.40

Component Description:
Project Management
Amount:
$2,023.60

Component Description:
Project Management
Amount:
$3,427.90
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
RF Exposure Measurements Information not provided.

Cost Information

Back to Top ↑

Other Expenses

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $61,190.00 $60,585.00 N/A $6,547.50 N/A
Total for all systems $532,930.00 $547,397.02 N/A $269,774.67 N/A
Other Expenses $61,190.00 $60,585.00 $6,547.50
MVPD Notification of Channel Change $500.00 $500.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $15,000.00 $15,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $15,000.00 $15,000.00 N/A $6,547.50 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $10,000.00 $10,000.00 N/A N/A N/A
Local Zoning $5,000.00 $5,000.00 N/A N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 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 $11,000.00 N/A N/A N/A
Non-zoning permits $2,500.00 $2,500.00 N/A N/A N/A

Components

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

Component Description:
FREIGHT, SHIPPING, AND HANDLING PAF VAN DELIVERY
Amount:
$6,547.50
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Local Zoning Information not provided.
FCC Filing Fees - Special Temporary Authorization request 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 Information not provided.
Non-zoning permits Information not provided.

Cost Information

Back to Top ↑

Grand Total

Predetermined
Cost Estimate 		Estimated Cost Actual Cost
Total for all systems $532,930.00 $547,397.02 $269,774.67

Reimbursement Status

Back to Top ↑
Question Response
The facility has ceased operating on its pre-auction channel. Yes
Construction of final facilities or all necessary modifications are complete. Yes
All receipts for reimbursement have been submitted no further costs are expected to be incurred. Note this will lock the Form 399 from further editing and begin close-out procedures with the Fund Administrator. No

Certification

Back to Top ↑
Section Question Response
Submission of Estimated Expenses Statements

WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.

  1. The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.

  2. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

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

  4. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD).

  5. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

  6. The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred.

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

  8. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Manuel Cavazos , III .

EVP- Director of Technology


09/24/2020

Certification

Back to Top ↑
Section Question Response
Submission of Actual Cost Documentation Statements

WILLFUL FALSE, FRAUDULENT, OR FICTITIOUS STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISIONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE AND/OR FRAUDULENT STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT (U.S. CODE, TITLE 31, SECTIONS 3729-3733).

  1. The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.

  2. The above-named entity certifies that the statements in this form and attached documentation are true, complete, and correct.

  3. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

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

  5. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (full power and Class A stations) and/or otherwise modify a television station’s facility as a result of the spectrum repack (LPTV/TV Translator stations); or to minimize service disruption resulting from a repacked television station (FM stations); or to continue to carry the signal of a broadcaster that changes channels (MVPD) .

  6. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

  7. The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred.

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

  9. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a prerequisite for obtaining the payments herein requested.
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Manuel Cavazos , III .

EVP - Director of Technology


09/24/2020

Certification

Back to Top ↑
Section Question Response
Submission of Final Allocation or Accounting Information Statements

WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.

  1. The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

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

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

  4. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

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

  6. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.
I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Manuel Cavazos , III .

EVP - Director of Technology


09/24/2020

Attachments

Back to Top ↑