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:
56176
Service:
LPD
Call Sign:
KQFX-LD
Channel:
30 (UHF)
File Number:
0000089518
FRN:
0021922711
Eligibility Status:
Eligible
Date Submitted:
09/11/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

NPG of Missouri, LLC

Doing Business As: NPG of Missouri, LLC

825 Edmond Street

Saint Joseph, MO 64501

United States

+1 (816) 271-8504 tim.hannan@npgco.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

The Preparer is same as the reimbursement contact.

 

 

 

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. No
Briefly describe transition plan Please refer to Supplemental Explanation

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)
Ownership Owned
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model RXi-5
Year 2009
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1.2 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 UAXTE-2R23
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1.2 kW
Justification for New Transmitter Please refer to revised transition plan exhibit

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Other Transmitter Costs
Does the transmitter installation require a Transmitter Building Site Survey/Installation? No
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Rigid Conduit and Wiring No
Other Electrical Service No
HVAC Service Does the replacement transmitter require HVAC Service? No
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Tune System from Channel 22 to Channel 30

Tune System from Channel 22 to Channel 30

Installation for Proof of Performance

Installation for Proof of Performance

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 Horizontal
Type Slotted Coaxial
ERP: 11.8 kW
Manufacturer
Model ALP16M4-HS0C
Year 2009

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? Yes
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 Horizontal
Type Slotted Coaxial
ERP: 15.0 kW
Manufacturer
Model RD24OM488548L3S
Year 2019
Justification for New Antenna Please refer to revised transition plan exhibit

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? 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? No

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Combiner Related Expenses

Combiner Related Expenses

Engineering Component Costs

Engineering Component Costs

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 900 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 Rigid
Diameter Other
Other Diameter 4 inches
Segment Length Other
Other Segment Length 19.38 feet
Number of parallel runs 1
Length 1000 feet per run
Justification for New Transmission Line Please refer to revised transition plan exhibit
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

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 Construct New
Tower Use Primary (Main)
Ownership Owned
Is this tower consider Complex? No
Is this tower currently shared with any other stations? Yes
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 1003118
Coordinates (NAD83) Latitude (NAD83) 38° 46' 32.1" N-
Longitude (NAD83) 092° 33' 24.9" W-
Overall Structure Height 1099.07 feet
Support Structure Height 1026.89 feet
Ground Elevation Above Mean Sea Level (AMSL) 818.89 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner NPG of Missouri, LLC
Date Constructed 01/01/1970

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
63164 KMIZ DTV

Primary Tower

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Tower Construction Costs

Section Question Response
Construct New Tower Use Primary (Main)
Is this a request for upgraded equipment? No
Height 1099.10 feet
Justification for New Tower Please refer to revised transition plan exhibit

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

Name Description

Engineering expenses relating to new tower and transmission system

Engineering expenses relating to new tower and transmission system

Spencer Fane Tower Study Legal Fees

Spencer Fane Tower Study Legal Fees

RIA Corporation multi-rate distribution amplifier

RIA Corporation multi-rate distribution amplifier

Rent for Use of Temporary Tower

Rent for Use of Temporary Tower

Internet Service at Temporary Tower Site

Internet Service at Temporary Tower Site

FDH Infrastructure Tower Evaluation and Structural Analysis

FDH Infrastructure Tower Evaluation and Structural Analysis

Allstate Tower Ultra-Sonic Test on Tower and Visual Inspection

Allstate Tower Ultra-Sonic Test on Tower and Visual Inspection

Electrical Service at Temporary Tower Site

Electrical Service at Temporary Tower Site

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 Perform engineering study for displacement application 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 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 Yes
For Auxiliary Facility No
For Main Facility Yes
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 No
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

Additional Displacement Legal Services Not Otherwise Specified in Form 399

Additional Displacement Legal Services Not Otherwise Specified in Form 399

du Treil Invoices relating to antenna and tower work

du Treil Invoices relating to antenna and tower work

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 Yes
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? No
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

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 $101,945.25 $48,273.49 N/A $48,273.49 N/A
Total for all systems $3,280,875.55 $820,508.97 N/A $814,320.87 N/A
Primary Transmitter UAXTE-2R23 $101,945.25 $48,273.49 $48,273.49
Installation for Proof of Performance $6,698.25 $6,698.25 N/A $6,698.25 N/A
Tune System from Channel 22 to Channel 30 $11,247.00 $11,247.00 N/A $11,247.00 N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $84,000.00 $30,328.24 N/A $30,328.24 N/A

Components

Actual Information Description File Name
Installation for Proof of Performance

Component Description:
Proof of Performance
Amount:
$6,698.25
Tune System from Channel 22 to Channel 30

Component Description:
Travel and Labor for Channel Retune
Amount:
$11,247.00
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
GatesAir UAXTE-2R23 Transmitter
Amount:
$30,328.24

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 $28,562.06 $28,562.06 N/A $28,562.06 N/A
Total for all systems $3,280,875.55 $820,508.97 N/A $814,320.87 N/A
Primary Antenna RD24OM488548L3S $28,562.06 $28,562.06 $28,562.06
Engineering Component Costs $0.00 $0.00 N/A $0.00 N/A
Combiner Related Expenses $14,523.80 $14,523.80 Additional expenses were incurred as indicated in the attached invoices. $14,523.80 Additional expenses were incurred as indicated in the attached invoices.
UHF-Low Power, Side Mount, Slotted Coaxial, 15.0kW input, Horizontal $14,038.26 $14,038.26 N/A $14,038.26 N/A

Components

Actual Information Description File Name
Engineering Component Costs

Component Description:
Engineering Components (first payment)
Amount:
N/A

Component Description:
Engineering Components (second payment)
Amount:
N/A
Combiner Related Expenses

Component Description:
Combiner Freight Charge
Amount:
$1,257.20

Component Description:
Combiner Related Expenses (first payment)
Amount:
$6,633.30

Component Description:
Combiner Related Expenses (second payment)
Amount:
$6,633.30
UHF-Low Power, Side Mount, Slotted Coaxial, 15.0kW input, Horizontal

Component Description:
Antenna Freight Charge
Amount:
$1,462.62

Component Description:
Side-Mount Antenna Expenses (first payment)
Amount:
$6,287.82

Component Description:
Side-Mount Antenna Expenses (second payment)
Amount:
$6,287.82

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 $42,329.09 $42,329.09 N/A $42,329.09 N/A
Total for all systems $3,280,875.55 $820,508.97 N/A $814,320.87 N/A
Primary Transmission Line $42,329.09 $42,329.09 $42,329.09
Interior RF Systems: Inside RF system including switching, patch panels and dehydrators $0.00 $0.00 N/A $0.00 N/A
Rigid Transmission Line - 4" 1 parallel runs 1000 feet $42,329.09 $42,329.09 Additional expenses were incurred as indicated in the attached invoices. $42,329.09 Additional expenses were incurred as indicated in the attached invoices.

Components

Actual Information Description File Name
Interior RF Systems: Inside RF system including switching, patch panels and dehydrators

Component Description:
Change Order for APD-D Dehydrator and kit
Amount:
N/A
Rigid Transmission Line - 4" 1 parallel runs 1000 feet

Component Description:
Freight on transmission line
Amount:
$784.59

Component Description:
Transmission Line Related Expenses (first payment)
Amount:
$20,772.25

Component Description:
Transmission Line Related Expenses (second payment)
Amount:
$20,772.25

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 $3,080,450.99 $669,821.17 N/A $669,821.17 N/A
Total for all systems $3,280,875.55 $820,508.97 N/A $814,320.87 N/A
Primary Tower GTOWER $0.00 $0.00 $0.00
Primary Tower $3,080,450.99 $669,821.17 $669,821.17
New tower between 1000' and 1500' without elevator, presumptive soil conditions $2,890,370.00 $637,490.18 N/A $637,490.18 Estimated and actual are equal
RIA Corporation multi-rate distribution amplifier $0.00 $0.00 N/A $0.00 N/A
Rent for Use of Temporary Tower $0.00 $0.00 Additional expenses were incurred as indicated in the attached invoices. $0.00 Additional expenses were incurred as indicated in the attached invoices.
Tower Rigging Tall Tower (greater than 500') $157,750.00 $0.00 N/A N/A N/A
Engineering expenses relating to new tower and transmission system $922.24 $922.24 N/A $922.24 Placeholder
Internet Service at Temporary Tower Site $0.00 $0.00 N/A $0.00 N/A
Allstate Tower Ultra-Sonic Test on Tower and Visual Inspection $11,425.00 $11,425.00 N/A $11,425.00 N/A
Spencer Fane Tower Study Legal Fees $13,483.75 $13,483.75 N/A $13,483.75 N/A
Electrical Service at Temporary Tower Site $0.00 $0.00 N/A $0.00 N/A
FDH Infrastructure Tower Evaluation and Structural Analysis $6,500.00 $6,500.00 N/A $6,500.00 N/A

Components

Actual Information Description File Name
New tower between 1000' and 1500' without elevator, presumptive soil conditions

Component Description:
Tower Erection (first payment)
Amount:
$77,855.99

Component Description:
Tower Removal (second payment)
Amount:
$22,497.75

Component Description:
Fence for Tower Building
Amount:
$3,152.40

Component Description:
Tower Removal (first payment)
Amount:
$22,497.75

Component Description:
Tower Foundation (first payment)
Amount:
$25,497.45

Component Description:
Tower Foundation (second payment)
Amount:
$25,497.45

Component Description:
New Tower Package (third payment)
Amount:
$92,340.77

Component Description:
New Tower Package (second payment)
Amount:
$92,340.77

Component Description:
New Tower Package (first payment)
Amount:
$151,351.53

Component Description:
Tower Erection (second payment)
Amount:
$77,855.99

Component Description:
APD-D Dehydrator
Amount:
$2,071.89

Component Description:
Change Order for Heliax required at temporary tower site
Amount:
N/A

Component Description:
Tower Erection (third payment)
Amount:
$44,530.44

Component Description:
Tower Erection for reaching 2/3 of tower height (one-third of balance)
Amount:
N/A
RIA Corporation multi-rate distribution amplifier

Component Description:
Multi-Rate Amplifier
Amount:
$752.64

Component Description:
PSIP Guide Data for ATSC
Amount:
$2,091.00
Rent for Use of Temporary Tower

Component Description:
Rent for temporary tower
Amount:
$8,500.00

Component Description:
Rent for temporary tower
Amount:
$8,500.00

Component Description:
Rent for temporary tower
Amount:
$8,500.00

Component Description:
Rent for temporary tower
Amount:
$21,250.00

Component Description:
Rent for temporary tower
Amount:
$8,500.00

Component Description:
Rent for temporary tower
Amount:
$8,500.00
Tower Rigging Tall Tower (greater than 500') Information not provided.
Engineering expenses relating to new tower and transmission system

Component Description:
In-house engineer tower work
Amount:
$340.85

Component Description:
In-house engineer installation of studio to transmitter link at temporary tower facility
Amount:
$98.18

Component Description:
In-house engineer installation of device to feed programming
Amount:
$92.85

Component Description:
In-house engineer tower work
Amount:
$304.58

Component Description:
In-house engineer SRT Gateway Installation and Configuration
Amount:
$85.78
Internet Service at Temporary Tower Site

Component Description:
Internet Service at Temporary Tower Site
Amount:
$709.20

Component Description:
Internet Service at Temporary Tower Site
Amount:
$279.95

Component Description:
Internet Service at Temporary Tower Site
Amount:
$279.95
Allstate Tower Ultra-Sonic Test on Tower and Visual Inspection

Component Description:
Visual Tower Inspection
Amount:
$2,500.00

Component Description:
Ultra-Sonic Test on Tower
Amount:
$8,925.00
Spencer Fane Tower Study Legal Fees

Component Description:
Tower Study Legal Fees
Amount:
$8,951.00

Component Description:
Tower Study Legal Fees
Amount:
$368.50

Component Description:
Tower Study Legal Fees
Amount:
$4,164.25

Component Description:
Tower Study Legal Fees
Amount:
N/A
Electrical Service at Temporary Tower Site

Component Description:
Electric Service at Temporary Tower Site
Amount:
$996.73

Component Description:
Electric Service at Temporary Tower Site
Amount:
$576.29

Component Description:
Electric Service at Temporary Tower Site
Amount:
$1,350.00

Component Description:
Electric Service at Temporary Tower Site
Amount:
$1,809.59
FDH Infrastructure Tower Evaluation and Structural Analysis

Component Description:
Structural Analysis
Amount:
$3,250.00

Component Description:
Tower Evaluation
Amount:
$3,250.00

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 $27,283.16 $31,218.16 N/A $25,335.06 N/A
Total for all systems $3,280,875.55 $820,508.97 N/A $814,320.87 N/A
Outside Professional Services $27,283.16 $31,218.16 $25,335.06
du Treil Invoices relating to antenna and tower work $5,166.66 $5,166.66 Additional expenses were incurred as indicated in the attached invoices. $5,166.66 Additional expenses were incurred as indicated in the attached invoices.
Additional Displacement Legal Services Not Otherwise Specified in Form 399 $9,964.00 $9,964.00 Additional expenses were incurred as indicated in the attached invoices. $9,964.00 Additional expenses were incurred as indicated in the attached invoices.
Attorney Fees - Prepare and File request for Special Temporary Authorization $2,235.00 $2,235.00 N/A $979.70 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $3,025.00 $3,025.00 N/A $1,387.20 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $2,102.50 $2,975.00 Additional expenses were incurred as indicated in the attached invoices. $2,975.00 N/A
Prepare request for Special Temporary Authorization $1,280.00 $1,280.00 N/A N/A N/A
Perform engineering study for displacement application $1,800.00 $4,862.50 Additional expenses were incurred as indicated in the attached invoices. $4,862.50 N/A
Prepare/ Review 399 reimbursement form $1,710.00 $1,710.00 N/A N/A N/A

Components

Actual Information Description File Name
du Treil Invoices relating to antenna and tower work

Component Description:
du Treil Invoices relating to antenna and tower work
Amount:
$83.33

Component Description:
du Treil Invoices relating to antenna and tower work
Amount:
N/A

Component Description:
du Treil Invoices relating to antenna and tower work
Amount:
$2,041.67

Component Description:
du Treil Invoices relating to antenna and tower work
Amount:
$583.33

Component Description:
du Treil Invoices relating to antenna and tower work
Amount:
$416.67

Component Description:
du Treil Invoices relating to antenna and tower work
Amount:
N/A

Component Description:
du Treil Invoices relating to antenna and tower work
Amount:
N/A

Component Description:
du Treil Invoices relating to antenna and tower work
Amount:
N/A

Component Description:
du Treil Invoices relating to antenna and tower work
Amount:
$166.67

Component Description:
du Treil Invoices relating to antenna and tower work
Amount:
$833.33

Component Description:
du Treil Invoices relating to antenna and tower work
Amount:
$83.33

Component Description:
du Treil Invoices relating to antenna and tower work
Amount:
N/A

Component Description:
du Treil Invoices relating to antenna and tower work
Amount:
$208.33

Component Description:
du Treil Invoices relating to antenna and tower work
Amount:
$750.00

Component Description:
du Treil Invoices relating to antenna and tower work
Amount:
N/A

Component Description:
du Treil Invoices relating to antenna and tower work
Amount:
N/A
Additional Displacement Legal Services Not Otherwise Specified in Form 399

Component Description:
Legal fees associated with Columbia, MO. displacement activity.
Amount:
$3,363.60

Component Description:
Legal fees associated with Columbia, MO. displacement activity.
Amount:
$1,408.80

Component Description:
Legal fees associated with Columbia, MO. displacement activity.
Amount:
$300.60

Component Description:
Legal fees associated with Columbia, MO. displacement activity.
Amount:
$2,116.20

Component Description:
Legal fees associated with Columbia, MO. displacement activity.
Amount:
$2,542.80

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$232.00
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
Prepare and file STA
Amount:
$877.70

Component Description:
Prepare and review STA extension request
Amount:
$102.00
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
File displacement application
Amount:
$165.00

Component Description:
Prepare and file minor change amendment
Amount:
$1,222.20
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Prepare engineering portion of displacement application
Amount:
$1,000.00

Component Description:
Engineering portion of displacement modification
Amount:
$625.00

Component Description:
Prepare engineering portion of displacement application
Amount:
$1,050.00

Component Description:
Prepare engineering portion of displacement application
Amount:
$50.00

Component Description:
Engineering mod of displacement application
Amount:
$250.00
Prepare request for Special Temporary Authorization Information not provided.
Perform engineering study for displacement application

Component Description:
Search for displacement channel
Amount:
$1,500.00

Component Description:
TPO Calculations
Amount:
$375.00

Component Description:
Displacement study
Amount:
$250.00

Component Description:
TPO Calculations
Amount:
$250.00

Component Description:
Evaluate competitor filings
Amount:
$50.00

Component Description:
TPO Calculations
Amount:
$62.50

Component Description:
Engineering study to stay on air
Amount:
$1,500.00

Component Description:
Study of options for relicense
Amount:
$875.00
Prepare/ Review 399 reimbursement form 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 $305.00 $305.00 N/A $0.00 N/A
Total for all systems $3,280,875.55 $820,508.97 N/A $814,320.87 N/A
Other Expenses $305.00 $305.00 $0.00
FCC Filing Fees - Special Temporary Authorization request $305.00 $305.00 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 $3,280,875.55 $820,508.97 $814,320.87

Reimbursement Status

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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

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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.

James W. DeChant

VP of Technology


09/11/2020

Certification

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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.

James W. DeChant

VP of Technology


09/11/2020

Attachments

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