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:
53716
Service:
DTV
Call Sign:
WQLN
Channel:
27 (UHF)
File Number:
0000027396
FRN:
0007473234
Date Submitted:
11/02/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

PUBLIC BROADCASTING OF NORTHWEST PENNSYLVANIA, INC.

Doing Business As: PUBLIC BROADCASTING OF NORTHWEST PENNSYLVANIA, INC.

Aaron Coseo

8425 PEACH ST

ERIE, PA 16509

United States

+1 (814) 864-3001 acoseo@wqln.org Not-for-Profit

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

Aaron Coseo

Director of Broadcast Operations

Public Broadcasting of Northwest Pennsylvania Inc.

Aaron Coseo

8425 Peach St.

Erie, PA 16509

United States

+1 (814) 217-6038 acoseo@wqln.org

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 WQLN will be moving from channel 50 to channel 27 in phase 6. Please see attached full transition plan.

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 HP50SAW
Year 2001
Type Inductive Output Tube
IOT Power Type Single
Power Capacity 25 kW

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Manufacturer
Model THU9evo-16
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 25.5 kW
Justification for New Transmitter Please see attached revised transition plan. This is to change the transmitter manufacturer.

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) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service Yes
Description Miscellaneous conduit, wiring and ladder tray installation. Please see attached transition plan.
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Heating and Cooling
Size 5 tons
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

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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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type Class Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 300.0 kW
Manufacturer
Model TFU-13JTT/VP-R 4C170
Year 2013

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Ownership Owned
Owner N/A
Is antenna shared? 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 Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 191.0 kW
Manufacturer
Model TFU-10GTH/VP-R 4C170
Year 2019
Justification for New Antenna Current antenna is designed for channel 50. Please see attached transition plan.

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? 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? Yes
Broadband or Single Channel? Single Channel
Feed Line Size 7 3/16 inches inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? No
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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Section Question Response
Transmission Line Related Expenses Do you have transmission line related expenses? No

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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Add 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? Yes
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1001555
Coordinates (NAD83) Latitude (NAD83) 42° 02' 33.3" N-
Longitude (NAD83) 080° 03' 55.8" W-
Overall Structure Height 707.01 feet
Support Structure Height 681.75 feet
Ground Elevation Above Mean Sea Level (AMSL) 1304.77 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner SBA GC Towers, LLC
Date Constructed 01/01/1978

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
53720 WQLN-FM FM

Primary Tower

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Tower Modification Costs

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

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Interim Rigging Expense

Expenses related to installation of interim antenna and transmission line.

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 160
Explanation To assist with the implementation and completion of transition from channel 50 to channel 27.
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 Yes
Quantity 1
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 Yes
Quantity 1
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 Yes
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

Name Description

Prepare and Review Progress Reports

Engineering and legal expenses associated with preparation of quarterly progress reports.

Tower Application Fee

Cost to apply for equipment change for tower leasing company

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 No
Non-zoning permits No
BLM or NFS Coordination No
FCC Construction Permit Minor Change No
FCC License to Cover Application No
FCC Special Temporary Authority Application No
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? Yes
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Name Description

Inside RF system

This equipment will be used to rework the feed to the antenna to support the new channel. Please see attached transition plan.

PE Review

This is to cover the professional engineer costs for the required review of the rigging plan.

Site Survey

Site survey to measure available space and develop plan for transition.

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 $1,691,807.27 $638,793.80 N/A $638,793.80 N/A
Total for all systems $2,511,153.27 $1,276,533.08 N/A $1,105,834.14 N/A
Primary Transmitter THU9evo-16 $1,691,807.27 $638,793.80 $638,793.80
Other -- HVAC Service Type: H Size:5 (Other) $34,387.27 $34,387.27 The original quoted zoned HVAC system will not be sufficient to provide heating and cooling to the 2 separate room’s equipment resides. $34,387.27 The original quoted zoned HVAC system will not be sufficient to provide heating and cooling to the two separate rooms where the transmitter and mask filter reside.
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW $684,000.00 $567,236.53 ***System Notice: Estimate adjusted and locked because line has been superseded.***Change to lower cost Rohde & Schwarz transmitter. Please see attached revised transition plan $567,236.53 N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW $947,000.00 $10,750.00 Please see attached revised transition plan. This is the small remainder required to complete the transition in phase 6. $10,750.00 N/A
Other Electrical Service: Miscellaneous conduit, wiring and ladder tray installation. Please see attached transition plan. $26,420.00 $26,420.00 Electrical work completed. Please see attached revised transition plan. $26,420.00 N/A

Components

Actual Information Description File Name
Other -- HVAC Service Type: H Size:5 (Other)

Component Description:
Move duct work
Amount:
$2,065.27

Component Description:
Installation of HVAC unit capable to providing heat
Amount:
$8,722.00

Component Description:
HVAC for room in which the mask filter for post repack channel 27 resides.
Amount:
$23,600.00

Component Description:
Installation of HVAC unit capable to providing heat
Amount:
$8,722.00
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW

Component Description:
Final payment for Channel 27 transmitter mask filter. Downpayment was paid by FCC on 2/9/18 but the initial quote and down payment invoice have disappeared from our Form 399.
Amount:
$27,815.79

Component Description:
50% downpayment on quote #1802T from SJ Ramer Associates for mask filter and components for Channel 27 installation
Amount:
$27,815.80

Component Description:
Transmitter installation services
Amount:
$21,500.00

Component Description:
25% downpayment for transmitter to move from Channel 50 to Channel 27
Amount:
$116,463.75

Component Description:
Transmitter installation services
Amount:
$24,250.00

Component Description:
Final payment on transmitter
Amount:
$349,391.19
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW

Component Description:
Final tuning and proof of transmitter into post repack rf system and antenna
Amount:
$10,750.00
Other Electrical Service: Miscellaneous conduit, wiring and ladder tray installation. Please see attached transition plan.

Component Description:
Electrical construction for transmitter install
Amount:
$26,420.00

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 $310,130.00 $174,608.28 N/A $172,831.71 N/A
Total for all systems $2,511,153.27 $1,276,533.08 N/A $1,105,834.14 N/A
Primary Antenna TFU-10GTH/VP-R 4C170 $310,130.00 $174,608.28 $172,831.71
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $289,500.00 $172,426.00 Please see attached quotation from Dielectric and revised transition plan. $170,649.43 N/A
Sweep test of existing antenna $6,730.00 $2,182.28 Antenna and transmission line sweep required to determine if line was acceptable for use on assigned replacement channel. Please see attached revised transition plan for details. $2,182.28 N/A
Elbow complex, single channel, at antenna input, per 7 3/16. feedline (if needed) $13,900.00 $0.00 N/A $0.00 N/A

Components

Actual Information Description File Name
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
Balance due upon delivery of post repack channel 27 antenna
Amount:
$5,199.60

Component Description:
Freight, shipping and handling for post repack channel 27 antenna delivery
Amount:
$4,500.00

Component Description:
Progress payment-45% due prior to shipment
Amount:
$77,591.70

Component Description:
Downpayment on UHF High Power Top Mount Antenna
Amount:
$77,591.70

Component Description:
Final pieces of transmission line that connect the antenna elbow complex to the transmission line. Multiple pieces were needed to ensure there were no delays that would necessitate the tower crew staying and billing an additional day.
Amount:
$5,766.43
Sweep test of existing antenna

Component Description:
RF engineer to perform sweep test - only requesting $1,490.88 of this invoice for the sweep test. The remainder of the invoice will be requested under another category.
Amount:
$1,490.88

Component Description:
O rings and hardware necessary to break transmission line for sweep test
Amount:
$91.40

Component Description:
Tower crew to open transmission line at tower base for sweep test
Amount:
$600.00

Component Description:
Tower crew to open transmission line at tower base for sweep test
Amount:
$600.00

Component Description:
O rings and hardware necessary to break transmission line for sweep test
Amount:
$91.40

Component Description:
This invoice is split across 3 categories. Please see attached cover letter.
Amount:
$1,490.88
Elbow complex, single channel, at antenna input, per 7 3/16. feedline (if needed) Information not provided.

Cost Information

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Transmission Line

Information not provided.

Cost Information

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Tower Equipment and Rigging Costs

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $223,100.00 $201,250.00 N/A $201,250.00 N/A
Total for all systems $2,511,153.27 $1,276,533.08 N/A $1,105,834.14 N/A
Primary Tower GTOWER $223,100.00 $201,250.00 $201,250.00
Interim Rigging Expense $0.00 $0.00 N/A N/A N/A
Tall Tower (greater than 500') $210,500.00 $196,250.00 Please see attached "Vertical Technologies revised quote". The quote has been revised due to the impact of delays to their schedules that have been out of their control. To meet our phase 6 deadline, they must use a helicopter to save time. $196,250.00 N/A
Structural engineering tower load study for well documented tower $12,600.00 $5,000.00 Cost to SBA for initial tower study and future application fee for antenna replacement on rental tower. Please see attached revised transition plan. $5,000.00 N/A

Components

Actual Information Description File Name
Interim Rigging Expense Information not provided.
Tall Tower (greater than 500')

Component Description:
Additional downpayment for services required to remove our current channel 50 antenna and replace it and connect our post repack channel 27 antenna.
Amount:
$10,385.00

Component Description:
Final 70% payment for the tower crew to remove the pre repack channel 50 antenna and install and tune the post repack channel 27 antenna
Amount:
$137,375.00

Component Description:
Downpayment for rigging expense for the installation of the post repack channel antenna
Amount:
$9,240.00

Component Description:
20% due to tower crew upon mobilization. This crew will do the antenna installation for the post repack channel 27 antenna and input components.
Amount:
$39,250.00
Structural engineering tower load study for well documented tower

Component Description:
Structural analysis done by tower owner
Amount:
$2,500.00

Component Description:
Structural analysis
Amount:
$2,500.00

Component Description:
Structural analysis
Amount:
$2,500.00

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $154,650.00 $137,025.00 N/A $29,466.15 N/A
Total for all systems $2,511,153.27 $1,276,533.08 N/A $1,105,834.14 N/A
Outside Professional Services $154,650.00 $137,025.00 $29,466.15
Prepare and or review reimbursement form $2,630.00 $1,000.00 N/A $0.00 N/A
Project management of the transition $25,280.00 $24,000.00 N/A $20,445.15 N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $2,500.00 N/A N/A N/A
Tower Application Fee $2,250.00 $2,250.00 Application fee to change equipment on tower lease $2,250.00 N/A
Prepare and Review Progress Reports $8,000.00 $8,000.00 Engineering and legal expenses associated with the preparation and review of quarterly reports. Please see attached revised transition plan. N/A N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,500.00 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 $521.00 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $4,000.00 N/A $0.00 N/A
Prepare request for Special Temporary Authorization $2,050.00 $1,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,000.00 N/A $600.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $5,650.00 Antenna study completed. Please see attached revised transition plan. $5,650.00 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $1,875.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $0.00 N/A N/A N/A

Components

Actual Information Description File Name
Prepare and or review reimbursement form

Component Description:
Legal fees for reviewing reimbursement form 399. Only a portion of this invoice is requested. The remaining amount will be requested under another category.
Amount:
$746.00
Project management of the transition

Component Description:
Project management
Amount:
$56.00

Component Description:
Project management
Amount:
$3,037.50

Component Description:
Project management services for Form 399 completion and main transmitter selection, design, and installation
Amount:
$3,449.25

Component Description:
Project management
Amount:
$1,421.25

Component Description:
Project management
Amount:
$3,271.60

Component Description:
Project management
Amount:
$50.50

Component Description:
Project management
Amount:
$3,271.60

Component Description:
Project management
Amount:
$825.00

Component Description:
Project management
Amount:
$50.50

Component Description:
Project management
Amount:
$825.00

Component Description:
Project management
Amount:
$50.50

Component Description:
Project management
Amount:
$50.50

Component Description:
Project management
Amount:
$287.50

Component Description:
Project management regarding repack progress reports
Amount:
$35.00

Component Description:
This invoice is split across 3 categories. Please see attached cover letter for details.
Amount:
$1,503.05

Component Description:
Project management
Amount:
$50.50

Component Description:
Project management
Amount:
$272.00

Component Description:
Project management
Amount:
$50.50

Component Description:
project management
Amount:
$600.00

Component Description:
Project management
Amount:
$101.00

Component Description:
Project management
Amount:
$1,421.25

Component Description:
Project management
Amount:
$609.00

Component Description:
Project management - services regarding RF system
Amount:
$2,550.00

Component Description:
Project management regarding post repack facility
Amount:
$645.50

Component Description:
Project management
Amount:
$151.50

Component Description:
Project management
Amount:
$1,176.00

Component Description:
Project management
Amount:
$151.00

Component Description:
Project management. Only requesting a portion of the invoice for project management. The rest of the invoice will be requested under another category.
Amount:
$2,993.92
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
Tower Application Fee

Component Description:
Tower application fee
Amount:
$2,250.00
Prepare and Review Progress Reports Information not provided.
Comprehensive coverage verification via field study, if needed Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
Attorney fees regarding post repack facility
Amount:
$521.00
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Legal fees for construction permit application. Only requesting a portion of the total invoice. The remaining balance will be requested under another category
Amount:
$430.00
Prepare request for Special Temporary Authorization Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
Preparation of application for license to cover
Amount:
$600.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Perform engineering study for new channel assignment and antenna development
Amount:
$2,025.00

Component Description:
Perform engineering study for new channel assignment and antenna development
Amount:
$1,300.00

Component Description:
Perform engineering study for new channel assignment and antenna development
Amount:
$1,300.00

Component Description:
Review of main antenna and aux antenna design. Update power calculations of city of Erie.
Amount:
$2,325.00

Component Description:
Perform engineering study for new channel assignment and antenna development
Amount:
$2,025.00
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application 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 $131,466.00 $124,856.00 N/A $63,492.48 N/A
Total for all systems $2,511,153.27 $1,276,533.08 N/A $1,105,834.14 N/A
Other Expenses $131,466.00 $124,856.00 $63,492.48
Site Survey $1,491.00 $1,491.00 Site survey required to assess existing space and equipment to develop transition plan. Please see attached revised transition plan. $1,490.87 N/A
PE Review $7,500.00 $7,500.00 Please see attached revised transition plan. N/A N/A
Inside RF system $60,697.00 $60,697.00 Please see attached revised transition plan. $46,108.42 N/A
MVPD Notification of Channel Change $3,728.00 $3,728.00 Tower crew experienced delays beyond their control and had to change the date for our antenna swap, therefor we were forced to send a second letter. $3,728.00 N/A
Develop and air announcement of upcoming channel change $5,000.00 $5,000.00 Please see attached transition plan. N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $25,000.00 $25,000.00 Please see attached transition plan. $7,225.19 N/A
DTV Medical Facility Notification $11,550.00 $4,940.00 Tower crew experienced delays beyond their control and had to change the date for our antenna swap, therefor we were forced to send a second letter. $4,940.00 N/A
Equipment Delivery and Handling Charges $15,000.00 $15,000.00 Please see attached transition plan. N/A N/A
Equipment Storage $1,500.00 $1,500.00 Rental storage container for an estimated 6 months during the transmitter construction phase. Please see attached transition plan. N/A N/A

Components

Actual Information Description File Name
Site Survey

Component Description:
This invoice is split across 3 categories. Please see attached cover letter for details.
Amount:
$1,490.87
PE Review Information not provided.
Inside RF system

Component Description:
Final payment for RF components necessary to move to channel 27. Down payment was paid by FCC on 2/9/18 but the initial quote and down payment invoice have disappeared from our Form 399.
Amount:
$11,743.62

Component Description:
Inside RF system work
Amount:
$9,900.00

Component Description:
RF system mod
Amount:
$2,760.00

Component Description:
50% downpayment for Quote #1801R from SJ Ramer Associates for necessary RF components for Channel 27 installation
Amount:
$11,743.62

Component Description:
4" solder flanges necessary to make the proper length pieces of transmission components to connect the post repack channel 27 transmitter to the post repack mask filter
Amount:
$204.00

Component Description:
complete final RF system modifications to connect post repack channel 27 transmitter to post repack channel 27 mask filter and antenna
Amount:
$9,675.00

Component Description:
rental of oxygen and acetylene tanks required to make the solder connections on the flanges required to make the components to connect the post repack channel 27 transmitter to the post repack channel 27 mask filter
Amount:
$82.18
MVPD Notification of Channel Change

Component Description:
Notification of cable and satellite MVPD providers of new RF channel and transport stream parameters on repack channel
Amount:
$1,864.00

Component Description:
Second set of MVPD notifications. Necessary because of tower crew delays beyond their control.
Amount:
$1,864.00
Develop and air announcement of upcoming channel change Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
Disposal of oil and glycol located in area where new heat exchangers will go
Amount:
$3,432.81

Component Description:
Glycol removal from old transmitter
Amount:
$166.22

Component Description:
Pumpout of oil from old beam supplies located in area where new heat exchangers will be placed
Amount:
$3,792.38
DTV Medical Facility Notification

Component Description:
Notification of medical facitilies
Amount:
$2,470.00

Component Description:
Second set of medical facilities notifications. Necessary because of tower crew delays beyond their control.
Amount:
$2,470.00
Equipment Delivery and Handling Charges Information not provided.
Equipment Storage Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $2,511,153.27 $1,276,533.08 $1,105,834.14

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. 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.

Cynthia Spizarny

Vice President and General Manager


11/02/2020

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.

Cynthia Spizarny

Vice President and General Manager


11/02/2020

Attachments

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