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FCC Form 399: Reimbursement Request

Approved by OMB 3060-1178
Go to the Federal Communications Commission homepage at www.fcc.gov

(REFERENCE COPY - Not for submission) FCC Form 399: Reimbursement Request

Facility ID:
74169
Service:
DTV
Call Sign:
WVNS-TV
Channel:
11 (High VHF)
File Number:
0000028280
FRN:
0009961889
Date Submitted:
12/17/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

NEXSTAR INC.

Elizabeth Ryder

545 E. JOHN CARPENTER FREEWAY

SUITE 700

IRVING, TX 75062

United States

 +1 (972) 373-8800 eryder@nexstar.tv Corporation

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

Elizabeth Ryder

General Counsel

Nexstar Inc.

Elizabeth Ryder

545 E. John Carpenter Freeway

Suite 700

Irving, TX 75062

United States

 +1 (972) 373-8800 eryder@nexstar.tv

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 Purchase new transmitter, antenna and transmission line. See attachment.

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 Innovator DT
Year 2005
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 2.1 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 VAXTE-8R37
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 6.4 kW
Justification for New Transmitter The manufacturer of the existing transmitter is out of business and no factory support is available for the existing transmitter. See attachment. The TPO required to compensate for greater than 1% pop loss in the CP is 5.4kW.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) Yes
Transformer (480V) Yes
Power 150 kVA
Rigid Conduit and Wiring Yes
Size 2 inches
Length 100.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Transmitter Test Load

Replacement Test Load for New RePack Transmitter. Please see Bird Electronics Co. Quote # 00147191 Attached.

Additional Interior RF System

Interior RF System Existing Transmitter to Interim Transmission line

Additional Transmitter Costs

Transmitter change orders

Standby Exciter and Switch

Standby Exciter with Automatic Change Over Switch

Transmitter Site Survey

Transmitter Site Survey

Transmitter Electrical and Installation

Transmitter Electrical and Installation

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? No
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 Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Other
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 Batwing
ERP: 3.68 kW
Manufacturer
Model TK-2HT
Year 2005

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? No
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 Horizontal
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: 10.0 kW
Manufacturer
Model THV-2A11-R
Year 2020
Justification for New Antenna Manufacturer recommends replacement due to poor sweep results on assigned channel.

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna?
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? N/A
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Single Channel
Feed Line Size 3 1/8 inches inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna?
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.

Interim Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? No
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
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: 7.5 kW
Manufacturer
Model TLS-V4BB-R
Year 2019
Justification for New Antenna A temporary antenna is necessary to keep station on the air during primary antenna changeover.

Interim Antenna

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Other Antenna Costs

Section Question Response
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 an 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

Interim Antenna

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Other Antenna Cost Not Listed

Name Description

Additional Antenna Costs

Additional Antenna 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 Utilize Existing
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 Dielectric
Type Rigid
Diameter 3 1/8 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 2
Length 300 feet per run

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Sweep Tests

Sweep lines to ensure performance on assigned channel

Transmission Line 3-50

Transmission Line 3-50

Interim Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Interim
Description of Use N/A
Change Type Purchase New
Type Flexible Air
Diameter 1 5/8 inches
Segment Length N/A
Other Segment Length
Number of parallel runs 1
Length 250 feet per run
Justification for New Transmission Line Temporary line to stay on the air while replacing the primary antenna. Will rent if possible.

Interim Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Owned
Is this tower consider Complex? No
Is this tower currently shared with any other stations? No
One or more FM, AM or TV radio broadcaster(s) N/A
Others Types of Users N/A
Is tower documented for structural analysis? No
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1034390
Coordinates (NAD83) Latitude (NAD83) 37° 46' 22.5" N-
Longitude (NAD83) 080° 42' 25.7" W-
Overall Structure Height 268.04 feet
Support Structure Height 262.46 feet
Ground Elevation Above Mean Sea Level (AMSL) 3874.95 feet
Structure Type LTOWER - Lattice Tower
Tower Owner Nexstar Broadcasting, Inc.
Date Constructed 01/19/2016


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 undocumented/poorly 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

Weather Delays, Additional Charges

Weather Delays, Additional Charges

Tower Top Plate Modification

Top Plate Removal, Modification and Re-Installation to accommodate the new RePack Antenna. Please see Precision Communications Proposal 20465-5 Attached

Tower Equipment Removal, Plumb and Tension

Tower Modifications for Aux Antenna Installation. Please see Precision Communications Proposal # 20391-5 attached.

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 304
Explanation Schedule and coordinate multiple vendors, complete progress reports, and update Schedule 399. Station does not have available personnel or personnel trained in project management for such complex projects. Internal accounting and Project management.
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 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 No
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements No
Additional Field Engineering Service Yes
Number of Days 9
Justification It will be necessary to survey the site, plan the equipment, develop specifications for purchasing, and oversee multiple vendor RF projects. Station does not have available personnel or personnel trained in such services.

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning No
Non-zoning permits Yes
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

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 $326,985.92 $323,735.92 N/A $216,635.92 N/A
Total for all systems $1,095,125.92 $1,234,341.24 N/A $983,463.00 N/A
Primary Transmitter VAXTE-8R37 $326,985.92 $323,735.92 $216,635.92
Transmitter Electrical and Installation $36,817.25 $36,817.25 See GatesAir quote Q-86730 $36,817.25 N/A
Transmitter Site Survey $7,209.00 $7,209.00 See GatesAir quote Q-84947 $7,209.00 N/A
Standby Exciter and Switch $25,000.00 $25,000.00 N/A N/A N/A
Additional Transmitter Costs $14,180.51 $14,180.51 See GatesAir quotes Q-86253 and Q-86458 $14,180.51 N/A
Additional Interior RF System $19,000.00 $19,000.00 N/A N/A N/A
Transmitter Test Load $10,050.00 $10,050.00 Replacement Test Load for New RePack Transmitter. Please see Bird Electronics Co. Quote # 00147191 Attached. $10,050.00 N/A
Transformer 3 phase/480v - 150 KVA $25,550.00 $24,300.00 N/A N/A N/A
2" Rigid Conduit and Wiring (Cost per foot) $2,600.00 $2,500.00 N/A N/A N/A
High VHF - Air Cooled Solid State Transmitter 6.4 kW $148,379.16 $148,379.16 See GatesAir quote Q-84845. $148,379.16 N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A

Components

Actual Information Description File Name
Transmitter Electrical and Installation

Component Description:
Transmitter electrical and installation
Amount:
$36,817.25
Transmitter Site Survey

Component Description:
Transmitter site survey
Amount:
$7,209.00
Standby Exciter and Switch Information not provided.
Additional Transmitter Costs

Component Description:
Change order Q-86253
Amount:
$6,823.89

Component Description:
Change order Q-86458
Amount:
$7,356.62
Additional Interior RF System Information not provided.
Transmitter Test Load

Component Description:
Transmitter test load
Amount:
$10,050.00
Transformer 3 phase/480v - 150 KVA Information not provided.
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
High VHF - Air Cooled Solid State Transmitter 6.4 kW

Component Description:
Transmitter, installment #1
Amount:
$49,459.72

Component Description:
Transmitter, installment #3
Amount:
$49,459.72

Component Description:
Transmitter, installment #2
Amount:
$49,459.72
Switchgear - industrial 800 amp Information not provided.

Cost Information

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Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate 		Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $238,886.00 $225,469.00 N/A $218,550.50 N/A
Total for all systems $1,095,125.92 $1,234,341.24 N/A $983,463.00 N/A
Interim Antenna TLS-V4BB-R $77,953.00 $62,018.00 $55,618.00
Additional Antenna Costs $1,610.00 $1,610.00 See Dielectric order confirmation 1929968 $1,610.00 N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $7,545.00 See Dielectric quote 700451CMZ-1 $7,545.00 N/A
High VHF - High Power Side Mount One Station horizontally polarized $46,463.00 $46,463.00 See Dielectric quote 700451CMZ-1 $46,463.00 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Primary Antenna THV-2A11-R $160,933.00 $163,451.00 $162,932.50
Sweep test of existing antenna $6,730.00 $10,000.00 Feasibility test originally performed $3600, new antenna was required resulting in additional sweep test $10,000.00 N/A
High VHF - High Power Top Mount One Station horizontally polarized $146,603.00 $146,603.00 See Dielectric quote 200116CMZ-1 $146,603.00 N/A
Elbow complex, single channel, at antenna input, per 3 1/8. feedline (if needed) $7,600.00 $6,848.00 See Dielectric quote 200116CMZ-1 $6,329.50 N/A

Components

Actual Information Description File Name
Additional Antenna Costs

Component Description:
Additional antenna cost
Amount:
$1,610.00
Side mount brackets for high power antennas (if not included in antenna base cost)

Component Description:
Side mount brackets
Amount:
$7,545.00
High VHF - High Power Side Mount One Station horizontally polarized

Component Description:
Interim antenna
Amount:
$46,463.00
Sweep test of existing antenna Information not provided.
Sweep test of existing antenna

Component Description:
Main antenna sweep test
Amount:
$6,400.00

Component Description:
Repack Sweep
Amount:
$3,600.00
High VHF - High Power Top Mount One Station horizontally polarized

Component Description:
Main antenna, balance due
Amount:
$73,301.50

Component Description:
Main antenna, installment #1
Amount:
$73,301.50
Elbow complex, single channel, at antenna input, per 3 1/8. feedline (if needed)

Component Description:
Elbow complex, installment #1
Amount:
$3,424.00

Component Description:
Elbow complex, installment #2
Amount:
$2,905.50

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 $15,687.00 $15,806.32 N/A $8,887.82 N/A
Total for all systems $1,095,125.92 $1,234,341.24 N/A $983,463.00 N/A
Interim Transmission Line $8,250.00 $8,369.32 $8,369.32
Flexible Air Transmission Line - dielectric, 1 5/8" $8,250.00 $8,369.32 See Dielectric quote 700451CMZ-1 $8,369.32 N/A
Primary Transmission Line $7,437.00 $7,437.00 $518.50
Sweep Tests $6,400.00 $6,400.00 N/A N/A N/A
Transmission Line 3-50 $1,037.00 $1,037.00 See Dielectric quote 200116CMZ-1 $518.50 N/A

Components

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

Component Description:
Transmission line
Amount:
$8,369.32
Sweep Tests Information not provided.
Transmission Line 3-50

Component Description:
Transmission line, installment #1
Amount:
$518.50

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 $320,455.00 $480,205.00 N/A $480,205.00 N/A
Total for all systems $1,095,125.92 $1,234,341.24 N/A $983,463.00 N/A
Primary Tower LTOWER $320,455.00 $480,205.00 $480,205.00
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $21,250.00 See Reese Tower Services quote 10/4/19 $10350; see Morrison Hershfield quotes 2/19/20 $7250 and 8/24/20 $3650 $21,250.00 N/A
Tower Top Plate Modification $67,500.00 $67,500.00 Top Plate Removal, Modification and Re-Installation to accommodate the new RePack Antenna. Please see Precision Communications Proposal 20465-5 Attached $67,500.00 N/A
Tower Equipment Removal, Plumb and Tension $117,300.00 $117,300.00 Tower Modifications for Aux Antenna Installation. Please see Precision Communications Proposal # 20391-5 attached. $117,300.00 N/A
Weather Delays, Additional Charges $25,155.00 $25,155.00 See Precision Communications Addendum to Proposal 20390-5 $25,155.00 N/A
Short Tower (less than 500') $84,200.00 $249,000.00 See Precision Communications Quote 20390-5 $99,600 interim antenna and 20464-5 $149,400 main antenna $249,000.00 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
Amount:
$10,350.00

Component Description:
Structural analysis
Amount:
$7,250.00

Component Description:
Structural analysis
Amount:
$3,650.00
Tower Top Plate Modification

Component Description:
Tower top plate modifications, installment #1
Amount:
$45,000.00

Component Description:
Tower top plate modifications, installment #2
Amount:
$22,500.00
Tower Equipment Removal, Plumb and Tension

Component Description:
Tower modifications, installment #1
Amount:
$78,200.00

Component Description:
Tower modifications, installment #2
Amount:
$39,100.00
Weather Delays, Additional Charges

Component Description:
Weather delays and additional tower work costs
Amount:
$25,155.00
Short Tower (less than 500')

Component Description:
Main antenna installation, installment #1
Amount:
$99,600.00

Component Description:
Interim antenna installation, installment #1
Amount:
$66,400.00

Component Description:
Main antenna installation, installment #2
Amount:
$49,800.00

Component Description:
Interim antenna installation, installment #2
Amount:
$33,200.00

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 $93,062.00 $89,625.00 N/A $47,051.40 N/A
Total for all systems $1,095,125.92 $1,234,341.24 N/A $983,463.00 N/A
Outside Professional Services $93,062.00 $89,625.00 $47,051.40
Project management of the transition $48,032.00 $45,600.00 N/A $44,151.40 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $2,050.00 $2,275.00 See KGA invoices for STA and STA Extension $2,275.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A $625.00 N/A
Additional Field Engineering Service, 9 Days $18,000.00 $18,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A N/A 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

Components

Actual Information Description File Name
Project management of the transition

Component Description:
Project management services
Amount:
$225.00

Component Description:
Project management services
Amount:
$1,106.00

Component Description:
Project management services
Amount:
$2,283.00

Component Description:
Project management services
Amount:
$250.00

Component Description:
Project management services
Amount:
$237.00

Component Description:
Project management services March 2019
Amount:
$221.00

Component Description:
Project management services April 2019
Amount:
$45.50

Component Description:
Project management services
Amount:
$150.00

Component Description:
Project management services
Amount:
$1,923.00

Component Description:
Project management services
Amount:
$250.00

Component Description:
Project management services 2.1.19 through 3.1.19
Amount:
$975.00

Component Description:
Project management services
Amount:
$250.00

Component Description:
Project management services
Amount:
$150.00

Component Description:
Prepare FCC Schedule 387, item 2 from invoice summary
Amount:
$300.00

Component Description:
Project management services 3.2.19 through 3.29.19
Amount:
$1,200.00

Component Description:
Project management services 4.27.19 through 5.31.19
Amount:
$600.00

Component Description:
Project management services 3.30.19 through 4.26.19
Amount:
$225.00

Component Description:
Project management services
Amount:
$1,335.00

Component Description:
Project management services
Amount:
$495.00

Component Description:
Prepare FCC Schedule 387, item 3 from invoice summary
Amount:
$150.00

Component Description:
Project Management for Structural Analysis and Tower Modifications. Services from October 27, 2017 through December 31, 2017.
Amount:
$300.00

Component Description:
Project management services various, item 4 from invoice summary
Amount:
$2,184.00

Component Description:
Project management services 12.1.18 through 1.31.19
Amount:
$150.00

Component Description:
Project management services 9.29.18 through 10.26.18
Amount:
$150.00

Component Description:
Project Management for Structural Analysis and Tower Modifications. Services from January 1, 2018 through January 26, 2018.
Amount:
$750.00

Component Description:
Project management services
Amount:
$387.00

Component Description:
Project management services, item 1 from invoice summary
Amount:
$1,648.12

Component Description:
Project management services 10.27.18 through 11.30.18
Amount:
$500.00

Component Description:
Project management services
Amount:
$250.00

Component Description:
Project management services
Amount:
$1,106.00

Component Description:
Project Management for Structural Analysis and Tower Modifications including consultants Kessler and Gehman Associates. Services from August 26, 2017 through September 29, 2017.
Amount:
$9,828.78

Component Description:
Project management services Nov 2019
Amount:
$75.00

Component Description:
Project management services 5/26/18 through 6/29/18
Amount:
$825.00

Component Description:
Project Management for Structural Analysis and Tower Modifications including consultants Kessler and Gehman Associates. Services from May 27, 2017 through June 30, 2017.
Amount:
$13,500.00

Component Description:
Project management services 7.28.18 through 9.28.18
Amount:
$525.00

Component Description:
Project management services 6.1.19 through 6.28.19
Amount:
$150.00

Component Description:
Project management services
Amount:
$633.00

Component Description:
Project Management for Structural Analysis and Tower Modifications including consultants Kessler and Gehman Associates.
Amount:
$300.00
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 Information not provided.
Prepare request for Special Temporary Authorization

Component Description:
Prepare STA
Amount:
$1,500.00

Component Description:
Prepare STA Extension
Amount:
$775.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
Prepare License to Cover
Amount:
$625.00
Additional Field Engineering Service, 9 Days Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Perform engineering study for new channel assignment and antenna development Information not provided.
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review 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 $100,050.00 $99,500.00 N/A $12,132.36 N/A
Total for all systems $1,095,125.92 $1,234,341.24 N/A $983,463.00 N/A
Other Expenses $100,050.00 $99,500.00 $12,132.36
Equipment Storage $25,000.00 $25,000.00 N/A $2,020.00 N/A
Equipment Delivery and Handling Charges $25,000.00 $25,000.00 N/A $8,064.36 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $25,000.00 $25,000.00 N/A N/A N/A
Non-zoning permits $10,000.00 $10,000.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A $2,048.00 N/A
MVPD Notification of Channel Change $2,000.00 $2,000.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $1,500.00 $1,500.00 N/A N/A N/A

Components

Actual Information Description File Name
Equipment Storage

Component Description:
Interim antenna storage
Amount:
$2,020.00
Equipment Delivery and Handling Charges

Component Description:
Interim antenna freight cost
Amount:
$282.40

Component Description:
Transmitter freight
Amount:
$3,256.46

Component Description:
Interim antenna freight and shipping
Amount:
$4,525.50
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Non-zoning permits Information not provided.
DTV Medical Facility Notification

Component Description:
Notification of medical facilities
Amount:
$2,048.00
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate 		Estimated Cost Actual Cost
Total for all systems $1,095,125.92 $1,234,341.24 $983,463.00

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.

Elizabeth Ryder

General Counsel


12/17/2020

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.

Elizabeth Ryder

General Counsel


12/17/2020

Attachments

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