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:
58978
Service:
DTV
Call Sign:
KPXN-TV
Channel:
38 (UHF)
File Number:
0000028489
FRN:
0001808468
Date Submitted:
01/11/2021

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

ION TELEVISION LICENSE, LLC

Doing Business As: ION TELEVISION LICENSE, LLC

601 CLEARWATER PARK ROAD

WEST PALM BEACH, FL 33401

United States

+1 (561) 682-4110 BIANCAFRYE@IONMEDIA.COM 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

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. Yes
Briefly describe transition plan Relocate from existing tower to ASR #1036897. No interim facilities needed. Construct post-repack facilities at alternate location pursuant to CP authorization. Install new transmitter, RF system, transmission line, and antenna on post-repack channel.

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 Millennium
Year 2005
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 40 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 THU9-24 EVO
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 37 kW
Justification for New Transmitter See attached Transmitter Exhibits. See attached Transmitter Upgrade Disclaimer.

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 Electrical Installation for replacement transmitter
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 10 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

Name Description

RF Interconnect

Interconnect between RF System and transmission line

Removal of Existing Equipment

Removal of existing transmitters and equipment / Site Prep

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? Yes
Existing 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 N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 1000.0 kW
Manufacturer
Model TFU-26DSC-R C170
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? Yes
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? Yes
New Antenna Manufacturer and Types Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 1000.0 kW
Manufacturer
Model TFU-26DSC/VP-R C170
Year 2018
Justification for New Antenna Current slot antenna cannot be re-channeled

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 6 1/8 inches inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? Yes
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

RTLSCR675-15

T/L 6-75 EIA LENGTH 10' TO 15' FIXED FLG 1 END/SWIVEL FLG 1 END

Transmission Line

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

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 19 1/2 inches
Other Segment Length N/A
Number of parallel runs 1
Length 400 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 250 feet per run
Justification for New Transmission Line See attached Transmission Line Exhibit.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Sweep existing transmission line

Sweep existing transmission line

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 Move Equipment
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? 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? Unknown
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? No
ASR Number
Coordinates (NAD83) Latitude (NAD83) 34° 12' 46.0" N-
Longitude (NAD83) 118° 03' 41.0" W-
Overall Structure Height 199.00 feet
Support Structure Height 199.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 5426.50 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner American Tower
Date Constructed 09/14/2005


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

Information not provided.

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 1036897
Coordinates (NAD83) Latitude (NAD83) 34° 13' 36.0" N-
Longitude (NAD83) 118° 04' 02.2" W-
Overall Structure Height 209.97 feet
Support Structure Height 150.92 feet
Ground Elevation Above Mean Sea Level (AMSL) 5689.89 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner InSite Towers Development, LLC
Date Constructed 06/01/1977

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
26231 KWHY-TV DTV

Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: No study needed
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

Tower Structural Study

Tower Structural Study

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 180
Explanation Required by tower landlord
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 Yes
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 Yes
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning Yes
Non-zoning permits Yes
BLM or NFS Coordination Yes
FCC Construction Permit Minor Change Yes
FCC License to Cover Application Yes
FCC Special Temporary Authority Application Yes
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? 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

Sales Tax

Sales tax for repack equipment paid directly to the state of California

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 $1,647,488.33 $1,067,035.02 N/A $1,030,035.02 N/A
Total for all systems $2,403,773.78 $1,748,327.47 N/A $1,485,475.76 N/A
Primary Transmitter THU9-24 EVO $1,647,488.33 $1,067,035.02 $1,030,035.02
Removal of Existing Equipment $59,890.00 $59,890.00 Please see Wireless Infrastructure Quote #Ground De-intsallRev.1 $59,890.00 N/A
RF Interconnect $15,198.33 $15,198.33 Please see Rohde & Schwarz Quotes #128507.1 and #138623.1 $15,198.33 N/A
10 Ton system $38,900.00 $37,000.00 N/A N/A N/A
Other Electrical Service: Electrical Installation for replacement transmitter $60,500.00 $60,500.00 See attached SCE Contractors Quote #06.13.18 $60,500.00 N/A
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW $1,473,000.00 $894,446.69 See Rohde & Schwarz 2018-04-18 Rohde & Schwarz Quotes #106097.0 and #3608.0 $894,446.69 N/A

Components

Actual Information Description File Name
Removal of Existing Equipment

Component Description:
50% "deposit" payment for removal old transmitter equipment. Supporting documentation is attached. This invoice has been paid.
Amount:
$29,945.00

Component Description:
50% "remaining contract" payment for removal old transmitter equipment. Supporting documentation is attached. This invoice has been paid.
Amount:
$29,945.00

Component Description:
50% "deposit" payment for removal old transmitter equipment. Supporting documentation is attached. This invoice has been paid.
Amount:
$29,945.00
RF Interconnect

Component Description:
Cost of equipment for RF interconnect. Supporting documentation is attached. This invoice has been paid.
Amount:
$6,608.33

Component Description:
Cost to install RF interconnect equipment. Supporting documentation is attached. This invoice has been paid.
Amount:
$8,590.00
10 Ton system Information not provided.
Other Electrical Service: Electrical Installation for replacement transmitter

Component Description:
Down payment for electrical installation of primary transmitter. Supporting documentation attached. This invoice has been paid.
Amount:
$20,500.00

Component Description:
Final payment for electrical installation of primary transmitter. Supporting documentation attached. This invoice has been paid.
Amount:
$5,000.00

Component Description:
Progress payment #2 for electrical installation of primary transmitter. Tax ID has been corrected. Supporting documentation attached. This invoice has been paid.
Amount:
$20,000.00

Component Description:
Progress payment #3 for electrical installation of primary transmitter. Supporting documentation attached. This invoice has been paid.
Amount:
$15,000.00
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW

Component Description:
25% "deposit" payment for Rohde & Schwarz transmitter. Per FCC reviewers request, supporting documentation has been revised and attached. This invoice has been paid.
Amount:
$203,703.75

Component Description:
Remaining 75% balance due on primary transmitter and 100% of taxes payable on the order. Supporting documentation attached.
Amount:
$683,132.69

Component Description:
25% "deposit" payment for Rohde & Schwarz transmitter. Supporting documentation attached. This invoice has been paid.
Amount:
$203,703.75

Component Description:
Cost of additional material and labor for transmitter installation. Supported documentation is attached. This invoice has been paid.
Amount:
$7,610.25

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 $199,067.00 $195,074.50 N/A $189,286.80 N/A
Total for all systems $2,403,773.78 $1,748,327.47 N/A $1,485,475.76 N/A
Primary Antenna TFU-26DSC/VP-R C170 $199,067.00 $195,074.50 $189,286.80
RTLSCR675-15 $1,477.00 $1,477.00 See attached Dielectric Quote #44990. $1,329.30 N/A
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $5,000.00 N/A N/A N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $21,750.00 See attached Dielectric Quote #44990. $21,750.00 N/A
UHF - High Power, Side Mount, basic slot antenna, 1000 kW input, directional,, elliptically or circularly polarized $150,150.00 $150,150.00 Cost of Vertical Polarization not included in estimate. See attached Dielectric Quote #44990. $150,150.00 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 See attached Dielectric Quote #44990. $5,760.00 N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $10,297.50 See attached Dielectric Quote #44990. $10,297.50 N/A

Components

Actual Information Description File Name
RTLSCR675-15

Component Description:
45% "prior to ship" payment for flanges. Supporting documentation and explanation of variance attached.
Amount:
$664.65

Component Description:
45% "down payment" for flanges. Supporting documentation and explanation of variance attached.
Amount:
$664.65
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) Information not provided.
Side mount brackets for high power antennas (if not included in antenna base cost)

Component Description:
45% "down payment" for primary antenna side mount brackets. Supporting documentation and explanation of variance attached.
Amount:
$9,787.50

Component Description:
45% "prior to ship" payment for side mount brackets. Supporting documentation and explanation of variance attached.
Amount:
$9,787.50

Component Description:
Remaining balance due on primary antenna side mount brackets. Explanation of variance form, supporting documentation, and detailed cost breakout attached.
Amount:
$2,175.00
UHF - High Power, Side Mount, basic slot antenna, 1000 kW input, directional,, elliptically or circularly polarized

Component Description:
Remaining balance due on primary side antenna. Explanation of variance form, supporting documentation, and detailed cost breakout attached.
Amount:
$15,015.00

Component Description:
45% "down payment" for primary side mount antenna. Supporting documentation and explanation of variance attached.
Amount:
$67,567.50

Component Description:
45% "prior to ship" payment for primary antenna. Supporting documentation and explanation of variance attached.
Amount:
$67,567.50
Sweep test of existing antenna

Component Description:
45% "down payment" for repack sweep of primary antenna operations. Supporting documentation and explanation of variance attached.
Amount:
$2,880.00

Component Description:
45% "prior to ship" payment for repack sweep of primary antenna operations. Supporting documentation and explanation of variance attached.
Amount:
$2,880.00
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
45% "down payment" for primary elbow complex. Supporting documentation and explanation of variance attached.
Amount:
$4,633.87

Component Description:
Remaining balance due on primary elbow complex. Explanation of variance form, supporting documentation, and detailed cost breakout attached.
Amount:
$1,029.76

Component Description:
45% "prior to ship" payment for primary elbow complex. Supporting documentation and explanation of variance attached.
Amount:
$4,633.87

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 $56,900.00 $54,074.50 N/A $47,321.40 N/A
Total for all systems $2,403,773.78 $1,748,327.47 N/A $1,485,475.76 N/A
Primary Transmission Line $56,900.00 $54,074.50 $47,321.40
Rigid Transmission Line - copper, 6 1/8" $50,500.00 $47,674.50 See attached Dielectric Quote #44990. $47,321.40 N/A
Sweep existing transmission line $6,400.00 $6,400.00 N/A N/A N/A

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 6 1/8"

Component Description:
45% "down payment" for primary transmission line. Supporting documentation and explanation of variance attached.
Amount:
$19,500.08

Component Description:
45% "prior to ship" payment for primary transmission line. Supporting documentation and explanation of variance attached.
Amount:
$19,500.08

Component Description:
45% "down payment" for primary transmission line cut pieces. Supporting documentation and explanation of variance attached.
Amount:
$1,993.95

Component Description:
45% "prior to ship" payment for primary transmission line cut pieces. Supporting documentation and explanation of variance attached.
Amount:
$1,993.95

Component Description:
Remaining balance due on primary transmission line. Explanation of variance form, supporting documentation, and detailed cost breakout attached.
Amount:
$4,333.34
Sweep existing 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 $178,400.00 $127,180.00 N/A $121,680.00 N/A
Total for all systems $2,403,773.78 $1,748,327.47 N/A $1,485,475.76 N/A
Primary Tower TOWER $84,200.00 $27,480.00 $27,480.00
Short Tower (less than 500') $84,200.00 $27,480.00 See attached Wireless Infrastructure Quote #Antenna De-intsall $27,480.00 N/A
Primary Tower TOWER $94,200.00 $99,700.00 $94,200.00
Short Tower (less than 500') $84,200.00 $89,700.00 See attached revised Seacomm Erectors Quote #Revised-10-17-18-R1. In addition, Seacomm Erectors, Inc #4785 had to perform additional labor in the amount of $7,300 / Cover letter attached. $89,700.00 N/A
Tower Structural Study $10,000.00 $10,000.00 See attached Insite Towers, LLC Quote #CA041(A) and Tower Engineering Company Quote #01 $4,500.00 N/A

Components

Actual Information Description File Name
Short Tower (less than 500')

Component Description:
50% "remaining" payment to remove old antenna system. Supporting documentation is attached. This invoice has been paid.
Amount:
$13,740.00

Component Description:
50% "deposit" to remove old antenna system. Supporting documentation is attached. This invoice has been paid.
Amount:
$13,740.00
Short Tower (less than 500')

Component Description:
50% "remaining balance" payment for tower service plus additional $7,300 charge. Cover letter and supporting documentation attached. This invoice has been paid.
Amount:
$48,500.00

Component Description:
50% Deposit payment for tower service. Supporting documentation attached. This invoice has been paid.
Amount:
$41,200.00
Tower Structural Study

Component Description:
Cost of tower structural study. Supporting documentation attached. This invoice has been paid.
Amount:
$4,500.00

Component Description:
Cost of professional engineering services. Supporting documentation is attached. This invoice has been paid.
Amount:
$5,500.00

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 $179,130.00 $165,280.00 N/A $32,617.99 N/A
Total for all systems $2,403,773.78 $1,748,327.47 N/A $1,485,475.76 N/A
Outside Professional Services $179,130.00 $165,280.00 $32,617.99
RF Exposure Measurements $21,050.00 $24,000.00 See attached Insite Wireless Group #CA041ION pages 3 through 7. $24,000.00 N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $2,050.00 $1,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $1,500.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $2,375.00 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
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet $10,520.00 $10,000.00 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 - Negotiation of lease and other matters for shared locations $4,210.00 $4,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A $4,742.99 N/A
Project management of the transition $28,440.00 $18,530.00 See AT Exhibits for more information. N/A N/A

Components

Actual Information Description File Name
RF Exposure Measurements

Component Description:
Cost of RF Exposure Measurement Studies. Cover letter and supporting documentation attached. This invoice has been paid.
Amount:
$24,000.00
Comprehensive coverage verification via field study, if needed Information not provided.
Prepare request for Special Temporary Authorization Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Cost of RF consultant preparation of engineering part of FCC Form 2100. Hourly supporting documentation attached. This invoice has been paid.
Amount:
$1,500.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Cost of RF consultant work for new channel assignment and antenna development. Hourly supporting documentation attached. This invoice has been paid. Please note that KNBC is in description but this is not a shared expense. KPXN is assuming full cost.
Amount:
$1,750.00

Component Description:
Cost of RF consultant work for new channel assignment and antenna development. Hourly supporting documentation attached. This invoice has been paid.
Amount:
$562.50

Component Description:
Cost of RF consultant work for new channel assignment and antenna development. Hourly supporting documentation attached. This invoice has been paid.
Amount:
$62.50
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form Information not provided.
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Invoice for station's portion of general repack legal expenses incurred for 42 of the ION repack stations for period 2/1/2017 - 12/15/2017. Payee has corresponded with FCC staff and has provided corrected supporting documentation.
Amount:
$4,837.97

Component Description:
Invoice for KPXN's portion of general repack legal expenses incurred for 42 of the ION repack stations for period 2/1/2017 - 12/15/2017. Payee has corresponded with FCC staff. Hourly supporting documentation and invoice attached.
Amount:
$4,742.99
Project management of the transition 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 $142,788.45 $139,683.45 N/A $64,534.55 N/A
Total for all systems $2,403,773.78 $1,748,327.47 N/A $1,485,475.76 N/A
Other Expenses $142,788.45 $139,683.45 $64,534.55
MVPD Notification of Channel Change $3,000.00 $3,000.00 N/A $1,600.00 N/A
Develop and air announcement of upcoming channel change $0.00 $0.00 The amount is yet to be determined (TBD) and ION will submit on-air announcement costs when finalized. N/A N/A
Equipment Storage $10,000.00 $10,000.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $15,000.00 $15,000.00 N/A $500.00 N/A
Non-zoning permits $15,000.00 $15,000.00 N/A N/A N/A
Local Zoning $25,000.00 $25,000.00 N/A $0.00 N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $8,500.00 N/A $5,022.17 N/A
BLM or NFS Coordination $6,460.00 $6,460.00 N/A $6,460.00 N/A
Equipment Delivery and Handling Charges $30,153.60 $30,153.60 What ION has been charged by vendors to deliver equipment for repack $30,153.60 N/A
Sales Tax $24,984.85 $24,984.85 Sales tax paid directly to the state of California for repack equipment. Please see Los Angeles - Sales Tax Repack spreadsheet $20,798.78 N/A

Components

Actual Information Description File Name
MVPD Notification of Channel Change

Component Description:
Cost of MVPD notifications for channel change. Supporting documentation is attached. This invoice has been paid.
Amount:
$1,600.00
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
Cost of hauling transmitter packing debris from transmitter building to the dumpsite. Supporting documentation attached. This invoice has been paid.
Amount:
$500.00
Non-zoning permits Information not provided.
Local Zoning

Component Description:
Cost for local permitting. Supporting documentation is attached. This invoice has been paid.
Amount:
$9,416.80
FCC Filing Fees - Special Temporary Authorization request Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
DTV Medical Facility Notification

Component Description:
Cost of medical notifications for channel change. Supporting documentation is attached. This invoice has been paid.
Amount:
$5,022.17
BLM or NFS Coordination

Component Description:
50% "deposit" payment for road closures during antenna installation. Supporting documentation is attached. This invoice has been paid.
Amount:
$3,230.00

Component Description:
50% "balance" payment for road closures during antenna installation. Supporting documentation is attached. This invoice has been paid.
Amount:
$3,230.00
Equipment Delivery and Handling Charges

Component Description:
50% "balance" payment for delivery of antenna package to transmitter site. Supporting documentation is attached. This invoice has been paid.
Amount:
$4,060.00

Component Description:
Cost of delivery of transmitter equipment to transmitter building on 6/5/2018. Supporting documentation attached. This invoice has been paid.
Amount:
$520.00

Component Description:
50% "deposit" payment for delivery of antenna package to transmitter site. Supporting documentation is attached. This invoice has been paid.
Amount:
$4,060.00

Component Description:
Cost of freight, shipping, and handling related to Dielectric invoice #257005. Explanation of variance form, supporting documentation, and detailed breakout attached.
Amount:
$21,513.60
Sales Tax

Component Description:
Sales tax paid directly to the state of California for repack equipment. Supporting documentation and explanation of variance are attached. This one time payment has been made.
Amount:
$4,186.07

Component Description:
Sales tax paid directly to the state of California for repack equipment. Supporting documentation and explanation of variance are attached. This one time payment has been made.
Amount:
$10,167.55

Component Description:
Sales tax paid directly to the state of California for repack equipment. Supporting documentation and explanation of variance are attached. This one time payment has been made.
Amount:
$10,631.23

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $2,403,773.78 $1,748,327.47 $1,485,475.76

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.

Mario Vasquez

Vice President - Finance, Operations


01/11/2021

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.

Mario Vasquez

Vice President - Finance, Operations


01/11/2021

Attachments

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