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:
77483
Service:
DTV
Call Sign:
KPXO-TV
Channel:
32 (UHF)
File Number:
0000028446
FRN:
0030297451
Date Submitted:
08/12/2021

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

INYO BROADCAST LICENSES LLC

Doing Business As: INYO BROADCAST LICENSES LLC

Michelle Brester

3110 W California Avenue, Suite C

Salt Lake City, UT 84104

United States

+1 (435) 414-1338 mbrester@inyotv.com Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

The Preparer is same as the reimbursement contact.

 

 

 

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan Relocated from current site to two DTS sites. DTS-1 (ASR# 1202444) covers the community of license. DTS-2 (ASR#1278248) covers the main population on island.

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 Retune Existing
Use Primary (Main)
Ownership Owned
Owner 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 Rohde & Schwarz
Model Solid State
Year 2010
Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1 kW

Primary Transmitter

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Retuning Transmitter Costs

Section Question Response
New IOT Tubes Number of Tubes (including accessories) needed N/A
New Mask Filter
Power 1.5 kW
Other Power N/A
New Exciter Is a new exciter needed? No

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 of Transmitter
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

Information not provided.

Primary Transmitter

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Add 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 Solid State
Year 2010
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 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? Yes
Manufacturer
Model TLU9
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity .2 kW
Justification for New Transmitter Required to cover community of license.

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 of Transmitter
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

RF Interconnect

Interconnect between RF System and Transmission Line

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? No
Existing Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 1
Number of Panels 32
Design power capacity in use 25.0 %
Lower Limit 470.00 MHz
Upper Limit 698.00 MHz
Other Antenna Type N/A
ERP: 34.0 kW
Manufacturer
Model 955118
Year 1998

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? No
New Antenna Manufacturer and Types Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Other
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 Log Periodic
ERP: 0.68 kW
Manufacturer
Model CL-1469B
Year 2018
Justification for New Antenna Needed to cover community of license, post-repack 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? No
Broadband or Single Channel? N/A
Feed Line Size N/A
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

Primary Antenna

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Add 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 this antenna currently shared with any other stations? No
Is this antenna directional? No
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 1
Number of Panels 32
Design power capacity in use 25.0 %
Lower Limit 470.00 MHz
Upper Limit 698.00 MHz
Other Antenna Type N/A
ERP: 34.0 kW
Manufacturer
Model 955118
Year 1998

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 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: 17.0 kW
Manufacturer
Model DLP-12J
Year 2018
Justification for New Antenna Needed to cover main population on island, post-repack 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? No
Broadband or Single Channel? N/A
Feed Line Size N/A
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

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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? 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 Flexible Air
Diameter 3 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 75 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 Flexible Foam
Diameter Other
Other Diameter 1/2 inches
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 100 feet per run
Justification for New Transmission Line Needed to cover community of license, post-repack channel.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Primary Transmission Line

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Add 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 this transmission currently shared with any other stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Flexible Air
Diameter 3 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 75 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 Flexible Foam
Diameter 1 5/8 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 200 feet per run
Justification for New Transmission Line Needed to cover main population on island, post-repack channel.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

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

Primary Tower

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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? 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? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1202444
Coordinates (NAD83) Latitude (NAD83) 21° 25' 20.5" N-
Longitude (NAD83) 157° 45' 25.1" W-
Overall Structure Height 63.98 feet
Support Structure Height 50.85 feet
Ground Elevation Above Mean Sea Level (AMSL) 514.76 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner InSite Towers Development, LLC
Date Constructed 09/19/2000


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

Information not provided.

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? Terrain Constrained
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? Unknown
Existing Tower Structure Registration Do you have a tower registration number? No
ASR Number
Coordinates (NAD83) Latitude (NAD83) 21° 19' 37.6" N-
Longitude (NAD83) 157° 45' 14.1" W-
Overall Structure Height 116.00 feet
Support Structure Height 116.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 2439.93 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Mount Wilson FM Broadcasters
Date Constructed 09/19/2006


Primary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower Terrain constrained
Helicopter Services Required Are helicopter services required? Yes

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? 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? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1278248
Coordinates (NAD83) Latitude (NAD83) 21° 24' 11.8" N-
Longitude (NAD83) 158° 05' 52.8" W-
Overall Structure Height 160.10 feet
Support Structure Height 149.93 feet
Ground Elevation Above Mean Sea Level (AMSL) 2720.11 feet
Structure Type LTOWER - Lattice Tower
Tower Owner CCATT LLC
Date Constructed 04/06/2007


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

Information not provided.

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 40
Explanation Crown Castle Project Management for antenna and line installation at DTS-2 site.
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 Yes
Environmental Assessment Yes
ASR Modification Yes
FAA Consultation (including preparation of FAA Form 7460) Yes
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 No
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 paid directly to the state of Hawaii for repack equipment.

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 $129,510.83 $25,400.33 N/A $5,802.89 N/A
Total for all systems $1,093,293.98 $332,941.10 N/A $84,022.21 N/A
Primary Transmitter Solid State $113,082.14 $8,971.64 $5,052.89
UHF and VHF - minor banding issues $105,200.00 $0.00 N/A N/A N/A
1.5 kW mask filter $3,030.00 $4,119.50 Please see Rohde & Schwarz Quote #802-054445.0 plus sales tax $4,119.50 N/A
Other Electrical Service: Electrical Installation of Transmitter $4,852.14 $4,852.14 See attached Crown Castle Quotes #490765 and #96616 $933.39 N/A
Primary Transmitter TLU9 $16,428.69 $16,428.69 $750.00
Other Electrical Service: Electrical Installation of Transmitter $350.00 $350.00 See attached Harmer Electric & Radio #1011257. N/A N/A
UHF - Air Cooled Solid State Transmitter .2 kW $15,328.69 $15,328.69 Please see attached Rohde & Schwarz Quote #802-052288.0 plus sales tax $0.00 N/A
RF Interconnect $750.00 $750.00 Please see Connecticut Microwave Quote #9442 $750.00 N/A

Components

Actual Information Description File Name
UHF and VHF - minor banding issues Information not provided.
1.5 kW mask filter

Component Description:
Cost of 1.5kW filter for transmitter. Supporting documentation is attached. This invoice has been paid.
Amount:
$4,119.50
Other Electrical Service: Electrical Installation of Transmitter

Component Description:
Cost of surge protector for transmitter. Supporting documentation is attached. This invoice has been paid.
Amount:
$933.39

Component Description:
Cost of electric installation for transmitter. Supporting documentation is attached. This invoice has been paid.
Amount:
$3,918.75
Other Electrical Service: Electrical Installation of Transmitter Information not provided.
UHF - Air Cooled Solid State Transmitter .2 kW

Component Description:
Cost of new transmitter for DTS-1 site. Supporting documentation is attached. This invoice has been paid.
Amount:
$15,328.69
RF Interconnect

Component Description:
Cost of directional coupler for RF Interconnect. Supporting documentation is attached. This invoice has been paid.
Amount:
$750.00

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 $73,020.00 $31,192.24 N/A $30,930.99 N/A
Total for all systems $1,093,293.98 $332,941.10 N/A $84,022.21 N/A
Primary Antenna CL-1469B $33,030.00 $8,682.99 $8,682.99
Sweep test of existing antenna $6,730.00 $7,980.00 Sweep of existing antenna and line for feasibility of operation on post-repack channel. $7,980.00 N/A
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $26,300.00 $702.99 See attached Broadcasters General Store Quote #528531 $702.99 N/A
Primary Antenna DLP-12J $39,990.00 $22,509.25 $22,248.00
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $5,738.00 See attached Dielectric Quote #800067CMZ $5,738.00 N/A
Sweep test of existing antenna $6,730.00 $6,661.25 See attached Dielectric Quote #800067CMZ $6,400.00 N/A
UHF - High Power, Side Mount, basic slot antenna, 17 kW input, directional,, horizontally polarized $10,110.00 $10,110.00 See attached Dielectric Quote #800067CMZ $10,110.00 N/A

Components

Actual Information Description File Name
Sweep test of existing antenna

Component Description:
Cost to sweep existing antenna and line to determine post-repack feasibility. Supporting documentation attached. Invoice has been paid.
Amount:
$7,980.00
UHF - Lower Power Side Mount, Class A One Station antenna -- basic

Component Description:
Cost of log-periodic antenna and mounting kit. Supporting documentation is attached. This invoice has been paid.
Amount:
$702.99
Side mount brackets for high power antennas (if not included in antenna base cost)

Component Description:
10% balance due payment for antenna mounts. Supporting documentation attached. Invoice has been paid.
Amount:
$573.80

Component Description:
45% "prior to ship" payment for custom mounts. Supporting documentation is attached. This invoice has been paid.
Amount:
$2,582.10

Component Description:
45% "with order" payment for custom mounts. Supporting documentation is attached. This invoice has been paid.
Amount:
$2,582.10
Sweep test of existing antenna

Component Description:
10% "balance" payment for repack sweep. Supporting documentation is attached. This invoice has been paid.
Amount:
$640.00

Component Description:
45% "prior to ship" payment for repack sweep. Supporting documentation is attached. This invoice has been paid.
Amount:
$2,880.00

Component Description:
Additional sweep/PIM testing by tower landlord. Supporting documentation is attached. This invoice has been paid.
Amount:
$261.25

Component Description:
45% "with order" payment for repack sweep. Supporting documentation is attached. This invoice has been paid.
Amount:
$2,880.00
UHF - High Power, Side Mount, basic slot antenna, 17 kW input, directional,, horizontally polarized

Component Description:
45% "prior to ship" payment for main antenna. Supporting documentation is attached. This invoice has been paid.
Amount:
$4,549.50

Component Description:
45% "with order" payment for main antenna. Supporting documentation is attached. This invoice has been paid.
Amount:
$4,549.50

Component Description:
10% "balance" payment for main antenna. Supporting documentation is attached. This invoice has been paid.
Amount:
$1,011.00

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 $5,150.00 $3,595.75 N/A $3,595.75 N/A
Total for all systems $1,093,293.98 $332,941.10 N/A $84,022.21 N/A
Primary Transmission Line $350.00 $260.01 $260.01
Flexible Foam Transmission Line - dielectric, 1/2" $350.00 $260.01 Please see Broadcasters General Store Quote #528531 plus sales tax $260.01 N/A
Primary Transmission Line $4,800.00 $3,335.74 $3,335.74
Flexible Foam Transmission Line - dielectric, 1 5/8" $4,800.00 $3,335.74 See attached Dielectric Quote #800067CMZ and Dielectric - Reducer Change Order $3,335.74 Estimated costs and subtotal are the same.

Components

Actual Information Description File Name
Flexible Foam Transmission Line - dielectric, 1/2"

Component Description:
Cost of transmission line for DTS-1 antenna. Supporting documentation is attached. This invoice has been paid.
Amount:
$260.01
Flexible Foam Transmission Line - dielectric, 1 5/8"

Component Description:
45% "prior to ship" payment for main transmission line. Supporting documentation is attached. This invoice has been paid.
Amount:
$1,097.88

Component Description:
Cost of 1-50 adapter for transmission line. Supporting documentation is attached. This invoice has been paid.
Amount:
$546.00

Component Description:
Cost of adapter for transmission line. Supporting documentation attached. Invoice has been paid.
Amount:
$350.00

Component Description:
45% "with order" payment for main transmission line. Supporting documentation is attached. This invoice has been paid.
Amount:
$1,097.88

Component Description:
10% "balance" payment for main transmission line. Supporting documentation is attached. This invoice has been paid.
Amount:
$243.98

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 $615,700.00 $29,929.70 N/A $11,900.80 N/A
Total for all systems $1,093,293.98 $332,941.10 N/A $84,022.21 N/A
Primary Tower LTOWER $110,500.00 $16,615.75 $2,351.25
Short Tower (less than 500') $84,200.00 $14,264.50 Please see Crown Castle quote #490765 $0.00 N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $2,351.25 N/A $2,351.25 N/A
Primary Tower TOWER $421,000.00 $9,549.55 $9,549.55
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $9,549.55 Please see Putnam Installation Wili Removal Quote #026018-01 $9,549.55 N/A
Tower Helicopter Lift $0.00 $0.00 See attached Paradise Helicopters and Magnum (more justifiable because of personnel transport) N/A N/A
Primary Tower TOWER $84,200.00 $3,764.40 $0.00
Short Tower (less than 500') $84,200.00 $3,764.40 Please see Harmer Electronics Quote #01 $0.00 N/A

Components

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

Component Description:
Cost of antenna and transmission line installation. Supporting documentation is attached. This invoice has been paid.
Amount:
$14,264.25
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study

Component Description:
Cost of application fee charged by landlord. Supporting documentation is attached. This invoice has been paid.
Amount:
$261.25

Component Description:
Cost of structural analysis for tower. Supporting documentation is attached. This invoice has been paid.
Amount:
$2,090.00
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)

Component Description:
Cost to remove old antenna equipment. Supporting documentation is attached. This invoice has been paid.
Amount:
$9,549.55
Tower Helicopter Lift Information not provided.
Short Tower (less than 500')

Component Description:
Cost to install antenna at DTS-1 tower site. Supporting documentation is attached. This invoice has been paid.
Amount:
$3,764.40

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 $167,530.00 $149,856.93 N/A $8,505.49 N/A
Total for all systems $1,093,293.98 $332,941.10 N/A $84,022.21 N/A
Outside Professional Services $167,530.00 $149,856.93 $8,505.49
ASR modification (prepare FCC Form 854) $2,105.00 $2,000.00 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
NEPA Section 106 environmental review, if needed $6,310.00 $6,000.00 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
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 $2,000.00 Please see Du Treil Invoice 240751 for detailed billing lines. $2,000.00 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 $1,762.50 N/A $1,762.50 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A N/A N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase $2,105.00 $2,000.00 N/A N/A N/A
Project management of the transition $6,320.00 $1,844.43 See attached Crown Castle quote #490765 $0.00 N/A

Components

Actual Information Description File Name
ASR modification (prepare FCC Form 854) Information not provided.
Environmental Assessment, if triggered by NEPA Section 106 review or for certain structures over 450 feet Information not provided.
NEPA Section 106 environmental review, if needed 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 KPXO'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

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
Prepare request for Special Temporary Authorization Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
Cost to prepare engineering section of FCC Form 2100, study of configurations for antenna pattern. This invoice has been paid.
Amount:
$2,000.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Perform engineering study for new channel assignment and antenna development

Component Description:
Cost of engineering study. Supporting documentation is attached. This invoice has been paid.
Amount:
$1,450.00

Component Description:
Cost of engineering study for new channel assignment and antenna. Invoice has been paid.
Amount:
$250.00

Component Description:
Cost of engineering study for antenna specs. 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.
RF Exposure Measurements Information not provided.
Comprehensive coverage verification via field study, if needed Information not provided.
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase Information not provided.
Project management of the transition

Component Description:
Cost of project management charged by landlord. Supporting documentation is attached. This invoice has been paid.
Amount:
$1,844.43

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 $102,383.15 $92,966.15 N/A $23,286.29 N/A
Total for all systems $1,093,293.98 $332,941.10 N/A $84,022.21 N/A
Other Expenses $102,383.15 $92,966.15 $23,286.29
Sales Tax $2,029.63 $2,029.63 Sales tax for equipment paid directly to the state of Hawaii. See repack sales tax - KPXO Honolulu spreadsheet for additional backup. $2,029.63 N/A
MVPD Notification of Channel Change $1,200.00 $1,200.00 N/A $1,200.00 N/A
Equipment Storage $10,000.00 $10,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $11,403.52 $11,403.52 Actual cost charged by vendors to deliver equipment for repack $10,868.64 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $670.00 $670.00 Tajiri Quote $670.00 N/A
BLM or NFS Coordination $25,000.00 $25,000.00 N/A N/A N/A
Non-zoning permits $15,000.00 $15,000.00 N/A $4,506.04 N/A
Local Zoning $25,000.00 $25,000.00 N/A $1,863.98 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
DTV Medical Facility Notification $11,550.00 $2,148.00 N/A $2,148.00 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

Components

Actual Information Description File Name
Sales Tax

Component Description:
Sales tax paid to state of Hawaii not charged by vendor for repack equipment. Supporting documentation attached. This payment has been made.
Amount:
$1,017.93

Component Description:
Sales tax paid to state of Hawaii not charged by vendor for repack equipment. Supporting documentation attached. This payment has been made.
Amount:
$359.10

Component Description:
Sales tax paid to state of Hawaii not charged by vendor for repack equipment. Supporting documentation attached. This payment has been made.
Amount:
$652.60
MVPD Notification of Channel Change

Component Description:
Cost of MVPD notifications for repack channel change. Supporting documentation is attached. This invoice has been paid.
Amount:
$1,200.00

Component Description:
Cost of MVPD notifications for repack channel change. Supporting documentation is attached. This invoice has been paid.
Amount:
$1,200.00
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges

Component Description:
Cost of freight for main antenna package. Supporting documentation is attached. This invoice has been paid.
Amount:
$10,557.00

Component Description:
Cost of freight for antenna equipment. Supporting documentation attached. Invoice has been paid.
Amount:
$165.58

Component Description:
Cost of freight for additional transmission line equipment. Supporting documentation attached. Invoice has been paid.
Amount:
$51.81

Component Description:
Cost of freight for transmitter. Supporting documentation is attached. This invoice has been paid.
Amount:
$534.88

Component Description:
Cost of shipping and handling for RF Interconnect equipment. Supporting documentation is attached. This invoice has been paid.
Amount:
$15.00

Component Description:
Cost of freight for DTS-1 antenna. Supporting documentation is attached. This invoice has been paid.
Amount:
$79.25
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
Cost of dumpster rental during repack transition. Supporting documentation is attached. This invoice has been paid.
Amount:
$670.00
BLM or NFS Coordination Information not provided.
Non-zoning permits

Component Description:
Cost of pulling building permit. Supporting documentation is attached. This invoice has been paid.
Amount:
$1,789.04

Component Description:
Cost of construction drawings for permits. Supporting documentation is attached. This invoice has been paid.
Amount:
$1,828.75

Component Description:
Cost of permitting services. Supporting documentation is attached. This invoice has been paid.
Amount:
$888.25
Local Zoning

Component Description:
Cost of zoning services. Supporting documentation is attached. This invoice has been paid.
Amount:
$1,567.50

Component Description:
Cost of zoning and permitting charged by landlord. Supporting documentation is attached. This invoice has been paid.
Amount:
$296.48
FCC Filing Fees - Special Temporary Authorization request Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
DTV Medical Facility Notification

Component Description:
Cost of medical notifications for repack channel change. Supporting documentation is attached. This invoice has been paid.
Amount:
$2,148.00

Component Description:
Cost of medical notifications for repack channel change. Supporting documentation is attached. This invoice has been paid.
Amount:
$2,148.00
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 $1,093,293.98 $332,941.10 $84,022.21

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.

Grant Boren

Chief Financial Officer


08/12/2021

Attachments

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