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:
62180
Service:
LPD
Call Sign:
WAUG-LD
Channel:
4 (Low VHF)
File Number:
0000090860
FRN:
0011324423
Eligibility Status:
Eligible
Date Submitted:
08/10/2022

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

Saint Augustine's University

Doing Business As: Saint Augustine's University

1315 Oakwood Avenue

Raleigh, NC 27610

United States

+1 (919) 516-4430 adwilliams@st-aug.edu Private Not-for-Profit Educational Institution

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 E Spainhour

Outside Legal Counsel

Brooks, Pierce et al.

150 Fayetteville Street

Suite 1700

Raleigh, NC 27601

United States

+1 (919) 839-0300 espainhour@brookspierce.com

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 WAUG-LD is currently dark/silent as a result of the need to vacate its ch. 8 operation due to a full-service repack facility. WAUG-LD must remain off-the-air until the new ch. 4 facility is ready for operation. See WAUG-LD Displacement Form 399 Exhibit.

Transmitters

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Section Question Response
Transmitter Related Expenses Do you have transmitter related expenses? Yes

Primary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Primary (Main)
Ownership Owned
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model PW2VTX3KW
Year 2014
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 3.0 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-3L
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 3.75 kW
Justification for New Transmitter Current Transmitter operates on Channel 8 a hi-VHF frequency. Displacement channel is Channel 4, a lo-vhf channel. The current transmitter cannot be re-tuned to operate on the new displacement channel.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Other Transmitter Costs
Does the transmitter installation require a Transmitter Building Site Survey/Installation? Yes
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Rigid Conduit and Wiring No
Other Electrical Service No
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 5 tons
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Additional Adapters for Transmitter Installation

Additional Adapters for Transmitter 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)
Ownership Owned
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? No
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Circular
Type Slotted Coaxial
ERP: 3.0 kW
Manufacturer
Model EMT2V1-CSO-8
Year 2014

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Change Type Purchase New
Ownership Owned
Is antenna shared? No
Is antenna directional? No
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Circular
Type Cross Dipole
ERP: 3.0 kW
Manufacturer
Model ATC-BDH2O-4
Year 2019
Justification for New Antenna The current antenna is a hi-VHF channel 8 slotted coaxial antenna that cannot be re-tuned for operation on the lo-VHF channel 4 displacement channel.

Primary Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Single Channel
Feed Line Size 1 5/8 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? 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

Name Description

Flange and Bullet Coupling

Flange and Bullet Coupling

Custom Antenna Brackets

Custom Antenna Brackets

Antenna Installation

Antenna Installation

Transmission Line Iso-Coupler

Transmission Line Iso-Coupler

Transmission Line

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

Tower Equipment And Rigging Costs

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

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Move Equipment
Tower Use Primary (Main)
Ownership Owned
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? Unknown
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1022011
Coordinates (NAD83) Latitude (NAD83) 35° 47' 30.0" N-
Longitude (NAD83) 078° 37' 09.0" W-
Overall Structure Height 288.05 feet
Support Structure Height 284.45 feet
Ground Elevation Above Mean Sea Level (AMSL) 319.88 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner SAINT AUGUSTINES COLLEGE DBA = WAUG
Date Constructed 04/01/1987

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
58586 WAUG AM

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

Structural Analysis

Structural Analysis

Tower Modifications

Tower Modifications

Geotechnical Report

Geotechnical Report

Foundation Mapping

Foundation Mapping

Appurtenance Mapping

Appurtenance Mapping

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 50
Explanation The licensee does not have available staff resources that can coordinate and manage the project during the pre and post construction phases.
Outside RF consulting Engineering Services Perform engineering study for displacement application Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 2
Prepare Form 601 No
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 2
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement Yes
Form 399 assistance or other program management costs No
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements No
Additional Field Engineering Service Yes
Number of Days 1
Justification The proposal is co-located with an AM facility that will require field measurements to determine that no changes in the AM station antenna operation have occurred.

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

RF Consultant Project Review

RF Consulting Engineering review of equipment selection, assistance in technical matters concerning FCC rule compliance and product suitability. Estimated 10 hours at $250/hr.

Tower Structural Engineering Study

Tower mapping and structural study.

RF Consultant Form 399

Review of RF related items for inclusion in form 399 estimates.

RF Consultant Prepare Engineering STA

Prepare Engineering STA for interim antenna operation and supporting application material if needed during transition period.

Additional Displacement Legal Services Not Otherwise Specified in Form 399

Additional Displacement Legal Services Not Otherwise Specified in Form 399

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? Yes
Is Remediation needed? No
Permit and Filing Costs FCC Construction Permit Major Change No
FCC Construction Permit Minor Change No
FCC License to Cover Application No
FCC Special Temporary Authority Application 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? No
Does this relocation require Equipment Storage? No
Point to Point Microwave (STL/ICR) Frequency Coordination for Unidirection System No
Frequency Coordination for Bi-Direction System No
New Point to Point Microwave System No

Other Expenses

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Other Expenses Not Listed

Name Description

Shipping Charges

Shipping Charges

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 $227,207.56 $204,457.56 N/A $201,545.54 N/A
Total for all systems $578,962.15 $536,455.67 N/A $496,768.76 N/A
Primary Transmitter VAXTE-3L $227,207.56 $204,457.56 $201,545.54
Transmitter Building Site Survey/Installation $10,000.00 $0.00 N/A N/A N/A
Low VHF - Air Cooled Solid State Transmitter 3.75 kW $140,493.91 $140,493.91 N/A $137,581.89 Additional expenses were incurred as indicated in the attached invoices.
Low VHF - Air Cooled Solid State Transmitter 3.0 kW $56,206.56 $56,206.56 ***System Notice: Estimate adjusted and locked because line has been superseded.***.Additional expenses were incurred as indicated in the attached invoices. $56,206.56 Additional expenses were incurred as indicated in the attached invoices.
Additional Adapters for Transmitter Installation $257.09 $257.09 N/A $257.09 N/A
5 Ton system $20,250.00 $7,500.00 N/A $7,500.00 N/A

Components

Actual Information Description File Name
Transmitter Building Site Survey/Installation Information not provided.
Low VHF - Air Cooled Solid State Transmitter 3.75 kW

Component Description:
Balance of New Transmitter
Amount:
$137,581.89

Component Description:
Waveguide Dehydrator
Amount:
$2,912.02
Low VHF - Air Cooled Solid State Transmitter 3.0 kW

Component Description:
Balance of new transmitter
Amount:
N/A

Component Description:
Down Payment on New Transmitter
Amount:
$56,206.56
Additional Adapters for Transmitter Installation

Component Description:
Additional adapters for transmitter installation
Amount:
$257.09
5 Ton system

Component Description:
New HVAC Unit
Amount:
$7,500.00

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 $119,665.29 $123,261.51 N/A $121,031.62 N/A
Total for all systems $578,962.15 $536,455.67 N/A $496,768.76 N/A
Primary Antenna ATC-BDH2O-4 $119,665.29 $123,261.51 $121,031.62
Transmission Line Iso-Coupler $5,254.00 $5,254.00 N/A $5,254.00 N/A
Antenna Installation $89,749.00 $89,749.00 Additional expenses were incurred as indicated in the attached invoices. $89,749.11 Additional expenses were incurred as indicated in the attached invoices.
Custom Antenna Brackets $5,731.95 $5,731.95 N/A $5,731.95 N/A
Flange and Bullet Coupling $580.34 $580.34 N/A $580.34 N/A
Side Mount antenna brackets $4,625.00 $0.00 N/A N/A N/A
Elbow complex, single channel, 1 5/8” input (if needed) $6,900.00 $0.00 N/A N/A N/A
Sweep test of transmission line and antenna $5,730.00 $5,730.00 N/A $3,500.00 N/A
Low-VHF, Low Power,Yagi/Cross dipole/Log Periodic Transmit antenna $1,095.00 $16,216.22 N/A $16,216.22 N/A

Components

Actual Information Description File Name
Transmission Line Iso-Coupler

Component Description:
Payment for New Iso-Coupler
Amount:
$5,254.00
Antenna Installation

Component Description:
Antenna Installation
Amount:
$21,918.48

Component Description:
Antenna Installation
Amount:
$31,250.00

Component Description:
Antenna Installation
Amount:
$36,580.63
Custom Antenna Brackets

Component Description:
Additional Brackets
Amount:
$5,731.95
Flange and Bullet Coupling

Component Description:
Custom Flange and Bullet Coupling
Amount:
$580.34
Side Mount antenna brackets Information not provided.
Elbow complex, single channel, 1 5/8” input (if needed) Information not provided.
Sweep test of transmission line and antenna

Component Description:
Line Sweep
Amount:
$3,500.00
Low-VHF, Low Power,Yagi/Cross dipole/Log Periodic Transmit antenna

Component Description:
Payment for New Antenna
Amount:
$16,216.22

Cost Information

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Transmission Line

Information not provided.

Cost Information

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Tower Equipment and Rigging Costs

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $157,220.00 $101,030.00 N/A $101,030.00 N/A
Total for all systems $578,962.15 $536,455.67 N/A $496,768.76 N/A
Primary Tower TOWER $157,220.00 $101,030.00 $101,030.00
Tower Rigging Short Tower (less than 500') $56,190.00 $0.00 N/A N/A N/A
Foundation Mapping $5,000.00 $5,000.00 N/A $5,000.00 N/A
Geotechnical Report $3,200.00 $3,200.00 N/A $3,200.00 N/A
Structural Analysis $19,800.00 $19,800.00 Additional expenses were incurred as indicated in the attached invoices $19,800.00 Additional expenses were incurred as indicated in the attached invoices
Appurtenance Mapping $1,750.00 $1,750.00 N/A $1,750.00 N/A
Tower Modifications $71,280.00 $71,280.00 N/A $71,280.00 N/A

Components

Actual Information Description File Name
Tower Rigging Short Tower (less than 500') Information not provided.
Foundation Mapping

Component Description:
Foundation Mapping
Amount:
$5,000.00
Geotechnical Report

Component Description:
Geotechnical Report
Amount:
$3,200.00
Structural Analysis

Component Description:
Structural Design
Amount:
$14,300.00

Component Description:
Structural Analysis
Amount:
$1,500.00

Component Description:
Structural Design
Amount:
$4,000.00
Appurtenance Mapping

Component Description:
Appurtenance Mapping
Amount:
$1,750.00
Tower Modifications

Component Description:
Tower Modifications
Amount:
$71,280.00

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 $58,279.30 $93,126.60 N/A $63,631.60 N/A
Total for all systems $578,962.15 $536,455.67 N/A $496,768.76 N/A
Outside Professional Services $58,279.30 $93,126.60 $63,631.60
Additional Displacement Legal Services Not Otherwise Specified in Form 399 $15,706.80 $15,706.80 Additional expenses were incurred as indicated in the attached invoices. $15,706.80 Additional expenses were incurred as indicated in the attached invoices.
RF Consultant Prepare Engineering STA $1,500.00 $1,500.00 Prepare Engineering STA for interim antenna operation and supporting application material N/A N/A
RF Consultant Form 399 $1,500.00 $1,500.00 Review of RF related items for inclusion in form 399 estimates. N/A N/A
Tower Structural Engineering Study $10,000.00 $10,000.00 Tower mapping and structural engineering study of the existing tower, as a result of the change in tower loading, Addition of the displacement channel 4 panel antenna on the structure. N/A N/A
RF Consultant Project Review $2,500.00 $2,500.00 RF Consulting Engineering review of equipment selection, assistance in technical matters concerning FCC rule compliance and product suitability. Estimated 10 hours at $250/hr. N/A N/A
Additional Field Engineering Service, 1 Days $3,500.00 $3,500.00 AM antenna proof or antenna impedance adjustment estimated at 1-day on-site, including travel if needed. The facility is co-located on AM radiator/tower. N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $4,470.00 $4,470.00 N/A $0.00 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $1,577.50 $1,577.50 N/A $857.50 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $3,025.00 $3,025.00 N/A $2,294.50 N/A
Prepare request for Special Temporary Authorization $2,560.00 $3,989.90 Additional expenses were incurred as indicated in the attached invoices. $3,989.90 Additional expenses were incurred as indicated in the attached invoices.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,052.50 $1,052.50 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $2,102.50 $2,850.00 Additional expenses were incurred as indicated in the attached invoices. $2,850.00 Additional expenses were incurred as indicated in the attached invoices.
Perform engineering study for displacement application $1,800.00 $1,800.00 N/A N/A N/A
Prepare/ Review 399 reimbursement form $1,710.00 $14,294.90 Additional expenses were incurred as indicated in the attached invoices. $14,294.90 Additional expenses were incurred as indicated in the attached invoices.
Project management of the transition $5,275.00 $25,360.00 Additional expenses are expected as described in the attached quote. $23,638.00 N/A

Components

Actual Information Description File Name
Additional Displacement Legal Services Not Otherwise Specified in Form 399

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$329.20

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$511.90

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$42.50

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$255.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$227.50

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$560.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$317.50

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$1,530.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$85.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$857.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$510.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$90.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$510.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$307.50

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$232.20

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$811.50

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$537.50

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$137.50

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$1,575.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$3,900.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$2,380.00
RF Consultant Prepare Engineering STA Information not provided.
RF Consultant Form 399 Information not provided.
Tower Structural Engineering Study Information not provided.
RF Consultant Project Review Information not provided.
Additional Field Engineering Service, 1 Days Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
Draft displacement license application
Amount:
$82.50

Component Description:
Displacement License Application
Amount:
$775.00
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Minor modification of displacement construction permit
Amount:
$275.00

Component Description:
Prepare and File Displacement Construction Permit Application
Amount:
$609.50

Component Description:
Tolling Request for Extension of Displacement CP
Amount:
$1,410.00
Prepare request for Special Temporary Authorization

Component Description:
Prepare request for Special Temporary Authorization
Amount:
$1,755.00

Component Description:
Draft reduced power STA request
Amount:
$275.00

Component Description:
Prepare and file silent STA extension and waiver request.
Amount:
$1,184.00

Component Description:
Prepare and file silent STA extension and waiver request.
Amount:
$602.50

Component Description:
STA Preparation
Amount:
$173.40
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:
Prepare engineering section of Displacement Construction Permit
Amount:
$2,850.00
Perform engineering study for displacement application Information not provided.
Prepare/ Review 399 reimbursement form

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$366.40

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$110.00

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$960.00

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$3,880.50

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$220.00

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$1,017.50

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$512.50

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$620.50

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$212.00

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$275.00

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$1,532.50

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$1,122.50

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$317.90

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$495.00

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$1,419.10

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$347.50

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$886.00
Project management of the transition

Component Description:
Project Management of Transition
Amount:
$7,871.00

Component Description:
Project Management fees
Amount:
$7,884.00

Component Description:
Project Management of Transition
Amount:
$7,883.00

Component Description:
Project Management of Transition (final invoice)
Amount:
$7,884.00

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 $16,590.00 $14,580.00 N/A $9,530.00 N/A
Total for all systems $578,962.15 $536,455.67 N/A $496,768.76 N/A
Other Expenses $16,590.00 $14,580.00 $9,530.00
Shipping Charges $9,530.00 $9,530.00 Additional expenses were incurred as indicated in the attached invoices. $9,530.00 Additional expenses were incurred as indicated in the attached invoices.
AM Pattern Disturbance -- Impact study $5,260.00 $3,250.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $1,800.00 $1,800.00 N/A N/A N/A

Components

Actual Information Description File Name
Shipping Charges

Component Description:
Additional Shipping Costs
Amount:
$2,855.00

Component Description:
Shipping charges
Amount:
$6,675.00
AM Pattern Disturbance -- Impact study Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $578,962.15 $536,455.67 $496,768.76

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. Yes
All receipts for reimbursement have been submitted no further costs are expected to be incurred. Note this will lock the Form 399 from further editing and begin close-out procedures with the Fund Administrator. No

Certification

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Section Question Response
Submission of Estimated Expenses Statements

WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.

  1. The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.

  2. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

  3. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.

  4. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD).

  5. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

  6. The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred.

  7. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.

  8. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.

I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Dr Carolyn Carter

Vice President for University Advancement


08/10/2022

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.

Dr Carolyn Carter

Vice President for University Advancement


08/10/2022

Certification

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Section Question Response
Submission of Final Allocation or Accounting Information Statements

WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.

  1. The Authorized Person signing below certifies and represents that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

  2. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.

  3. The above-named entity certifies that all costs identified as "actual costs" herein accurately represent the costs actually paid by the above-named entity, including any discounts, refunds, or rebates.

  4. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

  5. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.

  6. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.

I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Dr Carolyn Carter

Vice President for University Advancement


08/10/2022

Attachments

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