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:
64981
Service:
LPA
Call Sign:
KTLO-LD
Channel:
29 (UHF)
File Number:
0000089504
FRN:
0014920581
Eligibility Status:
Eligible
Date Submitted:
08/26/2022

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

Pikes Peak Television, Inc.

Doing Business As: Pikes Peak Television, Inc.

825 Edmond Street

Saint Joseph, MO 64501

United States

+1 (816) 271-8504 tim.hannan@npgco.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. No
Briefly describe transition plan Please see Transition Plan Description Exhibit; please also see Revised Transition Plan 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 AT725P
Year 2012
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 25 W

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 UAXTE-4-G2
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2400 W
Justification for New Transmitter Please see Revised Transition Plan Description Exhibit

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? No
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? No
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

Miscellaneous Items for Preparation of Transmitter Building

Miscellaneous Items for Preparation of Transmitter Building

Documentation and RF Proof

Documentation and RF Proof

RF Parts for New Transmitter

RF Parts for New Transmitter

Electrical and Mechanical Parts and Installation for Transmitter Building

Electrical and Mechanical Parts and Installation for Transmitter Building

Electrical - Surge Protector

Electrical - Surge Protector

Commissioning and Sweep

Commissioning and Sweep

Transmitter Building

Transmitter Building

Mask Filter System

Mask Filter System

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? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Other
Other Antenna Type Panel
ERP: 0.14 kW
Manufacturer
Model B8UA
Year 2012

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? Yes
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 Horizontal
Type Broadband Panel
Number of Stations Supported 1
Number of Panels/Bays 8
Lower Limit 560.00 MHz
Upper Limit 566.00 MHz
Design power capacity in use 30.0 %
ERP: 14.0 kW
Manufacturer
Model 4DR-16-2HW
Year 2012
Justification for New Antenna Please See Revised Transition Plan Exhibit

Primary Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? No
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? No
Power Dividers Does the panel antenna require power dividers? No
Cable Harness Does the panel antenna require cable harness? No

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Tower rigging, removal of existing panel antenna, and installation of new panel antenna

Tower rigging, removal of existing panel antenna, and installation of new panel antenna

Coax Andrew, hangers, standoffs, EIA connectors

Coax Andrew, hangers, standoffs, EIA connectors

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 1012530
Coordinates (NAD83) Latitude (NAD83) 38° 49' 43.0" N-
Longitude (NAD83) 104° 50' 22.0" W-
Overall Structure Height 464.89 feet
Support Structure Height 459.97 feet
Ground Elevation Above Mean Sea Level (AMSL) 5961.87 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner PIKES PEAK TELEVISION INC
Date Constructed 07/01/1953

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
66250 KRDO 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

Ice Bridge

Ice Bridge

Rigging Services including freight, travel, per diem, labor on site and at plant

Rigging Services including freight, travel, per diem, labor on site and at plant

Kintronics 150 Complete Isocoupler to avoid impairment of AM signal

Kintronics 150 Complete Isocoupler to avoid impairment of AM signal

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? No
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 1
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 1
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 No

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

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? No
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 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)? No
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

Freight for Transmitter

Freight for Transmitter

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 $175,034.00 $140,412.20 N/A $140,412.20 N/A
Total for all systems $415,208.03 $333,309.63 N/A $327,004.13 N/A
Primary Transmitter UAXTE-4-G2 $175,034.00 $140,412.20 $140,412.20
Mask Filter System $3,380.00 $3,380.00 N/A $3,380.00 N/A
Transmitter Building $48,985.00 $48,985.00 N/A $48,985.00 N/A
Electrical and Mechanical Parts and Installation for Transmitter Building $20,000.00 $20,000.00 N/A $20,000.00 N/A
Documentation and RF Proof $1,000.00 $1,000.00 N/A $1,000.00 N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $84,000.00 $49,378.20 N/A $49,378.20 Additional expenses were incurred as indicated in the attached invoices.
RF Parts for New Transmitter $6,090.00 $6,090.00 N/A $6,090.00 N/A
Commissioning and Sweep $3,500.00 $3,500.00 N/A $3,500.00 N/A
Electrical - Surge Protector $1,979.00 $1,979.00 N/A $1,979.00 N/A
Miscellaneous Items for Preparation of Transmitter Building $6,100.00 $6,100.00 N/A $6,100.00 N/A

Components

Actual Information Description File Name
Mask Filter System

Component Description:
8 Pole RFS Mask Filter
Amount:
$3,380.00
Transmitter Building

Component Description:
Transmitter Building
Amount:
$48,985.00
Electrical and Mechanical Parts and Installation for Transmitter Building

Component Description:
Partial balance of all electrical and mechanical parts and installation
Amount:
$5,000.00

Component Description:
Remaining balance of all electrical and mechanical parts and installation
Amount:
$5,000.00

Component Description:
50% of all electrical and mechanical parts and installation
Amount:
$10,000.00
Documentation and RF Proof

Component Description:
50% of RF Proof
Amount:
$500.00

Component Description:
Balance of RF Proof
Amount:
$500.00
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
Transmitter plus tax
Amount:
$49,378.20
RF Parts for New Transmitter

Component Description:
RF Parts
Amount:
$6,090.00
Commissioning and Sweep

Component Description:
50% of commissioning and sweep
Amount:
$1,750.00

Component Description:
Balance of commissioning and sweep
Amount:
$1,750.00
Electrical - Surge Protector

Component Description:
Surge Suppressor
Amount:
$1,979.00
Miscellaneous Items for Preparation of Transmitter Building

Component Description:
Partial balance of buried electrical
Amount:
$900.00

Component Description:
Fence repairs (2)
Amount:
$100.00

Component Description:
Partial balance to provide and install buried fiber cable in conduit
Amount:
$300.00

Component Description:
Partial Balance for removal of satellite dish and mount other
Amount:
$225.00

Component Description:
Fence repairs (3)
Amount:
$100.00

Component Description:
Final balance to provide and install buried fiber cable in conduit
Amount:
$300.00

Component Description:
Final balance of buried electrical
Amount:
$900.00

Component Description:
Remaining Balance for removal of satellite dish and mount other
Amount:
$225.00

Component Description:
50% removal of satellite dish and mount other
Amount:
$450.00

Component Description:
50% Buried electrical
Amount:
$1,800.00

Component Description:
Fence repairs
Amount:
$200.00

Component Description:
50% provide and install buried fiber cable in conduit
Amount:
$600.00

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 $25,574.48 $22,782.48 N/A $18,157.48 N/A
Total for all systems $415,208.03 $333,309.63 N/A $327,004.13 N/A
Primary Antenna 4DR-16-2HW $25,574.48 $22,782.48 $18,157.48
Coax Andrew, hangers, standoffs, EIA connectors $4,598.00 $4,598.00 N/A $4,598.00 N/A
Tower rigging, removal of existing panel antenna, and installation of new panel antenna $2,351.48 $2,351.48 N/A $2,351.48 N/A
Side Mount antenna brackets $4,625.00 $4,625.00 N/A N/A N/A
UHF Broadband panel antenna (per panel), horizontally-polarized $14,000.00 $11,208.00 N/A $11,208.00 N/A

Components

Actual Information Description File Name
Coax Andrew, hangers, standoffs, EIA connectors

Component Description:
Coax Andrew, hangers, standoffs, EIA connectors
Amount:
$4,598.00
Tower rigging, removal of existing panel antenna, and installation of new panel antenna

Component Description:
Labor to remove existing single panel antenna
Amount:
$2,351.48
Side Mount antenna brackets Information not provided.
UHF Broadband panel antenna (per panel), horizontally-polarized

Component Description:
Antenna
Amount:
$11,208.00

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 $179,609.00 $123,419.00 N/A $123,419.00 N/A
Total for all systems $415,208.03 $333,309.63 N/A $327,004.13 N/A
Primary Tower TOWER $179,609.00 $123,419.00 $123,419.00
Tower Rigging Short Tower (less than 500') $56,190.00 $0.00 N/A N/A N/A
Rigging Services including freight, travel, per diem, labor on site and at plant $109,329.00 $109,329.00 N/A $109,329.00 N/A
Kintronics 150 Complete Isocoupler to avoid impairment of AM signal $9,250.00 $9,250.00 N/A $9,250.00 N/A
Ice Bridge $4,840.00 $4,840.00 N/A $4,840.00 N/A

Components

Actual Information Description File Name
Tower Rigging Short Tower (less than 500') Information not provided.
Rigging Services including freight, travel, per diem, labor on site and at plant

Component Description:
Partial balance of rigging services
Amount:
$27,332.25

Component Description:
Final balance of rigging services
Amount:
$27,332.25

Component Description:
50% of rigging services
Amount:
$54,664.50
Kintronics 150 Complete Isocoupler to avoid impairment of AM signal

Component Description:
Kintronics 150
Amount:
$9,250.00
Ice Bridge

Component Description:
Ice Bridge
Amount:
$4,840.00

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 $31,149.60 $42,160.00 N/A $40,599.50 N/A
Total for all systems $415,208.03 $333,309.63 N/A $327,004.13 N/A
Outside Professional Services $31,149.60 $42,160.00 $40,599.50
Additional Displacement Legal Services Not Otherwise Specified in Form 399 $16,367.10 $16,367.10 Additional expenses were incurred as indicated in the attached invoices. $16,367.10 Additional expenses were incurred as indicated in the attached invoices.
Attorney Fees - Prepare and File request for Special Temporary Authorization $2,235.00 $1,842.50 Additional expenses were incurred as indicated in the attached invoices. $1,842.50 Additional expenses were incurred as indicated in the attached invoices.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $1,577.50 $1,577.50 N/A $804.50 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $3,025.00 $4,223.90 Additional expenses were incurred as indicated in the attached invoices. $4,113.90 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 $375.00 N/A
Perform engineering study for displacement application $1,800.00 $2,475.00 Additional expenses were incurred as indicated in the attached invoices. $2,475.00 Additional expenses were incurred as indicated in the attached invoices.
Prepare/ Review 399 reimbursement form $1,710.00 $5,936.80 Additional expenses were incurred as indicated in the attached invoices. $5,936.80 Additional expenses were incurred as indicated in the attached invoices.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $2,102.50 $4,875.00 Additional expenses were incurred as indicated in the attached invoices. $4,875.00 Additional expenses were incurred as indicated in the attached invoices.
Prepare request for Special Temporary Authorization $1,280.00 $3,809.70 Additional expenses were incurred as indicated in the attached invoices. $3,809.70 Additional expenses were incurred as indicated in the attached invoices.

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:
$220.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$58.50

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$803.50

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$788.80

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$105.50

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$2,736.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$51.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$472.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$24.50

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$1,224.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$153.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$49.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$723.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$22.80

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$27.50

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$4,958.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$366.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$1,275.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$98.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$2,162.00

Component Description:
Additional Displacement Legal Services Not Otherwise Specified in Form 399
Amount:
$49.00
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
Prepare and file interim operations STA request
Amount:
$1,061.00

Component Description:
Prepare and file interim operations STA extension request
Amount:
$73.50

Component Description:
Prepare and file interim operations STA extension request
Amount:
$634.50

Component Description:
Prepare and file interim operations STA request
Amount:
$73.50
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
Prepare and file displacement license application
Amount:
$804.50
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Prepare modification of displacement construction permit
Amount:
$888.00

Component Description:
Prepare and file displacement construction permit
Amount:
$257.40

Component Description:
Draft and file displacement construction permit extension request
Amount:
$590.00

Component Description:
Draft and file displacement construction permit extension request
Amount:
$686.00

Component Description:
Draft and file displacement construction permit extension request
Amount:
$915.00

Component Description:
Draft and file displacement construction permit extension request
Amount:
$53.00

Component Description:
Prepare and File Modification to FCC Form 2100 (main), Construction Permit
Amount:
$724.50
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
Technical for displacement license
Amount:
$300.00

Component Description:
Engineering for displacement license application
Amount:
$75.00
Perform engineering study for displacement application

Component Description:
Evaluate competitor filings
Amount:
$300.00

Component Description:
TPO calculations for displacement
Amount:
$125.00

Component Description:
Perform study of competitor applications
Amount:
$225.00

Component Description:
Perform study of Channel 34 analog and digital
Amount:
$325.00

Component Description:
Search for displacement channel
Amount:
$1,500.00
Prepare/ Review 399 reimbursement form

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$156.00

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$171.50

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$78.00

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$234.00

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$1,654.20

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$170.40

Component Description:
Prepare/review Form 399
Amount:
$91.20

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$73.50

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$104.00

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$73.50

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

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$819.00

Component Description:
Additional expenses were incurred as indicated in the attached invoices.
Amount:
$671.50

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$473.50

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$137.50

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$906.50
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Engineering for construction permit modification
Amount:
$600.00

Component Description:
Engineering for construction permit modification
Amount:
$875.00

Component Description:
Prepare engineering portion of displacement application
Amount:
$1,050.00

Component Description:
Prepare engineering portion of displacement application
Amount:
$50.00

Component Description:
Engineering for construction permit modification
Amount:
$250.00

Component Description:
Engineering for construction permit modification
Amount:
$600.00

Component Description:
Engineering for construction permit modification
Amount:
$1,000.00

Component Description:
Technical to change antenna height and modify construction permit
Amount:
$450.00
Prepare request for Special Temporary Authorization

Component Description:
Prepare STA Extension Request
Amount:
$78.00

Component Description:
Engineering for STA Request
Amount:
$500.00

Component Description:
Prepare STA Extension Request
Amount:
$550.00

Component Description:
Prepare request for Special Temporary Authorization
Amount:
$260.70

Component Description:
Engineering for STA request for Channel 29
Amount:
$250.00

Component Description:
Prepare STA Extension Request
Amount:
$1,232.00

Component Description:
Prepare STA Extension Request
Amount:
$939.00

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 $3,840.95 $4,535.95 N/A $4,415.95 N/A
Total for all systems $415,208.03 $333,309.63 N/A $327,004.13 N/A
Other Expenses $3,840.95 $4,535.95 $4,415.95
Freight for Transmitter $3,200.95 $3,200.95 N/A $3,200.95 N/A
FCC Filing Fees - Special Temporary Authorization request $305.00 $1,000.00 Additional expenses were incurred as indicated in the attached invoices. $1,000.00 Additional expenses were incurred as indicated in the attached invoices.
FCC Filing Fees - Form 2100 license to cover application $335.00 $335.00 N/A $215.00 N/A

Components

Actual Information Description File Name
Freight for Transmitter

Component Description:
Freight for Transmitter
Amount:
$3,200.95
FCC Filing Fees - Special Temporary Authorization request

Component Description:
STA Filing Fees
Amount:
$200.00

Component Description:
STA Filing Fees
Amount:
$200.00

Component Description:
STA Filing Fees
Amount:
$200.00

Component Description:
STA Filing Fees
Amount:
$200.00

Component Description:
STA Filing Fees
Amount:
$200.00
FCC Filing Fees - Form 2100 license to cover application

Component Description:
Filing Fees for Displacement License Application
Amount:
$215.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $415,208.03 $333,309.63 $327,004.13

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.

J. Timothy Hannan

EVP & CFO of Parent, NPGCO


08/26/2022

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.

J. Timothy Hannan

EVP & CFO of Parent, NPGCO


08/26/2022

Attachments

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