TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
HC2 STATION GROUP, INC.	RENEE ILHARDT 295 MADISON AVENUE, 12TH FLOOR NEW YORK, NY 10017 United States	+1 (954) 606-5486	RILHARDT@HC2BROADCASTING.COM	Corporation

Applicant

Address

Phone

Applicant Type

HC2 STATION GROUP, INC.

RENEE ILHARDT

295 MADISON AVENUE, 12TH FLOOR

NEW YORK, NY 10017

United States

+1 (954) 606-5486

RILHARDT@HC2BROADCASTING.COM

Corporation

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant	Address	Phone	Email
[Confidential]

Preparer Contact Information

Preparer Contact Name and Information

Applicant	Address	Phone	Email
The Preparer is same as the reimbursement contact.

Broadcaster Information and Transition Plan

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	Towards the end of the station's testing period, Applicant will remove old equipment, install new equipment and begin broadcasting on new channel. Applicant will not need or use any auxiliary equipment. See "Transition Plan" attachment for more info.

Transmitters

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

Primary Transmitter

Existing Transmitter Information

Section	Question	Response
Existing Transmitter Description	Type of change	Purchase New
	Use	Primary (Main)
	Description of Use	N/A
	Ownership	Owned
	Owner	N/A
	Site	N/A
	Is this transmitter currently shared with another station?	No
	Is this transmitter currently in operating condition?	Yes
Existing Transmitter Manufacturer and Type	Manufacturer
	Model	TXUD2000LD
	Year	2010
	Type	Solid State
	Solid State Cooling	Air Cooled
	Solid State Power Capacity	2 kW

Primary Transmitter

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	TRN-5X-U-38-C
	Transmitter Type	Solid State
	Solid State Cooling	Air Cooled
	Solid State Power capacity	5 kW
	Justification for New Transmitter	Transmitter will be over 9 years old at time of replacement. The cost of retuning the transmitter and purchasing a new mask filter will exceed the cost of buying a new replacement unit.

Primary Transmitter

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	No
	Description	N/A
HVAC Service	Does the replacement transmitter require HVAC Service?	No
	Type	N/A
	Size	N/A
	Other Size	N/A
Transmitter Building Addition/Modification or Leasehold Improvement	Does the Transmitter Building require an addition, modification, other leashold improvement?	No
	Size	N/A
Channel 14 Costs	Is an RF Consulting Engineer needed?	N/A
	Is a channel 14 Mask Filer needed?	N/A
	Is additional field engineering time needed?	N/A
	Number of Days	N/A

Primary Transmitter

Other Transmitter Cost Not Listed

Name	Description
Connectors and Elbows	For bypassing existing combined array with an LPTV station.
Additional Field Engineering Time	Additional Field Engineering Time

Antennas

Section	Question	Response
Antenna Related Expenses	Do you have antenna related expenses?	No

Transmission Line

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

Tower Equipment And Rigging Costs

Section	Question	Response
Tower Equipment or Rigging Costs Changes	Do you have tower equipment or rigging costs changes?	No

Outside Professional Services Costs

Section	Question	Response
Outside Project Management Services	Do you require outside project management services?	Yes
	Number of Hours	24
	Explanation	Our in house chief engineer will travel to site to oversee construction. However, we will need the services of our on-site, contract engineer for receipt of equipment, site management and coordination issues, and assistance with construction.
Outside RF consulting Engineering Services	Perform engineering study for new channel assignment and antenna development	No
	Prepare engineering section of Form FCC Construction Permit Application	No
	For Auxiliary Facility	N/A
	For Main Facility	N/A
	Prepare engineering section of Form FCC License to Cover Application	No
	For Auxiliary Facility	N/A
	For Main Facility	N/A
	Prepare request for Special Temporary Authority	No
	Quantity	N/A
	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	No
	For Auxiliary Facility	N/A
	For Main Facility	N/A
	Prepare and file Form FCC License to Cover Application	No
	For Auxiliary Facility	N/A
	For Main Facility	N/A
	Prepare request for Special Temporary Authority	No
	Quantity	N/A
	NEPA Section 106 environmental review	No
	Environmental Assessment	No
	ASR Modification	No
	FAA Consultation (including preparation of FAA Form 7460)	No
	Negotiation of Lease and other Matter for Shared Locations	No
	Prepare or Review FCC Form 399 for Reimbursement	No
	Address transition timing and coordination issues w/ other stations and wireless providers	Yes
RF Field Engineering Services	Comprehensive coverage verification via field study	No
	RF exposure measurements	No
	Additional Field Engineering Service	No
	Number of Days	N/A
	Justification	N/A

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Name	Description
Internal Employee Time Costs	Internal Employee Time Costs
Repacking Related Tax Services	Repacking Related Tax Services

Other Expenses

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

Other Expenses

Other Expenses Not Listed

Name	Description
Travel Expenses for Chief Engineer	Travel and lodging for 3 days.

Cost Information

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	$243,305.00	$61,933.73	N/A	$55,933.73	N/A
Total for all systems	$285,546.40	$94,081.18	N/A	$79,186.18	N/A
Primary Transmitter TRN-5X-U-38-C	$243,305.00	$61,933.73		$55,933.73
UHF - Air Cooled Solid State Transmitter 4 - 6 kW	$236,500.00	$55,128.73	N/A	$55,128.73	N/A
Additional Field Engineering Time	$805.00	$805.00	N/A	$805.00	N/A
Connectors and Elbows	$6,000.00	$6,000.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
UHF - Air Cooled Solid State Transmitter 4 - 6 kW	Component Description: TX installation. #60520 Amount: $1,035.00 Component Description: Transmitter cost. #7158-001 Amount: $53,343.00 Component Description: Transmitter related cost. #19529 Amount: $750.73 Component Description: TX installation. #60520 Amount: $1,035.00
Additional Field Engineering Time	Component Description: Replace filter, complete installation. #401 Amount: $805.00
Connectors and Elbows	Information not provided.

Cost Information

Antennas

Information not provided.

Cost Information

Transmission Line

Information not provided.

Cost Information

Tower Equipment and Rigging Costs

Information not provided.

Cost Information

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	$17,165.40	$16,893.68	N/A	$14,393.68	N/A
Total for all systems	$285,546.40	$94,081.18	N/A	$79,186.18	N/A
Outside Professional Services	$17,165.40	$16,893.68		$14,393.68
Repacking Related Tax Services	$120.74	$120.74	N/A	$120.74	N/A
Internal Employee Time Costs	$10,622.66	$10,622.66	N/A	$10,622.66	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
Project management of the transition	$3,792.00	$3,650.28	N/A	$3,650.28	N/A

Components

Actual Information Description	File Name
Repacking Related Tax Services	Component Description: Services rendered in relation to discussion and analysis of the tax treatment of invoice related to FCC repacking. Invoice is not billed on time basis. #1034466828-9 Amount: $120.74
Internal Employee Time Costs	Component Description: Internal expense - KUVM - 8-2020 Amount: $41.80 Component Description: Internal expense - KUVM - 10-2021 Amount: $954.05 Component Description: Internal expense - KUVM - 10-2021 Amount: $72.12 Component Description: Internal expense - KUVM - 10-2021 Amount: $1,874.86 Component Description: Internal expense - KUVM - 10-2021 Amount: $625.83 Component Description: Internal expense - KUVM - 8-2020 Amount: $75.96 Component Description: Internal expense - KUVM - 10-2021 Amount: $2,199.42 Component Description: Internal expense - KUVM - 8-2020 Amount: $57.43 Component Description: Install new transmitter and filter. #AFF366A848734FD4ADDB Amount: $612.46 Component Description: Internal expense - KUVM - 10-2021 Amount: $3,941.74 Component Description: Travel expenses. #611495DB0719460099CC Amount: $166.99
Address transition timing and coordination issues w/ other stations and wireless	Information not provided.
Project management of the transition	Component Description: ATC tower meeting. #10419 Amount: $90.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 10 stations. #187 Amount: $540.25 Component Description: Portion of general repack matter invoice attributable to this station - divided by 20 stations. #145 Amount: $745.25 Component Description: Portion of general repack matter invoice attributable to this station - divided by 27 stations. #119 Amount: $271.70 Component Description: Portion of general repack matter invoice attributable to this station - divided by 27 stations. #115 Amount: $467.12 Component Description: Legal services cost. #474792 Amount: $462.00 Component Description: Legal services cost. #475038 Amount: $18.15 Component Description: Portion of general repack matter invoice attributable to this station - divided by 8 stations. #321 Amount: $605.00 Component Description: Portion of general repack matter invoice attributable to this station - divided by 27 stations. #130 Amount: $450.81

Cost Information

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	$25,076.00	$15,253.77	N/A	$8,858.77	N/A
Total for all systems	$285,546.40	$94,081.18	N/A	$79,186.18	N/A
Other Expenses	$25,076.00	$15,253.77		$8,858.77
Travel Expenses for Chief Engineer	$4,000.00	$4,000.00	N/A	N/A	N/A
Equipment Delivery and Handling Charges	$3,581.00	$3,581.00	N/A	$3,581.00	N/A
Disposal Costs (for equipment and other waste, net of any salvage value)	$1,000.00	$1,000.00	N/A	N/A	N/A
FCC Filing Fees - Form 2100 license to cover application	$335.00	$325.00	N/A	N/A	N/A
FCC Filing Fees - Form 2100 minor change CP application	$1,110.00	$1,070.00	N/A	N/A	N/A
DTV Medical Facility Notification	$11,550.00	$1,777.77	N/A	$1,777.77	N/A
Develop and air announcement of upcoming channel change	$3,500.00	$3,500.00	N/A	$3,500.00	N/A

Components

Actual Information Description	File Name
Travel Expenses for Chief Engineer	Information not provided.
Equipment Delivery and Handling Charges	Component Description: Move out and packing tx, freight. #3322 Amount: $3,581.00
Disposal Costs (for equipment and other waste, net of any salvage value)	Information not provided.
FCC Filing Fees - Form 2100 license to cover application	Information not provided.
FCC Filing Fees - Form 2100 minor change CP application	Information not provided.
DTV Medical Facility Notification	Component Description: Medical notification services. #INV-001876 Amount: $1,777.77
Develop and air announcement of upcoming channel change	Component Description: Develop and air announcement. #5314006713 Amount: $2,955.00 Component Description: Develop and air announcement. #5314056075 Amount: $545.00

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$285,546.40	$94,081.18	$79,186.18

Reimbursement Status

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.	Yes

Certification

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.
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. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. 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. 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. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. 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.	Michael Voge Director of Engineering Operations 09/08/2022

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.

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.
The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.
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.
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.
The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.
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.

Michael Voge

Director of Engineering Operations

09/08/2022

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

Applicant Information

Applicant Name, Type, and Contact Information

Reimbursement Contact Information

Reimbursement Contact Name and Information

Preparer Contact Information

Preparer Contact Name and Information

Broadcaster Information and Transition Plan

Transmitters

Primary Transmitter

Existing Transmitter Information

Primary Transmitter

New Transmitter Costs

Primary Transmitter

Other Transmitter Costs

Primary Transmitter

Other Transmitter Cost Not Listed

Antennas

Transmission Line

Tower Equipment And Rigging Costs

Outside Professional Services Costs

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Other Expenses

Other Expenses

Other Expenses Not Listed

Cost Information

Transmitters

Components

Cost Information

Antennas

Cost Information

Transmission Line

Cost Information

Tower Equipment and Rigging Costs

Cost Information

Outside Professional Services

Components

Cost Information

Other Expenses

Components

Cost Information

Grand Total

Reimbursement Status

Certification

Attachments