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:
10154
Service:
LPD
Call Sign:
WDMR-LD
Channel:
23 (UHF)
File Number:
0000088507
FRN:
0019509470
Eligibility Status:
Eligible
Date Submitted:
11/02/2022

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

NBC TELEMUNDO LICENSE LLC

Angela Ball

300 NEW JERSEY AVENUE, NW

SUITE 700

WASHINGTON, DC 20001

United States

+1 (202) 524-6413 angela.ball@nbcuni.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

Angela Ball

Assistant Secretary

NBCUniversal, LLC

300 New Jersey Avenue, NW

Washington, DC 20001

United States

+1 (202) 524-6413 angela.ball@nbcuni.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 Install new antenna in place of existing analog antenna and new transmitter for new channel. The old transmitter and antenna will remain in place for interim use until the cut-over.

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 LU5000AT
Year 2006
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1.5 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 TMU9-3
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1.8 kW
Justification for New Transmitter Old transmitter, AXCERA LU5000AT, was no longer supported.

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 Yes
Description We installed one 20-amp, one 20 volt circuit to a new quad- receptacle and one new duplex receptacle. We also did one 1-1/4" conduit with 4 THHN conductors. We also installed one 10x10 junction box.
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

Installation Costs

Transmitter Installation Costs

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? Yes
Existing Antenna Manufacturer and Type
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
ERP: 15.0 kW
Manufacturer
Model TLP-12F/VP
Year 2006

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? Yes
New Antenna Manufacturer and Types
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Slotted Coaxial
ERP: 15.0 kW
Manufacturer
Model TLP-12F/VP
Year 2018
Justification for New Antenna The old antenna which was single channel would not operate on the new 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? No
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? No
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? 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 Modify Existing
Tower Use Primary (Main)
Ownership Owned
Is this tower consider Complex? No
Is this tower currently shared with any other stations? No
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? No
Coordinates (NAD83) Latitude (NAD83) 42° 05' 07.2" N-
Longitude (NAD83) 072° 42' 11.4" W-
Overall Structure Height 170.00 feet
Support Structure Height 155.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 759.00 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner NBC
Date Constructed 11/30/1988


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 need for guyed or free-standing tower
Tower Reinforcements Please select whether tower reinforcements are needed: Minor Reinforcements needed

Primary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower N/A
Helicopter Services Required Are helicopter services required? No

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Installation Costs

Antenna installation and tower modification

Fiber Guy Wires

The furnish and installation of three 40' Long HPTG 270001 Fiber Guy assembly with corona sockets factory install on each end.

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 350
Explanation Project oversight of transmitter install, electrical connectivity, tower work, and antenna installation. Additional time will be spent tracking financial and legal process and coordinating with other broadcasters.
Outside RF consulting Engineering Services Perform engineering study for displacement application No
Prepare engineering section of Form FCC Construction Permit Application No
Prepare engineering section of Form FCC License to Cover Application No
Prepare request for Special Temporary Authority No
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 No
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 Yes
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements Yes
Additional Field Engineering Service Yes
Number of Days 5
Justification Site survey prior to install

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Medical Notifications

Notification to medical facilities

RF Field Strength Signal Survey

RF Field Strength Signal Survey

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 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? Yes
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

Field Verification

Verifying existing conditions at antenna, mounts and feedline connector

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 $125,530.00 $121,152.71 N/A $2,090.91 N/A
Total for all systems $439,851.43 $545,929.14 N/A $312,333.32 N/A
Primary Transmitter TMU9-3 $125,530.00 $121,152.71 $2,090.91
Installation Costs $30,000.00 $30,000.00 N/A $2,090.91 N/A
Other Electrical Service: We installed one 20-amp, one 20 volt circuit to a new quad- receptacle and one new duplex receptacle. We also did one 1-1/4" conduit with 4 THHN conductors. We also installed one 10x10 junction box. $1,530.00 $1,530.00 N/A $0.00 N/A
Transmitter Building Site Survey/Installation $10,000.00 $12,750.00 Decommissioning of the existing Axcera transmitter to create space in the room for install added to the cost. $0.00 N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $84,000.00 $76,872.71 N/A $0.00 N/A

Components

Actual Information Description File Name
Installation Costs

Component Description:
ADAPTER 1-5/8" EIA MALE X 7/16 DIN FEMALE
Amount:
$463.75

Component Description:
Installation services for Rhode & Schwarz TMU9-3 and associated RF system components, to include installation, commissioning, and proof of performance.
Amount:
$16,150.00

Component Description:
Install a 3-phase, 40-amp circuit for the transmitter from the existing circuit breaker panel. duplex receptacle
Amount:
$1,627.16
Other Electrical Service: We installed one 20-amp, one 20 volt circuit to a new quad- receptacle and one new duplex receptacle. We also did one 1-1/4" conduit with 4 THHN conductors. We also installed one 10x10 junction box. Information not provided.
Transmitter Building Site Survey/Installation

Component Description:
WDMR-LD TV RF Field Strength Signal Survey & Report
Amount:
$5,800.00
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW Information not provided.

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 $15,730.00 $30,000.00 N/A $16,150.00 N/A
Total for all systems $439,851.43 $545,929.14 N/A $312,333.32 N/A
Primary Antenna TLP-12F/VP $15,730.00 $30,000.00 $16,150.00
Sweep test of transmission line and antenna $5,730.00 $20,000.00 Estimated cost is greater than predetermined cost estimate $16,150.00 N/A
UHF-Low Power, Side Mount, Slotted Coaxial, 15.0kW input, Elliptical $10,000.00 $10,000.00 N/A $0.00 N/A

Components

Actual Information Description File Name
Sweep test of transmission line and antenna

Component Description:
Contract Engineering Services to include the below listed scope of work: Sweep Test transmission line and CH23 antenna. Assist with decommissioning of existing Axcera transmitter Installation services and associated RF system components.
Amount:
$16,150.00
UHF-Low Power, Side Mount, Slotted Coaxial, 15.0kW input, Elliptical

Component Description:
ELBOW 1-50 EQUAL LEG 3 X 3 CU "QS" T/L 1-50 EIA LENGTH UP TO 5' FIXED, FLG 1 END/ SWIVEL FLG 1 END
Amount:
$3,139.20

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 $196,080.06 $138,190.06 N/A $106,995.42 N/A
Total for all systems $439,851.43 $545,929.14 N/A $312,333.32 N/A
Primary Tower TOWER $196,080.06 $138,190.06 $106,995.42
Tower Rigging Short Tower (less than 500') $56,190.00 $0.00 Rigging costs are included in the $53,085 price for tower modifications. N/A N/A
Study needed for guyed or free-standing tower $8,700.00 $7,000.00 N/A $6,400.00 N/A
Minor tower reinforcement/modifications $25,000.00 $25,000.00 N/A $3,360.00 N/A
Installation Costs $100,000.00 $100,000.00 N/A $91,292.42 N/A
Fiber Guy Wires $6,190.06 $6,190.06 N/A $5,943.00 N/A

Components

Actual Information Description File Name
Tower Rigging Short Tower (less than 500') Information not provided.
Study needed for guyed or free-standing tower

Component Description:
Item 1: Anthony Flores Coordinated cursory SA and preparation of permitting analysis Item 3: Cursory Review for Proposed Antenna Change Tower Modification Design and Stamped Drawings
Amount:
$6,400.00
Minor tower reinforcement/modifications

Component Description:
Revised/Updated Tower Modification Design and Stamped Drawings and Specifications for Guy Wire Change
Amount:
$3,360.00
Installation Costs

Component Description:
Complete Structural modifications per ESC drawings costs plus sales tax are requested here. Please see calculation attachment
Amount:
$49,161.87

Component Description:
Replace existing WDMR antenna with new customer provided TLP- 12F/VP side mounted antenna at top of tower. F and I new mounting brackets to accommodate existing leg.
Amount:
$42,130.55

Component Description:
ELBOW 1-5/8" EQ. LEG, and TL 1-5/8" 14 INCHES LONG
Amount:
N/A
Fiber Guy Wires

Component Description:
Furnish and install (3) 40' long HPTG 270001 aramid fiber guy assembly with CS 35000 corona sockets factory installed on each end
Amount:
$5,943.00

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 $76,957.50 $231,032.50 N/A $166,780.18 N/A
Total for all systems $439,851.43 $545,929.14 N/A $312,333.32 N/A
Outside Professional Services $76,957.50 $231,032.50 $166,780.18
RF Field Strength Signal Survey $5,800.00 $5,800.00 N/A $5,800.00 N/A
Medical Notifications $2,000.00 $2,000.00 N/A $2,000.00 N/A
Additional Field Engineering Service, 5 Days $7,500.00 $7,500.00 N/A $7,450.00 N/A
RF Exposure Measurements $12,100.00 $12,100.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $1,577.50 $1,577.50 N/A $360.00 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $3,025.00 $3,025.00 N/A N/A N/A
Form 399 assistance or other Program Management costs $6,320.00 $6,320.00 N/A $3,285.00 N/A
Project management of the transition $36,925.00 $191,000.00 Project management cost exceed predetermined cost $147,488.58 N/A
Prepare/ Review 399 reimbursement form $1,710.00 $1,710.00 N/A $396.60 N/A

Components

Actual Information Description File Name
RF Field Strength Signal Survey

Component Description:
Services Provided - WDMR-LD TV RF Field Strength Signal Survey & Report
Amount:
$5,800.00
Medical Notifications

Component Description:
WDMR LD FCC ID 10154 Medical Notification Mailing Complete per FCC Repack
Amount:
$2,000.00
Additional Field Engineering Service, 5 Days

Component Description:
Building permit package to obtain approvals for Building, and Building Permit Drawings
Amount:
$7,450.00
RF Exposure Measurements Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
License to cover application prepared by the legal team
Amount:
$225.00

Component Description:
Legal fees
Amount:
$135.00
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application Information not provided.
Form 399 assistance or other Program Management costs

Component Description:
Patty Chuh- Outside professional legal fees for the Repack Station
Amount:
$135.00

Component Description:
Patty Chuh- Outside professional legal fees for the Repack Station
Amount:
$540.00

Component Description:
Patty Chuh- Outside professional legal fees for the Repack Station
Amount:
$2,610.00
Project management of the transition

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services- 10154
Amount:
$2,212.00

Component Description:
WDMR-LD-Engagement Leader-Project Management Services- 10154
Amount:
$1,885.00

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services- 10154
Amount:
$948.00

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services- 10154
Amount:
$3,160.00

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services- 10154
Amount:
$1,264.00

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services- 10154
Amount:
$3,160.00

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services- 10154
Amount:
$1,738.00

Component Description:
WDMR-LD-Engagement Leader-Project Management Services- 10154
Amount:
$8,316.00

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services - 10154
Amount:
$12,166.00

Component Description:
WDMR-LD-Engagement Leader-Project Management Services- 10154
Amount:
$6,776.00

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services - 10154
Amount:
$7,110.00

Component Description:
WDMR-LD-Engagement Leader-PROJECT MANAGEMENT Services- 10154
Amount:
$395.00

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services- 10154
Amount:
$1,738.00

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services- 10154
Amount:
$790.00

Component Description:
WDMR Project Management Services - November 2019
Amount:
$13,087.50

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services- 10154
Amount:
$1,580.00

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services- 10154
Amount:
$1,106.00

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services - 10154
Amount:
$632.00

Component Description:
WDMR-LD-Engagement Leader-Project Management Services- 10154
Amount:
$5,945.00

Component Description:
WDMR-LD-Program Leaders project management Services- 10154
Amount:
$4,252.00

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services - 10154
Amount:
$7,584.00

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services- 10154
Amount:
$790.00

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services - 10154
Amount:
$790.00

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services- 10154
Amount:
$3,160.00

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services- 10154
Amount:
$1,659.00

Component Description:
WDMR-LD-Engagement Leader-Project Management Services- 10154
Amount:
$6,162.00

Component Description:
WDMR-LD-Engagement Leader-Project Management Services- 10154
Amount:
$8,855.00

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services - 10154
Amount:
$5,688.00

Component Description:
WDMR-LD-Repack Finance Resource-Project Management Services - 10154
Amount:
$13,114.00

Component Description:
WDMR-LD-Engagement Leader-Project Management Services- 10154
Amount:
$5,846.00

Component Description:
WCAU - Project Management Services
Amount:
$1,549.50

Component Description:
WDMR Point B project management July 2019
Amount:
$1,164.58

Component Description:
WDMR-LD-Engagement Leader-Project Management Services- 10153
Amount:
$8,316.00

Component Description:
PROJECT MANAGEMENT SERVICE - Joseph DiMaggio WDMR Springfield- Observation climb conducted by Eastern Communications to inspect the antennae and tower, especially the glass rods for the top guys
Amount:
$1,000.50

Component Description:
Project Management Service 10/1/2018 - 10/31/2018 WDMR-LD -Anthony Flores Complete SA and coordinate with structural engineer on tower modifications plans
Amount:
$750.00

Component Description:
Project management services
Amount:
$8,855.00

Component Description:
Project Management Services - Communications Crew dropped off materials needed for the tower modification and reinforcement. Also met with the welder to go over the scope of work for the project.
Amount:
$13,087.50

Component Description:
WDMR Point B project management December 2019
Amount:
$6,162.00

Component Description:
WDMR Point B project management September 2019
Amount:
$1,896.00

Component Description:
WDMR Point B project management August 2019
Amount:
$770.00

Component Description:
WDMR Point B project management October 2019
Amount:
$5,846.00

Component Description:
Project Management Service - 1/21/19 Joseph DiMaggio WDMR Springfield-Site Survey.
Amount:
$937.50

Component Description:
WDMR Point B project management May 2019
Amount:
$8,855.00

Component Description:
WDMR AFF Consulting project management June 2019
Amount:
$5,550.00

Component Description:
WDMR Point B project management January 2020
Amount:
$1,580.00

Component Description:
Field verification - Verify existing conditions at antenna will accommodate new antenna. Verify mounts and feedline connector and routing. Minus sales tax.
Amount:
N/A

Component Description:
NBC - WDMR - Project Management Services. January 1-31, 2019.
Amount:
$937.50

Component Description:
Project Management Services - WDMR - Equipment installation 9/1/2019 to 9/30/2019
Amount:
$150.00

Component Description:
WDMR Point B project management November 2019
Amount:
$4,252.00

Component Description:
Management WDMR-LD-Engagement Services- 10153 Leader-Project
Amount:
$5,945.00

Component Description:
WDMR LD Repack Finance Resource-Project Management Services 10153.
Amount:
$1,580.00

Component Description:
WDMR AFF Consulting project management August 2019
Amount:
$874.50

Component Description:
12/9/19 Joseph DiMaggio WDMR- No tower work today. Fog, with heavy periods of rain throughout the day, temps in the 50s.
Amount:
$1,549.50
Prepare/ Review 399 reimbursement form

Component Description:
prepared 399 form and assisted internal team for the station
Amount:
$315.00

Component Description:
Review 399 reimbursement request for the station
Amount:
$45.90

Component Description:
Attention to FCC email regarding additional allocation of reimbursement funds of the station
Amount:
$35.70

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 $25,553.87 $25,553.87 N/A $20,316.81 N/A
Total for all systems $439,851.43 $545,929.14 N/A $312,333.32 N/A
Other Expenses $25,553.87 $25,553.87 $20,316.81
Field Verification $3,270.00 $3,270.00 N/A $3,270.00 N/A
Equipment Storage $6,865.00 $6,865.00 N/A $3,832.00 N/A
Equipment Delivery and Handling Charges $5,973.87 $5,973.87 Kenco Shipping cost $5,973.87 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $8,000.00 $8,000.00 tbd $7,240.94 N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $335.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,110.00 N/A N/A N/A

Components

Actual Information Description File Name
Field Verification

Component Description:
Field verification - Verify existing conditions at antenna will accommodate new antenna. Verify mounts and feedline connector and routing.
Amount:
$3,270.00
Equipment Storage

Component Description:
Consolidation and first Month Storage of Transmitter and Third Party Equipment plus 1 Month additional storage
Amount:
$3,832.00
Equipment Delivery and Handling Charges

Component Description:
Total line haul and Gap insurance for shipping- requesting full amount for the invoice attached
Amount:
$5,973.87
Disposal Costs (for equipment and other waste, net of any salvage value)

Component Description:
Removal of fiberglass insulting rod costs plus sales tax are requested here. Please see calculation attachment.
Amount:
$7,240.94
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Form 2100 minor change CP application Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $439,851.43 $545,929.14 $312,333.32

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. Yes

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.

Angela Ball

Assistant Secretary


11/02/2022

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.

Angela Ball

Assistant Secretary


11/02/2022

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.

Angela Ball

Assistant Secretary


11/02/2022

Attachments

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