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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:
18736
Service:
DCA
Call Sign:
KMUM-CD
Channel:
19 (UHF)
File Number:
0000026683
FRN:
0019509470
Date Submitted:
12/12/2022

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

PO Box 2630

Washington, DC, 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 No new transmitter needed as the existing unit is frequency agile Existing Antenna to be replaced to accommodate new frequency of Ch 19 assigned 500 Mhz to 506 Mhz Past attatchment with new transmitter costs removed CP filed Transition Phase

Transmitters

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

Primary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Retune Existing
Use Primary (Main)
Ownership Owned
Owner N/A
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer Rodhe & Schwarz, Inc.
Model 8000
Year 2013
Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 3 kW

Primary Transmitter

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Retuning Transmitter Costs

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

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service 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

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Other Transmitter Cost Not Listed

Name Description

Transmitter and Filter Retune

Transmitter and Filter Retune

Antennas

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Section Question Response
Antenna Related Expenses Do you have antenna related expenses? Yes

Primary Antenna

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Add Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is this antenna currently shared with any other stations? No
Is this antenna directional? 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 Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 15.0 kW
Manufacturer
Model PSILP8ARA-31
Year 2007

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 15.0 kW
Manufacturer
Model JA/SS-12/19 SEC
Year 2017
Justification for New Antenna CHANNEL REPACK TO CH 19 500 MHZ TO 506 MHZ OLD ANTENNA NOT BROADBAND

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna?
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? N/A
Elbow Complex Do you require the separate purchase of the Elbow Complex? No
Broadband or Single Channel? N/A
Feed Line Size N/A
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? 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

Name Description

Antenna System Installation

Labor- Broadcast Antenna System

Filter- Untuned- 6PPXX160E Filter

6PPXX160E FILTER 16UF MYAT UNTUNED PACK

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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Add Tower

Section Question Response
Existing Tower Description Type of change Move Equipment
Tower Use Primary (Main)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? 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 1021056
Coordinates (NAD83) Latitude (NAD83) 38° 42' 28.1" N-
Longitude (NAD83) 121° 28' 36.3" W-
Overall Structure Height 503.93 feet
Support Structure Height 499.99 feet
Ground Elevation Above Mean Sea Level (AMSL) 34.12 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner American Towers, LLC.
Date Constructed 08/07/2001

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
60300 KFBK-FM FM

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

BECKMAN TOWER RIGGING COSTS

INSTALL NEW ANTENNA DE INSTALL OLD ANTENNA

Tower Mapping for an Undocumented and Poorly Documented tower load study

Structural Analysis and load study

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 400
Explanation Project Management of Station
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority 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 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
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 Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study Yes
RF exposure measurements Yes
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Bob Du treil, Lundin, Rackley Inc

CP study / intererference ets

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning Yes
Non-zoning permits 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? Yes
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Name Description

AMERICAN TOWER

STRUCTURAL ENTEGRITY STUDY

HOME DEPOT

MISC HARDWARE / UNISTRUT/BOLTS/NUTS

Paul Johnson

Lodging/ Meals cost Engineering

RBW ELECTRICAL

INSTALL NEW TRANSMITTER WIRING

Call Support

Toll free inbound minutes

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 $127,200.00 $77,000.00 N/A $22,000.00 N/A
Total for all systems $759,928.55 $534,632.40 N/A $297,243.62 N/A
Primary Transmitter 8000 $127,200.00 $77,000.00 $22,000.00
Transmitter and Filter Retune $22,000.00 $22,000.00 N/A $22,000.00 N/A
UHF and VHF - minor banding issues $105,200.00 $55,000.00 N/A $0.00 N/A

Components

Actual Information Description File Name
Transmitter and Filter Retune

Component Description:
Transmitter and Filter Retune expenses at KMUM, CA
Amount:
$11,000.00

Component Description:
Transmitter and Filter Retune at KMUM, CA.
Amount:
$11,000.00
UHF and VHF - minor banding issues 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 $89,298.55 $78,507.40 N/A $66,443.24 N/A
Total for all systems $759,928.55 $534,632.40 N/A $297,243.62 N/A
Primary Antenna JA/SS-12/19 SEC $89,298.55 $78,507.40 $66,443.24
Filter- Untuned- 6PPXX160E Filter $4,028.55 $4,028.55 Untuned Filter for RFS system $3,704.40 N/A
Antenna System Installation $52,240.00 $52,240.00 Install Broadcast Antenna System, Labor and materials $42,980.00 N/A
Sweep test of existing antenna $6,730.00 $6,730.00 N/A $4,250.00 N/A
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $26,300.00 $15,508.85 JA-SS-12 Super Slot Low Power Elliptically Polarized UHF Slot Antenna, to produce a Cardioid pattern. $15,508.84 N/A

Components

Actual Information Description File Name
Filter- Untuned- 6PPXX160E Filter

Component Description:
Untuned filter included tax with revised invoice. tax calculation error has been fixed
Amount:
$4,028.53

Component Description:
Untuned filter included tax with revised invoice. tax calculation error has been fixe REVISED
Amount:
$4,028.54

Component Description:
25.70178.109 6PPXX160 16UF FILTER 16UF MYAT UNTUNED PACK
Amount:
$3,704.40
Antenna System Installation

Component Description:
Labor- Broadcast Antenna system Installation
Amount:
$26,120.00

Component Description:
Remaining charge for the Antenna Installation
Amount:
$16,860.00
Sweep test of existing antenna

Component Description:
Sweep Antenna and Transmission line cost
Amount:
$4,250.00
UHF - Lower Power Side Mount, Class A One Station antenna -- basic

Component Description:
Final payment- 50%
Amount:
$7,754.42

Component Description:
Down payment 50%.
Amount:
$7,754.42

Component Description:
wrong upload
Amount:
N/A

Component Description:
Final invoice payment for the remaining 50% including Tax.
Amount:
$7,754.42

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 $265,500.00 $61,000.00 N/A $28,075.00 N/A
Total for all systems $759,928.55 $534,632.40 N/A $297,243.62 N/A
Primary Tower GTOWER $265,500.00 $61,000.00 $28,075.00
Tower Mapping for an Undocumented and Poorly Documented tower load study $30,000.00 $30,000.00 Structural Analysis and tower load study and document preparation. $28,075.00 N/A
Tall Tower (greater than 500') $210,500.00 $6,000.00 N/A N/A N/A
BECKMAN TOWER RIGGING COSTS $25,000.00 $25,000.00 N/A $0.00 N/A

Components

Actual Information Description File Name
Tower Mapping for an Undocumented and Poorly Documented tower load study

Component Description:
Remaining 50% contract for KMUM tower inspection and structural analysis
Amount:
$8,800.00

Component Description:
Rigorous Structural Analysis cost
Amount:
$10,475.00

Component Description:
50% deposit for KMUM Tower inspections & Structural analysis
Amount:
$8,800.00
Tall Tower (greater than 500') Information not provided.
BECKMAN TOWER RIGGING COSTS Information not provided.

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 $197,930.00 $240,300.00 N/A $169,246.11 N/A
Total for all systems $759,928.55 $534,632.40 N/A $297,243.62 N/A
Outside Professional Services $197,930.00 $240,300.00 $169,246.11
Bob Du treil, Lundin, Rackley Inc $4,500.00 $4,500.00 N/A $0.00 N/A
RF Exposure Measurements $21,050.00 $2,500.00 N/A $0.00 N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $2,250.00 N/A $0.00 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A $0.00 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A $90.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A $0.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $270.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $2,500.00 N/A $0.00 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $5,300.00 exceed pre-determined cost $5,212.40 N/A
Prepare and or review reimbursement form $2,630.00 $1,500.00 N/A $399.45 N/A
Project management of the transition $63,200.00 $210,000.00 Project Management is higher than expected. KMUM was extended to Phase 10, and a lot of project coordination was needed in that period to ensure the antenna would be built and shipped in time, during the COVID shutdown. $163,274.26 N/A

Components

Actual Information Description File Name
Bob Du treil, Lundin, Rackley Inc Information not provided.
RF Exposure Measurements Information not provided.
Comprehensive coverage verification via field study, if needed Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Legal fees for KMUM
Amount:
$90.00
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:
Legal fees for KMUM
Amount:
$270.00
Perform engineering study for new channel assignment and antenna development Information not provided.
Address transition timing and coordination issues w/ other stations and wireless

Component Description:
Legal fees for KMUM
Amount:
$1,320.90

Component Description:
Legal fees for KMUM
Amount:
$45.00

Component Description:
Legal fees for KMUM
Amount:
$1,485.20

Component Description:
Legal fees for KMUM
Amount:
$142.80

Component Description:
Legal fees for KMUM
Amount:
$1,468.80

Component Description:
Legal fees for KMUM
Amount:
$714.00

Component Description:
Legal fees for KMUM
Amount:
$35.70
Prepare and or review reimbursement form

Component Description:
Legal fees for the station, KMUM
Amount:
$216.75

Component Description:
Legal fees for KMUM
Amount:
$45.00

Component Description:
Legal fees for KMUM
Amount:
$137.70
Project management of the transition

Component Description:
KMUM - Point B July2019 invoice for project management
Amount:
$1,232.00

Component Description:
Project Management services for KMUM
Amount:
$12,084.26

Component Description:
KMUM-Engagement Leader-Project Management Services- 18736
Amount:
$3,397.00

Component Description:
KMUM-Repack Finance Resource-Project Management Services- 18736
Amount:
$4,740.00

Component Description:
Point B May 2020 invoices
Amount:
$19,208.00

Component Description:
P. Blakely 4/1/20 - 4/30/20, 3 hrs. T-Mobile work non-reimbursable.
Amount:
($690.00)

Component Description:
KMUM - Point B invoice March 2020
Amount:
$10,351.00

Component Description:
KMUM - Point B invoice August 2020
Amount:
$1,659.00

Component Description:
KMUM-Engagement Leader-Project Management Services- 18736
Amount:
$3,080.00

Component Description:
KMUM-Repack Finance Resource-Project Management Services- 18736. 11/01/2021 - 11/30/2021
Amount:
$3,002.00

Component Description:
KMUM-Engagement Leader-Project Management Services- 18736
Amount:
$3,080.00

Component Description:
Point B Dec. 2019 invoice for Project Management and Consulting.
Amount:
$3,397.00

Component Description:
KMUM-Program Leader-Project Management Services- 18736, from 08/01/2021 - 08/31/2021
Amount:
$977.00

Component Description:
KMUM - Point B invoice April 2020
Amount:
$20,730.00

Component Description:
Program Leader-Project Management Services
Amount:
$924.00

Component Description:
Project lead engagement and Repack Finance resources for the station- Professional services
Amount:
$11,773.00

Component Description:
KMUM-Engagement Leader-Project Management Services- 18736
Amount:
$11,773.00

Component Description:
Project Management cost
Amount:
$9,480.00

Component Description:
KMUM-Program Leader-Project Management Services- 18736 KMUM-Repack Finance Resource-Project Management Services- 18736
Amount:
$977.00

Component Description:
KMUM-Engagement Leader-Project Management Services- 18736
Amount:
$1,232.00

Component Description:
KMUM-Repack Finance Resource-Project Management Services- 18736
Amount:
$5,688.00

Component Description:
KMUM-Engagement Leader-Project Management Services- 18736
Amount:
$9,661.00

Component Description:
KMUM - Point B invoice May 2020
Amount:
$19,208.00

Component Description:
Point B May invoice for Project Management service
Amount:
$1,540.00

Component Description:
KMUM-Engagement Leader-Project Management Services- 18736
Amount:
$924.00

Component Description:
Point B November 2019 Invoice KMUM
Amount:
$1,659.00

Component Description:
Project Management Services- 18736
Amount:
$1,540.00

Component Description:
Project Management cost
Amount:
$5,000.00

Component Description:
Please see attached CL for the variance in line 4 since T-Mobile cost is not reimbursable.
Amount:
$20,040.00

Component Description:
KMUM-Repack Finance Resource-Project Management Services- 18736
Amount:
$4,898.00

Component Description:
Repack Finance- Project Management services
Amount:
$4,740.00

Component Description:
KMUM - Point B invoice February 2020
Amount:
$11,773.00

Component Description:
KMUM-Engagement Leader-Project Management Services- 18736
Amount:
$1,463.00

Component Description:
KMUM - Point B invoice July 2020
Amount:
$1,150.00

Component Description:
Project management services
Amount:
$5,056.00

Component Description:
KMUM-Engagement Leader-Project Management Services- 18736 REVISED
Amount:
$3,080.00

Component Description:
KMUM-Repack Finance Resource-Project Management Services- 18736
Amount:
$5,688.00

Component Description:
KMUM-Repack Finance Resource-Project Management Services- 18736. 10/01/2021 - 10/31/2021
Amount:
$4,108.00

Component Description:
KMUM-Engagement Leader-Project Management Services
Amount:
$1,232.00

Component Description:
KMUM-Engagement Leader-Project Management Services- 18736. REVISED
Amount:
$9,661.00

Component Description:
Point B September 2019 invoice for KMUM
Amount:
$2,212.00

Component Description:
Project management services
Amount:
$6,162.00

Component Description:
KMUM-Engagement Leader-Project Management Services- 18736
Amount:
$6,810.00

Component Description:
please see cover letter for the reimbursement amount for the variance in line 3.
Amount:
$9,661.00

Component Description:
KMUM - Point B December 2019 invoice for project management
Amount:
$3,397.00

Component Description:
Point B October 2019 Invoice for KMUM
Amount:
$4,582.00

Component Description:
Point B October invoice for Project management services
Amount:
$4,582.00

Component Description:
Point B June invoice for Project Management service
Amount:
$3,080.00

Component Description:
Point B April invoice for Project Management service
Amount:
$924.00

Component Description:
KMUM - Point B invoice June 2020
Amount:
$16,587.00

Component Description:
KMUM - Point B January 2020 invoice for project management
Amount:
$6,810.00

Component Description:
Point B August invoice for Project Management service
Amount:
$1,463.00

Component Description:
Professional Services for KMUM
Amount:
$1,264.00

Component Description:
Project management services
Amount:
$4,898.00

Component Description:
KMUM-Repack Finance Resource-Project Management Services- 18736
Amount:
$5,056.00

Component Description:
KMUM- Engagement Leader and Finance Resource- Project Management services- 18736
Amount:
$16,587.00

Component Description:
KMUM-Program Leader-Project Management Services
Amount:
$6,810.00

Component Description:
Point B August 2019 invoice for KMUM
Amount:
$1,463.00

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 $80,000.00 $77,825.00 N/A $11,479.27 N/A
Total for all systems $759,928.55 $534,632.40 N/A $297,243.62 N/A
Other Expenses $80,000.00 $77,825.00 $11,479.27
Call Support $6,200.00 $6,200.00 N/A $6,169.27 N/A
RBW ELECTRICAL $3,500.00 $3,500.00 N/A $0.00 N/A
Paul Johnson $3,500.00 $3,500.00 N/A N/A N/A
HOME DEPOT $1,800.00 $1,800.00 N/A $0.00 N/A
AMERICAN TOWER $30,105.00 $30,105.00 N/A $0.00 N/A
MVPD Notification of Channel Change $8,500.00 $8,500.00 N/A $0.00 N/A
Develop and air announcement of upcoming channel change $3,500.00 $3,500.00 N/A $0.00 N/A
Equipment Storage $2,000.00 $2,000.00 N/A $0.00 N/A
Equipment Delivery and Handling Charges $5,000.00 $5,000.00 N/A $0.00 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $2,200.00 $2,200.00 N/A $0.00 N/A
Local Zoning $700.00 $700.00 N/A $0.00 N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $250.00 N/A $0.00 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 $9,500.00 N/A $5,310.00 N/A

Components

Actual Information Description File Name
Call Support

Component Description:
KMUM - 2 Dedicated Bilingual Live Answering Agents for Call Support
Amount:
$3,360.00

Component Description:
KMUM - 2 Dedicated Bilingual Live Answering Agents
Amount:
$3,360.00

Component Description:
Live Answering Enterprise Plan - KMUM and Custom voice mail options
Amount:
$1,348.95

Component Description:
Live Answering Enterprise Plan - KMUM and Custom voice mail options
Amount:
$1,348.95

Component Description:
2 Dedicated Bilingual Live Answering Agents
Amount:
$3,360.00

Component Description:
Live Answering Enterprise Plan- Vendor don't provide quote for such expense
Amount:
$1,348.95

Component Description:
Live Answering Enterprise Plan
Amount:
$1,348.95

Component Description:
Toll free Inbound Minutes for KMUM.
Amount:
$111.37
RBW ELECTRICAL Information not provided.
Paul Johnson Information not provided.
HOME DEPOT Information not provided.
AMERICAN TOWER Information not provided.
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges

Component Description:
Equipment & Delivery charges for stations KNTV
Amount:
$3,533.75
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Local Zoning 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:
KMUM CD FCC ID 18736 Medical Notification Mailing Complete per FCC Repack
Amount:
$2,950.00

Component Description:
Medical Notification Mailing Complete per FCC Repack
Amount:
$2,360.00

Cost Information

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Grand Total

Predetermined
Cost Estimate 		Estimated Cost Actual Cost
Total for all systems $759,928.55 $534,632.40 $297,243.62

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


12/12/2022

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


12/12/2022

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


12/12/2022

Attachments

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