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:
18410
Service:
DTV
Call Sign:
WIDP
Channel:
34 (UHF)
File Number:
0000026596
FRN:
0011244886
Date Submitted:
01/08/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

EBENEZER BROADCASTING GROUP, INC.

WILLIAM ADORNO

PO Box 13428

San Juan, Puerto Rico 00908

Puerto Rico

7879990360 ingenieriaebn@gmail.com Not-for-Profit

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. Yes
Briefly describe transition plan Both station will be planning the installation at the same time with the same rigger company and possibly using the same transmitter/antenna manufacturer. Both stations are co-located in the same tower and share the building.

Transmitters

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

Auxiliary Transmitter

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Add Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Auxiliary (Backup)
Description of Use Backup used when Main transmitter fail or needs repair/maintenace
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 Affinity
Year 2000
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 0.5 kW

Auxiliary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Auxiliary (Backup)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model EC701HP-BB
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 0.7 kW
Justification for New Transmitter Existing transmitter manufacturer not longer on the market.

Auxiliary 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 Yes
Size 1 inches
Length 30.0 feet
Other Electrical Service Yes
Description Panel breaker, grounding system, connecting cables.
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

Auxiliary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Transportation and Shipping

Crating, transportation, shipping costs to Puerto Rico

PR Local Taxes

11.5% tax over purchase

System Design Service and Site Survey

Visit to coordinate system design, installation and site survey.

8-Pole Filter

8-Pole Filter 8-VSB adjacent channels

Primary Transmitter

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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 Ultimate TDU2 1K40
Year 2006
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1.4 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 EC703HP-BB
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2.5 kW
Justification for New Transmitter Existing transmitter manufacturing company does not exist and/or is not bringing technical support to this transmitter. Transmitter TPO increased to achieve the assigned ERP with the selected antenna and transmission line.

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 Yes
Size 2 inches
Length 30.0 feet
Other Electrical Service Yes
Description Additional protection circuit breaker and surge suppressor, electrical conduits and cables, grounding system, etc.
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

Shipping and Transportation

Crating, shipping and transportation cost to Puerto Rico

Transmitter 8-Pole Filter

8-Pole filter to protect adjacent channels from IX.

PR Local Taxes

11.5% over purchase

Installation, Commisssioning and Proof of Performance

Main TX installation installation, checkout, commissioning, proof of performance, etc.

5 KW RF Package

Includes frame to install filter, system load, directional couplers, 3-port patch. Replace existing RF system (See attachment)

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)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
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 Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
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: 50.1 kW
Manufacturer
Model ALP32M5-HSP-46
Year 2001

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? Yes
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 Full Power
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: 40.3 kW
Manufacturer
Model PSILPD24AW-34-CP
Year 2018
Justification for New Antenna Old slotted antenna is not tunable to new frequency. Antenna slots reduced to decrease the antenna size and weight, and decrease load to the tower. Same antenna pattern of existing one.

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? No
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? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? Yes
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

Dehydrator

Transmission line dehydrator, accessories.

PR Local Taxes

11.5% tax over purchase

Transportation Shipping

Crating, shipping, transportation to Puerto Rico

Elbows

Three 1-5/8" Elbows to connect transmission line to antenna

Antenna Tower Installation

Installation and riggers costs

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 Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
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: 50.1 kW
Manufacturer
Model ALP32M5-HSP-46
Year 2001

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? Yes
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 Full Power
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: 40.3 kW
Manufacturer
Model PSILPD24AW-34-CP
Year 2018
Justification for New Antenna Old slotted antenna is not tunable to new frequency. Antenna slots reduced to decrease the antenna size and weight, and decrease load to the tower. Same antenna pattern of existing one.

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? No
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? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? Yes
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.

Interim Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
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 Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
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: 20.0 kW
Manufacturer
Model PSILP8AW-34
Year 2018
Justification for New Antenna To be used during installation of the new main antenna. Antenna could be used later with the new assigned channel after conversion.

Interim Antenna

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Other Antenna Costs

Section Question Response
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 an 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

Interim Antenna

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Other Antenna Cost Not Listed

Name Description

Shipping, Transportation

Crating, shipping and transportation to Puerto Rico

Antenna Tower Installation

Antenna installation and rigger costs

PR Local Taxes

11.5% local taxes over purchase

Transmission Line

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Section Question Response
Transmission Line Related Expenses Do you have transmission line related expenses? Yes

Interim Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Interim
Description of Use N/A
Change Type Purchase New
Type Flexible Foam
Diameter 1 5/8 inches
Segment Length N/A
Other Segment Length
Number of parallel runs 1
Length 325 feet per run
Justification for New Transmission Line Transmission line to be used with the interim antenna during new main antenna installation. (Transmission line corrected to 325 FT)

Interim Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Connectors Adapters

1-5/8" Adapters, connectors

PR Local Taxes

11.5% Tax over purchase

Transmission Line Installation

Installation and rigger costs related to line installation

Transportation Shipping

Crating, shipping, transportation to Puerto Rico

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)
Description of Use N/A
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 Yes
Is tower documented for structural analysis? No
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1027505
Coordinates (NAD83) Latitude (NAD83) 18° 16' 37.0" N-
Longitude (NAD83) 065° 51' 08.0" W-
Overall Structure Height 265.74 feet
Support Structure Height 265.74 feet
Ground Elevation Above Mean Sea Level (AMSL) 2522.94 feet
Structure Type LTOWER - Lattice Tower
Tower Owner EBENEZER BROADCASTING GROUP INC
Date Constructed 07/06/2000

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
67190 WVSN DTV

Other Types of Users

Users
Internet Wirele

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 needed for undocumented/poorly documented 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

Antennas relocation on tower

Some antennas need to be moved to permit the new installations

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 200
Explanation Religious station with limited technical personnel with the expertise necessary to handle this type of project.
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 Yes
Quantity 2
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 Yes
Quantity 2
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification Yes
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 No
RF exposure measurements Yes
Additional Field Engineering Service Yes
Number of Days 10
Justification Verify installation and coordination with parallel installations in the same tower, buildings. Coordinate channel switching to new frequency with other stations on August 1, 2018.

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Information not provided.

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 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 Yes
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

Station Personnel

Extra time incurred by station personnel and travel expenses.

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 $266,814.00 $244,984.00 N/A $119,481.02 N/A
Total for all systems $904,487.00 $818,997.00 N/A $194,556.22 N/A
Primary Transmitter EC703HP-BB $194,803.00 $172,973.00 $87,850.52
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $104,200.00 From vendor proposal $52,100.00 N/A
2" Rigid Conduit and Wiring (Cost per foot) $780.00 $750.00 N/A N/A N/A
Other Electrical Service: Additional protection circuit breaker and surge suppressor, electrical conduits and cables, grounding system, etc. $3,000.00 $3,000.00 Estimated materials and installation costs. $1,004.02 N/A
Installation, Commisssioning and Proof of Performance $15,800.00 $15,800.00 From vendor proposal $7,900.00 N/A
5 KW RF Package $26,036.00 $26,036.00 From vendor proposal $13,018.00 N/A
PR Local Taxes $16,000.00 $16,000.00 Puerto Rico local taxes (11.5%) over purchases $10,235.00 N/A
Shipping and Transportation $5,340.00 $5,340.00 From vendor proposal. Amount corrected. $2,670.00 N/A
Transmitter 8-Pole Filter $1,847.00 $1,847.00 From vendor proposal. Amount corrected. $923.50 N/A
Auxiliary Transmitter EC701HP-BB $72,011.00 $72,011.00 $31,630.50
PR Local Taxes $8,000.00 $8,000.00 Puerto Rico 11.5% Tax N/A N/A
Transportation and Shipping $5,340.00 $5,340.00 Estimated from vendor proposal. Amount corrected. $2,670.00 N/A
UHF - Air Cooled Solid State Transmitter 0.7 kW $40,000.00 $40,000.00 From vendor proposal $20,000.00 N/A
1" Rigid Conduit and Wiring $400.00 $400.00 Material and installation. N/A N/A
Other Electrical Service: Panel breaker, grounding system, connecting cables. $1,500.00 $1,500.00 Electrical connection, materials and installation. $575.00 N/A
System Design Service and Site Survey $15,300.00 $15,300.00 From vendor proposal $7,650.00 N/A
8-Pole Filter $1,471.00 $1,471.00 From vendor proposal $735.50 N/A

Components

Actual Information Description File Name
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
Item #1 (2.5Kw Transmitter) 50% Contract Price
Amount:
$52,100.00
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Other Electrical Service: Additional protection circuit breaker and surge suppressor, electrical conduits and cables, grounding system, etc.

Component Description:
Electrical Parts
Amount:
$1,004.02
Installation, Commisssioning and Proof of Performance

Component Description:
Item #1 (Instalation) 50% Contract Price
Amount:
$7,900.00
5 KW RF Package

Component Description:
Item #6 50% Contract Price
Amount:
$13,018.00
PR Local Taxes

Component Description:
Puerto Rico Local Taxes for Transmitter
Amount:
$10,235.00
Shipping and Transportation

Component Description:
Airport Entry Cargo Fees
Amount:
$709.38

Component Description:
Ground transportation to the transmition site.
Amount:
$400.00

Component Description:
Item #3 50% Contract Price
Amount:
$2,670.00
Transmitter 8-Pole Filter

Component Description:
Item #6 (8 pole Filter) 50% Contract Price
Amount:
$923.50
PR Local Taxes Information not provided.
Transportation and Shipping

Component Description:
Item #4 (Shipping) 50% Contract Price
Amount:
$2,670.00
UHF - Air Cooled Solid State Transmitter 0.7 kW

Component Description:
Item #2 (.7 Kw Aux Transmitter) 50% Contract Price
Amount:
$20,000.00
1" Rigid Conduit and Wiring Information not provided.
Other Electrical Service: Panel breaker, grounding system, connecting cables.

Component Description:
Labor of the Electrician
Amount:
$575.00
System Design Service and Site Survey

Component Description:
Item #5 (System Design) 50% Contract Price
Amount:
$7,650.00
8-Pole Filter

Component Description:
Item #2 (Aux 8 Pole Filter) 50% Contract Price
Amount:
$735.50

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 $170,238.00 $133,028.00 N/A $51,603.75 N/A
Total for all systems $904,487.00 $818,997.00 N/A $194,556.22 N/A
Interim Antenna PSILP8AW-34 $26,680.00 $26,350.00 $14,825.00
UHF - High Power, Side Mount, basic slot antenna, 20 kW input, directional,, horizontally polarized $11,550.00 $11,550.00 Vendor proposal $11,550.00 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Antenna Tower Installation $3,500.00 $3,500.00 Estimated. Waiting final quote. N/A N/A
Shipping, Transportation $3,500.00 $3,500.00 Estimated. Waiting for final costs $3,275.00 N/A
PR Local Taxes $1,400.00 $1,400.00 Puerto Rico 11.5% Tax N/A N/A
Primary Antenna PSILPD24AW-34-CP $108,418.00 $106,678.00 $36,778.75
Antenna Tower Installation $10,000.00 $10,000.00 Estimated until rigger provide final cost. N/A N/A
Elbows $2,000.00 $2,000.00 Five 3-1/8" elbows cost, shipping, installation N/A N/A
Transportation Shipping $4,500.00 $4,500.00 Estimated. Vendor will provide final cost. $0.00 N/A
PR Local Taxes $5,500.00 $5,500.00 Puerto Rico 11.5% Tax N/A N/A
Dehydrator $4,500.00 $4,500.00 To pressurize with dry air the transmission line and antenna $2,128.75 N/A
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $5,000.00 N/A N/A N/A
UHF - High Power, Side Mount, basic slot antenna, 40 kW input, directional,, elliptically or circularly polarized $46,778.00 $46,778.00 Old slotted antenna is not tunable to new frequency. Antenna slots reduced to decrease the antenna size and weight, and decrease load to the tower. Same antenna pattern of existing one. $34,650.00 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $22,000.00 N/A N/A N/A
Primary Antenna PSILPD24AW-34-CP $35,140.00 $0.00 $0.00
UHF - High Power, Side Mount, basic slot antenna, 40 kW input, directional,, elliptically or circularly polarized $0.00 $0.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $0.00 N/A N/A N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $0.00 N/A N/A N/A
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $0.00 N/A N/A N/A

Components

Actual Information Description File Name
UHF - High Power, Side Mount, basic slot antenna, 20 kW input, directional,, horizontally polarized

Component Description:
50% Down payment due with order. Balance due prior to shipment.
Amount:
$5,775.00

Component Description:
Final 50% Interim 8 bay antenna.
Amount:
$5,775.00
Sweep test of existing antenna Information not provided.
Antenna Tower Installation Information not provided.
Shipping, Transportation

Component Description:
Freight Charge
Amount:
$3,275.00
PR Local Taxes Information not provided.
Antenna Tower Installation Information not provided.
Elbows Information not provided.
Transportation Shipping Information not provided.
PR Local Taxes Information not provided.
Dehydrator

Component Description:
Final 50 % Item #8 APD-20D Air Dehydrator
Amount:
$1,064.38

Component Description:
First 50% item #8
Amount:
$1,064.37
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) Information not provided.
UHF - High Power, Side Mount, basic slot antenna, 40 kW input, directional,, elliptically or circularly polarized

Component Description:
Main Antenna upgrade. (Station pay upgrade difference Price)
Amount:
$34,650.00
Sweep test of existing antenna Information not provided.
Side mount brackets for high power antennas (if not included in antenna base cost) Information not provided.
UHF - High Power, Side Mount, basic slot antenna, 40 kW input, directional,, elliptically or circularly polarized Information not provided.
Sweep test of existing antenna Information not provided.
Side mount brackets for high power antennas (if not included in antenna base cost) Information not provided.
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) Information not provided.

Cost Information

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Transmission Line

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 $18,750.00 $17,850.00 N/A $4,127.45 N/A
Total for all systems $904,487.00 $818,997.00 N/A $194,556.22 N/A
Interim Transmission Line $18,750.00 $17,850.00 $4,127.45
Transportation Shipping $3,500.00 $3,500.00 Estimated crating and transportation to Puerto Rico. Waiting for final costs from vendor. $505.80 N/A
Transmission Line Installation $4,000.00 $4,000.00 Estimated until rigger provide costs. N/A N/A
PR Local Taxes $950.00 $950.00 Puerto Rico 11.5% Tax N/A N/A
Connectors Adapters $2,500.00 $2,500.00 N/A $1,596.90 N/A
Flexible Foam Transmission Line - dielectric, 1 5/8" $7,800.00 $6,900.00 N/A $2,024.75 N/A

Components

Actual Information Description File Name
Transportation Shipping

Component Description:
First 50% Packing Fee Item #9
Amount:
$86.26

Component Description:
Freight Charge
Amount:
$333.29

Component Description:
Final 50% Packing Fee Item #9
Amount:
$86.25
Transmission Line Installation Information not provided.
PR Local Taxes Information not provided.
Connectors Adapters

Component Description:
First 50% Connectors supplies. Items # 2, 3, 4, 5, 6, 7.
Amount:
$798.45

Component Description:
Final 50% Connectors supplies. Items # 2, 3, 4, 5, 6, 7 -PSJ-158EIA 1-5/8" EJA Connector for 1-5/8" -CONN FEE Connector -CLAMP-158 Hanger Kits, Bolit-On -RMA-BI Round Member -Adapter Kit 2-3" -HOIST I-I 58L -GKFORM60-l 58
Amount:
$798.45
Flexible Foam Transmission Line - dielectric, 1 5/8"

Component Description:
Final 50% Transmission Line Item #1
Amount:
$1,012.37

Component Description:
First 50% Transmission Line Item #1
Amount:
$1,012.38

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 $272,500.00 $259,000.00 N/A $0.00 N/A
Total for all systems $904,487.00 $818,997.00 N/A $194,556.22 N/A
Primary Tower LTOWER $272,500.00 $259,000.00 $0.00
Short Tower (less than 500') $84,200.00 $80,000.00 N/A N/A N/A
Antennas relocation on tower $4,000.00 $4,000.00 Estimated N/A N/A
Minor tower reinforcement/modifications $158,000.00 $150,000.00 N/A N/A N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $25,000.00 N/A N/A N/A

Components

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 $96,195.00 $84,750.00 N/A $19,344.00 N/A
Total for all systems $904,487.00 $818,997.00 N/A $194,556.22 N/A
Outside Professional Services $96,195.00 $84,750.00 $19,344.00
Additional Field Engineering Service, 10 Days $5,000.00 $5,000.00 10 days @ $500 per day professional services N/A N/A
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A
Project management of the transition $31,600.00 $24,000.00 N/A $19,344.00 N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A 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
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $4,100.00 $3,000.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $7,360.00 $7,000.00 N/A N/A N/A
ASR modification (prepare FCC Form 854) $2,105.00 $2,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Additional Field Engineering Service, 10 Days Information not provided.
RF Exposure Measurements Information not provided.
Project management of the transition

Component Description:
Project Engineering Management Services
Amount:
$19,344.00
Prepare and or review reimbursement form Information not provided.
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Perform engineering study for new channel assignment and antenna development Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare request for Special Temporary Authorization Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
ASR modification (prepare FCC Form 854) Information not provided.

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 $79,990.00 $79,385.00 N/A $0.00 N/A
Total for all systems $904,487.00 $818,997.00 N/A $194,556.22 N/A
Other Expenses $79,990.00 $79,385.00 $0.00
DTV Medical Facility Notification $11,550.00 $11,000.00 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
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $20,000.00 $20,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $15,000.00 $15,000.00 N/A N/A N/A
Equipment Storage $5,000.00 $5,000.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $2,500.00 $2,500.00 N/A N/A N/A
MVPD Notification of Channel Change $10,000.00 $10,000.00 N/A N/A N/A
Station Personnel $14,300.00 $14,300.00 See attachment "WIDP Station Personnel Expenses" N/A N/A

Components

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $904,487.00 $818,997.00 $194,556.22

Reimbursement Status

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Question Response
The facility has ceased operating on its pre-auction channel. No
Construction of final facilities or all necessary modifications are complete. No
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.

Ricardo Montanez

President of board


01/08/2019

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.

William Adorno

General Manager


01/08/2019

Attachments

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