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:
3001
Service:
DTV
Call Sign:
WCCV-TV
Channel:
35 (UHF)
File Number:
0000026050
FRN:
0009237223
Date Submitted:
06/19/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

ASOCIACION EVANGELISTICA CRISTO VIENE, INC.

Doing Business As: ASOCIACION EVANGELISTICA CRISTO VIENE, INC.

Tomas Figueroa

PO BOX 949

CAMUY, PR 00627

United States

+1 (787) 262-5400 gerenciacdm@gmail.com Corporation

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

The Preparer is same as the reimbursement contact.

 

 

 

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan We will be replacing our exisitng transmitter and the antenna.

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 Ultimate HF
Year 2001
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 2 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 EC702HP-BB
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2 kW
Justification for New Transmitter This transmitter replace and existing 2 KW backup transmitter

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 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

Auxiliary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Shipping and Crating

TV Transmitter Installation

TV Transmitter Installation

Tv Transmitter installation

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 DTT5KSU
Year 2006
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 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? No
Manufacturer
Model MPTV-PRLX-U4
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 5 kW
Justification for New Transmitter Existing transmitter manufacturer no longer on the market.

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 panel breaker, safety switches for liquid pumps, electrical conduits and cables, 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? Yes
Size 400.0 square feet
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 Crating

Tv Shipping and Crating

Materials Cooling System

Distilled water for transmitter colling system

Local Puerto Rico Taxes

Local PR Taxes 11.5% over purchase

Transmitter Cooling System

Ethylene Glycol

Transmitter Installation

TV Transmitter Installation

Transmitter Proof of Performance

Tv Transmitter Proof of Performance

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 JA/MS-16/46 SHP
Year 2008

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: 40.6 kW
Manufacturer
Model PSILP16AP-35-EP
Year 2018
Justification for New Antenna Existing antenna can't be frequency change.

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? Yes
Broadband or Single Channel? Single Channel
Feed Line Size 3 1/8 inches inches
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

Connectors Adapters

Connectors, adapters, miscellaneous materials.

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 PSILP8AP-35
Year 2018
Justification for New Antenna Antenna to be used during installation of the new main antenna. Later this antenna could be used with the new assigned frequency.

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

Connectors Adapters

To be used to couple the antenna and transmission line

Transmission Line

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

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Rigid
Diameter 4 1/16 inches
Other Diameter N/A
Segment Length 19 1/2 inches
Other Segment Length N/A
Number of parallel runs 1
Length 580 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Rigid
Diameter 3 1/8 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 580 feet per run
Justification for New Transmission Line Existing line is for operation on CH 46, for new assigned channel 35 the line must be 20 FT segment lengths.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Connectors Adapters

Adapters, connectors and miscellaneous materials for installation.

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 250 feet per run
Justification for New Transmission Line Line for interim antenna

Interim Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

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? No
One or more FM, AM or TV radio broadcaster(s) N/A
Others Types of Users N/A
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 1041596
Coordinates (NAD83) Latitude (NAD83) 18° 13' 59.0" N-
Longitude (NAD83) 066° 45' 35.0" W-
Overall Structure Height 547.89 feet
Support Structure Height 547.89 feet
Ground Elevation Above Mean Sea Level (AMSL) 3051.14 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner ASOCIACION EVANGELISTICA CRISTO VIENE INC DBA = LA CADENA DEL MILAGRO
Date Constructed 08/01/1991


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: Major 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

Information not provided.

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 750
Explanation It is a religious station with limited operating costs and do not have personnel with the expertise and qualifications to manage a complicated project like this.
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 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 No
RF exposure measurements Yes
Additional Field Engineering Service Yes
Number of Days 10
Justification Transmitter related RF components connections, test coordination with Arecibo Observatory and other local entities.

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 $541,710.28 $442,446.28 N/A $279,746.28 N/A
Total for all systems $1,680,510.78 $1,536,131.78 N/A $297,013.61 N/A
Primary Transmitter MPTV-PRLX-U4 $396,421.28 $355,991.28 $236,718.78
Transmitter Proof of Performance $13,100.00 $13,100.00 N/A $6,550.00 N/A
Transmitter Installation $18,635.00 $18,635.00 N/A $9,317.50 N/A
Transmitter Cooling System $1,299.20 $1,299.20 N/A $1,299.20 N/A
Local Puerto Rico Taxes $32,442.08 $32,442.08 WCCV Puerto Rico Local taxes for Comark-Hitachi main and auxiliary transmitters $32,442.08 N/A
Materials Cooling System $208.00 $208.00 N/A $208.00 N/A
Shipping and Crating $11,457.00 $11,457.00 N/A $5,728.50 N/A
Other -- Building Addition Size: 400.0 $40,000.00 $40,000.00 N/A N/A N/A
Other Electrical Service: Additional panel breaker, safety switches for liquid pumps, electrical conduits and cables, etc. $5,000.00 $5,000.00 N/A N/A N/A
2" Rigid Conduit and Wiring (Cost per foot) $780.00 $750.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW $273,500.00 $233,100.00 N/A $181,173.50 N/A
Auxiliary Transmitter EC702HP-BB $145,289.00 $86,455.00 $43,027.50
TV Transmitter Installation $13,549.00 $13,549.00 N/A $6,774.50 N/A
Shipping and Crating $5,340.00 $5,340.00 N/A $2,670.00 N/A
1" Rigid Conduit and Wiring $400.00 $400.00 N/A N/A N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $67,166.00 N/A $33,583.00 N/A

Components

Actual Information Description File Name
Transmitter Proof of Performance

Component Description:
First 50% payment of Tv Transmitter Proof of Prformance
Amount:
$6,550.00
Transmitter Installation

Component Description:
First 50% Payment of Tv Transmitter installation
Amount:
$9,317.50
Transmitter Cooling System

Component Description:
Ethylene Glycol transmitter coolling system
Amount:
$1,299.20
Local Puerto Rico Taxes

Component Description:
WCCV Puerto Rico Local Taxes for Comark-Hitachi main and auxiliary transmitters
Amount:
$32,442.08
Materials Cooling System

Component Description:
Destilled water for transmitter cooling system.
Amount:
$208.00
Shipping and Crating

Component Description:
First 50% Payment of Shipping of TV transmitter
Amount:
$5,728.50
Other -- Building Addition Size: 400.0 Information not provided.
Other Electrical Service: Additional panel breaker, safety switches for liquid pumps, electrical conduits and cables, etc. Information not provided.
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
UHF - Liquid Cooled Solid State Transmitter 4.9 . 6.5 kW

Component Description:
50 % Payment of TV Transmitter Paralax U4 D35 invoice due.
Amount:
$181,173.50
TV Transmitter Installation

Component Description:
First 50% payment of Tv tranmitter installation
Amount:
$6,774.50
Shipping and Crating

Component Description:
First 50% payment of Tv Transmitter Shipping and Crating
Amount:
$2,670.00
1" Rigid Conduit and Wiring Information not provided.
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
First 50% Payment of Tv Transmitter
Amount:
$33,583.00

Cost Information

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Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $104,000.50 $101,730.50 N/A $14,136.33 N/A
Total for all systems $1,680,510.78 $1,536,131.78 N/A $297,013.61 N/A
Interim Antenna PSILP8AP-35 $22,725.50 $22,395.50 $3,458.00
Connectors Adapters $2,500.00 $2,500.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
UHF - High Power, Side Mount, basic slot antenna, 20 kW input, directional,, horizontally polarized $10,037.50 $10,037.50 N/A N/A N/A
UHF - High Power, Side Mount, basic slot antenna, 20 kW input, horizontally polarized $3,458.00 $3,458.00 ***System Notice: Estimate adjusted and locked because line has been superseded.*** $3,458.00 N/A
Primary Antenna PSILP16AP-35-EP $81,275.00 $79,335.00 $10,678.33
Connectors Adapters $6,500.00 $6,500.00 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 $5,000.00 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
Elbow complex, single channel, at antenna input, per 3 1/8. feedline (if needed) $7,600.00 $7,400.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
UHF - High Power, Side Mount, basic slot antenna, 41 kW input, directional,, elliptically or circularly polarized $32,035.00 $32,035.00 N/A $10,678.33 N/A

Components

Actual Information Description File Name
Connectors Adapters Information not provided.
Sweep test of existing antenna Information not provided.
UHF - High Power, Side Mount, basic slot antenna, 20 kW input, directional,, horizontally polarized Information not provided.
UHF - High Power, Side Mount, basic slot antenna, 20 kW input, horizontally polarized

Component Description:
First 1/3 payment of the cost of the antenna that is due now
Amount:
$3,458.00
Connectors Adapters Information not provided.
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) Information not provided.
Side mount brackets for high power antennas (if not included in antenna base cost) Information not provided.
Elbow complex, single channel, at antenna input, per 3 1/8. feedline (if needed) Information not provided.
Sweep test of existing antenna Information not provided.
UHF - High Power, Side Mount, basic slot antenna, 41 kW input, directional,, elliptically or circularly polarized

Component Description:
First 1/3 payment of the cost of the primary Antenna that is Due now.
Amount:
$10,678.33

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 $72,820.00 $73,120.00 N/A $1,131.00 N/A
Total for all systems $1,680,510.78 $1,536,131.78 N/A $297,013.61 N/A
Interim Transmission Line $6,000.00 $9,200.00 $1,131.00
Flexible Foam Transmission Line - dielectric, 1 5/8" $6,000.00 $9,200.00 N/A $1,131.00 N/A
Primary Transmission Line $66,820.00 $63,920.00 $0.00
Connectors Adapters $6,500.00 $6,500.00 N/A N/A N/A
Rigid Transmission Line - copper, 3 1/8" $60,320.00 $57,420.00 N/A N/A N/A

Components

Actual Information Description File Name
Flexible Foam Transmission Line - dielectric, 1 5/8"

Component Description:
First 1/3 payment of the cost of the transmission line its due now
Amount:
$1,131.00
Connectors Adapters Information not provided.
Rigid Transmission Line - copper, 3 1/8" 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 $657,800.00 $625,000.00 N/A $0.00 N/A
Total for all systems $1,680,510.78 $1,536,131.78 N/A $297,013.61 N/A
Primary Tower TOWER $657,800.00 $625,000.00 $0.00
Major tower reinforcement/modifications $421,000.00 $400,000.00 N/A N/A N/A
Tall Tower (greater than 500') $210,500.00 $200,000.00 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 $180,990.00 $171,250.00 N/A $0.00 N/A
Total for all systems $1,680,510.78 $1,536,131.78 N/A $297,013.61 N/A
Outside Professional Services $180,990.00 $171,250.00 $0.00
Additional Field Engineering Service, 10 Days $5,000.00 $5,000.00 N/A N/A N/A
RF Exposure Measurements $21,050.00 $20,000.00 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
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 FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $4,100.00 $3,000.00 N/A N/A N/A
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 engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 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
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A
Project management of the transition $118,500.00 $112,500.00 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.
Attorney Fees - Prepare and File request for Special Temporary Authorization 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 Information not provided.
Prepare request for Special Temporary Authorization Information not provided.
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 Information not provided.
Perform engineering study for new channel assignment and antenna development Information not provided.
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form Information not provided.
Project management of the transition

Component Description:
WCCV Repack Project Management Engineering Services
Amount:
$55,380.00

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 $123,190.00 $122,585.00 N/A $2,000.00 N/A
Total for all systems $1,680,510.78 $1,536,131.78 N/A $297,013.61 N/A
Other Expenses $123,190.00 $122,585.00 $2,000.00
Station Personnel $30,000.00 $30,000.00 Extra time incurred by station personnel and travel expenses. N/A N/A
MVPD Notification of Channel Change $10,000.00 $10,000.00 N/A $0.00 N/A
Develop and air announcement of upcoming channel change $10,000.00 $10,000.00 N/A N/A N/A
Equipment Storage $5,000.00 $5,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $25,000.00 $25,000.00 Very difficult roads and mountain area. N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $30,000.00 $30,000.00 N/A N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A $2,000.00 N/A

Components

Actual Information Description File Name
Station Personnel 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 Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
FCC Filing Fees - Special Temporary Authorization request 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:
WCCV Notification of a Medical Facility
Amount:
$2,000.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $1,680,510.78 $1,536,131.78 $297,013.61

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. Yes
All receipts for reimbursement have been submitted no further costs are expected to be incurred. Note this will lock the Form 399 from further editing and begin close-out procedures with the Fund Administrator. No

Certification

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Section Question Response
Submission of Estimated Expenses Statements

WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT.

  1. The Authorized Person signing below certifies that he/she is authorized to submit this TV Broadcaster Relocation Fund Reimbursement Form on behalf of the above-named entity.

  2. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

  3. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.

  4. The above-named entity certifies that the equipment and services paid for with money from the TV Broadcaster Relocation Fund are necessary to change channels (broadcasters) or to continue to carry the signal of a broadcaster that changes channels (MVPD).

  5. The above-named entity certifies that all payments from the TV Broadcaster Relocation Fund (Fund) received by the entity listed on this form will be used only for expenses that are eligible for reimbursement from the Fund.

  6. The above-named entity certifies that it will maintain and provide to the Commission detailed records, including receipts, of all costs eligible for reimbursement actually incurred.

  7. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.

  8. The above-named entity certifies that it is in full compliance with all statutes, rules, regulations and governmental requirements for which compliance is a pre-requisite for obtaining the payments herein requested.

I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above.

Tomas Figueroa

President


06/19/2019

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.

Tomas Figueroa

President


06/19/2019

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.

Tomas Figueroa

President


06/19/2019

Attachments

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