Applicant | Address | Phone | Applicant Type | |
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MOHAVE COUNTY BOARD OF SUPERVISORS Applicant Doing Business As: MOHAVE COUNTY BOARD OF SUPERVISORS |
PO BOX 7000 KINGMAN, AZ 86402 United States |
+1 (928) 753-0729 | yvonne.orr@mohavecounty.us | Other |
Applicant | Address | Phone | |
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[Confidential] |
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Applicant | Address | Phone | |
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The Preparer is same as the reimbursement contact. |
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Question | Response |
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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 | Transition complete required based on T-Mobile/FCC Repackaging |
Section | Question | Response |
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Transmitter Related Expenses | Do you have transmitter related expenses? | No |
Section | Question | Response |
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Antenna Related Expenses | Do you have antenna related expenses? | Yes |
Section | Question | Response |
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Existing Antenna Description | Type of change | Purchase New |
Antenna Use | Primary (Main) | |
Ownership | Owned | |
Is the existing antenna shared with another station or stations? | No | |
Is the existing antenna directional? | Yes | |
Is antenna in operating condition? | Yes | |
Is antenna located on or in close proximity to an antenna farm? | No | |
Existing Antenna Manufacturer and Type | ||
Mounting | Top Mount | |
Antenna position in stack | Not in Stack | |
Polarization | Horizontal | |
Type | Broadband Panel | |
Number of Stations Supported | 1 | |
Number of Panels | 1 | |
Design power capacity in use | 5.0 % | |
Lower Limit | 602.00 MHz | |
Upper Limit | 608.00 MHz | |
ERP: | 60.0 W | |
Manufacturer | ||
Model | 4DR-4S | |
Year | 2019 |
Section | Question | Response |
---|---|---|
New Antenna Description | Use | Primary (Main) |
Change Type | Purchase New | |
Ownership | Owned | |
Is antenna shared? | No | |
Is antenna directional? | Yes | |
Will antenna be located on or in close proximity to an antenna farm? | No | |
New Antenna Manufacturer and Types | ||
Mounting | Top Mount | |
Antenna position in stack | Not in Stack | |
Polarization | Horizontal | |
Type | Broadband Panel | |
Number of Stations Supported | 1 | |
Number of Panels/Bays | 1 | |
Lower Limit | 602.00 MHz | |
Upper Limit | 608.00 MHz | |
Design power capacity in use | 5.0 % | |
ERP: | 60.0 W | |
Manufacturer | ||
Model | 4DR-4S | |
Year | 2019 | |
Justification for New Antenna | Existing antenna cannot be modified or re-tuned. New build required to match assigned frequency. |
Section | Question | Response |
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Elbow Complex | Do you require the separate purchase of the Elbow Complex? | 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? | No |
Power Dividers | Does the panel antenna require power dividers? | No |
Cable Harness | Does the panel antenna require cable harness? | No |
Section | Question | Response |
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Transmission Line Related Expenses | Do you have transmission line related expenses? | No |
Section | Question | Response |
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Tower Equipment or Rigging Costs Changes | Do you have tower equipment or rigging costs changes? | No |
Section | Question | Response |
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Outside Project Management Services | Do you require outside project management services? | No |
Outside RF consulting Engineering Services | Perform engineering study for displacement application | 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 | |
Prepare Form 601 | No | |
Attorney and Other Outside Consulting Services | Prepare and file Form FCC Construction Permit Application | Yes |
For Auxiliary Facility | No | |
For Main Facility | Yes | |
Prepare and file Form FCC License to Cover Application | Yes | |
For Auxiliary Facility | No | |
For Main Facility | Yes | |
Prepare request for Special Temporary Authority | No | |
Negotiation of Lease and other Matter for Shared Locations | No | |
Prepare or Review FCC Form 399 for Reimbursement | No | |
Form 399 assistance or other program management costs | No | |
RF Field Engineering Services | Comprehensive coverage verification via field study | No |
RF exposure measurements | No | |
Additional Field Engineering Service | No |
Section | Question | Response |
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AM Pattern Disturbance | Is an Impact Study needed? | No |
Is Remediation needed? | No | |
Permit and Filing Costs | FCC Construction Permit Major Change | No |
FCC Construction Permit Minor Change | No | |
FCC License to Cover Application | No | |
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)? | No |
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? | No | |
Does this relocation require Equipment Storage? | No | |
Point to Point Microwave (STL/ICR) | Frequency Coordination for Unidirection System | No |
Frequency Coordination for Bi-Direction System | No | |
New Point to Point Microwave System | No |
Name | Description |
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Construction |
Actual |
Staff expenses |
8 hours 63.90 |
Technical expense |
2 hours at 33.95 |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
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Sub-total | $1,750.00 | $1,396.99 | N/A | $0.00 | N/A |
Total for all systems | $14,606.60 | $7,871.18 | N/A | $0.00 | N/A |
Primary Antenna 4DR-4S | $1,750.00 | $1,396.99 | $0.00 | ||
UHF Broadband panel antenna (per panel), horizontally-polarized | $1,750.00 | $1,396.99 | Actual + Shipping & Band Pass Filer | N/A | N/A |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $9,557.50 | $3,175.09 | N/A | $0.00 | N/A |
Total for all systems | $14,606.60 | $7,871.18 | N/A | $0.00 | N/A |
Outside Professional Services | $9,557.50 | $3,175.09 | $0.00 | ||
Prepare engineering section of FCC Form 2100 (main), License to Cover Application | $1,052.50 | $2,284.72 | Actual | N/A | N/A |
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application | $2,102.50 | $0.00 | N/A | N/A | N/A |
Perform engineering study for displacement application | $1,800.00 | $0.00 | N/A | N/A | N/A |
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | $1,577.50 | $890.37 | Actual | N/A | N/A |
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application | $3,025.00 | $0.00 | N/A | N/A | N/A |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
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Sub-total | $3,299.10 | $3,299.10 | N/A | $0.00 | N/A |
Total for all systems | $14,606.60 | $7,871.18 | N/A | $0.00 | N/A |
Other Expenses | $3,299.10 | $3,299.10 | $0.00 | ||
Construction | $2,720.00 | $2,720.00 | Actual | N/A | N/A |
Technical expense | $67.90 | $67.90 | Actual | $0.00 | N/A |
Staff expenses | $511.20 | $511.20 | Actual | N/A | N/A |
Predetermined Cost Estimate |
Estimated Cost | Actual Cost | |
---|---|---|---|
Total for all systems | $14,606.60 | $7,871.18 | $0.00 |
Question | Response |
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The facility has ceased operating on its pre-auction channel. | |
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 |
Section | Question | Response |
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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. |
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I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above. | Yvonne Orr Administrative Services Director 09/30/2020 |