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:
69535
Service:
LPA
Call Sign:
WRCX-LP
Channel:
9 (High VHF)
File Number:
0000088408
FRN:
0004279584
Eligibility Status:
Eligible
Date Submitted:
10/19/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

ROSS COMMUNICATIONS, LTD.

Doing Business As: ROSS COMMUNICATIONS, LTD.

Glenn N. Ross

708 WEST HILLCREST AVENUE

DAYTON, OH 45406

United States

+1 (937) 275-7677 skipross3@gmail.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

Tony Zummallen

Anywave Communication Technologies

Tony Zummallen

300 Knightsbridge Parkway

Suite 150

Lincolnshire, IL 60069

United States

+1 (816) 882-5600 tony.zummallen@anywavecom.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 Replace the transmitter and antenna per the channel relocation project using reasonable and customary engineering and business practices.

Transmitters

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

Primary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Primary (Main)
Ownership Owned
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model SBTXU-RFA-2000
Year 2015
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 2 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 TXVD-2000
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2 kW
Justification for New Transmitter Replace the transmitter per the channel relocation project

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Other Transmitter Costs
Does the transmitter installation require a Transmitter Building Site Survey/Installation? Yes
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Rigid Conduit and Wiring No
Other Electrical Service No
HVAC Service Does the replacement transmitter require HVAC Service? No
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Taxes

Estimated sales tax

Emergency Alert System

Emergency alert system replacement due to Repack

Decommission

Decommission old transmitter

Encoder

Encoder

Shipping

Estimated shipping

Site Prep

Prepare site for installation of new transmitter

Antennas

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

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Primary (Main)
Ownership Owned
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type
Mounting Side Mount
Antenna position in stack Top
Polarization Horizontal
Type Slotted Coaxial
ERP: 34.0 kW
Manufacturer
Model JA/LS-AB-24
Year 2015

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Change Type Purchase New
Ownership Owned
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types
Mounting Side Mount
Antenna position in stack Top
Polarization Horizontal
Type Slotted Coaxial
ERP: 3.0 kW
Manufacturer
Model PA31-SDP
Year 2019
Justification for New Antenna Replace the antenna per the channel relocation project

Primary Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? No
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? Yes
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

Taxes

Estimated sales tax

Shipping

Estimated shipping costs

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)
Ownership Owned
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 Flexible Air
Diameter Other
Other Diameter 2 1/4 inches
Number of parallel runs 1
Length 1000 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Flexible Foam
Diameter 1 5/8 inches
Number of parallel runs 1
Length 1000 feet per run
Justification for New Transmission Line Original line will not be able to mate with new antenna or transmitter due to no connectors nor adapters for existing line available.
Interior RF Systems Does the Installation of the Transmission Line require an additional or replacement Inside RF system including switching, patch panels, and dehydrators? No

Primary 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)
Ownership Leased
Is this tower consider Complex? Located on Building
Is this tower currently shared with any other stations? No
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1013716
Coordinates (NAD83) Latitude (NAD83) 39° 43' 28.0" N-
Longitude (NAD83) 084° 15' 18.0" W-
Overall Structure Height 1152.87 feet
Support Structure Height 1099.07 feet
Ground Elevation Above Mean Sea Level (AMSL) 895.99 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner WRGT-TV
Date Constructed 08/15/1984


Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Tower mapping and report for structural engineer
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 Located on Building
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 200
Explanation Required to assist in the turnkey management of the channel relocation project in order that the existing internal personnel can maintain and operate the stations daily operational requirements and plans.
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 Yes
Quantity 1
Prepare Form 601 Yes
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 1
Negotiation of Lease and other Matter for Shared Locations Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Form 399 assistance or other program management costs Yes
RF Field Engineering Services Comprehensive coverage verification via field study Yes
RF exposure measurements No
Additional Field Engineering Service No

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

General Legal

General Legal Services for Repack

General Consulting Engineering

General Consulting Engineering services as needed.

Engineering Services

Engineering Services - Interior equipment installation and testing

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Permit and Filing Costs FCC Construction Permit Major Change Yes
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
Point to Point Microwave (STL/ICR) Frequency Coordination for Unidirection System No
Frequency Coordination for Bi-Direction System No
New Point to Point Microwave System No

Other Expenses

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Other Expenses Not Listed

Information not provided.

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 $191,158.70 $139,983.70 N/A $107,585.00 N/A
Total for all systems $487,443.70 $442,661.99 N/A $155,562.29 N/A
Primary Transmitter TXVD-2000 $191,158.70 $139,983.70 $107,585.00
Site Prep $7,000.00 $7,000.00 Estimated costs to prepare site for transmitter installation crew. Includes receiving and inventory of transmitter and all components; pre-assembly of cabinets and subasssemblies; ensuring site has all materials required by installation crew $0.00 N/A
Shipping $4,750.00 $4,750.00 Freight for all equipment on Transcom Invoice 11520CH9ttl-2 $5,060.00 Freight for all equipment on Transcom invoice including transmitter, mask filter, encoder, antenna, emergency alert system and transmission line/components
Encoder $49,221.20 $49,221.20 Per attached Transcom quote. $33,392.50 Per actual invoice and quote from Transcom Corporation.
Decommission $6,000.00 $6,000.00 Estimated costs to deinstall, disconnect and decommission old transmitter in preparation for installation of new transmitter. $0.00 N/A
Taxes $10,100.00 $10,100.00 Estimated sales tax $0.00 N/A
High VHF - Air Cooled Solid State Transmitter 1.1 - 4.4 kW $101,000.00 $52,425.00 N/A $52,425.00 N/A
Transmitter Building Site Survey/Installation $10,000.00 $7,400.00 Estimated costs for site survey and transmitter installation. Revised upon Site Survey. $7,400.00 N/A
Emergency Alert System $3,087.50 $3,087.50 Replacement of Emergency Alert System due to repack. Purchase of Gorman Redlich EASCG1-2R per Transcom Corporation Invoice # 11520CH9ttl-2 and quote. $9,307.50 actual costs per vendor invoice from Transcom. INV WRCX72420-EAS

Components

Actual Information Description File Name
Site Prep Information not provided.
Shipping

Component Description:
Shipping & Handling for encoder. Transcom INV WRCX72420
Amount:
$310.00

Component Description:
Freight for all equipment on Transcom INV 11520CH9ttl-2
Amount:
$4,750.00

Component Description:
Estimated shipping on transmitter, line, antenna. INV 72320-1
Amount:
$4,750.00
Encoder

Component Description:
Simple, single-channel encoder. WRCX - INV 72320-3
Amount:
$33,392.50

Component Description:
Encoder and IP Transport System. Transcom INV 11520CH9ttl-2
Amount:
$49,221.00

Component Description:
Simple, single channel encoder equivalent reimbursement request. Transcom INV WRCX72420
Amount:
$33,392.50
Decommission Information not provided.
Taxes Information not provided.
High VHF - Air Cooled Solid State Transmitter 1.1 - 4.4 kW

Component Description:
Transmitter and Mask Filter. Transcom INV 11520CH9ttl-2
Amount:
$50,130.00

Component Description:
Revised Transmitter and Mask filter - WRCX - Transcom - INV 72320-1
Amount:
$52,425.00
Transmitter Building Site Survey/Installation

Component Description:
Equipment installation - WRCX - Transcom - INV 72320-1
Amount:
$7,400.00
Emergency Alert System

Component Description:
EAS system. Transcom INV WRCX72420-EAS
Amount:
$9,307.50

Component Description:
Gorman Redlich EASCG1-2R Emergency Alert System components - Transcom INV 11520CH9ttl-2
Amount:
$3,087.50

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 $20,910.00 $20,910.00 N/A $6,555.00 N/A
Total for all systems $487,443.70 $442,661.99 N/A $155,562.29 N/A
Primary Antenna PA31-SDP $20,910.00 $20,910.00 $6,555.00
Shipping $2,000.00 $2,000.00 Estimated shipping and freight. Actual costs to be determined. $0.00 N/A
Taxes $2,000.00 $2,000.00 Estimated sales tax $0.00 N/A
Side Mount antenna brackets $4,625.00 $4,625.00 N/A $0.00 N/A
High VHF-Low Power, Side Mount, Slotted Coaxial, 3.0kW input, Horizontal $6,555.00 $6,555.00 Per attached Transcom quote. $6,555.00 N/A
Sweep test of transmission line and antenna $5,730.00 $5,730.00 N/A $0.00 N/A

Components

Actual Information Description File Name
Shipping Information not provided.
Taxes Information not provided.
Side Mount antenna brackets Information not provided.
High VHF-Low Power, Side Mount, Slotted Coaxial, 3.0kW input, Horizontal

Component Description:
Antenna - Transcom INV 11520CH9ttl-2
Amount:
$6,555.00

Component Description:
VHF Side mounted antenna - WRCX - Transcom - INV 72320-1
Amount:
$6,555.00
Sweep test of transmission line and antenna 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 $24,000.00 $16,596.29 N/A $16,596.29 N/A
Total for all systems $487,443.70 $442,661.99 N/A $155,562.29 N/A
Primary Transmission Line $24,000.00 $16,596.29 $16,596.29
Flexible Foam Transmission Line - dielectric, 1 5/8" $24,000.00 $16,596.29 N/A $16,596.29 N/A

Components

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

Component Description:
Cellflex line, connectors, cable, accessories and 10' 7/8 jumper. Transcom INV 11520CH9ttl-2
Amount:
$15,352.79

Component Description:
TX line and jumper. WRCX - Transcom - INV 72320-1
Amount:
$16,596.29

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 $101,000.00 $101,000.00 N/A $0.00 N/A
Total for all systems $487,443.70 $442,661.99 N/A $155,562.29 N/A
Primary Tower TOWER $101,000.00 $101,000.00 $0.00
Tower mapping and report for structural engineer $21,000.00 $21,000.00 N/A $0.00 N/A
Complex Tower (includes, e.g., towers with candelabras and/or stacked antennas) $50,000.00 $50,000.00 Estimated costs of tower rigging. Actual costs to be determined. $0.00 N/A
Minor tower reinforcement/modifications $30,000.00 $30,000.00 Estimated cost of modifications to tower, if required by study. $0.00 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 $136,665.00 $150,462.00 N/A $24,826.00 N/A
Total for all systems $487,443.70 $442,661.99 N/A $155,562.29 N/A
Outside Professional Services $136,665.00 $150,462.00 $24,826.00
Engineering Services $7,400.00 $7,400.00 Engineering services (Transcom Corporation) for interior equipment installation and Testing. Transcom invoice 11520CH9ttl-2 and quote $0.00 N/A
General Consulting Engineering $5,000.00 $5,000.00 Consulting Engineer services if needed. $1,290.00 N/A
Comprehensive coverage verification via field study, if needed $52,600.00 $43,732.00 Per attached quote 706-R $0.00 N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $2,235.00 $2,235.00 N/A $0.00 N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $3,262.50 $3,262.50 N/A $0.00 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $1,577.50 $1,577.50 N/A $0.00 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $3,025.00 $12,000.00 Estimate of attorney fees for preparation of CP. Actual costs to be determined. $0.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,052.50 $1,052.50 N/A $0.00 N/A
Perform engineering study for displacement application $1,800.00 $5,000.00 Estimate of engineering fees for displacement application. Actual costs to be determined. $2,850.00 N/A
Form 399 assistance or other Program Management costs $21,290.00 $21,290.00 Per Anywave Quote # PR1910-0534 dated 10/16/19, line items 1 & 3 PLUS Additional Hours quote PR2008-0919. $9,586.00 N/A
Prepare/ Review 399 reimbursement form $1,710.00 $2,500.00 Per attached Anywave quote PR1910-0534 dated 10/16/19 $2,500.00 N/A
Prepare Form 601 $755.00 $755.00 N/A $0.00 N/A
Project management of the transition $21,100.00 $30,800.00 Estimated 200 hours at $154/hour $0.00 N/A
General Legal $10,475.00 $10,475.00 General legal expenses due to Repack $8,600.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $2,102.50 $2,102.50 N/A $0.00 N/A
Prepare request for Special Temporary Authorization $1,280.00 $1,280.00 N/A $0.00 N/A

Components

Actual Information Description File Name
Engineering Services

Component Description:
Engineering services from Transcom - interior equipment installation and testing - Transcom INV 11520CH9ttl-2
Amount:
$7,400.00
General Consulting Engineering

Component Description:
Consulting Engineering - Vendor name Lohnes & Culver - INV 202009-1607-01-69535
Amount:
$1,290.00
Comprehensive coverage verification via field study, if needed Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations 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 engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Perform engineering study for displacement application

Component Description:
WRCX - T Z Sawyer - engineering services - INV 18003
Amount:
$2,850.00
Form 399 assistance or other Program Management costs

Component Description:
Paper PM - August 2020 - Anywave INV FA2010-0604
Amount:
$2,610.30

Component Description:
Anywave May 2020 PM Hours - INV FA2008-500
Amount:
$500.50

Component Description:
July hours - paperwork PM - Anywave - FA2009-0581
Amount:
$3,511.20

Component Description:
8-13-20 See cover letter. Prepare and process form 399. Anywave invoice 7448-01.
Amount:
$500.00

Component Description:
Anywave - June 2020 PM Hours - INV FA2008-0522
Amount:
$1,470.70

Component Description:
Anywave - March, April 2020 PM hours - INV FA2008-0499
Amount:
$993.30
Prepare/ Review 399 reimbursement form

Component Description:
399 form submittal by 11/14/19. Anywave INV 7448-01
Amount:
$2,500.00
Prepare Form 601 Information not provided.
Project management of the transition Information not provided.
General Legal

Component Description:
Requesting current charges only. "and" was substituted for special character "&" in vendor name. INV 212192
Amount:
$2,200.00

Component Description:
See cover letter for explanation of variance. "and" was substituted for special character "&". INV 215793
Amount:
$1,875.00

Component Description:
Requesting current charges only. "and" was substituted for special character "&" in vendor name. INV 211063
Amount:
$250.00

Component Description:
Requesting current charges only. "and" substituted for special character "&" in vendor name. INV 205545
Amount:
$125.00

Component Description:
Current charges only. "and" was substituted for special character "&" in vendor name. INV 214223
Amount:
$125.00

Component Description:
Current charges only. "and" substituted for "&" in vendor name. INV 204690
Amount:
$125.00

Component Description:
Requesting current charges only. "and" substituted for special character "&" in vendor name. INV 201999
Amount:
$375.00

Component Description:
Current charges only. Vendor Name is Fletcher, Heald & Hildreth, P.L.C; "and" was substituted for special character "&". INV 201903
Amount:
$375.00

Component Description:
Requesting current charges only. "and" was substituted for special character "&" in vendor name. INV 218792
Amount:
$150.00

Component Description:
8-13-20 Zeroed out. Duplicate invoice. See cover letter for explanation of variance. "and" was substituted for special character "&". INV 215793
Amount:
N/A

Component Description:
Amount requested is total current charges. "and" was substituted for special character "&" in vendor name. INV 210300
Amount:
$500.00

Component Description:
Requesting current charges only. "and" substituted for special character "&" in vendor name. INV 206210
Amount:
$375.00

Component Description:
Current charges only. "and" was substituted for special character "&" on vendor name. INV 218145
Amount:
$1,000.00

Component Description:
Total amount of invoice on this submission is the total current amount. "and" was substituted for special character "&" on vendor name. INV 206731
Amount:
$750.00

Component Description:
Requesting current charges only. "and" was substituted for special character "&" on vendor name. INV 212924
Amount:
$375.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Prepare request for Special Temporary Authorization 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 $13,710.00 $13,710.00 N/A $0.00 N/A
Total for all systems $487,443.70 $442,661.99 N/A $155,562.29 N/A
Other Expenses $13,710.00 $13,710.00 $0.00
Disposal Costs (for equipment and other waste, net of any salvage value) $2,000.00 $2,000.00 4-6 yard disposal bin on site to capture all waste from on site system integration and tower vendors $0.00 N/A
FCC Filing Fees - Special Temporary Authorization request $305.00 $305.00 N/A $0.00 N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,110.00 N/A $0.00 N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $335.00 N/A $0.00 N/A
FCC Filing Fees - Form 2100 Major change CP application $4,960.00 $4,960.00 N/A $0.00 N/A
Equipment Delivery and Handling Charges $2,500.00 $2,500.00 Estimated costs to transport, rent forklift and handling fees from staging area to transmitter site $0.00 N/A
Equipment Storage $2,500.00 $2,500.00 Expecting multiple staggered equipment deliveries from different vendors and need to store and stage new equipment prior to installation date. Anticipate 6-24 months of storage time. $0.00 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 $487,443.70 $442,661.99 $155,562.29

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.

Glenn Ross

Sole Proprietor


10/19/2020

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.

Glenn Ross

Sole Proprietor


10/19/2020

Attachments

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