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:
183761
Service:
LPD
Call Sign:
W05DH-D
Channel:
5 (Low VHF)
File Number:
0000088035
FRN:
0028631521
Eligibility Status:
Eligible
Date Submitted:
01/28/2021

Applicant Information

Back to Top

Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

New Hola TV LLC

Wandeley Gonzalez Macias

6115 Lake Avenue

West Palm Beach, FL 33405

United States

+1 (416) 301-5862 ISSY@HOLATV47.COM Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

Back to Top

Preparer Contact Name and Information

Applicant Address Phone Email

The Preparer is same as the reimbursement contact.

 

 

 

Broadcaster Information and Transition Plan

Back to Top
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 The station is purchasing a new VHF transmitter, antenna, etc. and locating the same at the coordinates approved by the FCC (File No. 0000121282). Once all equipment is in place, the previous UHF equipment will be removed.

Transmitters

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

Primary Transmitter

Back to Top

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 A1KST8U
Year 1998
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1000 W

Primary Transmitter

Back to Top

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 AAT-VHF III-3000
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 3000 W
Justification for New Transmitter Requested by the FCC, due to transmitting frequency change

Primary Transmitter

Back to Top

Other Transmitter Costs

Section Question Response
Other Transmitter Costs
Does the transmitter installation require a Transmitter Building Site Survey/Installation? No
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 Yes
Description all electrical power supply to transmitter
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

Back to Top

Other Transmitter Cost Not Listed

Information not provided.

Antennas

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

Primary Antenna

Back to Top

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? No
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 Broadband Panel
Number of Stations Supported 5
Number of Panels 1
Design power capacity in use 50.0 %
Lower Limit 54.00 MHz
Upper Limit 88.00 MHz
ERP: 500.0 W
Manufacturer
Model CL-26/HCM
Year 2018

Primary Antenna

Back to Top

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? No
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: 500.0 W
Manufacturer
Model CL-26/HCM
Year 2019
Justification for New Antenna requested by FCC Transmitter change from UHF to VHF

Primary Antenna

Back to Top

Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Broadband
Feed Line Size 7/8 inches inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? No
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? Yes
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

Back to Top

Other Antenna Cost Not Listed

Name Description

Filter

Filter

cable

coaxial cable

Modulator

Modulator

Endec

Encoder and decoder

connector

7/16 DIN male connector for 7/8 Coaxial cable

fittings

7/8 fittings

Transmission Line

Back to Top
Section Question Response
Transmission Line Related Expenses Do you have transmission line related expenses? No

Tower Equipment And Rigging Costs

Back to Top
Section Question Response
Tower Equipment or Rigging Costs Changes Do you have tower equipment or rigging costs changes? Yes

Primary Tower

Back to Top

Existing Tower

Section Question Response
Existing Tower Description Type of change Move Equipment
Tower Use Primary (Main)
Ownership
Is this tower consider Complex? No
Is this tower currently shared with any other stations?
Is tower documented for structural analysis?
Is tower compliant with Rev G?
Existing Tower Structure Registration Do you have a tower registration number?
Coordinates (NAD83) Latitude (NAD83) - -
Longitude (NAD83) - -
Overall Structure Height
Support Structure Height
Ground Elevation Above Mean Sea Level (AMSL)
Structure Type -
Tower Owner
Date Constructed


Primary Tower

Back to Top

Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower N/A
Helicopter Services Required Are helicopter services required? No

Primary Tower

Back to Top

Other Tower Expenses Not Listed

Name Description

Tower Climber

Tower climber

Outside Professional Services Costs

Back to Top
Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 40
Explanation Engineering cost and labor crew for specialty and qualified personnel.
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 Yes
Form 399 assistance or other program management costs Yes
RF Field Engineering Services Comprehensive coverage verification via field study No
RF exposure measurements No
Additional Field Engineering Service Yes
Number of Days 15
Justification Mounting Installation, analitics and software installation, and staff trainning.

Outside Professional Services Costs

Back to Top

Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

Back to Top
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 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 Yes
Type Unlicensed

Other Expenses

Back to Top

Other Expenses Not Listed

Information not provided.

Cost Information

Back to Top

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 $64,537.43 $64,537.43 N/A $57,537.43 N/A
Total for all systems $125,091.93 $125,187.93 N/A $63,154.43 N/A
Primary Transmitter AAT-VHF III-3000 $64,537.43 $64,537.43 $57,537.43
Low VHF - Air Cooled Solid State Transmitter 3.0 kW $57,537.43 $57,537.43 N/A $57,537.43 N/A
Other Electrical Service: all electrical power supply to transmitter $7,000.00 $7,000.00 N/A $0.00 N/A

Components

Actual Information Description File Name
Low VHF - Air Cooled Solid State Transmitter 3.0 kW

Component Description:
Transmitter related cost. #02021
Amount:
$57,537.43
Other Electrical Service: all electrical power supply to transmitter Information not provided.

Cost Information

Back to Top

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 $32,730.00 $32,000.00 N/A $0.00 N/A
Total for all systems $125,091.93 $125,187.93 N/A $63,154.43 N/A
Primary Antenna CL-26/HCM $32,730.00 $32,000.00 $0.00
Filter $5,000.00 $5,000.00 N/A $0.00 N/A
cable $2,500.00 $2,500.00 N/A $0.00 Actual cost greater than estimate provided by vendor.
fittings $1,200.00 $1,200.00 N/A N/A N/A
connector $5,000.00 $5,000.00 N/A N/A N/A
Endec $1,700.00 $1,700.00 N/A $0.00 N/A
Modulator $3,600.00 $3,600.00 N/A $0.00 N/A
Low VHF-Low Power, Side Mount, Slotted Coaxial, 500.0watt input, Horizontal $7,000.00 $7,000.00 N/A N/A N/A
Pattern scatter analysis for side mount (if not included in antenna base cost) $1,000.00 $1,000.00 N/A N/A N/A
Sweep test of transmission line and antenna $5,730.00 $5,000.00 N/A N/A N/A
$0.00 $0.00 N/A N/A N/A

Components

Actual Information Description File Name
Filter

Component Description:
Antenna filter
Amount:
$5,000.00
cable

Component Description:
Cable Elia 7/8 500 Feet
Amount:
$7,000.00
fittings Information not provided.
connector Information not provided.
Endec

Component Description:
Encoder and decoder
Amount:
$1,700.00
Modulator

Component Description:
Modulator
Amount:
$3,600.00
Low VHF-Low Power, Side Mount, Slotted Coaxial, 500.0watt input, Horizontal Information not provided.
Pattern scatter analysis for side mount (if not included in antenna base cost) Information not provided.
Sweep test of transmission line and antenna Information not provided.
Information not provided.

Cost Information

Back to Top

Transmission Line

Information not provided.

Cost Information

Back to Top

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 $7,000.00 $7,000.00 N/A $0.00 N/A
Total for all systems $125,091.93 $125,187.93 N/A $63,154.43 N/A
Primary Tower $7,000.00 $7,000.00 $0.00
Tower Climber $7,000.00 $7,000.00 N/A $0.00 N/A

Components

Actual Information Description File Name
Tower Climber

Component Description:
Tower Climber invoice
Amount:
$7,000.00

Cost Information

Back to Top

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 $18,574.50 $20,150.50 N/A $5,617.00 N/A
Total for all systems $125,091.93 $125,187.93 N/A $63,154.43 N/A
Outside Professional Services $18,574.50 $20,150.50 $5,617.00
Project management of the transition $4,220.00 $4,220.00 N/A $3,730.00 Consolidated engineering fee
Form 399 assistance or other Program Management costs $1,887.00 $1,887.00 N/A $1,887.00 N/A
Prepare/ Review 399 reimbursement form $1,710.00 $3,286.00 Unanticipated complexity of completing Form 399 $0.00 Complications with form preparation due to LMS issues and significant time needed to complete forms.
Additional Field Engineering Service, 15 Days $1,200.00 $1,200.00 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 N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $3,025.00 $3,025.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,052.50 $1,052.50 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $2,102.50 $2,102.50 N/A N/A N/A
Perform engineering study for displacement application $1,800.00 $1,800.00 N/A N/A N/A

Components

Actual Information Description File Name
Project management of the transition

Component Description:
Legal Service Cost. #1045240
Amount:
$277.50

Component Description:
Legal Service Cost. #1028634
Amount:
$1,272.00

Component Description:
Legal Service Cost. #1029679
Amount:
$2,014.00

Component Description:
Legal Service Cost. #1037193
Amount:
$166.50

Component Description:
Engineering invoice
Amount:
$8,000.00
Form 399 assistance or other Program Management costs

Component Description:
Form 1876 and Form 399 preparation
Amount:
$277.50

Component Description:
Form 1876 preparation
Amount:
$1,609.50
Prepare/ Review 399 reimbursement form

Component Description:
Legal invoice - Form 399 preparation
Amount:
$2,014.00

Component Description:
Legal invoice - Form 399 preparation
Amount:
$1,272.00
Additional Field Engineering Service, 15 Days 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.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Perform engineering study for displacement application Information not provided.

Cost Information

Back to Top

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 $2,250.00 $1,500.00 N/A $0.00 N/A
Total for all systems $125,091.93 $125,187.93 N/A $63,154.43 N/A
Other Expenses $2,250.00 $1,500.00 $0.00
New Point to Point Microwave System: Unlicensed $2,250.00 $1,500.00 N/A N/A N/A

Components

Information not provided.

Cost Information

Back to Top

Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $125,091.93 $125,187.93 $63,154.43

Reimbursement Status

Back to Top
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

Back to Top
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.

Wandeley Gonzalez Macia

Vice President


01/28/2021

Certification

Back to Top
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.

Wandeley Gonzalez Macias

Vice President


01/28/2021

Attachments

Back to Top