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:
69922
Service:
LPT
Call Sign:
K47IK
Channel:
30 (UHF)
File Number:
0000089841
FRN:
0005009618
Eligibility Status:
Eligible
Date Submitted:
06/14/2021

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

THE CAMP VERDE TV CLUB

Doing Business As: THE CAMP VERDE TV CLUB

Roger Doering

420 W Angus Dr

CAMP VERDE, AZ 86322

United States

+1 (928) 399-9402 rpd@verdeonline.com Not-for-Profit

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

Nick Solano

Anywave Communications Technologies

Nick Solano

300 Knightsbridge Parkway, Suite 150

Lincolnshire, IL 60069

United States

+1 (816) 882-5600 nick.solano@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. Yes
Briefly describe transition plan Install transmitter and combiner. K30OI and K32ME plan to share antenna with combiner.

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? Yes
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model MX-20U
Year 2004
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity .02 kW

Facility ID's and Call Signs of all stations with whom the transmitter is shared.

Facility ID Call Sign
69924 K49HP

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 TRN-U-200-D-FB
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 200 W
Justification for New Transmitter Lowest power transmitter sold manufactured by Anywave.

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

Combiner

Combiner for K32ME and K30OI

Antennas

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Section Question Response
Antenna Related Expenses Do you have antenna related expenses? No

Transmission Line

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

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? No

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? No
Outside RF consulting Engineering Services Perform engineering study for displacement application No
Prepare engineering section of Form FCC Construction Permit Application No
Prepare engineering section of Form FCC License to Cover Application No
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 No
Prepare and file Form FCC License to Cover Application No
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 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

Engineering-General

Engineering Consultation

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 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

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 $35,700.00 $34,485.00 N/A $0.00 N/A
Total for all systems $95,370.00 $85,287.00 N/A $0.00 N/A
Primary Transmitter TRN-U-200-D-FB $35,700.00 $34,485.00 $0.00
UHF - Air Cooled Solid State Transmitter 160 - 300 Watts $24,300.00 $23,085.00 Per attached quote PR1911-0589 N/A N/A
Transmitter Building Site Survey/Installation $10,000.00 $10,000.00 N/A N/A N/A
Combiner $1,400.00 $1,400.00 N/A N/A N/A

Components

Information not provided.

Cost Information

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Antennas

Information not provided.

Cost Information

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Transmission Line

Information not provided.

Cost Information

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Tower Equipment and Rigging Costs

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 $59,670.00 $50,802.00 N/A $0.00 N/A
Total for all systems $95,370.00 $85,287.00 N/A $0.00 N/A
Outside Professional Services $59,670.00 $50,802.00 $0.00
Engineering-General $360.00 $360.00 Cost determined by invoices. $0.00 N/A
Comprehensive coverage verification via field study, if needed $52,600.00 $43,732.00 Per-attached quote number 744-R for Coverage Verification N/A N/A
Prepare/ Review 399 reimbursement form $1,710.00 $1,710.00 N/A N/A N/A
Form 399 assistance or other Program Management costs $5,000.00 $5,000.00 N/A $0.00 N/A

Components

Actual Information Description File Name
Engineering-General

Component Description:
Consultation Services
Amount:
$360.00
Comprehensive coverage verification via field study, if needed Information not provided.
Prepare/ Review 399 reimbursement form Information not provided.
Form 399 assistance or other Program Management costs

Component Description:
Paperwork PM
Amount:
$369.60

Component Description:
Paperwork PM
Amount:
$492.80

Component Description:
Paperwork PM
Amount:
$882.42

Component Description:
Paperwork PM
Amount:
$200.20

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 $0.00 $0.00 N/A $0.00 N/A
Total for all systems $95,370.00 $85,287.00 N/A $0.00 N/A
Other Expenses $0.00 $0.00 $0.00

Components

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $95,370.00 $85,287.00 $0.00

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

Attachments

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