| Applicant | Address | Phone | Applicant Type | |
|---|---|---|---|---|
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KPVM TELEVISION, INC. Doing Business As: KPVM TELEVISION, INC. |
890 S. HIGLEY PAHRUMP, NV 89041 United States |
+1 (775) 727-9400 | videovern@kpvm.tv | Corporation |
| Applicant | Address | Phone | |
|---|---|---|---|
|
[Confidential] |
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| Applicant | Address | Phone | |
|---|---|---|---|
|
The Preparer is same as the reimbursement contact. |
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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 | KPVM Ch 46 displaced into the core and T-Mobile Oct 2018 off ch 46. |
| Section | Question | Response |
|---|---|---|
| Transmitter Related Expenses | Do you have transmitter related expenses? | Yes |
| 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 | 1 | |
| Year | 2017 | |
| Type | Solid State | |
| Solid State Cooling | Air Cooled | |
| Solid State Power Capacity | 1 kW |
| Section | Question | Response |
|---|---|---|
| New Transmitter | Use | Primary (Main) |
| Change Type | Purchase New | |
| Is this a request for upgraded equipment? | No | |
| Manufacturer | ||
| Model | BE-TV1k2-FA-U | |
| Transmitter Type | Solid State | |
| Solid State Cooling | Air Cooled | |
| Solid State Power capacity | 1.2 kW | |
| Justification for New Transmitter | Old transmitter could not be retuned from Ch 46 to Ch 25. |
| 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 |
| Name | Description |
|---|---|
Interim Facility |
due to T-Mobile shut down. |
| Section | Question | Response |
|---|---|---|
| Antenna Related Expenses | Do you have antenna related expenses? | Yes |
| 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? | No | |
| 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 | Not in Stack | |
| Polarization | Horizontal | |
| Type | Slotted Coaxial | |
| ERP: | 10.7 kW | |
| Manufacturer | ||
| Model | PSILP | |
| Year | 2017 |
| 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? | Yes | |
| New Antenna Manufacturer and Types | ||
| Mounting | Side Mount | |
| Antenna position in stack | Not in Stack | |
| Polarization | Horizontal | |
| Type | Other | |
| Other Antenna Type | PRTV-25/50 Paraflector | |
| ERP: | 13.0 kW | |
| Manufacturer | ||
| Model | PRTV-25/50 Paraflector | |
| Year | 2018 | |
| Justification for New Antenna | Displaced channel required directional array at new location to avoid interference. |
| 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 |
| Name | Description |
|---|---|
Interim Facility |
Temporary antenna due to coverage issues related to STA to operate while coordinating CP buildout. |
| Section | Question | Response |
|---|---|---|
| Transmission Line Related Expenses | Do you have transmission line related expenses? | Yes |
| 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? | No | |
| Existing Transmission Line Manufacturer and Type | Manufacturer | |
| Type | Flexible Foam | |
| Diameter | 1 5/8 inches | |
| Number of parallel runs | 1 | |
| Length | 220 feet per run |
| 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 | 250 feet per run | |
| Justification for New Transmission Line | New line required to construction of CP at new location. | |
| Interior RF Systems | Does the Installation of the Transmission Line require an additional or replacement Inside RF system including switching, patch panels, and dehydrators? | Yes |
| Section | Question | Response |
|---|---|---|
| Tower Equipment or Rigging Costs Changes | Do you have tower equipment or rigging costs changes? | Yes |
| Section | Question | Response |
|---|---|---|
| Existing Tower Description | Type of change | Move Equipment |
| Tower Use | Primary (Main) | |
| Ownership | Owned | |
| Is this tower consider Complex? | No | |
| Is this tower currently shared with any other stations? | No | |
| Is tower documented for structural analysis? | Unknown | |
| Is tower compliant with Rev G? | Unknown | |
| Existing Tower Structure Registration | Do you have a tower registration number? | No |
| Coordinates (NAD83) | Latitude (NAD83) | 36° 12' 24.8" N- |
| Longitude (NAD83) | 115° 57' 38.0" W- | |
| Overall Structure Height | 194.00 feet | |
| Support Structure Height | 194.00 feet | |
| Ground Elevation Above Mean Sea Level (AMSL) | 2871.00 feet | |
| Structure Type | TOWER - Free Standing or Guyed Structure | |
| Tower Owner | KPVM | |
| Date Constructed | 01/01/2007 |
| Section | Question | Response |
|---|---|---|
| Tower Rigging Costs | Complex Tower | N/A |
| Helicopter Services Required | Are helicopter services required? | No |
| Name | Description |
|---|---|
STA installation |
tower rigging for STA and trouble shooting cable / antenna problem |
| 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 | Yes |
| Prepare engineering section of Form FCC Construction Permit Application | No | |
| 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 | 3 | |
| 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 | No |
| RF exposure measurements | No | |
| Additional Field Engineering Service | No |
| 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 | 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)? | 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 |
|---|---|
Misc |
STA associated interim expenses |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $100,191.70 | $48,654.96 | N/A | $48,654.96 | N/A |
| Total for all systems | $216,093.96 | $94,117.36 | N/A | $94,117.36 | N/A |
| Primary Transmitter BE-TV1k2-FA-U | $100,191.70 | $48,654.96 | $48,654.96 | ||
| Transmitter Building Site Survey/Installation | $10,000.00 | $0.00 | Cost catalog | $0.00 | N/A |
| Interim Facility | $6,191.70 | $6,191.70 | Gapinski etc | $6,191.70 | N/A |
| UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW | $84,000.00 | $42,463.26 | BE Transmitter Quote encoder | $42,463.26 | N/A |
| Actual Information Description | File Name |
|---|---|
| Transmitter Building Site Survey/Installation | Information not provided. |
| Interim Facility | |
| UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $20,807.45 | $11,675.26 | N/A | $11,675.26 | N/A |
| Total for all systems | $216,093.96 | $94,117.36 | N/A | $94,117.36 | N/A |
| Primary Antenna PRTV-25/50 Paraflector | $20,807.45 | $11,675.26 | $11,675.26 | ||
| Side Mount antenna brackets | $4,625.00 | $722.81 | 18.76 Autozone misc parts 112.75 H & H Pipe misc parts 591.80 Patterson Fabrication | $722.81 | N/A |
| Interim Facility | $3,365.36 | $3,365.36 | See ERI Quote | $3,365.36 | N/A |
| Sweep test of transmission line and antenna | $5,730.00 | $500.00 | 500 Todd Comm 12/31/18 | $500.00 | N/A |
| UHF-Low Power, Side Mount, Other, 13.0kW input, Horizontal | $7,087.09 | $7,087.09 | PRTV Array . BWS Inv 5931 | $7,087.09 | N/A |
| Actual Information Description | File Name |
|---|---|
| Side Mount antenna brackets | |
| Interim Facility | |
| Sweep test of transmission line and antenna | |
| UHF-Low Power, Side Mount, Other, 13.0kW input, Horizontal |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $14,612.31 | $12,107.14 | N/A | $12,107.14 | N/A |
| Total for all systems | $216,093.96 | $94,117.36 | N/A | $94,117.36 | N/A |
| Primary Transmission Line | $14,612.31 | $12,107.14 | $12,107.14 | ||
| Flexible Foam Transmission Line - dielectric, 1 5/8" | $6,000.00 | $3,494.83 | 2881.58 250 ft Eupen include freight | $3,494.83 | N/A |
| Interior RF Systems: Inside RF system including switching, patch panels and dehydrators | $8,612.31 | $8,612.31 | BE Sales Order A600274 | $8,612.31 | N/A |
| Actual Information Description | File Name |
|---|---|
| Flexible Foam Transmission Line - dielectric, 1 5/8" | |
| Interior RF Systems: Inside RF system including switching, patch panels and dehydrators |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $68,440.00 | $13,450.00 | N/A | $13,450.00 | N/A |
| Total for all systems | $216,093.96 | $94,117.36 | N/A | $94,117.36 | N/A |
| Primary Tower TOWER | $68,440.00 | $13,450.00 | $13,450.00 | ||
| STA installation | $12,250.00 | $12,250.00 | 1800 Errett 1800 21 Century 1800 Donovan 750 Cooley 300 Glazener 300 Donovan 200 Errett 200 Donovan 600 21 Century Remove 600 Donovan 600 Errett 1200 21 Century AL8 1200 Donovan 1200 ERRETT | $12,250.00 | N/A |
| Tower Rigging Short Tower (less than 500') | $56,190.00 | $1,200.00 | 300 21 Century 150 Donovan 750 21 Century | $1,200.00 | N/A |
| Actual Information Description | File Name |
|---|---|
| STA installation | |
| Tower Rigging Short Tower (less than 500') |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $11,402.50 | $7,870.00 | N/A | $7,870.00 | N/A |
| Total for all systems | $216,093.96 | $94,117.36 | N/A | $94,117.36 | N/A |
| Outside Professional Services | $11,402.50 | $7,870.00 | $7,870.00 | ||
| Prepare engineering section of FCC Form 2100 (main), License to Cover Application | $1,052.50 | $60.00 | BWS Inv 6233 | $60.00 | N/A |
| Form 399 assistance or other Program Management costs | $3,000.00 | $3,000.00 | BWS Eligibility 1876 preparation / submission See BWS Inv 6214 & Estimate | $3,000.00 | actual cost |
| Prepare/ Review 399 reimbursement form | $1,710.00 | $3,710.00 | actual cost | $3,710.00 | actual cost |
| Prepare request for Special Temporary Authorization | $3,840.00 | $200.00 | 100 5896 50 6068 50 6138 | $200.00 | N/A |
| Perform engineering study for displacement application | $1,800.00 | $900.00 | 450 BWS 5896 450 BWS 6101 | $900.00 | N/A |
| Actual Information Description | File Name |
|---|---|
| Prepare engineering section of FCC Form 2100 (main), License to Cover Application | |
| Form 399 assistance or other Program Management costs | |
| Prepare/ Review 399 reimbursement form | |
| Prepare request for Special Temporary Authorization | |
| Perform engineering study for displacement application |
| Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
|---|---|---|---|---|---|
| Sub-total | $640.00 | $360.00 | N/A | $360.00 | N/A |
| Total for all systems | $216,093.96 | $94,117.36 | N/A | $94,117.36 | N/A |
| Other Expenses | $640.00 | $360.00 | $360.00 | ||
| Misc | $0.00 | $0.00 | REcap Rebranding Expense | $0.00 | N/A |
| FCC Filing Fees - Special Temporary Authorization request | $305.00 | $190.00 | BWS 5876 | $190.00 | N/A |
| FCC Filing Fees - Form 2100 license to cover application | $335.00 | $170.00 | BWS Inv 6233 | $170.00 | N/A |
| Actual Information Description | File Name |
|---|---|
| Misc | |
| FCC Filing Fees - Special Temporary Authorization request | |
| FCC Filing Fees - Form 2100 license to cover application |
| Predetermined Cost Estimate |
Estimated Cost | Actual Cost | |
|---|---|---|---|
| Total for all systems | $216,093.96 | $94,117.36 | $94,117.36 |
| Question | Response |
|---|---|
| The facility has ceased operating on its pre-auction channel. | Yes |
| 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. | Yes |
| 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. |
|
| I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above. | Susan Hansen Consultant 11/03/2021 |
| 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. |
|
| I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above. | Vernon VanWinkle President 11/03/2021 |
