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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:
125417
Service:
LPD
Call Sign:
W26EY-D
Channel:
26 (UHF)
File Number:
0000086947
FRN:
0010274462
Eligibility Status:
Eligible
Date Submitted:
10/25/2021

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

LAWRENCE F. LOESCH

Sole Proprietorship

Doing Business As: LAWRENCE F. LOESCH

P.O. BOX 1418

NAGS HEAD, NC 27959

United States

 +1 (252) 449-8331 rloesch@ecri.net Other

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

J Benjamin Davis

Brooks, Pierce et al.

150 Fayetteville Street

Suite 1700

Raleigh, NC 27601

United States

 +1 (919) 839-0300 bdavis@brookspierce.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 Please see attached exhibit titled FCC Form 399 Displacement Plan Description

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 TAUD500
Year 2012
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 500 W

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

Facility ID Call Sign
190587 W22EN-D
130375 W30DN-D
125413 W24EC-D
125383 W28CJ-D
73366 WOBR-FM
125393 W17CT-D

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 TMU9-1
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 600 W
Justification for New Transmitter Please see attached exhibit titled FCC Form 399 Displacement Plan Description

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? No
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Rigid Conduit and Wiring Yes
Size 3 inches
Length 20.0 feet
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

RF System 6 Channel Manifold

Dielectric RF System 6 Channel Manifold

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 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 2
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 No
RF Field Engineering Services Comprehensive coverage verification via field study No
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

Additional Repack Legal Services Not Otherwise Specified in Form 399

Non-Catalog Legal Services such as review of other miscellaneous non-catalog legal fees

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 Yes
FCC License to Cover Application Yes
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? 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 $61,085.00 $65,572.72 N/A $64,532.72 N/A
Total for all systems $80,357.50 $91,148.22 N/A $78,030.22 N/A
Primary Transmitter TMU9-1 $61,085.00 $65,572.72 $64,532.72
RF System 6 Channel Manifold $31,945.00 $31,945.00 N/A $31,945.00 N/A
3" Rigid Conduit and Wiring (Cost per foot) $1,040.00 $1,040.00 N/A N/A N/A
UHF - Air Cooled Solid State Transmitter 320 - 700 Watts $28,100.00 $32,587.72 Existing transmitter cannot be retuned to the required frequency. $32,587.72 Additional expenses were incurred as indicated in the attached invoices.

Components

Actual Information Description File Name
RF System 6 Channel Manifold

Component Description:
Combiner and freight
Amount:
$31,945.00
3" Rigid Conduit and Wiring (Cost per foot) Information not provided.
UHF - Air Cooled Solid State Transmitter 320 - 700 Watts

Component Description:
New Transmitter plus taxes
Amount:
$32,587.72

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 $16,327.50 $22,630.50 N/A $13,497.50 N/A
Total for all systems $80,357.50 $91,148.22 N/A $78,030.22 N/A
Outside Professional Services $16,327.50 $22,630.50 $13,497.50
Additional Repack Legal Services Not Otherwise Specified in Form 399 $2,500.00 $2,500.00 N/A $804.50 N/A
Prepare/ Review 399 reimbursement form $1,710.00 $6,532.00 Additional expenses were incurred as indicated in the attached invoices. $6,532.00 Additional expenses were incurred as indicated in the attached invoices.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $1,577.50 $1,577.50 N/A $302.50 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $3,025.00 $3,025.00 N/A $817.50 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 $1,000.00 N/A
Prepare request for Special Temporary Authorization $2,560.00 $4,041.00 Additional expenses were incurred as indicated in the attached invoices. $4,041.00 Additional expenses were incurred as indicated in the attached invoices.
Perform engineering study for displacement application $1,800.00 $1,800.00 N/A $0.00 N/A

Components

Actual Information Description File Name
Additional Repack Legal Services Not Otherwise Specified in Form 399

Component Description:
Additional Repack Legal Services Not Otherwise Specified in Form 399
Amount:
$103.00

Component Description:
Additional Repack Legal Services Not Otherwise Specified in Form 399
Amount:
$72.00

Component Description:
Additional Repack Legal Services Not Otherwise Specified in Form 399
Amount:
$54.50

Component Description:
Additional Repack Legal Services Not Otherwise Specified in Form 399
Amount:
$272.50

Component Description:
Additional Repack Legal Services Not Otherwise Specified in Form 399
Amount:
$302.50
Prepare/ Review 399 reimbursement form

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$79.50

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$82.50

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$106.00

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$132.50

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$79.50

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$690.00

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$4,196.00

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$212.00

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$556.50

Component Description:
Prepare/ Review 399 reimbursement form
Amount:
$397.50
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
Prepare and file displacement license application
Amount:
$302.50
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Legal fees for preparation of displacement construction permit application.
Amount:
$817.50
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

Component Description:
Prepare Technical Portion of Displacement CP Application
Amount:
$1,000.00
Prepare request for Special Temporary Authorization

Component Description:
Finalize STA extension request
Amount:
$159.00

Component Description:
Preparation and filing of STA
Amount:
$3,465.00

Component Description:
Prepare request for STA
Amount:
$417.00
Perform engineering study for displacement application 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 $2,945.00 $2,945.00 N/A $0.00 N/A
Total for all systems $80,357.50 $91,148.22 N/A $78,030.22 N/A
Other Expenses $2,945.00 $2,945.00 $0.00
Equipment Storage $1,500.00 $1,500.00 N/A $0.00 N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $335.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,110.00 N/A N/A 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 $80,357.50 $91,148.22 $78,030.22

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.

Lawrence F. Loesch

Individual


10/25/2021

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.

Lawrence F. Loesch

Individual


10/25/2021

Attachments

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