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:
16230
Service:
LPD
Call Sign:
KSOY-LD
Channel:
34 (UHF)
File Number:
0000089365
FRN:
0022119663
Eligibility Status:
Eligible
Date Submitted:
01/25/2023

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

EDUARDO S. GALLEGOS

Applicant

Doing Business As: EDUARDO S. GALLEGOS

5232 RUSTIC MANOR

BROWNSVILLE, TX 78526

United States

+1 (956) 346-5328 EDUARDOGALLEGOS@ME.COM 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

Tony Zummallen

President

QCommunications, LLC

Tony zumMallen

705 SE MELODY LN

STE B

LEES SUMMIT, MO 64063

United States

+1 (816) 729-1177 Tony@qcomm.tv

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 Primary RF 44 to Primary RF 34. We are changing transmission line, replacing filter, and replacing antenna.

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 Retune Existing
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 GatesAir
Model USXT
Year 2014
Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1.5 kW

Primary Transmitter

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Retuning Transmitter Costs

Section Question Response
New Mask Filter Does the transmitter require a new mask filter? Yes
Mask Filter Type Full Service
Power 1.1-2kW
New Exciter Is a new exciter needed? No

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

Manufacturer Technician

Expenses for on-site manufacturer technician to assist with proof and retuning of old 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? Yes
Existing Antenna Manufacturer and Type
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 1
Number of Panels 16
Design power capacity in use 50.0 %
Lower Limit 650.00 MHz
Upper Limit 656.00 MHz
ERP: 15.0 kW
Manufacturer
Model ALP16L2-8SER-44
Year 2014

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? Yes
New Antenna Manufacturer and Types
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
ERP: 15.0 kW
Manufacturer
Model TLP-16M (SP)
Year 2022
Justification for New Antenna Old antenna cannot be retuned.

Primary Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Single Channel
Feed Line Size 4 1/16 inches inches
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? Yes
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

11000013395

Adaptor SMA (F) to Type-N (M)

300000839

Jumper Cable 7/8" Foam Flex 1-5/8 Conn 9 Feet LG

Mounting Plates

Mounting Plates

Connectors

Connectors

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 Leased
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 Rigid
Diameter 4 1/16 inches
Segment Length 20 inches
Number of parallel runs 72
Length 20 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 Rigid
Diameter 4 1/16 inches
Segment Length 19 1/2 inches
Number of parallel runs 72
Length 19 feet per run
Justification for New Transmission Line Electrical performance of the current line is not compatible with RF 34
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

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Removal of Existing Line

Costs to remove existing transmission line

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? Candelabra
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users Yes
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1222106
Coordinates (NAD83) Latitude (NAD83) 26° 06' 02.3" N-
Longitude (NAD83) 097° 50' 21.5" W-
Overall Structure Height 1491.12 feet
Support Structure Height 1402.87 feet
Ground Elevation Above Mean Sea Level (AMSL) 56.10 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Pinnacle Towers LLC
Date Constructed 08/20/2001

FM, AM or TV radio broadcasters. Facility ID's, Call Signs and Services of other broadcast stations with whom the tower is shared

Facility ID Call Sign Service
12523 KVEO-TV DTV
40777 KBFM FM
43328 KRGV-TV DTV
64631 KTEX FM

Other Types of Users

Users
US Gov't Use

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: Major Reinforcements needed

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Structural Analysis and Site Inspection

Structural Analysis and Site Inspection

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 80
Explanation No expertise.
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 Yes
Quantity 2
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 Yes
Number of Days 3
Justification Change of RF, proof of performance, making certain direction antenna is correct

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Outside Engineering Services

General engineering services

General Legal

General Legal Services

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 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

Name Description

Public Notification

Advertising Campaign to inform public of new channel and to encourage rescan of equipment to allow Repack Channel to be Received

Bank Fees

Bank fees

Permit

county permit

Signal Survey

Signal Survey

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 $34,597.65 $40,897.65 N/A $38,197.65 N/A
Total for all systems $731,040.33 $808,008.59 N/A $537,192.49 N/A
Primary Transmitter USXT $34,597.65 $40,897.65 $38,197.65
Manufacturer Technician $9,547.65 $9,547.65 On-site assistance from manufacture to assist with retuning and proof of transmitter $9,547.65 N/A
Transmitter Building Site Survey/Installation $10,000.00 $7,350.00 This is the amount charged $7,350.00 This is the amount charged
1.1-2kW w mask filter Full Service $4,050.00 $2,700.00 Per actual costs $0.00 N/A
Retune - UHF and VHF - minor re-channel issues $11,000.00 $21,300.00 Per actual costs from invoices $21,300.00 N/A

Components

Actual Information Description File Name
Manufacturer Technician

Component Description:
onsite mfg technician - GatesAir - INV JD20000276-1
Amount:
$9,547.65
Transmitter Building Site Survey/Installation

Component Description:
Site survey
Amount:
$7,350.00
1.1-2kW w mask filter Full Service

Component Description:
Filter - Dielectric - INV 1936140
Amount:
$2,700.00

Component Description:
Dielectric - filter - INV 1936140
Amount:
$2,700.00
Retune - UHF and VHF - minor re-channel issues

Component Description:
retune transmitter/assist mfg tech - QComm - INV 20220825
Amount:
$21,300.00

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 $47,778.00 $52,807.00 N/A $49,307.00 N/A
Total for all systems $731,040.33 $808,008.59 N/A $537,192.49 N/A
Primary Antenna TLP-16M (SP) $47,778.00 $52,807.00 $49,307.00
Connectors $276.00 $276.00 Per actual costs $276.00 N/A
Mounting Plates $2,325.00 $2,325.00 Mounting plates per Dielectric sales order 1936081 and INV 1324037 $2,325.00 N/A
300000839 $57.00 $57.00 N/A $57.00 N/A
11000013395 $935.00 $935.00 N/A $935.00 N/A
Pattern scatter analysis for side mount (if not included in antenna base cost) $3,500.00 $3,500.00 N/A N/A N/A
Side Mount antenna brackets $4,625.00 $12,500.00 Custom Pole Mounts per Dielectric Quote 1935142 $12,500.00 N/A
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed) $9,570.00 $6,054.00 Per Dielectric quote 1935142 $6,054.00 N/A
Sweep test of transmission line and antenna $5,730.00 $6,400.00 Per Dielectric Quote 1935142 $6,400.00 N/A
UHF-Low Power, Side Mount, Slotted Coaxial, 15.0kW input, Horizontal $20,760.00 $20,760.00 ***System Notice: Estimate adjusted and locked because line has been superseded.***Antenna TLP-16M Ch34 per Dielectric Quote 1935142 $20,760.00 N/A

Components

Actual Information Description File Name
Connectors

Component Description:
connectors - Dielectric - INV 1329029
Amount:
$276.00
Mounting Plates

Component Description:
mounting plates - Dielectric - INV 1324037
Amount:
$2,325.00
300000839

Component Description:
Adaptor for Jumper Cable for Tower
Amount:
$57.00
11000013395

Component Description:
Jumper Cables for tower
Amount:
$935.00
Pattern scatter analysis for side mount (if not included in antenna base cost) Information not provided.
Side Mount antenna brackets

Component Description:
Custom Pole Mounts
Amount:
$11,250.00

Component Description:
10/7/2022 Zeroed out. Will add under different line item. Balance - Dielectric - INV 1244034
Amount:
N/A

Component Description:
Dielectric - antenna & line - INV 1244034
Amount:
$1,250.00
Elbow complex, single channel, at antenna input, per 4 1/16. feedline (if needed)

Component Description:
Balance - elbow - Dielectric INV 1244034
Amount:
$605.40

Component Description:
Elbow - Dielectric
Amount:
$5,448.60
Sweep test of transmission line and antenna

Component Description:
Sweep will be resubmitted on a different invoice.
Amount:
($5,760.00)

Component Description:
Sweep - Dielectric - INV 1355044
Amount:
$6,400.00

Component Description:
Repack Sweep - Dielectric
Amount:
$5,760.00
UHF-Low Power, Side Mount, Slotted Coaxial, 15.0kW input, Horizontal

Component Description:
Antenna - Dielectric
Amount:
$18,684.00

Component Description:
Antenna balance - Dielectric - INV 1244034
Amount:
$2,076.00

Component Description:
jumper & adapter - Dielectric - INV 1319038
Amount:
N/A

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 $213,264.00 $246,561.40 N/A $200,311.50 N/A
Total for all systems $731,040.33 $808,008.59 N/A $537,192.49 N/A
Primary Transmission Line $213,264.00 $246,561.40 $200,311.50
Removal of Existing Line $35,000.00 $35,000.00 N/A N/A N/A
Interior RF Systems: Inside RF system including switching, patch panels and dehydrators $10,000.00 $10,000.00 N/A N/A N/A
Rigid Transmission Line - copper, 4 1/16" $168,264.00 $201,561.40 Per Dielectric quote 1935142. Includes freight charges $200,311.50 Per actual costs

Components

Actual Information Description File Name
Removal of Existing Line Information not provided.
Interior RF Systems: Inside RF system including switching, patch panels and dehydrators Information not provided.
Rigid Transmission Line - copper, 4 1/16"

Component Description:
Coupler - Dielectric - INV 1320034
Amount:
$870.00

Component Description:
Freight for tx line - Dielectric - INV 1309043
Amount:
$11,100.00

Component Description:
tx line - Dielectric - INV 1308036
Amount:
$5,772.00

Component Description:
tx line - Dielectric - INV 1308028
Amount:
$8,933.25

Component Description:
Transmission line and component parts - Dielectric
Amount:
$160,905.83

Component Description:
transmission line - Dielectric - INV 1308038
Amount:
$624.00

Component Description:
balance of all lines except for 9 & 25 on order # 1935142
Amount:
$12,106.42

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 $150,768.74 $150,768.74 N/A $99,768.74 N/A
Total for all systems $731,040.33 $808,008.59 N/A $537,192.49 N/A
Primary Tower TOWER $150,768.74 $150,768.74 $99,768.74
Major tower reinforcement/modifications $93,268.74 $93,268.74 Per Rio Steel proposal dated 10/27/21 plus (2) change order invoices. $93,268.74 per actual costs
Complex Tower (includes, e.g., towers with candelabras and/or stacked antennas) $30,000.00 $30,000.00 N/A N/A N/A
Tower mapping and report for structural engineer $21,000.00 $21,000.00 N/A N/A N/A
Structural Analysis and Site Inspection $6,500.00 $6,500.00 Per actual Crown Castle invoice $6,500.00 N/A

Components

Actual Information Description File Name
Major tower reinforcement/modifications

Component Description:
Tower Rigging/antenna removal and install.
Amount:
$17,320.00

Component Description:
completion invoice - Rio Steel - INV 821194-3
Amount:
$34,640.00

Component Description:
2nd 25% - Rio Steel - INV 821194-2
Amount:
$17,320.00

Component Description:
change order - Rio Steel - INV 821194-4
Amount:
$21,823.74

Component Description:
replace bolts - Rio Steel - INV 821194-5
Amount:
$2,165.00
Complex Tower (includes, e.g., towers with candelabras and/or stacked antennas) Information not provided.
Tower mapping and report for structural engineer Information not provided.
Structural Analysis and Site Inspection

Component Description:
Structural analysis and site inspection - Crown - INV 303393
Amount:
$6,500.00

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 $130,836.25 $163,333.11 N/A $131,561.86 N/A
Total for all systems $731,040.33 $808,008.59 N/A $537,192.49 N/A
Outside Professional Services $130,836.25 $163,333.11 $131,561.86
General Legal $7,305.00 $7,305.00 Per actual invoice amounts $7,305.00 N/A
Outside Engineering Services $7,880.00 $7,880.00 Per actual invoices $7,880.00 N/A
Additional Field Engineering Service, 3 Days $15,000.00 $15,000.00 N/A N/A N/A
Comprehensive coverage verification via field study, if needed $52,600.00 $26,125.00 Antenna pattern verification only $13,062.50 N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $4,470.00 $1,425.00 This is the amount charged $1,425.00 This is the amount charged
Attorney Fees - Negotiation of lease and other matters for shared locations $3,262.50 $3,262.50 N/A $3,262.50 This is the amount charged
Perform engineering study for displacement application $1,800.00 $1,800.00 N/A N/A N/A
Form 399 assistance or other Program Management costs $20,611.25 $20,611.25 Per actual invoice amounts $19,755.00 This is the amount charged
Prepare/ Review 399 reimbursement form $1,710.00 $950.00 This is the amount charged $950.00 This is the amount charged
Project management of the transition $8,440.00 $64,478.11 Per actual costs $64,478.11 Estimated same as actual
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $1,577.50 $356.25 N/A $356.25 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $3,025.00 $9,787.50 this is the amount charged $9,787.50 This is the amount charged.
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 $3,300.00 This is the amount charged $3,300.00 This is the amount charged

Components

Actual Information Description File Name
General Legal

Component Description:
Legal services - Brooks Pierce - INV 4013389
Amount:
$7,112.50

Component Description:
Legal April 2022 - Brooks - INV 4014643
Amount:
$192.50
Outside Engineering Services

Component Description:
Engineering consulting services - Lohnes - INV 202208-1619-01
Amount:
$3,300.00

Component Description:
Engineering - Lohnes - INV 202201-1619-01
Amount:
$4,580.00
Additional Field Engineering Service, 3 Days Information not provided.
Comprehensive coverage verification via field study, if needed

Component Description:
pattern verification - QComm - INV 20220851
Amount:
$13,062.50
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
Legal Fees - STA Request
Amount:
$1,425.00
Attorney Fees - Negotiation of lease and other matters for shared locations

Component Description:
Legal Fees
Amount:
$3,262.50
Perform engineering study for displacement application Information not provided.
Form 399 assistance or other Program Management costs

Component Description:
Legal fees - FCC Form 399
Amount:
$712.50

Component Description:
Additional legal fees re FCC Form 399
Amount:
$950.00

Component Description:
Legal fees
Amount:
$7,650.00

Component Description:
April 2022 PM - QComm - INV 20220511
Amount:
$308.00

Component Description:
Legal Fees re Fcc Form 399
Amount:
$118.75

Component Description:
FCC Form 399 assistance
Amount:
$475.00

Component Description:
May 2022 PM - QComm - INV 20220613
Amount:
$1,078.00

Component Description:
June 2022 PM - QComm - INV 20220709
Amount:
$1,694.00

Component Description:
Additional legal fees re FCC Form 399
Amount:
$2,968.75

Component Description:
Legal fees - FCC Form 399
Amount:
$475.00

Component Description:
Additional legal fees re FCC Form 399
Amount:
$2,493.75

Component Description:
FCC Work - FCC Form 399
Amount:
$356.25

Component Description:
Additional legal fees re FCC Form 399
Amount:
$1,306.25
Prepare/ Review 399 reimbursement form

Component Description:
FCC Form 399 ancillary assistance
Amount:
$200.00

Component Description:
FCC Form 399 ancillary assistance
Amount:
$750.00
Project management of the transition

Component Description:
Sept & Oct 2022 Tech PM - QComm - INV 20221015
Amount:
$2,310.00

Component Description:
Technical PM for Dec 2022 - QComm - INV 20221026
Amount:
$1,848.00

Component Description:
August 2022 PM thru closeout - QComm - INV 20220835
Amount:
$7,961.80

Component Description:
399 & Tech PM - QComm - INV 20220809
Amount:
$4,881.80

Component Description:
Jan 2022 PM - QComm - INV 220028
Amount:
$3,619.00

Component Description:
March 2022 PM - QComm - INV 20220306
Amount:
$3,565.10

Component Description:
October 2021 PM Hours - QComm - INV 230076
Amount:
$2,109.80

Component Description:
Nov 2021 PM Hours - QComm - INV 230092
Amount:
$1,078.00

Component Description:
Oct - Dec 399 PM - QComm - INV 20221024
Amount:
$462.00

Component Description:
Dec 2021 PM - QComm - INV 2022007
Amount:
$5,005.00

Component Description:
April 2022 Tech PM - QComm - INV 20220511
Amount:
$3,080.00

Component Description:
Feb 2022 PM - QComm - INV 220044
Amount:
$3,957.80

Component Description:
IBSC - broadcast consult - INV 2022-102
Amount:
$24,599.81

Component Description:
Repack implementation consultation
Amount:
$24,599.81
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
Legal review of license to cover
Amount:
$356.25
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Legal Fees
Amount:
$9,787.50
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:
Engineering - Construction Permit
Amount:
$3,300.00

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 $153,795.69 $153,640.69 N/A $18,045.74 N/A
Total for all systems $731,040.33 $808,008.59 N/A $537,192.49 N/A
Other Expenses $153,795.69 $153,640.69 $18,045.74
Signal Survey $4,500.00 $4,500.00 This is the amount charged $4,500.00 This is the amount charged
Permit $632.42 $632.42 County Permit costs to replace antenna $632.42 N/A
Bank Fees $14.95 $14.95 Bank fees $0.00 N/A
Public Notification $0.00 $0.00 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
FCC Filing Fees - Form 2100 license to cover application $335.00 $215.00 License to cover - FCC filing fees $215.00 N/A
FCC Filing Fees - Special Temporary Authorization request $305.00 $270.00 N/A $270.00 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $8,000.00 $8,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $10,408.32 $10,408.32 Per actual costs $10,408.32 N/A
Equipment Storage $5,000.00 $5,000.00 N/A $2,020.00 N/A
Advertising Campaign $123,490.00 $123,490.00 ***System Notice: Estimate adjusted and locked because line has been superseded.***Costs for re-scan advertising campaign. $0.00 This is the amount charged

Components

Actual Information Description File Name
Signal Survey

Component Description:
Signal Survey inside protected contour
Amount:
$4,500.00
Permit

Component Description:
Permit for KSOY to replace antenna - receipt # 84257
Amount:
$632.42
Bank Fees

Component Description:
bank fees - IBC
Amount:
$14.95
Public Notification Information not provided.
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
FCC Filing Fees - Form 2100 license to cover application

Component Description:
LTC filing fees - FCC - LMS0000197365
Amount:
$215.00
FCC Filing Fees - Special Temporary Authorization request

Component Description:
FCC filing fee - STA
Amount:
$270.00
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Equipment Delivery and Handling Charges

Component Description:
Freight - Dielectric - INV 1325038
Amount:
$1,265.56

Component Description:
freight - Dielectric - INV 1330035
Amount:
$148.38

Component Description:
freight - Dielectric - INV 1322039
Amount:
$1,194.38

Component Description:
Shipping costs - Dielectric - INV 1307041
Amount:
$7,800.00
Equipment Storage

Component Description:
Storage of antenna - Dielectric invoice 1307041
Amount:
$2,020.00
Advertising Campaign

Component Description:
Repack viewer education campaign
Amount:
$990.00

Component Description:
September 2022 Rescan Campaign
Amount:
$122,500.00

Component Description:
Repack viewer awareness campaign
Amount:
N/A

Component Description:
Repack viewer awareness campaign
Amount:
$660.00

Component Description:
Repack viewer awareness campaign
Amount:
$1,240.00

Component Description:
Repack viewer awareness campaign
Amount:
$1,200.00

Component Description:
Local rescan campaign
Amount:
$122,500.00

Component Description:
Repack viewer awareness campaign
Amount:
$660.00

Component Description:
Repack public awareness campaign
Amount:
$4,800.00

Component Description:
Repack public awareness campaign
Amount:
$4,960.00

Component Description:
Repack viewer awareness campaign
Amount:
$660.00

Component Description:
Local rescan campaign
Amount:
$122,500.00

Component Description:
Repack viewer awareness campaign
Amount:
$990.00

Component Description:
Repack viewer awareness campaign
Amount:
$9,280.00

Component Description:
December 2022 Rescan Campaign
Amount:
$122,500.00

Component Description:
Repack viewer awareness campaign
Amount:
$990.00

Component Description:
Repack viewer awareness campaign
Amount:
$990.00

Component Description:
Repack viewer awareness campaign
Amount:
$1,200.00

Component Description:
Repack viewer awareness campaign
Amount:
$1,240.00

Component Description:
Repack public awareness campaign
Amount:
$4,960.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $731,040.33 $808,008.59 $537,192.49

Reimbursement Status

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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. 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.

Eduardo Gallegos

Applicant


01/25/2023

Certification

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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.

  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. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

  2. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.

  3. The above-named entity certifies that all costs identified as "actual costs" herein accurately represent the costs actually paid by the above-named entity, including any discounts, refunds, or rebates.

  4. 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.

  5. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.

  6. 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.

Eduardo Gallegos

Applicant


01/25/2023

Attachments

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