Applicant | Address | Phone | Applicant Type | |
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THE CAMP VERDE TV CLUB, INC. Doing Business As: THE CAMP VERDE TV CLUB |
Roger Doering 420 W Angus Drive CAMP VERDE, AZ 86322 United States |
+1 (928) 399-9402 | RPDELECTRONICS@HOTMAIL.COM | Not-for-Profit |
Applicant | Address | Phone | |
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[Confidential] |
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Applicant | Address | Phone | |
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The Preparer is same as the reimbursement contact. |
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Question | Response |
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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 | The Camp Verde TV club proposes to install digital transmitter and combiner feeding common antenna for K30OI-D and K32ME-D. |
Section | Question | Response |
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Transmitter Related Expenses | Do you have transmitter related expenses? | Yes |
Section | Question | Response |
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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 | Call Sign |
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69922 | K30OI-D |
Section | Question | Response |
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New Transmitter | Use | Primary (Main) |
Change Type | Purchase New | |
Is this a request for upgraded equipment? | No | |
Manufacturer | ||
Model | TRN-U-50-FA | |
Transmitter Type | Solid State | |
Solid State Cooling | Air Cooled | |
Solid State Power capacity | .05 kW | |
Justification for New Transmitter | This is the minimum size output power to achieve required power. |
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 | 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 |
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Combiner |
channel 30 K30OI-D FID 69922 and 32 K32ME-D FID 69924 Replacement combiner |
Section | Question | Response |
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Antenna Related Expenses | Do you have antenna related expenses? | No |
Section | Question | Response |
---|---|---|
Transmission Line Related Expenses | Do you have transmission line related expenses? | No |
Section | Question | Response |
---|---|---|
Tower Equipment or Rigging Costs Changes | Do you have tower equipment or rigging costs changes? | No |
Section | Question | Response |
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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 | 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 | 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 |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $11,600.00 | $11,390.00 | N/A | $0.00 | N/A |
Total for all systems | $15,020.00 | $14,600.00 | N/A | $0.00 | N/A |
Primary Transmitter TRN-U-50-FA | $11,600.00 | $11,390.00 | $0.00 | ||
Combiner | $1,400.00 | $1,400.00 | N/A | N/A | N/A |
UHF - Air Cooled Solid State Transmitter 5 - 50 Watts | $10,200.00 | $9,990.00 | N/A | N/A | N/A |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $3,420.00 | $3,210.00 | N/A | $0.00 | N/A |
Total for all systems | $15,020.00 | $14,600.00 | N/A | $0.00 | N/A |
Outside Professional Services | $3,420.00 | $3,210.00 | $0.00 | ||
Form 399 assistance or other Program Management costs | $1,710.00 | $1,710.00 | N/A | N/A | N/A |
Prepare/ Review 399 reimbursement form | $1,710.00 | $1,500.00 | N/A | N/A | N/A |
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 | $15,020.00 | $14,600.00 | N/A | $0.00 | N/A |
Other Expenses | $0.00 | $0.00 | $0.00 |
Predetermined Cost Estimate |
Estimated Cost | Actual Cost | |
---|---|---|---|
Total for all systems | $15,020.00 | $14,600.00 | $0.00 |
Question | Response |
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The facility has ceased operating on its pre-auction channel. | |
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 |
Section | Question | Response |
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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. |
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I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above. | Roger Doering vice president 11/14/2019 |