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:
3242
Service:
FM
Call Sign:
WVIK
File Number:
0000086622
FRN:
0002861383
Eligibility Status:
Eligible
Date Submitted:
05/26/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

AUGUSTANA COLLEGE

Doing Business As: AUGUSTANA COLLEGE

Jay Pearce

639 38TH STREET

ROCK ISLAND, IL 61201

United States

+1 (309) 794-7500 jaypearce@wvik.org Private Not-for-Profit Educational Institution

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

The Preparer is same as the reimbursement contact.

 

 

 

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 With partial local funding & to serve our community better during times of disaster, WVIK took the opportunity during the repack to develop and build an auxiliary facility on the campus of our licensee on an existing tower near our main broadcast studio.

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? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model NV40
Year 2012
Type Solid State
Solid State Cooling Air Cooled
Model Type Hybrid
Solid State Power Capacity 40 kW

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 VS300-N
Transmitter Type Solid State
Solid State Cooling Air Cooled
Model Type Analog
Solid State Power capacity 300 W
Justification for New Transmitter We purchased this item for the dual purpose of being able to continue to broadcast during the repack and as part of our larger commitment to our community of providing service during disasters and extreme weather.
Does the transmitter require the purchase of a new HD Importer? No
Does the transmitter require the purchase of a new HD Exporter? No

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Other Transmitter Costs Does the transmitter installation require an Additional Exciter? No
Does the transmitter installation require any additional transmitter installation costs? Yes
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
Other Transmitter-Related Expenses Does the replacement transmitter require a Remote Control? No
Does the replacement transmitter require an RDS Encoder? No
Does the replacement transmitter require Audio Processing? No

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Transmitter

Transmitter Electric Supply and Misc Parts

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? No
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 Circular
Type Other
Other Antenna Type 4 Bay FM
ERP: 31.0 W
Manufacturer
Model BESP-4AC
Year 1991

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? No
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Circular
Type Other
Other Antenna Type 2 Bay Low Power FM
ERP: 815.0 W
Manufacturer
Model 100A
Year 2018
Justification for New Antenna There was no antenna for the transmitter that we are using for our auxiliary location. The tower and facility was available to us at no cost because it is owned by our licensee.

Primary Antenna

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Other Antenna Costs

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? No
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? No
FM Band Pass Filters Do you require an FM band pass filter? No
Notch Filter Do you require a Notch filter? No
De-Icers Do you require De-Icers? No
Radomes Do you require Radomes? No

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Antenna

Installation and Misc Parts

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 Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility Yes
For Main Facility No
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
For Main Facility No
Prepare request for Special Temporary Authority Yes
Quantity 1
Prepare Form 601 No
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility Yes
For Main Facility No
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
For Main Facility No
Prepare request for Special Temporary Authority Yes
Quantity 1
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement No
Form 399 assistance or other program management costs No
RF Field Engineering Services Comprehensive coverage verification via field study Yes
RF exposure measurements Yes
Additional Field Engineering Service No

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Gray Miller Persch LLP

Broadcast Attorneys

Doug Vernier

Telecommunications Consultant

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? 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
1 pair IP-only Codecs for fiber, internet or IP microwave systems 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 $78,650.00 $2,304.00 N/A $2,303.80 N/A
Total for all systems $155,045.00 $8,649.00 N/A $8,648.51 N/A
Primary Transmitter VS300-N $78,650.00 $2,304.00 $2,303.80
Air Cooled Solid State FM Transmitter 300 - 500 Watts Analog $8,150.00 $0.00 Paid for by another funder $0.00 N/A
Transmitter $0.00 $0.00 received funding from another source $0.00 N/A
Transmitter Installation $70,500.00 $2,304.00 Electric supply to transmitter and related misc parts not paid for by other funding sources. $2,303.80 N/A

Components

Actual Information Description File Name
Air Cooled Solid State FM Transmitter 300 - 500 Watts Analog Information not provided.
Transmitter Information not provided.
Transmitter Installation

Component Description:
Dummy Load - 1500 Watts
Amount:
$1,036.80

Component Description:
Cage Nuts
Amount:
$13.60

Component Description:
Install power supply to transmitter.
Amount:
$1,092.00

Component Description:
UPS and surge protector
Amount:
$132.29

Component Description:
NetGear Network Port
Amount:
$29.11

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 $2,985.00 $1,685.00 N/A $1,684.71 N/A
Total for all systems $155,045.00 $8,649.00 N/A $8,648.51 N/A
Primary Antenna 100A $2,985.00 $1,685.00 $1,684.71
Antenna $1,685.00 $1,685.00 Mount of new antenna and misc parts $1,684.71 N/A
Low Power 200 Watt - 1000 Watt Circularly-polarized $1,300.00 $0.00 Paid for by another funder N/A N/A

Components

Actual Information Description File Name
Antenna

Component Description:
COAX Cable
Amount:
$62.93

Component Description:
Female to Female N connector
Amount:
$14.15

Component Description:
Installed 2 bay broadcast antenna on tower with coax cable to transmitter.
Amount:
$1,438.43

Component Description:
P900VDG w/N Connectors 948MHZ
Amount:
$169.20
Low Power 200 Watt - 1000 Watt Circularly-polarized 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 $72,875.00 $4,660.00 N/A $4,660.00 N/A
Total for all systems $155,045.00 $8,649.00 N/A $8,648.51 N/A
Outside Professional Services $72,875.00 $4,660.00 $4,660.00
Doug Vernier $4,036.00 $4,036.00 Engineering provided by consultant. $4,036.00 N/A
Gray Miller Persch LLP $624.00 $624.00 Legal services required. $624.00 N/A
RF Exposure Measurements $12,100.00 $0.00 N/A N/A N/A
Comprehensive coverage verification via field study, if needed $52,600.00 $0.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $2,235.00 $0.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $1,280.00 $0.00 N/A N/A N/A

Components

Actual Information Description File Name
Doug Vernier

Component Description:
FCC Coverage map showing service contours for WVIK and WVIK auxiliary. Population are and percentage calculations.
Amount:
$500.00

Component Description:
General consulting services - File 2nd part of FCC tower registration, with waiver. File 7640-2 with FAA. Amend CP application.
Amount:
$570.00

Component Description:
Electronic filing - tower registration with ASR/ULS.
Amount:
$578.00

Component Description:
Application - License to cover CP WVIK auxiliary; FCC tower registration application
Amount:
$975.00

Component Description:
Application to FAA - Form 7460-1
Amount:
$578.00

Component Description:
Change to WVIK Auxiliary. Amendment to use side-mount antenna.
Amount:
$835.00
Gray Miller Persch LLP

Component Description:
FAA/FCC tower registration issue for auxiliary antenna permit and follow up correspondence
Amount:
$117.00

Component Description:
auxiliary antenna construction permit
Amount:
$117.00

Component Description:
Follow-up correspondence re WVIK auxiliary antenna application status of FAA/FCC tower reg filings.
Amount:
$39.00

Component Description:
engineering amendment; antenna permit; structure registration;
Amount:
$312.00

Component Description:
filing of license to cover application for auxiliary
Amount:
$39.00
RF Exposure Measurements Information not provided.
Comprehensive coverage verification via field study, if needed Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Prepare request for Special Temporary Authorization 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 $535.00 $0.00 N/A $0.00 N/A
Total for all systems $155,045.00 $8,649.00 N/A $8,648.51 N/A
Other Expenses $535.00 $0.00 $0.00
FCC Filing Fees - Form 2100 license to cover application $335.00 $0.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $200.00 $0.00 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 $155,045.00 $8,649.00 $8,648.51

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. 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

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.

Colleen Sibthorp

Director of Finance and Membership


05/26/2020

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.

Colleen Sibthorp

Director of Finance and Membership


05/26/2020

Attachments

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