Applicant | Address | Phone | Applicant Type | |
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INDIAN WELLS VALLEY TV BOOSTER, INC. Doing Business As: INDIAN WELLS VALLEY TV BOOSTER, INC. |
P. O. BOX 562 RIDGECREST, CA 93556 United States |
+1 (760) 375-0233 | edwort@earthlink.net | 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 | Applicant had 6 Stations displaced during the "Special Displacement Window". K18MP-D FI 28590 is PBS Eligible and not seeking reimbursement thru this program. |
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? | No | |
Is this transmitter currently in operating condition? | Yes | |
Existing Transmitter Manufacturer and Type | Manufacturer | |
Model | 820A | |
Year | 2011 | |
Type | Solid State | |
Solid State Cooling | Air Cooled | |
Solid State Power Capacity | .1 kW |
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-5X022-U-C | |
Transmitter Type | Solid State | |
Solid State Cooling | Air Cooled | |
Solid State Power capacity | 60 W | |
Justification for New Transmitter | ITS no longer supported. |
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 |
Section | Question | Response |
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Antenna Related Expenses | Do you have antenna related expenses? | Yes |
Section | Question | Response |
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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 | Elliptical | |
Type | Other | |
Other Antenna Type | Zig Zag Cut to Ch35 | |
ERP: | 0.1 kW | |
Manufacturer | ||
Model | Zig Zag | |
Year | 1997 |
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 | Elliptical | |
Type | Broadband Panel | |
Number of Stations Supported | 1 | |
Number of Panels/Bays | 2 | |
Lower Limit | 470.00 MHz | |
Upper Limit | 698.00 MHz | |
Design power capacity in use | 30.0 % | |
ERP: | 0.65 kW | |
Manufacturer | ||
Model | 2x1 750 10325 | |
Year | 2019 | |
Justification for New Antenna | Old antenna cut to ch 35 |
Section | Question | Response |
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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 |
Power Dividers | Does the panel antenna require power dividers? | No |
Cable Harness | Does the panel antenna require cable harness? | Yes |
Number of Cable Harnesses | 2 |
Section | Question | Response |
---|---|---|
Transmission Line Related Expenses | Do you have transmission line related expenses? | No |
Section | Question | Response |
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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 |
Name | Description |
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Almendarez Technical Services |
Remove and install antennas |
Section | Question | Response |
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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 | 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 |
Name | Description |
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CA USE TAX |
California Use Tax |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
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Sub-total | $13,750.00 | $12,828.42 | N/A | $12,828.42 | N/A |
Total for all systems | $25,740.47 | $22,653.89 | N/A | $22,553.89 | N/A |
Primary Transmitter TRN-5X022-U-C | $13,750.00 | $12,828.42 | $12,828.42 | ||
UHF - Air Cooled Solid State Transmitter 50.001 - 150 Watts | $13,750.00 | $12,828.42 | N/A | $12,828.42 | N/A |
Actual Information Description | File Name |
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UHF - Air Cooled Solid State Transmitter 50.001 - 150 Watts |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
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Sub-total | $7,155.30 | $5,155.30 | N/A | $5,155.30 | N/A |
Total for all systems | $25,740.47 | $22,653.89 | N/A | $22,553.89 | N/A |
Primary Antenna 2x1 750 10325 | $7,155.30 | $5,155.30 | $5,155.30 | ||
LCF78-78NM-50 | $651.06 | $651.06 | LCF78-78NM-50 7/8" Foam Cable and Connectors, 50 ft | $651.06 | N/A |
Cable harness (each, for panel antenna system, if not included in antenna cost) | $2,000.00 | $0.00 | Included with antenna cost. | N/A | N/A |
UHF-Low Power, Side Mount, Broadband Panel, 2 bay, 0.65kW input, Elliptical | $4,504.24 | $4,504.24 | 750 10325 adjusted for horizontal cost only. Includes Harness. | $4,504.24 | N/A |
Actual Information Description | File Name |
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LCF78-78NM-50 | |
Cable harness (each, for panel antenna system, if not included in antenna cost) | Information not provided. |
UHF-Low Power, Side Mount, Broadband Panel, 2 bay, 0.65kW input, Elliptical |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $3,210.00 | $3,210.00 | N/A | $3,210.00 | N/A |
Total for all systems | $25,740.47 | $22,653.89 | N/A | $22,553.89 | N/A |
Outside Professional Services | $3,210.00 | $3,210.00 | $3,210.00 | ||
Almendarez Technical Services | $500.00 | $500.00 | Removed-installed antennas | $500.00 | N/A |
Form 399 assistance or other Program Management costs | $1,000.00 | $1,000.00 | BWS consulting for 399 Eligibility Filing | $1,000.00 | N/A |
Prepare/ Review 399 reimbursement form | $1,710.00 | $1,710.00 | BWS consulting services for 399 Reimbursement Expense fiing | $1,710.00 | N/A |
Actual Information Description | File Name |
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Almendarez Technical Services | |
Form 399 assistance or other Program Management costs | |
Prepare/ Review 399 reimbursement form |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $1,625.17 | $1,460.17 | N/A | $1,360.17 | N/A |
Total for all systems | $25,740.47 | $22,653.89 | N/A | $22,553.89 | N/A |
Other Expenses | $1,625.17 | $1,460.17 | $1,360.17 | ||
CA USE TAX | $1,290.17 | $1,290.17 | California Use Tax | $1,290.17 | N/A |
FCC Filing Fees - Form 2100 license to cover application | $335.00 | $170.00 | N/A | $70.00 | N/A |
Actual Information Description | File Name |
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CA USE TAX | |
FCC Filing Fees - Form 2100 license to cover application |
Predetermined Cost Estimate |
Estimated Cost | Actual Cost | |
---|---|---|---|
Total for all systems | $25,740.47 | $22,653.89 | $22,553.89 |
Question | Response |
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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 |
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. | Susan Hansen Consultant 06/04/2020 |
Section | Question | Response |
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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). |
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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. | Susan Hansen Consultant 06/04/2020 |
Section | Question | Response |
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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. |
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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. | Edward Middlemiss President 06/04/2020 |