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:
31570
Service:
DTV
Call Sign:
WPAN
Channel:
21 (UHF)
File Number:
0000028768
FRN:
0019006501
Date Submitted:
08/20/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

B&C COMMUNICATIONS, LLC

Doing Business As: B&C COMMUNICATIONS, LLC

William Smith, Manager

155 MIDDLE PLANTATION LANE

GULF BREEZE, FL 32561

United States

+1 (716) 310-3711 BILLSMEDIA@GMAIL.COM Limited Liability Company

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 L. zumMallen

President

QCommunications, LLC

Tony zumMallen

705B SE Melody LN

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 See attached Transition Plan Exhibit.

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)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model NV8604e
Year 2008
Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power Capacity 3.6 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 ULXTE-20
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 12.9 kW
Justification for New Transmitter 3-9-2020-CH21- ERP of 620kW see attached- 3-9-power budget showing -TPO -11.82kW. The ULXTE-20- 12.9kW is the min available transmitter. OLD power budget for Ch. 31-was 84 kw ERP which required 7 kw.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) Yes
Switchgear (industrial 800 amp) Yes
Transformer (480V) Yes
Power 150 kVA
Rigid Conduit and Wiring Yes
Size 2 inches
Length 200.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Heating and Cooling
Size 10 tons
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Site Survey

Site Survey - required to perform the engineering and design of new equipment at new ch21 site

Transmitter Site Preparation

Site prep for installation of the main transmitter and RF components not part of Gates SOW.

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)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
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? No
Existing Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Other
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type Broadband Slot
ERP: 33.5 kW
Manufacturer
Model CS-2030-5771-14
Year 2008

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Slot
Number of Stations Supported 1
Number of Panels/Bays 24
Lower Limit 512.00 MHz
Upper Limit 518.00 MHz
Design power capacity in use 90.0 %
Other Antenna Type N/A
ERP: 620.0 kW
Manufacturer
Model ALP24M3-HSBx-21
Year 2020
Justification for New Antenna ch 21 requires new antenna model form ch 31 see the attached 3-9-WPAN_ERI-ALP24m3 -power budget file

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna?
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? N/A
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Broadband
Feed Line Size 6 1/8 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? No
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

Information not provided.

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)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
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 Flexible Foam
Diameter 1 5/8 inches
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 790 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 19 1/2 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1270 feet per run
Justification for New Transmission Line ch21 requires new line at new site. see the attached power budget for line details. 3-9-WPAN_ERI-ALP24M3-HSBx-21_TPO20200226 and quote WPAN ERI 20200218-051RevA ALP24 wMACX675 Line Installed

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

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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Add Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Owned
Is this tower consider Complex? No
Is this tower currently shared with any other stations? No
One or more FM, AM or TV radio broadcaster(s) N/A
Others Types of Users N/A
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1054512
Coordinates (NAD83) Latitude (NAD83) 30° 42' 21.0" N-
Longitude (NAD83) 087° 24' 12.0" W-
Overall Structure Height 1414.02 feet
Support Structure Height 1328.72 feet
Ground Elevation Above Mean Sea Level (AMSL) 134.51 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner B&C Communications, LLC
Date Constructed 01/01/1997


Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Study needed for documented tower
Tower Reinforcements Please select whether tower reinforcements are needed: Serious Reinforcements needed

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Angle Brackets

Angle support brackets to reattach line to tower.

Tower Lighting

Tower Lighting due to height change. See letter attached to INV WPAN-37457F

Engineering Services - Land survey

3 separate visits to site to determine existing conditions, land survey, underground utilities, stake new tower centerline, new tower "as built" of base

Reinforcing Analysis and Design

Includes analysis and design of required tower reinforcements/modifications based on the previous ERI study

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 900
Explanation Scope and significance of project require outside management services to augment existing internal personnel to assist turnkey management of and ensure timely and safe execution of channel relocation.
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development 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 4
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
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 4
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification Yes
FAA Consultation (including preparation of FAA Form 7460) Yes
Negotiation of Lease and other Matter for Shared Locations Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study Yes
RF exposure measurements No
Additional Field Engineering Service Yes
Number of Days 10
Justification the new ch21 site requires additional field engineering prior to and during the repack system installation due to the unknown nature of the new sites existing building and other tenants facilities to ensure proper engineering and designs are imposed

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Vendor travel expenses

Reimbursable Vendor Travel expenses for working in the field on behalf of the station for the Repack project

Geotechnical Survey and Report

Geotech survey, report, and associated borings.

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning No
Non-zoning permits No
BLM or NFS Coordination 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? No
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Name Description

Disconnect and decommission existing transmission and RF components

Disconnect transmitter and RF components from existing configuration to make way for new facilities.

Portapotty

Portapotty for installation activities

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 $658,050.00 $658,050.00 N/A $466,395.41 N/A
Total for all systems $2,858,979.71 $3,352,673.71 N/A $2,787,058.26 N/A
Primary Transmitter ULXTE-20 $658,050.00 $658,050.00 $466,395.41
Transmitter Site Preparation $5,700.00 $5,700.00 Site prep for installation of the main transmitter and RF components not part of Gates SOW. N/A N/A
Site Survey $14,000.00 $14,000.00 Site survey and report are required to be performed before the new transmitter and components installation plan can be finalized. N/A N/A
10 Ton system $60,500.00 $60,500.00 N/A N/A N/A
2" Rigid Conduit and Wiring (Cost per foot) $5,200.00 $5,200.00 N/A N/A N/A
Transformer 3 phase/480v - 150 KVA $25,550.00 $25,550.00 N/A N/A N/A
Switchgear - industrial 800 amp $38,200.00 $38,200.00 N/A N/A N/A
Service entrance 3 phase/800 amp/208 volt $14,400.00 $14,400.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW $494,500.00 $494,500.00 N/A $466,395.41 N/A

Components

Actual Information Description File Name
Transmitter Site Preparation Information not provided.
Site Survey Information not provided.
10 Ton system Information not provided.
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Transformer 3 phase/480v - 150 KVA Information not provided.
Switchgear - industrial 800 amp Information not provided.
Service entrance 3 phase/800 amp/208 volt Information not provided.
UHF - Liquid Cooled Solid State Transmitter 8.2 - 13 kW

Component Description:
2nd invoice for transmitter. GatesAir JW30004736-2
Amount:
$144,998.42

Component Description:
Gates Air - 1st transmitter invoice # JW30004736-1 - Q-86562
Amount:
$144,998.42

Component Description:
Third and final invoice for transmitter. Includes sales tax & Freight. Gates INV US0339470
Amount:
$176,398.57

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 $114,558.61 $114,228.61 N/A $76,603.61 N/A
Total for all systems $2,858,979.71 $3,352,673.71 N/A $2,787,058.26 N/A
Primary Antenna ALP24M3-HSBx-21 $114,558.61 $114,228.61 $76,603.61
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $23,150.00 N/A N/A N/A
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed) $13,700.00 $13,700.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $5,625.00 N/A
UHF - High Power, Side Mount, basic slot antenna, 24 bay,, 620 kW input, directional,, horizontally polarized $70,978.61 $70,978.61 per attached proposal - 3-9- WPAN ERI 20200218-051RevA ALP24 wMACX675 Line Installed $70,978.61 N/A

Components

Actual Information Description File Name
Side mount brackets for high power antennas (if not included in antenna base cost) Information not provided.
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed) Information not provided.
Sweep test of existing antenna

Component Description:
WPAN - SWEEP TEST LINE 028 - INV WPAN-64000
Amount:
$3,125.00

Component Description:
WPAN - ERI - Sweep - INV WPAN-64000A
Amount:
$2,500.00
UHF - High Power, Side Mount, basic slot antenna, 24 bay,, 620 kW input, directional,, horizontally polarized

Component Description:
WPAN-ERI ANTENNA LINE 001
Amount:
$35,489.31

Component Description:
Antenna portion of invoice - WPAN - ERI - INV WPAN-64000A
Amount:
$35,489.30

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 $256,540.00 $199,500.00 N/A $175,166.30 N/A
Total for all systems $2,858,979.71 $3,352,673.71 N/A $2,787,058.26 N/A
Primary Transmission Line $256,540.00 $199,500.00 $175,166.30
Rigid Transmission Line - copper, 6 1/8" $256,540.00 $199,500.00 per attacehd proposal - 3-9-WPAN ERI 20200218-051RevA ALP24 wMACX675 Line Installed plus estimated freight $175,166.30 N/A

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 6 1/8"

Component Description:
WPAN - TX LINE AND DRYER - LINES 002-026 INV WPAN-64000
Amount:
$87,583.15

Component Description:
WPAN - ERI - Transmission line & dryer - INV WPAN-64000A
Amount:
$87,583.15

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 $1,459,021.10 $2,057,330.10 N/A $1,904,337.69 N/A
Total for all systems $2,858,979.71 $3,352,673.71 N/A $2,787,058.26 N/A
Primary Tower TOWER $1,459,021.10 $2,057,330.10 $1,904,337.69
Angle Brackets $12,695.00 $12,695.00 Per ERI change order 37457D.1 attached to invoice WPAN-56218 $12,695.00 N/A
Engineering Services - Land survey $29,280.00 $29,280.00 Per proposal from Electronics Research, Inc #20200103-684 for $29280.00. N/A N/A
Tall Tower (greater than 500') $210,500.00 $291,175.00 per ERI Proposal 20200218-05, line item 029 - TV Services. see attached $262,057.49 N/A
Serious tower reinforcement/modifications $1,052,000.00 $1,552,259.00 per ERI Proposal 20200213-002, line item 002 - TV Services. see attached WPAN-399-Tower mod summary-Final 3-9-2020 includes foundation repair $1,457,664.10 N/A
Structural engineering tower load study for well documented tower $12,600.00 $29,975.00 Two TAs needed to determine refurbished versus replaced. The 2nd TA was able to determine the tower can be refurbished if shortened and all tenents removed and with substantial reinforcements of tower and foundation work. see ERI 20200213-002 $29,975.00 N/A
Reinforcing Analysis and Design $5,250.00 $5,250.00 Per actual costs charged on ERI invoice #54843 $5,250.00 N/A
Tower Lighting $136,696.10 $136,696.10 Tower lighting - includes sales tax. Per ERI invoice WPAN-37457F $136,696.10 N/A

Components

Actual Information Description File Name
Angle Brackets

Component Description:
Angle support brackets - ERI - INV WPAN-56218
Amount:
$12,695.00
Engineering Services - Land survey Information not provided.
Tall Tower (greater than 500')

Component Description:
WPAN - ERI INSTALLATION OF LINE AND ANTENNA - LINE 029 - INV WPAN-64000 - ROUNDED DOWN 1 PENNY
Amount:
$145,587.49

Component Description:
Installation of line & antenna - WPAN - ERI - INV WPAN-64000A
Amount:
$116,470.00
Serious tower reinforcement/modifications

Component Description:
WPAN- ERI - TOWER REFURBISHMENT LINE 001,002,003 MATERIAL, FOUNDATION INV WPAN-54000
Amount:
$776,129.50

Component Description:
WPAN Tower Work: ERI reinforcement, foundation, tv install - INV WPAN-54000A
Amount:
$681,534.60
Structural engineering tower load study for well documented tower

Component Description:
2nd invoice engineering tower climbing inspection - ERI WPAN-54187
Amount:
$11,737.50

Component Description:
2nd invoice Tower reinforcing analysis & design. ERI invoice WPAN-37457C-1
Amount:
$3,250.00

Component Description:
1st invoice engineering climbing inspection of tower - ERI INV WPAN-3000
Amount:
$11,737.50

Component Description:
Tower: Reinforcing analysis and design. ERI INV WPAN-37457C
Amount:
$3,250.00
Reinforcing Analysis and Design

Component Description:
ERI - reinforcing analysis and design - INV 54843
Amount:
$5,250.00
Tower Lighting

Component Description:
Tower light change due to height. WPAN - ERI - INV WPAN-37457F
Amount:
$136,696.10

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 $328,720.00 $285,575.00 N/A $164,405.25 N/A
Total for all systems $2,858,979.71 $3,352,673.71 N/A $2,787,058.26 N/A
Outside Professional Services $328,720.00 $285,575.00 $164,405.25
Project management of the transition $142,200.00 $142,200.00 estimated based upon catalog rate per hour $136,620.25 N/A
Geotechnical Survey and Report $9,500.00 $9,500.00 Per ERI Proposals 2019717-126 and 20190913-739 attached to invoice 54838 $9,500.00 N/A
Additional Field Engineering Service, 10 Days $22,500.00 $22,500.00 estimated amount for 10 days of field engineering N/A N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $42,000.00 N/A N/A N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase $2,105.00 $2,000.00 N/A $210.00 N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $14,720.00 $14,720.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $4,000.00 N/A $1,140.00 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A $0.00 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A $4,860.00 N/A
Prepare request for Special Temporary Authorization $8,200.00 $8,200.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A $0.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $2,975.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $6,000.00 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A $0.00 N/A
Prepare and or review reimbursement form $2,630.00 $3,100.00 Estimated Cost Justification WPAN-590-Prepare and_or Review Reimbursement Form v4 $3,100.00 Only asking for reimbursement of the $2500, but duplicate entry because adding required cover letter (can't delete or amend prior submission).
ASR modification (prepare FCC Form 854) $2,105.00 $2,105.00 N/A N/A N/A
Vendor travel expenses $14,000.00 $14,000.00 estimated vendor travel for the project N/A N/A

Components

Actual Information Description File Name
Project management of the transition

Component Description:
Widelity April project management - INV B&C-WPAN-037. NOTE: INVOICE NUMBER IS B&C-WPAN-037. "And" was substituted for "&" in the invoice number.
Amount:
$2,233.35

Component Description:
Provide Project Management to station for repack - QComm INV QC20-272
Amount:
$1,698.50

Component Description:
8-3-20 QComm - PM hours for June 2020 - QC20-354
Amount:
$466.10

Component Description:
Tech & field Proj mgmt Dec 2019
Amount:
$4,345.00

Component Description:
Technical and field PM Aug 2019 QC20-370
Amount:
$7,094.20

Component Description:
Field and Tech proj mgmt - Feb 2020
Amount:
$18,154.20

Component Description:
Tech and Field Proj mgmt Jan 2020
Amount:
$24,000.20

Component Description:
Tech and Field proj mgmt September 2019
Amount:
$6,399.00

Component Description:
Tech & field proj mgmt July 2020
Amount:
$10,886.20

Component Description:
Field and Tech Proj mgmt - June 2020
Amount:
$14,046.20

Component Description:
Technical and field proj mgmt - May 2020
Amount:
$14,172.60

Component Description:
Tech and field PM April 2020
Amount:
$10,175.20

Component Description:
Tech and field PM March 2020 -
Amount:
$17,143.00

Component Description:
Technical and field proj mgmt - Nov 2019
Amount:
$2,133.00

Component Description:
Technical and field proj mgmt Oct 2019
Amount:
$1,027.00

Component Description:
Technical and Field project management - July 2019 -
Amount:
$2,196.20

Component Description:
May 2020 PM Hours - QComm - INV QC20-330
Amount:
$450.30
Geotechnical Survey and Report

Component Description:
ERI prop 20190717-129 and 20190913-739. Geotech survey and associated borings. INV 54838
Amount:
$9,500.00
Additional Field Engineering Service, 10 Days Information not provided.
Comprehensive coverage verification via field study, if needed Information not provided.
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase

Component Description:
Legal invoice for Ch. 31 FAA filing work (replaces prior invoices submitted).
Amount:
$210.00
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations

Component Description:
Calls with client and conference call with Widelity re: repack reimbursement issues
Amount:
$270.00

Component Description:
WPAN-550-Attorney - Negotiate Lease and Other Matters
Amount:
$210.00

Component Description:
Legal Services
Amount:
$660.00
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Legal invoice for Ch. 31 construction permit application work (replaces prior invoices submitted).
Amount:
$4,860.00
Prepare request for Special Temporary Authorization Information not provided.
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:
CP Application Modification
Amount:
$1,240.00

Component Description:
FCC Form 2100 Construction Permit Application
Amount:
$1,735.00
Perform engineering study for new channel assignment and antenna development

Component Description:
New Channel Assignment & Antenna Development
Amount:
$2,400.00

Component Description:
Alternate Channel Analysis
Amount:
$3,600.00
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form

Component Description:
Legal Services
Amount:
$120.00

Component Description:
Upload invoice to Widelity site
Amount:
$60.00

Component Description:
Legal Services
Amount:
$90.00

Component Description:
Legal Services
Amount:
$180.00

Component Description:
Legal Services
Amount:
$30.00

Component Description:
Legal Services
Amount:
$150.00

Component Description:
Legal invoice for cost estimates/reimbursements work. Request reimburse $2500 approved in allotment, vendor wrote off/credit for $1250 per retainer.
Amount:
$2,500.00

Component Description:
Legal invoice for cost estimates/reimbursements work. Request reimburse $2500 approved in allotment, vendor wrote off/credit for $1250 per retainer; adds cover letter to previously submission.
Amount:
$2,500.00
ASR modification (prepare FCC Form 854) Information not provided.
Vendor travel expenses 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 $42,090.00 $37,990.00 N/A $150.00 N/A
Total for all systems $2,858,979.71 $3,352,673.71 N/A $2,787,058.26 N/A
Other Expenses $42,090.00 $37,990.00 $150.00
MVPD Notification of Channel Change $1,000.00 $1,000.00 Prepare and send notices to MVPDs. $0.00 N/A
Develop and air announcement of upcoming channel change $250.00 $250.00 Voice talent to tape announcement. $0.00 N/A
Portapotty $150.00 $150.00 Actual costs per XTreme Inv 1032150767743 $150.00 N/A
Equipment Delivery and Handling Charges $8,500.00 $8,500.00 N/A N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $195.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A $0.00 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $5,000.00 $5,000.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $7,500.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 N/A $0.00 N/A
Disconnect and decommission existing transmission and RF components $14,000.00 $14,000.00 estimated amount to disconnect and decommission tx and rf components N/A N/A

Components

Actual Information Description File Name
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Portapotty

Component Description:
Portapotty for one month with 2 cleanings/week. INV 1032150767743
Amount:
$150.00
Equipment Delivery and Handling Charges Information not provided.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
DTV Medical Facility Notification Information not provided.
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
Disconnect and decommission existing transmission and RF components Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $2,858,979.71 $3,352,673.71 $2,787,058.26

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. 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.

William Smith

President


08/20/2020

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.

William Smith

President


08/20/2020

Attachments

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