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:
52887
Service:
DCA
Call Sign:
KCNZ-CD
Channel:
21 (UHF)
File Number:
0000028325
FRN:
0026495465
Date Submitted:
10/16/2020

Applicant Information

Back to Top

Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

Poquito Mas Communications LLC

Doing Business As: Poquito Mas Communications LLC

Randy Nonberg

15200 SUNSET BOULEVARD

Suite 202

Pacific Palisades, CA 90272

United States

+1 (310) 573-1600 randynonberg@cnzcommunications.com Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

Back to Top

Preparer Contact Name and Information

Applicant Address Phone Email

Robert Wayne Jordan

Engineer

ACME RF INC

Robert Wayne Jordan

9851 CENTER DRIVE

VILLA PARK, CA 92861

United States

+1 (714) 412-1951 rjordan@acmerf.com

Broadcaster Information and Transition Plan

Back to Top
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 Current transmission system consists of a single transmitter feeding a flexible transmission line which connects to an antenna on the tower. Work includes tower study/rehabilitation to support new antenna, mounting antenna and replacing transmitter.

Transmitters

Back to Top
Section Question Response
Transmitter Related Expenses Do you have transmitter related expenses? Yes

Primary Transmitter

Back to Top

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 UTV2
Year 2006
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 2 kW

Primary Transmitter

Back to Top

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 TMU9-4
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2 kW
Justification for New Transmitter Existing transmitter cannot be converted to repacked channel per manufacturer and manufacturer is no longer in business.

Primary Transmitter

Back to Top

Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) Yes
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring Yes
Size 3 inches
Length 100.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
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

Back to Top

Other Transmitter Cost Not Listed

Name Description

Transmitter installation parts

Required transmitter RF system parts.

Transmitter installation labor and testing.

RF system parts installation and system test once installed.

Antennas

Back to Top
Section Question Response
Antenna Related Expenses Do you have antenna related expenses? Yes

Primary Antenna

Back to Top

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? No
Is antenna located on or in close proximity to an antenna farm? No
Existing Antenna Manufacturer and Type Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 1
Number of Panels 4
Design power capacity in use 25.0 %
Lower Limit 470.00 MHz
Upper Limit 700.00 MHz
Other Antenna Type N/A
ERP: 15.0 kW
Manufacturer
Model k723147
Year 2005

Primary Antenna

Back to Top

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? Yes
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 Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Circular
Type Broadband Panel
Number of Stations Supported 1
Number of Panels/Bays 5
Lower Limit 470.00 MHz
Upper Limit 700.00 MHz
Design power capacity in use 10.0 %
Other Antenna Type N/A
ERP: 100.0 kW
Manufacturer
Model PEPL5U-CM4
Year 2019
Justification for New Antenna Existing antenna has failed and is more cost effective to replace than to repair.

Primary Antenna

Back to Top

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? No
Broadband or Single Channel? N/A
Feed Line Size N/A
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? Yes
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

Back to Top

Other Antenna Cost Not Listed

Name Description

Antenna removal

Abandoned antenna removal required as part of lease.

Transmission Line

Back to Top
Section Question Response
Transmission Line Related Expenses Do you have transmission line related expenses? Yes

Primary Transmission Line

Back to Top

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 200 feet per run

Primary Transmission Line

Back to Top

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 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 80 feet per run
Justification for New Transmission Line Extension of transmission line to connect with relocated antenna.

Primary Transmission Line

Back to Top

Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

Back to Top
Section Question Response
Tower Equipment or Rigging Costs Changes Do you have tower equipment or rigging costs changes? Yes

Primary Tower

Back to Top

Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? No
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 No
Is tower documented for structural analysis? Unknown
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1205149
Coordinates (NAD83) Latitude (NAD83) 37° 41' 14.4" N-
Longitude (NAD83) 122° 26' 05.3" W-
Overall Structure Height 311.02 feet
Support Structure Height 306.10 feet
Ground Elevation Above Mean Sea Level (AMSL) 1255.89 feet
Structure Type LTOWER - Lattice Tower
Tower Owner American Towers, LLC.
Date Constructed 03/02/2001

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
22644 KKPX-TV DTV

Primary Tower

Back to Top

Tower Modification Costs

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

Primary Tower

Back to Top

Tower Rigging Costs

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

Primary Tower

Back to Top

Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

Back to Top
Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 200
Explanation Applicant has no internal resources capable of overseeing, identifying, purchasing, installing and commissioning this repack project. It will rely solely on outside services to manage all work required.
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 No
Quantity N/A
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 No
Quantity N/A
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
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 No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

Back to Top

Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

Back to Top
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 Yes
Non-zoning permits Yes
BLM or NFS Coordination 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)? 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
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

Back to Top

Other Expenses Not Listed

Information not provided.

Cost Information

Back to Top

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 $199,900.00 $217,000.00 N/A $163,182.92 N/A
Total for all systems $699,595.00 $662,386.00 N/A $351,234.90 N/A
Primary Transmitter TMU9-4 $199,900.00 $217,000.00 $163,182.92
Transmitter installation labor and testing. $28,000.00 $28,000.00 Engineering labor to install transmitter system components and for transmitter engineering tests. $25,100.00 N/A
Transmitter installation parts $2,500.00 $2,500.00 Parts required to connect to the outside transmission line. $2,347.23 N/A
3" Rigid Conduit and Wiring (Cost per foot) $5,200.00 $5,200.00 N/A N/A N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A $17,078.47 N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $145,000.00 Verified estimate. $118,657.22 N/A

Components

Actual Information Description File Name
Transmitter installation labor and testing.

Component Description:
Field, engineering and installation services.
Amount:
$9,550.00

Component Description:
Field, engineering and installation services.
Amount:
$15,550.00
Transmitter installation parts

Component Description:
Additional transmitter parts.
Amount:
$2,347.23
3" Rigid Conduit and Wiring (Cost per foot) Information not provided.
Switchgear - industrial 800 amp

Component Description:
Cost of material for transmitter installation.
Amount:
$17,078.47
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
Engineering services: complete proof of transmitter performance, calibrate transmitter, complete power increase.
Amount:
$3,895.00

Component Description:
Cost of mask filter and other parts.
Amount:
$1,592.25

Component Description:
Transferred to a new line item.
Amount:
N/A

Component Description:
Cost of transmitter installation services.
Amount:
$13,250.00

Component Description:
Invoice for the installation of R&S TMU9 digital TV Transmitter at San Bruno, CA facility.
Amount:
$9,500.00

Component Description:
Transmitter and Filter Kit: TMU9-4 2.4KW UHF (Quote, Purchase Order and Invoice).
Amount:
$73,735.63

Component Description:
Cost of delivery of stored equipment and partial transmitter suite electrical installation.
Amount:
$13,850.00

Component Description:
Transferred to a new line item.
Amount:
N/A

Component Description:
Transferred to a new line item.
Amount:
N/A

Component Description:
Invoice for the materials and products used in the installation of the R&S TMU9 Digital Transmitter.
Amount:
$4,426.59

Cost Information

Back to Top

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 $48,290.00 $46,001.00 N/A $30,000.00 N/A
Total for all systems $699,595.00 $662,386.00 N/A $351,234.90 N/A
Primary Antenna PEPL5U-CM4 $48,290.00 $46,001.00 $30,000.00
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $0.00 N/A
UHF - Lower Power Side Mount, Class A broadband panel (cost per panel) $6,300.00 $9,600.00 RFS antenna mount. Custom antenna mounting system. $0.00 N/A
Antenna removal $30,000.00 $30,000.00 N/A $30,000.00 N/A
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $1.00 N/A N/A N/A

Components

Actual Information Description File Name
Sweep test of existing antenna Information not provided.
UHF - Lower Power Side Mount, Class A broadband panel (cost per panel)

Component Description:
Cost of RFS antenna mount.
Amount:
$9,585.00
Antenna removal

Component Description:
Cost of antenna system removal.
Amount:
$30,000.00
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) Information not provided.

Cost Information

Back to Top

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 $1,920.00 $46,000.00 N/A $41,235.48 N/A
Total for all systems $699,595.00 $662,386.00 N/A $351,234.90 N/A
Primary Transmission Line $1,920.00 $46,000.00 $41,235.48
Flexible Foam Transmission Line - dielectric, 1 5/8" $1,920.00 $46,000.00 Routing of T-Line from transmitter to relocated antenna needs approximately 80 ft of line and extra hardware. Cost of line includes coax switch and controller that replaces patch panel. See cover letter. Please refer to American Amplifier proposal 2562. $41,235.48 N/A

Components

Actual Information Description File Name
Flexible Foam Transmission Line - dielectric, 1 5/8"

Component Description:
Cost of transmission system components less coaxial switch and controller plus cost of replacement patch panel.
Amount:
$41,235.48

Cost Information

Back to Top

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 $268,500.00 $255,000.00 N/A $63,170.00 N/A
Total for all systems $699,595.00 $662,386.00 N/A $351,234.90 N/A
Primary Tower LTOWER $268,500.00 $255,000.00 $63,170.00
Short Tower (less than 500') $84,200.00 $80,000.00 N/A $30,000.00 N/A
Minor tower reinforcement/modifications $158,000.00 $150,000.00 N/A $10,475.00 N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study $26,300.00 $25,000.00 N/A $22,695.00 N/A

Components

Actual Information Description File Name
Short Tower (less than 500')

Component Description:
Removal of electrical wires, circuit conduits associated with existing transmitter; removal of transmitter and mask.
Amount:
$30,000.00
Minor tower reinforcement/modifications

Component Description:
Transferred item request to Short Tower, per FCC instructions.
Amount:
N/A

Component Description:
Line item request withdrawn.
Amount:
N/A

Component Description:
Structural engineering tower load study for documented tower.
Amount:
$10,475.00
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study

Component Description:
Complete tower services to map and measure tower members; gather tower documentation; information for use of propagation analysis/study and antenna stand-off design and configuration.
Amount:
$3,850.00

Component Description:
Address timing and coordination issues with other stations and wireless.
Amount:
$2,500.00

Component Description:
Tower mapping of an undocumented/poorly documented tower and preparation of documentation necessary for tower load study.
Amount:
$16,345.00

Cost Information

Back to Top

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 $144,990.00 $62,645.00 N/A $50,089.00 N/A
Total for all systems $699,595.00 $662,386.00 N/A $351,234.90 N/A
Outside Professional Services $144,990.00 $62,645.00 $50,089.00
Comprehensive coverage verification via field study, if needed $84,200.00 $4,895.00 N/A $4,895.00 N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $4,000.00 N/A $3,918.50 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A $2,011.50 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $2,625.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $2,275.00 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A $612.50 N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $2,137.50 N/A
Project management of the transition $31,600.00 $30,000.00 N/A $28,630.00 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A $2,984.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A

Components

Actual Information Description File Name
Comprehensive coverage verification via field study, if needed

Component Description:
Engineering repack services: field services, complete drive test of KCNZ signal, complete measurements of H and V polarization.
Amount:
$4,895.00
Attorney Fees - Negotiation of lease and other matters for shared locations

Component Description:
Attorney fee: analyze FCC policy for Class A/LPTV DTS and review FCC public policy regarding repack deadlines.
Amount:
$521.50

Component Description:
Draft update to FCC staff regarding move to interim antenna site; review email from FCC regarding transition to new facility; draft email to FCC regarding status of transition to new facility.
Amount:
$208.50

Component Description:
Attorney fees including filing fees for minor modification application for channel sharing.
Amount:
$3,188.50
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
Attorney fees: discuss modification of CP, procedures for licensing and filing, draft exhibit to license application; draft license to cover.
Amount:
$1,415.50

Component Description:
Attorney fees: review and file license to cover.
Amount:
$596.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Channel repack plan and preparation of construction permit exhibits.
Amount:
$2,625.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Antenna configuration, transmission system and transmitter power determination.
Amount:
$1,575.00

Component Description:
Engineering repack services; Quarter 3 2018 progress report submittal.
Amount:
$175.00

Component Description:
Quarterly progress report.
Amount:
$175.00

Component Description:
Engineering services: Q2 progress report.
Amount:
$87.50

Component Description:
Engineering repack services: review of KCNZ proposed service and antenna requirements.
Amount:
$262.50

Component Description:
Engineering repack services: cover letter for elliptical antenna and redo of FCC invoices.
Amount:
$175.00
Address transition timing and coordination issues w/ other stations and wireless

Component Description:
Prepare CP and assist with 399 preparation and review.
Amount:
$525.00

Component Description:
Determination of transmitter power needed at tower locations Sutro and Bruno.
Amount:
$87.50
Prepare and or review reimbursement form

Component Description:
Engineering repack services: 2/1 to 2/28/20, preparation of exhibits for 399 form.
Amount:
$1,125.00

Component Description:
Engineering repack services: 3/1/20-3/28/20, creation and modification of repack transition plan based on changes, creation of documentation for form 399 regarding changes.
Amount:
$1,012.50
Project management of the transition

Component Description:
Services from 5/2 to 5/31/2020: review of form 399 regarding changes in transmission system; discussion with FCC staff regarding license to cover application; review of field test plan.
Amount:
$6,637.50

Component Description:
Repack engineering services: quarterly progress report; for the period 4/1/19 to 5/31/19.
Amount:
$87.50

Component Description:
Project management fees: project management of the transition, for pre-construction services, antenna placement and RF compatibility review, zoning and permiting requirements review to support the transition.
Amount:
$9,480.00

Component Description:
Engineering repack services: quarterly progress report, review form 399 info, CP status investigation, 399/antenna history review, conference call with FCC.
Amount:
$1,400.00

Component Description:
Repack engineering services: from 12/1/19 to 1/4/2020; coverage map and Qtr 4 report.
Amount:
$700.00

Component Description:
Repack engineering services for the period 101/19 to 11/1/19; quarterly progress report.
Amount:
$500.00

Component Description:
Engineering repack services: 9/1-9/30/20; form 399 review and submissions.
Amount:
$450.00

Component Description:
Repack engineering services: 7/1 to 7/31/20 LTC and progress reports.
Amount:
$2,025.00

Component Description:
Engineering repack services: 3/29 to 5/1/20; creation of modification of repack license; creation of 399 documentation regarding transmission system facility changes.
Amount:
$5,625.00

Component Description:
Engineering repack services: 1/1/20 to 1/31/20, 4th quarter progress report.
Amount:
$225.00

Component Description:
Repack project management services. Research and coordination with engineering, attorney, equipment vendors and site owner. Included is the name of the person who performed the service.
Amount:
$1,500.00
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Attorney fees for reviewing and filing CP modification, reviewing minor modification application, telephone conference with FCC staff and drafting of email.
Amount:
$1,042.50

Component Description:
Research status and revise application; correspond with FCC staff.
Amount:
$641.00

Component Description:
Consultation with attorney regarding CP amendment.
Amount:
$486.50

Component Description:
Review, revise and refile 399.
Amount:
$814.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.

Cost Information

Back to Top

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 $35,995.00 $35,740.00 N/A $3,557.50 N/A
Total for all systems $699,595.00 $662,386.00 N/A $351,234.90 N/A
Other Expenses $35,995.00 $35,740.00 $3,557.50
MVPD Notification of Channel Change $5,000.00 $5,000.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $2,500.00 $2,500.00 N/A N/A N/A
Equipment Storage $7,000.00 $7,000.00 N/A $0.00 N/A
Equipment Delivery and Handling Charges $2,500.00 $2,500.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $2,000.00 $2,000.00 N/A N/A N/A
Non-zoning permits $2,000.00 $2,000.00 N/A N/A N/A
Local Zoning $2,000.00 $2,000.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $670.00 Cost of FCC fees. $670.00 N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 N/A $0.00 N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A $2,887.50 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.
Equipment Storage

Component Description:
Line item request withdrawn.
Amount:
N/A
Equipment Delivery and Handling Charges Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Non-zoning permits Information not provided.
Local Zoning Information not provided.
FCC Filing Fees - Form 2100 license to cover application

Component Description:
Cost of license to cover filing fees.
Amount:
$670.00
FCC Filing Fees - Form 2100 minor change CP application

Component Description:
Cost of filing fees: engineering STA and license to cover.
Amount:
$870.00
DTV Medical Facility Notification

Component Description:
Engineering repack services: Qtr 4 2018 reports and coverage map for DTV reception threshold contour.
Amount:
$437.50

Component Description:
Cost of medical notification mailing as required by the FCC.
Amount:
$2,450.00

Cost Information

Back to Top

Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $699,595.00 $662,386.00 $351,234.90

Reimbursement Status

Back to Top
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

Back to Top
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.

Randy E Nonberg

Manager


10/16/2020

Certification

Back to Top
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.

Randy E Nonberg

Manager


10/16/2020

Certification

Back to Top
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.

Randy E Nonberg

Manager


10/16/2020

Attachments

Back to Top