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:
168641
Service:
LPD
Call Sign:
KZDN-LD
Channel:
14 (UHF)
File Number:
0000089272
FRN:
0005741558
Eligibility Status:
Eligible
Date Submitted:
02/10/2021

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

SYNCOM MEDIA GROUP, INC.

Doing Business As: SYNCOM MEDIA GROUP

3253 SAND MARSH LANE

MOUNT PLEASANT, SC 29466

United States

+1 (303) 520-9996 JCBlair123@GMAIL.COM Corporation

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 zumMallen

Anywave Communication Technologies

Tony zumMallen

300 Knightsbridge Parkway, Suite 150

Lincolnshire, IL 60069

United States

+1 (816) 882-5600 tony.zummallen@anywavecom.com

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 Replace the transmitter and antenna per the channel reassignment with reasonable and customary engineering and business practices.

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 25P
Year 2009
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1.5 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 TRN-5X-U-28C
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2.5 kW
Justification for New Transmitter New transmitter required for new channel.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Other Transmitter Costs
Does the transmitter installation require a Transmitter Building Site Survey/Installation? Yes
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

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Transmitter Shipping fee

Shipping fees for new transmitter

Transmitter Decommissioning

Harvesting and removal of old equipment

Site Prep

Preparation of site for new transmitter

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? 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 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 860.00 MHz
ERP: 15.0 kW
Manufacturer
Model 955314
Year 2009

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? 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 Horizontal
Type Slotted Coaxial
ERP: 5.0 kW
Manufacturer
Model PSILP8EC-14
Year 2019
Justification for New Antenna New antenna required for new channel due to propagation issues with existing antenna on new channel.

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? 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

Name Description

Antenna Shipping fee

Shipping fees for new antenna

Antenna Sales Tax

Sales tax for new antenna

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? Yes

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Ownership Owned
Is this tower consider Complex? Located on Building
Is this tower currently shared with any other stations? 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? No
Coordinates (NAD83) Latitude (NAD83) 39° 43' 45.9" N-
Longitude (NAD83) 105° 14' 09.9" W-
Overall Structure Height 52.50 feet
Support Structure Height 52.50 feet
Ground Elevation Above Mean Sea Level (AMSL) 7372.00 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Mauna Towers LLC Lookout MTN #1
Date Constructed 06/06/2011


Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Tower mapping and report for structural engineer
Tower Reinforcements Please select whether tower reinforcements are needed: No reinforcements needed

Primary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower Located on Building
Helicopter Services Required Are helicopter services required? No

Primary Tower

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Other Tower Expenses Not Listed

Information not provided.

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 350
Explanation Required to assist in the turnkey management of the channel relocation project in order that the existing internal personal can maintain and operate the stations daily operational requirements and plans.
Outside RF consulting Engineering Services Perform engineering study for displacement application 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 1
Prepare Form 601 No
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 1
Negotiation of Lease and other Matter for Shared Locations Yes
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 Yes
RF exposure measurements No
Additional Field Engineering Service Yes
Number of Days 5
Justification Estimated field engineering services required during transition activities.

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Attorney Fees- General

General Attorney fees regarding Repack and KZDN

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 Yes
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? Yes
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

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 $314,714.27 $93,525.75 N/A $30,968.99 N/A
Total for all systems $551,155.37 $338,863.85 N/A $44,495.09 N/A
Primary Transmitter TRN-5X-U-28C $314,714.27 $93,525.75 $30,968.99
Site Prep $7,000.00 $7,000.00 4/3/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. N/A N/A
Transmitter Decommissioning $6,000.00 $6,000.00 Estimated costs of harvesting and removal of old transmitter from site. Revised upon Site Survey. N/A N/A
Channel 14 Mask Filter $189,500.00 $9,715.08 Per attached ProService invoice. $2,918.32 N/A
Transmitter Shipping fee $454.27 $454.27 Per attached Anywave invoice. $454.27 N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $84,000.00 $27,596.40 Per attached Anywave invoice. $27,596.40 N/A
RF Consulting Engineer $5,260.00 $5,260.00 N/A N/A N/A
Channel 14 -- Additional field engineering time, 5 days $12,500.00 $12,500.00 Estimated field engineering services during transition activities. Actual costs to be determined. N/A N/A
Transmitter Building Site Survey/Installation $10,000.00 $25,000.00 Estimated costs for site survey and transmitter installation. Actual costs to be determined. 4/3/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. N/A N/A

Components

Actual Information Description File Name
Site Prep Information not provided.
Transmitter Decommissioning Information not provided.
Channel 14 Mask Filter

Component Description:
Mask Filter Installation
Amount:
$2,000.00

Component Description:
Filter install
Amount:
$4,954.13

Component Description:
Filter Install/Turn on.
Amount:
$1,842.63

Component Description:
Elbows for filter.
Amount:
$918.32
Transmitter Shipping fee

Component Description:
Cost of shipping
Amount:
$454.27
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
Cost of transmitter
Amount:
$27,596.40
RF Consulting Engineer Information not provided.
Channel 14 -- Additional field engineering time, 5 days Information not provided.
Transmitter Building Site Survey/Installation Information not provided.

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 $25,385.00 $25,385.00 N/A $0.00 N/A
Total for all systems $551,155.37 $338,863.85 N/A $44,495.09 N/A
Primary Antenna PSILP8EC-14 $25,385.00 $25,385.00 $0.00
UHF-Low Power, Side Mount, Slotted Coaxial, 5.0kW input, Horizontal $11,550.00 $11,550.00 Per attached PSI quote. $0.00 N/A
Antenna Sales Tax $2,000.00 $2,000.00 Estimated sales tax for new antenna. Actual costs to be determined. 4/3/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. N/A N/A
Antenna Shipping fee $1,480.00 $1,480.00 Estimated shipping fees for new antenna. Actual costs to be determined. 4/3/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. N/A N/A
Side Mount antenna brackets $4,625.00 $4,625.00 4/3/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. $0.00 N/A
Sweep test of transmission line and antenna $5,730.00 $5,730.00 N/A N/A N/A

Components

Actual Information Description File Name
UHF-Low Power, Side Mount, Slotted Coaxial, 5.0kW input, Horizontal Information not provided.
Antenna Sales Tax Information not provided.
Antenna Shipping fee Information not provided.
Side Mount antenna brackets

Component Description:
This invoice was moved to Mask Filter components. Please Delete this invoice.
Amount:
N/A
Sweep test of transmission line and antenna 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

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 $71,000.00 $71,000.00 N/A $0.00 N/A
Total for all systems $551,155.37 $338,863.85 N/A $44,495.09 N/A
Primary Tower TOWER $71,000.00 $71,000.00 $0.00
Complex Tower (includes, e.g., towers with candelabras and/or stacked antennas) $50,000.00 $50,000.00 4/3/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. N/A N/A
Tower mapping and report for structural engineer $21,000.00 $21,000.00 4/3/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. N/A N/A

Components

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 $130,346.10 $139,243.10 N/A $13,526.10 N/A
Total for all systems $551,155.37 $338,863.85 N/A $44,495.09 N/A
Outside Professional Services $130,346.10 $139,243.10 $13,526.10
Attorney Fees- General $975.00 $975.00 Cost determined by submitted invoices $875.00 N/A
Form 399 assistance or other Program Management costs $9,301.10 $9,301.10 Estimate of Form 399 assistance required for reimbursement of invoices. Actual costs to be submitted. $9,301.10 N/A
Additional Field Engineering Service, 5 Days $12,500.00 $12,500.00 Estimated field engineering services during transition activities. Actual costs to be determined. N/A N/A
Comprehensive coverage verification via field study, if needed $52,600.00 $43,732.00 Per-attached quote number 711-R for Coverage Verification N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $2,235.00 $2,235.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $3,262.50 $3,262.50 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $1,577.50 $1,577.50 N/A $850.00 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $3,025.00 $3,025.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,052.50 $1,052.50 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $2,102.50 $2,102.50 N/A N/A N/A
Prepare request for Special Temporary Authorization $1,280.00 $1,280.00 N/A N/A N/A
Perform engineering study for displacement application $1,800.00 $1,800.00 N/A N/A N/A
Prepare/ Review 399 reimbursement form $1,710.00 $2,500.00 Per attached Anywave invoice. $2,500.00 N/A
Project management of the transition $36,925.00 $53,900.00 Estimated 350 hours x $154/hr N/A N/A

Components

Actual Information Description File Name
Attorney Fees- General

Component Description:
Legal Services
Amount:
$125.00

Component Description:
Legal Services
Amount:
$750.00

Component Description:
Work pertaining to KZDN on Repack
Amount:
$100.00
Form 399 assistance or other Program Management costs

Component Description:
Paperwork PM
Amount:
$1,617.00

Component Description:
399 Follow up work
Amount:
$939.40

Component Description:
Paperwork PM
Amount:
$1,463.00

Component Description:
399 Follow up work
Amount:
$1,016.40

Component Description:
399 Assistance
Amount:
$585.20

Component Description:
Paperwork PM
Amount:
$1,586.20

Component Description:
Prepare and process Form 399
Amount:
$500.00

Component Description:
Paperwork PM
Amount:
$877.80

Component Description:
Paperwork PM
Amount:
$716.10
Additional Field Engineering Service, 5 Days 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.
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
License to cover fees.
Amount:
$850.00
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application 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 Information not provided.
Prepare request for Special Temporary Authorization Information not provided.
Perform engineering study for displacement application Information not provided.
Prepare/ Review 399 reimbursement form

Component Description:
Form 399 Submission.
Amount:
$2,500.00
Project management of the transition 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 $9,710.00 $9,710.00 N/A $0.00 N/A
Total for all systems $551,155.37 $338,863.85 N/A $44,495.09 N/A
Other Expenses $9,710.00 $9,710.00 $0.00
Equipment Delivery and Handling Charges $1,000.00 $1,000.00 Estimated transport, forklift rental and handling fees from staging area to transmitter site. Actuals to be determined. N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $1,000.00 $1,000.00 Estimated 4-6 yard disposal bin on site to capture all waste from on site system integration and tower vendors. Actual costs to be determined. N/A N/A
FCC Filing Fees - Form 2100 Major change CP application $4,960.00 $4,960.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $335.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,110.00 N/A N/A N/A
Equipment Storage $1,000.00 $1,000.00 Expecting multiple staggered equipment deliveries from different vendors and need to store and stage new equipment prior to installation date. N/A N/A
FCC Filing Fees - Special Temporary Authorization request $305.00 $305.00 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 $551,155.37 $338,863.85 $44,495.09

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. 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.

J Christopher Blair

President


02/10/2021

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.

J Chistorpher Blair

President


02/10/2021

Attachments

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