Applicant | Address | Phone | Applicant Type | |
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THE CAMP VERDE TV CLUB Doing Business As: THE CAMP VERDE TV CLUB |
Roger Doering 420 W Angus Dr CAMP VERDE, AZ 86322 United States |
+1 (928) 567-3433 | rpdelectronics@hotmail.com | Not-for-Profit |
Applicant | Address | Phone | |
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[Confidential] |
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Applicant | Address | Phone | |
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The Preparer is same as the reimbursement contact. |
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Question | Response |
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Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. | Yes |
Briefly describe transition plan | Facility ID 69920 K31LZ with CP of K09ZX-D. The transmitter location is in the same building as the above stations, The plan is to install a new ch 9 transmit antenna, coax and new digital vhf transmitter with ch5 receive antenna, |
Section | Question | Response |
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Transmitter Related Expenses | Do you have transmitter related expenses? | Yes |
Section | Question | Response |
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Existing Transmitter Description | Type of change | Purchase New |
Use | Primary (Main) | |
Ownership | Owned | |
Is this transmitter currently shared with another station? | No | |
Is this transmitter currently in operating condition? | No | |
Existing Transmitter Manufacturer and Type | Manufacturer | |
Model | VEL20UTX | |
Year | 1986 | |
Type | Solid State | |
Solid State Cooling | Air Cooled | |
Solid State Power Capacity | 0.02 kW |
Section | Question | Response |
---|---|---|
New Transmitter | Use | Primary (Main) |
Change Type | Purchase New | |
Is this a request for upgraded equipment? | No | |
Manufacturer | ||
Model | TRN-VIII-160 | |
Transmitter Type | Solid State | |
Solid State Cooling | Air Cooled | |
Solid State Power capacity | 0.02 kW | |
Justification for New Transmitter | CHANGING BAND, CANNOT RETUNE |
Section | Question | Response |
---|---|---|
Other Transmitter Costs | ||
Does the transmitter installation require a Transmitter Building Site Survey/Installation? | No | |
Electrical Service | Service Entrance (3 phases 800A 208V) | No |
Switchgear (industrial 800 amp) | No | |
Transformer (480V) | No | |
Rigid Conduit and Wiring | No | |
Other Electrical Service | No | |
HVAC Service | Does the replacement transmitter require HVAC Service? | No |
Transmitter Building Addition/Modification or Leasehold Improvement | Does the Transmitter Building require an addition, modification, other leashold improvement? | No |
Section | Question | Response |
---|---|---|
Antenna Related Expenses | Do you have antenna related expenses? | Yes |
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? | No | |
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 | Yagi | |
ERP: | 0.16 kW | |
Manufacturer | ||
Model | CLA-7-13 | |
Year | 2019 |
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 | Yagi | |
ERP: | 0.165 kW | |
Manufacturer | ||
Model | CLA7-13 | |
Year | 2019 | |
Justification for New Antenna | BAND CHANGE REQUIRES IT. |
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? | No |
Name | Description |
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ANTENNA MOUNTING |
ANTENNA MOUNTING INSTALL |
Section | Question | Response |
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Transmission Line Related Expenses | Do you have transmission line related expenses? | Yes |
Section | Question | Response |
---|---|---|
Existing Transmission Line Description | Type of change | Purchase New |
Use | Primary (Main) | |
Ownership | Owned | |
Is the existing transmission line shared with another station or stations? | No | |
Is Transmission Line in operating condition? | No | |
Existing Transmission Line Manufacturer and Type | Manufacturer | |
Type | Flexible Foam | |
Diameter | 1/2 inches | |
Number of parallel runs | 1 | |
Length | 75 feet per run |
Section | Question | Response |
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New Transmission Line Costs | Use | Primary (Main) |
Change Type | Purchase New | |
Is this a request for upgraded equipment? | No | |
Type | Flexible Foam | |
Diameter | 1/2 inches | |
Number of parallel runs | 1 | |
Length | 65 feet per run | |
Justification for New Transmission Line | REPLACE AGING T-LINE, NOT IN COMBINED SYSTEM. | |
Interior RF Systems | Does the Installation of the Transmission Line require an additional or replacement Inside RF system including switching, patch panels, and dehydrators? | No |
Section | Question | Response |
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Tower Equipment or Rigging Costs Changes | Do you have tower equipment or rigging costs changes? | No |
Section | Question | Response |
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Outside Project Management Services | Do you require outside project management services? | No |
Outside RF consulting Engineering Services | Perform engineering study for displacement application | No |
Prepare engineering section of Form FCC Construction Permit Application | No | |
Prepare engineering section of Form FCC License to Cover Application | No | |
Prepare request for Special Temporary Authority | No | |
Prepare Form 601 | No | |
Attorney and Other Outside Consulting Services | Prepare and file Form FCC Construction Permit Application | No |
Prepare and file Form FCC License to Cover Application | Yes | |
For Auxiliary Facility | No | |
For Main Facility | Yes | |
Prepare request for Special Temporary Authority | No | |
Negotiation of Lease and other Matter for Shared Locations | No | |
Prepare or Review FCC Form 399 for Reimbursement | Yes | |
Form 399 assistance or other program management costs | Yes | |
RF Field Engineering Services | Comprehensive coverage verification via field study | Yes |
RF exposure measurements | No | |
Additional Field Engineering Service | No |
Name | Description |
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399 ELGIBLE FORM |
Preparation and Filing |
399 FORM |
Preparation and Filing |
Engineering-General |
Engineering Consultation |
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 | No | |
FCC License to Cover Application | Yes | |
FCC Special Temporary Authority Application | No | |
Other Miscellaneous Expenses | Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? | No |
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? | No | |
Does this relocation require Equipment Storage? | No | |
Point to Point Microwave (STL/ICR) | Frequency Coordination for Unidirection System | No |
Frequency Coordination for Bi-Direction System | No | |
New Point to Point Microwave System | No |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
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Sub-total | $11,300.00 | $20,663.00 | N/A | $0.00 | N/A |
Total for all systems | $85,478.20 | $82,013.20 | N/A | $2,023.20 | N/A |
Primary Transmitter TRN-VIII-160 | $11,300.00 | $20,663.00 | $0.00 | ||
High VHF - Air Cooled Solid State Transmitter 10 - 100 Watts | $11,300.00 | $20,663.00 | lowest powered transmitter on band viii available from Anywave | $0.00 | N/A |
Actual Information Description | File Name |
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High VHF - Air Cooled Solid State Transmitter 10 - 100 Watts |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $7,745.00 | $7,745.00 | N/A | $0.00 | N/A |
Total for all systems | $85,478.20 | $82,013.20 | N/A | $2,023.20 | N/A |
Primary Antenna CLA7-13 | $7,745.00 | $7,745.00 | $0.00 | ||
High-VHF, Low Power, Yagi/Cross-Dipole/Log Periodic Transmit Antenna | $1,120.00 | $1,120.00 | N/A | N/A | N/A |
Side Mount antenna brackets | $4,625.00 | $4,625.00 | N/A | N/A | N/A |
ANTENNA MOUNTING | $2,000.00 | $2,000.00 | N/A | N/A | N/A |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $227.50 | $227.50 | N/A | $0.00 | N/A |
Total for all systems | $85,478.20 | $82,013.20 | N/A | $2,023.20 | N/A |
Primary Transmission Line | $227.50 | $227.50 | $0.00 | ||
Flexible Foam Transmission Line - dielectric, 1/2" | $227.50 | $227.50 | N/A | N/A | N/A |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $60,910.70 | $52,042.70 | N/A | $2,023.20 | N/A |
Total for all systems | $85,478.20 | $82,013.20 | N/A | $2,023.20 | N/A |
Outside Professional Services | $60,910.70 | $52,042.70 | $2,023.20 | ||
Engineering-General | $360.00 | $360.00 | Cost determined by Invoices | $360.00 | N/A |
Prepare/ Review 399 reimbursement form | $1,710.00 | $1,710.00 | N/A | N/A | N/A |
Form 399 assistance or other Program Management costs | $1,663.20 | $1,663.20 | Cost determined by invoices. | $1,663.20 | N/A |
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | $1,577.50 | $1,577.50 | N/A | N/A | N/A |
399 FORM | $2,500.00 | $2,500.00 | N/A | N/A | N/A |
399 ELGIBLE FORM | $500.00 | $500.00 | N/A | N/A | N/A |
Comprehensive coverage verification via field study, if needed | $52,600.00 | $43,732.00 | Per-attached quote number 743-R for Coverage Verification | N/A | N/A |
Actual Information Description | File Name |
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Engineering-General | |
Prepare/ Review 399 reimbursement form | Information not provided. |
Form 399 assistance or other Program Management costs | |
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application | Information not provided. |
399 FORM | Information not provided. |
399 ELGIBLE FORM | Information not provided. |
Comprehensive coverage verification via field study, if needed | Information not provided. |
Description | Predetermined Cost Estimate |
Estimated Cost | Estimated Cost Justification | Actual Cost | Actual Cost Justification |
---|---|---|---|---|---|
Sub-total | $5,295.00 | $1,335.00 | N/A | $0.00 | N/A |
Total for all systems | $85,478.20 | $82,013.20 | N/A | $2,023.20 | N/A |
Other Expenses | $5,295.00 | $1,335.00 | $0.00 | ||
FCC Filing Fees - Form 2100 license to cover application | $335.00 | $335.00 | N/A | $0.00 | N/A |
FCC Filing Fees - Form 2100 Major change CP application | $4,960.00 | $1,000.00 | The Camp Verde TV Club met with the Full Power Stations in Phoenix and worked with a consultant to determine open channels. Travel $500 Filing Fees $500 | N/A | N/A |
Predetermined Cost Estimate |
Estimated Cost | Actual Cost | |
---|---|---|---|
Total for all systems | $85,478.20 | $82,013.20 | $2,023.20 |
Question | Response |
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The facility has ceased operating on its pre-auction channel. | Yes |
Construction of final facilities or all necessary modifications are complete. | 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 |
Section | Question | Response |
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Submission of Estimated Expenses Statements | WILLFUL FALSE STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT. |
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I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above. | Roger Doering Vice President and Engineer 02/11/2021 |
Section | Question | Response |
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Submission of Actual Cost Documentation Statements | WILLFUL FALSE, FRAUDULENT, OR FICTITIOUS STATEMENTS ON THIS FORM ARE PUNISHABLE BY FINE AND/OR IMPRISIONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503), AND ANY FALSE AND/OR FRAUDULENT STATEMENTS COULD SUBJECT THIS ENTITY TO LIABILITY UNDER THE FALSE CLAIMS ACT (U.S. CODE, TITLE 31, SECTIONS 3729-3733). |
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I declare, under penalty of perjury, that I am an authorized representative of the above-named applicant for the Authorization(s) specified above. | Roger Doering Vice President and Engineer 02/11/2021 |