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:
71112
Service:
LPA
Call Sign:
WTAS-LP
Channel:
23 (UHF)
File Number:
0000087190
FRN:
0011224524
Eligibility Status:
Eligible
Date Submitted:
06/10/2021

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

WAUKESHA TOWER ASSOCIATES

Applicant

Doing Business As: WAUKESHA TOWER ASSOCIATES

136 E. WALKER STREET

MILWAUKEE, WI 53204

United States

+1 (414) 672-1940 MARTY@R4DCOMWIRELESS.COM Other

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

705B SE Melody LN #314

Lee's Summit, MO 64063

United States

+1 (816) 729-1177 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 MX1000
Year 2006
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1000 W

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-U-2000-FA
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2.2 kW
Justification for New Transmitter Per the channel reassignment - Replace the transmitter with reasonable and customary engineering and business practices.

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 costs of new transmitter

Transmitter Taxes

Sales tax for new transmitter

Transmitter Decommissioning

Decommissioning costs of old 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 12
Design power capacity in use 100.0 %
Lower Limit 470.00 MHz
Upper Limit 860.00 MHz
ERP: 39.7 kW
Manufacturer
Model 9555212
Year 2006

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 Broadband Panel
Number of Stations Supported 1
Number of Panels/Bays 6
Lower Limit 470.00 MHz
Upper Limit 860.00 MHz
Design power capacity in use 100.0 %
ERP: 5.0 kW
Manufacturer
Model UTVC-01
Year 2019
Justification for New Antenna Replace the antenna per the channel reassignment using reasonable and customary engineering and business practices.

Primary Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Broadband
Feed Line Size 1 5/8 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
Power Dividers Does the panel antenna require power dividers? Yes
Number of Power Dividers 1
Cable Harness Does the panel antenna require cable harness? Yes
Number of Cable Harnesses 1

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Antenna Sales Tax

Sales Tax for new antenna

Antenna Shipping and Handling

Shipping and Handling costs 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 Leased
Is this tower consider Complex? No
Is this tower currently shared with any other stations? No
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1054380
Coordinates (NAD83) Latitude (NAD83) 42° 58' 05.0" N-
Longitude (NAD83) 088° 11' 20.1" W-
Overall Structure Height 488.84 feet
Support Structure Height 488.84 feet
Ground Elevation Above Mean Sea Level (AMSL) 1043.62 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Global Tower, LLC. through American Towers, LLC
Date Constructed 09/28/2006


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 N/A
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 200
Explanation Required to assist in the turnkey management of the channel relocation project in order so that the existing internal personnel can maintain and operate the station's 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 Yes
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 No

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Engineering-General

General engineering services

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 $110,900.00 $125,900.00 N/A $81,300.00 N/A
Total for all systems $331,393.90 $358,895.90 N/A $112,438.90 N/A
Primary Transmitter TRN-U-2000-FA $110,900.00 $125,900.00 $81,300.00
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
Transmitter Building Site Survey/Installation $10,000.00 $25,000.00 Estimated costs for site survey and transmitter installation. Revised upon Site Survey. N/A N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $84,000.00 $84,000.00 N/A $79,800.00 N/A
Transmitter Shipping fee $2,500.00 $2,500.00 Estimated shipping costs for transmitter. Actual cost to be determined. $1,500.00 N/A
Transmitter Taxes $8,400.00 $8,400.00 Estimated taxes to be collected for transmitter. Actual costs to be determined. N/A N/A

Components

Actual Information Description File Name
Transmitter Decommissioning Information not provided.
Transmitter Building Site Survey/Installation Information not provided.
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
Cost of transmitter
Amount:
$79,800.00
Transmitter Shipping fee

Component Description:
Cost of shipping
Amount:
$1,500.00
Transmitter Taxes 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 $26,855.00 $37,735.00 N/A $18,400.00 N/A
Total for all systems $331,393.90 $358,895.90 N/A $112,438.90 N/A
Primary Antenna UTVC-01 $26,855.00 $37,735.00 $18,400.00
Antenna Sales Tax $2,200.00 $2,200.00 Estimated sales tax collected by vendors as part of the repack. Actual costs to be determined. N/A N/A
Antenna Shipping and Handling $1,500.00 $1,500.00 Estimated costs for antenna shipping and handling. Actual costs to be determined. $1,500.00 N/A
Cable harness (each, for panel antenna system, if not included in antenna cost) $1,000.00 $1,000.00 N/A N/A N/A
Power Dividers (each, for panel antenna system, if not included in antenna cost) $1,300.00 $1,300.00 N/A N/A N/A
UHF Broadband panel antenna (per panel), horizontally-polarized $10,500.00 $21,380.00 Per attached quote #0115584 from Micro Communications, Inc. $16,900.00 N/A
Sweep test of transmission line and antenna $5,730.00 $5,730.00 N/A N/A N/A
Side Mount antenna brackets $4,625.00 $4,625.00 N/A N/A N/A

Components

Actual Information Description File Name
Antenna Sales Tax Information not provided.
Antenna Shipping and Handling

Component Description:
Cost of shipping
Amount:
$1,500.00
Cable harness (each, for panel antenna system, if not included in antenna cost) Information not provided.
Power Dividers (each, for panel antenna system, if not included in antenna cost) Information not provided.
UHF Broadband panel antenna (per panel), horizontally-polarized

Component Description:
Cost of antenna
Amount:
$16,900.00
Sweep test of transmission line and antenna Information not provided.
Side Mount antenna brackets 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 $77,190.00 $77,190.00 N/A $0.00 N/A
Total for all systems $331,393.90 $358,895.90 N/A $112,438.90 N/A
Primary Tower TOWER $77,190.00 $77,190.00 $0.00
Tower Rigging Short Tower (less than 500') $56,190.00 $56,190.00 N/A N/A N/A
Tower mapping and report for structural engineer $21,000.00 $21,000.00 N/A 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 $102,738.90 $104,360.90 N/A $12,738.90 N/A
Total for all systems $331,393.90 $358,895.90 N/A $112,438.90 N/A
Outside Professional Services $102,738.90 $104,360.90 $12,738.90
Engineering-General $1,600.00 $1,600.00 Cost determined by invoices $1,600.00 N/A
Comprehensive coverage verification via field study, if needed $52,600.00 $43,732.00 Per-attached quote number 733-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 N/A N/A
Prepare Form 601 $755.00 $755.00 N/A N/A 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
Perform engineering study for displacement application $1,800.00 $1,800.00 N/A N/A N/A
Form 399 assistance or other Program Management costs $8,638.90 $8,638.90 Cost determined by invoices. $8,638.90 N/A
Prepare request for Special Temporary Authorization $1,280.00 $1,280.00 N/A N/A N/A
Project management of the transition $21,100.00 $30,800.00 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. N/A N/A
Prepare/ Review 399 reimbursement form $1,710.00 $2,500.00 Per attached QCommunications quote. $2,500.00 N/A

Components

Actual Information Description File Name
Engineering-General

Component Description:
Engineering services
Amount:
$950.00

Component Description:
Engineering services
Amount:
$650.00
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 Information not provided.
Prepare Form 601 Information not provided.
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.
Perform engineering study for displacement application Information not provided.
Form 399 assistance or other Program Management costs

Component Description:
PM Paperwork
Amount:
$616.00

Component Description:
399 Project Management costs
Amount:
$369.60

Component Description:
Paperwork PM
Amount:
$616.00

Component Description:
399 Assistance
Amount:
$500.00

Component Description:
399 Assistance and PM Costs
Amount:
$400.40

Component Description:
Form 399 Assistance
Amount:
$415.80

Component Description:
Paperwork PM
Amount:
$646.80

Component Description:
Paperwork PM
Amount:
$1,116.50

Component Description:
Paperwork PM
Amount:
$708.40

Component Description:
PM Paperwork
Amount:
$2,756.60

Component Description:
Paperwork PM
Amount:
$323.40

Component Description:
PM Paperwork
Amount:
$169.40
Prepare request for Special Temporary Authorization Information not provided.
Project management of the transition Information not provided.
Prepare/ Review 399 reimbursement form

Component Description:
Form 399 submittal
Amount:
$2,500.00

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 $13,710.00 $13,710.00 N/A $0.00 N/A
Total for all systems $331,393.90 $358,895.90 N/A $112,438.90 N/A
Other Expenses $13,710.00 $13,710.00 $0.00
Equipment Storage $5,000.00 $5,000.00 Expecting multiple staggered equipment deliveries from different vendors and need to store and stage new equipment prior to installation date. N/A N/A
Equipment Delivery and Handling Charges $1,000.00 $1,000.00 Transport, forklift rental and handling fees from staging area to transmitter site. N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $1,000.00 $1,000.00 4-6 yard disposal bin on site to capture all the waste from on site system integration and tower vendors. N/A N/A
FCC Filing Fees - Special Temporary Authorization request $305.00 $305.00 N/A 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 minor change CP application $1,110.00 $1,110.00 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

Components

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $331,393.90 $358,895.90 $112,438.90

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.

Martin Franke

Partner


06/10/2021

Attachments

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