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:
55108
Service:
DCA
Call Sign:
WIRE-CD
Channel:
33 (UHF)
File Number:
0000028078
FRN:
0031452105
Date Submitted:
10/10/2021

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

D.T.V. LLC

Doing Business As: D.T.V. LLC

RANDOLPH WEIGNER

1903 SOUTH GREELEY HWY. #127

CHEYENNE, WY 82007

United States

+1 (877) 688-8954 DTVTV@YAHOO.COM Limited Liability Company

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

Tony zumMallen

QCommunications

705B SE Melody Ln

#314

Lee's Summit, MO 64063

United States

+1 (816) 729-1177 nick@qcomm.tv

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan Build the facilities as close to the current 15 kW ERP power level as possible. The station may opt for channel change and may have to change the antenna size depending on available tower space which may require an increase in transmitter power.

Transmitters

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

Primary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model AUTV/3500LD
Year 2009
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 3.5 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 TMU9-3
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1.8 kW
Justification for New Transmitter replace analog transmitter

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) Yes
Switchgear (industrial 800 amp) No
Transformer (480V) Yes
Power 150 kVA
Rigid Conduit and Wiring Yes
Size 1.5 inches
Length 70.0 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

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Other Transmitter Cost Not Listed

Name Description

Dehydrator

Dehydrator

Digital EAS

Emergency Alert System and related software

Antennas

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

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? Yes
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? Yes
Existing Antenna Manufacturer and Type Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 15.0 kW
Manufacturer
Model PSILP24AER-40
Year 2009

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? 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? Yes
New Antenna Manufacturer and Types Class Class A
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 15.0 kW
Manufacturer
Model TFU-14EST/VP-R 3C190
Year 2017
Justification for New Antenna EXISTING ANTENNA IS CHANNEL SPECIFIC

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna?
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? N/A
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Single Channel
Feed Line Size 3 1/8 inches inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? No
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Sweep after Antenna Install

Sweep of new antenna

Dehydrator and parts

Dehydrator and parts

Travel

Travel required to station for transitioning/testing

Antenna Mounts

Antenna mount costs

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)
Description of Use N/A
Ownership Leased
Is this tower consider Complex? Candelabra
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 Yes
Is tower documented for structural analysis? No
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1206253
Coordinates (NAD83) Latitude (NAD83) 33° 44' 40.9" N-
Longitude (NAD83) 084° 21' 35.7" W-
Overall Structure Height 1080.04 feet
Support Structure Height 956.03 feet
Ground Elevation Above Mean Sea Level (AMSL) 969.15 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner American Towers, LLC
Date Constructed 05/14/2002

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
23959 WRAS FM
168094 WYGA-CD DTV
11275 WWPW FM
73345 WWWQ FM
6809 WNNX FM
30822 WSTR FM
29735 WUBL FM

Other Types of Users

Users
WIRELESS 2
WIRELESS 1
WIGL-LD
W275BK
FM MICROWAVE

Primary Tower

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Tower Modification Costs

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

Primary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower Candelabra
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 605
Explanation Project management (Invoice processing, progress reporting, daisy chain monitoring and analysis, program management, and site visits as 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 Yes
Quantity 1
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification Yes
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 No
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

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Other Professional Services Expenses Not Listed

Name Description

Attorney fees - General

Attorney fees - General repack work

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning Yes
Non-zoning permits No
BLM or NFS Coordination No
FCC Construction Permit Minor Change Yes
FCC License to Cover Application Yes
FCC Special Temporary Authority Application Yes
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? Yes
Does this relocation require Equipment Storage? 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? No

Other Expenses

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Other Expenses Not Listed

Name Description

Travel Expenses

Travel expenses incurred during the course of the equipment installations

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 $176,290.19 $168,340.19 N/A $73,854.03 N/A
Total for all systems $1,084,823.99 $656,663.74 N/A $282,140.88 N/A
Primary Transmitter TMU9-3 $176,290.19 $168,340.19 $73,854.03
Digital EAS $4,370.44 $4,370.44 Per attached invoice $0.00 Invoice submitted.
Dehydrator $2,829.75 $2,829.75 Dehydrator per ERI invoice. Includes freight and sales tax. $2,829.75 N/A
1.5" Rigid Conduit and Wiring $3,140.00 $3,140.00 Actual costs submitted $3,140.00 N/A
Transformer 3 phase/480v - 150 KVA $25,550.00 $24,300.00 Predetermined Cost Estimate $0.00 N/A
Service entrance 3 phase/800 amp/208 volt $14,400.00 $13,700.00 Predetermined Cost Estimate N/A N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $120,000.00 Predetermined Cost Estimate $67,884.28 N/A

Components

Actual Information Description File Name
Digital EAS

Component Description:
New EAS required to be compatible with new digital system.
Amount:
$4,370.44
Dehydrator

Component Description:
Dehydrator. ERI INV 39094. Inc tax & freight.
Amount:
$2,829.75
1.5" Rigid Conduit and Wiring

Component Description:
Electrical services related to REPACK
Amount:
$3,140.00
Transformer 3 phase/480v - 150 KVA Information not provided.
Service entrance 3 phase/800 amp/208 volt Information not provided.
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
Transmitter installation and proof
Amount:
$6,355.78

Component Description:
TMU9-3 1.8kW UHF CH 33
Amount:
$61,528.50

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 $65,525.91 $75,090.66 N/A $59,028.61 N/A
Total for all systems $1,084,823.99 $656,663.74 N/A $282,140.88 N/A
Primary Antenna TFU-14EST/VP-R 3C190 $65,525.91 $75,090.66 $59,028.61
Dehydrator and parts $7,480.91 $7,480.91 Actual costs submitted $4,908.03 Actual costs submitted
Antenna Mounts $10,125.00 $10,125.00 Per attached Dielectric quote. $10,125.00 Actual costs submitted.
Travel $2,000.00 $2,000.00 Actual invoices submitted $1,410.83 N/A
Sweep after Antenna Install $5,290.00 $5,290.00 Per Actual costs from Pro Service Invoice $5,290.00 N/A
Elbow complex, single channel, at antenna input, per 3 1/8. feedline (if needed) $7,600.00 $7,400.00 Predetermined Cost Estimate N/A N/A
Sweep test of existing antenna $6,730.00 $11,000.00 Actual invoices uploaded. $5,500.00 Actual Invoices uploaded
UHF - Lower Power Side Mount, Class A One Station antenna -- basic $26,300.00 $31,794.75 Actual costs submitted. $31,794.75 Actual costs submitted.

Components

Actual Information Description File Name
Dehydrator and parts

Component Description:
Sales tax CM for defective dehydrator - Dielectric - CM-ST687008
Amount:
($245.84)

Component Description:
Credit memo - defective dehydrator
Amount:
($2,762.25)

Component Description:
Washers
Amount:
$11.18

Component Description:
Antenna parts invoices, minus dehydrator
Amount:
$4,107.27

Component Description:
Clevis Hanger
Amount:
$151.33

Component Description:
Line dehydrator
Amount:
$2,762.25

Component Description:
Antenna install parts - bolts
Amount:
$25.49

Component Description:
Parts invoice sales tax
Amount:
$611.39

Component Description:
Antenna install misc parts
Amount:
$82.42

Component Description:
Antenna install parts
Amount:
$32.35

Component Description:
Install parts
Amount:
$105.10

Component Description:
Misc fasteners for antenna installation
Amount:
$27.34
Antenna Mounts

Component Description:
CUSTOM MOUNTS FOR ANTENNA TFU- 14EST/VP-R 3C190, WIRE CH 33
Amount:
$10,125.00

Component Description:
CUSTOM MOUNTS FOR ANTENNA TFU- 14EST/VP-R 3C190, WIRE CH 33
Amount:
$10,125.00
Travel

Component Description:
Travel Expenses
Amount:
$109.04

Component Description:
Travel expenses
Amount:
$109.04

Component Description:
Travel Expenses
Amount:
$251.46

Component Description:
Travel Expenses
Amount:
$120.73

Component Description:
Travel Expenses
Amount:
$135.11

Component Description:
Travel Expenses
Amount:
$582.08

Component Description:
Travel Expenses
Amount:
$103.37
Sweep after Antenna Install

Component Description:
Sweep - new antenna - Pro Service INV 200324B
Amount:
$5,290.00
Elbow complex, single channel, at antenna input, per 3 1/8. feedline (if needed) Information not provided.
Sweep test of existing antenna

Component Description:
Antenna sweep
Amount:
$5,500.00

Component Description:
Previous Dielectric "Proforma Invoice" erroneously uploaded for Sweep. REPACK Sweep actually performed by ProService, not Dielectric.
Amount:
$5,500.00
UHF - Lower Power Side Mount, Class A One Station antenna -- basic

Component Description:
Freight fees for antenna
Amount:
$4,725.00

Component Description:
Invoice for antenna, requesting antenna cost (without VPOL upgrade)
Amount:
$23,512.50

Component Description:
Antenna sales tax
Amount:
$3,557.25

Component Description:
Invoice for antenna, requesting antenna cost (without VPOL upgrade)
Amount:
$23,512.50

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 $599,000.00 $223,000.00 N/A $35,499.80 N/A
Total for all systems $1,084,823.99 $656,663.74 N/A $282,140.88 N/A
Primary Tower GTOWER $599,000.00 $223,000.00 $35,499.80
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $40,000.00 Predetermined Cost Estimate $26,629.80 N/A
Structural engineering tower load study for a documented tower with candelabra $20,000.00 $33,000.00 Predetermined Cost Estimate $8,870.00 N/A
Minor tower reinforcement/modifications $158,000.00 $150,000.00 Predetermined Cost Estimate N/A N/A

Components

Actual Information Description File Name
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)

Component Description:
Antenna Install - DaVinci Solutions INV 1726
Amount:
$18,129.80

Component Description:
Antenna removal
Amount:
$8,500.00
Structural engineering tower load study for a documented tower with candelabra

Component Description:
Broadcast Structural
Amount:
$3,910.00

Component Description:
Broadcast Tower Mapping
Amount:
$4,960.00
Minor tower reinforcement/modifications 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 $222,947.50 $169,767.50 N/A $109,053.05 N/A
Total for all systems $1,084,823.99 $656,663.74 N/A $282,140.88 N/A
Outside Professional Services $222,947.50 $169,767.50 $109,053.05
Project management of the transition $95,590.00 $109,155.00 Per Quote $68,790.55 N/A
Attorney fees - General $8,762.50 $8,762.50 Actual costs submitted. $8,762.50 Actual costs submitted.
Comprehensive coverage verification via field study, if needed $84,200.00 $18,600.00 Actuals submitted $18,600.00 N/A
ASR modification (prepare FCC Form 854) $2,105.00 $2,000.00 Predetermined Cost Estimate N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,500.00 Predetermined Cost Estimate $0.00 N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $4,000.00 Predetermined Cost Estimate $3,400.00 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 Predetermined Cost Estimate N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $6,000.00 Actual costs submitted $6,000.00 Actual costs submitted.
Prepare request for Special Temporary Authorization $2,050.00 $1,500.00 Predetermined Cost Estimate N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 Predetermined Cost Estimate $0.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 Predetermined Cost Estimate $1,750.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 Predetermined Cost Estimate $1,600.00 N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 Predetermined Cost Estimate $150.00 N/A

Components

Actual Information Description File Name
Project management of the transition

Component Description:
Sept 2021 PM - QComm - INV 230037
Amount:
$4,758.60

Component Description:
August 2021 PM - QComm INV 230027
Amount:
$2,679.60

Component Description:
June 2021 PM - QComm - INV QC21-913
Amount:
$2,479.40

Component Description:
April 2021 PM - QComm - INV QC21-863
Amount:
$1,647.80

Component Description:
July 2021 PM - Qcomm - INV 230011
Amount:
$1,647.80

Component Description:
May 2021 PM - QComm - INV QC21-884
Amount:
$2,202.20

Component Description:
Widelity PM Hours: Aug 2019
Amount:
$2,632.70

Component Description:
QC20-503 : Oct PM Hours
Amount:
$862.40

Component Description:
QC20-362 : May PM Hours
Amount:
$785.40

Component Description:
Nov 2020 PM hours
Amount:
$569.80

Component Description:
Project management
Amount:
$1,899.15

Component Description:
Project Management - Apr 2020
Amount:
$646.80

Component Description:
Sept 2020 PM
Amount:
$1,216.60

Component Description:
Project Management
Amount:
$2,129.30

Component Description:
Project Management
Amount:
$2,410.70

Component Description:
Feb 2021 PM hours
Amount:
$2,017.40

Component Description:
August Paperwork PM Hours
Amount:
$569.80

Component Description:
Project Management
Amount:
$2,379.15

Component Description:
Dec 2020 PM hours
Amount:
$3,865.40

Component Description:
PO Line 1 - NTP Billable - Project Mgmt
Amount:
$9,480.00

Component Description:
QC20-431 : July PM Hours
Amount:
$1,001.00

Component Description:
Project Management
Amount:
$1,965.40

Component Description:
Project Management
Amount:
$185.00

Component Description:
Jan 2021 Hours
Amount:
$1,971.20

Component Description:
Mar 2021 PM hours
Amount:
$2,202.20

Component Description:
Project Management
Amount:
$3,372.80

Component Description:
Project Management
Amount:
$1,625.70

Component Description:
Widelity PM Hours: July 2019
Amount:
$390.00

Component Description:
Project Management - Oct 2019 - Jan 2020
Amount:
$3,803.80

Component Description:
Project Management
Amount:
$1,628.60

Component Description:
Cost Reconciliation
Amount:
$246.25

Component Description:
Project Management
Amount:
$176.25

Component Description:
Project Management - Feb 2020
Amount:
$754.60

Component Description:
Project Management
Amount:
$123.75

Component Description:
Project Management - Mar 2020
Amount:
$1,170.40

Component Description:
QC20-350 : June PM Hours
Amount:
$1,293.60
Attorney fees - General

Component Description:
Attorney fees re. general repack work
Amount:
$150.00

Component Description:
Attorney fees re. general repack work
Amount:
$650.00

Component Description:
Oct 2020 Legal fees - Inv 223808
Amount:
$5,350.00

Component Description:
Attorney fees re. general repack work. Review of vendor contract.
Amount:
$100.00

Component Description:
General attorney fees for REPACK
Amount:
$500.00

Component Description:
REPACK legal fees
Amount:
$212.50

Component Description:
Sept 2020 Legal - Inv 223807
Amount:
$1,350.00

Component Description:
Nov 2020 Legal - Fletcher - INV 224187
Amount:
$300.00

Component Description:
Attorney fees re. general repack work.
Amount:
$150.00
Comprehensive coverage verification via field study, if needed

Component Description:
Coverage Verification
Amount:
$18,600.00
ASR modification (prepare FCC Form 854) Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
Attorney fees re. STA application
Amount:
$100.00
Attorney Fees - Negotiation of lease and other matters for shared locations

Component Description:
Phone Weigner and Cole
Amount:
$2,750.00

Component Description:
Attorney fees for lease negotiations
Amount:
$650.00
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Attorney fees re. CP application
Amount:
$650.00

Component Description:
Attorney fees re. CP application
Amount:
$3,250.00

Component Description:
Attorney fees re. CP application
Amount:
$2,100.00
Prepare request for Special Temporary Authorization Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
RF Eng Construction Permit Application
Amount:
$1,750.00
Perform engineering study for new channel assignment and antenna development

Component Description:
Interference analysis on present channel and repack channel.
Amount:
$850.00

Component Description:
Engineering for antenna change modification
Amount:
$750.00
Prepare and or review reimbursement form

Component Description:
Attorney fees re. 399 prep assistance
Amount:
$150.00

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 $21,060.39 $20,465.39 N/A $4,705.39 N/A
Total for all systems $1,084,823.99 $656,663.74 N/A $282,140.88 N/A
Other Expenses $21,060.39 $20,465.39 $4,705.39
Travel Expenses $620.39 $620.39 Actual costs submitted $620.39 N/A
Develop and air announcement of upcoming channel change $250.00 $250.00 No Predetermined Estimate N/A N/A
Equipment Storage $1,000.00 $1,000.00 No Predetermined Estimate N/A N/A
Equipment Delivery and Handling Charges $2,500.00 $2,500.00 No Predetermined Estimate N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $3,000.00 $3,000.00 No Predetermined Estimate N/A N/A
Local Zoning $500.00 $500.00 No Predetermined Estimate N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 Predetermined Estimate N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $335.00 Predetermined Estimate $335.00 Actual receipts uploaded.
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 Predetermined Estimate N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 Predetermined Estimate $3,750.00 N/A

Components

Actual Information Description File Name
Travel Expenses

Component Description:
Flight for transmitter install - Jet Blue - Ticket #2792142572263
Amount:
$250.39

Component Description:
Hotel - Antenna install - # 49524750
Amount:
$109.39

Component Description:
Travel - site visit - antenna removal - Jet Blue
Amount:
$260.61
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges Information not provided.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Local Zoning Information not provided.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
FCC Filing Fees - Form 2100 license to cover application

Component Description:
Receipt for FCC filing fees for License to Cover app
Amount:
$335.00

Component Description:
FCC filing fees for License to Cover Application
Amount:
$335.00
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
DTV Medical Facility Notification

Component Description:
Medical Facility Notification
Amount:
$3,750.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $1,084,823.99 $656,663.74 $282,140.88

Reimbursement Status

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Question Response
The facility has ceased operating on its pre-auction channel. Yes
Construction of final facilities or all necessary modifications are complete. 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. Yes

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.

RANDOLPH WEIGNER

LLC MEMBER


10/10/2021

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.

RANDOLPH WEIGNER

LLC MEMBER


10/10/2021

Certification

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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.

RANDOLPH WEIGNER

LLC MEMBER


10/10/2021

Attachments

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