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:
127875
Service:
LPD
Call Sign:
WUVI-LD
Channel:
3 (Low VHF)
File Number:
0000089863
FRN:
0018897850
Eligibility Status:
Eligible
Date Submitted:
06/15/2022

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

HOSANNA APOSTOLIC MINISTRIES BROADCASTING CORPORATION

Doing Business As: HOSANNA APOSTOLIC MINISTRIES BROADCASTING CORPORATION

Gaspar Cota

7812 W. Sage Creek Ct.

Tucson, AZ 85743

United States

+1 (520) 971-9274 ariveradlt@riveradelatorre.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

The Preparer is same as the reimbursement contact.

 

 

 

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 1. Move sites 2. Install new antenna at the new site 3. Install new transmitter at the new site 4. Install new coax cable at the new site

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 E1000
Year 2014
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1000 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 E-3000
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 3 kW
Justification for New Transmitter We are moving from channel 20 UHF to channel 3 VHF. Retuning is not possible.

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? 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 Yes
Description New electric circuit 100 amps
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 5 tons
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

Information not provided.

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? No
Existing Antenna Manufacturer and Type
Mounting Side Mount
Antenna position in stack Top
Polarization Horizontal
Type Slotted Coaxial
ERP: 3.0 kW
Manufacturer
Model JLPU
Year 2014

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? No
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types
Mounting Side Mount
Antenna position in stack Middle
Polarization Circular
Type Other
Other Antenna Type omni-directional
ERP: 3.0 kW
Manufacturer
Model JCPD-4/3(12)-V
Year 2020
Justification for New Antenna Changing from UHF Channel 20 to VHF Channel 3. Antenna cannot be re-tuned.

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? No

Primary Antenna

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Other Antenna Cost Not Listed

Information not provided.

Transmission Line

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

Primary Transmission Line

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Existing Transmission Line

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? Yes
Existing Transmission Line Manufacturer and Type Manufacturer
Type Flexible Foam
Diameter 1 5/8 inches
Number of parallel runs 1
Length 50 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? No
Type Flexible Foam
Diameter 1 5/8 inches
Number of parallel runs 1
Length 220 feet per run
Justification for New Transmission Line New Installation
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

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

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 Move Equipment
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? No
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? No
Coordinates (NAD83) Latitude (NAD83) 41° 28' 19.94" N-
Longitude (NAD83) 087° 19' 43.0" W-
Overall Structure Height 40.00 feet
Support Structure Height 40.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 679.00 feet
Structure Type MAST - Mast
Tower Owner Hosanna
Date Constructed 01/11/2011


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 40
Explanation Hosanna does not have the expertise to do the work so therefore it will need to hire outside professional services to do the job. We have put an approx. hours per week
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 No
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 No
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 No
RF exposure measurements Yes
Additional Field Engineering Service No

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Consulting and assistance

Assisting with forms 399, city permits, equipment acquisition, installation site walks and supervision, electric install accessories, general contractor, tower construction application and process, faa advice

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 No
FCC Construction Permit Minor Change Yes
FCC License to Cover Application Yes
FCC Special Temporary Authority Application No
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? 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

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 $301,893.20 $296,793.20 N/A $186,807.49 N/A
Total for all systems $553,457.52 $521,123.02 N/A $375,882.81 N/A
Primary Transmitter E-3000 $301,893.20 $296,793.20 $186,807.49
5 Ton system $20,250.00 $15,150.00 N/A $15,150.00 N/A
Low VHF - Air Cooled Solid State Transmitter 3 kW $272,443.20 $272,443.20 N/A $162,457.49 The reason why the sub-total cost is greater than the estimated cost is because the transmitter ELMWI E-3000 is discontinued and the manufacturer close down. We are using a different manufacturer now.
Other Electrical Service: New electric circuit 100 amps $9,200.00 $9,200.00 N/A $9,200.00 N/A

Components

Actual Information Description File Name
5 Ton system

Component Description:
Total payment is due for the installation of the 5 ton ac system
Amount:
$15,150.00
Low VHF - Air Cooled Solid State Transmitter 3 kW

Component Description:
line item BE-TV3k0-FAVI
Amount:
$106,700.00

Component Description:
line item SHIPPING
Amount:
$4,643.00

Component Description:
line item Total sales tax calculated by AvaTax
Amount:
$12,381.29

Component Description:
line item 86705-1
Amount:
$7,600.00

Component Description:
line item DC3A39/2C-LK
Amount:
$832.00

Component Description:
line item HE6P300A-03
Amount:
$11,744.00

Component Description:
line item Install/Check-out and Proof
Amount:
$5,250.00

Component Description:
line item LPF-5KW-VI
Amount:
$8,160.00

Component Description:
line item SPECIAL-BE-TV5k0-COAX_KIT
Amount:
$2,931.20

Component Description:
line item 150775
Amount:
$2,216.00
Other Electrical Service: New electric circuit 100 amps

Component Description:
Total payment is due for electrical work
Amount:
$9,200.00

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 $108,822.00 $114,182.00 N/A $104,197.00 N/A
Total for all systems $553,457.52 $521,123.02 N/A $375,882.81 N/A
Primary Antenna JCPD-4/3(12)-V $108,822.00 $114,182.00 $104,197.00
Side Mount antenna brackets $4,625.00 $9,985.00 The estimated cost is greater than the predetermined cost estimate because Jampro the manufacturer priced the mounting brackets at $9,985 $10,810.00 The reason the sub total is greater is because Jampro mounting brackets quoted at that price
Low VHF-Low Power, Side Mount, Other, 3.0kW input, Circular $93,387.00 $93,387.00 N/A $93,387.00 N/A
$10,810.00 $10,810.00 N/A $0.00 The sub total is greater than the estimated cost because this is a a VHF dipole panel antenna made from Jampro antennas inc

Components

Actual Information Description File Name
Side Mount antenna brackets

Component Description:
line item #2 mounting brackets
Amount:
$10,810.00
Low VHF-Low Power, Side Mount, Other, 3.0kW input, Circular

Component Description:
Jampro JCPD-4 antenna
Amount:
$93,387.00
Information not provided.

Cost Information

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Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $5,280.00 $6,144.00 N/A $10,251.00 N/A
Total for all systems $553,457.52 $521,123.02 N/A $375,882.81 N/A
Primary Transmission Line $5,280.00 $6,144.00 $10,251.00
Flexible Foam Transmission Line - dielectric, 1 5/8" $5,280.00 $6,144.00 N/A $10,251.00 the sub total is greater than the estimated cost because the quote includes coax cable, connectors, butterfly hanger kit, round member adaptor, standard ground kit and pre laced hoisting grip

Components

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

Component Description:
300' 1-5/8" Foam Transmission Line & Installation
Amount:
$3,840.00

Component Description:
Total payment is due for coax cable
Amount:
$6,411.00

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 $56,190.00 $26,100.00 N/A $26,100.00 N/A
Total for all systems $553,457.52 $521,123.02 N/A $375,882.81 N/A
Primary Tower MAST $56,190.00 $26,100.00 $26,100.00
Tower Rigging Short Tower (less than 500') $56,190.00 $26,100.00 N/A $26,100.00 N/A

Components

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

Component Description:
Full payment is due for installation of antenna and coax cable to the tower
Amount:
$26,100.00

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 $79,827.32 $76,438.82 N/A $48,527.32 N/A
Total for all systems $553,457.52 $521,123.02 N/A $375,882.81 N/A
Outside Professional Services $79,827.32 $76,438.82 $48,527.32
Consulting and assistance $48,527.32 $48,527.32 N/A $48,527.32 n/a
Attorney Fees - Negotiation of lease and other matters for shared locations $3,262.50 $3,250.00 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
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), 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
Project management of the transition $4,220.00 $844.00 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
RF Exposure Measurements $12,100.00 $12,100.00 N/A N/A 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 $450.00 $450.00 N/A N/A N/A

Components

Actual Information Description File Name
Consulting and assistance

Component Description:
assistance for 399-assisting with form 399 and uploading of invoices and corrections alongside legal representative
Amount:
$3,120.98

Component Description:
Installation Supervision- assisting in general with coordination of the security and protection of the team that takes over the project when the installation takes place.
Amount:
$4,581.07

Component Description:
FCC Consultation- studies made to search for a new channel, a new location and negotiation of the new installation site.
Amount:
$5,391.92

Component Description:
Electric install- supervision of the instalation and coordinating with site management to insure everything is complying with the regulations of the site.
Amount:
$683.25

Component Description:
#1 GC-coordination with team about SOW,coordinating with tower & following process from start to finish. Tower application submitting, lease review & corrections, review of CD's and SA.
Amount:
$16,173.20

Component Description:
Tower Construction-general coordination with different subcontractors for the installation of electricity, antennas, transmitter, coax cable, filter, internet, and general equipment for the different programmers.
Amount:
$10,782.00

Component Description:
General Contractor FCC Consultation FAA Advice Tower Construction Equipment Adquisition Assistance with City Permits Installation Supervision Electric Install Accesories Assistance For 399
Amount:
$48,527.32

Component Description:
assistance with city permits-coordinating with the city and applying for a city permit, following up with the process.
Amount:
$1,878.40

Component Description:
Equipment Acquisition-search of the different types of equipment, quotes from different companies to purchase the type of different equipment needed.
Amount:
$3,221.00

Component Description:
FAA Advice- necessary studies made for the installation of the channel and certification. studies made to determine there is no interference with FAA towers.
Amount:
$2,695.50
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.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit 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.
Project management of the transition Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
RF Exposure Measurements Information not provided.
Prepare/ Review 399 reimbursement form Information not provided.
Form 399 assistance or other Program Management costs 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 $1,445.00 $1,465.00 N/A $0.00 N/A
Total for all systems $553,457.52 $521,123.02 N/A $375,882.81 N/A
Other Expenses $1,445.00 $1,465.00 $0.00
FCC Filing Fees - Form 2100 license to cover application $335.00 $355.00 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

Components

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $553,457.52 $521,123.02 $375,882.81

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.

Gaspar Cota

Officer


06/15/2022

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.

Dan J Alpert

Attorney


06/15/2022

Attachments

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