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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:
26251
Service:
LPD
Call Sign:
WDNM-LD
Channel:
22 (UHF)
File Number:
0000089809
FRN:
0001843697
Eligibility Status:
Eligible
Date Submitted:
08/31/2022

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

WORD OF GOD FELLOWSHIP, INC.

Applicant

Doing Business As: WORD OF GOD FELLOWSHIP, INC.

Arnold Torres

3901 HIGHWAY 121, SOUTH

BEDFORD, TX 76021

United States

 +1 (817) 571-1229 arnold.torres@daystar.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

Samuel Hariton

Widelity, Inc.

Samuel Hariton

4031 University Drive

Ste 100

Fairfax, VA 22030

United States

 +1 (339) 222-8107 sam.hariton@widelity.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 WDNM will transition from channel 21 to channel 22 by changing its antenna and utilizing a mask filter. WDNM will not change tower sites.

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 Retune Existing
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 Pineapple
Model SS AC DTX-5KU-50
Year 2010
Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 5.0 kW

Primary Transmitter

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Retuning Transmitter Costs

Section Question Response
New Mask Filter Does the transmitter require a new mask filter? Yes
Mask Filter Type Full Service
Power 3.1-5kW
New Exciter Is a new exciter needed? No

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? Yes
Size 200.0

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? Yes
Existing Antenna Manufacturer and Type
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
ERP: 15.0 kW
Manufacturer
Model SWEDL8OI
Year 2010

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 16
Lower Limit 518.00 MHz
Upper Limit 524.00 MHz
Design power capacity in use 80.0 %
ERP: 15.0 kW
Manufacturer
Model SWEDL16NC/22
Year 2019
Justification for New Antenna Existing antenna cannot accommodate channel 22 operations.

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? Single Channel
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? No
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
Power Dividers Does the panel antenna require power dividers? No
Cable Harness Does the panel antenna require cable harness? No

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Antenna removal and installation

Antenna removal and installation

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? Located on Building
Is this tower currently shared with any other stations? No
Is tower documented for structural analysis? No
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? No
Coordinates (NAD83) Latitude (NAD83) 35° 06' 44.1" N-
Longitude (NAD83) 089° 53' 31.2" W-
Overall Structure Height 466.86 feet
Support Structure Height 375.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 320.86 feet
Structure Type B - Building
Tower Owner TRIZECHAHN TBI CLARK TOWER LLC
Date Constructed 01/01/1998


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 need for guyed or free-standing tower
Tower Reinforcements Please select whether tower reinforcements are needed: No reinforcements needed

Primary Tower

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Tower Rigging Costs

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

Primary Tower

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Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 254
Explanation WDNM-LD does not have sufficient resource capacity and expertise in house to handle all activities necessary for completion of the station's build by the construction deadline. WDNM-LD will hire an outside firm to facilitate a timely transition.
Outside RF consulting Engineering Services Perform engineering study for displacement application Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
Prepare Form 601 No
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
Negotiation of Lease and other Matter for Shared Locations 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 No
RF exposure measurements Yes
Additional Field Engineering Service No

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Information not provided.

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 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

Name Description

Building Permits

Building Permits

Construction Drawings

Construction Drawings

Internal Labor

Internal Labor

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 $52,150.00 $48,150.00 N/A $21,500.00 N/A
Total for all systems $230,563.26 $200,104.88 N/A $133,279.46 N/A
Primary Transmitter SS AC DTX-5KU-50 $52,150.00 $48,150.00 $21,500.00
Transmitter Building Site Survey/Installation $10,000.00 $6,000.00 N/A N/A N/A
Other -- Building Addition Size: 200.0 $21,500.00 $21,500.00 Please see WDNM-LD Transmitter Building Budget Revision Justification Letter $21,500.00 N/A
3.1-5kW w mask filter Full Service $9,650.00 $9,650.00 N/A N/A N/A
Retune - UHF and VHF - minor re-channel issues $11,000.00 $11,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Transmitter Building Site Survey/Installation Information not provided.
Other -- Building Addition Size: 200.0

Component Description:
Capital Contribution
Amount:
$21,500.00
3.1-5kW w mask filter Full Service Information not provided.
Retune - UHF and VHF - minor re-channel issues 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 $40,630.00 $36,941.00 N/A $31,941.00 N/A
Total for all systems $230,563.26 $200,104.88 N/A $133,279.46 N/A
Primary Antenna SWEDL16NC/22 $40,630.00 $36,941.00 $31,941.00
Elbow complex, single channel, 1 5/8” input (if needed) $6,900.00 $5,000.00 N/A N/A N/A
UHF Broadband panel antenna (per panel), horizontally-polarized $28,000.00 $30,017.50 Please see SWR, LP Quote 24159-02 $30,017.50 N/A
Antenna removal and installation $0.00 $0.00 N/A N/A N/A
Sweep test of transmission line and antenna $5,730.00 $1,923.50 ***System Notice: Estimate adjusted and locked because line has been superseded.***Please see COMB WDNM-LD Xenirad WDNM03142022 Rev 06.27.2022 $1,923.50 N/A

Components

Actual Information Description File Name
Elbow complex, single channel, 1 5/8” input (if needed) Information not provided.
UHF Broadband panel antenna (per panel), horizontally-polarized

Component Description:
Low power digital TV transmit antenna
Amount:
$30,017.50
Antenna removal and installation Information not provided.
Sweep test of transmission line and antenna

Component Description:
Site visit to sweep new antenna install.
Amount:
$1,923.50

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 $59,215.40 $54,515.40 N/A $54,515.40 N/A
Total for all systems $230,563.26 $200,104.88 N/A $133,279.46 N/A
Primary Tower B $59,215.40 $54,515.40 $54,515.40
Study needed for guyed or free-standing tower $8,700.00 $4,000.00 Please see WDNM-LD Primary Tower Structural Analysis Budget Revision Justification Letter $4,000.00 N/A
Complex Tower (includes, e.g., towers with candelabras and/or stacked antennas) $50,515.40 $50,515.40 Please see WDNMLD American Tower 474272 $50,515.40 N/A

Components

Actual Information Description File Name
Study needed for guyed or free-standing tower

Component Description:
PO Line 1 - WDNM-N22
Amount:
$4,000.00
Complex Tower (includes, e.g., towers with candelabras and/or stacked antennas)

Component Description:
PO LINE 1 - Closeout Complete Construction
Amount:
$50,515.40

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 $54,679.50 $36,620.12 N/A $14,185.12 N/A
Total for all systems $230,563.26 $200,104.88 N/A $133,279.46 N/A
Outside Professional Services $54,679.50 $36,620.12 $14,185.12
RF Exposure Measurements $12,100.00 $7,500.00 N/A 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 -Prepare and File FCC Form 2100 (main), License to Cover Application $1,577.50 $1,500.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $3,025.00 $3,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,052.50 $1,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $2,102.50 $2,000.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $1,280.00 $1,200.00 N/A N/A N/A
Perform engineering study for displacement application $1,800.00 $1,500.00 N/A N/A N/A
Form 399 assistance or other Program Management costs $1,000.00 $1,000.00 N/A N/A N/A
Prepare/ Review 399 reimbursement form $1,710.00 $1,500.00 N/A N/A N/A
Project management of the transition $26,797.00 $14,185.12 The estimated cost has been adjusted to include all invoices submitted for reimbursement at this time. $14,185.12 N/A

Components

Actual Information Description File Name
RF Exposure Measurements Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization 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), License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Prepare request for Special Temporary Authorization Information not provided.
Perform engineering study for displacement application Information not provided.
Form 399 assistance or other Program Management costs Information not provided.
Prepare/ Review 399 reimbursement form Information not provided.
Project management of the transition

Component Description:
Project Management
Amount:
$2,955.77

Component Description:
Project Management
Amount:
$116.25

Component Description:
Project Management
Amount:
$77.50

Component Description:
Project Management
Amount:
$77.50

Component Description:
Project Management
Amount:
$1,336.95

Component Description:
Project Management
Amount:
$132.50

Component Description:
Project Management
Amount:
$38.75

Component Description:
Project Management
Amount:
$705.05

Component Description:
Project Management
Amount:
$1,410.50

Component Description:
Project Management
Amount:
$309.95

Component Description:
Project Management
Amount:
$332.10

Component Description:
Project Management
Amount:
$319.15

Component Description:
Project management
Amount:
$155.00

Component Description:
Project Management
Amount:
$1,118.55

Component Description:
Project Management
Amount:
$314.90

Component Description:
Project Management
Amount:
$244.20

Component Description:
Project Management
Amount:
$38.75

Component Description:
Project Management
Amount:
$77.50

Component Description:
Project Management
Amount:
$3,362.90

Component Description:
Project Management
Amount:
$116.25

Component Description:
Project Management
Amount:
$232.50

Component Description:
Project Management
Amount:
$38.75

Component Description:
Project Management
Amount:
$113.75

Component Description:
Project Management
Amount:
$560.10

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 $23,888.36 $23,878.36 N/A $11,137.94 N/A
Total for all systems $230,563.26 $200,104.88 N/A $133,279.46 N/A
Other Expenses $23,888.36 $23,878.36 $11,137.94
Internal Labor $5,138.36 $5,138.36 Please see WDNM-LD Internal Labor Budget Justification Letter $5,137.94 N/A
Construction Drawings $3,500.00 $3,500.00 WDNM-LD Construction Drawings Budget Revision Justification Letter $3,500.00 N/A
Equipment Storage $1,000.00 $1,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $5,000.00 $5,000.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $5,000.00 $5,000.00 N/A 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 license to cover application $335.00 $335.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,100.00 N/A N/A N/A
Building Permits $2,500.00 $2,500.00 Please see WDNM-LD Building Permits Budget Revision Justification Letter $2,500.00 N/A

Components

Actual Information Description File Name
Internal Labor

Component Description:
Internal Labor for Arnold Torres
Amount:
$2,033.29

Component Description:
Internal Labor for Dave Thompson
Amount:
$3,104.65
Construction Drawings

Component Description:
PO LINE 1 - Construction Drawings Services
Amount:
$3,500.00
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.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
Building Permits

Component Description:
PO Line 1 Building Permit
Amount:
$2,500.00

Cost Information

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Grand Total

Predetermined
Cost Estimate 		Estimated Cost Actual Cost
Total for all systems $230,563.26 $200,104.88 $133,279.46

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.

Arnold Torres

Business Administrator


08/31/2022

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.

Arnold Torres

Business Administrator


08/31/2022

Attachments

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