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:
53512
Service:
LPT
Call Sign:
K33QB-D
Channel:
33 (UHF)
File Number:
0000086496
FRN:
0006132047
Eligibility Status:
Eligible
Date Submitted:
10/15/2019

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

PRIEST LAKE TRANSLATOR DISTRICT

Doing Business As: PRIEST LAKE TRANSLATOR DISTRICT

PO Box 53

COOLIN, ID 83821

United States

+1 (208) 443-2492 ayer.larry2@gmail.com Government Entity

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. Yes
Briefly describe transition plan Antenna for this facility will be on the same tower structure (utility pole) as are the antennas for K31DS-D and K32OA-D, both also sharing the same communications building, electricity, etc. and are licensed by the Priest Lake Translator District.

Question Response
Sharee Station Facility ID 53511
Call Sign K32OA-D
Type
Licensee Name PRIEST LAKE TRANSLATOR DISTRICT
Status LICENSED
DTS No
Community of License COOLIN, ID
Pre-auction RF Channel 32
Post-auction RF Channel
Neilsen DMA
Network Affiliation
Question Response
Sharee Station Facility ID 53513
Call Sign K31DS-D
Type
Licensee Name PRIEST LAKE TRANSLATOR DISTRICT
Status LICENSED
DTS No
Community of License COOLIN, ID
Pre-auction RF Channel 31
Post-auction RF Channel
Neilsen DMA
Network Affiliation

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 TADU-40
Year 2009
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 40.0 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? Yes
Manufacturer
Model UAXTE-50
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 50.0 W
Justification for New Transmitter Old transmitter on former channel-40, with lower power output; new repack channel-33 and higher power was required, and justified the purchase.

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 A new 120/240-volt, 100-amp service panel was installed, with additional service outlets for all equipment & 240-volt service for new air conditioner.
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Heating and Cooling
Size Other
Other Size 1 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

Name Description

GatesAir, Inc

Provided new UAXTE-50 transmitter, critical ATSC mask filter, and Sencore #MRD-2600 rcvr/transcoder.

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 Bottom
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 1
Number of Panels 2
Design power capacity in use 10.0 %
Lower Limit 584.00 MHz
Upper Limit 590.00 MHz
ERP: 75.0 W
Manufacturer
Model 4DR-4-2HW
Year 1993

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? No
New Antenna Manufacturer and Types
Mounting Side Mount
Antenna position in stack Bottom
Polarization Horizontal
Type Broadband Panel
Number of Stations Supported 1
Number of Panels/Bays 2
Lower Limit 584.00 MHz
Upper Limit 590.00 MHz
Design power capacity in use 10.0 %
ERP: 100.0 W
Manufacturer
Model 4DR-4-2HW
Year 2019
Justification for New Antenna Former antenna was cut to ch-51, and too far away from the new channel-33 to reutilize for this channel change

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? 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? Yes
Number of Power Dividers 1
Cable Harness Does the panel antenna require cable harness? Yes
Number of Cable Harnesses 2

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? 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 Move Equipment
Tower Use Primary (Main)
Ownership Owned
Is this tower consider Complex? No
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) No
Others Types of Users Yes
Is tower documented for structural analysis? Unknown
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1293841
Coordinates (NAD83) Latitude (NAD83) 48° 31' 51.2" N-
Longitude (NAD83) 116° 49' 01.4" W-
Overall Structure Height 49.87 feet
Support Structure Height 49.87 feet
Ground Elevation Above Mean Sea Level (AMSL) 3158.10 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner Priest Lake Translator District
Date Constructed 01/01/1991


Other Types of Users

Users
K32OA-D
K31DS-D

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

Name Description

Replace antennas

Air Pipe 2-man crew to remove old channel-51 antennas & power divider, and replace with new channel 33 antennas & power divider

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? No
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 No
Prepare and file Form FCC License to Cover Application No
Prepare request for Special Temporary Authority No
Negotiation of Lease and other Matter for Shared Locations No
Prepare or Review FCC Form 399 for Reimbursement Yes
Form 399 assistance or other program management costs Yes
RF Field Engineering Services Comprehensive coverage verification via field study No
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

Barnett Professional Services

Assist with initial start-up of new transmitter, plus programming the menu to achieve proper power output and all other operational parameters; Barnett's invoice total is divided 50/50 with station K32OA-D, with the same equipment & in the same comm bldg.

KSPS, PBS-Spokane,WA

Provided consulting engineering assistance in resolving input channel interference to Sencore rcvr/ transcoder.

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 No
FCC License to Cover Application No
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 $27,416.90 $17,216.90 N/A $17,216.90 N/A
Total for all systems $99,485.33 $24,613.33 N/A $24,613.33 N/A
Primary Transmitter UAXTE-50 $27,416.90 $17,216.90 $17,216.90
UHF - Air Cooled Solid State Transmitter 5 - 50 Watts $10,200.00 $0.00 N/A $0.00 N/A
Other Electrical Service: A new 120/240-volt, 100-amp service panel was installed, with additional service outlets for all equipment & 240-volt service for new air conditioner. $1,071.20 $1,071.20 Eagle Electric, a licensed contractor, installed a new 100-amp electrical panel and additional 20-amp outlets in the communications bldg., and connected a new 240-volt service to the air conditioning system; all new wiring in armored cable. $1,071.20 N/A
Other -- HVAC Service Type: H Size:1 (Other) $1,900.00 $1,900.00 N/A $1,900.00 N/A
GatesAir, Inc $14,245.70 $14,245.70 N/A $14,245.70 N/A

Components

Actual Information Description File Name
UHF - Air Cooled Solid State Transmitter 5 - 50 Watts Information not provided.
Other Electrical Service: A new 120/240-volt, 100-amp service panel was installed, with additional service outlets for all equipment & 240-volt service for new air conditioner.

Component Description:
Cost is being shared 50/50 with station K32OA-D since both operate from the same comm. bldg. & share the electrical system upgrades.
Amount:
$1,071.20
Other -- HVAC Service Type: H Size:1 (Other)

Component Description:
No Invoice Number Invoice total is being split 50/50 with K320A-D, since both stations are in the same building
Amount:
$1,900.00
GatesAir, Inc

Component Description:
GatesAir, providing new transmitter, mask filter & input channel receiver/transcoder. The amount of reimbursement requested is one-half of the invoice total; the other half is being requested for station K32OA-D in a separate application.
Amount:
$14,245.70

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 $6,800.00 $2,510.50 N/A $2,510.50 N/A
Total for all systems $99,485.33 $24,613.33 N/A $24,613.33 N/A
Primary Antenna 4DR-4-2HW $6,800.00 $2,510.50 $2,510.50
UHF Broadband panel antenna (per panel), horizontally-polarized $3,500.00 $1,790.50 N/A $1,790.50 N/A
Power Dividers (each, for panel antenna system, if not included in antenna cost) $1,300.00 $332.00 N/A $332.00 N/A
Cable harness (each, for panel antenna system, if not included in antenna cost) $2,000.00 $388.00 N/A $388.00 N/A

Components

Actual Information Description File Name
UHF Broadband panel antenna (per panel), horizontally-polarized

Component Description:
Scala/Kathrein: one pair of panel antennas cut to channel-33. Costs on this invoice are shared 50/50 with station K30OA-D. Invoice total $2663 plus $2358 deposit equals $5021.00
Amount:
$1,790.50
Power Dividers (each, for panel antenna system, if not included in antenna cost)

Component Description:
Power Divider (1). Total cost on invoice is shared 50/50 with station K32OA-D Invoice total $2663 plus $2358 deposit equals $5021.00
Amount:
$332.00
Cable harness (each, for panel antenna system, if not included in antenna cost)

Component Description:
Scala/Kathrein cable harness for new antenna-power divider installation. Invoice total $2663 plus $2358 deposit equals $5021.00
Amount:
$388.00

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 $56,883.78 $2,768.78 N/A $2,768.78 N/A
Total for all systems $99,485.33 $24,613.33 N/A $24,613.33 N/A
Primary Tower GTOWER $56,883.78 $2,768.78 $2,768.78
Replace antennas $693.78 $693.78 N/A $693.78 N/A
Tower Rigging Short Tower (less than 500') $56,190.00 $2,075.00 N/A $2,075.00 N/A

Components

Actual Information Description File Name
Replace antennas

Component Description:
Air Pipe 2-man crew to remove old channel-51 antennas & power divider, and replace with new channel-33 antennas & power divider; cost share 50/50 with K32OA-D
Amount:
$693.78
Tower Rigging Short Tower (less than 500')

Component Description:
American Tree Service rigging crew, with rental hydraulic self-propelled 2-man hoist to access antennas for replacement; cost shared 50/50 with station K32OA-D
Amount:
$2,075.00

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 $8,384.65 $2,117.15 N/A $2,117.15 N/A
Total for all systems $99,485.33 $24,613.33 N/A $24,613.33 N/A
Outside Professional Services $8,384.65 $2,117.15 $2,117.15
Barnett Professional Services $457.15 $457.15 N/A $457.15 N/A
Prepare/ Review 399 reimbursement form $1,710.00 $0.00 N/A $0.00 N/A
Form 399 assistance or other Program Management costs $1,000.00 $1,000.00 See BWSEstimate K33QB-D.pdf $1,000.00 N/A
KSPS, PBS-Spokane,WA $262.50 $262.50 N/A $262.50 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,052.50 $60.00 N/A $60.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $2,102.50 $337.50 N/A $337.50 N/A
Perform engineering study for displacement application $1,800.00 $0.00 N/A $0.00 N/A

Components

Actual Information Description File Name
Barnett Professional Services

Component Description:
Total for start-up programming of K33QB-D; invoice total is shared 50/50 with station K32OA-D, also licensed to the applicant & operating in the same building.
Amount:
$457.15
Prepare/ Review 399 reimbursement form Information not provided.
Form 399 assistance or other Program Management costs

Component Description:
Assistance & guidance in preparing FCC reimbursement form-399 for filing.
Amount:
$1,000.00
KSPS, PBS-Spokane,WA

Component Description:
KSPS technical consulting; one-half the invoice amount is being requested; the other half will be in a separate reimbursement application from station K32OA-D
Amount:
$262.50
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
BW St.Clair professional service costs are being shared equally with station K32OA-D, since both are owned & operated by this applicant in the same communications building.
Amount:
$60.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Additional consulting engineering for preparation & filing of application for displacement construction permit; total invoiced cost is shared 50/50 with translator station K32OA-D
Amount:
$337.50
Perform engineering study for displacement application 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 $0.00 $0.00 N/A $0.00 N/A
Total for all systems $99,485.33 $24,613.33 N/A $24,613.33 N/A
Other Expenses $0.00 $0.00 $0.00

Components

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $99,485.33 $24,613.33 $24,613.33

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.

Larry Ayer

Acting District Chairman


10/15/2019

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.

Larry Ayer

Acting District Chairman


10/15/2019

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.

Larry Ayer

Acting District Chairman


10/15/2019

Attachments

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