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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:
69711
Service:
LPT
Call Sign:
K35NF-D
Channel:
35 (UHF)
File Number:
0000084292
FRN:
0014315691
Eligibility Status:
Eligible
Date Submitted:
04/30/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

VALLEY COUNTY TELEVISION DISTRICT #1

Doing Business As: VALLEY COUNTY TELEVISION DISTRICT #1

501 COURT SQ.BOX 2

GLASGOW, MT 59230

United States

 +1 (406) 263-9353 terry.lighthizer@outlook.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 Applicant had 7 channels displaced during the 2018 "Special Displacement Window" K22MN-D - 69709, K24MV-D -125637, K26NS-D - 69712, K31NS-D - 69706, K33ON-D - 69719, K35NF-D 69711, K36OC-D - 69718. Required new antennas and microwave feeds.

Transmitters

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Section Question Response
Transmitter Related Expenses Do you have transmitter related expenses? No

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? No
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 Not in Stack
Polarization Horizontal
Type Slotted Coaxial
ERP: 1.0 kW
Manufacturer
Model SL-8
Year 1988

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? Yes
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 Not in Stack
Polarization Horizontal
Type Slotted Coaxial
ERP: 1.0 kW
Manufacturer
Model SL-8
Year 2018
Justification for New Antenna Old antenna cut to channel 49

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? Yes
Type New
Number of channels supported 3
Frequencies of channels supported RF channel
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

Enter a list of RF channel numbers.

RF Channel Number
35
31
33

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? No

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 No
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 Yes
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

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 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 Yes
Type 7/13 GHz Licensed Part 74

Other Expenses

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Other Expenses Not Listed

Name Description

Cannaliato

Travel / System Install

Cost Information

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Transmitters

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 $17,223.02 $4,088.45 N/A $4,088.45 N/A
Total for all systems $76,792.44 $19,273.63 N/A $19,273.63 N/A
Primary Antenna SL-8 $17,223.02 $4,088.45 $4,088.45
UHF-Low Power, Side Mount, Slotted Coaxial, 1.0kW input, Horizontal $3,123.02 $3,123.02 Total antenna cost 9369.06 3 channels 31, 33, 35 Divided by 3 is 3123.02 ea $3,123.02 N/A
1 kW UHF Combiner (per channel) $14,100.00 $965.43 N/A $965.43 N/A

Components

Actual Information Description File Name
UHF-Low Power, Side Mount, Slotted Coaxial, 1.0kW input, Horizontal

Component Description:
Inv 497 line 4 antenna connectors $555.45 divided by 7 equals 79.35 ea
Amount:
$79.35

Component Description:
Inv 477 line 4 $8550 divided by 3 channels (31,33,35) equals $2850 ea
Amount:
$2,850.00

Component Description:
Inv 477 line 5 $116 divided by 3 channels (31,33,35) equals $38.67ea
Amount:
$38.67

Component Description:
Inv 477 Antenna freight 3 antennas equals $465 ea $465 divided by 3 channels (31, 33, 35) equals $155 ea
Amount:
$155.00
1 kW UHF Combiner (per channel)

Component Description:
1 combiner ch 31, 33, 35 divided by 3
Amount:
$965.43

Cost Information

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Transmission Line

Information not provided.

Cost Information

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Tower Equipment and Rigging Costs

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 $6,620.00 $3,176.67 N/A $3,176.67 N/A
Total for all systems $76,792.44 $19,273.63 N/A $19,273.63 N/A
Outside Professional Services $6,620.00 $3,176.67 $3,176.67
Prepare Form 601 $755.00 $116.67 N/A $116.67 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,052.50 $50.00 N/A $50.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $2,102.50 $300.00 N/A $300.00 N/A
Form 399 assistance or other Program Management costs $1,000.00 $1,000.00 Turnkey 399 Eligibility preparation and filing and FCC Form 1876 Preparation and filing. $1,000.00 N/A
Prepare/ Review 399 reimbursement form $1,710.00 $1,710.00 N/A $1,710.00 N/A

Components

Actual Information Description File Name
Prepare Form 601

Component Description:
Comsearch 601 filing for use by K22MN, K33ON, K35NF
Amount:
$116.67
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
7 license filings @ $50 ea
Amount:
$50.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
7 Displacement Applications @ $300 ea
Amount:
$300.00
Form 399 assistance or other Program Management costs

Component Description:
Turnkey project cost per station Eligibility / 1876 filings
Amount:
$1,000.00
Prepare/ Review 399 reimbursement form

Component Description:
Complete Turnkey Project Cost per station 399 Expense Reimbursement Filing
Amount:
$1,710.00

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 $52,949.42 $12,008.51 N/A $12,008.51 N/A
Total for all systems $76,792.44 $19,273.63 N/A $19,273.63 N/A
Other Expenses $52,949.42 $12,008.51 $12,008.51
Cannaliato $1,649.42 $1,649.42 Travel / installation for system spread across 7 stations $1,649.42 N/A
New Point to Point Microwave System: 7/13 GHz Licensed Part 74 $51,300.00 $10,359.09 See VCTD Microwave Exhibit.pdf $10,359.09 N/A

Components

Actual Information Description File Name
Cannaliato

Component Description:
Inv 497 Line 7 $2210 microwave install and $480 system install. $2210 divided by 3 equals $736.67
Amount:
$736.67

Component Description:
Inv 497 Line 2 $975 divided by 3 channels (22, 33, 35) equals $325 ea
Amount:
$325.00

Component Description:
Inv 497 Line 5 $502.03 divided by 7 equals $71.72 ea
Amount:
$71.72

Component Description:
Inv 497 Line 6 $326.26 divided by 7 equals $51.75 ea
Amount:
$51.75

Component Description:
Inv 497 Line 7 $480 system install. $480 divided by 7 equals $68.57 ea
Amount:
$68.57

Component Description:
Inv 497 Line 7 $1870 divide by 7 equals $267.14
Amount:
$267.14

Component Description:
Inv 497 Line 1 $900 divided by 7 equals $128.57
Amount:
$128.57
New Point to Point Microwave System: 7/13 GHz Licensed Part 74

Component Description:
Inv 470 line 4 div by 3
Amount:
$164.64

Component Description:
Inv470 line 3 div by 3
Amount:
$357.86

Component Description:
Inv470 line 2 frt divvy 3
Amount:
$321.27

Component Description:
Inv 470 line 1 - divided over 3 stations K22MN, K33ON and K35NF
Amount:
$3,275.71

Component Description:
Transcoder cost is 3000 plus freight
Amount:
$3,025.00

Component Description:
Invoice total divided over 3 stations K22MN, K33ON and K35NF
Amount:
$7.24

Component Description:
Invoice Total divided over 3 stations K22MN, K33ON and K35NF
Amount:
$2,572.00

Component Description:
Inv 497 line 3 $584.65 divided by 3 channels (22, 33, 35) equals $194.88
Amount:
$194.88

Component Description:
Inv 477 Line 9 $ 866.03 divided by 3 channels (22,33,35) equals $288.68 ea
Amount:
$288.68

Component Description:
Invoice 477 Line 1 $450 / 3 channels (ch 22, 33, 35) equals $150
Amount:
$150.00

Component Description:
Invoice total divided over 3 stations K22MN, K33ON, K35NF
Amount:
$1.81

Cost Information

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Grand Total

Predetermined
Cost Estimate 		Estimated Cost Actual Cost
Total for all systems $76,792.44 $19,273.63 $19,273.63

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. 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.

Susan Hansen

Consultant


04/30/2020

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.

Terry Lighthizer

Secretary/Treasurer


04/30/2020

Attachments

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