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:
67878
Service:
LPD
Call Sign:
KEVE-LD
Channel:
31 (UHF)
File Number:
0000090118
FRN:
0019858117
Eligibility Status:
Eligible
Date Submitted:
08/28/2020

Applicant Information

Back to Top

Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

SOUTHERN OREGON CONFERENCE ASSN. OF SEVENTH-DAY ADVENTISTS

Doing Business As: SOUTHERN OREGON CONFERENCE ASSN. OF SEVENTH-DAY ADVENTISTS

Herald Follett

19800 OATFIELD ROAD

GLADSTONE, OR 97027

United States

+1 (503) 850-3500 Herald.Follett@oc.npuc.org Not-for-Profit

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

Back to Top

Preparer Contact Name and Information

Applicant Address Phone Email

Tony Zummallen

President

QCommunications, LLC

Tony Zummallen

705B SE Melody Lane #314

Lee's Summit, MO 64063

United States

+1 (816) 729-1177 tony@Qcomm.tv

Broadcaster Information and Transition Plan

Back to Top
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 Replace the transmitter and the antenna per the channel reassignment project using reasonable and customary engineering and business practices.

Transmitters

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

Primary Transmitter

Back to Top

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 SDT202UB ARK1_ATSC
Year 2010
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity .9 kW

Primary Transmitter

Back to Top

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 UAXTE-2R23
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1.2 kW
Justification for New Transmitter New transmitter required for new channel.

Primary Transmitter

Back to Top

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? No

Primary Transmitter

Back to Top

Other Transmitter Cost Not Listed

Name Description

Shipping

Estimated shipping and freight costs

Taxes

Estimated sales tax

Transmitter Site Prep

Prep site for installation crew

Decommission

De-install and disconnect old transmitter

Antennas

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

Primary Antenna

Back to Top

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 Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
ERP: 15.0 kW
Manufacturer
Model ALP16L2-HSOC
Year 2010

Primary Antenna

Back to Top

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 Slotted Coaxial
ERP: 8.6 kW
Manufacturer
Model DLP-H
Year 2019
Justification for New Antenna New antenna required for new channel

Primary Antenna

Back to Top

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? Yes

Primary Antenna

Back to Top

Other Antenna Cost Not Listed

Name Description

Sales Tax

Sales tax for new antenna

Shipping

Shipping costs of new antenna

Transmission Line

Back to Top
Section Question Response
Transmission Line Related Expenses Do you have transmission line related expenses? No

Tower Equipment And Rigging Costs

Back to Top
Section Question Response
Tower Equipment or Rigging Costs Changes Do you have tower equipment or rigging costs changes? Yes

Primary Tower

Back to Top

Existing Tower

Section Question Response
Existing Tower Description Type of change Modify Existing
Tower Use Primary (Main)
Ownership Leased
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) Yes
Others Types of Users No
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? Yes
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1035761
Coordinates (NAD83) Latitude (NAD83) 45° 31' 13.0" N-
Longitude (NAD83) 122° 44' 41.0" W-
Overall Structure Height 918.62 feet
Support Structure Height 812.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 954.38 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Sinclair Portland Licensee, LLC
Date Constructed 08/15/1973

FM, AM or TV radio broadcasters. Facility ID's, Call Signs and Services of other broadcast stations with whom the tower is shared

Facility ID Call Sign Service
34882 KUNP-LD LPD
35380 KOIN DTV
10192 KRCW-TV DTV

Primary Tower

Back to Top

Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Tower mapping and report for structural engineer
Tower Reinforcements Please select whether tower reinforcements are needed: No reinforcements needed

Primary Tower

Back to Top

Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower N/A
Helicopter Services Required Are helicopter services required? No

Primary Tower

Back to Top

Other Tower Expenses Not Listed

Information not provided.

Outside Professional Services Costs

Back to Top
Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 200
Explanation Required to assist in the turnkey management of the channel relocation project in order that the existing internal personnel can maintain and operate the station's daily operational requirements and plans.
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 Yes
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 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 Yes
RF exposure measurements No
Additional Field Engineering Service Yes
Number of Days 5
Justification Estimated field engineering required during transition activities

Outside Professional Services Costs

Back to Top

Other Professional Services Expenses Not Listed

Information not provided.

Other Expenses

Back to Top
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 Yes
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

Back to Top

Other Expenses Not Listed

Information not provided.

Cost Information

Back to Top

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 $117,900.00 $84,520.52 N/A $0.00 N/A
Total for all systems $456,915.00 $425,157.52 N/A $5,340.80 N/A
Primary Transmitter UAXTE-2R23 $117,900.00 $84,520.52 $0.00
Transmitter Building Site Survey/Installation $10,000.00 $25,000.00 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. N/A N/A
Decommission $6,000.00 $6,000.00 Estimated costs to deinstall, disconnect and decommission old transmitter in preparation for new transmitter. N/A N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $84,000.00 $35,620.52 Estimated Cost determined by quote from GatesAir Q-84133 N/A N/A
Taxes $8,400.00 $8,400.00 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. N/A N/A
Shipping $2,500.00 $2,500.00 Estimated shipping and freight costs to ship transmitter from manufacturer to site. Actual costs to be determined. N/A N/A
Transmitter Site Prep $7,000.00 $7,000.00 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. N/A N/A

Components

Information not provided.

Cost Information

Back to Top

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 $34,355.00 $34,355.00 N/A $0.00 N/A
Total for all systems $456,915.00 $425,157.52 N/A $5,340.80 N/A
Primary Antenna DLP-H $34,355.00 $34,355.00 $0.00
Side Mount antenna brackets $4,625.00 $4,625.00 N/A N/A N/A
Sweep test of transmission line and antenna $5,730.00 $5,730.00 N/A N/A N/A
Sales Tax $2,000.00 $2,000.00 Estimated sales tax for new antenna. Actual costs to be determined. N/A N/A
UHF-Low Power, Side Mount, Slotted Coaxial, 8.6kW input, Horizontal $20,000.00 $20,000.00 Estimated costs of new antenna. Actual costs to be determined. N/A N/A
Shipping $2,000.00 $2,000.00 Estimated freight and shipping costs for new antenna. Actual costs to be determined. N/A N/A

Components

Information not provided.

Cost Information

Back to Top

Transmission Line

Information not provided.

Cost Information

Back to Top

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 $178,750.00 $178,750.00 N/A $0.00 N/A
Total for all systems $456,915.00 $425,157.52 N/A $5,340.80 N/A
Primary Tower TOWER $178,750.00 $178,750.00 $0.00
Tower Rigging Tall Tower (greater than 500') $157,750.00 $157,750.00 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. N/A N/A
Tower mapping and report for structural engineer $21,000.00 $21,000.00 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. N/A N/A

Components

Information not provided.

Cost Information

Back to Top

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 $113,200.00 $114,822.00 N/A $5,340.80 N/A
Total for all systems $456,915.00 $425,157.52 N/A $5,340.80 N/A
Outside Professional Services $113,200.00 $114,822.00 $5,340.80
Comprehensive coverage verification via field study, if needed $52,600.00 $43,732.00 Per-attached quote number 732-R for Coverage Verification N/A N/A
Project management of the transition $21,100.00 $30,800.00 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. N/A N/A
Prepare/ Review 399 reimbursement form $1,710.00 $2,500.00 Per attached QCommunications quote. $2,500.00 N/A
Perform engineering study for displacement application $1,800.00 $1,800.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $1,280.00 $1,280.00 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
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,052.50 $1,052.50 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 Form 601 $755.00 $755.00 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $1,577.50 $1,577.50 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. 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
Additional Field Engineering Service, 5 Days $12,500.00 $12,500.00 Estimated costs for field engineering services during transition activities. Actual costs to be determined. N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $3,262.50 $3,262.50 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. N/A N/A
Form 399 assistance or other Program Management costs $8,200.00 $8,200.00 Per attached QCommunications quote. $2,840.80 N/A

Components

Actual Information Description File Name
Comprehensive coverage verification via field study, if needed Information not provided.
Project management of the transition Information not provided.
Prepare/ Review 399 reimbursement form

Component Description:
From 399 Submission
Amount:
$2,500.00
Perform engineering study for displacement application Information not provided.
Prepare request for Special Temporary Authorization Information not provided.
Prepare engineering section of 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.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application Information not provided.
Prepare Form 601 Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Additional Field Engineering Service, 5 Days Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
Form 399 assistance or other Program Management costs

Component Description:
Prepare and Process From 399
Amount:
$500.00

Component Description:
399 Project Management
Amount:
$539.00

Component Description:
PM costs for transition
Amount:
$831.60

Component Description:
399 Assistance and PM costs
Amount:
$970.20

Cost Information

Back to Top

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 $12,710.00 $12,710.00 N/A $0.00 N/A
Total for all systems $456,915.00 $425,157.52 N/A $5,340.80 N/A
Other Expenses $12,710.00 $12,710.00 $0.00
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,110.00 N/A N/A N/A
FCC Filing Fees - Form 2100 Major change CP application $4,960.00 $4,960.00 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. 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 - Special Temporary Authorization request $305.00 $305.00 N/A N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $2,000.00 $2,000.00 4/1/2020- Working to obtain quote which may be delayed due to coronavirus pandemic. N/A N/A
Equipment Delivery and Handling Charges $2,000.00 $2,000.00 Estimate of transport, forklift rental and handling fees from staging area to transmitter site. Actual costs to be determined. N/A N/A
Equipment Storage $2,000.00 $2,000.00 Expecting multiple staggered equipment deliveries from different vendors and need to store and stage new equipment prior to installation date. Anticipate 6-24 months of storage time. N/A N/A

Components

Information not provided.

Cost Information

Back to Top

Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $456,915.00 $425,157.52 $5,340.80

Reimbursement Status

Back to Top
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

Back to Top
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.

Dan Linrud

President


08/28/2020

Attachments

Back to Top