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:
13459
Service:
LPT
Call Sign:
K17ML-D
Channel:
17 (UHF)
File Number:
0000089657
FRN:
0002624427
Eligibility Status:
Not Determined
Date Submitted:
08/25/2022

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

KOB-TV, LLC

Doing Business As: KOB-TV, LLC

Ryan M. Vandewiele, Esq.

3415 UNIVERSITY AVE., WEST

ST. PAUL, MN 55114

United States

+1 (651) 642-4334 KSHULDES@HBI.COM Limited Liability Company

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

Scott Arthur

Chief Engineer

KOB-TV, LLC

4 Broadcast Plaza, S.W.

Albuquerque, NM 87104

United States

+1 (505) 764-2442 sarthur@kob.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. Yes
Briefly describe transition plan Replace the existing antenna combiner and output mask filter

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 Larcan
Model MX-30D
Year 2010
Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 30 W

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 Stringent
Power 100-200W
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? 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 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

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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? No

Transmission Line

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

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Utilize Existing
Use Primary (Main)
Ownership Owned
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer Andrew
Type Flexible Foam
Diameter 7/8 inches
Number of parallel runs 1
Length 68 feet per run

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

2 way 50 watt per channel combiner

Technalogix SPL 0232 2 way 50 watt per channel combiner

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 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 No
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 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 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)? 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 $12,762.50 $4,762.50 N/A $0.00 N/A
Total for all systems $38,242.50 $28,625.00 N/A $6,256.25 N/A
Primary Transmitter MX-30D $12,762.50 $4,762.50 $0.00
100-200W w mask filter Stringent $1,762.50 $1,762.50 N/A $0.00 N/A
Retune - UHF and VHF - minor re-channel issues $11,000.00 $3,000.00 N/A N/A N/A

Components

Actual Information Description File Name
100-200W w mask filter Stringent

Component Description:
7 pole UHF CH17 Mask Filter
Amount:
$900.00
Retune - UHF and VHF - minor re-channel issues Information not provided.

Cost Information

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Antennas

Information not provided.

Cost Information

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Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $3,000.00 $3,000.00 N/A $0.00 N/A
Total for all systems $38,242.50 $28,625.00 N/A $6,256.25 N/A
Primary Transmission Line $3,000.00 $3,000.00 $0.00
2 way 50 watt per channel combiner $3,000.00 $3,000.00 N/A $0.00 N/A

Components

Actual Information Description File Name
2 way 50 watt per channel combiner

Component Description:
Technalogix 2 way 50 watt per channel combiner
Amount:
$1,400.00

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 $20,730.00 $20,312.50 N/A $6,256.25 N/A
Total for all systems $38,242.50 $28,625.00 N/A $6,256.25 N/A
Outside Professional Services $20,730.00 $20,312.50 $6,256.25
Attorney Fees - Prepare and File request for Special Temporary Authorization $2,235.00 $2,000.00 N/A $562.50 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $1,577.50 $1,500.00 N/A $337.50 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $3,025.00 $2,000.00 N/A $462.50 N/A
Form 399 assistance or other Program Management costs $7,000.00 $7,000.00 Preparation of Form 399, the eligibility certification, and the associated financial forms, as well as preparation of the accompanying invoices and supporting paperwork, and dealing with the forms' technical issues are all quite time-consuming. $2,893.75 N/A
Prepare request for Special Temporary Authorization $1,280.00 $1,280.00 N/A $750.00 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/ Review 399 reimbursement form $1,710.00 $2,630.00 Preparation of Form 399, the eligibility certification, and the associated financial forms, as well as preparation of the accompanying invoices and support paperwork, and dealing with the forms' technical issues are all quite time-consuming. $0.00 N/A
Perform engineering study for displacement application $1,800.00 $1,800.00 N/A $1,250.00 N/A

Components

Actual Information Description File Name
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
Legal advice and counsel with regard to STA request and extension due to displacement.
Amount:
$562.50
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
Legal advice and counsel in connection with application for license to cover.
Amount:
$337.50
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Legal advice and assistance with application for construction permit.
Amount:
$462.50
Form 399 assistance or other Program Management costs

Component Description:
Legal advice and assistance with preparing Form 399 and documenting expenses.
Amount:
$2,300.00

Component Description:
Legal advice and assistance with preparation of Form 399
Amount:
$593.75
Prepare request for Special Temporary Authorization

Component Description:
Engineering for STA request invoice
Amount:
$750.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Prepare/ Review 399 reimbursement form

Component Description:
FCC Form 399 preparation fee invoice
Amount:
$1,993.53
Perform engineering study for displacement application

Component Description:
Displacement Application engineering invoice
Amount:
$1,250.00

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 $1,750.00 $550.00 N/A $0.00 N/A
Total for all systems $38,242.50 $28,625.00 N/A $6,256.25 N/A
Other Expenses $1,750.00 $550.00 $0.00
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $0.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $170.00 N/A $0.00 N/A
FCC Filing Fees - Special Temporary Authorization request $305.00 $380.00 An extension of the STA was needed due to how long the displacement application was pending, which meant two $190 filing fees. $0.00 N/A

Components

Actual Information Description File Name
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
FCC Filing Fees - Form 2100 license to cover application

Component Description:
FCC filing fee for application for license to cover displacement construction permit
Amount:
$170.00
FCC Filing Fees - Special Temporary Authorization request

Component Description:
FCC filing fer displacement STA request
Amount:
$190.00

Component Description:
Filing fee for STA extension request.
Amount:
$190.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $38,242.50 $28,625.00 $6,256.25

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 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.

Ryan Vandewiele

Vice-President and General Counsel


08/25/2022

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.

Ryan Vandewiele

Vice-President and General Counsel


08/25/2022

Attachments

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