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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:
12551
Service:
FM
Call Sign:
KXJM
File Number:
0000086309
FRN:
0014042816
Eligibility Status:
Eligible
Date Submitted:
10/13/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

CITICASTERS LICENSES, INC.

Doing Business As: CITICASTERS LICENSES, INC.

Troy Langham

7136 S. YALE AVENUE

SUITE 501

TULSA, OK 74136

United States

+1 (918) 664-4581 FCCCONTACT@IHEARTMEDIA.COM Corporation

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. No
Briefly describe transition plan Structural work will force KXJM to stop using main antenna. Licensed aux site of KKCW will be modified and used via STA during repack work.

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 HRD50CDSWL
Year 2007
Type Other Type
Other Transmitter Type Tube
Power Capacity 30.5 kW

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? No
Manufacturer
Model GV40-D
Transmitter Type Solid State
Solid State Cooling Air Cooled
Model Type Hybrid
Solid State Power capacity 40 kW
Justification for New Transmitter To allow for better coverage from Aux site
Does the transmitter require the purchase of a new HD Importer? Yes
Does the transmitter require the purchase of a new HD Exporter? Yes

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Other Transmitter Costs Does the transmitter installation require an Additional Exciter? No
Does the transmitter installation require any additional transmitter installation costs? Yes
Does the transmitter installation require a Transmitter Building Site Survey/Installation? No
Electrical Service Service Entrance (3 phases 800A 208V) Yes
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
Other Transmitter-Related Expenses Does the replacement transmitter require a Remote Control? No
Does the replacement transmitter require an RDS Encoder? No
Does the replacement transmitter require Audio Processing? Yes
Audio Processing Analog/HD Upgraded

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 Leased
Owner CBS Inc
Is the existing antenna shared with another station or stations? Yes
Is the existing antenna directional? No
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 Not in Stack
Polarization Circular
Type Broadband Panel
Number of Stations Supported 5
Number of Panels 18
Design power capacity in use 99.0 %
Lower Limit 92.10 MHz
Upper Limit 106.90 MHz
ERP: 100.0 kW
Manufacturer
Model DCBD-O3-6FMB/18H-2
Year 2008

Facility ID's and Call Signs of all stations with whom the antenna is shared.

Facility ID Call Sign
26932 KXL-FM
4114 KUPL
4115 KLTH
53068 KINK

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? No
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 Circular
Type Cross Dipole
ERP: 11.0 kW
Manufacturer
Model SHPXA-4AC
Year 2019
Justification for New Antenna To allow full power operation of Aux site to cover majority of market.

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
FM Band Pass Filters Do you require an FM band pass filter? No
Notch Filter Do you require a Notch filter? No
De-Icers Do you require De-Icers? No
Radomes Do you require Radomes? No

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 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? Unknown
Is tower compliant with Rev G? Unknown
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1207367
Coordinates (NAD83) Latitude (NAD83) 45° 30' 57.8" N-
Longitude (NAD83) 122° 44' 03.1" W-
Overall Structure Height 989.82 feet
Support Structure Height 920.92 feet
Ground Elevation Above Mean Sea Level (AMSL) 1059.04 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Sylvan Tower Co., LLC
Date Constructed 02/09/2000

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
26932 KXL-FM FM
4114 KUPL FM
53068 KINK FM
4115 KLTH FM

Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: No study needed
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 N/A
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? No
Outside RF consulting Engineering Services Prepare engineering section of Form FCC Construction Permit Application No
Prepare engineering section of Form FCC License to Cover Application No
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 No
Form 399 assistance or other program management costs No
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

Prepare and or review reimbursement form

Prepare and or review reimbursement form

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
1 pair IP-only Codecs for fiber, internet or IP microwave systems Yes

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 $292,450.00 $204,121.56 N/A $174,121.56 N/A
Total for all systems $465,990.00 $268,286.85 N/A $192,631.79 N/A
Primary Transmitter GV40-D $292,450.00 $204,121.56 $174,121.56
Audio Processing - Analog /HD upgraded $11,000.00 $12,488.12 Omnia 11 FM+HD $12,488.12 N/A
Transmitter Installation $70,500.00 $30,000.00 N/A N/A N/A
Air Cooled Solid State FM Transmitter 40 kW Hybrid $191,450.00 $136,669.50 See attached invoice $136,669.50 N/A
HD Exporter $2,550.00 $4,781.97 1/2 of Flexiva FMXi 4g Embedded Exporter + Importer $4,781.97 N/A
HD Importer $2,550.00 $4,781.97 1/2 of Flexiva FMXi 4g Embedded Exporter + Importer $4,781.97 N/A
Service entrance 3 phase/800 amp/208 volt $14,400.00 $15,400.00 Complex install $15,400.00 N/A

Components

Actual Information Description File Name
Audio Processing - Analog /HD upgraded

Component Description:
Audio Proc
Amount:
$12,488.12
Transmitter Installation Information not provided.
Air Cooled Solid State FM Transmitter 40 kW Hybrid

Component Description:
Nautel 10024143 v200925pmv2
Amount:
$136,669.50
HD Exporter

Component Description:
Gates US0325918 v200925pmv2
Amount:
$4,781.97
HD Importer

Component Description:
Gates US0325918 v200925pmv2
Amount:
$4,781.97
Service entrance 3 phase/800 amp/208 volt

Component Description:
Tice 14741 v200925pmv2
Amount:
$15,400.00

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 $7,900.00 $45,655.06 N/A $0.00 N/A
Total for all systems $465,990.00 $268,286.85 N/A $192,631.79 N/A
Primary Antenna SHPXA-4AC $7,900.00 $45,655.06 $0.00
High Power 11 kW - 25 kW Circularly-polarized $7,900.00 $45,655.06 FM High power ERI $0.00 N/A

Components

Actual Information Description File Name
High Power 11 kW - 25 kW Circularly-polarized

Component Description:
Shared with KLTH and KXJM
Amount:
$45,655.06

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 $157,750.00 $12,330.23 N/A $12,330.23 N/A
Total for all systems $465,990.00 $268,286.85 N/A $192,631.79 N/A
Primary Tower TOWER $157,750.00 $12,330.23 $12,330.23
Tower Rigging Tall Tower (greater than 500') $157,750.00 $12,330.23 See attached invoice $12,330.23 N/A

Components

Actual Information Description File Name
Tower Rigging Tall Tower (greater than 500')

Component Description:
Radio Twr 00004844 v200925pmv2
Amount:
$12,330.23

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 $2,040.00 $2,040.00 N/A $2,040.00 N/A
Total for all systems $465,990.00 $268,286.85 N/A $192,631.79 N/A
Outside Professional Services $2,040.00 $2,040.00 $2,040.00
Prepare and or review reimbursement form $2,040.00 $2,040.00 See attached invoices. $2,040.00 N/A

Components

Actual Information Description File Name
Prepare and or review reimbursement form

Component Description:
KGA 991-23 v201013pmv1
Amount:
$1,990.00

Component Description:
KGA 991-05 v201013pmv1
Amount:
$50.00

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 $5,850.00 $4,140.00 N/A $4,140.00 N/A
Total for all systems $465,990.00 $268,286.85 N/A $192,631.79 N/A
Other Expenses $5,850.00 $4,140.00 $4,140.00
Point to Point Microwave (STL/ICR): 1 pair IP-only Codecs for fiber, internet or IP microwave systems $5,850.00 $4,140.00 Digital Codec and Network switch $4,140.00 N/A

Components

Actual Information Description File Name
Point to Point Microwave (STL/ICR): 1 pair IP-only Codecs for fiber, internet or IP microwave systems

Component Description:
Wheatstone IN057598 v200925pmv2
Amount:
$2,850.00

Component Description:
Curvature 671601 v200925pmv2
Amount:
$1,290.00

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $465,990.00 $268,286.85 $192,631.79

Reimbursement Status

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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

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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.

Jeffrey C Gehman

Engineering Associate


10/13/2020

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.

Jeffrey C Gehman

Engineering Associate


10/13/2020

Attachments

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