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:
68707
Service:
LPT
Call Sign:
K46AC-D
Channel:
33 (UHF)
File Number:
0000082851
FRN:
0003742913
Eligibility Status:
Eligible
Date Submitted:
12/29/2020

Applicant Information

Back to Top

Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

UHF TV, INC.

Doing Business As: UHF TV, INC.

PO BOX 610

WILLMAR, MN 56201

United States

+1 (866) 214-8214 mgeercpa@gmail.com 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

The Preparer is same as the reimbursement contact.

 

 

 

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. Yes
Briefly describe transition plan Upon receiving a displacement letter from T-Mobile for the Facility ID 68707, the required engineering and licensing was done to meet the deadline of converting to the new channel 33 (from channel 46) PRIOR to the T-Mobile deadlines.

Question Response
Sharee Station Facility ID 68699
Call Sign K34HO-D
Type
Licensee Name UHF TV, INC.
Status LICENSED
DTS No
Community of License WILLMAR, MN
Pre-auction RF Channel 34
Post-auction RF Channel
Neilsen DMA
Network Affiliation
Question Response
Sharee Station Facility ID 43
Call Sign K30FZ-D
Type
Licensee Name UHF TV, INC.
Status LICENSED
DTS No
Community of License WILLMAR, MN
Pre-auction RF Channel 30
Post-auction RF Channel
Neilsen DMA
Network Affiliation
Question Response
Sharee Station Facility ID 68700
Call Sign K26NU-D
Type
Licensee Name UHF TV, INC.
Status LICENSED
DTS No
Community of License WILLMAR, MN
Pre-auction RF Channel 26
Post-auction RF Channel
Neilsen DMA
Network Affiliation
Question Response
Sharee Station Facility ID 68709
Call Sign K35NR-D
Type
Licensee Name UHF TV, INC.
Status LICENSED
DTS No
Community of License WILLMAR, MN
Pre-auction RF Channel 35
Post-auction RF Channel
Neilsen DMA
Network Affiliation
Question Response
Sharee Station Facility ID 68708
Call Sign K22ND-D
Type
Licensee Name UHF TV, INC.
Status LICENSED
DTS No
Community of License WILLMAR, MN
Pre-auction RF Channel 22
Post-auction RF Channel
Neilsen DMA
Network Affiliation
Question Response
Sharee Station Facility ID 68697
Call Sign K17FA-D
Type
Licensee Name UHF TV, INC.
Status LICENSED
DTS No
Community of License WILLMAR, MN
Pre-auction RF Channel 17
Post-auction RF Channel
Neilsen DMA
Network Affiliation
Question Response
Sharee Station Facility ID 71547
Call Sign K28IF-D
Type
Licensee Name UHF TV, INC.
Status LICENSED
DTS No
Community of License WILLMAR, MN
Pre-auction RF Channel 28
Post-auction RF Channel
Neilsen DMA
Network Affiliation
Question Response
Sharee Station Facility ID 68711
Call Sign K19IH-D
Type
Licensee Name UHF TV, INC.
Status LICENSED
DTS No
Community of License WILLMAR, MN
Pre-auction RF Channel 19
Post-auction RF Channel
Neilsen DMA
Network Affiliation
Question Response
Sharee Station Facility ID 68701
Call Sign K14LF-D
Type
Licensee Name UHF TV, INC.
Status LICENSED
DTS No
Community of License WILLMAR, MN
Pre-auction RF Channel 14
Post-auction RF Channel
Neilsen DMA
Network Affiliation
Question Response
Sharee Station Facility ID 68712
Call Sign K36OL-D
Type
Licensee Name UHF TV, INC.
Status LICENSED
DTS No
Community of License WILLMAR, MN
Pre-auction RF Channel 36
Post-auction RF Channel
Neilsen DMA
Network Affiliation

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 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 Axcera
Model CU50BRD
Year 2001
Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 50 W

Primary Transmitter

Back to Top

Retuning Transmitter Costs

Section Question Response
New Mask Filter Does the transmitter require a new mask filter? No
New Exciter Is a new exciter needed? No

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? 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

Back to Top

Other Transmitter Cost Not Listed

Name Description

Channel Combiner

11 Channel combiner

Antennas

Back to Top
Section Question Response
Antenna Related Expenses Do you have antenna related expenses? No

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? No

Outside Professional Services Costs

Back to Top
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 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 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

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 No
FCC Construction Permit Minor Change No
FCC License to Cover Application Yes
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

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 $15,702.50 $5,130.00 N/A $5,130.00 N/A
Total for all systems $27,430.00 $8,581.75 N/A $8,581.75 N/A
Primary Transmitter CU50BRD $15,702.50 $5,130.00 $5,130.00
Channel Combiner $4,702.50 $4,702.50 N/A $4,702.50 N/A
Retune - UHF and VHF - minor re-channel issues $11,000.00 $427.50 N/A $427.50 N/A

Components

Actual Information Description File Name
Channel Combiner

Component Description:
One-fifth of the Combiner ($22,000 and sales tax of 6.875% is $23,512.50) is $ 4702.50
Amount:
$4,702.50

Component Description:
Letter explaining Combiner costs.
Amount:
N/A
Retune - UHF and VHF - minor re-channel issues

Component Description:
Re-tune channel 46 to channel 33.
Amount:
$427.50

Cost Information

Back to Top

Antennas

Information not provided.

Cost Information

Back to Top

Transmission Line

Information not provided.

Cost Information

Back to Top

Tower Equipment and Rigging Costs

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 $11,392.50 $3,281.75 N/A $3,281.75 N/A
Total for all systems $27,430.00 $8,581.75 N/A $8,581.75 N/A
Outside Professional Services $11,392.50 $3,281.75 $3,281.75
Prepare/ Review 399 reimbursement form $1,710.00 $1,000.00 N/A $1,000.00 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $1,577.50 $150.00 N/A $150.00 N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $3,025.00 $466.75 N/A $466.75 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $2,102.50 $300.00 N/A $300.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,052.50 $300.00 N/A $300.00 N/A
Perform engineering study for displacement application $1,800.00 $940.00 N/A $940.00 N/A
Form 399 assistance or other Program Management costs $125.00 $125.00 N/A $125.00 N/A

Components

Actual Information Description File Name
Prepare/ Review 399 reimbursement form

Component Description:
Prepare and file form 399
Amount:
$1,000.00
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application

Component Description:
One fifth of the fees are allocated to channel 33.
Amount:
$150.00
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
Attorney Fees
Amount:
$40.00

Component Description:
Attorney Fees
Amount:
$30.00

Component Description:
Attorney Fees
Amount:
$70.00

Component Description:
Attorney fees
Amount:
$326.75
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
Engineering for Displacement Applications.
Amount:
$300.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
Engineering for License to Cover
Amount:
$300.00
Perform engineering study for displacement application

Component Description:
In-core channel check for current channel 14 to 36 LPTV.
Amount:
$150.00

Component Description:
Out-of-Core LPTV channel displacement search studies.
Amount:
$300.00

Component Description:
Five channels were dislocated. This invoice is divided by five. $490.00
Amount:
$490.00
Form 399 assistance or other Program Management costs

Component Description:
Attorney fees
Amount:
$125.00

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 $335.00 $170.00 N/A $170.00 N/A
Total for all systems $27,430.00 $8,581.75 N/A $8,581.75 N/A
Other Expenses $335.00 $170.00 $170.00
FCC Filing Fees - Form 2100 license to cover application $335.00 $170.00 N/A $170.00 N/A

Components

Actual Information Description File Name
FCC Filing Fees - Form 2100 license to cover application

Component Description:
License to Cover Filing Fee.
Amount:
$170.00

Component Description:
The license application showing the $170 due for filing
Amount:
N/A

Cost Information

Back to Top

Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $27,430.00 $8,581.75 $8,581.75

Reimbursement Status

Back to Top
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

Back to Top
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.

Melissa Lynn Geer

Secretary/Treasurer


12/29/2020

Certification

Back to Top
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.

Melissa Lynn Geer

Secretary/Treasurer


12/29/2020

Attachments

Back to Top