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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:
191352
Service:
LPD
Call Sign:
KUKC-LD
Channel:
14 (UHF)
File Number:
0000088858
FRN:
0032881088
Eligibility Status:
Eligible
Date Submitted:
06/14/2021

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

MEDIA VISTA KANSAS CITY, LLC

Doing Business As: MEDIA VISTA KANSAS CITY, LLC

Orlando Rosales

1110 Pine Ridge Road

Suite 301

Naples, FL 34108

United States

 +1 (239) 877-8036 ORLANDO@MEDIAVISTA.TV 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

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 Install new antenna and transmitter to broadcast on displacement channel.

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 TMU9-3
Year 2014
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 1.8 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 TMU9-3
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 1.8 kW
Justification for New Transmitter Existing transmitter unable to operate on displacement channel.

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? 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? 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: 1.0 kW
Manufacturer
Model SWEDL16OI/14
Year 2014

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? 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: 15.0 kW
Manufacturer
Model SWEDL16OI/14
Year 2019
Justification for New Antenna Existing antenna will not operate on displacement channel.

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? Yes

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 Move Equipment
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 1003521
Coordinates (NAD83) Latitude (NAD83) 39° 04' 24.0" N-
Longitude (NAD83) 094° 29' 07.0" W-
Overall Structure Height 1021.97 feet
Support Structure Height 1020.00 feet
Ground Elevation Above Mean Sea Level (AMSL) 881.88 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner American Towers LLC
Date Constructed 01/01/1987

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
8401 KJNW FM
8609 WDAF-FM FM
2449 KMBZ-FM FM
27021 KCFX FM

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

Name Description

Structural Analysis

Tower owner requires structural analysis of tower

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? Yes
Number of Hours 1000
Explanation Due to budget constraints, the station lacks the necessary personnel
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 Yes
Number of Days 5
Justification Co-ordination of replacement of antenna and transmitter on site.

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

Land Mobile Protection Study

Engineering study of land mobile protection requirements to provide specification for sharp-tuned filter.

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 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? Yes
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 $273,500.00 $70,138.11 N/A $70,138.11 N/A
Total for all systems $620,242.50 $269,426.11 N/A $165,856.97 N/A
Primary Transmitter TMU9-3 $273,500.00 $70,138.11 $70,138.11
Channel 14 Mask Filter $189,500.00 $21,027.90 N/A $21,027.90 N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $84,000.00 $49,110.21 N/A $49,110.21 N/A

Components

Actual Information Description File Name
Channel 14 Mask Filter

Component Description:
Rohde and Schwarz, Transmitter, mask filter
Amount:
$21,027.90

Component Description:
Quote for Transmitter Mask Filter
Amount:
N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW

Component Description:
Transmitter main minus shipping charges, but with tax
Amount:
$49,110.21

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 $45,730.00 $45,730.00 N/A $24,817.00 N/A
Total for all systems $620,242.50 $269,426.11 N/A $165,856.97 N/A
Primary Antenna SWEDL16OI/14 $45,730.00 $45,730.00 $24,817.00
Sweep test of transmission line and antenna $5,730.00 $5,730.00 N/A N/A N/A
UHF-Low Power, Side Mount, Slotted Coaxial, 15.0kW input, Horizontal $40,000.00 $40,000.00 See invoice $24,817.00 See invoice

Components

Actual Information Description File Name
Sweep test of transmission line and antenna Information not provided.
UHF-Low Power, Side Mount, Slotted Coaxial, 15.0kW input, Horizontal

Component Description:
Re submission. Antenna Side Mount.
Amount:
$12,408.00

Component Description:
Antenna replacement
Amount:
$12,408.00

Component Description:
Proforma Invoice 22009_357465-KUKC revised, Antenna costs
Amount:
$24,817.00

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 $162,550.00 $17,208.00 N/A $12,408.00 N/A
Total for all systems $620,242.50 $269,426.11 N/A $165,856.97 N/A
Primary Tower GTOWER $162,550.00 $17,208.00 $12,408.00
Tower Rigging Tall Tower (greater than 500') $157,750.00 $12,408.00 N/A $12,408.00 N/A
Structural Analysis $4,800.00 $4,800.00 N/A N/A N/A

Components

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

Component Description:
Replace existing antenna.
Amount:
$12,408.00
Structural Analysis 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 $135,517.50 $133,405.00 N/A $56,993.86 N/A
Total for all systems $620,242.50 $269,426.11 N/A $165,856.97 N/A
Outside Professional Services $135,517.50 $133,405.00 $56,993.86
Additional Field Engineering Service, 5 Days $13,750.00 $13,750.00 Estimated 5 days X $2750/day. $8,558.50 N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $1,577.50 $1,577.50 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 engineering section of FCC Form 2100 (main), License to Cover Application $1,052.50 $1,052.50 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $2,102.50 $1,000.00 N/A N/A N/A
Perform engineering study for displacement application $1,800.00 $3,000.00 See invoices $0.00 See invoice
Form 399 assistance or other Program Management costs $500.00 $500.00 Assistance of consulting engineers in preparation of Form 399. N/A N/A
Prepare/ Review 399 reimbursement form $1,710.00 $5,000.00 Obtaining, processing and organizing information regarding equipment and other displacement expenses, and to demonstrate eligibility. $2,312.50 Obtaining, processing, and organizing information regarding equipment and other displacement expenses, and to demonstrate eligibility.
Project management of the transition $105,500.00 $100,000.00 N/A $41,622.86 N/A
Land Mobile Protection Study $4,500.00 $4,500.00 See invoice $4,500.00 tbd

Components

Actual Information Description File Name
Additional Field Engineering Service, 5 Days

Component Description:
Field Engineering
Amount:
$250.00

Component Description:
Field Engineering
Amount:
$2,875.50

Component Description:
Field Engineering
Amount:
$260.00

Component Description:
Field Engineering
Amount:
$2,240.00

Component Description:
Field Engineering
Amount:
$333.00

Component Description:
Field Engineering
Amount:
$270.00

Component Description:
Additional Field Engineering
Amount:
$1,960.00

Component Description:
Resubmitted under Land Mobile Protection Study.
Amount:
N/A

Component Description:
Field Engineering
Amount:
$120.00

Component Description:
Field Engineering
Amount:
$250.00
Attorney Fees -Prepare and File 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 engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Perform engineering study for displacement application Information not provided.
Form 399 assistance or other Program Management costs Information not provided.
Prepare/ Review 399 reimbursement form

Component Description:
21-May
Amount:
$1,362.50

Component Description:
21-Apr
Amount:
$450.00

Component Description:
Preparation of form 399
Amount:
$500.00
Project management of the transition

Component Description:
LS May 2020
Amount:
$2,642.50

Component Description:
Ls October 2019, Professional services
Amount:
$2,397.35

Component Description:
LS Jan 2021
Amount:
$300.00

Component Description:
LS Feb 2020, Professional Services
Amount:
$513.75

Component Description:
LS December 2020
Amount:
$4,556.25

Component Description:
March 2020 LS, professional services
Amount:
$2,122.75

Component Description:
LS Nov 2020
Amount:
$712.50

Component Description:
July 2020.
Amount:
$975.00

Component Description:
LS October 2020
Amount:
$4,296.25

Component Description:
LS April 2020
Amount:
$2,140.26

Component Description:
Nov 19 LS Fees
Amount:
$3,593.75

Component Description:
Oct 2020.
Amount:
$2,330.00

Component Description:
Aug 2020.
Amount:
$7,393.75

Component Description:
Sept 2020.
Amount:
$7,492.50

Component Description:
November 2020 LS, Professional services
Amount:
$3,612.35

Component Description:
Sept. 2019 LS, Professional services
Amount:
$156.25
Land Mobile Protection Study

Component Description:
Invoice Repack - duTreil, outside professional, Land Mobile study
Amount:
$1,500.00

Component Description:
Land Mobile Protection Study.
Amount:
$500.00

Component Description:
Invoice Repack - duTreil, outside professional, Land Mobile study
Amount:
$2,500.00

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 $2,945.00 $2,945.00 N/A $1,500.00 N/A
Total for all systems $620,242.50 $269,426.11 N/A $165,856.97 N/A
Other Expenses $2,945.00 $2,945.00 $1,500.00
Equipment Delivery and Handling Charges $1,500.00 $1,500.00 See uploaded invoices $1,500.00 N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $335.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,110.00 N/A N/A N/A

Components

Actual Information Description File Name
Equipment Delivery and Handling Charges

Component Description:
Transmitter shipping fees
Amount:
$1,500.00
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Form 2100 minor change CP application Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate 		Estimated Cost Actual Cost
Total for all systems $620,242.50 $269,426.11 $165,856.97

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.

Orlando Rosales

Authorized Representative


06/14/2021

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.

Orlando Rosales

Authorized Representative


06/14/2021

Attachments

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