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:
82476
Service:
DTV
Call Sign:
KLWB
Channel:
17 (UHF)
File Number:
0000028053
FRN:
0014881114
Date Submitted:
08/24/2018

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

WILDERNESS COMMUNICATIONS, LLC

Doing Business As: WILDERNESS COMMUNICATIONS, LLC

3501 NORTHWEST EVANGELINE THRUWAY

CARENCRO, LA 70520

United States

+1 (337) 896-1600 beth@delta-network.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

Arthur Lee Clardy , III .

Director of Engineering

Delta Media Corporation

Lee Clardy

3501 NW Evangeline Thwy

Carencro, LA 70520

United States

+1 (337) 896-2601 lclardy@deltamediacorp.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 Existing CH 50 RF system and waveguide is not capable of re-tuning to new channel. Existing transmitter is no longer supported by manufacturer. Need to purchase new antenna, transmission line, RF filters and transmitter.

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)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model CST II
Year 2002
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 60 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? Yes
Manufacturer
Model Parallax U15
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 24.3 kW
Justification for New Transmitter Advanced Broadcast Systems is no longer providing support for the existing transmitter.

Primary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) Yes
Transformer (480V) Yes
Power 150 kVA
Rigid Conduit and Wiring Yes
Size 2.0 inches
Length 100.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 10 tons
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

State and Local Sales Taxes

Purchase of new equipment is subject to Louisiana state and local sales tax rate of 9%

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)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
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? No
Existing Antenna Manufacturer and Type Class Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels N/A
Design power capacity in use N/A
Lower Limit N/A
Upper Limit N/A
Other Antenna Type N/A
ERP: 1000.0 kW
Manufacturer
Model TFU-31JTH-6T180
Year 2004

Primary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types Class Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Elliptical
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 1000.0 kW
Manufacturer
Model TFU-21ETT/VP-R 4CT170
Year 2018
Justification for New Antenna Existing channel 50 antenna is not capable of being re-tuned or re-manufactured for channel 17.

Primary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? No
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? N/A
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? Single Channel
Feed Line Size 6 1/8 inches inches
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

Name Description

State and Local Sales Taxes

Purchase of new equipment is subject to Louisiana state and local sales tax rate of 9%

Shipping from Raymond ME

Shipping and handling charges

Interim Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Interim
Description of Use N/A
Change Type Purchase New
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Slotted Coaxial
Number of Stations Supported N/A
Number of Panels/Bays N/A
Lower Limit N/A
Upper Limit N/A
Design power capacity in use N/A
Other Antenna Type N/A
ERP: 1000.0 kW
Manufacturer
Model TFU-24WB-1-R S230
Year 2018
Justification for New Antenna Interim antenna for use to maintain broadcasts over the air during the replacement of main antenna.

Interim Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? B
Feed Line Size 4 1/16 inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for an antenna? Yes
Pattern Scatter Analysis Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna? Yes
Sweep Test Do you require the sweep testing of transmission line and antenna? Yes

Interim 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? Yes

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
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
Type Waveguide
Diameter N/A
Other Diameter N/A
Segment Length N/A
Other Segment Length N/A
Number of parallel runs 1
Length 1100 feet per run

Primary Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Primary (Main)
Description of Use N/A
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 19 1/2 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1100 feet per run
Justification for New Transmission Line The existing channel 50 waveguide is not compatible for use on channel 17.

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Dehydrator System

The existing dehydrator is not compatible for use with rigid transmission line. The interim needs to be pressurized also.

State and Local Sales Taxes

Purchase of new equipment is subject to Louisiana state and local sales tax rate of 9%

Interim Transmission Line

Additional transmission line for use with interim antenna

Interim Transmission Line

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New Transmission Line

Section Question Response
New Transmission Line Costs Use Interim
Description of Use N/A
Change Type Purchase New
Type Flexible Air
Diameter 4 inches
Segment Length N/A
Other Segment Length
Number of parallel runs 1
Length 800 feet per run
Justification for New Transmission Line Needed for use with interim antenna to maintain over the air broadcasts during the replacement of the main antenna.

Interim Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

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)
Description of Use N/A
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 Yes
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 1251823
Coordinates (NAD83) Latitude (NAD83) 30° 20' 33.0" N-
Longitude (NAD83) 091° 57' 46.6" W-
Overall Structure Height 1025.91 feet
Support Structure Height 966.20 feet
Ground Elevation Above Mean Sea Level (AMSL) 22.97 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Delta Media Corp.
Date Constructed 05/01/2006

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
183335 KLWB-FM FM
33220 KOGM FM
349 KDCG-CD DTV

Other Types of Users

Users
Wi-Fi Network
Two-way radio

Primary Tower

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Tower Modification Costs

Section Question Response
Engineering Study Please what type of engineering study is required, if any: Study needed for documented tower
Tower Reinforcements Please select whether tower reinforcements are needed: Minor 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

Name Description

Crane and Crane Operator

Will require the rental of a crane to lift the new antenna off the truck transportation at the site. Then place the antenna in position for rigging and hoisting.

All-terrain Personnel Lift

Will require the rental of an all- terrain personnel lift (man-lift) in order to remove the waveguide from horizontal supports (ice bridge). Then will require the use of it to install new transmission line into the horizontal supports.

Staging Area Preparation

Staging area has to be prepared for tower rigging to hoist old antenna and waveguide down and hoist new antenna and transmission line up.

Road Preparation

One-mile ingress and egress must be made capable of handling heavy truck transportation into and out of the tower site.

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 200
Explanation Wilderness Communications engineering staff also works for 16 stations licensed to different licensees and significant project management assistance will be required.
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification Yes
FAA Consultation (including preparation of FAA Form 7460) Yes
Negotiation of Lease and other Matter for Shared Locations Yes
Prepare or Review FCC Form 399 for Reimbursement Yes
Address transition timing and coordination issues w/ other stations and wireless providers Yes
RF Field Engineering Services Comprehensive coverage verification via field study Yes
RF exposure measurements Yes
Additional Field Engineering Service No
Number of Days N/A
Justification N/A

Outside Professional Services Costs

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Other Professional Services Expenses Not Listed

Name Description

General Contractor

A Louisiana licensed and insured commercial general contractor will be retained to provide project management as well as general construction services for this project.

Outside Accounting Services

An independent accounting firm to provide oversight and assistance with compliance and reporting as required for this project.

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning Yes
Non-zoning permits Yes
BLM or NFS Coordination No
FCC Construction Permit Minor Change No
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
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Name Description

Tower Lights and Controller

There is a possibility that the tower lighting system may need to be changed due to some unforeseen failure after changing the main antenna.

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 $1,139,972.00 $1,087,922.00 N/A $587,782.28 N/A
Total for all systems $3,036,310.00 $2,838,550.00 N/A $1,096,724.52 N/A
Primary Transmitter Parallax U15 $1,139,972.00 $1,087,922.00 $587,782.28
State and Local Sales Taxes $87,822.00 $87,822.00 N/A $47,782.28 N/A
10 Ton system $38,900.00 $37,000.00 N/A N/A N/A
2.0" Rigid Conduit and Wiring $2,500.00 $2,500.00 N/A N/A N/A
Transformer 3 phase/480v - 150 KVA $25,550.00 $24,300.00 N/A N/A N/A
Switchgear - industrial 800 amp $38,200.00 $36,300.00 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW $947,000.00 $900,000.00 N/A $540,000.00 N/A

Components

Actual Information Description File Name
State and Local Sales Taxes

Component Description:
Louisiana State and Local 9% Sales Tax on transmitter purchase
Amount:
$47,782.28
10 Ton system Information not provided.
2.0" Rigid Conduit and Wiring Information not provided.
Transformer 3 phase/480v - 150 KVA Information not provided.
Switchgear - industrial 800 amp Information not provided.
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW

Component Description:
60% of the contract price is due to the manufacturer
Amount:
$540,000.00

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 $634,844.00 $527,624.00 N/A $175,183.20 N/A
Total for all systems $3,036,310.00 $2,838,550.00 N/A $1,096,724.52 N/A
Interim Antenna TFU-24WB-1-R S230 $282,990.00 $280,700.00 $0.00
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) $5,260.00 $5,000.00 N/A N/A N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $22,000.00 N/A N/A N/A
Elbow complex, broadband, at antenna input, per 4 1/16. feedline (if needed) $10,950.00 $10,400.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
UHF - High Power, Side Mount, basic slot antenna, 1000 kW input, directional,, horizontally polarized $236,900.00 $236,900.00 Please see attached quotation for side mounted antenna N/A N/A
Primary Antenna TFU-21ETT/VP-R 4CT170 $351,854.00 $246,924.00 $175,183.20
Shipping from Raymond ME $25,000.00 $25,000.00 N/A N/A N/A
State and Local Sales Taxes $18,324.00 $18,324.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $5,760.00 N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $11,700.00 N/A $9,885.60 N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized $289,500.00 $185,500.00 Wilderness elected to purchase an upgraded antenna per paragraph 624 of the Broadcast Incentive Auction Report and Order. The attachment provided is a quotation for a horizontally polarized antenna plus a line item for the vertical component. $159,537.60 N/A

Components

Actual Information Description File Name
Pattern scatter analysis for side mount high/med power antennas (if not included in antenna base cost) Information not provided.
Side mount brackets for high power antennas (if not included in antenna base cost) Information not provided.
Elbow complex, broadband, at antenna input, per 4 1/16. feedline (if needed) Information not provided.
Sweep test of existing antenna Information not provided.
UHF - High Power, Side Mount, basic slot antenna, 1000 kW input, directional,, horizontally polarized Information not provided.
Shipping from Raymond ME Information not provided.
State and Local Sales Taxes Information not provided.
Sweep test of existing antenna

Component Description:
45% Installment Payment Prior to Shipment for Antenna Sweep Testing per payment terms
Amount:
$2,880.00

Component Description:
45% Installment Payment with order
Amount:
$2,880.00
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
45% Installment Payment with order
Amount:
$4,942.80

Component Description:
45% Installment Payment Prior to Shipment per payment terms
Amount:
$4,942.80
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized

Component Description:
45% Installment Payment Prior to Shipment per payment terms
Amount:
$79,768.80

Component Description:
45% Installment Payment with order
Amount:
$79,768.80

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 $318,020.00 $303,820.00 N/A $146,413.44 N/A
Total for all systems $3,036,310.00 $2,838,550.00 N/A $1,096,724.52 N/A
Interim Transmission Line $59,200.00 $56,000.00 $0.00
Flexible Air Transmission Line - dielectric, 4" $59,200.00 $56,000.00 N/A N/A N/A
Primary Transmission Line $258,820.00 $247,820.00 $146,413.44
Interim Transmission Line $10,000.00 $10,000.00 N/A N/A N/A
State and Local Sales Taxes $21,620.00 $21,620.00 N/A N/A N/A
Dehydrator System $5,000.00 $5,000.00 N/A N/A N/A
Rigid Transmission Line - copper, 6 1/8" $222,200.00 $211,200.00 N/A $146,413.44 N/A

Components

Actual Information Description File Name
Flexible Air Transmission Line - dielectric, 4" Information not provided.
Interim Transmission Line Information not provided.
State and Local Sales Taxes Information not provided.
Dehydrator System Information not provided.
Rigid Transmission Line - copper, 6 1/8"

Component Description:
45% Installment Payment Prior to Shipment per payment terms
Amount:
$1,767.60

Component Description:
45% Installment Payment Prior to Shipment per payment terms
Amount:
$71,439.12

Component Description:
45% Installment Payment with order
Amount:
$71,439.12

Component Description:
45% Installment Payment with order
Amount:
$1,767.60

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 $534,119.00 $515,019.00 N/A $136,219.00 N/A
Total for all systems $3,036,310.00 $2,838,550.00 N/A $1,096,724.52 N/A
Primary Tower TOWER $534,119.00 $515,019.00 $136,219.00
Structural engineering tower load study for well documented tower $12,600.00 $12,000.00 N/A $700.00 N/A
Crane and Crane Operator $15,000.00 $15,000.00 N/A N/A N/A
Road Preparation $76,528.00 $76,528.00 Please see attached quotation. $76,528.00 N/A
Staging Area Preparation $58,991.00 $58,991.00 Please see attached vendor quotation for staging area preparation $58,991.00 Additional expense incurred due to unforeseen soil conditions for construction of work site pad at tower site on Wilderness Trail, Carencro, LA
All-terrain Personnel Lift $2,500.00 $2,500.00 N/A N/A N/A
Tall Tower (greater than 500') $210,500.00 $200,000.00 N/A N/A N/A
Minor tower reinforcement/modifications $158,000.00 $150,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Structural engineering tower load study for well documented tower

Component Description:
Engineering drawings for 952' tower in Lafayette, LA
Amount:
$300.00

Component Description:
Engineer services for 952' tv tower
Amount:
$400.00
Crane and Crane Operator Information not provided.
Road Preparation

Component Description:
Partial billing for KLWB TV road preparation
Amount:
$27,056.00

Component Description:
Road Prep for KLWB TV-420
Amount:
$49,472.00
Staging Area Preparation

Component Description:
Partial bill for work pad site prep for KLWB TV
Amount:
$26,650.00

Component Description:
Additional work site pad expense due to unforeseen soil issues-KLWB
Amount:
$6,977.50

Component Description:
Work Site Pad Prep for KLWB TV
Amount:
$32,341.00
All-terrain Personnel Lift Information not provided.
Tall Tower (greater than 500') Information not provided.
Minor tower reinforcement/modifications 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 $226,375.00 $221,750.00 N/A $37,755.00 N/A
Total for all systems $3,036,310.00 $2,838,550.00 N/A $1,096,724.52 N/A
Outside Professional Services $226,375.00 $221,750.00 $37,755.00
Outside Accounting Services $7,500.00 $7,500.00 N/A $555.00 N/A
General Contractor $35,000.00 $35,000.00 Please see attachment with copy State of Louisiana contractors License including statement that a contractor is required by state law. $35,000.00 N/A
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A
Comprehensive coverage verification via field study, if needed $84,200.00 $80,000.00 N/A N/A N/A
ASR modification (prepare FCC Form 854) $2,105.00 $2,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $7,000.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $4,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application $4,210.00 $4,000.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A $1,425.00 N/A
Prepare request for Special Temporary Authorization $2,050.00 $3,000.00 N/A N/A N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application $2,105.00 $2,000.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $775.00 N/A
Address transition timing and coordination issues w/ other stations and wireless $2,630.00 $2,500.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A
Project management of the transition $31,600.00 $30,000.00 N/A N/A N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase $2,105.00 $2,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Outside Accounting Services

Component Description:
Accounting services split between 2 facilities
Amount:
$555.00
General Contractor

Component Description:
Contractor Svces provided for Construction of road and stage area prep-KLWB
Amount:
$35,000.00
RF Exposure Measurements Information not provided.
Comprehensive coverage verification via field study, if needed Information not provided.
ASR modification (prepare FCC Form 854) Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
RF Consulting Engineer Fee prepare engineer section FCC Form 2100, Construction Permit App
Amount:
$1,425.00
Prepare request for Special Temporary Authorization Information not provided.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Perform engineering study for new channel assignment and antenna development

Component Description:
RF Consulting Engineer Fees for study for new channel assignment
Amount:
$775.00
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form Information not provided.
Project management of the transition Information not provided.
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase Information not provided.

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 $182,980.00 $182,415.00 N/A $13,371.60 N/A
Total for all systems $3,036,310.00 $2,838,550.00 N/A $1,096,724.52 N/A
Other Expenses $182,980.00 $182,415.00 $13,371.60
Tower Lights and Controller $94,400.00 $94,400.00 Please see attached vendor quotation N/A N/A
MVPD Notification of Channel Change $2,500.00 $2,500.00 N/A N/A N/A
Develop and air announcement of upcoming channel change $2,500.00 $2,500.00 N/A N/A N/A
Equipment Storage $15,000.00 $15,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $35,000.00 $35,000.00 N/A $13,371.60 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $15,000.00 $15,000.00 N/A N/A N/A
Non-zoning permits $5,000.00 $5,000.00 N/A N/A N/A
Local Zoning $1,500.00 $1,500.00 N/A N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Tower Lights and Controller Information not provided.
MVPD Notification of Channel Change Information not provided.
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage Information not provided.
Equipment Delivery and Handling Charges

Component Description:
Shipping, Offloading and Placement
Amount:
$13,371.60
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
Non-zoning permits Information not provided.
Local Zoning Information not provided.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
DTV Medical Facility Notification Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $3,036,310.00 $2,838,550.00 $1,096,724.52

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.

Arthur Lee Clardy , III .

Director of Engineering


08/24/2018

Attachments

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