Go to the Federal Communications Commission homepage at www.fcc.gov

FCC Form 399: Incentive Auction Relocation Reimbursement Fund System

Approved by OMB 3060-1178
Go to the Federal Communications Commission homepage at www.fcc.gov

(REFERENCE COPY - Not for submission)FCC Form 399: Incentive Auction Relocation Reimbursement Fund System

File Number:
0000028049
FRN:
0014881114
Facility ID:
16940
Repack Channel:
26 (UHF)
Entity:
Broadcaster
Filing Status:
Submitted
Date Submitted:
12/18/2018

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 eddie@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

PO Box 159

Carencro, LA 70520

United States

+1 (337) 896-1600 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. No
Briefly describe transition plan Existing CH 41 RF system is not capable of re-tuning to new channel. Existing transmitter no longer supported by manufacturer. Need to purchase new antenna, 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  
Ownership Owned
Owner  
Site  
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
Description  
Power capacity 60 kw
Solid State Cooling  
Solid State Power Capacity  
Other Transmitter Type  

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Description of Use  
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Manufacturer
Model Parallax U13
Transmitter Type Solid state
IOT Power Type  
Other  
Power capacity  
Solid State Cooling Liquid
Solid State Power Capacity 21 kw
Other Transmitter Type  
Justification for New Transmitter Advanced Broadcast Systems is no longer providing support for their transmitter products. Please see attached response to transmitter power question.

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  
HVAC Service Does the replacement transmitter require HVAC Service? Yes
Type Cooling Only
Size 10 tons
Other Size  
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size
Channel 14 Costs Is an RF Consulting Engineer needed?
Is a channel 14 Mask Filer needed?
Is additional field engineering time needed?
Number of Days  

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Louisiana State and Local Sales Taxes

Louisiana State and Local Sales Tax rate at 10%

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 single
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: 1000.00 kW
Manufacturer
Model ATW30H3-HTC4-41H
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 Type Class Full Power
Mounting Top-mount single
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: 1000.00 kW
Manufacturer
Model TFU-22ETT/VP-R 2C255 (SP)
Year 2018
Justification for New Antenna The existing channel 41 antenna is not capable of being re-tuned or re-manufactured for use on channel 26.

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
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

Louisiana State and Local Sales Taxes

Louisiana State and Local Sales Tax rate at 10%

50 to 75 OHM Transformer

50 to 75 OHM Transformer for connection from existing line to antenna

Shipping And Offloading

Shipping and handling costs for antenna

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: 1000.00 kW
Manufacturer
Model TFU-24WB-1-R S230
Year 2018
Justification for New Antenna Need to use an interim antenna to maintain over the air programming while the main antenna is being replaced.

Interim 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? Broadband
Feed Line Size 4 1/16 inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for a high power antenna? Yes
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

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 Utilize Existing
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 Electronics Research
Type Rigid
Diameter 6 1/8 inches
Segment Length 19 ¾ '
Other Segment Length
Number of parallel runs 1
Length 1020 feet per run

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Dehydrator System

Dehydrator system to pressurize interim transmission line.

Sweep Test Existing Transmission Line

Sweep test Existing transmission line to determine suitability for RF channel 26

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 810 feet per run
Justification for New Transmission Line Need transmission line to use with interim 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) No
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 1231316
Coordinates (NAD83) Latitude (NAD83) 30° 54' 17.4" N-
Longitude (NAD83) 092° 37' 28.9" W-
Overall Structure Height 999.99 feet
Support Structure Height 996.71 feet
Ground Elevation Above Mean Sea Level (AMSL) 142.06 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Delta Media Corp.
Date Constructed 04/28/2005


Other Types of Users

Users
Cellular

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.

Road Preparation

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

Staging Area Preparation

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

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 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 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 No
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility No
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
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

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 $1,101,960.00 $852,610.00 N/A $444,591.42 N/A
Total for all systems $2,549,546.50 $2,193,028.50 N/A $617,472.46 N/A
Primary Transmitter Parallax U13 $1,101,960.00 $852,610.00 $444,591.42
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW $922,000.00 $675,000.00 N/A $405,000.00 N/A
Switchgear - industrial 800 amp $37,150.00 $36,300.00 N/A N/A N/A
Transformer 3 phase/480v - 150 KVA $24,900.00 $24,300.00 N/A N/A N/A
2.0" Rigid Conduit and Wiring $2,500.00 $2,500.00 N/A N/A N/A
10 Ton system $37,900.00 $37,000.00 N/A N/A N/A
Louisiana State and Local Sales Taxes $77,510.00 $77,510.00 N/A $39,591.42 N/A

Components

Actual Information Description File Name
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW

Component Description:
60% of total contract price for transmitter equipment due to manufacturer
Amount:
$405,000.00
Switchgear - industrial 800 amp Information not provided.
Transformer 3 phase/480v - 150 KVA Information not provided.
2.0" Rigid Conduit and Wiring Information not provided.
10 Ton system Information not provided.
Louisiana State and Local Sales Taxes

Component Description:
10% Louisiana State and Local sales taxes due on this invoice
Amount:
$39,591.42

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 $625,145.00 $527,745.00 N/A $152,996.40 N/A
Total for all systems $2,549,546.50 $2,193,028.50 N/A $617,472.46 N/A
Interim Antenna TFU-24WB-1-R S230 $270,440.00 $269,490.00 $0.00
Side mount brackets for high power antennas (if not included in antenna base cost) $22,550.00 $22,000.00 N/A N/A N/A
Elbow complex, broadband, at antenna input, per 4 1/16. feedline (if needed) $10,650.00 $10,400.00 N/A N/A N/A
Sweep test of existing antenna $6,550.00 $6,400.00 N/A N/A N/A
UHF - High Power, Side Mount, basic slot antenna, 1000 kW input, directional,, horizontally polarized $230,690.00 $230,690.00 Please see attached vendor's quotation. N/A N/A
Primary Antenna TFU-22ETT/VP-R 2C255 (SP) $354,705.00 $258,255.00 $152,996.40
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,000.00 $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 $281,500.00 $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. $133,560.00 N/A
Sweep test of existing antenna $6,550.00 $6,400.00 N/A $5,760.00 N/A
Shipping And Offloading $25,000.00 $25,000.00 N/A N/A N/A
50 to 75 OHM Transformer $5,265.00 $5,265.00 N/A $3,790.80 N/A
Louisiana State and Local Sales Taxes $24,390.00 $24,390.00 N/A N/A N/A

Components

Actual Information Description File Name
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.
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
45% Installment Payment prior to shipping per payment terms
Amount:
$4,942.80

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

Component Description:
45% Installment Payment
Amount:
$66,780.00

Component Description:
45% Installment Payment prior to shipping per payment terms
Amount:
$66,780.00
Sweep test of existing antenna

Component Description:
45% Installment Payment
Amount:
$2,880.00

Component Description:
45% Installment Payment prior to shipping per payment terms
Amount:
$2,880.00
Shipping And Offloading Information not provided.
50 to 75 OHM Transformer

Component Description:
45% Installment Payment
Amount:
$1,895.40

Component Description:
45% Installment Payment prior to shipping per payment terms
Amount:
$1,895.40
Louisiana State and Local Sales Taxes Information not provided.

Cost Information

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Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $65,820.00 $64,200.00 N/A $2,133.04 N/A
Total for all systems $2,549,546.50 $2,193,028.50 N/A $617,472.46 N/A
Interim Transmission Line $58,320.00 $56,700.00 $0.00
Flexible Air Transmission Line - dielectric, 4" $58,320.00 $56,700.00 N/A N/A N/A
Primary Transmission Line $7,500.00 $7,500.00 $2,133.04
Dehydrator System $5,000.00 $5,000.00 N/A $0.00 N/A
Sweep Test Existing Transmission Line $2,500.00 $2,500.00 N/A $2,133.04 N/A

Components

Actual Information Description File Name
Flexible Air Transmission Line - dielectric, 4" Information not provided.
Dehydrator System Information not provided.
Sweep Test Existing Transmission Line

Component Description:
Engineering Services to perform a line sweep of existing transmission line for evaluation for service on repack channel 26
Amount:
$2,133.04

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 $475,008.50 $466,208.50 N/A $1,500.00 N/A
Total for all systems $2,549,546.50 $2,193,028.50 N/A $617,472.46 N/A
Primary Tower TOWER $475,008.50 $466,208.50 $1,500.00
Staging Area Preparation $58,991.00 $58,991.00 Please see attached contractor's quotation. N/A N/A
Crane and Crane Operator $15,000.00 $15,000.00 N/A N/A N/A
Road Preparation $30,217.50 $30,217.50 Please see attached contractor's quotation. N/A N/A
Tall Tower (greater than 500') $205,000.00 $200,000.00 N/A N/A N/A
Minor tower reinforcement/modifications $153,500.00 $150,000.00 N/A N/A N/A
Structural engineering tower load study for well documented tower $12,300.00 $12,000.00 N/A $1,500.00 N/A

Components

Actual Information Description File Name
Staging Area Preparation Information not provided.
Crane and Crane Operator Information not provided.
Road Preparation Information not provided.
Tall Tower (greater than 500') Information not provided.
Minor tower reinforcement/modifications Information not provided.
Structural engineering tower load study for well documented tower

Component Description:
Engineering Study for 940' Tower in Glenmora LA - KBCA - Due Date is Net 30
Amount:
$1,500.00

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 $213,335.00 $214,250.00 N/A $2,880.00 N/A
Total for all systems $2,549,546.50 $2,193,028.50 N/A $617,472.46 N/A
Outside Professional Services $213,335.00 $214,250.00 $2,880.00
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. N/A N/A
RF Exposure Measurements $20,500.00 $20,000.00 N/A N/A N/A
Comprehensive coverage verification via field study, if needed $81,900.00 $80,000.00 N/A N/A N/A
Perform engineering study for new channel assignment and antenna development $7,170.00 $7,000.00 N/A $825.00 N/A
Prepare request for Special Temporary Authorization $1,535.00 $3,000.00 N/A N/A N/A
Project management of the transition $30,800.00 $30,000.00 N/A N/A N/A
Prepare and or review reimbursement form $2,560.00 $2,500.00 N/A N/A N/A
Address transition timing and coordination issues w/ other stations and wireless $2,560.00 $2,500.00 N/A N/A N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,070.00 $3,000.00 N/A $1,500.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,535.00 $1,500.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,120.00 $5,000.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,305.00 $2,250.00 N/A N/A N/A
Attorney Fees - Negotiation of lease and other matters for shared locations $4,095.00 $4,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,585.00 $7,000.00 N/A N/A N/A
ASR modification (prepare FCC Form 854) $2,050.00 $2,000.00 N/A N/A N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase $2,050.00 $2,000.00 N/A N/A N/A
Outside Accounting Services $7,500.00 $7,500.00 N/A $555.00 N/A

Components

Actual Information Description File Name
General Contractor Information not provided.
RF Exposure Measurements Information not provided.
Comprehensive coverage verification via field study, if needed Information not provided.
Perform engineering study for new channel assignment and antenna development

Component Description:
Please disregard this invoice as it was submitted in error
Amount:
N/A

Component Description:
RF Consulting Engineer study for new channel assignment
Amount:
$825.00
Prepare request for Special Temporary Authorization Information not provided.
Project management of the transition Information not provided.
Prepare and or review reimbursement form Information not provided.
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
RF Consulting Engineer fee to prepare engineer section FCC Form 2100, Construction Permit App
Amount:
$1,500.00
Prepare engineering section of 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.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Negotiation of lease and other matters for shared locations Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
ASR modification (prepare FCC Form 854) Information not provided.
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase Information not provided.
Outside Accounting Services

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

Component Description:
CPA Accounting services through August 31, 2017 - Revised and re-submitted
Amount:
$555.00

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 $68,278.00 $68,015.00 N/A $13,371.60 N/A
Total for all systems $2,549,546.50 $2,193,028.50 N/A $617,472.46 N/A
Other Expenses $68,278.00 $68,015.00 $13,371.60
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 $5,000.00 $5,000.00 N/A N/A N/A
Equipment Delivery and Handling Charges $25,000.00 $25,000.00 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
DTV Medical Facility Notification $11,250.00 $11,000.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $333.00 $325.00 N/A N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
Local Zoning $1,500.00 $1,500.00 N/A N/A N/A
Non-zoning permits $5,000.00 $5,000.00 N/A N/A N/A

Components

Actual Information Description File Name
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:
60% of total shipping, offloading and placement of equipment costs due to transmitter manufacturer
Amount:
$13,371.60
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
DTV Medical Facility Notification Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
Local Zoning Information not provided.
Non-zoning permits Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $2,549,546.50 $2,193,028.50 $617,472.46

Construction Status

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Question Response
Is construction complete? 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


12/18/2018

Attachments

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