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:
16940
Service:
DTV
Call Sign:
KBCA
Channel:
26 (UHF)
File Number:
0000028049
FRN:
0014881114
Date Submitted:
04/24/2019

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 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 U13
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 21 kW
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 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

Louisiana State and Local Sales Taxes

Louisiana State and Local Sales Tax rate at 10%

Interim Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Interim
Description of Use N/A
Change Type Purchase
Manufacturer
Model EC703HP-BB
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 2.5 kW
Justification for New Transmitter KBCA needs interim transmission system in order to maintain over the air broadcasts while the main transmitter and antenna are being changed out.

Interim Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring Yes
Size 0.75 inches
Length 80.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
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
Inside RF System Is an additional interior RF system required to support this interim transmitter? Yes

Interim 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)
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 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 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-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 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

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

Louisiana State and Local Sales Taxes

Louisiana State and Local Sales Tax rate at 10%

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 Broadband Slot
Number of Stations Supported 1
Number of Panels/Bays 8
Lower Limit 470.00 MHz
Upper Limit 698.00 MHz
Design power capacity in use 12.5 %
Other Antenna Type N/A
ERP: 14.2 kW
Manufacturer
Model TFU-8WB
Year 2019
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
Elbow Complex Do you require the separate purchase of the Elbow Complex? No
Broadband or Single Channel? N/A
Feed Line Size N/A
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? 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
Other Diameter N/A
Segment Length 19 3/4 inches
Other Segment Length N/A
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 1 5/8 inches
Segment Length N/A
Other Segment Length
Number of parallel runs 1
Length 900 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 Owned
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

Excavator Rental

Excavator rental needed to assist with the removal of the old antenna and installation of the new antenna

Staging Area Preparation

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

Road Preparation

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

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.

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.

Attorney Fees related to repack

Additional attorney fees related to repack issues

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

Additional Hired Workers

Additional workers hired to assist with removal of old transmitter system

RF Consulting Engineer

RF consulting engineer to provide services related to KBCA repack

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 $1,404,660.00 $1,120,610.00 N/A $676,925.66 N/A
Total for all systems $2,714,776.61 $2,340,511.61 N/A $869,021.86 N/A
Interim Transmitter EC703HP-BB $275,000.00 $268,000.00 $0.00
0.75" Rigid Conduit and Wiring $1,500.00 $1,500.00 N/A N/A N/A
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW $126,000.00 $123,000.00 N/A N/A N/A
UHF inside RF system including switching $147,500.00 $143,500.00 N/A N/A N/A
Primary Transmitter Parallax U13 $1,129,660.00 $852,610.00 $676,925.66
Louisiana State and Local Sales Taxes $77,510.00 $77,510.00 N/A $59,387.13 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 $10,038.53 N/A
UHF - Liquid Cooled Solid State Transmitter 21 - 31 kW $947,000.00 $675,000.00 N/A $607,500.00 N/A
10 Ton system $38,900.00 $37,000.00 N/A N/A N/A

Components

Actual Information Description File Name
0.75" Rigid Conduit and Wiring Information not provided.
UHF - Air Cooled Solid State Transmitter 1 - 2.5 kW Information not provided.
UHF inside RF system including switching 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

Component Description:
10% State and local sales taxes due on this invoice
Amount:
$19,795.71
2.0" Rigid Conduit and Wiring Information not provided.
Transformer 3 phase/480v - 150 KVA Information not provided.
Switchgear - industrial 800 amp

Component Description:
480 VAC Electrical Panelboard needed for Comark transmitter installation
Amount:
$60.61

Component Description:
480 VAC Electrical branch panelboard, breakers and fuses needed for Comark transmitter installation
Amount:
$9,977.92
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

Component Description:
Invoice for 30% payment due to transmitter manufacturer, includes installation, check out and proof
Amount:
$202,500.00
10 Ton system Information not provided.

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 $453,065.00 $346,655.00 N/A $152,996.40 N/A
Total for all systems $2,714,776.61 $2,340,511.61 N/A $869,021.86 N/A
Interim Antenna TFU-8WB $89,880.00 $88,400.00 $0.00
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
UHF - High Power, Side Mount, basic slot antenna, 8 bay,, 14 kW input, directional,, horizontally polarized $60,000.00 $60,000.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Primary Antenna TFU-22ETT/VP-R 2C255 (SP) $363,185.00 $258,255.00 $152,996.40
Louisiana State and Local Sales Taxes $24,390.00 $24,390.00 N/A N/A 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
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
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $5,760.00 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. $133,560.00 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.
UHF - High Power, Side Mount, basic slot antenna, 8 bay,, 14 kW input, directional,, horizontally polarized Information not provided.
Sweep test of existing antenna Information not provided.
Louisiana State and Local Sales Taxes Information not provided.
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
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

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

Component Description:
45% Installment Payment prior to shipping per payment terms
Amount:
$4,942.80
Sweep test of existing antenna

Component Description:
45% Installment Payment prior to shipping per payment terms
Amount:
$2,880.00

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

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 $37,288.11 $27,588.11 N/A $7,221.15 N/A
Total for all systems $2,714,776.61 $2,340,511.61 N/A $869,021.86 N/A
Interim Transmission Line $29,700.00 $20,000.00 $0.00
Flexible Air Transmission Line - dielectric, 1 5/8" $29,700.00 $20,000.00 N/A N/A N/A
Primary Transmission Line $7,588.11 $7,588.11 $7,221.15
Sweep Test Existing Transmission Line $2,500.00 $2,500.00 N/A $2,133.04 N/A
Dehydrator System $5,088.11 $5,088.11 Quotation from Dielectric exceeded the initial predetermined cost estimate by $ 88.11. $5,088.11 N/A

Components

Actual Information Description File Name
Flexible Air Transmission Line - dielectric, 1 5/8" 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
Dehydrator System

Component Description:
Invoice for dehydrator system
Amount:
$5,088.11

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 $492,808.50 $523,708.50 N/A $1,500.00 N/A
Total for all systems $2,714,776.61 $2,340,511.61 N/A $869,021.86 N/A
Primary Tower TOWER $492,808.50 $523,708.50 $1,500.00
Staging Area Preparation $58,991.00 $58,991.00 Please see attached contractor's quotation. N/A N/A
Road Preparation $30,217.50 $30,217.50 Please see attached contractor's quotation. N/A N/A
Excavator Rental $7,500.00 $7,500.00 N/A N/A N/A
Tall Tower (greater than 500') $210,500.00 $250,000.00 New quotation for tower crew and rigging exceeds predetermined cost estimate N/A N/A
Minor tower reinforcement/modifications $158,000.00 $150,000.00 N/A N/A N/A
Crane and Crane Operator $15,000.00 $15,000.00 N/A N/A N/A
Structural engineering tower load study for well documented tower $12,600.00 $12,000.00 N/A $1,500.00 N/A

Components

Actual Information Description File Name
Staging Area Preparation Information not provided.
Road Preparation Information not provided.
Excavator Rental Information not provided.
Tall Tower (greater than 500') Information not provided.
Minor tower reinforcement/modifications Information not provided.
Crane and Crane Operator 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 $251,375.00 $246,935.00 N/A $9,971.25 N/A
Total for all systems $2,714,776.61 $2,340,511.61 N/A $869,021.86 N/A
Outside Professional Services $251,375.00 $246,935.00 $9,971.25
Attorney Fees related to repack $25,000.00 $25,000.00 N/A $7,091.25 N/A
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. N/A 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
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
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 $4,100.00 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 N/A N/A
Prepare request for Special Temporary Authorization $2,050.00 $3,000.00 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 $2,050.00 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 $1,500.00 N/A
Project management of the transition $31,600.00 $30,000.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application $1,580.00 $1,535.00 N/A $0.00 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
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $825.00 N/A

Components

Actual Information Description File Name
Attorney Fees related to repack

Component Description:
Attorney services rendered related to channel repack
Amount:
$2,275.00

Component Description:
Attorney services rendered related to channel repack
Amount:
$425.00

Component Description:
Attorney services rendered related to channel repack
Amount:
$62.50

Component Description:
Attorney services rendered related to channel repack
Amount:
$1,943.75

Component Description:
Attorney services rendered related to channel repack
Amount:
$250.00

Component Description:
Attorney services rendered related to channel repack
Amount:
$132.50

Component Description:
Attorney services rendered related to channel repack
Amount:
$62.50

Component Description:
Attorney services rendered related to channel repack
Amount:
$190.00

Component Description:
Attorney services rendered related to channel repack
Amount:
$875.00

Component Description:
Attorney services rendered related to channel repack
Amount:
$875.00
Outside Accounting Services

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

Component Description:
Accounting services split between 2 facilities
Amount:
$555.00
General Contractor Information not provided.
RF Exposure Measurements Information not provided.
Comprehensive coverage verification via field study, if needed Information not provided.
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase 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 Information not provided.
Prepare request for Special Temporary Authorization 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

Component Description:
RF Consulting Engineer fee to prepare engineer section FCC Form 2100, Construction Permit App
Amount:
$1,500.00
Project management of the transition Information not provided.
Prepare and or review reimbursement form Information not provided.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application Information not provided.
Address transition timing and coordination issues w/ other stations and wireless 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

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 $75,580.00 $75,015.00 N/A $20,407.40 N/A
Total for all systems $2,714,776.61 $2,340,511.61 N/A $869,021.86 N/A
Other Expenses $75,580.00 $75,015.00 $20,407.40
RF Consulting Engineer $2,000.00 $2,000.00 N/A $350.00 N/A
Additional Hired Workers $5,000.00 $5,000.00 N/A 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 $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 $20,057.40 N/A
DTV Medical Facility Notification $11,550.00 $11,000.00 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
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
Disposal Costs (for equipment and other waste, net of any salvage value) $15,000.00 $15,000.00 N/A N/A N/A

Components

Actual Information Description File Name
RF Consulting Engineer

Component Description:
RF engineer review prospective interim antenna for initial implementation of repack Ch-26
Amount:
$350.00
Additional Hired Workers 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:
30% of total shipping, offloading and placement of equipment costs due to transmitter manufacturer
Amount:
$6,685.80

Component Description:
60% of total shipping, offloading and placement of equipment costs due to transmitter manufacturer
Amount:
$13,371.60
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.
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $2,714,776.61 $2,340,511.61 $869,021.86

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


04/24/2019

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.

Arthur Lee Clardy , III .

Director of Engineering


04/24/2019

Attachments

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