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:
53905
Service:
DTV
Call Sign:
WYFF
Channel:
30 (UHF)
File Number:
0000026820
FRN:
0001565050
Date Submitted:
07/07/2017

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

WYFF HEARST TELEVISION INC.

Doing Business As: WYFF HEARST TELEVISION INC.

P.O. BOX 1800

RALEIGH, NC 27602

United States

+1 (919) 839-0300 mprak@brookspierce.com Corporation

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant Address Phone Email

[Confidential]

 

 

 


Preparer Contact Information

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Preparer Contact Name and Information

Applicant Address Phone Email

The Preparer is same as the reimbursement contact.

 

 

 

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. No
Briefly describe transition plan See attached transition plan document

Transmitters

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Section Question Response
Transmitter Related Expenses Do you have transmitter related expenses? Yes

Auxiliary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Auxiliary (Backup)
Description of Use backup to main tx
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 CD3300P3
Year 2002
Type Inductive Output Tube
IOT Power Type Three
Power Capacity 60 kW

Auxiliary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Auxiliary (Backup)
Change Type Purchase New
Is this a request for upgraded equipment? Yes
Manufacturer
Model ULXTE-100
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 62.9 kW
Justification for New Transmitter Existing IOT transmitter cannot be converted to post-transition channel, see GatesAir EOL and HTV IOT to Solid-State Justification statements. An IOT replacement is more expensive than proposed SS transmitter. See attached Comark IOT Transmitter quote.

Auxiliary 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) Yes
Power 300 kVA
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service Yes
Description Electrical installation for Auxiliary/Backup transmitter
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

Auxiliary Transmitter

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Other Transmitter Cost Not Listed

Name Description

RF Accessories

miscellaneous RF components

Sales Tax

transmitter sales tax

Electrical Accessories

Manufacturer reqired surge protection

Transmitter shipping

transmitter shipping

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 CD3260P2
Year 2008
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 ULXTE-100
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 62.9 kW
Justification for New Transmitter Existing IOT transmitter cannot be converted to post-transition channel, see GatesAir EOL and HTV IOT to Solid-State Justification statements. An IOT replacement is more expensive than proposed SS transmitter. See attached Comark IOT Transmitter quote.

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) No
Transformer (480V) Yes
Power 300 kVA
Rigid Conduit and Wiring No
Size N/A
Length N/A
Other Electrical Service Yes
Description Electrical installation for new main transmitter
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

Primary Transmitter

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Other Transmitter Cost Not Listed

Name Description

Old trasmitter removal

remove existing transmitter

Sales Tax

transmitter sales tax

RF Accessories

Waveguide switches, RF load, miscellaneous RF components

Transmitter shipping

transmitter shipping

Electical accessories

Manufacturer required surge protection

Antennas

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Section Question Response
Antenna Related Expenses Do you have antenna related expenses? Yes

Auxiliary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Auxiliary (Backup)
Description of Use emergency backup
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? No
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 Side 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-24JSC-R04
Year 2008

Auxiliary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Auxiliary (Backup)
Description of Use emergency backup
Change Type Purchase New
Is this a request for upgraded equipment? No
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? No
Will antenna be located on or in close proximity to an antenna farm? No
New Antenna Manufacturer and Types 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: 400.0 kW
Manufacturer
Model TFU-24JSC-4 04 D30
Year 2018
Justification for New Antenna Current antenna is channel specific (36) and cannot be retuned. Replacement antenna required for new channel (30).

Auxiliary 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? 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 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

Auxiliary Antenna

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Other Antenna Cost Not Listed

Name Description

Antenna Shipping

antenna shipping

Custom length line piece

Custom transmission line section required for installation

Sales Tax

antenna sales tax

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? No
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-26GTH-R-04
Year 2009

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? No
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? No
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 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: 884.0 kW
Manufacturer
Model TFU-24GTH-R 04 D30
Year 2019
Justification for New Antenna Current antenna is channel specific (36) and cannot be retuned. Replacement required for new channel (30).

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? Broadband
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

Antenna Shipping

antenna shipping

Sales Tax

antenna sales tax

Custom length line piece

custom length transmission line required for installation

Transmission Line

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Section Question Response
Transmission Line Related Expenses Do you have transmission line related expenses? No

Tower Equipment And Rigging Costs

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Section Question Response
Tower Equipment or Rigging Costs Changes Do you have tower equipment or rigging costs changes? Yes

Primary Tower

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Existing Tower

Section Question Response
Existing Tower Description Type of change 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) Yes
Others Types of Users Yes
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1052729
Coordinates (NAD83) Latitude (NAD83) 35° 06' 43.0" N-
Longitude (NAD83) 082° 36' 23.0" W-
Overall Structure Height 862.85 feet
Support Structure Height 808.39 feet
Ground Elevation Above Mean Sea Level (AMSL) 3085.92 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner WYFF Hearst Television Inc.
Date Constructed 08/19/2009

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
34390 WFBC-FM FM

Other Types of Users

Users
Public Safety
Ham Radio
Commercial 2way

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: Serious 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

Tower Consulting

tower consulting and tower project management

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? No
Number of Hours N/A
Explanation N/A
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 No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations No
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 No
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

Transmitter Site Survey

Transmitter planning survey & transmitter building drawings

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 No
Non-zoning permits No
BLM or NFS Coordination No
FCC Construction Permit Minor Change No
FCC License to Cover Application Yes
FCC Special Temporary Authority Application No
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? No
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? No
Does this relocation require Equipment Storage? 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 $4,448,827.00 $4,398,707.00 N/A $0.00 N/A
Total for all systems $6,382,688.00 $5,736,217.00 N/A $0.00 N/A
Primary Transmitter ULXTE-100 $2,276,147.00 $2,251,087.00 $0.00
Transformer 3 phase/480v - 300 KVA $36,800.00 $11,740.00 From GatesAir transmitter quote N/A N/A
Transmitter shipping $17,300.00 $17,300.00 Transmitter shipping cost per GatesAir transmitter quote. See Quote attached to transmitter cost. N/A N/A
Sales Tax $112,038.00 $112,038.00 transmitter sales tax per attached GatesAir quote N/A N/A
UHF - Liquid Cooled Solid State Transmitter 62.9 kW $1,739,728.00 $1,739,728.00 Quote for comparable transmitter from our transmitter vendor. Sections A, B & E of attached quote. Transmitter, mask filter, installation & proof. N/A N/A
Other Electrical Service: Electrical installation for new main transmitter $254,450.00 $254,450.00 Extensive electrical modification and equipment replacement required to convert from 480v to 208v. See attached quote. N/A N/A
Old trasmitter removal $25,489.00 $25,489.00 Must remove transmitter to make room for replacement. Section F in GatesAir transmitter quote. Quote attached to transmitter cost. N/A N/A
RF Accessories $86,457.00 $86,457.00 RF components required for transmitter operation. Section C in GatesAir transmitter quote. N/A N/A
Electical accessories $3,885.00 $3,885.00 manufacturer required surge protection N/A N/A
Auxiliary Transmitter ULXTE-100 $2,172,680.00 $2,147,620.00 $0.00
RF Accessories $18,110.00 $18,110.00 RF components required for transmitter operation per GatesAir auxiliary transmitter quote. N/A N/A
Transformer 3 phase/480v - 300 KVA $36,800.00 $11,740.00 From GatesAir transmitter quote N/A N/A
Transmitter shipping $17,300.00 $17,300.00 shipping cost per GatesAir transmitter quote N/A N/A
Sales Tax $106,407.00 $106,407.00 transmitter sales tax per attached GatesAir quote N/A N/A
UHF - Liquid Cooled Solid State Transmitter 62.9 kW $1,739,728.00 $1,739,728.00 Quote for comparable transmitter from our transmitter vendor. Sections A, B & E of attached quote. Transmitter, mask filter, installation & proof. N/A N/A
Other Electrical Service: Electrical installation for Auxiliary/Backup transmitter $250,450.00 $250,450.00 Extensive electrical modification and equipment replacement required to convert from 480v to 208v. See attached quote. N/A N/A
Electrical Accessories $3,885.00 $3,885.00 manufacturer required surge protection N/A N/A

Components

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 $527,371.00 $422,085.00 N/A $0.00 N/A
Total for all systems $6,382,688.00 $5,736,217.00 N/A $0.00 N/A
Primary Antenna TFU-24GTH-R 04 D30 $289,619.00 $232,479.00 $0.00
Custom length line piece $1,583.00 $1,583.00 custom transmitter line section required for antenna operation per Dielectric quote N/A N/A
Sales Tax $13,159.00 $13,159.00 estimated antenna sales tax based on South Carolina state sales tax rate of 6% N/A N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized $247,000.00 $193,592.00 N/A N/A N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed) $13,700.00 $10,298.00 N/A N/A N/A
Antenna Shipping $7,447.00 $7,447.00 antenna shipping per vendor quote N/A N/A
Auxiliary Antenna TFU-24JSC-4 04 D30 $237,752.00 $189,606.00 $0.00
Sweep test of existing antenna $6,730.00 $6,400.00 N/A N/A N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $17,520.00 N/A N/A N/A
Custom length line piece $1,583.00 $1,583.00 custom transmitter line section required for antenna operation per Dielectric quote N/A N/A
UHF - Lower Power Side Mount, One station - 200-500 kW, horizontally polarized $189,500.00 $147,314.00 see attached Dielectric quote N/A N/A
Sales Tax $10,732.00 $10,732.00 estimated antenna sales tax based on South Carolina state sales tax rate of 6% N/A N/A
Antenna Shipping $6,057.00 $6,057.00 antenna shipping per vendor quote N/A N/A

Components

Information not provided.

Cost Information

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Transmission Line

Information not provided.

Cost Information

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Tower Equipment and Rigging Costs

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $1,278,850.00 $795,750.00 N/A $0.00 N/A
Total for all systems $6,382,688.00 $5,736,217.00 N/A $0.00 N/A
Primary Tower TOWER $1,278,850.00 $795,750.00 $0.00
Serious tower reinforcement/modifications $1,052,000.00 $580,000.00 N/A N/A N/A
Tower Consulting $3,750.00 $3,750.00 tower consulting estimate - quote attached N/A N/A
Structural engineering tower load study for well documented tower $12,600.00 $12,000.00 N/A N/A N/A
Tall Tower (greater than 500') $210,500.00 $200,000.00 N/A N/A N/A

Components

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 $80,255.00 $76,850.00 N/A $0.00 N/A
Total for all systems $6,382,688.00 $5,736,217.00 N/A $0.00 N/A
Outside Professional Services $80,255.00 $76,850.00 $0.00
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
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
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A N/A 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 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
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), License to Cover Application $1,580.00 $1,500.00 N/A N/A N/A
Prepare request for Special Temporary Authorization $2,050.00 $1,500.00 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
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 - Prepare and File request for Special Temporary Authorization $3,680.00 $3,500.00 N/A N/A N/A
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A
Transmitter Site Survey $20,600.00 $20,600.00 transmitter site survey per attached quote N/A N/A

Components

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 $47,385.00 $42,825.00 N/A $0.00 N/A
Total for all systems $6,382,688.00 $5,736,217.00 N/A $0.00 N/A
Other Expenses $47,385.00 $42,825.00 $0.00
DTV Medical Facility Notification $11,550.00 $7,000.00 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
Equipment Storage $30,500.00 $30,500.00 Estimate for 1 year of antenna storage. See attached Dielectric document. N/A N/A
Develop and air announcement of upcoming channel change $2,500.00 $2,500.00 Attorney review to ensure FCC compliance N/A N/A
MVPD Notification of Channel Change $2,500.00 $2,500.00 Attorney assistance in coordinating MVPD notification N/A N/A

Components

Information not provided.

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $6,382,688.00 $5,736,217.00 $0.00

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.

John Drain

Hearst Television SVP Chief Financial Officer


07/07/2017

Attachments

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