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:
46979
Service:
DTV
Call Sign:
WLWT
Channel:
20 (UHF)
File Number:
0000026824
FRN:
0001587609
Date Submitted:
01/29/2018

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

OHIO/OKLAHOMA HEARST TELEVISION INC.

C/O BROOKS, PIERCE, ET. AL

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. Yes
Briefly describe transition plan see attached document

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 Sigma CD3300 P3
Year 2002
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 50 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-72
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 47.2 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 transmitter installation electrical service. See attached Bertke Electric quote.
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

Electrical Accessories

Manufacturer required surge protection

Sales Tax

transmitter sales tax

RF Accessories

additional RF components required for transmitter operation

Shipping

transmitter shipping

Transmitter de-install

removal of old transmitter

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? 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 Bottom
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-30GBH-R 06
Year 2002

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 Bottom
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: 722.0 kW
Manufacturer
Model TFU-26GBH-R 06
Year 2018
Justification for New Antenna Current antenna is channel specific and cannot be used on post-transition channel. Antenna must be replaced.

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

Shipping

antenna shipping

Antenna accessories

custom length transmission line & test transition

Sales Tax

antenna sales tax

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 16
Lower Limit 470.00 MHz
Upper Limit 608.00 MHz
Design power capacity in use 60.0 %
Other Antenna Type N/A
ERP: 500.0 kW
Manufacturer
Model TFU-16WB
Year 2018
Justification for New Antenna The proposed interim antenna is broadband and can be used for both pre and post transition channels and is required to facilitate a smooth and on-time transition to the assigned post-transition channel.

Interim Antenna

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Other Antenna Costs

Section Question Response
Elbow Complex Do you require the separate purchase of the Elbow Complex? Yes
Broadband or Single Channel? B
Feed Line Size 6 1/8 inches
Side Mount Brackets Do you require the separate purchase of side mount brackets for an 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

Interim Antenna

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Other Antenna Cost Not Listed

Name Description

Shipping

antenna shipping

Sales Tax

antenna sales tax

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 Dielectric
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 950 feet per run

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Information not provided.

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 Rigid
Diameter 6 1/8 inches
Segment Length Broadband
Other Segment Length
Number of parallel runs 1
Length 600 feet per run
Justification for New Transmission Line new transmission line required to support interim antenna

Interim Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Sales Tax

transmission line sales tax

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? Terrain Constrained
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 1038226
Coordinates (NAD83) Latitude (NAD83) 39° 07' 27.0" N-
Longitude (NAD83) 084° 31' 18.0" W-
Overall Structure Height 950.12 feet
Support Structure Height 895.99 feet
Ground Elevation Above Mean Sea Level (AMSL) 837.92 feet
Structure Type LTOWER - Lattice Tower
Tower Owner Ohio/Oklahoma Hearst Television Inc.
Date Constructed 01/01/1997

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
65666 WCET DTV

Other Types of Users

Users
Amateur Radio

Primary Tower

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Tower Modification Costs

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

Primary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower Terrain constrained
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 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 2
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 2
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 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

Security

Security service during tower modifications & antenna installation

Transmitter Site Survey

Transmitter planning survey & transmitter building drawings (aka Field Service, TV)

Transmitter Site Survey Sales Tax

Sales Tax for Transmitter Site Survey (aka Field Service, TV)

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 Yes
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? 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 $1,817,144.00 $1,584,005.00 N/A $402,875.72 N/A
Total for all systems $4,172,953.00 $3,460,962.00 N/A $728,494.92 N/A
Primary Transmitter ULXTE-72 $1,817,144.00 $1,584,005.00 $402,875.72
Sales Tax $89,769.00 $89,769.00 transmitter sales tax per attached GatesAir quote N/A N/A
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW $1,473,000.00 $1,265,173.00 GatesAir quote sections A, B & E. This is the transmitter, mask filter, installation and proof per the FCC "transmitter" definition. $402,875.72 N/A
Transformer 3 phase/480v - 300 KVA $36,800.00 $11,488.00 N/A N/A N/A
Other Electrical Service: transmitter installation electrical service. See attached Bertke Electric quote. $99,688.00 $99,688.00 transmitter installation electrical service. See attached Bertke Electrical quote. N/A N/A
Electrical Accessories $1,943.00 $1,943.00 Manufacturer required surge protection N/A N/A
Transmitter de-install $25,724.00 $25,724.00 removal of old transmitter to make room for replacement N/A N/A
Shipping $13,500.00 $13,500.00 shipping per attached GatesAir quote N/A N/A
RF Accessories $76,720.00 $76,720.00 Additional RF components required for transmitter operation and integration into current RF environment. N/A N/A

Components

Actual Information Description File Name
Sales Tax Information not provided.
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW

Component Description:
Transmitter 2nd deposit
Amount:
$264,187.87

Component Description:
Transmitter 1st deposit
Amount:
$138,687.85
Transformer 3 phase/480v - 300 KVA Information not provided.
Other Electrical Service: transmitter installation electrical service. See attached Bertke Electric quote. Information not provided.
Electrical Accessories Information not provided.
Transmitter de-install Information not provided.
Shipping Information not provided.
RF Accessories 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 $451,222.00 $572,186.00 N/A $241,529.85 N/A
Total for all systems $4,172,953.00 $3,460,962.00 N/A $728,494.92 N/A
Interim Antenna TFU-16WB $144,035.00 $141,005.00 $59,720.40
UHF - High Power, Side Mount, basic slot antenna, 16 bay,, 500 kW input, directional,, horizontally polarized $108,640.00 $108,640.00 antenna price per attached Dielectric quote $59,720.40 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $0.00 N/A
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed) $13,700.00 $11,000.00 N/A N/A N/A
Sales Tax $7,605.00 $7,605.00 estimated antenna sales tax based on Ohio state and local sales tax rate of 7% N/A N/A
Shipping $7,360.00 $7,360.00 shipping per attached Dielectric quote $0.00 N/A
Primary Antenna TFU-26GBH-R 06 $307,187.00 $431,181.00 $181,809.45
Sales Tax $27,160.00 $27,160.00 estimated antenna sales tax based on Ohio state and local sales tax rate of 7% N/A N/A
Antenna accessories $4,384.00 $4,384.00 RF components need for antenna installation per attached Dielectric quote $0.00 N/A
Shipping $9,613.00 $9,613.00 shipping per attached Dielectric quote $0.00 N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $10,984.00 N/A $0.00 N/A
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $0.00 N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized $247,000.00 $372,640.00 bottom of antenna stack price per attached Dielectric quote $181,809.45 N/A

Components

Actual Information Description File Name
UHF - High Power, Side Mount, basic slot antenna, 16 bay,, 500 kW input, directional,, horizontally polarized

Component Description:
Dielectric WLWT Interim Antenna progress payment 10% down and 35% with order equals 45% of invoice lines 1,22,23,24.
Amount:
$59,720.40
Sweep test of existing antenna Information not provided.
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed) Information not provided.
Sales Tax Information not provided.
Shipping Information not provided.
Sales Tax Information not provided.
Antenna accessories Information not provided.
Shipping Information not provided.
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) Information not provided.
Sweep test of existing antenna Information not provided.
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized

Component Description:
Dielectric WLWT Main Antenna and Elbow complex; 9.13.2017; $181,809.45; progress payments 10% & 35%
Amount:
$181,809.45

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 $148,848.00 $147,531.00 N/A $62,047.35 N/A
Total for all systems $4,172,953.00 $3,460,962.00 N/A $728,494.92 N/A
Interim Transmission Line $148,848.00 $147,531.00 $62,047.35
Rigid Transmission Line - copper, 6 1/8" broadband $139,200.00 $137,883.00 transmission line price per attached Dielectric quote $62,047.35 N/A
Sales Tax $9,648.00 $9,648.00 estimated transmission line sales tax based on Ohio state and local sales tax rate of 75 N/A N/A
Primary Transmission Line $0.00 $0.00 $0.00

Components

Actual Information Description File Name
Rigid Transmission Line - copper, 6 1/8" broadband

Component Description:
Dielectric WLWT Interim Transmission line payments 10% down & 35% with order equals 45% of invoice line item 2
Amount:
$62,047.35
Sales Tax 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 $1,490,600.00 $907,000.00 N/A $0.00 N/A
Total for all systems $4,172,953.00 $3,460,962.00 N/A $728,494.92 N/A
Primary Tower LTOWER $1,490,600.00 $907,000.00 $0.00
Serious tower reinforcement/modifications $1,052,000.00 $605,000.00 N/A N/A N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $285,000.00 N/A N/A N/A
Structural engineering tower load study for well documented tower $12,600.00 $12,000.00 N/A N/A N/A
Tower Consulting $5,000.00 $5,000.00 tower consulting per attached quote 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 $206,709.00 $198,559.00 N/A $22,042.00 N/A
Total for all systems $4,172,953.00 $3,460,962.00 N/A $728,494.92 N/A
Outside Professional Services $206,709.00 $198,559.00 $22,042.00
Transmitter Site Survey Sales Tax $1,442.00 $1,442.00 Ohio sales tax for Transmitter Site Survey (aka Field Service, TV) $1,442.00 N/A
Transmitter Site Survey $22,042.00 $22,042.00 Transmitter planning survey & transmitter building drawings attached quote does not include $1,442.00 sales tax added to invoice. $20,600.00 N/A
Security $37,325.00 $37,325.00 based on attached transmitter security proposal for 90 days. 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
Attorney Fees - Prepare and File request for Special Temporary Authorization $7,360.00 $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 - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 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
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 $4,100.00 $3,000.00 N/A N/A N/A

Components

Actual Information Description File Name
Transmitter Site Survey Sales Tax

Component Description:
Ohio sales tax for Transmitter Site Survey (aka Field Service, TV)
Amount:
$1,442.00
Transmitter Site Survey

Component Description:
WLWT Field Service, GatesAir, 6-30-2017 $20,600
Amount:
$20,600.00
Security Information not provided.
RF Exposure Measurements Information not provided.
Comprehensive coverage verification via field study, if needed 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 - Prepare and File FCC Form 2100 (main), Construction Permit Application 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.
Perform engineering study for new channel assignment and antenna development Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare request for Special Temporary Authorization 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 $58,430.00 $51,681.00 N/A $0.00 N/A
Total for all systems $4,172,953.00 $3,460,962.00 N/A $728,494.92 N/A
Other Expenses $58,430.00 $51,681.00 $0.00
MVPD Notification of Channel Change $2,500.00 $2,500.00 Attorney assistance in coordinating MVPD notification 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
Equipment Storage $30,500.00 $30,500.00 antenna storage estimate see attached Dielectric document N/A N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $9,740.00 $9,740.00 Equipment removal to make space for replacement transmitter installation. See Equipment Removal quotes 1 & 2. N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $4,856.00 quote attached N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 N/A 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 $4,172,953.00 $3,460,962.00 $728,494.92

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


01/29/2018

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