TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

Applicant	Address	Phone	Email	Applicant Type
WISN Hearst Television Inc. Doing Business As: WISN Hearst Television Inc.	PO Box 1800 Raleigh, NC 27602 United States	+1 (919) 839-0300	shartzell@brookspierce.com	Corporation

Applicant

Address

Phone

Applicant Type

WISN Hearst Television Inc.

Doing Business As: WISN Hearst Television Inc.

PO Box 1800

Raleigh, NC 27602

United States

+1 (919) 839-0300

shartzell@brookspierce.com

Corporation

Reimbursement Contact Information

Reimbursement Contact Name and Information

Applicant	Address	Phone	Email
[Confidential]

Preparer Contact Information

Preparer Contact Name and Information

Applicant	Address	Phone	Email
The Preparer is same as the reimbursement contact.

Broadcaster Information and Transition Plan

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 document

Transmitters

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

Primary Transmitter

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 CD3200P2
	Year	2001
	Type	Inductive Output Tube
	IOT Power Type	Two
	Power Capacity	40 kW

Primary Transmitter

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

Other Transmitter Costs

Section	Question	Response
Electrical Service	Service Entrance (3 phases 800A 208V)	No
	Switchgear (industrial 800 amp)	Yes
	Transformer (480V)	No
	Power	N/A
	Rigid Conduit and Wiring	No
	Size	N/A
	Length	N/A
	Other Electrical Service	Yes
	Description	transmitter installation electrical service See attached quote
HVAC Service	Does the replacement transmitter require HVAC Service?	Yes
	Type	Heating and Cooling
	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?	Yes
	Size	600.0 square feet
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

Other Transmitter Cost Not Listed

Name	Description
Electrical Accessories	Surge Protection required by manufacturer
Sales Tax	transmitter sales tax
RF Accessories	Additional RF components required for transmitter
Transmitter de-install	Remove old transmitter
Shipping	Transmitter shipping

Antennas

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

Auxiliary Antenna

Add Antenna Information

Section	Question	Response
Existing Antenna Description	Type of change	Purchase New
	Antenna Use	Auxiliary (Backup)
	Description of Use	backup to main antenna
	Ownership	Owned
	Owner	N/A
	Site	N/A
	Is this antenna currently shared with any other stations?	No
	Is this 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	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:	850.0 kW
	Manufacturer
	Model	TFU-26GTH-R CT160
	Year	2001

Auxiliary Antenna

New Antenna Costs

Section	Question	Response
New Antenna Description	Use	Auxiliary (Backup)
	Description of Use	Interim/Aux
	Change Type	Purchase New
	Is this a request for upgraded equipment?	No
	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	Side Mount
	Antenna position in stack	Not in Stack
	Polarization	Horizontal
	Type	Broadband Slot
	Number of Stations Supported	1
	Number of Panels/Bays	24
	Lower Limit	470.00 MHz
	Upper Limit	698.00 MHz
	Design power capacity in use	65.0 %
	Other Antenna Type	N/A
	ERP:	882.0 kW
	Manufacturer
	Model	TFU-24WB-1-R C160
	Year	2019
	Justification for New Antenna	Current antenna is channel specific and cannot be used on post-transition channel. Antenna must be replaced.

Auxiliary Antenna

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

Auxiliary Antenna

Other Antenna Cost Not Listed

Name	Description
Custom line section	custom length transmission line to connect antenna to existing line
Line Reducer	REDUCER 6-75 X 7-75 EIA CU. FOR ANTENNA INPUT
Shipping	antenna shipping
Sales Tax	antenna sales tax

Primary Antenna

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	Elliptical
	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-31ETT/VP-R 4C160
	Year	2010

Primary Antenna

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?	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:	882.0 kW
	Manufacturer
	Model	TFU-29ETT/VP-R 4C160
	Year	2019
	Justification for New Antenna	Current antenna is channel specific and cannot be used on post-transition channel. Antenna must be replaced.

Primary Antenna

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

Other Antenna Cost Not Listed

Name	Description
Shipping	Antenna shipping
Sales Tax	antenna sales tax

Transmission Line

Section	Question	Response
Transmission Line Related Expenses	Do you have transmission line related expenses?	Yes

Auxiliary Transmission Line

Add Transmission Line

Section	Question	Response
Existing Transmission Line Description	Type of change	Utilize Existing
	Use	Auxiliary (Backup)
	Description of Use	Auxiliary/Backup
	Ownership	Owned
	Owner	N/A
	Site	N/A
	Is this transmission currently shared with any other 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	Broadband
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	1000 feet per run

Auxiliary Transmission Line

Other Transmission Line Expenses Not Listed

Information not provided.

Primary Transmission Line

Existing Transmission Line

Section	Question	Response
Existing Transmission Line Description	Type of change	Purchase New
	Use	Primary (Main)
	Description of Use	N/A
	Ownership	Owned
	Owner	N/A
	Site	N/A
	Is the existing transmission line shared with another station or stations?	No
	Is Transmission Line in operating condition?	Yes
Existing Transmission Line Manufacturer and Type	Manufacturer
	Type	Rigid
	Diameter	6 1/8 inches
	Other Diameter	N/A
	Segment Length	19 1/2 inches
	Other Segment Length	N/A
	Number of parallel runs	1
	Length	1160 feet per run

Primary Transmission Line

New Transmission Line

Section	Question	Response
New Transmission Line Costs	Use	Primary (Main)
	Description of Use	N/A
	Change Type	Purchase New
	Is this a request for upgraded equipment?	No
	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	1160 feet per run
	Justification for New Transmission Line	Current transmission line segment length is not compatible with post-transition channel (28) and must be replaced.

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Name	Description
Sales Tax	transmission line sales tax

Tower Equipment And Rigging Costs

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

Primary Tower

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	No
	Is tower documented for structural analysis?	Yes
	Is tower compliant with Rev G?	Unknown
Existing Tower Structure Registration	Do you have a tower registration number?	Yes
Existing Tower Structure Registration	ASR Number	1035766
Coordinates (NAD83)	Latitude (NAD83)	43° 06' 42.0" N-
	Longitude (NAD83)	087° 55' 42.0" W-
	Overall Structure Height	1107.93 feet
	Support Structure Height	1032.80 feet
	Ground Elevation Above Mean Sea Level (AMSL)	623.35 feet
	Structure Type	TOWER - Free Standing or Guyed Structure
	Tower Owner	WISN Hearst Television Inc.
	Date Constructed	07/24/1955

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
26609	WRNW	FM

Primary Tower

Tower Modification Costs

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

Primary Tower

Tower Rigging Costs

Section	Question	Response
Tower Rigging Costs	Complex Tower	N/A
Helicopter Services Required	Are helicopter services required?	No

Primary Tower

Other Tower Expenses Not Listed

Name	Description
Tower Consulting	tower consulting and tower project management

Outside Professional Services Costs

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	No
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

Other Professional Services Expenses Not Listed

Name	Description
Transmitter Site Survey	Transmitter planning survey & transmitter building drawings

Other Expenses

Section	Question	Response
AM Pattern Disturbance	Is an Impact Study needed?	No
AM Pattern Disturbance	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	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

Other Expenses Not Listed

Information not provided.

Cost Information

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	$1,818,015.81	$1,471,573.92	N/A	$849,605.95	N/A
Total for all systems	$3,212,644.41	$2,805,983.52	N/A	$1,257,454.82	N/A
Primary Transmitter ULXTE-72	$1,818,015.81	$1,471,573.92		$849,605.95
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW	$1,473,000.00	$1,178,958.11	GatesAir quote sections A, B & E. This is the transmitter, mask filter, installation and proof per the FCC "transmitter" definition. Also, see attached "WISN Transmitter Justification".	$848,212.03	N/A
Shipping	$13,500.00	$13,500.00	Transmitter shipping. See GatesAir quote	N/A	N/A
Transmitter de-install	$25,330.20	$25,330.20	Old transmitter removal to make space for replacement. See GatesAir quote	N/A	N/A
RF Accessories	$76,720.12	$76,720.12	Additional RF components required for transmitter operation and integration into current RF environment.	N/A	N/A
Sales Tax	$77,325.00	$77,325.00	transmitter sales tax per attached GatesAir quote	N/A	N/A
Electrical Accessories	$13,430.49	$13,430.49	Manufacturer required surge protection and transformers	N/A	N/A
Other -- Building Addition Size: 600.0	$1,500.00	$1,500.00	Building modifications need for repack transmitter	$1,393.92	N/A
Other Electrical Service: transmitter installation electrical service See attached quote	$38,510.00	$38,510.00	per quote for transmitter installation electrical service	N/A	N/A
Switchgear - industrial 800 amp	$38,200.00	$36,300.00	N/A	N/A	N/A
10 Ton system	$60,500.00	$10,000.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW	Component Description: Transmitter 1st deposit Amount: $138,664.28 Component Description: WISN transmitter one-third prior to ship Amount: $445,359.88 Component Description: Transmitter 2nd deposit Amount: $264,187.87
Shipping	Information not provided.
Transmitter de-install	Information not provided.
RF Accessories	Information not provided.
Sales Tax	Information not provided.
Electrical Accessories	Information not provided.
Other -- Building Addition Size: 600.0	Component Description: WISN invoice for duct removal-Best Heating Amount: $1,393.92
Other Electrical Service: transmitter installation electrical service See attached quote	Information not provided.
Switchgear - industrial 800 amp	Information not provided.
10 Ton system	Information not provided.

Cost Information

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	$526,446.00	$515,561.00	N/A	$297,675.01	N/A
Total for all systems	$3,212,644.41	$2,805,983.52	N/A	$1,257,454.82	N/A
Primary Antenna TFU-29ETT/VP-R 4C160	$337,094.00	$333,215.00		$143,268.75
Shipping	$11,860.00	$11,860.00	Antenna shipping. See Dielectric quote.	N/A	N/A
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized	$289,500.00	$289,131.00	Antenna price for comparable antenna per attached Dielectric quote	$143,268.75	N/A
Sweep test of existing antenna	$6,730.00	$6,400.00	N/A	N/A	N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)	$12,300.00	$9,120.00	N/A	N/A	N/A
Sales Tax	$16,704.00	$16,704.00	estimated sales tax based on the Wisconsin state and local sales tax rate of 5.6%	N/A	N/A
Auxiliary Antenna TFU-24WB-1-R C160	$189,352.00	$182,346.00		$154,406.26
Sales Tax	$8,683.00	$8,683.00	estimated antenna sales tax based on Wisconsin state sales tax rate	N/A	N/A
Shipping	$5,234.00	$5,234.00	Shipping per Dielectric quote	N/A	N/A
Line Reducer	$2,100.00	$2,100.00	Required RF component for antenna installation. See Dielectric quote.	N/A	N/A
Custom line section	$2,455.00	$2,455.00	Custom length line for antenna installation per attached Dielectric quote	N/A	N/A
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed)	$13,700.00	$7,024.00	N/A	N/A	N/A
UHF - High Power, Side Mount, basic slot antenna, 24 bay,, 882 kW input, directional,, horizontally polarized	$150,450.00	$150,450.00	auxiliary antenna cost per attached Dielectric quote	$154,406.26	Includes components not yet itemized
Sweep test of existing antenna	$6,730.00	$6,400.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
Shipping	Information not provided.
UHF - High Power Top Mount (200-1000 kW), One station antenna , elliptically or circularly polarized	Component Description: WISN Dielectric main antenna; payments 1&2 - 45%; $143,268.75 Amount: $143,268.75
Sweep test of existing antenna	Information not provided.
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)	Information not provided.
Sales Tax	Information not provided.
Sales Tax	Information not provided.
Shipping	Information not provided.
Line Reducer	Information not provided.
Custom line section	Information not provided.
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed)	Information not provided.
UHF - High Power, Side Mount, basic slot antenna, 24 bay,, 882 kW input, directional,, horizontally polarized	Component Description: Invoice for WISN aux antenna 45% prior to ship Amount: $77,203.13 Component Description: WISN Dielectric Aux antenna; payments 1&2 - 45%; $77,203.13 Amount: $77,203.13
Sweep test of existing antenna	Information not provided.

Cost Information

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	$246,574.00	$231,080.00	N/A	$0.00	N/A
Total for all systems	$3,212,644.41	$2,805,983.52	N/A	$1,257,454.82	N/A
Primary Transmission Line	$246,574.00	$231,080.00		$0.00
Sales Tax	$12,254.00	$12,254.00	estimated transmission line sales tax based on Wisconsin state and local sales tax rate of 5.6%	N/A	N/A
Rigid Transmission Line - copper, 6 1/8"	$234,320.00	$218,826.00	N/A	$0.00	N/A
Auxiliary Transmission Line	$0.00	$0.00		$0.00

Components

Actual Information Description	File Name
Sales Tax	Information not provided.
Rigid Transmission Line - copper, 6 1/8"	Component Description: WISN Dielectric main transmission line; payments 1&2 - 45%; $73,853.78 Amount: $73,853.78

Cost Information

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	$401,050.00	$376,250.00	N/A	$84,507.76	N/A
Total for all systems	$3,212,644.41	$2,805,983.52	N/A	$1,257,454.82	N/A
Primary Tower TOWER	$401,050.00	$376,250.00		$84,507.76
Tower Consulting	$6,250.00	$6,250.00	tower consulting estimate from attached quote	$3,538.00	N/A
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study	$26,300.00	$20,000.00	N/A	$19,500.00	N/A
Tall Tower (greater than 500')	$210,500.00	$200,000.00	N/A	N/A	N/A
Minor tower reinforcement/modifications	$158,000.00	$150,000.00	N/A	$61,469.76	N/A

Components

Actual Information Description	File Name
Tower Consulting	Component Description: WISN Tower Consulting invoice 1 Amount: $3,538.00
Tower mapping for an undocumented/poorly documented tower and preparation of documentation necessary for tower load study	Component Description: WISN tower rigorous analysis invoice 1. Supporting quote provided. Amount: $2,500.00 Component Description: WISN tower rigorous analysis invoice 2. Supporting quote provided. Amount: $2,500.00 Component Description: WISN tower evaluation invoice 1. Supporting quote provided. Amount: $7,250.00 Component Description: WISN tower evaluation invoice 2. Supporting quote provided. Amount: $7,250.00
Tall Tower (greater than 500')	Information not provided.
Minor tower reinforcement/modifications	Component Description: Invoice for WISN tower modifications Amount: $61,469.76

Cost Information

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	$162,978.60	$155,503.60	N/A	$25,666.10	N/A
Total for all systems	$3,212,644.41	$2,805,983.52	N/A	$1,257,454.82	N/A
Outside Professional Services	$162,978.60	$155,503.60		$25,666.10
Transmitter Site Survey	$21,753.60	$21,753.60	Transmitter planning survey & transmitter building drawings quote attached	$21,753.60	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	$3,680.00	$3,500.00	N/A	N/A	N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	$2,365.00	$2,250.00	N/A	N/A	N/A
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application	$4,210.00	$4,000.00	N/A	N/A	N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	$5,260.00	$5,000.00	N/A	N/A	N/A
Prepare request for Special Temporary Authorization	$2,050.00	$1,500.00	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	$1,500.00	N/A	N/A	N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	$1,580.00	$1,500.00	N/A	N/A	N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application	$2,105.00	$2,000.00	N/A	N/A	N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	$3,155.00	$3,000.00	N/A	$1,937.50	N/A
Perform engineering study for new channel assignment and antenna development	$7,360.00	$7,000.00	N/A	$1,975.00	N/A
Prepare and or review reimbursement form	$2,630.00	$2,500.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
Transmitter Site Survey	Component Description: WISN Field Service, GatesAir, 7/25/2016 $21,753.60 Amount: $21,753.60
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 -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.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application	Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	Information not provided.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application	Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	Component Description: WISN RF consulting - Construction Permit Amount: $1,937.50
Perform engineering study for new channel assignment and antenna development	Component Description: WISN RF Consulting - study 3(aux antenna development) Amount: $550.00 Component Description: WISN RF consulting - study invoice 1 Amount: $800.00 Component Description: WISN RF consulting - study invoice 2 Amount: $625.00
Prepare and or review reimbursement form	Information not provided.

Cost Information

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	$57,580.00	$56,015.00	N/A	$0.00	N/A
Total for all systems	$3,212,644.41	$2,805,983.52	N/A	$1,257,454.82	N/A
Other Expenses	$57,580.00	$56,015.00		$0.00
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	Estimate for 1 year of antenna storage. See attached Dielectric document.	N/A	N/A
Disposal Costs (for equipment and other waste, net of any salvage value)	$10,000.00	$10,000.00	Need quote	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
MVPD Notification of Channel Change	$2,500.00	$2,500.00	Attorney assistance in coordinating MVPD notification	N/A	N/A
DTV Medical Facility Notification	$11,550.00	$10,000.00	N/A	N/A	N/A

Components

Information not provided.

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$3,212,644.41	$2,805,983.52	$1,257,454.82

Reimbursement Status

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

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.
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. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. 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). 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. 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. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. 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 04/20/2018

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.

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.
The above-named entity acknowledges that all certifications and attached documentation are considered material representations.
The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.
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).
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.
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.
The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.
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

04/20/2018

Certification

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).
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. The above-named entity certifies that the statements in this form and attached documentation are true, complete, and correct. The above-named entity acknowledges that all certifications and attached documentation are considered material representations. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount. 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) . 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. The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission. 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.	Douglas Durkee Hearst Television Manager of Spectrum Repack 04/20/2018

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).

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.
The above-named entity certifies that the statements in this form and attached documentation are true, complete, and correct.
The above-named entity acknowledges that all certifications and attached documentation are considered material representations.
The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.
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) .
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.
The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred.
The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.
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.

Douglas Durkee

Hearst Television Manager of Spectrum Repack

04/20/2018

(REFERENCE COPY - Not for submission) FCC Form 399: Reimbursement Request

Applicant Information

Applicant Name, Type, and Contact Information

Reimbursement Contact Information

Reimbursement Contact Name and Information

Preparer Contact Information

Preparer Contact Name and Information

Broadcaster Information and Transition Plan

Transmitters

Primary Transmitter

Existing Transmitter Information

Primary Transmitter

New Transmitter Costs

Primary Transmitter

Other Transmitter Costs

Primary Transmitter

Other Transmitter Cost Not Listed

Antennas

Auxiliary Antenna

Add Antenna Information

Auxiliary Antenna

New Antenna Costs

Auxiliary Antenna

Other Antenna Costs

Auxiliary Antenna

Other Antenna Cost Not Listed

Primary Antenna

Existing Antenna Information

Primary Antenna

New Antenna Costs

Primary Antenna

Other Antenna Costs

Primary Antenna

Other Antenna Cost Not Listed

Transmission Line

Auxiliary Transmission Line

Add Transmission Line

Auxiliary Transmission Line

Other Transmission Line Expenses Not Listed

Primary Transmission Line

Existing Transmission Line

Primary Transmission Line

New Transmission Line

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Tower Equipment And Rigging Costs

Primary Tower

Existing Tower

FM, AM or TV radio broadcasters. Facility ID's, Call Signs and Services of other broadcast stations with whom the tower is shared

Primary Tower

Tower Modification Costs

Primary Tower

Tower Rigging Costs

Primary Tower

Other Tower Expenses Not Listed

Outside Professional Services Costs

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Other Expenses

Other Expenses

Other Expenses Not Listed

Cost Information

Transmitters

Components

Cost Information

Antennas

Components

Cost Information

Transmission Line

Components

Cost Information

Tower Equipment and Rigging Costs

Components

Cost Information

Outside Professional Services

Components

Cost Information

Other Expenses

Components

Cost Information