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:
53921
Service:
DTV
Call Sign:
WXII-TV
Channel:
16 (UHF)
File Number:
0000026725
FRN:
0002538445
Date Submitted:
11/03/2018

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

HEARST PROPERTIES INC.

Doing Business As: Hearst Properties 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 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? Yes
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model Sigma CD3100P2
Year 2001
Type Inductive Output Tube
IOT Power Type Two
Power Capacity 42 kW

Facility ID's and Call Signs of all stations with whom the transmitter is shared.

Facility ID Call Sign
35385 WCWG

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-60
Transmitter Type Solid State
Solid State Cooling Liquid Cooled
Solid State Power capacity 38 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
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

Additional RF components

Additional RF components required for transmitter operation and integration into current RF environment per GatesAir quote.

Transmitter de-install

remove old transmitter

Shipping

transmitter shipping

Electrical Accessories

manufacturer required surge protection

Sales Tax

transmitter sales tax

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? Yes
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: 815.0 kW
Manufacturer
Model TFU-30-DSC-R04
Year 2001

Facility ID's and Call Signs of all stations with whom the antenna is shared.

Facility ID Call Sign
35385 WCWG

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? Yes
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: 640.0 kW
Manufacturer
Model TFU-30-DSC-R04
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

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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? 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

Primary Antenna

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Other Antenna Cost Not Listed

Name Description

Additional RF components

transformer, elbow & custom line section

Shipping

antenna shipping

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? Yes
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 24
Lower Limit 470.00 MHz
Upper Limit 698.00 MHz
Design power capacity in use 62.3 %
Other Antenna Type N/A
ERP: 815.0 kW
Manufacturer
Model TFU-24WB-1-R C160
Year 2019
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
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? 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

Impedence Transformer

transformer to match antenna to transmission line

Sales Tax

antenna sales tax

Change Order 1

additional elbows to connect transmitter

Shipping

antenna shipping

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? Yes
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 650 feet per run

Facility ID's and Call Signs of all stations with whom the transmission line is shared.

Facility ID Call Sign
35385 WCWG

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Transmission Line Sweep

line sweep to determine if line will work with post-transition channel

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 500 feet per run
Justification for New Transmission Line 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) No
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 1008241
Coordinates (NAD83) Latitude (NAD83) 36° 22' 31.0" N-
Longitude (NAD83) 080° 22' 25.0" W-
Overall Structure Height 682.73 feet
Support Structure Height 579.39 feet
Ground Elevation Above Mean Sea Level (AMSL) 2399.91 feet
Structure Type TOWER - Free Standing or Guyed Structure
Tower Owner Hearst Properties Inc.
Date Constructed 01/01/1953


Other Types of Users

Users
Commercial 2way
NOAA Wthr 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

Generator rental

Generator rental and fuel needed to complete guy wire replacement

Power line relocation

Relocate power lines - needed to perform tower modifications

Tower Consulting

tower consulting and tower project management

Tower site clearing

Remove trees and other objects to allow tower modifications and guy wire replacements

Transmitter Site Land Survey

Land survey required for relocating power lines

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 Yes
FAA Consultation (including preparation of FAA Form 7460) Yes
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

Non-Catalog legal expenses

Non-Catalog expenses for legal advice and services, including financial/reimbursement review, transition reporting, transition procedures, and other transition-related issues

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning 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)? 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 $1,784,066.49 $1,282,437.73 N/A $717,024.27 N/A
Total for all systems $4,182,386.73 $3,423,993.67 N/A $1,949,819.01 N/A
Primary Transmitter ULXTE-60 $1,784,066.49 $1,282,437.73 $717,024.27
Sales Tax $79,251.68 $79,251.68 transmitter sales tax per attached GatesAir quote N/A N/A
Electrical Accessories $1,942.49 $1,942.49 manufacturer required surge protection N/A N/A
Shipping $11,000.00 $11,000.00 transmitter shipping per attached GatesAir quote N/A N/A
Transmitter de-install $22,779.10 $22,779.10 removal of old transmitter per GatesAir quote N/A N/A
Additional RF components $67,893.22 $67,893.22 Additional RF components required for transmitter operation and integration into current RF environment per GatesAir quote. N/A N/A
Transformer 3 phase/480v - 300 KVA $36,800.00 $8,472.80 N/A N/A N/A
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW $1,473,000.00 $999,698.44 GatesAir quote sections A, B & E. This is the transmitter, mask filter, installation and proof per the FCC "transmitter" definition. $711,024.27 N/A
Other Electrical Service: transmitter installation electrical service $91,400.00 $91,400.00 Transmitter electrical design and installation services. $6,000.00 N/A

Components

Actual Information Description File Name
Sales Tax Information not provided.
Electrical Accessories Information not provided.
Shipping Information not provided.
Transmitter de-install Information not provided.
Additional RF components Information not provided.
Transformer 3 phase/480v - 300 KVA Information not provided.
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW

Component Description:
Transmitter 2nd deposit
Amount:
$215,264.19

Component Description:
WXII main transmitter 3 prior to ship
Amount:
$377,840.50

Component Description:
Transmitter 1st deposit
Amount:
$117,919.58
Other Electrical Service: transmitter installation electrical service

Component Description:
WXII transmitter electrical installation design
Amount:
$6,000.00

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 $458,443.35 $452,651.35 N/A $285,792.24 N/A
Total for all systems $4,182,386.73 $3,423,993.67 N/A $1,949,819.01 N/A
Interim Antenna TFU-24WB-1-R C160 $205,303.35 $203,243.35 $177,362.49
Shipping $8,729.85 $8,729.85 antenna shipping per attached Dielectric quote and shipping for custom cut T/L pieces $3,119.85 N/A
Change Order 1 $3,360.00 $3,360.00 additional elbows needed for antenna installation $3,360.00 N/A
Sales Tax $11,576.00 $11,576.00 estimated antenna sales tax based on North Carolina state and local sales tax rate of 6.75% N/A N/A
Impedence Transformer $727.50 $727.50 required to match antenna to transmission line $0.00 N/A
Elbow complex, broadband, at antenna input, per 6 1/8. feedline (if needed) $13,700.00 $11,970.00 see interim antenna quote $0.00 N/A
UHF - High Power, Side Mount, basic slot antenna, 24 bay,, 815 kW input, directional,, horizontally polarized $160,480.00 $160,480.00 antenna cost per attached Dielectric quote $164,482.64 Progress payments include accessories not itemized. See invoice explanations in Attachments.
Sweep test of existing antenna $6,730.00 $6,400.00 N/A $6,400.00 N/A
Primary Antenna TFU-30-DSC-R04 $253,140.00 $249,408.00 $108,429.75
Sales Tax $14,486.00 $14,486.00 estimated antenna sales tax based on North Carolina state and local sales tax rate of 6.75% N/A N/A
Shipping $10,317.00 $10,317.00 antenna shipping $0.00 N/A
Additional RF components $6,532.00 $6,532.00 custom line section, elbow & custom line section. Lines 4, 13 & 14 on attached Dielectric quote $0.00 N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $21,750.00 N/A $0.00 N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $10,298.00 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, Side Mount, basic slot antenna, 640 kW input, horizontally polarized $179,625.00 $179,625.00 antenna price per attached Dielectric quote $108,429.75 N/A

Components

Actual Information Description File Name
Shipping

Component Description:
WXII shipping for custom length transmission line sections
Amount:
$3,119.85
Change Order 1

Component Description:
WXII interim antenna CO1 additional elbows
Amount:
$3,360.00
Sales Tax Information not provided.
Impedence Transformer 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,, 815 kW input, directional,, horizontally polarized

Component Description:
WXII Dielectric Interim Antenna payment 1&2 equals 45% see invoice terms 82,241.32
Amount:
$82,241.32

Component Description:
WXII Dielectric Interim Antenna payment 3 according to terms, invoice type prepayment2 45%; 82,241.32
Amount:
$82,241.32
Sweep test of existing antenna

Component Description:
WXII interim antenna and line sweep
Amount:
$6,400.00
Sales Tax Information not provided.
Shipping Information not provided.
Additional RF components Information not provided.
Side mount brackets for high power antennas (if not included in antenna base cost) 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, Side Mount, basic slot antenna, 640 kW input, horizontally polarized

Component Description:
WXII Dielectric Main antenna Payment 10% down and 35% with order equals 45% $108,429.75
Amount:
$108,429.75

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 $124,824.90 $94,617.60 N/A $82,473.84 N/A
Total for all systems $4,182,386.73 $3,423,993.67 N/A $1,949,819.01 N/A
Interim Transmission Line $121,147.00 $90,939.70 $78,795.94
Sales Tax $5,147.00 $5,147.00 estimated antenna sales tax based on North Carolina state and local sales tax rate of 6.75% N/A N/A
Rigid Transmission Line - copper, 6 1/8" broadband $116,000.00 $85,792.70 see interim antenna quote $78,795.94 N/A
Primary Transmission Line $3,677.90 $3,677.90 $3,677.90
Transmission Line Sweep $3,677.90 $3,677.90 Transmission line sweep to determine if transmission line will work with post-transition channel. $3,677.90 N/A

Components

Actual Information Description File Name
Sales Tax Information not provided.
Rigid Transmission Line - copper, 6 1/8" broadband

Component Description:
WXII Dielectric Interim transmission line payments 10% down and 35% with order equals 45% 38,606.72
Amount:
$38,606.72

Component Description:
WXII Dielectric Interim Transmission line payment 45% prior to delivery 38,606.72
Amount:
$38,606.72

Component Description:
WXII interim transmission line custom length sections
Amount:
$1,582.50
Transmission Line Sweep

Component Description:
WXII transmission line sweep
Amount:
$3,677.90

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 $1,664,061.99 $1,448,851.99 N/A $823,903.82 N/A
Total for all systems $4,182,386.73 $3,423,993.67 N/A $1,949,819.01 N/A
Primary Tower TOWER $1,664,061.99 $1,448,851.99 $823,903.82
Generator rental $13,767.04 $13,767.04 Total of generator rental and fuel used. $13,767.04 N/A
Power line relocation $101,444.95 $101,444.95 Power line relocation required for tower modifications (guy wire replacement) $101,444.95 N/A
Transmitter Site Land Survey $18,500.00 $18,500.00 Land Survey required for power line relocation $15,058.00 N/A
Tower Consulting $6,250.00 $6,250.00 tower consulting estimate per attached quote $6,235.83 N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $350,000.00 N/A N/A N/A
Structural engineering tower load study for well documented tower $12,600.00 $12,000.00 N/A $6,800.00 N/A
Serious tower reinforcement/modifications $1,052,000.00 $908,390.00 TCI Tower Modification Quote attached $642,123.00 N/A
Tower site clearing $38,500.00 $38,500.00 Remove items blocking power line relocation and tower modifications. $38,475.00 N/A

Components

Actual Information Description File Name
Generator rental

Component Description:
WXII rental generator fuel 1
Amount:
$2,724.23

Component Description:
WXII rental generator fuel 2
Amount:
$1,425.35

Component Description:
WXII generator rental
Amount:
$9,617.46
Power line relocation

Component Description:
invoice for power line relocation. Supporting quote provided.
Amount:
$101,444.95
Transmitter Site Land Survey

Component Description:
WXII Invoice with cover letter for land survey required for power line relocation. Supporting quote provided.
Amount:
$15,058.00
Tower Consulting

Component Description:
WXII tower consulting 4
Amount:
$100.00

Component Description:
WXII tower consulting 3 revised
Amount:
$450.00

Component Description:
WXII tower consulting 2
Amount:
$4,538.00

Component Description:
WXII Tower consultant travel invoice for on-site visit. NOTE: One half of airfare and full lodging.
Amount:
$847.83

Component Description:
WXII tower consulting 5 rev
Amount:
$300.00
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) Information not provided.
Structural engineering tower load study for well documented tower

Component Description:
WXII Tower Geotechnical study invoice. Supporting quote provided.
Amount:
$5,400.00

Component Description:
WXII Geotechnical study access road invoice
Amount:
$1,400.00
Serious tower reinforcement/modifications

Component Description:
Invoice for 50% of tower mod quote less MOU deposit. See attached quote "TCI-17-050F - Hearst WXII 576ft Winston Salem NC - Mod Maint. LC2 10.31.17.pdf". Also see "WXII TCI down payment explanation.pdf".
Amount:
$352,995.00

Component Description:
WXII tower modifications 3
Amount:
$181,678.00

Component Description:
WXII portion of TCI tower modifications deposit. This and TCI invoice 8263 comprise the 50% down payment per quote payment terms.
Amount:
$101,200.00

Component Description:
WXII tower modification permit - CO3
Amount:
$6,250.00

Component Description:
WXII TCI tower mod MOU invoice. See attached MOU "TCI MOU 8-28-17 TCI.PDF" for support. Also see "WXII TCI down payment explanation.pdf".
Amount:
$101,200.00
Tower site clearing

Component Description:
WXII land clearing 2 rev
Amount:
$1,725.00

Component Description:
WXII land clearing 1 rev
Amount:
$24,750.00

Component Description:
removal of tower blocking power line relocation. supporting quote provided.
Amount:
$12,000.00

Cost Information

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Outside Professional Services

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).
Description Predetermined
Cost Estimate
Estimated Cost Estimated Cost Justification Actual Cost Actual Cost Justification
Sub-total $102,300.00 $98,350.00 N/A $40,624.84 N/A
Total for all systems $4,182,386.73 $3,423,993.67 N/A $1,949,819.01 N/A
Outside Professional Services $102,300.00 $98,350.00 $40,624.84
Non-Catalog legal expenses $20,000.00 $20,000.00 Non-Catalog expenses for legal advice and services, including financial/reimbursement review, transition reporting, transition procedures, and other transition-related issues $11,828.54 N/A
Transmitter Site Survey $20,600.00 $20,600.00 Transmitter planning survey & transmitter building drawings per attached quote $20,600.00 N/A
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase $2,105.00 $2,000.00 N/A N/A N/A
ASR modification (prepare FCC Form 854) $2,105.00 $2,000.00 N/A N/A N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $7,360.00 $7,000.00 N/A $1,726.40 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 $809.60 N/A
Prepare request for Special Temporary Authorization $4,100.00 $3,000.00 N/A $850.00 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 engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $1,600.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $1,712.50 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
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $1,497.80 N/A

Components

Actual Information Description File Name
Non-Catalog legal expenses

Component Description:
WXII non-catalog legal 1
Amount:
$11,828.54
Transmitter Site Survey

Component Description:
WXII Field Serivce Gates Air, 7/25/2016 $20,600
Amount:
$20,600.00
RF Exposure Measurements Information not provided.
FAA consultant, including cost of preparing FAA Form 7460 (Notice of Proposed Construction), if needed for height increase Information not provided.
ASR modification (prepare FCC Form 854) Information not provided.
Attorney Fees - Prepare and File request for Special Temporary Authorization

Component Description:
WXII Prepare and File request for Special Temporary Authorization
Amount:
$1,726.40
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

Component Description:
WXII Prepare and File FCC Form 2100, Construction Permit Application
Amount:
$809.60
Prepare request for Special Temporary Authorization

Component Description:
WXII RF consulting interim antenna for STA
Amount:
$100.00

Component Description:
WXII RF Consulting interim antenna STA
Amount:
$750.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application Information not provided.
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
WXII RF Consulting prepare CP engineering
Amount:
$1,600.00
Perform engineering study for new channel assignment and antenna development

Component Description:
WXII RF Consulting engineering study invoice 1
Amount:
$1,062.50

Component Description:
WXII RF Consulting engineering study invoice 2
Amount:
$650.00
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
Prepare and or review reimbursement form

Component Description:
WXII Prepare and/or review reimbursement Form 399
Amount:
$1,497.80

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 $48,690.00 $47,085.00 N/A $0.00 N/A
Total for all systems $4,182,386.73 $3,423,993.67 N/A $1,949,819.01 N/A
Other Expenses $48,690.00 $47,085.00 $0.00
MVPD Notification of Channel Change $2,500.00 $2,500.00 need BP quote N/A N/A
Develop and air announcement of upcoming channel change $2,500.00 $2,500.00 need BP quote N/A N/A
Equipment Storage $30,500.00 $30,500.00 antenna storage estimate. See attached Dielectric document. N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $190.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $10,000.00 N/A 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
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 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 $4,182,386.73 $3,423,993.67 $1,949,819.01

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


11/03/2018

Attachments

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