TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

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

Applicant

Address

Phone

Applicant Type

Ohio/Oklahoma Hearst Television Inc.

Doing Business As: Ohio/Oklahoma 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.	Yes
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 CD3300 P3
	Year	2002
	Type	Inductive Output Tube
	IOT Power Type	Two
	Power Capacity	50 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)	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

Other Transmitter Cost Not Listed

Name	Description
Transmitter installation incidentals	equipment and supplies needed for transmitter installation
RF System Modifications	changes to RF system required for installation of repack transmitter
Transmitter Room Modification	remove equipment, walls etc. to make room for new transmitter
RF Sweep	RF sweep of the existing RF infrastructure in the transmitter building to determine what components would work with the WLWT's post-repack channel 20
Shipping	transmitter shipping
Heat Exchanger Filters	Filters to prevent debris embedding in cooling fins
RF Accessories	additional RF components required for transmitter operation
Sales Tax	transmitter sales tax
Electrical Accessories	Manufacturer required surge protection
Transmitter de-install	removal of old transmitter

Antennas

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

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?	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

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

Other Antenna Costs

Section	Question	Response
Combiner for Shared Antenna	Do you need a Combiner for a Shared Antenna?
	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?
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
Antenna accessories	custom length transmission line & test transition

Interim Antenna

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

Other Antenna Costs

Section	Question	Response
Elbow Complex	Do you require the separate purchase of the Elbow Complex?	No
	Broadband or Single Channel?	N/A
	Feed Line Size	N/A
Side Mount Brackets	Do you require the separate purchase of side mount brackets for an antenna?	Yes
Pattern Scatter Analysis	Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna?	No
Sweep Test	Do you require the sweep testing of transmission line and antenna?	Yes

Interim Antenna

Other Antenna Cost Not Listed

Name	Description
Sales Tax	antenna sales tax
Shipping	antenna shipping

Transmission Line

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

Primary Transmission Line

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

Other Transmission Line Expenses Not Listed

Name	Description
Line sweep	test transmission line for use on post-transition channel
Refurbish Line	refurbish 6-1/8" transmission lines to be utilized by new top mount antenna
Elbows	replace tuned elbows for new channel

Interim Transmission Line

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

Other Transmission Line Expenses Not Listed

Name	Description
Sales Tax	transmission line sales tax
Additional TL Components	additional elbows, hangers etc. to complete transmission line run

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?	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
Existing Tower Structure Registration	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

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

Tower Rigging Costs

Section	Question	Response
Tower Rigging Costs	Complex Tower	Terrain constrained
Helicopter Services Required	Are helicopter services required?	No

Primary Tower

Other Tower Expenses Not Listed

Name	Description
Power line relocation	relocation of electrical lines to allow crew access
Tower Consulting	tower consulting and tower project management
Land clearing	remove trees and brush. Required for tower modifications.

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	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	3
	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

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	Transmitter planning survey & transmitter building drawings (aka Field Service, TV)
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.
Consulting-Project Management	Project Management and/or Consulting

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	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?	Yes
	Does this relocation require Equipment Storage?	Yes
	Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change?	Yes
	Does this relocation require MVPD Notification of a Channel Change?	Yes

Other Expenses

Other Expenses Not Listed

Name	Description
Contract Labor	labor directly related to the station channel change
in-house labor	in-house labor directly related to station's repack
Tower site restoraton	repair damage due to heavy equipment at tower site

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	$1,901,185.61	$1,600,920.42	N/A	$1,600,920.42	N/A
Total for all systems	$4,495,197.27	$3,609,774.09	N/A	$3,609,607.05	N/A
Primary Transmitter ULXTE-72	$1,901,185.61	$1,600,920.42		$1,600,920.42
Transmitter de-install	$34,177.33	$34,177.33	removal of old transmitter to make room for replacement	$34,177.33	N/A
Electrical Accessories	$3,884.98	$3,884.98	Manufacturer required surge protection	$3,884.98	N/A
Sales Tax	$94,714.17	$94,714.17	transmitter and transmitter parts sales tax	$94,714.17	N/A
RF Accessories	$65,289.39	$65,289.39	Additional RF components required for transmitter operation and integration into current RF environment.	$65,289.39	N/A
Heat Exchanger Filters	$1,000.00	$1,000.00	per quote	$1,000.00	N/A
Shipping	$17,483.11	$17,483.11	shipping per attached GatesAir invoice	$17,483.11	N/A
RF Sweep	$6,400.00	$6,400.00	RF sweep of the existing RF infrastructure in the transmitter building to determine what components would work with the WLWT's post-repack channel 20.	$6,400.00	N/A
Transmitter Room Modification	$35,647.23	$35,647.23	building mods required for new transmitter	$35,647.23	N/A
RF System Modifications	$31,112.93	$31,112.93	RF system modifications required to allow repack transmitter installation	$31,112.93	N/A
Transmitter installation incidentals	$5,455.47	$5,455.47	parts, supplies and equipment needed for transmitter installation	$5,455.47	N/A
Other Electrical Service: transmitter installation electrical service. See attached Bertke Electric quote.	$96,221.00	$96,221.00	per Bertke Electrical invoices	$96,221.00	N/A
Transformer 3 phase/480v - 300 KVA	$36,800.00	$16,867.80	N/A	$16,867.80	N/A
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW	$1,473,000.00	$1,192,667.01	GatesAir quote sections A, B & E. plus change orders	$1,192,667.01	N/A

Components

Actual Information Description	File Name
Transmitter de-install	Component Description: WLWT GA transmitter de-install Amount: $25,550.85 Component Description: WLWT de-install forklift rental 1 Amount: $3,039.92 Component Description: WLWT de-install forklift rental 2 Amount: $1,631.56 Component Description: WLWT old transmitter outside equipment removal Amount: $3,955.00
Electrical Accessories	Component Description: WLWT transmitter electrical accessories Amount: $3,884.98
Sales Tax	Component Description: WLWT transmitter RF components sales tax Amount: $2,192.16 Component Description: WLWT transmitter sales tax 3 Amount: $1,788.56 Component Description: WLWT transmitter sales tax 2 Amount: $7,913.37 Component Description: WLWT transmitter sales tax Amount: $82,820.08
RF Accessories	Component Description: WLWT transmitter RF accessories Amount: $65,289.39
Heat Exchanger Filters	Component Description: WLWT heat exchanger filters Amount: $1,000.00
Shipping	Component Description: WLWT transmitter shipping Amount: $17,483.11
RF Sweep	Component Description: WLWT RF sweep of existing switch to test compatibility with channel 20 Amount: $6,400.00
Transmitter Room Modification	Component Description: WLWT AC equipment removal Amount: $5,940.00 Component Description: WLWT transmitter building mods 2 Amount: $1,944.00 Component Description: WLWT transmitter building mods 3 rev Amount: $7,620.11 Component Description: WLWT scissor lift rental Amount: $559.99 Component Description: WLWT transmitter building mods Amount: $10,163.13 Component Description: WLWT fencing for transmitter heat exchangers Amount: $9,420.00
RF System Modifications	Component Description: WLWT RF reconfiguration parts shipping 1 Amount: $760.39 Component Description: WLWT RF reconfiguration parts 1 Amount: $13,044.11 Component Description: WLWT waveguide switch rev Amount: $16,674.68 Component Description: WLWT waveguide switch bracket shipping rev Amount: $470.65 Component Description: WLWT RF switch cable Amount: $163.10
Transmitter installation incidentals	Component Description: WLWT transmitter installation incidentals 1 Amount: $421.62 Component Description: WLWT transmitter installation incidentals 2 Amount: $2,832.26 Component Description: WLWT transmitter installation incidentals 4 Amount: $184.91 Component Description: WLWT forklift rental for transmitter installation Amount: $874.58 Component Description: WLWT scissorlift rental for transmitter installation Amount: $466.65 Component Description: WLWT transmitter installation incidentals 3 Amount: $675.45
Other Electrical Service: transmitter installation electrical service. See attached Bertke Electric quote.	Component Description: WLWT transmitter electrical installation 1 Amount: $48,110.50 Component Description: WLWT transmitter electrical installation 2 Amount: $48,110.50
Transformer 3 phase/480v - 300 KVA	Component Description: WLWT transmitter electrical transformers Amount: $16,867.80
UHF - Liquid Cooled Solid State Transmitter 35 - 50 kW	Component Description: WLWT GatesAir transmitter 1/3 prior to ship Amount: $433,669.74 Component Description: WLWT transmitter installation Amount: $95,565.15 Component Description: Transmitter 1st deposit Amount: $138,687.85 Component Description: WLWT transmitter delivery payment Amount: $260,556.40 Component Description: Transmitter 2nd deposit Amount: $264,187.87

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	$482,166.40	$587,180.40	N/A	$587,180.40	N/A
Total for all systems	$4,495,197.27	$3,609,774.09	N/A	$3,609,607.05	N/A
Interim Antenna TFU-16WB	$168,444.92	$149,464.92		$149,464.92
Shipping	$5,552.81	$5,552.81	shipping per attached Dielectric invoice	$5,552.81	N/A
Sales Tax	$9,245.51	$9,245.51	interim antenna sales tax	$9,245.51	N/A
Side mount brackets for high power antennas (if not included in antenna base cost)	$23,150.00	$4,500.00	N/A	$4,500.00	N/A
Sweep test of existing antenna	$6,730.00	$6,400.00	N/A	$6,400.00	N/A
UHF - High Power, Side Mount, basic slot antenna, 16 bay,, 500 kW input, directional,, horizontally polarized	$123,766.60	$123,766.60	per invoices	$123,766.60	Progress payments - not itemized
Primary Antenna TFU-26GBH-R 06	$313,721.48	$437,715.48		$437,715.48
Antenna accessories	$13,444.93	$13,444.93	RF components need for antenna installation per Dielectric invoices	$13,444.93	N/A
Sales Tax	$24,633.55	$24,633.55	main antenna sales tax	$24,633.55	N/A
Shipping	$9,613.00	$9,613.00	shipping per attached Dielectric quote	$9,613.00	N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)	$12,300.00	$10,984.00	N/A	$10,984.00	N/A
Sweep test of existing antenna	$6,730.00	$6,400.00	N/A	$6,400.00	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	$372,640.00	N/A

Components

Actual Information Description	File Name
Shipping	Component Description: WLWT interim antenna shipping to site Amount: $3,680.00 Component Description: WLWT interim antenna custom TL shipping rev2 Amount: $820.73 Component Description: WLWT interim antenna custom line section shipping rev Amount: $1,052.08
Sales Tax	Component Description: WLWT interim antenna sales tax Amount: $9,245.51
Side mount brackets for high power antennas (if not included in antenna base cost)	Component Description: WLWT side mount bracket redesign Amount: $4,500.00
Sweep test of existing antenna	Component Description: WLWT interim antenna sweep rev2 Amount: $6,400.00
UHF - High Power, Side Mount, basic slot antenna, 16 bay,, 500 kW input, directional,, horizontally polarized	Component Description: WLWT interim antenna payment 3 Amount: $1,573.33 Component Description: Dielectric WLWT Interim Antenna 45% progress payment (10% down and 35% with order equals). Supporting documentation included. Amount: $59,720.40 Component Description: WLWT Dielectric interim antenna payment 2 - 45% prior to ship. Supporting documentation included. Amount: $62,472.87
Antenna accessories	Component Description: WLWT custom length transmission line 2 rev Amount: $910.00 Component Description: WLWT custom TL shipping 2 rev2 Amount: $425.40 Component Description: WLWT custom TL shipping rev2 Amount: $403.39 Component Description: WLWT custom length transmission line rev Amount: $1,820.00 Component Description: WLWT cable for Antenna Obstruction Light Amount: $664.13 Component Description: WLWT test transition Amount: $2,420.00 Component Description: WLWT main antenna additional parts and shipping Amount: $6,802.01
Sales Tax	Component Description: WLWT main antenna sales tax Amount: $24,633.55
Shipping	Component Description: WLWT main antenna shipping rev2 Amount: $9,613.00
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)	Component Description: WLWT main antenna elbow complex Amount: $10,984.00
Sweep test of existing antenna	Component Description: WLWT main antenna sweep Amount: $6,400.00
UHF - High Power Top Mount (200-1000 kW), One station antenna, horizontally polarized	Component Description: WLWT main antenna payment 3 rev Amount: $9,021.10 Component Description: WLWT main antenna payment 45% prior to ship Amount: $181,809.45 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

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	$256,765.31	$256,127.97	N/A	$256,127.97	N/A
Total for all systems	$4,495,197.27	$3,609,774.09	N/A	$3,609,607.05	N/A
Interim Transmission Line	$238,990.79	$238,353.45		$238,353.45
Additional TL Components	$85,602.51	$85,602.51	additional transmission line components needed to complete installation	$85,602.51	N/A
Sales Tax	$14,188.28	$14,188.28	transmission line sales tax	$14,188.28	N/A
Rigid Transmission Line - copper, 6 1/8" broadband	$139,200.00	$138,562.66	transmission line price per attached Dielectric quote	$138,562.66	N/A
Primary Transmission Line	$17,774.52	$17,774.52		$17,774.52
Elbows	$855.18	$855.18	see Dielectric invoice	$855.18	N/A
Refurbish Line	$14,161.00	$14,161.00	transmission line parts	$14,161.00	N/A
Line sweep	$2,758.34	$2,758.34	see associated invoice	$2,758.34	N/A

Components

Actual Information Description	File Name
Additional TL Components	Component Description: WLWT additional interim transmission line parts shipping 5 Amount: $2,141.10 Component Description: WLWT additional interim transmission line parts Amount: $34,264.09 Component Description: WLWT additional interim transmission line parts shipping Amount: $997.85 Component Description: WLWT interim transmission line hangers Amount: $684.60 Component Description: WLWT additional interim transmission line parts shipping 2 Amount: $550.75 Component Description: WLWT additional interim transmission line parts 3 Amount: $1,447.50 Component Description: WLWT additional interim transmission line parts 2 Amount: $27,469.50 Component Description: WLWT additional interim transmission line parts shipping 4 Amount: $344.26 Component Description: WLWT additional interim transmission line parts shipping 3 Amount: $370.86 Component Description: WLWT additional interim transmission line parts 4 Amount: $1,302.00 Component Description: WLWT interim transmission line custom elbows Amount: $16,030.00
Sales Tax	Component Description: WLWT interim transmission line sales tax Amount: $14,188.28
Rigid Transmission Line - copper, 6 1/8" broadband	Component Description: WLWT interim transmission line payment 3 Amount: $13,788.30 Component Description: WLWT Dielectric interim transmission line payment 2 - 45% prior to ship Amount: $62,047.35 Component Description: WLWT transmission line cut pieces shipping Amount: $679.66 Component Description: Dielectric WLWT Interim Transmission line payments 10% down & 35% with order equals 45% of invoice line item 2 Amount: $62,047.35
Elbows	Component Description: WLWT main transmission line elbows shipping Amount: $855.18
Refurbish Line	Component Description: Credit for transmission line refurbishing Amount: ($25,864.00) Component Description: WLWT main transmission line refurb parts 2 Amount: $19,582.50 Component Description: WLWT main transmission line refurbish parts Amount: $14,161.00 Component Description: WLWT main transmission line refurbish 1 Amount: $25,864.00 Component Description: WLWT shipping main transmission line refurb parts 2 Amount: $2,095.00
Line sweep	Component Description: WLWT main transmission line sweep Amount: $2,758.34

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	$1,517,980.97	$975,166.29	N/A	$975,166.29	N/A
Total for all systems	$4,495,197.27	$3,609,774.09	N/A	$3,609,607.05	N/A
Primary Tower LTOWER	$1,517,980.97	$975,166.29		$975,166.29
Structural engineering tower load study for well documented tower	$12,600.00	$9,820.00	Quote TCI-16-104 - WLWT - Cincinnati OH - Analysis.pdf	$9,820.00	N/A
Power line relocation	$2,458.54	$2,458.54	see Duke Energy invoice	$2,458.54	N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)	$421,000.00	$272,612.00	N/A	$272,612.00	N/A
Land clearing	$24,170.00	$24,170.00	Clearing trees/brush and moving fences required for tower modifications	$24,170.00	N/A
Tower Consulting	$5,752.43	$5,752.43	tower consulting	$5,752.43	N/A
Serious tower reinforcement/modifications	$1,052,000.00	$660,353.32	N/A	$660,353.32	-

Components

Actual Information Description	File Name
Structural engineering tower load study for well documented tower	Component Description: WLWT tower feasibility structural analysis Amount: $9,820.00
Power line relocation	Component Description: WLWT power line relocation Amount: $2,458.54
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)	Component Description: WLWT antenna services phase 2 mobilization Amount: $29,644.00 Component Description: WLWT antenna services phase 2 completion Amount: $45,069.00 Component Description: WLWT phase 1 antenna services completion Amount: $7,560.00 Component Description: WLWT Tower Repack Antenna Services -main antenna installation 50% down payment per quote Amount: $75,115.00 Component Description: WLWT interim antenna 20% progress payment Amount: $30,046.00 Component Description: WLWT antenna services phase 2 change order rev Amount: $43,178.00 Component Description: WLWT Antenna Services - interim antenna and line installation 50% down payment. Amount: $42,000.00
Land clearing	Component Description: WLWT tree and brush removal 2 Amount: $5,000.00 Component Description: WLWT fence work 2 Amount: $9,550.00 Component Description: WLWT tree and brush removal Amount: $2,920.00 Component Description: WLWT fence work 3 Amount: $3,450.00 Component Description: WLWT fence work 1 Amount: $3,250.00
Tower Consulting	Component Description: WLWT consultant for on-site tower meeting Amount: $1,489.43 Component Description: WLWT Kube tower consulting Amount: $75.00 Component Description: WLWT tower consulting invoice 1 Amount: $4,038.00 Component Description: WLWT tower consulting invoice 2 Amount: $150.00
Serious tower reinforcement/modifications	Component Description: WLWT tower mods 20% mobilization less non-reimbursable items Amount: $125,170.00 Component Description: WLWT tower mods completion Amount: $48,766.50 Component Description: Deposit for tower modifications per TCI MOU 8-28-17 TCI.PDF Amount: $44,800.00 Component Description: WLWT partial completion payment less non-reimbursable items Amount: $131,428.50 Component Description: WLWT tower modifications 50% initial payment less MOU deposit Amount: $226,125.00 Component Description: WLWT tower mod change order 1 revision 3 Amount: $84,063.32

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	$206,312.22	$67,962.85	N/A	$67,795.81	N/A
Total for all systems	$4,495,197.27	$3,609,774.09	N/A	$3,609,607.05	N/A
Outside Professional Services	$206,312.22	$67,962.85		$67,795.81
Consulting-Project Management	$22,000.00	$22,000.00	N/A	$22,000.00	N/A
Non-catalog Legal Expenses	$14,132.22	$14,132.22	Non-Catalog expenses for legal advice and services, including financial/reimbursement review, transition reporting, transition procedures, and other transition-related issues.	$14,132.22	N/A
Transmitter Site Survey Sales Tax	$0.00	$0.00	*System Notice: Estimate adjusted and locked because line has been superseded.*Ohio sales tax for Transmitter Site Survey (aka Field Service, TV)	$0.00	N/A
Transmitter Site Survey	$20,600.00	$20,600.00	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	$0.00	$0.00	based on attached transmitter security proposal for 90 days.	N/A	N/A
RF Exposure Measurements	$21,050.00	$0.00	N/A	N/A	N/A
Comprehensive coverage verification via field study, if needed	$84,200.00	$0.00	N/A	N/A	N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization	$11,040.00	$2,441.60	N/A	$2,441.60	N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	$2,365.00	$105.00	N/A	$105.00	N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	$5,260.00	$1,846.53	N/A	$1,846.53	N/A
Prepare request for Special Temporary Authorization	$4,100.00	$0.00	N/A	N/A	N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	$1,580.00	$250.00	N/A	$250.00	N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	$3,155.00	$2,525.00	N/A	$2,525.00	N/A
Perform engineering study for new channel assignment and antenna development	$7,360.00	$2,062.50	N/A	$2,062.50	N/A
Address transition timing and coordination issues w/ other stations and wireless	$2,630.00	$0.00	N/A	N/A	N/A
Prepare and or review reimbursement form	$2,630.00	$2,000.00	N/A	$1,832.96	N/A
Attorney Fees - Negotiation of lease and other matters for shared locations	$4,210.00	$0.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
Consulting-Project Management	Component Description: WLWT Stitt consulting 1 Amount: $5,000.00 Component Description: WLWT Stitt consulting 5 Amount: $3,000.00 Component Description: WLWT Stitt consulting 2 Amount: $2,000.00 Component Description: WLWT Stitt consulting 4 Amount: $9,000.00 Component Description: WLWT Stitt consulting 3 Amount: $3,000.00
Non-catalog Legal Expenses	Component Description: WLWT non-catalog legal 4 Amount: $3,738.60 Component Description: WLWT non-catalog legal 5 Amount: $1,501.20 Component Description: WLWT non-catalog legal 3 Amount: $1,591.00 Component Description: WLWT non-catalog legal 2 Amount: $3,690.02 Component Description: WLWT non-catalog legal 1 Amount: $2,709.40 Component Description: WLWT non-catalog legal 6 Amount: $219.50 Component Description: WLWT non-catalog legal 7 Amount: $682.50
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	Component Description: WLWT Prepare and File request for Special Temporary Authorization 3 Amount: $552.80 Component Description: WLWT Prepare and File request for Special Temporary Authorization 2 Amount: $884.60 Component Description: WLWT Prepare and File request for Special Temporary Authorization Amount: $1,004.20
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	Component Description: WLWT Prepare and file FCC Form 2100 (main) License to Cover Application Amount: $105.00
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	Component Description: WLWT Prepare and File FCC Form 2100, Construction Permit Application Amount: $792.00 Component Description: WLWT Prepare and File FCC Form 2100, Construction Permit Application 2 Amount: $1,054.53
Prepare request for Special Temporary Authorization	Information not provided.
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	Component Description: WLWT RF consulting for license to cover Amount: $250.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	Component Description: WLWT CP engineering mod Amount: $700.00 Component Description: WLWT CP engineering prep Amount: $1,825.00
Perform engineering study for new channel assignment and antenna development	Component Description: WLWT engineering study for new channel assignment Amount: $562.50 Component Description: WLWT antenna development Amount: $625.00 Component Description: WLWT RF consulting for interim antenna development Amount: $875.00
Address transition timing and coordination issues w/ other stations and wireless	Information not provided.
Prepare and or review reimbursement form	Component Description: WLWT Prepare and/or review reimbursement Form 399 3 Amount: $47.00 Component Description: WLWT Prepare and/or review reimbursement Form 399 4 Amount: $141.00 Component Description: WLWT Prepare and/or review reimbursement Form 399 Amount: $1,082.40 Component Description: WLWT Prepare and/or review reimbursement Form 399 5 Amount: $105.00 Component Description: WLWT Prepare and/or review reimbursement Form 399 2 Amount: $300.06 Component Description: WLWT Prepare and/or review reimbursement Form 399 6 Amount: $157.50
Attorney Fees - Negotiation of lease and other matters for shared locations	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	$130,786.76	$122,416.16	N/A	$122,416.16	N/A
Total for all systems	$4,495,197.27	$3,609,774.09	N/A	$3,609,607.05	N/A
Other Expenses	$130,786.76	$122,416.16		$122,416.16
Tower site restoraton	$42,370.00	$42,370.00	repair damage to tower site due to heavy equipment used for tower modifications and antenna installations and replacements	$42,370.00	N/A
in-house labor	$17,008.21	$17,008.21	per attached documentation	$17,008.21	N/A
Contract Labor	$4,209.46	$4,209.46	accounting labor directly related to the Spectrum Repack project	$4,209.46	N/A
MVPD Notification of Channel Change	$2,842.40	$2,842.40	MVPD notification	$2,842.40	N/A
Develop and air announcement of upcoming channel change	$0.00	$0.00	Attorney review to ensure FCC compliance	N/A	N/A
Equipment Storage	$46,087.00	$46,087.00	per relevant invoices	$46,087.00	N/A
Equipment Delivery and Handling Charges	$4,990.00	$4,990.00	Transmitter local delivery per invoices	$4,990.00	N/A
Disposal Costs (for equipment and other waste, net of any salvage value)	$89.69	$89.69	per invoice	$89.69	N/A
FCC Filing Fees - Special Temporary Authorization request	$195.00	$590.00	per FCC receipts	$590.00	N/A
FCC Filing Fees - Form 2100 license to cover application	$335.00	$335.00	N/A	$335.00	N/A
FCC Filing Fees - Form 2100 minor change CP application	$1,110.00	$0.00	N/A	N/A	N/A
DTV Medical Facility Notification	$11,550.00	$3,894.40	quote attached	$3,894.40	N/A

Components

Actual Information Description	File Name
Tower site restoraton	Component Description: WLWT transmitter site pavement restoration Amount: $24,180.00 Component Description: WLWT tower site restoration 2 Amount: $12,127.00 Component Description: WLWT tower site restoration 1 Amount: $6,063.00
in-house labor	Component Description: WLWT in-house labor 3 Amount: $3,626.38 Component Description: WLWT in-house labor 4 Amount: $4,195.16 Component Description: WLWT in-house accounting labor 1 Amount: $5,709.60 Component Description: WLWT in-house labor 2 Amount: $3,477.07
Contract Labor	Component Description: WLWT accounting labor Amount: $4,209.46
MVPD Notification of Channel Change	Component Description: WLWT MVPD notification Amount: $2,842.40
Develop and air announcement of upcoming channel change	Information not provided.
Equipment Storage	Component Description: WLWT transmitter storage 3 Amount: $400.00 Component Description: WLWT transmitter storage 2 Amount: $400.00 Component Description: WLWT main antenna storage rev2 Amount: $28,450.00 Component Description: WLWT transmitter storage 1 Amount: $6,077.00 Component Description: WLWT interim antenna ship to storage Amount: $7,360.00 Component Description: WLWT interim antenna storage Amount: $3,400.00
Equipment Delivery and Handling Charges	Component Description: WLWT local transmitter delivery 2 Amount: $2,495.00 Component Description: WLWT local transmitter delivery 1 Amount: $2,495.00
Disposal Costs (for equipment and other waste, net of any salvage value)	Component Description: WLWT waste container delivery Amount: $89.69
FCC Filing Fees - Special Temporary Authorization request	Component Description: WLWT Engineering STA Extension Application fee 1 Amount: $200.00 Component Description: WLWT Engineering STA Extension Application fee 2 Amount: $200.00 Component Description: WLWT Engineering STA Application fee Amount: $190.00
FCC Filing Fees - Form 2100 license to cover application	Component Description: WLWT main antenna License To Cover Application fee Amount: $335.00
FCC Filing Fees - Form 2100 minor change CP application	Information not provided.
DTV Medical Facility Notification	Component Description: WLWT medical notification Amount: $3,894.40

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$4,495,197.27	$3,609,774.09	$3,609,607.05

Reimbursement Status

Question	Response
The facility has ceased operating on its pre-auction channel.	Yes
Construction of final facilities or all necessary modifications are complete.	Yes
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 04/22/2021

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

04/22/2021

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 04/22/2021

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

04/22/2021

Certification

Section	Question	Response
Submission of Final Allocation or Accounting Information 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 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 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 all costs identified as "actual costs" herein accurately represent the costs actually paid by the above-named entity, including any discounts, refunds, or rebates. 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 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.	Douglas Durkee Hearst Television Manager of Spectrum Repack 04/22/2021

Section

Question

Response

Submission of Final Allocation or Accounting Information Statements

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 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 all costs identified as "actual costs" herein accurately represent the costs actually paid by the above-named entity, including any discounts, refunds, or rebates.
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 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.

Douglas Durkee

Hearst Television Manager of Spectrum Repack

04/22/2021

(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

Primary Antenna

Existing Antenna Information

Primary Antenna

New Antenna Costs

Primary Antenna

Other Antenna Costs

Primary Antenna

Other Antenna Cost Not Listed

Interim Antenna

New Antenna Costs

Interim Antenna

Other Antenna Costs

Interim Antenna

Other Antenna Cost Not Listed

Transmission Line

Primary Transmission Line

Existing Transmission Line

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Interim Transmission Line

New Transmission Line

Interim 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

Other Types of Users

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