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:
65696
Service:
DTV
Call Sign:
WBAL-TV
Channel:
12 (High VHF)
File Number:
0000026833
FRN:
0003792926
Date Submitted:
09/21/2020

Applicant Information

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Applicant Name, Type, and Contact Information

Applicant Address Phone Email Applicant Type

WBAL HEARST TELEVISION INC.

Doing Business As: WBAL HEARST TELEVISION INC.

P.O. 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

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Preparer Contact Name and Information

Applicant Address Phone Email

The Preparer is same as the reimbursement contact.

 

 

 

Broadcaster Information and Transition Plan

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Question Response
Will the station be sharing equipment with another broadcast television station or stations (e.g., a shared antenna, co-location on a tower, use of the same transmitter room, multiple transmitters feeding a combiner, etc.)? If yes, enter the facility ID's of the other stations and click 'prefill' to download those stations' licensing information. Yes
Briefly describe transition plan see attached document

Transmitters

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

Auxiliary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Auxiliary (Backup)
Description of Use Auxiliary transmitter
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 TTP60M
Year 1998
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 3.5 kW

Auxiliary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Auxiliary (Backup)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model VAXTE-6R44
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 4.8 kW
Justification for New Transmitter Original transmitter manufacturer no long in business. See attached transmitter statement.

Auxiliary Transmitter

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Other Transmitter Costs

Section Question Response
Electrical Service Service Entrance (3 phases 800A 208V) No
Switchgear (industrial 800 amp) No
Transformer (480V) No
Power N/A
Rigid Conduit and Wiring Yes
Size 2 inches
Length 250.0 feet
Other Electrical Service No
Description N/A
HVAC Service Does the replacement transmitter require HVAC Service? No
Type N/A
Size N/A
Other Size N/A
Transmitter Building Addition/Modification or Leasehold Improvement Does the Transmitter Building require an addition, modification, other leashold improvement? No
Size N/A
Channel 14 Costs Is an RF Consulting Engineer needed? N/A
Is a channel 14 Mask Filer needed? N/A
Is additional field engineering time needed? N/A
Number of Days N/A

Auxiliary Transmitter

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Other Transmitter Cost Not Listed

Name Description

RF Accessories

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

Transmitter Accessories

additional equipment required for transmitter operation

Electrical Accessories

manufacturer required surge protection

Change Orders

Changes from the original transmitter order needed to complete transmitter installation

Shipping

transmitter shipping

Sales Tax

transmitter sales tax

Primary Transmitter

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Existing Transmitter Information

Section Question Response
Existing Transmitter Description Type of change Purchase New
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is this transmitter currently shared with another station? No
Is this transmitter currently in operating condition? Yes
Existing Transmitter Manufacturer and Type Manufacturer
Model TTP60M
Year 1998
Type Solid State
Solid State Cooling Air Cooled
Solid State Power Capacity 3.5 kW

Primary Transmitter

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New Transmitter Costs

Section Question Response
New Transmitter Use Primary (Main)
Change Type Purchase New
Is this a request for upgraded equipment? No
Manufacturer
Model VAXTE-6R44
Transmitter Type Solid State
Solid State Cooling Air Cooled
Solid State Power capacity 4.8 kW
Justification for New Transmitter Original transmitter manufacturer no long in business. See attached transmitter statement.

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) No
Power N/A
Rigid Conduit and Wiring Yes
Size 2 inches
Length 250.0 feet
Other Electrical Service No
Description N/A
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

Shipping

transmitter shipping

RF Accessories

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

Change Orders

Change from the original transmitter order needed to complete transmitter installation

Sales Tax

transmitter sales tax

Transmitter Accessories

additional equipment required for transmitter operation

Electrical Accessories

Manufacturer required surge protection

Transmitter de-install

removal of old transmitter

Antennas

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

Auxiliary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Auxiliary (Backup)
Description of Use backup to main antenna
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? Yes
Existing Antenna Manufacturer and Type Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Other
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 batwing
ERP: 12.6 kW
Manufacturer
Model TF4-AH
Year 1999

Auxiliary Antenna

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New Antenna Costs

Section Question Response
New Antenna Description Use Auxiliary (Backup)
Description of Use backup to main antenna
Change Type Purchase New
Is this a request for upgraded equipment? No
Ownership Owned
Owner N/A
Is antenna shared? No
Is antenna directional? Yes
Will antenna be located on or in close proximity to an antenna farm? Yes
New Antenna Manufacturer and Types Class Full Power
Mounting Side Mount
Antenna position in stack Not in Stack
Polarization Horizontal
Type Broadband Slot
Number of Stations Supported 1
Number of Panels/Bays 4
Lower Limit 174.00 MHz
Upper Limit 216.00 MHz
Design power capacity in use 70.0 %
Other Antenna Type N/A
ERP: 12.6 kW
Manufacturer
Model TLS-V4
Year 2019
Justification for New Antenna Changing from channel 11 to 12, current antenna will not work on new channel assignment.

Auxiliary Antenna

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Other Antenna Costs

Section Question Response
Combiner for Shared Antenna Do you need a Combiner for a Shared Antenna? No
Type
Number of channels supported N/A
Frequencies of channels supported N/A
Frequency N/A
Do you need a combiner output splitter/switcher for dual feed lines? N/A
Elbow Complex Do you require the separate purchase of the Elbow Complex? 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

Auxiliary Antenna

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Other Antenna Cost Not Listed

Name Description

Additional RF components

additional RF items required for operation

Sales Tax

antenna sales tax

Shipping

estimated antenna shipping (not quoted)

Primary Antenna

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Existing Antenna Information

Section Question Response
Existing Antenna Description Type of change Purchase New
Antenna Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing antenna shared with another station or stations? No
Is the existing antenna directional? No
Is antenna in operating condition? Yes
Is antenna located on or in close proximity to an antenna farm? Yes
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: 26.6 kW
Manufacturer
Model TW-9B11-R(S)
Year 1999

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? Yes
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? Yes
New Antenna Manufacturer and Types Class Full Power
Mounting Top Mount
Antenna position in stack Not in Stack
Polarization Circular
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: 26.6 kW
Manufacturer
Model THV-9A12/CPR 04
Year 2019
Justification for New Antenna Current antenna is channel specific and cannot be used on post-transition channel. Antenna must be replaced. Quotes for this and equivalent antenna attached.

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?
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

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Other Antenna Cost Not Listed

Name Description

Shipping

antenna shipping

Additional components

additional components needed for antenna installation

Antenna Obstruction Light

Replacement AOL for main antenna

Feed through components

REQUIRED 6-75 ELBOWS, CUT LENGTHS AND HANGERS TO ROUTE LINE FROM ANTENNA INPUT THROUGH SUPPORT STRUCTURE

Sales Tax

antenna sales tax

Transmission Line

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

Primary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Utilize Existing
Use Primary (Main)
Description of Use N/A
Ownership Owned
Owner N/A
Site N/A
Is the existing transmission line shared with another station or stations? No
Is Transmission Line in operating condition? Yes
Existing Transmission Line Manufacturer and Type Manufacturer Dielectric
Type Rigid
Diameter 6 1/8 inches
Other Diameter N/A
Segment Length 20 inches
Other Segment Length N/A
Number of parallel runs 1
Length 1250 feet per run

Primary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

Miscellaneous TL parts

replace frequency specific components in transmission line

Auxiliary Transmission Line

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Existing Transmission Line

Section Question Response
Existing Transmission Line Description Type of change Utilize Existing
Use Auxiliary (Backup)
Description of Use line to aux antenna
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 1026 feet per run

Auxiliary Transmission Line

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Other Transmission Line Expenses Not Listed

Name Description

RF Components

RF Components required to complete connection to repack transmitter and line refurb parts.

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 Leased
Is this tower consider Complex? Candelabra
Is this tower currently shared with any other stations? Yes
One or more FM, AM or TV radio broadcaster(s) Yes
Others Types of Users Yes
Is tower documented for structural analysis? Yes
Is tower compliant with Rev G? No
Existing Tower Structure Registration Do you have a tower registration number? Yes
ASR Number 1035558
Coordinates (NAD83) Latitude (NAD83) 39° 20' 05.0" N-
Longitude (NAD83) 076° 39' 02.0" W-
Overall Structure Height 997.36 feet
Support Structure Height 889.10 feet
Ground Elevation Above Mean Sea Level (AMSL) 318.24 feet
Structure Type GTOWER - Guyed Structure Used for Communication Purposes
Tower Owner Television Tower Inc
Date Constructed 08/26/1964

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
65693 WIYY FM
1916 WJZ-FM FM
25455 WJZ-TV DTV
74196 WWMX FM
28637 WLIF FM
59442 WMAR-TV DTV

Other Types of Users

Users
W291BA FM Txltr
W248AO FM Txltr

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: Minor Reinforcements needed

Primary Tower

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Tower Rigging Costs

Section Question Response
Tower Rigging Costs Complex Tower Candelabra
Helicopter Services Required Are helicopter services required? Yes

Primary Tower

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Other Tower Expenses Not Listed

Name Description

Gin Pole Prep

Gin pole support brackets and rigging plan

Tower Consulting

Tower consulting and tower project management

Outside Professional Services Costs

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Section Question Response
Outside Project Management Services Do you require outside project management services? No
Number of Hours N/A
Explanation N/A
Outside RF consulting Engineering Services Perform engineering study for new channel assignment and antenna development Yes
Prepare engineering section of Form FCC Construction Permit Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare engineering section of Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
Do you have Distributed Transmission System engineering services? N/A
Critical Facility N/A
Terrain-Shielded Facility N/A
Attorney and Other Outside Consulting Services Prepare and file Form FCC Construction Permit Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare and file Form FCC License to Cover Application Yes
For Auxiliary Facility Yes
For Main Facility Yes
Prepare request for Special Temporary Authority Yes
Quantity 1
NEPA Section 106 environmental review No
Environmental Assessment No
ASR Modification No
FAA Consultation (including preparation of FAA Form 7460) No
Negotiation of Lease and other Matter for Shared Locations 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 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

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

Transmitter Site Survey

Transmitter planning survey & transmitter building drawings

Other Expenses

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Section Question Response
AM Pattern Disturbance Is an Impact Study needed? No
Is Remediation needed? No
Facility Expenses Name N/A
Other Distributed Transmission System Expenses Not listed N/A
Name N/A
Is Notification of a Medical Facility required as a result of DTV broadcasting? Yes
Permit and Filing Costs Local Zoning No
Non-zoning permits No
BLM or NFS Coordination No
FCC Construction Permit Minor Change Yes
FCC License to Cover Application Yes
FCC Special Temporary Authority Application Yes
Other Miscellaneous Expenses Does this relocation require paying Disposal Costs (for equipment and other waste, net of any salvage value)? Yes
Does this relocation require Equipment Delivery or Handling Charges not otherwise included in individual item costs? No
Does this relocation require Equipment Storage? Yes
Does this relocation require the Development and Airing of an Announcement regarding an upcoming channel change? Yes
Does this relocation require MVPD Notification of a Channel Change? Yes

Other Expenses

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Other Expenses Not Listed

Name Description

Additional Security Guard

Pro rata cost for an additional security guard (plus sales tax) required to restrict traffic to the WJZ TV access road while the gin pole is used.

Construct Pathway 1 and Stairs

Pro rata cost for pathway through the southwest woods suitable for ATV to shuttle employees. Also includes stairway construction to quickly evacuate property.

Construct Pathway 2 and Fence

Pro rata cost to construct ATV Pathway 2, including delivery, installation, pickup and removal of mats as well as removal and reinstallation of fencing.

Contract Labor

labor directly related to the station channel change

Liability Insurance

Insurance needed for the helicopter replacement of the antennas of the shared tower.

Protective Scaffolding

Pro rata cost for protective scaffolding work.

Remove Reinstall Light Pole

Temporarily Remove and Reinstall Light Pole in Parking Lot and Helicopter Landing Zone.

Security Trailer Rental

Pro rata cost for guard trailer to receive packages, restrict traffic to WJZTV and coordinate vendor access to the WJZTV building while the ZOI is enacted for the gin pole.

Traffic Coord - Scaffold Install

Pro rata cost for traffic control during installation of protective scaffolding above roadway near tower.

Tree Removal

Tree removal required for helicopter lift of main antenna

in-house labor

in-house labor directly related to station's repack

Remote location rental

rental facility to house WBAL operations during required studio evacuation.

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 $436,913.96 $436,413.96 N/A $403,953.59 N/A
Total for all systems $3,411,425.85 $3,019,570.89 N/A $2,804,700.25 N/A
Primary Transmitter VAXTE-6R44 $233,635.78 $233,385.78 $227,135.78
Transmitter de-install $1,200.00 $1,200.00 per associated invoice $1,200.00 N/A
Electrical Accessories $1,942.49 $1,942.49 Manufacturer required surge protection $1,942.49 N/A
Transmitter Accessories $3,916.58 $3,916.58 per invoices $3,916.58 N/A
Sales Tax $12,050.58 $12,050.58 sales tax per attached GatesAir invoices $12,050.58 N/A
Change Orders $36,128.95 $36,128.95 per attached quote Q-87230 and Q-88544 $36,128.95 N/A
RF Accessories $26,383.76 $26,383.76 Additional RF components required for transmitter operation and integration into current RF environment. $26,383.76 N/A
Shipping $9,125.82 $9,125.82 transmitter shipping per GatesAir invoice US0339012 $9,125.82 N/A
2" Rigid Conduit and Wiring (Cost per foot) $6,500.00 $6,250.00 N/A N/A N/A
High VHF - Air Cooled Solid State Transmitter 4.8 kW $136,387.60 $136,387.60 per GatesAir invoices $136,387.60 N/A
Auxiliary Transmitter VAXTE-6R44 $203,278.18 $203,028.18 $176,817.81
Sales Tax $8,991.97 $8,991.97 transmitter sales tax per attached GatesAir quote $2,939.21 N/A
Shipping $8,292.66 $8,292.66 transmitter shipping per attached GatesAir invoice $8,292.66 N/A
Change Orders $37,974.89 $37,974.89 per attached GatesAir invoice $37,974.89 N/A
Electrical Accessories $1,942.49 $1,942.49 Manufacturer required surge protection N/A N/A
Transmitter Accessories $1,027.57 $1,027.57 per invoice $1,027.57 N/A
RF Accessories $4,532.93 $4,532.93 Additional RF components required for transmitter operation and integration into current RF environment. N/A N/A
2" Rigid Conduit and Wiring (Cost per foot) $6,500.00 $6,250.00 N/A N/A N/A
High VHF - Air Cooled Solid State Transmitter 4.8 kW $134,015.67 $134,015.67 GatesAir quote sections A, B & E. This is the transmitter, mask filter, installation and proof per the FCC "transmitter" definition. $126,583.48 N/A

Components

Actual Information Description File Name
Transmitter de-install

Component Description:
WBAL transmitter de-install 1
Amount:
$1,200.00
Electrical Accessories

Component Description:
WBAL transmitter electrical surge protector
Amount:
$1,942.49
Transmitter Accessories

Component Description:
WBAL main transmitter GPS kit
Amount:
$1,027.58

Component Description:
WBAL transmitter remote control
Amount:
$2,889.00
Sales Tax

Component Description:
WBAL main transmitter sales tax
Amount:
$9,222.14

Component Description:
WBAL main transmitter sales tax 2
Amount:
$2,828.44
Change Orders

Component Description:
WBAL main transmitter change orders
Amount:
$36,128.95
RF Accessories

Component Description:
WBAL main transmitter RF accessories
Amount:
$26,383.76
Shipping

Component Description:
WBAL main transmitter shipping
Amount:
$9,125.82
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
High VHF - Air Cooled Solid State Transmitter 4.8 kW

Component Description:
Main transmitter 1st deposit
Amount:
$17,644.67

Component Description:
WBAL main transmitter installation and proof
Amount:
$11,011.45

Component Description:
Main transmitter 2nd deposit
Amount:
$88,062.62

Component Description:
WBAL main transmitter payment 3 prior to ship
Amount:
$19,668.86
Sales Tax

Component Description:
WBAL aux transmitter sales tax
Amount:
$2,939.21
Shipping

Component Description:
WBAL aux transmitter shipping
Amount:
$8,292.66
Change Orders

Component Description:
WBAL aux transmitter change orders
Amount:
$37,974.89
Electrical Accessories Information not provided.
Transmitter Accessories

Component Description:
WBAL aux transmitter GPS kit
Amount:
$1,027.57
RF Accessories Information not provided.
2" Rigid Conduit and Wiring (Cost per foot) Information not provided.
High VHF - Air Cooled Solid State Transmitter 4.8 kW

Component Description:
WBAL aux transmitter payment 4 installation
Amount:
$11,011.45

Component Description:
WBAL aux transmitter payment 3 prior to ship
Amount:
$12,459.53

Component Description:
Aux transmitter 1st deposit
Amount:
$15,049.88

Component Description:
Aux transmitter 2nd deposit
Amount:
$88,062.62

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 $406,098.61 $388,190.21 N/A $354,895.85 N/A
Total for all systems $3,411,425.85 $3,019,570.89 N/A $2,804,700.25 N/A
Primary Antenna THV-9A12/CPR 04 $312,299.74 $308,840.04 $286,036.74
High VHF - High Power Top Mount One Station elliptically or circularly polarized $243,400.00 $243,400.00 antenna cost per attached Dielectric quote $243,400.00 N/A
Shipping $11,818.78 $11,818.78 antenna shipping per invoices SO: $7180.00 854010: $923.14 852001: $2904.95+810.69=$3,715.64 $8,809.48 N/A
Feed through components $15,053.00 $15,053.00 REQUIRED 6-75 ELBOWS, CUT LENGTHS AND HANGERS TO ROUTE LINE FROM ANTENNA INPUT THROUGH SUPPORT STRUCTURE - see quote $15,053.00 N/A
Antenna Obstruction Light $2,342.96 $2,342.96 Obstruction lighting needed for antenna $2,342.96 N/A
Additional components $861.00 $861.00 per Dielectric invoice $861.00 N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $6,585.00 see quote $6,585.00 N/A
Sales Tax $19,794.00 $19,794.00 estimated antenna sales tax based on Maryland state and local sales tax rate of 6% N/A N/A
Sweep test of existing antenna $6,730.00 $8,985.30 sweep of existing antenna/line (Chuck Britt) $2,585.30 plus sweep of new antenna and existing line (Dielectric) $6,400 $8,985.30 N/A
Auxiliary Antenna TLS-V4 $93,798.87 $79,350.17 $68,859.11
Additional RF components $9,628.87 $9,628.87 required RF components Items 4-8 on attached Dielectric quote $995.93 N/A
Shipping $1,693.00 $1,693.00 shipping per attached Dielectric quote $0.00 N/A
Sales Tax $3,737.00 $3,737.00 estimated antenna sales tax based on Maryland state and local sales tax rate of 6% N/A N/A
Side mount brackets for high power antennas (if not included in antenna base cost) $23,150.00 $7,762.00 N/A $0.00 N/A
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed) $12,300.00 $10,984.00 N/A $0.00 N/A
Sweep test of existing antenna $6,730.00 $8,985.30 sweep of existing antenna/line plus sweep of new antenna $8,985.30 N/A
High VHF - High Power Side Mount One Station horizontally polarized $36,560.00 $36,560.00 antenna price per attached Dielectric quote $58,877.88 Progress payments - accessories not itemized

Components

Actual Information Description File Name
High VHF - High Power Top Mount One Station elliptically or circularly polarized

Component Description:
WBAL invoice distribution for main antenna
Amount:
$1,940.30

Component Description:
WBAL main antenna payment 2
Amount:
$109,530.00

Component Description:
WBAL main antenna partial
Amount:
$6,551.60

Component Description:
Dielectric WBAL Main Antenna, progress payments 1&2 - 45%. This contains an upgrade. Reimbursement request less upgrade cost.
Amount:
$125,378.10
Shipping

Component Description:
WBAL main antenna CO shipping and additional invoice distribution
Amount:
$1,862.84

Component Description:
WBAL main antenna shipping 2
Amount:
$3,715.64

Component Description:
WBAL shipping
Amount:
$3,231.00
Feed through components

Component Description:
WBAL main antenna feed through components
Amount:
$6,773.85

Component Description:
WBAL main antenna feed through components
Amount:
$8,279.15
Antenna Obstruction Light

Component Description:
WBAL Antenna Obstruction Light - main antenna
Amount:
$2,342.96
Additional components

Component Description:
WBAL main antenna custom TL 1
Amount:
$861.00
Elbow complex, single channel, at antenna input, per 6 1/8. feedline (if needed)

Component Description:
WBAL elbow complex
Amount:
$2,963.25

Component Description:
WBAL main antenna elbow complex
Amount:
$3,621.75
Sales Tax Information not provided.
Sweep test of existing antenna

Component Description:
WBAL invoice distribution for main antenna sweep
Amount:
$3,520.00

Component Description:
WBAL sweep test new main antenna
Amount:
$2,880.00

Component Description:
WBAL sweep of main line and antenna
Amount:
$2,585.30
Additional RF components

Component Description:
WBAL custom TL 1 shipping
Amount:
$584.44

Component Description:
WBAL custom TL 1
Amount:
$411.49
Shipping Information not provided.
Sales Tax 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

Component Description:
WBAL replacement aux antenna sweep
Amount:
$6,400.00

Component Description:
WBAL sweep of auxiliary line and antenna
Amount:
$2,585.30
High VHF - High Power Side Mount One Station horizontally polarized

Component Description:
WBAL Dielectric Auxiliary Antenna; payment 3 - 45% 10.5.2017; $29,438.94
Amount:
$29,438.94

Component Description:
WBAL Dielectric Auxiliary Antenna; payments 1&2 - 45% 9.29.2017; $29,438.94
Amount:
$29,438.94

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 $37,164.75 $37,164.75 N/A $37,164.75 N/A
Total for all systems $3,411,425.85 $3,019,570.89 N/A $2,804,700.25 N/A
Primary Transmission Line $37,164.75 $37,164.75 $37,164.75
Miscellaneous TL parts $37,164.75 $37,164.75 replace frequency specific components, add impedance matching devices and misc components $37,164.75 N/A
Auxiliary Transmission Line $0.00 $0.00 $0.00
RF Components $0.00 $0.00 transmission line components for transmitter room connection to transmitter and refurbish transmission line $0.00 Quote did not include shipping which was added to invoice.

Components

Actual Information Description File Name
Miscellaneous TL parts

Component Description:
WBAL Dielectric transmission line components; payments 1&2 - 45%
Amount:
$17,815.95

Component Description:
WBAL Dielectric transmission line components; final payment
Amount:
$19,348.80
RF Components

Component Description:
Station reimbursed for non- reimbursable expense (transmission line refurbish)
Amount:
($52,600.50)

Component Description:
WBAL RF components for transmission line refurbishing
Amount:
$52,600.50

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 $2,162,288.48 $1,785,339.81 N/A $1,783,089.81 N/A
Total for all systems $3,411,425.85 $3,019,570.89 N/A $2,804,700.25 N/A
Primary Tower GTOWER $2,162,288.48 $1,785,339.81 $1,783,089.81
Minor tower reinforcement/modifications $158,000.00 $34,633.33 per attached quotes and invoices $34,633.33 N/A
Tower Consulting $16,226.24 $16,226.24 tower consulting per invoices $16,076.24 Complex tower shared by three stations.
Gin Pole Prep $91,176.00 $91,176.00 per attached quote $91,176.00 N/A
Structural engineering tower load study for well documented tower $12,600.00 $25,000.00 Complex candelabra tower requiring custom antenna pedestals. Turns out this tower wasn't as well documented as originally thought. $22,900.00 N/A
Complex Tower (includes, for example, those with candelabras and/or stacked antennas) $421,000.00 $155,018.00 per attached quote and invoices for auxiliary antenna installation less transmission line refurbishing $155,018.00 N/A
Tower Helicopter Lift $1,463,286.24 $1,463,286.24 per attached revised Tower Services Agreement for main antenna replacement "CTC Hearst WBAL Tower Services Agreement HTS Helo V4.pdf". Revised due to helicopter vendor change and change order $1,463,286.24 N/A

Components

Actual Information Description File Name
Minor tower reinforcement/modifications

Component Description:
WBAL tower post-modification inspection
Amount:
$2,833.33

Component Description:
WBAL tower mods completion
Amount:
$21,800.00

Component Description:
WBAL tower mods 1
Amount:
$10,000.00
Tower Consulting

Component Description:
WBAL tower consulting September and October 2018
Amount:
$150.00

Component Description:
WBAL tower consulting 2
Amount:
$550.00

Component Description:
WBAL tower consulting March 2019
Amount:
$1,954.68

Component Description:
WBAL tower consulting Oct 2018
Amount:
$150.00

Component Description:
WBAL tower consulting Jan & Feb 2020
Amount:
$1,000.00

Component Description:
WBAL tower consulting March 2020
Amount:
$500.00

Component Description:
WBAL tower consulting January 2019
Amount:
$300.00

Component Description:
WBAL tower consulting Dec 2018
Amount:
$300.00

Component Description:
WBAL tower consulting 3
Amount:
$150.00

Component Description:
WBAL tower consulting September 2019
Amount:
$300.00

Component Description:
WBAL tower consultant on-site visit
Amount:
$220.90

Component Description:
WBAL tower consulting - construction permit
Amount:
$5,265.66

Component Description:
WBAL tower consulting July 2019
Amount:
$200.00

Component Description:
WBAL tower consulting May 2018
Amount:
$300.00

Component Description:
WBAL tower consulting August 2019
Amount:
$200.00

Component Description:
WBAL tower consulting 1
Amount:
$4,535.00

Component Description:
WBAL tower consulting Sept 2018
Amount:
$150.00
Gin Pole Prep

Component Description:
WBAL gin pole prep 2
Amount:
$22,795.00

Component Description:
WBAL gin pole prep 1
Amount:
$45,587.00

Component Description:
WBAL gin pole prep 3
Amount:
$22,794.00
Structural engineering tower load study for well documented tower

Component Description:
WBAL updated structural analysis and antenna pedestal design
Amount:
$2,000.00

Component Description:
WBAL special mount design rev
Amount:
$2,500.00

Component Description:
WBAL tower structural analysis
Amount:
$1,500.00

Component Description:
WBAL tower structural analysis
Amount:
$3,000.00

Component Description:
WBAL tower structural analysis
Amount:
$1,200.00

Component Description:
WBAL tower structural analysis
Amount:
$4,000.00

Component Description:
WBAL design structural modifications
Amount:
$6,700.00

Component Description:
WBAL limited tower mapping
Amount:
$2,000.00
Complex Tower (includes, for example, those with candelabras and/or stacked antennas)

Component Description:
WBAL auxiliary antenna replacement change order
Amount:
$1,425.00

Component Description:
WBAL CTC Aux antenna installation down payment
Amount:
$74,642.00

Component Description:
WBAL auxiliary antenna replacement completion
Amount:
$27,724.00

Component Description:
WBAL auxiliary antenna replacement progress payment 1 rev
Amount:
$51,227.00
Tower Helicopter Lift

Component Description:
WBAL main antenna replacement 1
Amount:
$481,000.00

Component Description:
WBAL main antenna replacement 4
Amount:
$300,000.00

Component Description:
WBAL main antenna replacement 2
Amount:
$135,675.00

Component Description:
WBAL main antenna replacement 3
Amount:
$300,000.00

Component Description:
WBAL main antenna replacement completion
Amount:
$64,500.00

Component Description:
WBAL main antenna replacement change order
Amount:
$32,111.24

Component Description:
WBAL main antenna replacement 4
Amount:
$150,000.00

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 $104,465.00 $113,606.91 N/A $58,980.51 N/A
Total for all systems $3,411,425.85 $3,019,570.89 N/A $2,804,700.25 N/A
Outside Professional Services $104,465.00 $113,606.91 $58,980.51
Attorney Fees - Negotiation of lease and other matters for shared locations $4,210.00 $17,831.91 pro rata cost for negotiations for use of parking lot as helicopter landing zone and other joint legal issues. Costs shared between the three TTI Stations $17,831.91 N/A
Transmitter Site Survey $20,600.00 $20,600.00 Transmitter planning survey & transmitter building drawings per attached GatesAir quote $20,600.00 N/A
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 $12,009.52 N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization $3,680.00 $3,500.00 N/A N/A N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application $2,365.00 $2,250.00 N/A N/A N/A
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application $4,210.00 $4,000.00 N/A N/A N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application $5,260.00 $5,000.00 N/A $2,110.52 N/A
Prepare request for Special Temporary Authorization $2,050.00 $1,500.00 N/A N/A N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application $1,580.00 $425.00 N/A $425.00 N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application $1,580.00 $1,500.00 N/A $450.00 N/A
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application $2,105.00 $2,000.00 N/A $775.00 N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application $3,155.00 $3,000.00 N/A $1,950.00 N/A
Perform engineering study for new channel assignment and antenna development $7,360.00 $7,000.00 N/A $987.50 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
RF Exposure Measurements $21,050.00 $20,000.00 N/A N/A N/A
Prepare and or review reimbursement form $2,630.00 $2,500.00 N/A $1,841.06 N/A

Components

Actual Information Description File Name
Attorney Fees - Negotiation of lease and other matters for shared locations

Component Description:
WBAL TTI legal 8
Amount:
$244.33

Component Description:
WBAL TTI legal 6
Amount:
$150.00

Component Description:
WBAL TTI legal 7
Amount:
$175.66

Component Description:
WBAL TTI legal 4
Amount:
$1,694.66

Component Description:
WBAL TTI legal 3
Amount:
$855.00

Component Description:
WBAL TTI legal 5
Amount:
$6,516.33

Component Description:
WBAL TTI legal 2
Amount:
$2,968.50

Component Description:
WBAL TTI legal 1
Amount:
$5,227.43
Transmitter Site Survey

Component Description:
WBAL transmitter site survey
Amount:
$20,600.00
Non-Catalog legal expenses

Component Description:
WBAL non-catalog legal 3
Amount:
$1,081.00

Component Description:
WBAL non-catalog legal 1
Amount:
$3,235.90

Component Description:
WBAL non-catalog legal 5
Amount:
$564.00

Component Description:
WBAL non-catalog legal 4
Amount:
$3,438.60

Component Description:
WBAL non-catalog legal 2
Amount:
$3,690.02
Attorney Fees - Prepare and File request for Special Temporary Authorization Information not provided.
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application Information not provided.
Attorney Fees - Aux Antenna, prepare and File Form 2100 Construction Permit or License Application Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application

Component Description:
WBAL Prepare and File FCC Form 2100, Construction Permit Application
Amount:
$1,054.52

Component Description:
WBAL Prepare and File FCC Form 2100, Construction Permit Application
Amount:
$1,056.00
Prepare request for Special Temporary Authorization Information not provided.
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, License to Cover Application

Component Description:
WBAL RF consulting auxiliary antenna license to cover
Amount:
$425.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application

Component Description:
WBAL RF consulting main antenna license to cover
Amount:
$450.00
RF Consulting Engineer Fees- Aux Antenna: Prepare engineering section of FCC Form 2100, Construction Permit Application

Component Description:
WBAL RF consulting for auxiliary antenna construction permit
Amount:
$775.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application

Component Description:
WBAL CP engineering prep
Amount:
$1,950.00
Perform engineering study for new channel assignment and antenna development

Component Description:
WBAL CP engineering study
Amount:
$675.00

Component Description:
WBAL RF consulting antenna dev
Amount:
$312.50
Address transition timing and coordination issues w/ other stations and wireless Information not provided.
RF Exposure Measurements Information not provided.
Prepare and or review reimbursement form

Component Description:
WBAL Prepare and/or review reimbursement Form 399 3
Amount:
$94.00

Component Description:
WBAL Prepare and/or review reimbursement Form 399 4
Amount:
$94.00

Component Description:
WBAL Prepare and/or review reimbursement Form 399
Amount:
$1,353.00

Component Description:
WBAL Prepare and/or review reimbursement Form 399
Amount:
$300.06

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 $264,495.05 $258,855.25 N/A $166,615.74 N/A
Total for all systems $3,411,425.85 $3,019,570.89 N/A $2,804,700.25 N/A
Other Expenses $264,495.05 $258,855.25 $166,615.74
Liability Insurance $10,653.60 $10,653.60 WBAL portion liability insurance per invoices $10,653.60 N/A
Remote location rental $21,677.00 $21,677.00 Remote facility rental to house WBAL operations during the required studio evacuation. The helicopter activity needed for the antenna changes on the shared TTI tower required studio evacuation. $21,677.00 N/A
in-house labor $5,709.60 $5,709.60 in-house labor directly related to station's repack $5,709.60 N/A
Tree Removal $4,000.00 $4,000.00 per attached tree removal quote $4,000.00 N/A
Traffic Coord - Scaffold Install $762.75 $762.75 Pro rata cost for traffic control during installation of protective scaffolding above roadway near tower. Please see attached quote. $762.75 N/A
Security Trailer Rental $669.13 $669.13 Pro rata cost for guard trailer to receive packages, restrict traffic to WJZTV and coordinate vendor access to the WJZTV building while the ZOI is enacted for the gin pole. Please see attached quote. N/A N/A
Remove Reinstall Light Pole $0.00 $0.00 N/A N/A N/A
Protective Scaffolding $118,166.66 $118,166.66 Pro rata cost for scaffolding protection within the ZOI over Pathway 2 (Area 1) and the WJZTV roadway (Area 2) Required during the Initial and Gin Pole phases. Please see attached quote $59,333.33 N/A
Construct Pathway 2 and Fence $12,683.33 $12,683.33 Pro rata cost to construct ATV Pathway 2, including delivery, installation, pickup and removal of mats as well as removal and re-installation of fencing. Please see attached quote. N/A N/A
Construct Pathway 1 and Stairs $18,804.00 $18,804.00 Pro rata cost for pathway through the southwest woods suitable for ATV to shuttle employees. Also includes stairway construction to quickly evacuate property. See attached quote. $18,804.00 N/A
Additional Security Guard $8,058.72 $8,058.72 Pro rata cost for an additional security guard plus sales tax) required to restrict traffic to the WJZ TV access road while the gin pole is used. Please see attached quote. N/A N/A
MVPD Notification of Channel Change $8,220.80 $8,220.80 per DTV Notification invoices $8,220.80 N/A
Develop and air announcement of upcoming channel change $2,500.00 $2,500.00 Attorney review to ensure FCC compliance N/A N/A
Equipment Storage $27,690.00 $27,690.00 antenna storage cost per Dielectric invoice $27,690.00 N/A
Disposal Costs (for equipment and other waste, net of any salvage value) $7,500.00 $7,500.00 need quote N/A N/A
FCC Filing Fees - Special Temporary Authorization request $195.00 $600.00 per receipts N/A N/A
FCC Filing Fees - Form 2100 license to cover application $335.00 $325.00 N/A N/A N/A
FCC Filing Fees - Form 2100 minor change CP application $1,110.00 $1,070.00 N/A N/A N/A
DTV Medical Facility Notification $11,550.00 $5,555.20 N/A $5,555.20 N/A
Contract Labor $4,209.46 $4,209.46 accounting labor directly related to the Spectrum Repack project $4,209.46 N/A

Components

Actual Information Description File Name
Liability Insurance

Component Description:
WBAL portion of TTI liability insurance 2
Amount:
$3,820.27

Component Description:
WBAL portion of TTI liability insurance
Amount:
$6,833.33
Remote location rental

Component Description:
WBAL remote facility rental
Amount:
$21,677.00
in-house labor

Component Description:
WBAL in-house accounting labor 1
Amount:
$5,709.60
Tree Removal

Component Description:
WBAL tree removal
Amount:
$4,000.00
Traffic Coord - Scaffold Install

Component Description:
WBAL one-third portion for guard services needed during scaffolding installation
Amount:
$762.75
Security Trailer Rental Information not provided.
Remove Reinstall Light Pole Information not provided.
Protective Scaffolding

Component Description:
WBAL safety scaffolding 1
Amount:
$59,333.33
Construct Pathway 2 and Fence Information not provided.
Construct Pathway 1 and Stairs

Component Description:
WBAL concrete safety services 1
Amount:
$9,402.00

Component Description:
WBAL concrete safety services 2
Amount:
$9,402.00
Additional Security Guard Information not provided.
MVPD Notification of Channel Change

Component Description:
WBAL MVPD notification
Amount:
$4,110.40

Component Description:
WBAL MVPD re-notification due to transition date change
Amount:
$4,110.40
Develop and air announcement of upcoming channel change Information not provided.
Equipment Storage

Component Description:
WBAL main antenna storage
Amount:
$27,690.00
Disposal Costs (for equipment and other waste, net of any salvage value) Information not provided.
FCC Filing Fees - Special Temporary Authorization request Information not provided.
FCC Filing Fees - Form 2100 license to cover application Information not provided.
FCC Filing Fees - Form 2100 minor change CP application Information not provided.
DTV Medical Facility Notification

Component Description:
WBAL medical notification
Amount:
$5,555.20
Contract Labor

Component Description:
WBAL accounting labor
Amount:
$4,209.46

Cost Information

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Grand Total

Predetermined
Cost Estimate
Estimated Cost Actual Cost
Total for all systems $3,411,425.85 $3,019,570.89 $2,804,700.25

Reimbursement Status

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Question Response
The facility has ceased operating on its pre-auction channel. Yes
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


09/21/2020

Certification

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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).

  1. 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.

  2. The above-named entity certifies that the statements in this form and attached documentation are true, complete, and correct.

  3. The above-named entity acknowledges that all certifications and attached documentation are considered material representations.

  4. The above-named entity acknowledges the submission of the information herein creates no obligation on the part of the government to pay any amount.

  5. 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) .

  6. 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.

  7. The above-named entity certifies that the cost information/documents submitted reflect costs actually incurred.

  8. The above-named entity acknowledges that overpayments or payments in error must be promptly refunded to the Commission.

  9. 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


09/21/2020

Attachments

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