TV Broadcaster Relocation Fund Reimbursement Application

Applicant Information

Applicant Name, Type, and Contact Information

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

Applicant

Address

Phone

Applicant Type

Hearst Properties 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

Auxiliary Transmitter

Add Transmitter Information

Section	Question	Response
Existing Transmitter Description	Type of change	Purchase New
	Use	Auxiliary (Backup)
	Description of Use	backup to main 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	Sigma CD3100P1
	Year	2001
	Type	Inductive Output Tube
	IOT Power Type	Single
	Power Capacity	25 kW

Auxiliary Transmitter

New Transmitter Costs

Section	Question	Response
New Transmitter	Use	Auxiliary (Backup)
	Change Type	Purchase New
	Is this a request for upgraded equipment?	Yes
	Manufacturer
	Model	ULXTE-30
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	19.2 kW
	Justification for New Transmitter	Existing IOT transmitter cannot be converted to ch 14. See GatesAir EOL and HTV IOT to Solid-State Justification. IOT replacement is more costly than proposed SS transmitter. See Comark Transmitter quote. Also see Transmitter Justification.

Auxiliary 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	150 kVA
	Rigid Conduit and Wiring	No
	Size	N/A
	Length	N/A
	Other Electrical Service	Yes
	Description	Electrical installation of aux transmitter
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

Other Transmitter Cost Not Listed

Name	Description
Change Order Q-77786	Added two transmission line elbows
Transmitter de-install	removal and disposal of old transmitter
Change Order Q-79567	Added RF components needed to complete installation
Installation and Proof	transmitter installation and proof
Change Order Q-78969	Added needed installation hardware
Sales Tax	transmitter sales tax
Transmitter installation incidentals	Additional equipment, parts and supplies needed for transmitter installation
Additional RF components	Additional RF components required for transmitter operation and integration into current RF environment
Shipping	transmitter shipping
Electrical Accessories	manufacturer required surge protection
Change Order Q-62164	Added transmission line impedance transformer

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 CD3100P1
	Year	2006
	Type	Inductive Output Tube
	IOT Power Type	Single
	Power Capacity	25 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-30
	Transmitter Type	Solid State
	Solid State Cooling	Liquid Cooled
	Solid State Power capacity	19.2 kW
	Justification for New Transmitter	Existing IOT transmitter cannot be converted to ch 14. See GatesAir EOL and HTV IOT to Solid-State Justification. IOT replacement is more costly than proposed SS transmitter. See Comark Transmitter quote. Also see Transmitter Justification.

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	150 kVA
	Rigid Conduit and Wiring	No
	Size	N/A
	Length	N/A
	Other Electrical Service	Yes
	Description	transmitter electrical installation
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	90

Primary Transmitter

Other Transmitter Cost Not Listed

Name	Description
Change Order Q-76080	additional transmitter equipment and services
Land Mobile Interference Compensation	replace LM channel rendered unusable by WLKY's move to ch 14
Electrical Accessories	manufacturer required surge protection
Transmitter installation incidentals	items needed to complete transmitter installation
Additional Services	GatesAir services needed for to complete transmitter configuration and integration
Heat Exchanger Filters	filters to prevent heat exchanger airflow blockage
Remote Control	RC components needed to integrate new transmitters
Additional RF components	Additional RF components required for transmitter operation and integration into current RF environment
Shipping	transmitter shipping
Transmitter de-install	needed to make space for replacement transmitter
Ch 14 Land-Mobile Interference Mitigation	Cost associated with eliminating land-mobile interference caused by channel 14
Sales Tax	transmitter sales tax

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	Leased
	Owner	Raycom Media
	Site	N/A
	Is the existing antenna shared with another station or stations?	Yes
	Is the existing antenna directional?	Yes
	Is antenna in operating condition?	Yes
	Is antenna located on or in close proximity to an antenna farm?	No
Existing Antenna Manufacturer and Type	Class	Full Power
	Mounting	Top Mount
	Antenna position in stack	Not in Stack
	Polarization	Horizontal
	Type	Broadband Panel
	Number of Stations Supported	2
	Number of Panels	51
	Design power capacity in use	50.0 %
	Lower Limit	545.00 MHz
	Upper Limit	695.00 MHz
	Other Antenna Type	N/A
	ERP:	1000.0 kW
	Manufacturer
	Model	ABBP14H4-HTOC5-26/51
	Year	2003

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

Facility ID	Call Sign
13989	WAVE

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	Leased
	Owner	Raycom Media
	Is antenna shared?	Yes
	Is antenna directional?	Yes
	Will antenna be located on or in close proximity to an antenna farm?	No
New Antenna Manufacturer and Types	Class	Full Power
	Mounting	Top Mount
	Antenna position in stack	Not in Stack
	Polarization	Horizontal
	Type	Broadband Panel
	Number of Stations Supported	2
	Number of Panels/Bays	14
	Lower Limit	470.00 MHz
	Upper Limit	608.00 MHz
	Design power capacity in use	50.0 %
	Other Antenna Type	N/A
	ERP:	452.0 kW
	Manufacturer
	Model	TUD-C5-14/70-2-T
	Year	2019
	Justification for New Antenna	Existing antenna does not support channel 14

Primary Antenna

Other Antenna Costs

Section	Question	Response
Combiner for Shared Antenna	Do you need a Combiner for a Shared Antenna?	Yes
	Type	New
	Number of channels supported	2
	Frequencies of channels supported	RF channel
	Frequency	N/A
	Do you need a combiner output splitter/switcher for dual feed lines?	Yes
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 a high power antenna?	No
Pattern Scatter Analysis	Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna?	No
Sweep Test	Do you require the sweep testing of transmission line and antenna?	Yes

Enter a list of RF channel numbers.

RF Channel Number
36
14

Primary Antenna

Other Antenna Cost Not Listed

Information not provided.

Interim Antenna

New Antenna Costs

Section	Question	Response
New Antenna Description	Use	Interim
	Description of Use	N/A
	Change Type	Purchase New
	Ownership	Leased
	Owner	Raycom Media
	Is antenna shared?	Yes
	Is antenna directional?	Yes
	Will antenna be located on or in close proximity to an antenna farm?	No
New Antenna Manufacturer and Type	Class	Full Power
	Mounting	Side Mount
	Antenna position in stack	Not in Stack
	Polarization	Horizontal
	Type	Broadband Slot
	Number of Stations Supported	2
	Number of Panels/Bays	24
	Lower Limit	470.00 MHz
	Upper Limit	680.00 MHz
	Design power capacity in use	100.0 %
	Other Antenna Type	N/A
	ERP:	452.0 kW
	Manufacturer
	Model	TFU-WB24
	Year	2018
	Justification for New Antenna	required while main antenna is replaced

Interim Antenna

Other Antenna Costs

Section	Question	Response
Combiner for Shared Antenna	Do you need a Combiner for a Shared Antenna?	No
	Type
	Number of channels supported	N/A
	Frequencies of channels supported	N/A
	Frequency	N/A
	Do you need a combiner output splitter/switcher for dual feed lines?	N/A
Elbow Complex	Do you require the separate purchase of the Elbow Complex?	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?	No
Pattern Scatter Analysis	Do you require separate purchase of pattern scatter analysis for a side mount high or medium power antenna?	No
Sweep Test	Do you require the sweep testing of transmission line and antenna?	Yes

Interim Antenna

Other Antenna Cost Not Listed

Information not provided.

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?	Yes
	Is Transmission Line in operating condition?	Yes
Existing Transmission Line Manufacturer and Type	Manufacturer	Andrew
	Type	Rigid
	Diameter	7 3/16 inches
	Other Diameter	N/A
	Segment Length	Broadband
	Other Segment Length	N/A
	Number of parallel runs	2
	Length	1000 feet per run

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

Facility ID	Call Sign
13989	WAVE

Primary Transmission Line

Other Transmission Line Expenses Not Listed

Information not provided.

Interim Transmission Line

New Transmission Line

Section	Question	Response
New Transmission Line Costs	Use	Interim
	Description of Use	N/A
	Change Type	Lease New
	Type	Rigid
	Diameter	6 1/8 inches
	Segment Length	Broadband
	Other Segment Length
	Number of parallel runs	1
	Length	950 feet per run
	Justification for New Transmission Line	Interim during main antenna replacement

Interim Transmission Line

Other Transmission Line Expenses Not Listed

Information not provided.

Tower Equipment And Rigging Costs

Section	Question	Response
Tower Equipment or Rigging Costs Changes	Do you have tower equipment or rigging costs changes?	No

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	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	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	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	Yes
	RF exposure measurements	No
	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
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
Prepare engineering for Program Test Authority Application	Prepare engineering for Program Test Authority Application

Other Expenses

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

Other Expenses

Other Expenses Not Listed

Name	Description
Contract Labor	labor directly related to the station channel change
Land Mobile Notification	notify land mobile users of the coming channel 14 signal
in-house labor	in-house labor directly related to station's repack

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	$2,287,320.13	$1,857,231.32	N/A	$1,689,607.72	N/A
Total for all systems	$3,517,325.86	$2,028,088.77	N/A	$1,857,020.61	N/A
Primary Transmitter ULXTE-30	$1,124,504.59	$940,011.73		$772,388.13
Ch 14 Land-Mobile Interference Mitigation	$140,000.00	$140,000.00	See "Floyds Knobs Repeater Units - Reprogram Estimate Worksheet.pdf" and channel 14 filters invoices	$24,846.40	N/A
Transmitter de-install	$33,579.03	$33,579.03	current transmitter removal required to make space for replacement and removal of old RF system post-transition	$33,579.03	N/A
Additional RF components	$764.50	$764.50	GPS antennas - exciter accuracy to reduce potential of land-mobile interference	$764.50	N/A
Remote Control	$2,064.00	$2,064.00	per invoice	$2,064.00	N/A
Additional Services	$12,894.00	$12,894.00	Services required to complete transmitter configuration and integration.	$12,894.00	N/A
Transmitter installation incidentals	$4,062.16	$4,062.16	items needed to complete transmitter installation	$4,062.16	N/A
Electrical Accessories	$1,942.49	$1,942.49	manufacturer required surge protection	$1,942.49	N/A
Channel 14 -- Additional field engineering time, 90 days	$78,239.34	$78,239.34	per invoices	$78,239.34	N/A
RF Consulting Engineer	$5,260.00	$9,817.50	Channel 14 interference investigation and remediation. Many land-mobile users and great difficulty in remediating to eliminate interference.	$9,817.50	N/A
Other Electrical Service: transmitter electrical installation	$8,351.16	$8,351.16	N/A	$8,351.16	N/A
Transformer 3 phase/480v - 150 KVA	$25,550.00	$5,222.93	N/A	$5,222.93	N/A
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW	$684,000.00	$515,276.71	per GatesAir invoices This is the transmitter, mask filter, installation and proof	$515,276.71	N/A
Heat Exchanger Filters	$6,110.00	$6,110.00	transmitter heat exchanger filters to prevent transmitter overheating	$6,110.00	N/A
Shipping	$7,700.00	$7,700.00	transmitter shipping per attached GatesAir quote	$7,700.00	N/A
Sales Tax	$33,645.15	$33,645.15	transmitter and related sales tax per invoices	$33,645.15	N/A
Land Mobile Interference Compensation	$52,470.00	$52,470.00	Per attached invoice. Cost to replace Land Mobile channel lost due to move to channel 14. See "Davis Electronics Channel Replacement.pdf" for full explanation.	$0.00	N/A
Change Order Q-76080	$27,872.76	$27,872.76	per change order	$27,872.76	N/A
Auxiliary Transmitter ULXTE-30	$1,162,815.54	$917,219.59		$917,219.59
Change Order Q-62164	$5,231.64	$5,231.64	transmission line impedance transformer	$5,231.64	N/A
Electrical Accessories	$1,510.82	$1,510.82	manufacturer required surge protection	$1,510.82	N/A
Shipping	$13,222.51	$13,222.51	transmitter shipping per attached GatesAir quote	$13,222.51	N/A
Additional RF components	$99,869.34	$99,869.34	Additional RF components required for transmitter operation and integration into current RF environment per GatesAir quote.	$99,869.34	N/A
Transmitter installation incidentals	$6,252.89	$6,252.89	Additional equipment, parts and supplies needed for transmitter installation	$6,252.89	N/A
Sales Tax	$45,868.81	$45,868.81	transmitter sales tax	$45,868.81	N/A
Installation and Proof	$41,960.00	$41,960.00	see quote	$41,960.00	N/A
Transmitter de-install	$1,000.54	$1,000.54	removal and disposal of old transmitter to make space for repack transmitter	$1,000.54	N/A
Change Order Q-77786	$3,272.72	$3,272.72	two transmission line elbows	$3,272.72	N/A
Channel 14 Mask Filter	$189,500.00	$154,371.62	N/A	$154,371.62	N/A
Other Electrical Service: Electrical installation of aux transmitter	$32,013.84	$32,013.84	aux transmitter electrical installation	$32,013.84	N/A
Transformer 3 phase/480v - 150 KVA	$25,550.00	$2,798.21	N/A	$2,798.21	N/A
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW	$684,000.00	$501,544.22	per GatesAir invoices Transmitter, mask filter, installation and proof	$501,544.22	1
Change Order Q-78969	$681.72	$681.72	Additional installation hardware	$681.72	N/A
Change Order Q-79567	$7,620.71	$7,620.71	additional RF components; see invoice/change order	$7,620.71	N/A
RF Consulting Engineer	$5,260.00	$0.00	N/A	N/A	N/A

Components

Actual Information Description	File Name
Ch 14 Land-Mobile Interference Mitigation	Component Description: WLKY land-mobile interference filter 2 Amount: $10,100.00 Component Description: WLKY land-mobile interference filter 1 Amount: $10,100.00 Component Description: WLKY land-mobile interference filter 2 tax Amount: $606.00 Component Description: WLKY land-mobile interference filter 1 tax Amount: $606.00 Component Description: WLKY land-mobile filter shipping and handling sales tax Amount: $194.40 Component Description: WLKY land-mobile filters shipping Amount: $3,240.00
Transmitter de-install	Component Description: WLKY old RF system removal after Phase 6 completion Amount: $12,900.00 Component Description: WLKY main transmitter de-install Amount: $20,679.03
Additional RF components	Component Description: WLKY exciter GPS antennas Amount: $764.50
Remote Control	Component Description: WLKY remote control equipment rev Amount: $2,064.00
Additional Services	Component Description: WLKY additional transmitter services 1 Amount: $12,894.00
Transmitter installation incidentals	Component Description: WLKY main transmitter installation lift rentals Amount: $3,873.27 Component Description: WLKY water for cooling system flush Amount: $65.30 Component Description: WLKY rental equipment fuel Amount: $123.59
Electrical Accessories	Component Description: WLKY main transmitter surge suppressor Amount: $1,942.49
Channel 14 -- Additional field engineering time, 90 days	Component Description: WKLY land-mobile interference mitigation 9 Amount: $2,645.00 Component Description: WKLY land-mobile interference mitigation 7 rev Amount: $11,198.57 Component Description: WKLY land-mobile interference mitigation 6 Amount: $5,697.50 Component Description: WKLY land-mobile interference mitigation 3 Amount: $8,413.75 Component Description: WKLY land-mobile interference mitigation 4 Amount: $25,730.84 Component Description: WKLY land-mobile interference mitigation 2 Amount: $9,155.68 Component Description: WKLY land-mobile interference mitigation 5 Amount: $6,360.00 Component Description: WLKY land-mobile interference mitigation 1 Amount: $6,360.00 Component Description: WKLY land-mobile interference mitigation 8 Amount: $2,678.00
RF Consulting Engineer	Component Description: WLKY Preliminary Land-Mobile Analysis Amount: $3,105.00 Component Description: WLKY RF Consulting channel 14 land-mobile remediation investigation and planning - invoice Amount: $4,807.50 Component Description: WLKY RF Consulting channel 14 land-mobile remediation investigation and planning Amount: $1,905.00
Other Electrical Service: transmitter electrical installation	Component Description: WLKY main transmitter electrical installation Amount: $8,351.16
Transformer 3 phase/480v - 150 KVA	Component Description: WLKY main transmitter transformer Amount: $5,222.93
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW	Component Description: Main transmitter 1st deposit Amount: $78,095.00 Component Description: Main transmitter 2nd deposit Amount: $150,684.93 Component Description: WLKY main transmitter final proof Amount: $4,800.00 Component Description: WKLY main transmitter installation Amount: $29,158.00 Component Description: WLKY main transmitter 1/3 prior to shipment Amount: $188,731.31 Component Description: WLKY main transmitter delivery Amount: $63,807.47
Heat Exchanger Filters	Component Description: WLKY heat exchanger filters Amount: $6,110.00
Shipping	Component Description: WLKY main transmitter shipping Amount: $7,700.00
Sales Tax	Component Description: WLKY main transmitter additional sales tax Amount: $507.87 Component Description: WLKY heat exchanger filters sales tax Amount: $214.15 Component Description: WKLY main transmitter sales tax Amount: $32,923.13
Land Mobile Interference Compensation	Component Description: WLKY LM channel replacement Amount: $52,470.00
Change Order Q-76080	Component Description: WLKY GA change order Q-76080 services only Amount: $6,482.80 Component Description: WLKY GA change order Q-76080 hardware only Amount: $21,389.96
Change Order Q-62164	Component Description: WLKY aux transmitter T/L impedance transformer Amount: $5,231.64
Electrical Accessories	Component Description: WKLY aux transmitter surge suppressor Amount: $1,510.82
Shipping	Component Description: WKLY aux transmitter shipping Amount: $13,222.51
Additional RF components	Component Description: WLKY aux transmitter RF Accessories Amount: $99,869.34
Transmitter installation incidentals	Component Description: WLKY transmitter installation supplies - acetylene Amount: $53.93 Component Description: WLKY aux transmitter installation supplies Amount: $412.50 Component Description: WLKY 4 week equipment rental Amount: $3,858.45 Component Description: WLKY 1 week equipment rental Amount: $1,928.01
Sales Tax	Component Description: WKLY aux transmitter sales tax Amount: $45,868.81
Installation and Proof	Component Description: WLKY aux transmitter installation and proof Amount: $41,960.00
Transmitter de-install	Component Description: WLKY old aux transmitter glycol disposal Amount: $1,000.54
Change Order Q-77786	Component Description: WLKY aux transmitter two T/L elbows Amount: $3,272.72
Channel 14 Mask Filter	Component Description: WLKY channel 14 mask filter Amount: $154,371.62
Other Electrical Service: Electrical installation of aux transmitter	Component Description: WLKY aux transmitter electrical installation Amount: $32,013.84
Transformer 3 phase/480v - 150 KVA	Component Description: WLKY aux transmitter 480v transformer Amount: $2,798.21
UHF - Liquid Cooled Solid State Transmitter 14.2 - 20 kW	Component Description: Aux transmitter 2nd deposit Amount: $150,684.93 Component Description: WLKY aux transmitter final proof Amount: $4,800.00 Component Description: WLKY aux transmitter 1/3 prior to ship Amount: $265,751.40 Component Description: Aux transmitter 1st deposit Amount: $69,596.80 Component Description: WKLY aux transmitter Amount: $10,711.09
Change Order Q-78969	Component Description: WLKY aux transmitter additional installation parts Amount: $681.72
Change Order Q-79567	Component Description: WLKY aux transmitter change order Q-79567 Amount: $7,620.71
RF Consulting Engineer	Information not provided.

Cost Information

Antennas

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$770,660.00	$0.00	N/A	$0.00	N/A
Total for all systems	$3,517,325.86	$2,028,088.77	N/A	$1,857,020.61	N/A
Interim Antenna TFU-WB24	$6,730.00	$0.00		$0.00
Sweep test of existing antenna	$6,730.00	$0.00	WAVE/Raycom Media submitting for reimbursement	N/A	N/A
UHF - High Power, Side Mount, basic slot antenna, 24 bay,, 452 kW input, directional,, horizontally polarized	$0.00	$0.00	WAVE (Raycom Media) Quote and "TFU-24WB interim antenna justification" attached. Raycom submitting for full reimbursement.	N/A	N/A
Primary Antenna TUD-C5-14/70-2-T	$763,930.00	$0.00		$0.00
UHF - High Power Top Mount (200-1000 kW), Two Station broadband panel antenna, horizontally polarized	$547,000.00	$0.00	WAVE/Raycom Media submitting for full reimbursement	N/A	N/A
Combiner output splitting/switching for dual feed lines, if applicable	$126,000.00	$0.00	WAVE/Raycom Media submitting for full reimbursement	N/A	N/A
New combiner, cost per channel (without antenna)	$84,200.00	$0.00	WAVE/Raycom Media submitting for full reimbursement	N/A	N/A
Sweep test of existing antenna	$6,730.00	$0.00	WAVE/Raycom Media submitting for full reimbursement	N/A	N/A

Components

Information not provided.

Cost Information

Transmission Line

Where no predetermined cost estimate is available, any estimate provided will also become the predetermined cost (displayed in italics).

Description	Predetermined Cost Estimate	Estimated Cost	Estimated Cost Justification	Actual Cost	Actual Cost Justification
Sub-total	$220,400.00	$0.00	N/A	$0.00	N/A
Total for all systems	$3,517,325.86	$2,028,088.77	N/A	$1,857,020.61	N/A
Interim Transmission Line	$220,400.00	$0.00		$0.00
Rigid Transmission Line - copper, 6 1/8" broadband	$220,400.00	$0.00	WAVE/Raycom Media submitting for full reimbursement	N/A	N/A
Primary Transmission Line	$0.00	$0.00		$0.00

Components

Information not provided.

Cost Information

Tower Equipment and Rigging Costs

Information not provided.

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	$179,033.52	$118,540.24	N/A	$115,095.68	N/A
Total for all systems	$3,517,325.86	$2,028,088.77	N/A	$1,857,020.61	N/A
Outside Professional Services	$179,033.52	$118,540.24		$115,095.68
Non-Catalog legal expenses	$37,363.52	$37,363.52	Non-Catalog expenses for legal advice and services, including financial/reimbursement review, transition reporting, transition procedures, and other transition-related issues	$37,363.52	-
Prepare engineering for Program Test Authority Application	$1,950.00	$1,950.00	per invoice	$1,950.00	N/A
Transmitter Site Survey	$20,600.00	$20,600.00	Transmitter planning survey & transmitter building drawings quote attached	$20,600.00	N/A
Comprehensive coverage verification via field study, if needed	$84,200.00	$37,016.53	per quotes and invoices	$33,571.97	N/A
Attorney Fees - Prepare and File request for Special Temporary Authorization	$3,680.00	$4,151.60	per invoices	$4,151.60	N/A
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	$2,365.00	$0.00	N/A	N/A	N/A
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	$5,260.00	$3,818.63	N/A	$3,818.63	N/A
Prepare request for Special Temporary Authorization	$2,050.00	$450.00	N/A	$450.00	N/A
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	$1,580.00	$625.00	N/A	$625.00	N/A
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	$3,155.00	$1,800.00	N/A	$1,800.00	N/A
Perform engineering study for new channel assignment and antenna development	$7,360.00	$8,675.00	see invoices	$8,675.00	Increased cost due to channel 14 assignment
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	$2,089.96	N/A	$2,089.96	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
Non-Catalog legal expenses	Component Description: WLKY non-catalog legal 5 Amount: $5,816.80 Component Description: WLKY non-catalog legal 4 Amount: $6,506.00 Component Description: WLKY non-catalog legal 7 Amount: $2,913.50 Component Description: WLKY non-catalog legal 6 Amount: $797.00 Component Description: WLKY non-catalog legal 8 Amount: $157.50 Component Description: WLKY non-catalog legal 1 Amount: $8,590.70 Component Description: WLKY non-catalog legal 2 Amount: $3,690.02 Component Description: WLKY non-catalog legal 3 Amount: $8,892.00
Prepare engineering for Program Test Authority Application	Component Description: WLKY RF consulting for Program Test Authority Amount: $1,950.00
Transmitter Site Survey	Component Description: WLKY Field Service, GatesAir, 6/1/2017, $20,600 Amount: $20,600.00
Comprehensive coverage verification via field study, if needed	Component Description: WLKY signal verification 2-1 Amount: $8,815.44 Component Description: WLKY signal verification Amount: $17,916.53 Component Description: WLKY signal verification 2-2 Amount: $6,840.00
Attorney Fees - Prepare and File request for Special Temporary Authorization	Component Description: WLKY Prepare and File request for STA 3 Amount: $2,521.20 Component Description: WLKY Prepare and File request for STA 1 Amount: $132.00 Component Description: WLKY Prepare and File request for STA 2 Amount: $1,498.40
Attorney Fees -Prepare and File FCC Form 2100 (main), License to Cover Application	Information not provided.
Attorney Fees - Prepare and File FCC Form 2100 (main), Construction Permit Application	Component Description: WLKY Prepare and File FCC Form 2100, Construction Permit Application 2 Amount: $1,054.53 Component Description: WLKY Prepare and File FCC Form 2100, Construction Permit Application Amount: $2,764.10
Prepare request for Special Temporary Authorization	Component Description: WLKY engineering for STA Amount: $450.00
Prepare engineering section of FCC Form 2100 (main), License to Cover Application	Component Description: WLKY engineering license to cover 2 Amount: $375.00 Component Description: WLKY RF consulting for license to cover Amount: $250.00
Prepare engineering section of FCC Form 2100 (main), Construction Permit Application	Component Description: WLKY RF consulting - prepare engineering for CP invoice Amount: $1,800.00
Perform engineering study for new channel assignment and antenna development	Component Description: WLKY RF consulting-channel 14 issues Amount: $1,837.50 Component Description: WLKY interim antenna ch26 Amount: $625.00 Component Description: WLKY RF Consulting engineering study for new channel assignment invoice 3 Amount: $3,800.00 Component Description: WLKY RF Consulting engineering study for new channel assignment invoice 2 Amount: $687.50 Component Description: WLKY interim antenna ch14 Amount: $100.00 Component Description: WLKY RF Consulting engineering study for new channel assignment invoice 1 Amount: $1,625.00
Address transition timing and coordination issues w/ other stations and wireless	Information not provided.
Prepare and or review reimbursement form	Component Description: WLKY Prepare and/or review reimbursement Form 399 4 Amount: $141.00 Component Description: WLKY Prepare and/or review reimbursement Form 399 3 Amount: $94.00 Component Description: WLKY Prepare and/or review reimbursement Form 399 6 Amount: $262.50 Component Description: WLKY Prepare and/or review reimbursement Form 399 5 Amount: $105.00 Component Description: WLKY Prepare and/or review reimbursement Form 399 7 Amount: $105.00 Component Description: WKLY Prepare and/or review reimbursement Form 399 Amount: $1,082.40 Component Description: WLKY Prepare and/or review reimbursement Form 399 2 Amount: $300.06
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	$59,912.21	$52,317.21	N/A	$52,317.21	N/A
Total for all systems	$3,517,325.86	$2,028,088.77	N/A	$1,857,020.61	N/A
Other Expenses	$59,912.21	$52,317.21		$52,317.21
Land Mobile Notification	$9,400.00	$9,400.00	needed to fulfill FCC requirement to notify land mobile users of the potential interference from channel 14. Quote attached.	$9,400.00	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	$2,710.40	$2,710.40	per DTV Notifications invoice	$2,710.40	N/A
Develop and air announcement of upcoming channel change	$0.00	$0.00	N/A	N/A	N/A
Equipment Storage	$7,302.75	$7,302.75	Additional storage at transmitter site	$7,302.75	N/A
Disposal Costs (for equipment and other waste, net of any salvage value)	$836.36	$836.36	disposal costs	$836.36	N/A
FCC Filing Fees - Special Temporary Authorization request	$195.00	$400.00	two STAs and price increase	$400.00	N/A
FCC Filing Fees - Form 2100 license to cover application	$335.00	$335.00	N/A	$335.00	N/A
in-house labor	$23,373.24	$23,373.24	in-house labor directly related to station's repack	$23,373.24	N/A
DTV Medical Facility Notification	$11,550.00	$3,750.00	N/A	$3,750.00	N/A

Components

Actual Information Description	File Name
Land Mobile Notification	Component Description: WLKY land-mobile notification invoice 2 Amount: $4,700.00 Component Description: WLKY land-mobile notification 50% deposit Amount: $4,700.00
Contract Labor	Component Description: WLKY accounting labor Amount: $4,209.46
MVPD Notification of Channel Change	Component Description: WLKY MVPD notification Amount: $2,710.40
Develop and air announcement of upcoming channel change	Information not provided.
Equipment Storage	Component Description: WLKY storage container Amount: $7,302.75
Disposal Costs (for equipment and other waste, net of any salvage value)	Component Description: WLKY glycol disposal Amount: $836.36
FCC Filing Fees - Special Temporary Authorization request	Component Description: WLKY STA 1 fee Amount: $200.00 Component Description: WKLY STA 2 fee Amount: $200.00
FCC Filing Fees - Form 2100 license to cover application	Component Description: WLKY main license to cover fee Amount: $335.00
in-house labor	Component Description: WLKY in-house accounting labor 1 Amount: $5,709.60 Component Description: WLKY in-house labor 6 Amount: $717.93 Component Description: WLKY in-house labor 5 Amount: $1,577.52 Component Description: WLKY in-house labor 2 Amount: $2,340.79 Component Description: WLKY in-house labor 3 Amount: $4,952.15 Component Description: WLKY in-house labor 4 Amount: $8,075.25
DTV Medical Facility Notification	Component Description: WLKY medical notification invoice Amount: $3,750.00

Cost Information

Grand Total

	Predetermined Cost Estimate	Estimated Cost	Actual Cost
Total for all systems	$3,517,325.86	$2,028,088.77	$1,857,020.61

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 07/02/2021

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

07/02/2021

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 07/02/2021

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

07/02/2021

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 07/02/2021

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

07/02/2021

(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

Auxiliary Transmitter

Add Transmitter Information

Auxiliary Transmitter

New Transmitter Costs

Auxiliary Transmitter

Other Transmitter Costs

Auxiliary Transmitter

Other Transmitter Cost Not Listed

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

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

Primary Antenna

New Antenna Costs

Primary Antenna

Other Antenna Costs

Enter a list of RF channel numbers.

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

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

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

Outside Professional Services Costs

Outside Professional Services Costs

Other Professional Services Expenses Not Listed

Other Expenses

Other Expenses

Other Expenses Not Listed

Cost Information

Transmitters

Components

Cost Information

Antennas

Components

Cost Information

Transmission Line

Components

Cost Information

Tower Equipment and Rigging Costs

Cost Information

Outside Professional Services

Components