Since I'm not typically contributor I will try to explain it succinctly. This is a really useful tool in TBC and makes vertical profiles a breeze.
First you will need your horizontal alignment built, and the vertical profile line in TBC as a 3dpolyline or preferably a linestring.
When you are in the "edit alignment command" go to the vertical tab, hit the "create vertical alignment" button. Once it populates the first row you want to hit the button right of the "create vertical alignment" button. When you hover mouse over, it should read "append selected line" and you know you have the right one. Chose the horizontal alignment that you want to add the vertical info to; and then choose the 3d linework with the profile elevation info as the "line to append". Once you hit ok, you will have a vertical profile added to your horizontal alignment.
Before using the vertical alignment for anything make sure to verify that both the horizontal and vertical stations are jiving with the plans and do some checks to see if it will work with the proposed site conditions.