CKC Certification Services, LLC CB: US0103; NB/AB: 0976 5046 Sierra Pines Drive Mariposa, CA 95338 Phone: 1 800-500-4EMC (4362) Fax: 209-787-5568 Email: tcbadmin@ckc.com APP-FCC-A Applicant Attestation Applicant Information Company Name:
Contact Name:
Contact Title:
Company Address:
Telephone No:
Facsimile No:
Email Address:
Trimble Inc. Jeff Mallari Compliance Engineering Manager 10368 Westmoor Drive, Westminster, CO 80021, United States
+1 (408)481-8220 jeff_mallari@trimble.com Certification Type / Equipment Identification Certification Program:
Certification Number:
FCC Equipment Authorization / Radio Certification JUP-SMSE013 The equipment identified above is / is not covered equipment prohibited from receiving an equipment authorization pursuant to 47 CFR Part 2, Subpart J, 2.903. The applicant identified above is / is not identified on the FCCs Covered List as an entity, affiliate, or subsidiary which produces equipment on the Covered List or identified as an entity which has rebranded or relabeled equipment produced by entities identified on the Covered List. I hereby attest and certify that the above statements are true and correct. Signature of Authorized Individual: 1 Printed Name:
Title of authorized signature:
Date Jeff Mallari Compliance Engineering Manager 9/25/2023 Note this attestation shall be signed by the applicant or their direct appointee within the same legal entity. A third party agent is not permitted to sign on behalf of the applicant. 1 Signature is not subject to the FCCs authorized individual policy (KDB 852134) and may be signed by any appropriate company official. APP-FCC-A Page 1 of 2 Rev 3 CKC Certification Services, LLC CB: US0103; NB/AB: 0976 5046 Sierra Pines Drive Mariposa, CA 95338 Phone: 1 800-500-4EMC (4362) Fax: 209-787-5568 Email: tcbadmin@ckc.com Attachment A Additional Information The FCCs Covered List includes certain telecommunications equipment and video surveillance equipment produced by specific manufacturers, their Affiliates or Subsidiaries and including any products produced by these entities which are rebranded or relabeled by other entities. (191, 184, 185, 188) The FCC claims the identified equipment poses an unacceptable risk to United States national security. Telecommunications Equipment (195):
2 Any equipment used in fixed or mobile networks that provides advanced communications service, provided the equipment includes or uses electronic components, as defined under section 1.50001(c). Video Surveillance Equipment (205):
Advanced Communications Service (195, 205) Any equipment that is used in fixed and mobile networks that provides advanced communications service in the form of a video surveillance service, provided the equipment includes or uses electronic components. Any equipment that can be used in such a fixed or mobile broadband network to enable users to originate and receive high quality voice, data, graphics, and video telecommunications service using any technology with connection speeds of at least 200 kbps in either direction. Affiliate (183):
Subsidiary (184):
An entity that (directly or indirectly) owns or controls, is owned or controlled by, or is under common ownership or control with, another entity, where the term own means to have, possess, or otherwise control an equity interest (or the equivalent thereof) of more than 10 percent. Any entity in which such named entity directly or indirectly (1) holds de facto control or (2) owns or controls more than 50% of the total voting power of the entitys outstanding voting stock. Useful Links:
FCC Covered List https://www.fcc.gov/supplychain/coveredlist 47 CFR Part 2 Subpart J (including 2.903 and 2.911) https://www.ecfr.gov/current/title-47/chapter-I/subchapter-A/part-2/subpart-J FCC KDB System:
https://apps.fcc.gov/oetcf/kdb/index.cfm FCC Report and Order 22-84 https://docs.fcc.gov/public/attachments/FCC-22-84A1.pdf 2 Parenthetical references are citations of paragraph numbers in FCC Report and Order FCC 22-84 (ET Docket 21.232). APP-FCC-A Page 2 of 2 Rev 3