SGS North America lnc. 620 Old Peachtree Road SUITE 1OO Suwanee, Georgia 30024 United States Applicant Declaration Applicant Legal Business Name Edgenectar Inc. Address Grantee Code FCC ID I l1 N, Market St. #300, San Jose, CA US 95113 21i929 2A9Z95GEMOOI Authorized Contact Name Rich Cabico Contact Email Contact Phone rich@edgenectar.com
+I 9253998062 l, the undersigned, certiry that I am an authorized signatory for the Applicant and therefore declare;
a) in accordance with 47CFR2.S11(d), all of the statements herein and the exhibits attached hereto are true and clnect to the best of my b) in accepting a Grant of Equipment Authorization issued by a TCB, under the authority of the FCC, as a result of the representations made in knowledge and belief. this application, the Applicant is responsible for:
(1) labeling the equipment with the exact FCC lD as specified in this application,
{2') compliance statement labeling pursuant to the applicable rules,
(3) compliance of the equipment with the applicable technical rules, that produc'tion units of this equipment will continue to comply with the FCC,s technical requirements. c) if the Applicant is not the actual manuracturer of the equipment, appropriate arrangements have been made with the manufacturer to ensure d) in accordance with 47 CFR 2.909 and KD8394321, the Applicant has read, understood and agrees to accept that they are the responsible e) in accordance with ISO 17065, FCC KD8641163, FCC KDB6100Z7,KDgg943Z1 and RSp-100, the Applicant has read, under$tood, accepts party and agree to abide by their responsibilities as specitied under 47 CFR 2.909 and KDBO94A21. and agrees to abide by the post market surveillance requirements.
(1) the Applicant understands, accepb and agrees that a $ample may be reque$ted for surveillance testing.
(2) the Applicant slrall make provisions to always have a production sample available upon request Oy SOS, FCC and/or ISED.
(3) the Applicant_"Err, upon request by SGS, at the Applicant's expense, provide a production samplL of the requested product to SGS, FCC and/or ISED as instructed. The sample shall include all support devices, cables, software, accessories or other hardware or software required for evaluation, review, certification and audit surveillance of products certified by $GS. f) neither the Applicant nor any party to the applicalion is subject to a denial of Federal benefits, that includes FCC benefits, pursuant to Section 5301 of the Anti-Drug Abuse Act of 1988, 21 U.S.C. 9862 because of a conviction for possession or distribution of a controlled substance. See 47QFR 1.2002(b) for the definition of a "party" for these purposes. S) the Applicant has read, understood, accepts and agrees to abide by the SGS North America, lnc.(TCB) terms and conditions. Link to CFRs: https:/A,vww.fcc.gov/wireless/bureaugivisions/technologies-svstems-and-innovationdivision/rules-requlations-tifle-47 Link to KDBs: https://aops.fcc.o9v/oetcf/kdb/index.cfm Link to RSP-100: https://www.ic.gc.caleic/sitrelsmhost.nsf/eng/sfl1 Link to the Covercd List: Covered List B Edge,nectar Inc. ('tne applicant") certifies that the equipment for which authorization is sought is not 'covered" equipment prohibited from 130.html receiving an equipment authorization pursuant to section 2.903 of the FCC rules. El Edgenectar Inc. ("the applicant") certilies that, a$ of the date of the liling of the application, the appticant is not identified on the Covered tist, established pursuant to $1.50002, as an entity producing "covered" equipment. Applicant Signature:
, fu,[, (rt"u Print Name:
Rich Cabico Title:
Operation Manager Date:
iln lzr by an authoized person listed in the FCC database QSF27-14-04 Rev 1.0 Rev. Feb 6,2023 Page 1 of 1 Original lssue: Jan. 4,2021