S Inc. SGS North America 620 Old Peachtree Road SUITE 100 Suwanee, United States Georgia 30024 Applicant Declaration Applicant Legal Business Name Lorex Technology Inc. Address Grantee Code FCCID 250 Royal crest Court, Markham, L3R 3Sl, Ontario, ucz
-Z UCZ-B451AJ Canada. Authorized Contact Name Niles Kanapathipillai Contact Email niles@lorexcorp.com Contact Phone
(905) 946-8589 Ext: 125 I, the undersigned, certify that I am an authorized signatory for the Applicant and therefore declare;
a) in accordance with 47CFR2.911
(d), all of the statements herein and the exhibits attached hereto are true and correct to the best of my knowledge and belief. 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 this application, the Applicant is responsible for
(1) labeling
(2) compliance
(3) compliance the equipment statement of the equipment with the exact FCC ID as specified to the applicable labeling technical in this application, rules, rules, with the applicable pursuant c) if the Applicant that production is not the actual units of this equipment manufacturer of the equipment, appropriate arrangements have been made with the manufacturer to ensure will continue to comply with the FCC's technical requirements. d) in accordance with 47 CFR 2.909 and KDB394321, the Applicant has read, understood and agrees to accept that they are the responsible party and agree to abide by their responsibilities as specified under 47 CFR 2.909 and KDB394321 e) in accordance with 1S017065, FCC KDB641163, FCC KDB610077, KDB394321 and RSP-100, the Applicant has read, understood, accepts and agrees to abide by the post maketsurveillance requirements.
(1) the Applicant
(2) the Applicant
(3) the Applicant understands, shall make provisions shall, upon request accepts and agrees that a sample may be requested to always have a production sample available for surveillance testing. by SGS, by SGS, at the Applicant's expense, provide upon request a production cables, software, FCC and/or ISED sample of the requested or other hardware or product to SGS, FCC and/or ISED as instructed. for evaluation, software The sample shall include review, all support devices, of products audit surveillance certification and required accessories by SGS. certified f) neither the Applicant 5301 of the Anti-Drug 47CFR 1.2002(b
) for the definition of a "party"
for these purposes nor any party to the application Abuse Act of 1988, 21 U.S.C. \jl62 because of a conviction of Federal is subject to a denial benefits, that includes for possession or distribution FCC benefits, pursuant of a controlled to Section substance. See g) the Applicant has read, understood, accepts and agrees to abide by the SGS North America, lnc.(TCB) terms and conditions Link to CFRs: hit s://www.fcc. Link to KDBs: https://apps.fcc.qov/oetcf/kdb/index.cfm Link to RSP-100:
ov/wireless/bureau-divisions/technolo c.ca/eic/site/smt-
st.nsf/en
/sf01130.html hit s://www.ic. ies-s stems-and-innovation-division/rules-re ulations-title-47 Date:2020-06-30
(,,, ft shall be ,;g,ed by ao amhoe,oo pe"oo /fated;, the FCC d,taba,e Applicant Declaration Rev:0.0