SGS North America Inc 620 Old Peachtree Road SUITE 100 Suwanee, Georgia 30024 United States Applicant Legal Business Name Marquardt GmbH Applicant Declaration Address Schloss-StraBe Germany 16, 78604 Rietheim-Weilheim, Grantee Code /FRN IYZ /0007486251 FCCID Authorized Contact Name Contact Ema il Contact Phone IYZHH5 Gerd Villing Gerd.Villing@Marquardt.com 91 206693 8273 I, the undersigned, certify that I am an authoriz ed signatory for the Applicant and therefore declare;
a) in accordance with 47CFR2.911
(d), all of the statements herein and the exhtsattached hereto are true and correct to the best of m y knowledge and belief. b) in accepting a Grant of Equipme nt Authoriz this application, the Applicant is responsibl
(1)labeling the equipment with the exact FCC ID as specified in this application, rules,
(2)com pliance statement labeling pursuant to the applicable rules,
(3)com pliance of the equipment with the applicable technical ation issued by a TCB, undethe authority e for of the FCC, as a result of made 1n the representations c) if the Applicant is not the actual manufactuerof the equipme nt, appropri ate arrangements have been made with the manufactur er to ensure that production units of this equipment will continu e to com ply with the FCC's technical requirements. d) in accordance with 47 CFR 2.909 and KDB394321, party and agree to abide by theiesponsibti e) in accordance with ISO 17065, FCC KDB641163, and agrees to abide by the post market surveillanc FCC KDB610077, e requireme nts the Applicant has read, understood and agrees to accept that they are the responsibl e esas specified under 47 CFR 2.909 and KDB394321 KDB394321 and RSP-100, the Applicant has read, understood, accepts
(1)the Applicant understands, accepts
(2)the Applicant shall make provisions
(3)the Applicant FCC and/or ISED as instruct software required for evaluation, shall, upon request by SGS, at the Applicant's expense, provide a production sample of the requested product to SGS, ed. The sam ple shall include all support devices, cables, software, accessori es or other hardware or review, certification and audit surveillanc e of products certified by SGS and agrees that a sample ma y be requested for surv to always have a production sample available upon request by SGS, FCC and/or ISED eillance testing f) neither the Applicant nor any party to the application is subject to a denial of Federal benefits, 5301 of the Anti-Drug 47CFR 1.2002(b) for the definition of a "party" for these purposes Abuse Act of 1988, 21 U.S.C. 862 because of a conviction that includes fopossessionor distribution FCC benefits, of a controll ed substance. See pursuant to Section g) the Applicant has read, understood, accepts and agrees to abide by the SGS North Ameica,lnc.(TCB) term s and conditions Link to CFRs: hit s://www .fcc. ov/wireless/bureau-divisions/t Link to KDBs: https://apps.fcc.qov/oetcf/kdb/
Link to RSP-100:
Link to the Covered List: Covered List hit s://www.ic. c.ca/eic/site/sm t-st.nsf/
en /sf01130.htm l index.cfm echnolo ies-s stem s-and-innovation-division/rules
-re ulations-title-47 MarquardtGmbH ("the applicant") certifies that the equipme nt for which authorization is sought is not "covered" equipme nt prohtedfrom eceiving an equipment authoriz ation pursuant to section 2.903 of the FCC rules MarquardtGmbH ("the applicant") certifies of the application, the applicant [ is not] identified on the Covered list, established pursuant to1.50002, that, as of the date of the filing
"covered" equipme nt as an entity producing Ppa. Date:2023/12/11 Name
: I:::
nesearch& Development
*NOTE: This declaration cannot be signed by an Agent, it shall be signed by an authorized person listed in the FCC database QSF27-14-04 Rev 1.0 Rev. Feb 6, 2023 Page 1 of 1 Original Issue: Jan. 4, 2021