RSP-100, Issue 12, August 2019 Modular Approval Attestation Federal Communication Commission Equipment Authorization Division, Application Processing Branch 7435 Oakland Mills Road Columbia, MD 21048 Certification and Engineering Bureau Innovation, Science and Economic Development Canada Spectrum Engineering Branch 3701 Carling Avenue, Building 94 Ottawa, Ontario K2H 8S2 Subject: FCC / ISED Modular Approval Statement Grantee Code Equipment Product Code Check your GC here. Click Grantee Search. Check your CN here. FCC ID:
CN:
(Company Number) HVIN:
(Hardware Version Id. Number) HMN:
(Host Marketing Name) UPN:
(Unique Product Number) PMN:
(Product Marketing Name) FVIN:
(Firmware Version Id. Number) TO WHOM IT MAY CONCERN Pursuant to Paragraphs RSP-100, Issue 12 and CFR 15.212, we herewith declare for our module. Modular approval requirement
(a) The radio elements shall have the radio frequency circuitry shielded. Physical/discrete and tuning capacitors may be located external to the shield, but shall be on the module assembly. Yes No *
*Please provide a detailed explanation if the answer is No.:
(b) If the module has modulation/data input(s), they shall be buffered in order to ensure that the module will comply with the requirements set out in the applicable Radio Standards Specification (RSS) and Part 15 under conditions of excessive data rates or over-modulation.
*Please provide a detailed explanation if the answer is No.:
(c) The module shall have its own power supply regulation on the module itself. This is to ensure that the module will comply with the requirements set out in the applicable standard regardless of the design of the power supplying circuitry in the host product that houses the module.
*Please provide a detailed explanation if the answer is No.:
(d) The module shall comply with the provisions for external power amplifiers and antennas detailed in the applicable RSS and rule part. The equipment certification application shall contain:
i. a detailed description of the configuration of highest antenna gain for each type of transmitting antenna for licence-exempt modules;
ii. the maximum transmitting antenna gain for licence modules; and iii. a detailed description of the configuration of lowest antenna gain for each type of receiving antenna for Dynamic Frequency Selection
(DFS) modules with removable antenna(s).
*Please provide a detailed explanation if the answer is No.:
Modular approval requirement
(e) The module shall be tested for compliance with the applicable standard in a stand-alone configuration
(i.e. the module shall not be inside another product during testing). Yes No *
*Please provide a detailed explanation if the answer is No.:
(f) The module complies or will comply with applicable RSS-102 exposure requirements and any applicable FCC RF exposure requirement (1.1307(b), 1.1310, 2.1091, and 2.1093) in its intended configuration/integration in a host.
*Please provide a detailed explanation if the answer is No.:
(g) The module must be labeled with its permanently affixed label (indicating ISED certification number, HVIN and FCC identifier), or use an electronic display (see KDB Publication 784748 and RSP-100, section 5).
*Please provide a detailed explanation if the answer is No.:
(h) The module must comply with all specific rules applicable to the transmitter, including all the conditions provided in the integration instructions by the grantee.
*Please provide a detailed explanation if the answer is No.:
(i) (Only applicable for FCC) The module must contain a permanently attached antenna, or contain a unique antenna connector, and be marketed and operated only with specific antenna(s), per 15.203, 15.204(b), 15.204(c), 15.212(a), 2.929(b). For further information concerning antenna connectors see: DA-00-1087.
*Please provide a detailed explanation if the answer is No.:
If you have any questions, please feel free to contact us at the address shown below Best regards, Company Name:
Company Address:
Contact Name:
Signature:
Phone:
Fax:
E-mail:
Signature Date:
INFO for applicant: Limited Modolar Approval (LMA) may be granted when one or more of the requirements in the table above cannot be demonstrated. LMA will also be issued in those instances where applicants can demonstrate that they will retain control over the final installation of the device, such that compliance of the end product is assured. In such cases, an operating condition on the LMA for the module must state that the module is only approved for use when installed in devices produced by a specificmanufacturer. When LMA is sought, the application for equipment certification must specifically state how control of the end product, into which the module will be installed, will be maintained, such that full compliance of the end product is always ensured. Document Version 2.1 2020-10-30