FCC ID: 2AREB-12-2019 PowerPic Mod

SGS North America Inc. i i 620 Old Peachtree Road ppp liceht Bealaretors SUITE 100 Suwanee, Georgia 30024 United States Applicant Legal Business Name TWELVE SOUTH, LLC Address 1503 KING ST STE201 Charleston, SC29405, USA Grantee Code 2AREB FCC ID 2AREB-12-2019 Authorized Contact Name Andrew Green Contact Email Andrew.Green@twelvesouth.com Contact Phone 843-849-1212

|, the undersigned, certify that | am an authorized signatory for the Applicant and therefore declare;

a) b)

) d) 9) in accordance with 47CFR2.91 1(d), all of the statements herein and the exhibits attached hereto are true and correct to the best of my knowledge and belief. 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 the equipment with the exact FCC ID as specified in this application,

(2) compliance statement labeling pursuant to the applicable rules,

(3) compliance of the equipment with the applicable technical rules, if the Applicant is not the actual manufacturer of the equipment, appropriate arrangements have been made with the manufacturer to ensure that production units of this equipment will continue to comply with the FCC's technical requirements. 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. in accordance with IS017065, FCC KDB641163, FCC KDB610077, KDB394321 and RSP-100, the Applicant has read, understood, accepts and agrees to abide by the post market surveillance requirements.

(1) the Applicant understands, accepts and agrees that a sample may be requested for surveillance testing.

(2) the Applicant shal/ make provisions to always have a production sample available upon request by SGS, FCC and/or ISED.

(3) the Applicant shall, upon request by SGS, at the Applicant's expense, provide a production sample 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 SGS. neither the Applicant nor any party to the application 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. 862 because of a conviction for possession or distribution of a controlled substance. See 47CFR 1.2002(b) for the definition of a party for these purposes. the Applicant has read, understood, accepts and agrees to abide by the SGS North America, Inc.(TCB) terms and conditions. Link to CFRs: httos:/Awww.fec.gov/wireless/bureau-divisions/technologies-systems-and-innovation-division/rules-requlations-title-47 Link to KDBs: https://apps. fcc. gov/oetcf/kdb/index.cfm Link to RSP-100: https:/www.ic.ac.ca/eic/site/smt-ast.nsflena/sf01130.htm!

Applicant Signature: q Date:

L Ae i 7-12-27 }

Print Name: [Andrew Green) Title:

Fee dey i NOTE: This declaration cannot be signed by an Agent, if shall be signed by an authorized person listed in the FCC database south Applicant Declaration twe Rev:0.0

TWELVE SOUTH, LLC TO: Federal Communication Commission Equipment Authorization Branch 7435 Oakland Mills Road Columbia, MID 21046 Regarding: Confidentiality Request regarding application for FCC ID: 2AREB-12-2019 LONG TERM CONFIDENTIALITY Pursuant to 47 CFR Section 0.459 and 0.457 of the commissions rules, the applicant hereby request confidential treatment of the documents listed below, associated with the certification application referenced above. Schematic(s) Block Diagrams Operational Descriptions The documents above contain proprietary information not released to the public. Public disclosure of this information may prove harmful to the business of the applicant. SHORT TERM CONFIDENTIALITY Additionally, the applicant requests the following documents be held confidential until the device is marketed or 0 days from the grant date, whichever is less. If the device is marketed within 0 days of the Grant Date, the applicant will notify the TCB per FCC KDB 726920 DO1 Confidentiality Request Procedures. Delete any document that is NOT included in your application External Photos Internal Photos Test Setup Photos User manual(s) Sincerely, Print Name: Andrew Green me fe [Posh On behalf of Company: TWELVE SOUTH, LLC Telephone: 843-849-1212 E-mail: Andrew.Green@twelvesouth.com St twelve south

Model / Item Confirmation Letter We__ TWELVE SOUTH, LLC ___declare that our product .:__PowerPic Mod _and its below model (s) / item(s):

12-2019, 12-2037 are identical on circuitry design, PCB layout, electrical components used, internal wiring and functions with the model/item No.:

12-2019 which we chose to be tested by SGS and only different on color of housing

&) twelvesouth Company Chop:

Date __2021,06.30_

TWELVE SOUTH, LLC Date: 2021.06.30 TO: Federal Communication Commission Equipment Authorization Branch 7435 Oakland Mills Road Columbia, MID 21046 Regarding: FCC ID: 2AREB-12-2019 To whom it may concern:

We, the undersigned, hereby authorize SGS-CSTC Standards Technical Services Co., Ltd. (SGS) Shenzhen Branch and Keny Xu in SGS-CSTC Standards Technical Services Co., Ltd. (SGS) Shenzhen Branch to act on our behalf in all manners relating to application for equipment authorization with respect to the FCC ID above, including signing of all documents relating to these matters. Any and all acts carried out by the agent on our behalf shall have the same effect as acts of our own. We, the undersigned, hereby certify that we are not 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. 853(a). Where our agent signs the application for certification on our behalf, | acknowledge that all responsibility for complying with the terms and conditions for Certification, as specified by SGS North America, Inc., still resides with TWELVE SOUTH, LLC This authorization is valid until further written notice from the applicant. Print Name: Andrew Green Title:

we / | favs On behalf of Company: TWELVE SOUTH, LLC Telephone: 843-849-1212 E-mail: Andrew.Green@twelvesouth.com Y twelve souti:

TWELVE SOUTH, LLC Cover Letter-Wireless Charger Approval Gentlemen:

Theres a wireless charger that would like to have your authorization as an Inductive wireless power transfer applications approval. The specific product as below, wireless charger, with its designed features and specified description, meets special requirements for KDB 680106 D011 section 5.2 requirements. Company: TWELVE SOUTH, LLC Date: 2021-06-30 PowerPic Mod 12-2019 Product Name:

Model Number:

FCC ID: 2AREB-12-2019 KDB 680106 DO1 Section 5.2 Requirements Product Technical Specification Result a) Power transfer frequency is less that 1 MHz b) Output power from each primary coil is less than or equal to 15 watts. 1110-205 kHz Complied 10 watts Complied c) The transfer system includes only single primary and secondary coils. This includes charging systems that may have multiple primary coils and clients that are able to detect and allow coupling only between individual pairs of coils d) Client device is placed directly in contact with the transmitter. e) Mobile exposure conditions only Complied Complied For inductive applications where the primary does not physically attach to the client, and it is intended for desktop use, the desktop guidance in KDB 680106 DO1 may be applied Complied f) The aggregate H-field strengths at 15 cm surrounding the device and 20 cm above the top surface from all simultaneous transmitting coils are demonstrated to be less than 50% of the MPE limit. Sincerely, Print Name: Andrew Green On behalf of Company: TWELVE SOUTH, LLC Telephone: 843-849-1212 Please refer to RF exposure report Complied Pcs. Pelt E-mail: Andrew.Green@twelvesouth.com Y twelve south