Modular Approval Letter

FCC ID: W38-28010087

Cover Letter(s)

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FCCID_2771164

775 Montague Expressway Milpitas, CA 95035 Tel: 408-526-1188 Fax: 408-526-1088 Email: TCB@siemic.com Modular Approval Declaration Letter Revision History Reason for Amendment (current / obsolete) From To Approved Date Initial Release (Obsolete) 1.0 1.0 Dec-04-2006 Added IC Modular Letter (Obsolete) 1.0 2.0 Feb 16 2009 Add LMA and MA option (Obsolete) 2.0 3.0 April 14 2010 Revised per RSS Gen issue 3.0 (Obsolete) 3.0 4.0 Jan 12 2011 Removed Foot(2) (obsolete) 4.0 5.0 July 19 2011 Adding New note per KDB996369 D01 V01R03 5.0 6.0 August 29 2011 (obsolete) Updated company template & Added text box 6.0 7.0 Jan-31-2012 (obsolete) Updated modular requirement (obsolete) 7.0 8.0 Sept 05 2014 Updated template to meet RSP 100 issue 10 8.0 9.0 Nov 20 2014 (obsolete) Updated template to meet RSP 100 issue 11 (current) 9.0 10.0 March 19 2015

9/14/2015 (Product name) FCC ID : W38-28010087 , is seeking FCC Authorization as a Single Modular transmitter / Single Limited Modular Approval (Please check one). The EUT meets the requirements for Single Modular approval / Single Limited Modular Approval (please check one) as detailed in FCC public Notice DA00-1407. Compliance to each of the requirements is described below: Questions are: * Please provide a detailed explanation if the answer is “No.” Item Modular requirement Yes No 1 The radio elements must have the radio frequency circuitry shielded. Physical components and tuning x capacitor(s) may be located external to the shield, but must be on the module assembly; 2 The module must have buffered modulation/data inputs to ensure that the device will comply with Part x 15 requirements with any type of input signal; 3 The module must contain power supply regulation on the module; x 4 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 Sections 15.203, 15.204(b), 15.204(c), x 15.212(a), 2.929(b); 5 The module must demonstrate compliance in a stand-alone configuration; x 6 The module must be labelled with its permanently affixed FCC ID label, or use an electronic display x (See KDB Publication 784748 about labelling requirements); 7 The module must comply with all specific rules applicable to the transmitter including all the conditions x provided in the integration instructions by the grantee; 8 The module must comply with RF exposure requirements x Note: (1) 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 specific manufacturer. 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, and will be maintained, such that full compliance of the end product is always ensured. (2) Please provide Clear and specific instructions describing the conditions, limitations and procedures for third-parties to use and/or integrate the module into a host device. (3) For non-Software Defined Radio transmitter modules where software is used to ensure compliance of the device, technical description of how such control is implemented to ensure prevention of third party modification must be provided (see KDB 594280). Note 1: Compliance of a module in its final configuration is the responsibility of the applicant. A host device will not be considered certified if the instructions regarding antenna configuration provided in the original description, of one or more separately certified modules it contains, were not followed. Example: A separately certified low-power transceiver module using Bluetooth technology which is housed in a desktop computer, laptop or peripheral does not require the overall system to be recertified, if the desktop computer, laptop or peripheral, as a stand-alone unit, complies with all applicable technical standards. Gary Eldridge, P.E. Regulatory Compliance Manager Phone: 408-841-4536 Gary.Eldridge@chargepoint.com ChargePoint, Inc. 254 E. Hacienda Ave Campbell CA 95008 SCS-F26 Modular Approval Letter Page 2 of 3 Rev 10.0

LMA Declaration Letter We, ChargePoint, Inc., declare that we will retain control over the final installation of the device, (FCC ID: W38-28010087) so that compliance of the end product is assured. In such cases, an operating condition on the LMA for the module must be only approved for use when installed in devices produced by a specific manufacturer. Gary Eldridge, P.E. Regulatory Compliance Manager Phone: 408-841-4536 Gary.Eldridge@chargepoint.com ChargePoint, Inc. 254 E. Hacienda Ave Campbell CA 95008 SCS-F26 Modular Approval Letter Page 3 of 3 Rev 10.0


Document Created: 2015-10-02 08:58:37
Document Modified: 2015-10-02 08:58:37
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