Test report_15.247 (BT EDR)

FCC ID: Z64-2564N

Test Report

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FCCID_2716620

                          FCC C2PC Test Report
            FCC ID                 : Z64-2564N
            Equipment              : CC2564 Bluetooth HCI Module
            Model No.              : CC2564MODA
            Brand Name             : Texas Instruments
            Applicant              : Texas Instruments Inc
            Address                : 12500 TI Blvd, Dallas USA 75243
            Standard               : 47 CFR FCC Part 15.247
            Received Date          : Jul. 01, 2015
            Tested Date            : Jul. 01 ~ Jul. 06, 2015


      We, International Certification Corp., would like to declare that the tested sample has been
      evaluated and in compliance with the requirement of the above standards. The test results
      contained in this report refer exclusively to the product. It may be duplicated completely for
      legal use with the approval of the applicant. It shall not be reproduced except in full without
      the written approval of our laboratory.



      Approved & Reviewed by:




      Gary Chang / Manager                            Ty: XXX




Report No.: FR3D0402-02AD                                                             Page : 1 of 30
Report Version: Rev. 01


                                                         Table of Contents
1        GENERAL DESCRIPTION .................................................................................................................... 5

1.1      Information.............................................................................................................................................. 5
1.2      Local Support Equipment List ................................................................................................................ 7
1.3      Test Setup Chart .................................................................................................................................... 7
1.4      The Equipment List ................................................................................................................................ 8
1.5      Test Standards ....................................................................................................................................... 9
1.6      Measurement Uncertainty ...................................................................................................................... 9

2        TEST CONFIGURATION .....................................................................................................................10

2.1      Testing Condition .................................................................................................................................10
2.2      The Worst Test Modes and Channel Details .......................................................................................10

3        TRANSMITTER TEST RESULTS........................................................................................................11

3.1      Conducted Emissions ...........................................................................................................................11
3.2      Unwanted Emissions into Restricted Frequency Bands ......................................................................14

4        TEST LABORATORY INFORMATION ...............................................................................................30




Report No.: FR3D0402-02AD                                                                                                           Page : 2 of 30
Report Version: Rev. 01


                                      Release Record
     Report No.             Version                   Description      Issued Date
 FR3D0402-02AD              Rev. 01   Initial issue                   Aug. 14, 2015




Report No.: FR3D0402-02AD                                           Page : 3 of 30
Report Version: Rev. 01


                                  Summary of Test Results
        FCC Rules                   Test Items                Measured                       Result
                                                  [dBuV]: 0.482MHz
           15.207           Conducted Emissions                                               Pass
                                                  30.65 (Margin -15.65dB) - AV
         15.247(d)                                [dBuV/m at 3m]: 697.36MHz
                            Radiated Emissions                                                Pass
           15.209                                 42.58 (Margin -3.42dB) - PK




Report No.: FR3D0402-02AD                                                        Page : 4 of 30
Report Version: Rev. 01


1          General Description
1.1        Information
This report is prepared for FCC class II change.
This report is issued as a supplementary report to original ICC report no. FR3D0402AD. The modification is
concerned with adding new antenna and model name. In this report, conducted emission and radiated
emission tests had been re-tested and only its data was presented in the following sections.


1.1.1      Product Details
The following models are provided to this EUT.

             Model                     Antenna type                Gain (dBi)               Remark
          CC2564MODN                         Chip                    -1.38                   Original
          CC2564MODA                         Chip                    1.69                     C2PC


1.1.2      Specification of the Equipment under Test (EUT)
                                              RF General Information
 Frequency Range                 Bluetooth          Ch. Frequency
                                                                         Channel Number          Data Rate
      (MHz)                        Mode                 (MHz)
      2400-2483.5                BR V2.1               2402-2480                0-78 [79]          1 Mbps
      2400-2483.5                EDR V2.1              2402-2480                0-78 [79]          2 Mbps
      2400-2483.5                EDR V2.1              2402-2480                0-78 [79]          3 Mbps
Note 1: RF output power specifies that Maximum Peak Conducted Output Power.
Note 2: Bluetooth BR uses a GFSK.
Note 3: Bluetooth EDR uses a combination of π/4-DQPSK and 8DPSK.


1.1.3      Antenna Details
 Ant. No.                 Type                 Connector                 Gain (dBi)             Remarks
      1                   Chip                      1.69                     N/A                    ---


1.1.4      Power Supply Type of Equipment under Test (EUT)
Power Supply Type                    3.3Vdc from host


1.1.5      Accessories
N/A




Report No.: FR3D0402-02AD                                                                   Page : 5 of 30
Report Version: Rev. 01


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1.1.6         Channel List

                     Frequency band (MHz)                                            2400~2483.5

  Channel            Frt(e'?niezr;cy   Channel   Frt(e'?nLhezr;cy   Channel   Fr‘:lflnfiz’;cy   Channel       Fr‘:lflnfiz’;cy

        0                2402            20          2422             40         2442           60              2462

        1                2403            21          2423             41         2443           61              2463

        2                2404            22          2424             42         2444           62              2464

        3                2405            23          2425             43         2445           63              2465

        4                2406            24          2426             44         2446           64              2466

        5                2407            25          2427             45         2447           65              2467

        6                2408            26          2428             46         2448           66              2468

        7                2409            27          2429             47         2449           67              2469

        8                2410            28          2430             48         2450           68              2470

        9                2411            29          2431             49         2451           69              2471

      10                 2412            30          2432             50         2452           70              2472

       11                2413            31          2433             51         2453           71              2473

      12                 2414            32          2434             52         2454           72              2474

      13                 2415            33          2435             53         2455           73              2475
      14                 2416            34          2436             54         2456           74              2476

      15                 2417            35          2437             55         2457           75              2477

      16                 2418            36          2438             56         2458           76              2478
      17                 2419            37          2439             57         2459           77              2479

      18                 2420            38          2440             58         2460           78              2480
      19                 2421            39          2441             59         2461



1.1.7        Test Tool
Test Tool                                 HCI Tester V3.0.0.24


1.1.8         Power Setting

            Modulation Mode                                           Test Frequency (MHz)
                                                   2402                       2441                       2480
              GFSK/1 Mbps                          Ox18                       Ox18                       Ox19
             BDPSK/3Mbps                           Ox19                       Ox19                       Ox19



Report No.: FR3D0402—02AD                                                                          Page : 6 of 30
Report Version: Rev. 01


1.2       Local Support Equipment List
                                    Support Equipment List
 No.        Equipment       Brand          Model          FCC ID     Signal cable / Length (m)
   1         Notebook       DELL           E5420             DoC   USB, 1.8m non-shielded.
                                       WSDT-700XX_
   2           Fixture      Ampak                            ---   ---
                                        EVB_V00


1.3       Test Setup Chart
                                     Test Setup Diagram




Report No.: FR3D0402-02AD                                                    Page : 7 of 30
Report Version: Rev. 01


1.4        The Equipment List
      Test Item        Conducted Emission
       Test Site       Conduction room 1 / (CO01-WS)
      Instrument           Manufacturer             Model No.            Serial No.      Calibration Date      Calibration Until
   EMC Receiver                 R&S                  ESCS 30              100169          Oct. 17, 2014          Oct. 16, 2015
         LISN             SCHWARZBECK          Schwarzbeck 8127          8127-667         Nov. 17, 2014         Nov. 16, 2015
        LISN
                          SCHWARZBECK          Schwarzbeck 8127          8127-666         Nov. 26, 2014         Nov. 25, 2015
    (Support Unit)
   RF Cable-CON               Woken                CFD200-NL           CFD200-NL-001      Dec. 31, 2014         Dec. 30, 2015
   50 ohm terminal
                                NA                      50                  04            Apr. 15, 2015          Apr. 14, 2016
    (Support Unit)
    Measurement
                              AUDIX                     e3               6.120210k             NA                     NA
     Software
Note: Calibration Interval of instruments listed above is one year.


       Test Item       Radiated Emission
       Test Site       966 chamber 2 / (03CH02-WS)
      Instrument          Manufacturer          Model No.                Serial No.      Calibration Date      Calibration Until
  Spectrum Analyzer           R&S                    FSV40                101499          Dec. 31, 2014          Dec. 30, 2015
       Receiver               R&S                     ESR3                101657          Jan. 15, 2015          Jan. 14, 2016
    Bilog Antenna         SCHWARZBECK               VULB9168           VULB9168-524       Oct. 16, 2014          Oct. 15, 2015
    Horn Antenna
                          SCHWARZBECK             BBHA 9120 D         BBHA 9120 D 1095    Oct. 14, 2014          Oct. 13, 2015
       1G-18G
    Horn Antenna
                          SCHWARZBECK              BBHA 9170           BBHA 9170517       Nov. 10, 2014          Nov. 09, 2015
      18G-40G
    Loop Antenna               R&S                   HFH2-Z2               11900          Nov. 10, 2014          Nov. 09, 2015
     Preamplifier             Burgeon                BPA-530              100218          Nov. 10, 2014          Nov. 09, 2015
      Preamplifier             Agilent              83017A              MY39501309        Sep. 29, 2014          Sep. 28, 2015
      Preamplifier              EMC               EMC184045B              980192          Aug. 26, 2014          Aug. 25, 2015
       RF Cable           HUBER+SUHNER           SUCOFLEX104             MY16140/4        Dec. 16, 2014          Dec. 15, 2015
       RF Cable           HUBER+SUHNER           SUCOFLEX104             MY16018/4        Dec. 16, 2014          Dec. 15, 2015
       RF Cable           HUBER+SUHNER           SUCOFLEX104             MY16015/4        Dec. 16, 2014          Dec. 15, 2015
     LF cable 3M              Woken               CFD400NL-LW          CFD400NL-003       Dec. 16, 2014          Dec. 15, 2015
    LF cable 10M              Woken               CFD400NL-LW          CFD400NL-004       Dec. 16, 2014          Dec. 15, 2015
    Measurement
                               AUDIX                    e3               6.120210g             NA                     NA
     Software
Note: Calibration Interval of instruments listed above is one year.




Report No.: FR3D0402-02AD                                                                                 Page : 8 of 30
Report Version: Rev. 01


C          Infernational
           Certification
           Corp.




1.5        Test Standards
According to the specification of EUT, the EUT must comply with following standards and KDB documents.

47 CFR FCC Part 15.247
FCC Public notice DA 00—705
ANSI C63.10—2013


1.6        Measurement Uncertainty
I1SO/IEC 17025 requires that an estimate of the measurement uncertainties associated with the emissions test
results be included in the report. The measurement uncertainties given below are based on a 95% confidence
level (based on a coverage factor (k=2)

                                          Measurement Uncertainty
                                    Parameters                                            Uncertainty
Bandwidth                                                                                 +34.134 Hz

Conducted power                                                                            +0.808 dB
Power density                                                                              +0.463 dB
Conducted emission                                                                         +2.670 dB
AC conducted emission                                                                      +2.92 dB
Radiated emission         1GHz                                                             +3.62 dB
Radiated emission > 1GHz                                                                    +5.6 dB




Report No.: FR3D0402—02AD                                                              Page : 9 of 30
Report Version: Rev. 01


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2             Test Configuration
2.1           Testing Condition
              Test Item                     Test Site              Ambient Condition                  Tested By
AC Conduction                              COo1—wS                      22°C / 68%                     Kevin Ma
          .        nsl                                                     o                           Mark Liao
Radiated Emissions                        O3CHO2—WS                  22—26°C / 61—63%                 Felix Sung

» FCC site registration No.:          657002
> IC site registration No.:        10807A—2



2.2             The Worst Test Modes and Channel Details

                 Test item                    Mode          Test m?zl;ency       Data Rate (Mbps)     Test Configuration

Conducted Emissions                          GFSK                2480                  1Mbps

Radiated Emissions S 1GHz                    GFSK                2480                  1Mbps

      .           e
Radiated Emissions > 1GHz
                                             GFSK
                                            BDPSK
                                                           2402, 2441, 2480
                                                           2402, 2441, 2480
                                                                                       1Mbps
                                                                                       3Mbps

NOTE:
1.        The EUT was pretested with 3 orientations placed on the table for the radiated emission measurement — X, Y, and
          Z—plane. The Z—plane results were found as the worst case and were shown in this report.




Report No.: FR3D0402—02AD                                                                            Page : 10 of 30
Report Version: Rev. 01


3         Transmitter Test Results
3.1       Conducted Emissions
3.1.1     Limit of Conducted Emissions
                                        Conducted Emissions Limit
     Frequency Emission (MHz)                   Quasi-Peak                            Average
                0.15-0.5                          66 - 56 *                            56 - 46 *
                  0.5-5                              56                                   46
                   5-30                              60                                   50
Note 1: * Decreases with the logarithm of the frequency.


3.1.2     Test Procedures
1.    The device is placed on a test table, raised 80 cm above the reference ground plane. The vertical
      conducting plane is located 40 cm to the rear of the device.
2.    The device is connected to line impedance stabilization network (LISN) and other accessories are
      connected to other LISN. Measured levels of AC power line conducted emission are across the 50 Ω
      LISN port.
3.    AC conducted emission measurements is made over frequency range from 150 kHz to 30 MHz.
4.    This measurement was performed with AC 120V/60Hz


3.1.3     Test Setup




Report No.: FR3D0402-02AD                                                               Page : 11 of 30
Report Version: Rev. 01


3.1.4     Test Result of Conducted Emissions
Modulation Mode             GFSK                    Test Freq. (MHz)             2480
Power Phase                 Line




Note 1: Level (dBuV) = Read Level (dBuV) + LISN Factor (dB) + Cable Loss (dB).
     2: Over Limit (dB) = Level (dBuV) – Limit Line (dBuV).




Report No.: FR3D0402-02AD                                                               Page : 12 of 30
Report Version: Rev. 01


Modulation Mode             GFSK                    Test Freq. (MHz)             2480
Power Phase                 Neutral




Note 1: Level (dBuV) = Read Level (dBuV) + LISN Factor (dB) + Cable Loss (dB).
     2: Over Limit (dB) = Level (dBuV) – Limit Line (dBuV).




Report No.: FR3D0402-02AD                                                               Page : 13 of 30
Report Version: Rev. 01


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3.2           Unwanted Emissions into Restricted Frequency Bands
3.2.1        Limit of Unwanted Emissions into Restricted Frequency Bands

                                           Restricted Band Emissions Limit
Frequency Range (MHz)|             Field Strength (uV/m)       |Field Strength (dBuV/m)|        Measure Distance (m)
           0.009~0.490                   2400/F(kHz)                    48.5 — 13.8                        300
           0.490~1.705                  24000/F(kHz)                        33.8 — 23                       30
           1.705~30.0                         30                               29                           30
              30~88                           100                              40                           3
             88~216                           150                             43.5                          3
             216~960                         200                               46                           3
            Above 960                        500                               54                           3
Note 1:
Qusai—Peak value is measured for frequency below 1GHz except for 9—90 kHz, 110—490 kHz frequency band. Peak and
average value are measured for frequency above 1GHz. The limit on average radio frequency emission is as above
table. The limit on peak radio frequency emissions is 20 dB above the maximum permitted average emission limit
Note 2:
Measurements may be performed at a distance other than what is specified provided. When performing measurements
at a distance other than that specified, the results shall be extrapolated to the specified distance using an extrapolation
factor as below, Frequency at or above 30 MHz: 20 dB/decade Frequency below 30 MHz: 40 dB/decade.



3.2.2       Test Procedures
1.        Measurement is made at a semi—anechoic chamber that incorporates a turntable allowing a EUT
         rotation of 360°. A continuously—rotating, remotely—controlled turntable is installed at the test site to
         support the EUT and facilitate determination of the direction of maximum radiation for each EUT
         emission frequency. The EUT is placed at test table. For emissions testing at or below 1 GHz, the table
         height is 80 cm above the reference ground plane. For emission measurements above 1 GHz, the table
         height is 1.5 m
2.        Measurement is made with the antenna positioned in both the horizontal and vertical planes of
         polarization. The measurement antenna is varied in height (1m ~4m) above the reference ground plane
         to obtain the maximum signal strength. Distance between EUT and antenna is 3 m.
3.       This investigation is performed with the EUT rotated 360°, the antenna height scanned between 1 m
         and 4 m, and the antenna rotated to repeat the measurements for both the horizontal and vertical
         antenna polarizations.
Note:
1.       120kHz measurement bandwidth of test receiver and Quasi—peak detector is for radiated emission below 1GHz.
         Radiated emission above 1GHz / Peak value
2.       RBW=1MHz, VBW=3MHz and Peak detector
         Radiated emission above 1GHz / Average value for harmonics
         The average value is: Average = Peak value + 20l0g(Duty cycle) Where the duty factor is calculated from following
3        formula for DHS5 packet type which has worst duty factor:
    *                                                       1s / 1600 * 5
                             20l0g (Duty cycle) = 20log   100                  m —30.10B


4        Radiated emission above 1GHz / Average value for other emissions
    ~_   RBW=1MHz, VBW=1/T and Peak detector

Report No.: FR3D0402—02AD                                                                            Page : 14 of 30
Report Version: Rev. 01


3.2.3     Test Setup
Radiated Emissions below 1 GHz




Radiated Emissions above 1 GHz




Report No.: FR3D0402-02AD        Page : 15 of 30
Report Version: Rev. 01


3.2.4     Transmitter Radiated Unwanted Emissions (Below 1GHz)
Modulation                  GFSK                     Test Freq. (MHz)             2480
Polarization                Horizontal




Note 1: Emission Level (dBuV/m) = SA Reading (dBuV/m) + Factor* (dB)
      *Factor includes antenna factor , cable loss and amplifier gain
Note 2: Margin (dB) = Emission level (dBuV/m) – Limit (dBuV/m).
Note 3: All spurious emissions below 30MHz are more than 20 dB below the limit.



Report No.: FR3D0402-02AD                                                                Page : 16 of 30
Report Version: Rev. 01


Modulation                  GFSK                     Test Freq. (MHz)             2480
Polarization                Vertical




Note 1: Emission Level (dBuV/m) = SA Reading (dBuV/m) + Factor* (dB)
      *Factor includes antenna factor , cable loss and amplifier gain
Note 2: Margin (dB) = Emission level (dBuV/m) – Limit (dBuV/m).
Note 3: All spurious emissions below 30MHz are more than 20 dB below the limit.




Report No.: FR3D0402-02AD                                                                Page : 17 of 30
Report Version: Rev. 01


3.2.5     Transmitter Radiated Unwanted Emissions (Above 1GHz) for GFSK
Modulation                  GFSK                    Test Freq. (MHz)    2402
Polarization                Horizontal




Note 1: Emission Level (dBuV/m) = SA Reading (dBuV/m) + Factor* (dB)
      *Factor includes antenna factor , cable loss and amplifier gain
Note 2: Margin (dB) = Emission level (dBuV/m) – Limit (dBuV/m).




Report No.: FR3D0402-02AD                                                      Page : 18 of 30
Report Version: Rev. 01


Modulation                  GFSK                    Test Freq. (MHz)    2402
Polarization                Vertical




Note 1: Emission Level (dBuV/m) = SA Reading (dBuV/m) + Factor* (dB)
      *Factor includes antenna factor , cable loss and amplifier gain
Note 2: Margin (dB) = Emission level (dBuV/m) – Limit (dBuV/m).




Report No.: FR3D0402-02AD                                                      Page : 19 of 30
Report Version: Rev. 01


Modulation                  GFSK                    Test Freq. (MHz)    2441
Polarization                Horizontal




Note 1: Emission Level (dBuV/m) = SA Reading (dBuV/m) + Factor* (dB)
      *Factor includes antenna factor , cable loss and amplifier gain
Note 2: Margin (dB) = Emission level (dBuV/m) – Limit (dBuV/m).




Report No.: FR3D0402-02AD                                                      Page : 20 of 30
Report Version: Rev. 01


Modulation                  GFSK                    Test Freq. (MHz)    2441
Polarization                Vertical




Note 1: Emission Level (dBuV/m) = SA Reading (dBuV/m) + Factor* (dB)
      *Factor includes antenna factor , cable loss and amplifier gain
Note 2: Margin (dB) = Emission level (dBuV/m) – Limit (dBuV/m).




Report No.: FR3D0402-02AD                                                      Page : 21 of 30
Report Version: Rev. 01


Modulation                  GFSK                    Test Freq. (MHz)    2480
Polarization                Horizontal




Note 1: Emission Level (dBuV/m) = SA Reading (dBuV/m) + Factor* (dB)
      *Factor includes antenna factor , cable loss and amplifier gain
Note 2: Margin (dB) = Emission level (dBuV/m) – Limit (dBuV/m).




Report No.: FR3D0402-02AD                                                      Page : 22 of 30
Report Version: Rev. 01


Modulation                  GFSK                    Test Freq. (MHz)    2480
Polarization                Vertical




Note 1: Emission Level (dBuV/m) = SA Reading (dBuV/m) + Factor* (dB)
      *Factor includes antenna factor , cable loss and amplifier gain
Note 2: Margin (dB) = Emission level (dBuV/m) – Limit (dBuV/m).




Report No.: FR3D0402-02AD                                                      Page : 23 of 30
Report Version: Rev. 01


3.2.6     Transmitter Radiated Unwanted Emissions (Above 1GHz) for 8DPSK
Modulation                  8DPSK                   Test Freq. (MHz)    2402
Polarization                Horizontal




Note 1: Emission Level (dBuV/m) = SA Reading (dBuV/m) + Factor* (dB)
      *Factor includes antenna factor , cable loss and amplifier gain
Note 2: Margin (dB) = Emission level (dBuV/m) – Limit (dBuV/m).




Report No.: FR3D0402-02AD                                                      Page : 24 of 30
Report Version: Rev. 01


Modulation                  8DPSK                   Test Freq. (MHz)    2402
Polarization                Vertical




Note 1: Emission Level (dBuV/m) = SA Reading (dBuV/m) + Factor* (dB)
      *Factor includes antenna factor , cable loss and amplifier gain
Note 2: Margin (dB) = Emission level (dBuV/m) – Limit (dBuV/m).




Report No.: FR3D0402-02AD                                                      Page : 25 of 30
Report Version: Rev. 01


Modulation                  8DPSK                   Test Freq. (MHz)    2441
Polarization                Horizontal




Note 1: Emission Level (dBuV/m) = SA Reading (dBuV/m) + Factor* (dB)
      *Factor includes antenna factor , cable loss and amplifier gain
Note 2: Margin (dB) = Emission level (dBuV/m) – Limit (dBuV/m).




Report No.: FR3D0402-02AD                                                      Page : 26 of 30
Report Version: Rev. 01


Modulation                  8DPSK                   Test Freq. (MHz)    2441
Polarization                Vertical




Note 1: Emission Level (dBuV/m) = SA Reading (dBuV/m) + Factor* (dB)
      *Factor includes antenna factor , cable loss and amplifier gain
Note 2: Margin (dB) = Emission level (dBuV/m) – Limit (dBuV/m).




Report No.: FR3D0402-02AD                                                      Page : 27 of 30
Report Version: Rev. 01


Modulation                  8DPSK                   Test Freq. (MHz)    2480
Polarization                Horizontal




Note 1: Emission Level (dBuV/m) = SA Reading (dBuV/m) + Factor* (dB)
      *Factor includes antenna factor , cable loss and amplifier gain
Note 2: Margin (dB) = Emission level (dBuV/m) – Limit (dBuV/m).




Report No.: FR3D0402-02AD                                                      Page : 28 of 30
Report Version: Rev. 01


Modulation                  8DPSK                   Test Freq. (MHz)    2480
Polarization                Vertical




Note 1: Emission Level (dBuV/m) = SA Reading (dBuV/m) + Factor* (dB)
      *Factor includes antenna factor , cable loss and amplifier gain
Note 2: Margin (dB) = Emission level (dBuV/m) – Limit (dBuV/m).




Report No.: FR3D0402-02AD                                                      Page : 29 of 30
Report Version: Rev. 01


C          Infernational
           Certification
           Corp.




4          Test laboratory information
Established in 2012, ICC provides foremost EMC & RF Testing and advisory consultation services by our
skilled engineers and technicians. Our services employ a wide variety of advanced edge test equipment and
one of the widest certification extents in the business.


International Certification Corp, it is our definitive objective is to institute long term, trust—based associations
with our clients. The expectation we set up with our clients is based on outstanding service, practical expertise
and devotion to a certified value structure. Our passion is to grant our clients with best EMC / RF services by
oriented knowledgeable and accommodating staff.


Our Test sites are located at Linkou District and Kwei Shan Hsiang. Location map can be found on our
website http://www.icertifi.com.tw.


Linkou                                     Kwei Shan                             Kwei Shan Site II
Tel: 886—2—2601—1640                       Tel: 886—3—271—8666                   Tel: 886—3—271—8640
No. 30—2, Ding Fwu Tsuen, Lin Kou          No. 3—1, Lane 6, Wen San 3rd          No. 14—1, Lane 19, Wen San 3rd
District, New Taipei City, Taiwan,         St., Kwei Shan Hsiang, Tao Yuan       St., Kwei Shan Hsiang, Tao Yuan
R.0.C.                                     Hsien 333, Taiwan, R.0.C.             Hsien 333, Taiwan, R.0.C.


If you have any suggestion, please feel free to contact us as below information

Tel: 886—3—271—8666
Fax: 886—3—318—0155
Email: ICC_Service@icertifi.com.tw




==END=




Report No.: FR3D0402—02AD                                                                     Page : 30 of 30
Report Version: Rev. 01



Document Created: 2017-09-17 20:12:29
Document Modified: 2017-09-17 20:12:29

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