Ic cert Application



Yüklə 110,05 Kb.
tarix05.04.2018
ölçüsü110,05 Kb.
növüApplication form

c:\users\decrowder\appdata\local\microsoft\windows\temporary internet files\content.outlook\od26t181\elite_logo_process.jpg


IC Equipment Certification Application Form


Appendix A:

Item 1. Applicant Information
Company Name:      

Address:      

Line 2:      

City:      

State:    Country (if foreign address):       Zip/Postal Code:      

Contact Name:      

Phone:       Fax:      

Email:      

ISED Company Number:      

Item 2. Canadian Representative Information
Company Name:      

Address:      

Line 2:      

City:      

State:    Country (if foreign address):       Zip/Postal Code:      

Contact Name:      

Phone:       Fax:      

Email:      

ISED Company Number:      

Item 3. *ISED Company Number:       *UPN Number (11 characters maximum):      

*Hardware Version Identification Number (HVIN):      

Product Description:      

*Product Marketing Name (PMN):      

Firmware Version Identification Number (FVIN):      

RSS(s) and Issue numbers:      

*Type of Service: 

*Modular Approval: 

Host Marketing Name (HMN):      

Item 4. AGREEMENT:

THE APPLICANT AGREES TO:

(i) Accept responsibility for all charges arising from this application;

(ii) Meet all requirements in accordance with Radio Standards Procedure 100 and other applicable procedures;

(iii) Warrant that the test results submitted are a true representation of the characteristics of the radio equipment type for which certification is requested;

(iv) Inform Elite of any changes to the information submitted.



Name:       Title and Company Name:      

Signature:       Date:      



Appendix B:

Manufacturer:

     

ISED Company Number:

     

Hardware Version Identification Number (HVIN):

     

UPN Number:

     

Test Laboratory Name:

     

Product Description:

     

Test Laboratory Contact, Phone and Email:

     

Antenna Type & Gain:

     

All Used IC OATS Registration Numbers:

     

Test Lab Company Number:

     




Emissions Information

Radio Standard

Frequency Range

RF Power

Field Strength

Bandwidth

Emission Classification

Transmitter Spurious Units at Distance

RSS No.

Issue No.

Minimum (MHz)

Maximum

(MHz)

Minimum (W)

Maximum (W)

Units at Distance

Measured

(kHz)

Calculated

(kHz)







     

     

     

     

     

     

     

      

     

     

     

     

     

     

     

     

     

     

      

     

     

     

     

     

     

     

     

     

     

      

     

     

     

     

     

     

     

     

     

     

      

     

     

     

     

     

     

     

     

     

     

      

     

     

     

     

     

     

     

     

     

     

      

     

     

     

     

     

     

     

     

     

     

      

     

     

     

     

     

     

     

     

     

     

      

     

     

     

     

     

     

     

     

     

     

      

     

     

     

     

     

     

     

     

     

     

      

     

     

     

     

     

     

     

     

     

     

      

     

     

     

     

     

     

     

     

     

     

      

     

     

     

     

     

     

     

     

     

     

      

     

     

     

     

     

     

     

     

     

     

      

     

     

     

     

     

     

     

     

     

     

      

     

     

     

     

     

     

     

     

     

     

      

     

     

     

     

     

     

     

     

     

     

      

     

     

     

     

     

     

     

     

     

     

      

     

     

     



Agreement Signature

ATTESTATION: The test measurements were made in accordance with the above-mentioned departmental standard(s), and the equipment identified in this application has been subject to all the applicable test conditions specified in the departmental standards and all of the requirements of the standards have been met.

Applicant/Agent Name:

     

Applicant/Agent Title:

     

Applicant/Agent Signature:

     

Signature Date:

     



Annex A – RF Technical Brief Cover Sheet

All Fields must be completed with the requested information or the following codes: N/A for Not Applicable, N/P for Not Performed or N/V for Not Available. Where applicable, check appropriate box.

ISED Company Number:      

Hardware Version Identification Number (HVIN):      

Manufacturer:      

SAR Test Lab Company Number:      

Multiple Simultaneous Transmission:      

TYPE OF EVALUATION: Complete the applicable sections: (a) SAR Evaluation: Device Used in the Vicinity of the Human Head; (b) SAR Evaluation: Body-worn Device; (c) SAR Evaluation: Limb-worn Device (d) RF Evaluation)

Note: The worst-case scenario (i.e. highest measured value obtained) should be reported.


(a) SAR Evaluation: Device used in the Vicinity of the Human Head

● Multiple transmitters: Yes  No 

● Exposure limits used: General Public Use  Controlled Use 

● Duty cycle used in evaluation:      %

● Standard used for evaluation:      

● SAR value:      W/kg. Measured  Computed  Calculated 


(b) SAR Evaluation: Body-worn Device

● Multiple transmitters: Yes  No 

● Exposure limits used: General Public Use  Controlled Use 

● Duty cycle used in evaluation:      %

● Standard used for evaluation:      

● SAR value:      W/kg. Measured  Computed  Calculated 


(c) SAR Evaluation: Limb-worn Device

● Multiple transmitters: Yes  No 

● Exposure limits used: General Public Use  Controlled Use 

● Duty cycle used in evaluation:      %

● Standard used for evaluation:      

● SAR value:      W/kg. Measured  Computed  Calculated 


(d) RF Evaluation

● Exposure limits used: General Public Use  Controlled Use 

● Duty cycle used in evaluation:      %

● Standard used for evaluation:      

● Measurement distance:      m

● RF value:       V/m  A/m  W/m2 



● Measurement Method: Measured  Computed  Calculated 




Annex B - Declaration of RF Exposure Compliance

ATTESTATION: I attest that the information provided in Annex A is correct; that the Technical Brief was prepared and the information contained therein is correct; that the device evaluation was performed or supervised by me; that applicable measurement methods and evaluation methodologies have been followed; and that the device meets the SAR and/or RF field strength limits of RSS-102.

Signature:       Date:      

NAME:      

TITLE:      

COMPANY:      

PRODUCT MARKETING NAME (PMN):      

HARDWARE VERSION IDENTIFICATION NO. (HVIN):      

FIRMWARE VERSION IDENTIFICATION NO. (FVIN):      

HOST MARKETING NAME (HMN):      

IC CERTIFICATION NUMBER:      




Annex C - Declaration of RF Exposure Compliance for Exemption from Routine Evaluation Limits

ATTESTATION: I attest that the radio communication apparatus meets the exemption from the routine evaluation limits in Section 2.5 of RSS-102; that the Technical Brief was prepared and the information contained therein is correct; that the device evaluation was performed or supervised by me; that applicable measurement methods and evaluation methodologies have been followed; and that the device meets the SAR and/or RF field strength limits of RSS-102.

Signature:       Date:      

NAME (Please print or type):      

TITLE (Please print or type):      

COMPANY (Please print or type):      

PRODUCT MARKETING NAME (PMN):      

HARDWARE VERSION IDENTIFICATION NO. (HVIN):      

FIRMWARE VERSION IDENTIFICATION NO. (FVIN):      

HOST MARKETING NAME (HMN):      

IC CERTIFICATION NUMBER:      



Annex D - Modular Approval Attestation

Product Information

PMN:




FVIN:




HMN:




ISED Company Number:




HVIN:




UPN Number:




For Modular Approval, the module shall meet all the requirements listed below. Please check () if the module complies with the stated requirement.

Modular Checklist/Information




The radio elements shall have the radio frequency circuitry shielded. Physical / discrete and tuning capacitors may be located external to the shield, but must be on the module assembly;



The module shall have buffered modulation/data input(s) (if such inputs are provided) to ensure that the module will comply with the requirements set out in the applicable RSS standard under conditions of excessive data rates or over-modulation.



The module shall have its own power supply regulation on the module. 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 which houses the module.



The module shall comply with the provisions for external power amplifiers and antennas detailed in the applicable RSS standard. The equipment certification submission shall contain a detailed description of the configuration of highest antenna gain for each type of antenna.



The module shall be tested for compliance with the applicable standard in a stand-alone configuration, i.e. the module must not be inside another product during testing.



The module complies or will comply with applicable RSS-102 exposure requirements, in its intended configuration/integration in a host.









Limited Modular Approval (LMA)

If a module(s) does NOT meet one or more of the above listed requirements, the applicant may request Limited Modular Approval (LMA). For LMA, please state details about why the above requirement(s) could not be met; and state how control of the end product, into which the module will be installed, will be maintained by the applicant / manufacturer, such that full compliance of the end product is always ensured:      

Applicant/Agent Name:       Applicant/Agent Title:      

Applicant/Agent Signature:       Signature Date:      

Instructions for completing the Elite Electronic Engineering, Inc.

Industry Canada Equipment Certification Application Form

Appendix A:

Item 1: Please complete these sections with the APPLICANT’S contact information. All correspondence regarding the application will be directed to this contact. When issued, the original certificate will be sent to this contact. This contact may not always be the test lab that performed the testing of the device. This contact may be a third-party agent or the Applicant itself. Please complete all areas.
Item 2: Please complete these sections with the CANADIAN REPRESENTATIVE’S contact information. The applicant must provide, in writing, the identity of a representative in Canada who is capable of responding to enquiries and who can provide post-certification audit samples at no charge to Industry Canada.
Item 3: Certified radio equipment must be labeled with a unique certification/registration number, which consists of the ISED Company Number (CN), assigned by the Bureau, followed by the Unique Product Number (UPN), assigned by the TAC or Certificate holder.
The certification number is made up of a ISED Company Number (CN) assigned by the Bureau followed by the Unique Product Number (UPN), assigned by the applicant.
The certification number shall appear as follows: “IC: XXXXXX-YYYYYYYYYYY”
Where:

• “XXXXXX-YYYYYYYYYYY” is the certification number;


• “XXXXXX” is the Company Number (CN) assigned by Industry Canada, made of at most 6 alphanumeric characters (A-Z, 0-9), including a letter at the end of the CN to distinguish between different company addresses;

General Requirements and Information for the

Certification of Radiocommunication Equipment RSS-Gen

12
• “YYYYYYYYYYY” is the Unique Product Number (UPN) assigned by the applicant, made of at most 11 alphanumeric characters (A-Z, 0-9); and


• the letters “IC” have no other meaning or purpose than to identify the Industry Canada certification number.

Permitted alphanumerical characters used in the CN and UPN are limited to capital letters (A-Z) and digits (0-9). An example of the new format for a company having a CN of “21A” and wishing to use a UPN of “WILAN3” would thus be: IC: 21A-WILAN3. Each equipment model shall be explicitly identified. The use of characters, such as #, / or -, in the certification number is not allowed. The use of "wild card" characters in the model number (for the purpose of identifying multiple models with one name) is not allowed.


Definition of Terms:
Product Marketing Name (PMN) – The PMN is the name used to identify certified product whether it’s final product or module. The PMN is the

name/model used for advertising a product to consumers. The PMN may be identical for all models in family. If the PMN is identical for all models, the HVIN must be different

Host Marketing Name (HMN) - Name used to identify the host in which a module being certified will be integrated. HMN is not required for non-

modular applications. HMN is not required when module being certified doesn’t require host involvement. HMN is required when module certification requires assessment in host.

Hardware Version Identification Number (HVIN) - IMPORTANT: The HVIN will replace the existing Model Number. The HVIN meant to be a

reference to the technical specs of a model in a family. The HVIN will not require to be right beside certification number on product label –As long as it’s displayed somewhere on the product external surface.

Firmware Version Identification Number (FVIN) - This number is the reference to the specific firmware of a model. IC is only interested in the

firmware number which affects the RF whether it’s the overall product firmware or the radio firmware. The FVIN not required to be on the external surface of device if displayed electronically.


Equipment that has received certification but is not labeled with the applicant’s name, model number and the certification number as outlined above is not considered certified.

Item 4: Please affix the signature and Title of the authorized Applicant.

Appendix B:

Please complete the appropriate sections for the Equipment Specifications.



Annex A, B, and C:

Please complete the appropriate sections for Annex A and B or C. To obtain approval under this Standard, the above mentioned application for certification shall be accompanied by the duly completed RF technical brief cover sheet (see Annex A) and a properly signed declaration of compliance (see Annex B). However, if the device in question meets the exemption from routine evaluation limits of Sections 2.5.1 or 2.5.2 of RSS-102, only a properly signed declaration of compliance (Annex C) shall be submitted. Although submission of the RF exposure technical brief is not required for certification, it shall be made available upon request, for as long as the device model is marketed in Canada.



Modular Approval Requirements:

To obtain equipment certification for a modular device, the application for equipment certification shall include a cover letter in which the applicant requests modular approval for the transmitter concerned. The application for equipment certification shall also include the included completed checklist demonstrating that the modular transmitter complies with each of the required conditions.FOR USE BY ELITE PERSONNEL ONLY DO NOT MARK BELOW LINE



Form Confirmation

Confirmation Number

     

Date filed w/IC

     



Date

Rev.

Description

05/12/2006

1.2

Re-format to match Appendix I and Appendix II of RSP-100.

10/10/2006

1.3

Removed references to RSP-100 and reference to CB-03

04/02/2008

1.4

Updated Labeling requirements

03/12/2009

1.5

Added Annex A and B forms

05/04/2010

1.6

Added Annex C form

5/23/2011

1.7

Added Modular Approval form

2/6/2013

1.8

Added necessary bandwidth

2/22/2013

1.9

Updated appendix B

9/25/13

2.0

Added IC Site and antenna information to appendix B

1/8/15

2.1

Cleaned up form added SAR test lab company number

12/30/15

2.2

Added information to Annex B and Annex C




IC Application Rev. 2.2 Page of



Dostları ilə paylaş:


Verilənlər bazası müəlliflik hüququ ilə müdafiə olunur ©genderi.org 2019
rəhbərliyinə müraciət

    Ana səhifə