W38-241083GCommunication Board with 802.11 WLAN module

Module Installation Instructions And Regulatory Approval Conditions 802.11b/g/n Module Model No: 241083G FCC ID: W38-241083G IC: 8854A-241083G Date: 10-19-2014 Revision: 1 FCC Compliance Statement This device complies with part 15 of the FCC Rules. Operation is subjected to the following two conditions: (1) This device may not cause harmful interference, and (2) this device must accept any interference received, including interference that may cause undesired operation. FCC Warning: Any changes or modifications to this device not expressly approved by the party responsible for compliance could void the user’s authority to operate this equipment. Industry Canada This device complies with Industry Canada license-exempt RSS standard(s). Operation is subject to the following two conditions: (1) this device may not cause interference, and (2) this device must accept any interference, including interference that may cause undesired operation of the device.” Le présent appareil est conforme aux CNR d'Industrie Canada applicables aux appareils radio exempts de licence. L'exploitation est autorisée aux deux conditions suivantes : (1) l'appareil ne doit pas produire de brouillage, et (2) l'utilisateur de l'appareil doit accepter tout brouillage radioélectrique subi, même si le brouillage est susceptible d'en compromettre le fonctionnement." Regulatory Approval Conditions for using 241083G Module: 1. Antennas must have a greater distance than 20 cm separation from the transmitting antenna to the user body during normal operation condition. This device can be used with Prestta WLAN Embedded Antenna. The specification of the antenna including antenna gain is shown below. 2. If a different antenna than the original certificated antenna is being use for the final product, the host will need to consult with Chargepoint, Inc. to verify the condition of approval applicability. 3. A permissive change from Chargepoint, Inc. is required as part of final system FCC/IC submission. The WLAN module does not have RF shielding and was tested in stand- alone configuration. When the module is installed in a new host, it is subject to additional evaluation. 4. If the host has other transmitters beside from the module, simultaneous transmitting is not permitted unless a permissive change from the module manufacture is received. 5. For FCC, the label on the final system must include a statement: use “Contains FCC ID: W38-241083G”. For IC, use “Contains IC: 8854A-241083G”. 6. Labeling requirement for FCC, “This device complies with part 15 of the FCC Rules. Operation is subjected to the following two conditions: (1) This device may not cause harmful interference, and (2) this device must accept any interference received, including interference that may cause undesired operation”. For IC, “This device complies with Industry Canada license-exempt RSS standard(s). Operation is subject to the following two conditions: (1) this device may not cause interference, and (2) this device must accept any interference, including interference that may cause undesired operation of the device.” “Le présent appareil est conforme aux CNR d'Industrie Canada applicables aux appareils radio exempts de licence. L'exploitation est autorisée aux deux conditions suivantes : (1) l'appareil ne doit pas produire de brouillage, et (2) l'utilisateur de l'appareil doit accepter tout brouillage radioélectrique subi, même si le brouillage est susceptible d'en compromettre le fonctionnement." A user’s manual or instruction manual must be included with customer product.

775 Montague Expressway Milpitas, CA 95035 Tel: 408-526-1188 Fax: 408-526-1088 Email: [email protected] Modular Approval Declaration Letter Reason for Amendment (current / obsolete) Revision History Approved Date From To 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 (obsolete) 5.0 6.0 August 29 2011 Updated company template & Added text box (obsolete) 6.0 7.0 Jan-31-2012 Updated modular requirement (current) 7.0 8.0 Sept 05 2014 SCS-F26 Modular Approval Letter Page 2 of 2 Rev 8.0 10/31/2014 (Product name) FCC ID : W38-241083G , 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 capacitor(s) may be located external to the shield, but must be on the module assembly; X 2 The module must have buffered modulation/data inputs to ensure that the device will comply with Part 15 requirements with any type of input signal; X 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), 15.212(a), 2.929(b); X 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 (See KDB Publication 784748 about labelling requirements); X 7 The module must comply with all specific rules applicable to the transmitter including all the conditions provided in the integration instructions by the grantee; X 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 [email protected] Chargepoint, Inc. 1692 Dell Ave. Campbell CA 95008-6901

775 Montague Expressway Milpitas, CA 95035 Tel: 408-526-1188 Fax: 408-526-1088 Email: [email protected] Project and Product Certification Representative Authorization Letter Reason for Amendment (current / obsolete) Revision History Approved Date From To Initial Release (obsolete) 1.0 1.0 Nov-14-2006 Revised wording (obsolete) 1.0 2.0 Sept–25-2007 Updated company template (obsolete) 2.0 3.0 Jan-31-2012 Updated letter information (obsolete) 3.0 4.0 May-23-2014 Added FCC ID field (current) 4.0 5.0 Sept 16 2014 SCS-F18: Project and Product Certification Representative Authorization Letter Page 2 of 2 Rev 5.0 10/31/2014 To: SIEMIC, Inc. 775 Montague Expressway, Milpitas, CA 95035 USA Dear Sir/Madam, Re: Project and Product Certification Representative Authorization Letter We, ChargePoint, Inc., hereby authorize SIEMIC, Inc. to act as Certification Body for certifying for the following project(s): Model: 241083G Product Descriptio: Communication Board with 802.11 WLAN module FCC ID : W38-241083G We affirm that between SIEMIC, Inc. and ChargePoint, Inc., any difference in understanding, including test plan, measurement methods, applicable standards and relevant procedures and processes have been resolved prior to commencement of testing activities. Sincerely, Gary Eldridge, P.E. Regulatory Compliance Manager Phone: 408-841-4536 [email protected] Chargepoint, Inc. 1692 Dell Ave. Campbell CA 95008-6901

775 Montague Expressway Milpitas, CA 95035 Tel: 408-526-1188 Fax: 408-526-1088 Email: [email protected] Confidentiality Request Letter Reason for Amendment (current / obsolete) Revision History Approved Date From To Initial Release (obsolete) 1.0 1.0 Nov-14-2006 Adding CFR 2.459 (obsolete) 1.0 2.0 August – 11 - 2008 Updated company template & Added text box (current) 2.0 3.0 Jan-31-2012 SCS-F19: Confidentiality Request Letter Page 2 of 2 Rev 3.0 10/31/2014 To: Federal Communications Commission Authorization and Evaluation Division 7435 Oakland Mills Road Columbia, MD Subject: Permanent Confidentiality Request for FCC ID: W38-241083G We hereby request confidential treatment of information accompanying this application as outlined below: - Block Diagram - Schematics - Operational Description The above materials contain trade secrets and proprietary information not customarily released to the public. The public disclosure of these materials may be harmful to the applicant and provide unjustified benefits to its competitors. The applicant understands that pursuant to Section 0.457 & 0.459 of the Rules, disclosure of this application and all accompanying documentation will not be made before the date of the Grant for this application. Sincerely, Gary Eldridge, P.E. Regulatory Compliance Manager Phone: 408-841-4536 [email protected] Chargepoint, Inc. 1692 Dell Ave. Campbell CA 95008-6901

EUT Photos EUT – PCBA 1 Component Side EUT – PCBA 1 Solder Side EUT – PCBA1 Component Side EUT – PCBA1 Solder Side EUT – WLAN Radio with Shielding EUT – WLAN Radio without Shielding EUT – WWAN Radio with Shielding EUT – WWAN Radio without Shielding

Label Location

EUT Photos EUT – PCBA 1 Component Side EUT – PCBA 1 Solder Side EUT – PCBA1 Component Side EUT – PCBA1 Solder Side EUT – WLAN Radio with Shielding EUT – WLAN Radio without Shielding EUT – WWAN Radio with Shielding EUT – WWAN Radio without Shielding

MPE CALCULATION WLAN: FCC ID: W38-241083G / IC ID: 8854A-241083G WWAN: FCC ID: W38-PXS8 / IC ID: 8854A-PXS8 _____________________________________________________________________________________________________________________ RF Exposure Requirements: 47 CFR §1. 1307(b) RF Radiation Exposure Limits: 47 CFR §1. 1310 RF Radiation Exposure Guidelines: FCC OST/OET Bulletin Number 65 EUT Frequency Band: 2412-2462 MHz Limits for General Population/Uncontrolled Exposure in the band of: 1500 - 100,000 MHz Power Density Limit: 1 mW / cm 2 Equation: S = PG / 4R 2 or R = √PG / 4S Where, S = Power Density P = Power Input to Antenna G = Antenna Gain R = distance to the center of radiated antenna ______________________________________________________________________________________________________________________ Prediction distance 20cm (WLAN): Power = 17.9 dBm, Antenna Gain = 2.5 dBi, Power density = 0.022 mW/ cm 2 (WWAN 1900MHz): Power = 27.29 dBm, Antenna Gain = 2.5 dBi, Power density = 0.190 mW/ cm 2 (WWAN 850MHz): Power = 30.49 dBm, Antenna Gain = 2.5 dBi, Power density = 0.396 mW/ cm 2 Total Ratio =(P WLAN /1) + (P WWAN 850MHz /0.5495) = 0.022 mW/ cm 2 + 0.721 mW/ cm 2 = 0.743 mW/ cm 2 The Above Result had shown that the Device complied with MPE requirement. Completed By: Teody Manansala SIEMIC, Inc 775 Montague Expressway, Milpitas, CA 95035 Phone: (408) 526-1188 Date: November 3, 2014

775 Montague Expressway, Milpitas, CA 95035, USA • Phone: (+1) 408 526 1188 • Facsimile (+1) 408 526 1088 Visit us at: www.siemic.com; Follow us at: Report No.: FCC_RF_SL14090901-CPC-006 WLAN_Rev1.0 Supersede Report No.: FCC_RF_SL14090901-CPC-006 WLAN Applicant : ChargePoint, Inc. Product Name : Communication Board with 802.11 WLAN module Model No. : 241083G Test Standard : 47 CRF 15.247: 2013 RSS-210 Issue 8: 2010 Test Method : ANSI C63.10: 2009 RSS-Gen Issue 3: 2010 558074 D01 DTS Meas Guidance v03r02 FCC ID : WLAN Module: W38-241083G IC ID : WLAN Module: 8854A-241083G Dates of test : Oct 2, 2014 to Oct 10, 2014 Issue Date : 11/03/2014 Test Result : ☒ Pass ☐ Fail Equipment complied with the specification [X] Equipment did not comply with the specification [ ] This Test Report is Issued Under the Authority of: Teody Manansala Nima Molaei Test Engineer Engineer Reviewer This test report may be reproduced in full only Test result presented in this test report is applicable to the tested sample only Issued By: SIEMIC Laboratories 775 Montague Expressway, Milpitas, 95035 CA RF TEST REPORT Test report No. FCC_RF_SL14090901-CPC-006 WLAN_Rev1.0 Page 2 of 42 775 Montague Expressway, Milpitas, CA 95035, USA • Phone: (+1) 408 526 1188 • Facsimile (+1) 408 526 1088 Visit us at: www.siemic.com; Follow us at: Laboratory Introduction SIEMIC, headquartered in the heart of Silicon Valley, with superior facilities in US and Asia, is one of the leading independent testing and certification facilities providing customers with one-stop shop services for Compliance Testing and Global Certifications. In addition to testing and certification, SIEMIC provides initial design reviews and compliance management throughout a project. Our extensive experience with China, Asia Pacific, North America, European, and International compliance requirements, assures the fastest, most cost effective way to attain regulatory compliance for the global markets. Accreditations for Conformity Assessment Country/Region Accreditation Body Scope USA FCC, A2LA EMC, RF/Wireless, Telecom Canada IC, A2LA, NIST EMC, RF/Wireless, Telecom Taiwan BSMI, NCC, NIST EMC, RF, Telecom, Safety Hong Kong OFTA, NIST RF/Wireless, Telecom Australia NATA, NIST EMC, RF, Telecom, Safety Korea KCC/RRA, NIST EMI, EMS, RF, Telecom, Safety Japan VCCI, JATE, TELEC, RFT EMI, RF/Wireless, Telecom, Mexico NOM, COFETEL, Caniety EMC, RF/Wireless, Telecom, Safety Europe A2LA, NIST EMC, RF, Telecom, Safety Israel MOC, NIST EMC, RF, Telecom, Safety Accreditations for Product Certifications Country Accreditation Body Scope USA FCC TCB, NIST EMC, RF, Telecom Canada IC FCB, NIST EMC, RF, Telecom Singapore iDA, NIST EMC, RF, Telecom EU NB EMC & R&TTE Directive Japan MIC (RCB 208) RF, Telecom Hong Kong OFTA (US002) RF, Telecom Test report No. FCC_RF_SL14090901-CPC-006 WLAN_Rev1.0 Page 3 of 42 775 Montague Expressway, Milpitas, CA 95035, USA • Phone: (+1) 408 526 1188 • Facsimile (+1) 408 526 1088 Visit us at: www.siemic.com; Follow us at: CONTENTS 1 REPORT REVISION HISTORY ....................................................................................................................................... 4 2 EXECUTIVE SUMMARY ................................................................................................................................................. 5 3 CUSTOMER INFORMATION .......................................................................................................................................... 5 4 TEST SITE INFORMATION ............................................................................................................................................ 5 5 MODIFICATION ............................................................................................................................................................. 5 6 EUT INFORMATION ...................................................................................................................................................... 6 6.1 EUT Description ........................................................................................................................................................ 6 6.2 Radio Description ...................................................................................................................................................... 6 6.3 EUT test modes/configuration Description.................................................................................................................... 7 6.4 EUT Photos .............................................................................................................................................................. 8 6.5 EUT Test Setup Photos ............................................................................................................................................. 9 7 SUPPORTING EQUIPMENT/SOFTWARE AND CABLING DESCRIPTION ....................................................................... 10 7.1 Supporting Equipment ............................................................................................................................................. 10 7.2 Cabling Description ................................................................................................................................................. 10 7.3 Test Software Description ........................................................................................................................................ 10 8 TEST SUMMARY ......................................................................................................................................................... 11 9 MEASUREMENT UNCERTAINTY ................................................................................................................................. 12 10 MEASUREMENTS, EXAMINATION AND DERIVED RESULTS .................................................................................. 13 10.…

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775 Montague Expressway, Milpitas, CA 95035, USA • Phone: (+1) 408 526 1188 • Facsimile (+1) 408 526 1088 Visit us at: www.siemic.com; Follow us at: Report No.: FCC_RF_SL14090901-CPC-006_Rev1.0 Supersede Report No.: FCC_RF_SL14090901-CPC-006 Applicant : ChargePoint, Inc. Product Name : Communication Board with 802.11 WLAN module Model No. : 241083G and PXS8 Test Standard : 47 CRF 15.247: 2013 RSS-210 Issue 8: 2010 Test Method : ANSI C63.10: 2009 RSS-Gen Issue 3: 2010 558074 D01 DTS Meas Guidance v03r02 FCC ID : WLAN Module: W38-241083G WWAN Module:W38-PXS8 IC ID : WLAN Module: 8854A-241083G WWAN Module: 8854A -PXS8 Dates of test : Oct 2, 2014 to Oct 10, 2014 Issue Date : 11/03/2014 Test Result : ☒ Pass ☐ Fail Equipment complied with the specification [X] Equipment did not comply with the specification [ ] This Test Report is Issued Under the Authority of: Teody Manansala Nima Molaei Test Engineer Engineer Reviewer This test report may be reproduced in full only Test result presented in this test report is applicable to the tested sample only Issued By: SIEMIC Laboratories 775 Montague Expressway, Milpitas, 95035 CA RF TEST REPORT Test report No. FCC_RF_SL14090901-CPC-006_Rev1.0 Page 2 of 21 775 Montague Expressway, Milpitas, CA 95035, USA • Phone: (+1) 408 526 1188 • Facsimile (+1) 408 526 1088 Visit us at: www.siemic.com; Follow us at: Laboratory Introduction SIEMIC, headquartered in the heart of Silicon Valley, with superior facilities in US and Asia, is one of the leading independent testing and certification facilities providing customers with one-stop shop services for Compliance Testing and Global Certifications. In addition to testing and certification, SIEMIC provides initial design reviews and compliance management throughout a project. Our extensive experience with China, Asia Pacific, North America, European, and International compliance requirements, assures the fastest, most cost effective way to attain regulatory compliance for the global markets. Accreditations for Conformity Assessment Country/Region Accreditation Body Scope USA FCC, A2LA EMC, RF/Wireless, Telecom Canada IC, A2LA, NIST EMC, RF/Wireless, Telecom Taiwan BSMI, NCC, NIST EMC, RF, Telecom, Safety Hong Kong OFTA, NIST RF/Wireless, Telecom Australia NATA, NIST EMC, RF, Telecom, Safety Korea KCC/RRA, NIST EMI, EMS, RF, Telecom, Safety Japan VCCI, JATE, TELEC, RFT EMI, RF/Wireless, Telecom, Mexico NOM, COFETEL, Caniety EMC, RF/Wireless, Telecom, Safety Europe A2LA, NIST EMC, RF, Telecom, Safety Israel MOC, NIST EMC, RF, Telecom, Safety Accreditations for Product Certifications Country Accreditation Body Scope USA FCC TCB, NIST EMC, RF, Telecom Canada IC FCB, NIST EMC, RF, Telecom Singapore iDA, NIST EMC, RF, Telecom EU NB EMC & R&TTE Directive Japan MIC (RCB 208) RF, Telecom Hong Kong OFTA (US002) RF, Telecom Test report No. FCC_RF_SL14090901-CPC-006_Rev1.0 Page 3 of 21 775 Montague Expressway, Milpitas, CA 95035, USA • Phone: (+1) 408 526 1188 • Facsimile (+1) 408 526 1088 Visit us at: www.siemic.com; Follow us at: CONTENTS 1 REPORT REVISION HISTORY ....................................................................................................................................... 4 2 EXECUTIVE SUMMARY ................................................................................................................................................. 5 3 CUSTOMER INFORMATION .......................................................................................................................................... 5 4 TEST SITE INFORMATION ............................................................................................................................................ 5 5 MODIFICATION ............................................................................................................................................................. 5 6 EUT INFORMATION ...................................................................................................................................................... 6 6.1 EUT Description ........................................................................................................................................................ 6 6.2 Radio Description ...................................................................................................................................................... 6 6.3 EUT test modes/configuration Description.................................................................................................................... 7 6.4 EUT Photos .............................................................................................................................................................. 8 6.5 EUT Test Setup Photos ........................................................................................................................................... 10 7 SUPPORTING EQUIPMENT/SOFTWARE AND CABLING DESCRIPTION ....................................................................... 11 7.1 Supporting Equipment ............................................................................................................................................. 11 7.2 Cabling Description ................................................................................................................................................. 11 7.3 Test Software Description ........................................................................................................................................ 11 8 TEST SUMMARY ......................................................................................................................................................... 12 9 MEASUREMENT UNCERTAINTY ................................................................................................................................. 13 10 MEASUREMENTS, EXAMINATION AND DERIVED RESULTS .......................................................…

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EUT Test Setup Photos Radiated Emissions (<1GHz) – Front View Radiated Emissions (<1GHz) – Rear View Radiated Emissions (>1GHz) – Front View Radiated Emissions (>1GHz) – Rear View Conducted Emissions – AC Line Front View Conducted Emissions – AC Line Rear View