W38-28010087RFID reader

Module Installation Instructions And Regulatory Approval Conditions 802.11a/b/g/n and RFID Model No: 28010077 and 28010087 FCC ID: W38-28010077 & W38-28010087 IC: 8854A-28010077 & 8854A-28010087 Date: 8-12-2015 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 28010077 and 28010087 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 for 28010077. The specification of the antenna including antenna gain is shown below. For 28010087, the antenna is integrated onboard. 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 Coulomb Technologies Inc. is required as part of final system FCC/IC submission. 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: W38-28010077, W38-28010087”. For IC, use “Contains IC: 8854A-28010077, 8854A-28010087”. 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.

SCS-F18: Project and Product Certification Representative Authorization Letter Page 1 of 2 Rev 5.0 775 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 September 14, 2015 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): FCC ID: W38-28010087 Product Description: RFID reader Model Number: 28010087 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. 254 E. Hacienda Ave Campbell CA 95008

SCS-F19: Confidentiality Request Letter Page 1 of 2 Rev 4.0 775 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 (obsolete) 2.0 3.0 Jan-31-2012 Added IC confidentiality letter form (current) 3.0 4.0 March-26-2015 SCS-F19: Confidentiality Request Letter Page 2 of 2 Rev 4.0 10/1/2015 To: Federal Communications Commission Authorization and Evaluation Division 7435 Oakland Mills Road Columbia, MD Subject: Permanent Confidentiality Request for FCC ID: W38-28010087 We hereby request confidential treatment of information accompanying this application as outlined below: - e.g. Block Diagram - e.g. Schematics - e.g. 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. 254 E. Hacienda Ave Campbell CA 95008

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 (obsolete) 7.0 8.0 Sept 05 2014 Updated template to meet RSP 100 issue 10 (obsolete) 8.0 9.0 Nov 20 2014 Updated template to meet RSP 100 issue 11 (current) 9.0 10.0 March 19 2015 SCS-F26 Modular Approval LetterPage 2 of 3Rev 10.0 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.” ItemModularrequirementYesNo 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); 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. 254 E. Hacienda Ave Campbell CA 95008 x SCS-F26 Modular Approval LetterPage 3 of 3Rev 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 [email protected] ChargePoint, Inc. 254 E. Hacienda Ave Campbell CA 95008

Test report No. RF_SL15081001-CPC-008-FCC-IC_RFID Page 1 775 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: PCBA1 RFID Antenna - View 1 PCBA1 RFID Antenna- View 2

ChargePoint Inc. Model: 28010087 FCC ID: W38-28010087 IC: 8854A-28010087 This device complies with Part 15 of the FCC rules. Operation is subject to the 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. CAN ICES-3 (B)/NMB-3 (B)

Test report No. RF_SL15081001-CPC-008-FCC-IC_RFID Page 1 775 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: PCBA1 RFID Antenna - View 1 PCBA1 RFID Antenna- View 2

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: Issued By: SIEMIC Laboratories 775 Montague Expressway, Milpitas, CA 95035 RF TEST REPORT Report No.: RF_SL15081001-CPC-008-FCC-IC_RFID Supersede Report No.: None This Test Report is Issued Under the Authority of: Osvaldo Casorla Chen Ge 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 Applicant : ChargePoint, Inc. Product Name : RFID Reader Model No. : 28010087 Test Standard : FCC 15.225 2014 RSS-210 Issue 8: 2010 Test Method : FCC 15.225 2014 ANSI C63.10 2013 RSS Gen Issue 4 2014 FCC ID : W38-28010087 IC ID : 8854A-28010087 Dates of test : August 24 th , 28 th , September 18 th , and 23 rd of 2015 Issue Date : 9/24/2015 Test Result : ☒ Pass ☐ Fail Equipment complied with the specification [X ] Equipment did not comply with the specification [ ] Test report No. RF_SL15081001-CPC-008-FCC-IC_RFID Page 2 of 29 775 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. RF_SL15081001-CPC-008-FCC-IC_RFID Page 3 of 29 775 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 – External .............................................................................................................................................. 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 10.1 Antenna Requirement.............................................................................…

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Test report No. RF_SL15081001-CPC-008-FCC-IC_RFID Page 1 775 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: AC Line Conducted Emissions– Front View AC Line Conducted Emissions– Rear View Radiated Emissions (<1GHz) – Front View Radiated Emissions (<1GHz) – Rear View Radiated Emissions (<30MHz) – Front View Radiated Emissions (<30MHz) – Rear View