Z6N-107394CWR 107394

Page 1 of 3 CAN Wireless Receiver (CWR) Page 2 of 3 1.0 CAN WIRELESS RECEIVER 1.1 FUNCTION The CWR facilitates data transfers and other communications between the WDS and the TC3. 1.2 INSTALLATION The CWR is mounted onto the front pedestal using 1/4" self-tapping screws. VM0063 Screw, Hex Head Self Tapping 1/4"-14 x 1" Consider the following requirements when selecting a mounting location for the CWR: o Mount the CWR with the cables facing down. o Mount the CWR as low on the pedestal as close to the frame rail as possible (allowing for the cables to be connected correctly). o The CWR cannot block any safety stickers or placards. Page 3 of 3 1.3 CONNECTIONS The male M12 connector connects to a Bus Cable that runs to the Y Cable Assembly. VM0444 1.5 Meter 3.1 Bus Cable The female M12 connector connects to a Bus Cable that runs to the DRS. VM0444 1.5 Meter 3.1 Bus Cable 1.4 FCC Per FCC 15.19(a)(3) and (a)(4) This device complies with part 15 of the FCC Rules. Operation is subject 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. Per FCC 15.21, The user manual or instruction manual for an intentional or unintentional radiator shall caution the user that changes or modifications not expressly approved by the party responsible for compliance could void the user's authority to operate the equipment. To satisfy RF exposure requirements, this device and its antenna must operate with a separation distance of at least 20 cm from all persons." Reference FCC KDB 784748, Section A.8.

CWR – Frequency Block Diagram Transmitted Frequency 2.4GHz – 2.4835GHz

CAN WIRELESS RECEIVER (CWR) Cover Letter Date: January 29, 2021 Element Materials Technology 6775 NE Evergreen Parkway, Suite 400 Hillsboro, OR 97124, United States RE: Cover Letter for FCC Application for Certification for CWR To Whom it may concern: We would like to file for our can wireless receiver (CWR) model CWR-107394 where we are pursuing its original certification according to rule parts in FCC 15.247. The CWR is a device that facilitates communications with the wireless sensor in the Verifi system. The FCC ID number is Z6N – 107394 Verifi LLC is a wholly owned subsidiary company of GCP Applied Technologies Inc. Sincerely yours, Susan Dalton VP Smart Technology & IoT Phone: +1 617-498-3852 Email: [email protected] GCP Applied Technologies 62 Whittemore Avenue Cambridge, Massachusetts 02140 USA

Request for Confidentiality Letter Date: Jan 29, 2021 Federal Communications Commission Authorization and Evaluation Division 7435 Oakland Mills Road Columbia, Maryland 21046 Re: Request for confidentiality FCC ID: Z6N-107394 To whom it may concern, We hereby respectfully request that under the provision of 47 CFR 0.459 and 0.457(d) the documents listed below and attached with this application for certification be provided with confidential status. • Schematics.pdf • Operational Description.pdf Any exhibit / information for which we have requested confidentiality, but which may not be accorded such treatment by the FCC, should be returned to us. The documents listed above contain trade secrets that are treated as confidential by us. Substantial competitive harm to us could result should they be made available to the public. Sincerely, Susan Dalton VP Smart Technology & IoT Phone: +1 617-498-3852 Email: [email protected] GCP Applied Technologies 62 Whittemore Avenue Cambridge, Massachusetts 02140 USA

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1 FCC E-Label Navigation, Steps 1 and 2 Weclome to Verifi Turn the knob and press to select Slump Management System Ticket Information Driver Initiated Messages Fluid and Revolution Detail Drum Washout Winter EOD Process Select Language Weclome to Verifi Turn the knob and press to select Drum Washout Winter EOD Process Select Language Settings FCC E-Label Log Out Turn Verifi System Off When system turns on, user is taken to the Home Screen By turning the knob, user scrolls to FCC E-Label selection and presses the knob 2 This is editable using the Powerpoint footer functionality FCC E-Label Navigation, Step 3 FCC E-Labels Turn the knob and press to select CAN Wireless Receiver Wireless Drum Sensor FCC Statement -- CWR FCC Certification CAN Wireless Receiver FCC ID Z6N-107394 This device complies with part 15 of the FCC Rules. Operation is subject 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. Press the Home button for Main Menu CWR: FCC ID Z6N-107394

Radio Antenna

CWR - Antenna Info Manufacturer Taoglas Model Number WLP.2450.25.4.A.02 Gain 5 dBi Description Patch Photograph FCC 15.203 compliance Antenna is soldered to the PCB

This report must not be used to claim product certification, approval, or endorsement by NVLAP, NIST, or any agency of the U.S. Government. This Report shall not be reproduced, except in full without written approval of the laboratory. EAR-Controlled Data - This document contains technical data whose export and reexport/retransfer is subject to control by the U.S. Department of Commerce under the Export Administration Act and the Export Administration Regulations. The Department of Commerce’s prior written approval may be required for the export or re- export/retransfer of such technical data to any foreign person, foreign entity or foreign organization whether in the United States or abroad. More: https://www.bis.doc.gov/index.php/forms-documents/regulations-docs/14-commerce-country-chart/fileT GCPAT CWR FCC 2.1091:2020 2.4 GHz DTS Radio Report: GCPA0001.1, Issue Date: June 15, 2020 NVLAP Lab Code: 200630 CERTIFICATE OF EVALUATION 2018-09-14 Product compliance is the responsibility of the client; therefore, the tests and equipment modes of operation represented in this report were agreed upon by the client, prior to testing. The results of this test pertain only to the sample(s) tested. The specific description is noted in each of the individual sections of the test report supporting this certificate of test. This report reflects only those tests from the referenced standards shown in the certificate of test. It does not include inspection or verification of labels, identification, marking or user information. As indicated in the Statement of Work sent with the quotation, Element’s standard process is to always use the latest published version of the test methods even when earlier versions are cited in the test specification. Issuance of a purchase order was de facto acceptance of this approach. Otherwise, the client would have advised Element in writing of the specific version of the test methods they wanted applied to the subject testing Last Date of Evaluation: Thursday, June 11, 2020 GCPAT EUT: CWR RF Exposure Evaluation Standards Specification Method FCC 2.1091:2020 FCC 447498 D01 General RF Exposure Guidance v06 Results Method Clause Description Applied Results Comments 7.1 Maximum Permissible Exposure Yes Pass None Deviations From Evaluation Standards None Approved By: Donald Facteau, Process Architect Report No. GCPA0001.1EAR-Controlled Data2/9 REVISION HISTORY 2018.07.17 Revision Number Description Date (yyyy-mm-dd) Page Number 00 None Report No. GCPA0001.1EAR-Controlled Data3/9 ACCREDITATIONS AND AUTHORIZATIONS 2019.03.08 United States FCC - Designated by the FCC as a Telecommunications Certification Body (TCB). Certification chambers, Open Area Test Sites, and conducted measurement facilities are listed with the FCC. A2LA - Accredited by A2LA to ISO / IEC 17065 as a product certifier. This allows Element to certify transmitters to FCC and IC specifications. NVLAP - Each laboratory is accredited by NVLAP to ISO 17025 Canada ISED - Recognized by Innovation, Science and Economic Development Canada as a Certification Body (CB) and as a CAB for the acceptance of test data. European Union European Commission – Within Element, we have a EU Notified Body validated for the EMCD and RED Directives. Australia/New Zealand ACMA - Recognized by ACMA as a CAB for the acceptance of test data. Korea MSIT / RRA - Recognized by KCC’s RRA as a CAB for the acceptance of test data. Japan VCCI - Associate Member of the VCCI. Conducted and radiated measurement facilities are registered. Taiwan BSMI – Recognized by BSMI as a CAB for the acceptance of test data. NCC - Recognized by NCC as a CAB for the acceptance of test data. Singapore IDA – Recognized by IDA as a CAB for the acceptance of test data. Israel MOC – Recognized by MOC as a CAB for the acceptance of test data. Hong Kong OFCA – Recognized by OFCA as a CAB for the acceptance of test data. Vietnam MIC – Recognized by MIC as a CAB for the acceptance of test data. SCOPE For details on the Scopes of our Accreditations, please visit: https://www.nwemc.com/emc-testing-accreditations Report No. GCPA0001.1EAR-Controlled Data4/9 FACILITIES 2019.03.08 California Labs OC01-17 41 Tesla Irvine, CA 92618 (949) 861-8918 Minnesota Labs MN01-10 9349 W Broadway Ave. Brooklyn Park, MN 55445 (612)-638-5136 Oregon Labs EV01-12 6775 NE Evergreen Pkwy #400 Hillsboro, OR 97124 (503) 844-4066 Texas Labs TX01-09 3801 E Plano Pkwy Plano, TX 75074 (469) 304-5255 Washington Labs NC01-05 19201 120 th Ave NE Bothell, WA 98011 (425)984-6600 NVLAP NVLAP Lab Code: 200676-0 NVLAP Lab Code: 200881-0 NVLAP Lab Code: 200630-0 NVLAP Lab Code:201049-0 NVLAP Lab Code: 200629-0 Innovation, Science and Economic Development Canada 2834B-1, 2834B-3 2834E-1, 2834E-3 2834D-1 2834G-1 2834F-1 BSMI SL2-IN-E-1154R SL2-IN-E-1152R SL2-IN-E-1017 SL2-IN-E-1158R SL2-IN-E-1153R VCCI A-0029 A-0109 A-0108 A-0201 A-0110 Recognized Phase I CAB for ISED, ACMA, BSMI, IDA, KCC/RRA, MIC, MOC, NCC, OFCA US0158 US0175 US0017 US0191 US0157 Report No. GCPA0001.1EAR-Controlled Data5/9 PRODUCT DESCRIPTION 2018-07-17 Client and Equipment Under Evaluation Information Company Name: GCPAT Address: 62 Whittemore Avenue City, State, Zip: Cambridge, MA 02140 Evaluation Requested By: Mike Castro EUT: CWR Date of Evaluation: Thursday, June 11, 2020 Information Provided by the Party Requesting the Evaluation Functional Description of the Equipment: The CWP is a device which relays wired CAN communication via Zigbee enabling communication between other wired CAN devices and a Zigbee wireless sensor. Objective: To demonstrate compliance with FCC requirements for RF exposure for 2.1091 mobile/fixed devices Report No. GCPA0001.1EAR-Controlled Data6/9 RF Exposure Condition 2018-07-17 The following RF Exposure conditions were used for the assessment documented in this report: Intended Use Mobile Location on Body (if applicable) NA How is the Device Used The CWR is used at a distance of greater than 20 cm from the user. Radios…

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This report must not be used to claim product certification, approval, or endorsement by NVLAP, NIST, or any agency of the U.S. Government. This Report shall not be reproduced, except in full without written approval of the laboratory. GCPAT CWR FCC 15.247:2020 2.4 GHz DTS Radio Report: GCPA0001, Issue Date: June 9, 2020 NVLAP LAB CODE: 200881-0 CERTIFICATE OF TEST 2018-09-14 Product compliance is the responsibility of the client; therefore, the tests and equipment modes of operation represented in this report were agreed upon by the client, prior to testing. The results of this test pertain only to the sample(s) tested. The specific description is noted in each of the individual sections of the test report supporting this certificate of test. This report reflects only those tests from the referenced standards shown in the certificate of test. It does not include inspection or verification of labels, identification, marking or user information. As indicated in the Statement of Work sent with the quotation, Element’s standard process is to always use the latest published version of the test methods even when earlier versions are cited in the test specification. Issuance of a purchase order was de facto acceptance of this approach. Otherwise, the client would have advised Element in writing of the specific version of the test methods they wanted applied to the subject testing. Last Date of Test: May 21, 2020 GCPAT EUT: CWR Radio Equipment Testing Standards Specification Method FCC 15.247:2020 ANSI C63.10:2013, KDB 558074 Results Method Clause Test Description Applied Results Comments 6.2 Powerline Conducted Emissions No N/A Not required for a battery powered EUT. 6.5, 6.6, 11.12.1, 11.13.2, Spurious Radiated Emissions Yes Pass 11.6 Duty Cycle Yes N/A 11.8.2 Occupied Bandwidth Yes Pass 11.9.1.1 Output Power Yes Pass 11.9.1.1 Equivalent Isotropic Radiated Power Yes Pass 11.10.2 Power Spectral Density Yes Pass 11.11 Band Edge Compliance Yes Pass 11.11 Spurious Conducted Emissions Yes Pass Deviations From Test Standards None Approved By: Eric Brandon, Department Manager Report No. GCPA00012/38 REVISION HISTORY 2018.07.17 Revision Number Description Date (yyyy-mm-dd) Page Number 00 None Report No. GCPA00013/38 ACCREDITATIONS AND AUTHORIZATIONS 2019.03.08 United States FCC - Designated by the FCC as a Telecommunications Certification Body (TCB). Certification chambers, Open Area Test Sites, and conducted measurement facilities are listed with the FCC. A2LA - Accredited by A2LA to ISO / IEC 17065 as a product certifier. This allows Element to certify transmitters to FCC and IC specifications. NVLAP - Each laboratory is accredited by NVLAP to ISO 17025 Canada ISED - Recognized by Innovation, Science and Economic Development Canada as a Certification Body (CB) and as a CAB for the acceptance of test data. European Union European Commission – Within Element, we have a EU Notified Body validated for the EMCD and RED Directives. Australia/New Zealand ACMA - Recognized by ACMA as a CAB for the acceptance of test data. Korea MSIT / RRA - Recognized by KCC’s RRA as a CAB for the acceptance of test data. Japan VCCI - Associate Member of the VCCI. Conducted and radiated measurement facilities are registered. Taiwan BSMI – Recognized by BSMI as a CAB for the acceptance of test data. NCC - Recognized by NCC as a CAB for the acceptance of test data. Singapore IDA – Recognized by IDA as a CAB for the acceptance of test data. Israel MOC – Recognized by MOC as a CAB for the acceptance of test data. Hong Kong OFCA – Recognized by OFCA as a CAB for the acceptance of test data. Vietnam MIC – Recognized by MIC as a CAB for the acceptance of test data. SCOPE For details on the Scopes of our Accreditations, please visit: https://www.nwemc.com/emc-testing-accreditations Report No. GCPA00014/38 FACILITIES 2019.03.08 California Labs OC01-17 41 Tesla Irvine, CA 92618 (949) 861-8918 Minnesota Labs MN01-10 9349 W Broadway Ave. Brooklyn Park, MN 55445 (612)-638-5136 Oregon Labs EV01-12 6775 NE Evergreen Pkwy #400 Hillsboro, OR 97124 (503) 844-4066 Texas Labs TX01-09 3801 E Plano Pkwy Plano, TX 75074 (469) 304-5255 Washington Labs NC01-05 19201 120 th Ave NE Bothell, WA 98011 (425)984-6600 NVLAP NVLAP Lab Code: 200676-0 NVLAP Lab Code: 200881-0 NVLAP Lab Code: 200630-0 NVLAP Lab Code:201049-0 NVLAP Lab Code: 200629-0 Innovation, Science and Economic Development Canada 2834B-1, 2834B-3 2834E-1, 2834E-3 2834D-1 2834G-1 2834F-1 BSMI SL2-IN-E-1154R SL2-IN-E-1152R SL2-IN-E-1017 SL2-IN-E-1158R SL2-IN-E-1153R VCCI A-0029 A-0109 A-0108 A-0201 A-0110 Recognized Phase I CAB for ISED, ACMA, BSMI, IDA, KCC/RRA, MIC, MOC, NCC, OFCA US0158 US0175 US0017 US0191 US0157 Report No. GCPA00015/38 MEASUREMENT UNCERTAINTY TMU.2015.07.10 Measurement Uncertainty When a measurement is made, the result will be different from the true or theoretically correct value. The difference is the result of tolerances in the measurement system that cannot be completely eliminated. To the extent that technology allows us, it has been our aim to minimize this error. Measurement uncertainty is a statistical expression of measurement error qualified by a probability distribution. A measurement uncertainty estimation has been performed for each test per our internal quality document QM205.4.6. The estimation is used to compare the measured result with its "true" or theoretically correct value. The expanded measurement uncertainty (K=2) can be found included as part of the applicable test description page. Our measurement data meets or exceeds the measurement uncertainty requirements of the applicable specification; therefore, the test data can be compared directly to the specification limit to determine compliance. The calculations for estimating measurement uncertainty are based upon ETSI TR 100 028 (or CISPR 16-4-2 as applicable), and are available upon request. The following table represents the Measurement Uncertainty (MU) budgets for each of the tests that may b…

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XMit 2020.03.25.0 WDS_BENCH 001.jpg WDS_BENCH 002.jpg DIRECT CONNECT SPURIOUS RADIATED EMISSIONS photo PSA-ESCI 2020.04.03.0 photos PSA-ESCI 2020.04.03.0 CWR_SE 002.jpg CWR_SE 003.jpg _SE 003 Report No. GCPA00012/5 SPURIOUS RADIATED EMISSIONS photo PSA-ESCI 2020.04.03.0 photos PSA-ESCI 2020.04.03.0 CWR_SE 004.jpg CWR_SE 005.jpg _SE 005 Report No. GCPA00013/5 SPURIOUS RADIATED EMISSIONS photo PSA-ESCI 2020.04.03.0 photos PSA-ESCI 2020.04.03.0 CWR_SE 006.jpg CWR_SE 007.jpg _SE 007 Report No. GCPA00014/5 SPURIOUS RADIATED EMISSIONS photo PSA-ESCI 2020.04.03.0 photos PSA-ESCI 2020.04.03.0 CWR_SE 008.jpg Report No. GCPA00015/5