FCC ID RBV-041

RBV041, RBV 041, RBV-041, RBV-O41, RBV-04I

Insulet Corporation OmniPod DASH 041

An FCC ID is the product ID assigned by the FCC to identify wireless products in the market. The FCC chooses 3 or 5 character "Grantee" codes to identify the business that created the product. For example, the grantee code for FCC ID: RBV-041 is RBV. The remaining characters of the FCC ID, -041, are often associated with the product model, but they can be random. These letters are chosen by the applicant. In addition to the application, the FCC also publishes internal images, external images, user manuals, and test results for wireless devices. They can be under the "exhibits" tab below.

Purchase on Amazon: OmniPod DASH

Application: OmniPod DASH
Equipment Class: DTS - Digital Transmission System
Short Link: fcc.id/RBV-041
Sources: FCC.gov | FCC.report
Registered By: Insulet Corporation - RBV (United States)

App #	Purpose	Date	Unique ID
1	Original Equipment	2018-06-30	NxSo0AsSLppdzRYtF+3QcA==

Operating Frequencies

Frequency Range	Power Output	Rule Parts	Line Entry
2.402-2.48 GHz	1.8 mW	15C	1

Exhibits

Document	Type	Submitted Available
User Guide	Users Manual Adobe Acrobat PDF (4998 kB)	2018-06-27 2018-12-23
Confidentiality request	Cover Letter(s) Adobe Acrobat PDF (53 kB)	2018-06-27 2018-06-30
Test setup photos	Test Setup Photos Adobe Acrobat PDF (627 kB)	2018-06-27 2018-06-30
Test report	Test Report Adobe Acrobat PDF (2794 kB)	2018-06-27 2018-06-30
Label artwork and location info	ID Label/Location Info Adobe Acrobat PDF (656 kB)	2018-06-27 2018-06-30
External photos	External Photos Adobe Acrobat PDF (3137 kB)	2018-06-27 2018-06-30
Internal photos	Internal Photos Adobe Acrobat PDF (518 kB)	2018-06-27
Operational description	Operational Description Adobe Acrobat PDF (5861 kB)	2018-06-27
Block diagram	Block Diagram Adobe Acrobat PDF (176 kB)	2018-06-27
Schematics	Schematics Adobe Acrobat PDF (662 kB)	2018-06-27

Application Forms

1 (2018-06-30)

Application for Equipment Authorization FCC Form 731 TCB Version

Applicant Information

Applicant's complete, legal business name:	Insulet Corporation
FCC Registration Number (FRN):	0007720857
Alphanumeric FCC ID:	RBV041
Unique Application Identifier:	NxSo0AsSLppdzRYtF+3QcA==
Line one:	600 Technology Park Drive
Line two:	Suite 200
City:	Billerica
State:	Massachusetts
Country:	United States
Zip Code:	01821-4150

TCB Information

TCB Application Email Address:	TCB_Admin@intertek.com
TCB Scope:	A4: UNII devices & low power transmitters using spread spectrum techniques

FCC ID

Grantee Code:	RBV
Product Code:	-041

Person at the applicant's address to receive grant or for contact

Name:	Chuck Vadala
Title:	Sr Director, Systems Engineering

Telephone Number:

978-600-7639

Extension:

Fax Number:	978-408-4191
Email:	cvadala@insulet.com

Technical Contact

Firm Name:	Insulet Corporation
First Name:	Jon
Middle Name:	David
Last Name:	Hardy
Line 1:	600 Technology Park Drive
Line 2:	200
City:	Billerica
Country:	United States
Zip Code:	01821

Telephone Number:

978-600-7976

Extension:

E-Mail:

johardy@insulet.com

Non Technical Contact

Firm Name:	Insulet Corporation
First Name:	CHuck
Last Name:	Vadala
Line 1:	600 Technology Park Drive
Line 2:	200
City:	Billerica
Country:	United States
Zip Code:	01821

Telephone Number:

978-600-7639

Extension:

Fax Number:	978-600-7639
E-Mail:	cvadala@insulet.com

Long-Term Confidentiality

Does this application include a request for confidentiality for any portion(s) of the data contained in this application pursuant to 47 CFR § 0.459 of the Commission Rules?: Yes

Short-Term Confidentiality

Does short-term confidentiality apply to this application?: Yes

If so, specify the short-term confidentiality release date (MM/DD/YYYY format): 12/23/2018
Note: If no date is supplied, the release date will be set to 45 calendar days past the date of grant.

Software Defined/Cognitive Radio

Is this application for software defined/cognitive radio authorization? No

Equipment Class

Equipment Class: DTS - Digital Transmission System
Description of product as it is marketed: (NOTE: This text will appear below the equipment class on the grant):	OmniPod DASH

Related OET KnowledgeDataBase Inquiry

Is there a KDB inquiry associated with this application? Yes

Modular Equipment

Modular Type: Does not apply

Application Purpose

Application is for: Original Equipment

Composite/Related Equipment

Is the equipment in this application a composite device subject to an additional equipment authorization? No

Is the equipment in this application part of a system that operates with, or is marketed with, another device that requires an equipment authorization? Yes

Test Firm Information

Name of test firm and contact person on file with the FCC:

Firm Name: Intertek Testing Services NA Inc.

First Name: Mark

Last Name: Barry

Telephone Number:

9782632662

Extension:

Fax Number: 9782637086

E-mail: mark.barry@intertek.com

Grant Comments

Enter any text that you would like to appear at the bottom of the Grant of Equipment Authorization:
Output Power is conducted.

Set the grant of this application to be deferred to a specified date:
No

Equipment Authorization Waiver

Is there an equipment authorization waiver associated with this application? No

If there is an equipment authorization waiver associated with this application, has the associated waiver been approved and all information uploaded?: No

WILLFUL FALSE STATEMENTS MADE ON THIS FORM ARE PUNISHABLE BY FINE AND IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001), AND/OR REVOCATION OF ANY STATION LICENSE OR CONSTRUCTION PERMIT (U.S. CODE, TITLE 47, SECTION 312(a)(1)), AND/OR FORFEITURE (U.S. CODE, TITLE 47, SECTION 503).

SECTION 5301 (ANTI-DRUG ABUSE) CERTIFICATION:

The applicant must certify that neither the applicant nor any party to the application is subject to a denial of Federal benefits, that include FCC benefits, pursuant to Section 5301 of the Anti-Drug Abuse Act of 1988, 21 U.S.C. § 862 because of a conviction for possession or distribution of a controlled substance. See 47 CFR 1.2002(b) for the definition of a "party" for these purposes.

Does the applicant or authorized agent so certify? Yes

Applicant/Agent Certification:

I certify that I am authorized to sign this application. All of the statements herein and the exhibits attached hereto, are true and correct to the best of my knowledge and belief. In accepting a Grant of Equipment Authorization as a result of the representations made in this application, the applicant is responsible for (1) labeling the equipment with the exact FCC ID specified in this application, (2) compliance statement labeling pursuant to the applicable rules, and (3) compliance of the equipment with the applicable technical rules. If the applicant is not the actual manufacturer of the equipment, appropriate arrangements have been made with the manufacturer to ensure that production units of this equipment will continue to comply with the FCC's technical requirements.

Authorizing an agent to sign this application, is done solely at the applicant's discretion; however, the applicant remains responsible for all statements in this application.

If an agent has signed this application on behalf of the applicant, a written letter of authorization which includes information to enable the agent to respond to the above section 5301 (Anti-Drug Abuse) Certification statement has been provided by the applicant. It is understood that the letter of authorization must be submitted to the FCC upon request, and that the FCC reserves the right to contact the applicant directly at any time.

Signature of Authorized Person Filing: Chuck Vadala

Title of authorized signature: Sr Director, Systems Engineering

Applications are submitted for FCC ID and Grant requests. Click an above application to view details

TCB	GRANT OF EQUIPMENT AUTHORIZATION	TCB
Certification
Issued Under the Authority of the
Federal Communications Commission
By:

Intertek Testing Services NA, Inc.
70 Codman Hill Road
Boxborough, MA 01719

Date of Grant: 06/30/2018

Application Dated: 06/26/2018

Insulet Corporation

600 Technology Park Drive

Suite 200

Billerica, MA 01821-4150

Attention: Chuck Vadala , Sr Director, Systems Engineering

NOT TRANSFERABLE

EQUIPMENT AUTHORIZATION is hereby issued to the named GRANTEE, and is VALID ONLY for the equipment identified hereon for use under the Commission's Rules and Regulations listed below.

FCC IDENTIFIER:	RBV-041

Name of Grantee:	Insulet Corporation

Equipment Class:	Digital Transmission System
Notes:	OmniPod DASH

Grant Notes	FCC Rule Parts	Frequency Range (MHZ)	Output Watts	Frequency Tolerance	Emission Designator
	15C	2402.0 - 2480.0	0.0018

Output Power is conducted.

COPY	FEDERAL COMMUNICATIONS COMMISSION WASHINGTON, D.C. 20554 GRANT OF EQUIPMENT AUTHORIZATION	COPY
Certification

Insulet Corporation
600 Technology Park Drive Suite 200
Billerica, MA 01821-4150
United States

Date of Grant: 06/30/2018

Application Dated: 06/26/2018

Attention: Chuck Vadala , Sr Director, Systems Engineering

NOT TRANSFERABLE

EQUIPMENT AUTHORIZATION is hereby issued to the named GRANTEE, and is VALID ONLY for the equipment identified hereon for use under the Commission's Rules and Regulations listed below.

FCC IDENTIFIER:	RBV-041

Name of Grantee:	Insulet Corporation

Equipment Class:	Digital Transmission System
Notes:	OmniPod DASH
Modular Type:	Does not apply

Grant Notes	FCC Rule Parts	Frequency Range (MHZ)	Output Watts	Frequency Tolerance	Emission Designator
	15C	2402.0 - 2480.0	0.0018

Output Power is conducted.

Mail To:

EA910202

FCC ID RBV-041

RBV041, RBV 041, RBV-041, RBV-O41, RBV-04I

Insulet Corporation OmniPod DASH 041

Purchase on Amazon: OmniPod DASH

Operating Frequencies

Exhibits

Application Forms

Applications are submitted for FCC ID and Grant requests. Click an above application to view details

Grants

Grants authorize equipment for operation at approved frequencies and sale within the USA. Click an above grant to view details