FCC ID RBV-SAW

RBVSAW, RBV SAW, RBV-SAW, RBV-5AW

Insulet Corporation OmniPod Dash SAW

Omnipod Insulin Management System
Tray Lid, POD Saw Dash

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-SAW is RBV. The remaining characters of the FCC ID, -SAW, 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

App # Purpose Date Unique ID
1 Original Equipment 2020-04-16 bRD6KF1+VQattEIDnxneiA==
2 Class II Permissive Change 2020-09-01 lwkZSEUWNzEwpE6BbOn1ZA==

Operating Frequencies

Frequency RangePower OutputRule Parts App #
2.402-2.48 GHz Bluetooth1.9 mW15C 1.1
2.402-2.48 GHz Bluetooth1.9 mW15C 2.1

Exhibits

Available Exhibits

App #Document Type Submitted
Available
2 Test Setup PhotosTest Setup Photos
Adobe Acrobat PDF (1185 kB)		 2020-09-01
2020-09-01
2 Test ReportTest Report
Adobe Acrobat PDF (851 kB)		 2020-09-01
2020-09-01
2 Internal PhotosInternal Photos
Adobe Acrobat PDF (829 kB)		 2020-09-01
2020-09-24
2 Cover LetterCover Letter(s)
Adobe Acrobat PDF (1128 kB)		 2020-09-01
2020-09-01
2 Confidentiality LetterCover Letter(s)
Adobe Acrobat PDF (728 kB)		 2020-09-01
2020-09-01
2 Agent AuthorizationCover Letter(s)
Adobe Acrobat PDF (32 kB)		 2020-09-01
2020-09-01
1 RF Exposure Info MPERF Exposure Info
Adobe Acrobat PDF (142 kB)		 2020-04-16
2020-04-16
1 User ManualUsers Manual
Adobe Acrobat PDF (4524 kB)		 2020-04-15
2020-04-16
1 Test Setup PhotosTest Setup Photos
Adobe Acrobat PDF (651 kB)		 2020-04-15
2020-04-16
1 Test ReportTest Report
Adobe Acrobat PDF (943 kB)		 2020-04-15
2020-04-16
1 LabelID Label/Location Info
Adobe Acrobat PDF (386 kB)		 2020-04-15
2020-04-16
1 Internal PhotosInternal Photos
Adobe Acrobat PDF (567 kB)		 2020-04-15
2020-05-31
1 External PhotosExternal Photos
Adobe Acrobat PDF (83 kB)		 2020-04-15
2020-04-16
1 Confidentiality LetterCover Letter(s)
Adobe Acrobat PDF (728 kB)		 2020-04-15
2020-04-16
1 Agent AuthorizationCover Letter(s)
Adobe Acrobat PDF (32 kB)		 2020-04-15
2020-04-16

APP # 2 (2020-09-01)

App # Document Type Submitted
Available
2 Test Setup Photos Test Setup Photos
Adobe Acrobat PDF (1185 kB)		 2020-09-01 00:00:00
2020-09-01 00:00:00
2 Test Report Test Report
Adobe Acrobat PDF (851 kB)		 2020-09-01 00:00:00
2020-09-01 00:00:00
2 Internal Photos Internal Photos
Adobe Acrobat PDF (829 kB)		 2020-09-01 00:00:00
2020-09-24 00:00:00
2 Cover Letter Cover Letter(s)
Adobe Acrobat PDF (1128 kB)		 2020-09-01 00:00:00
2020-09-01 00:00:00
2 Confidentiality Letter Cover Letter(s)
Adobe Acrobat PDF (728 kB)		 2020-09-01 00:00:00
2020-09-01 00:00:00
2 Agent Authorization Cover Letter(s)
Adobe Acrobat PDF (32 kB)		 2020-09-01 00:00:00
2020-09-01 00:00:00

APP # 1 (2020-04-16)

App # Document Type Submitted
Available
1 RF Exposure Info MPE RF Exposure Info
Adobe Acrobat PDF (142 kB)		 2020-04-16 00:00:00
2020-04-16 00:00:00
1 User Manual Users Manual
Adobe Acrobat PDF (4524 kB)		 2020-04-15 00:00:00
2020-04-16 00:00:00
1 Test Setup Photos Test Setup Photos
Adobe Acrobat PDF (651 kB)		 2020-04-15 00:00:00
2020-04-16 00:00:00
1 Test Report Test Report
Adobe Acrobat PDF (943 kB)		 2020-04-15 00:00:00
2020-04-16 00:00:00
1 Label ID Label/Location Info
Adobe Acrobat PDF (386 kB)		 2020-04-15 00:00:00
2020-04-16 00:00:00
1 Internal Photos Internal Photos
Adobe Acrobat PDF (567 kB)		 2020-04-15 00:00:00
2020-05-31 00:00:00
1 External Photos External Photos
Adobe Acrobat PDF (83 kB)		 2020-04-15 00:00:00
2020-04-16 00:00:00
1 Confidentiality Letter Cover Letter(s)
Adobe Acrobat PDF (728 kB)		 2020-04-15 00:00:00
2020-04-16 00:00:00
1 Agent Authorization Cover Letter(s)
Adobe Acrobat PDF (32 kB)		 2020-04-15 00:00:00
2020-04-16 00:00:00
1 Schematics Schematics
Adobe Acrobat PDF (424 kB)		 2020-04-15 00:00:00
N/A
1 Block Diagram Block Diagram
Adobe Acrobat PDF (82 kB)		 2020-04-15 00:00:00
N/A

APP # 2 (2020-09-01)

App # Document Type Submitted
Available
2 Schematics Schematics
Adobe Acrobat PDF (63 kB)		 2020-09-01 00:00:00
N/A

APP # 1 (2020-04-16)

App # Document Type Submitted
Available
1 Operational Description Operational Description
Adobe Acrobat PDF (158 kB)		 2020-04-15 00:00:00
N/A

APP # 2 (2020-09-01)

App # Document Type Submitted
Available
2 Block Diagram Block Diagram
Adobe Acrobat PDF (82 kB)		 2020-09-01 00:00:00
N/A
2 Operational Description Operational Description
Adobe Acrobat PDF (158 kB)		 2020-09-01 00:00:00
N/A

Application Forms

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: RBVSAW
Unique Application Identifier: bRD6KF1+VQattEIDnxneiA==
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: hotline@acbcert.com
TCB Scope: A4: UNII devices & low power transmitters using spread spectrum techniques

FCC ID
Grantee Code: RBV
Product Code: -SAW

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
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):   05/31/2020
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?  No

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?   No


Test Firm Information
Name of test firm and contact person on file with the FCC:
Firm Name:   Washington Laboratories, Ltd.
First Name:   John
Last Name:   Repella
Telephone Number: 301-216-1500 Extension:
Fax Number:  301-216-1590
E-mail:  johnr@wll.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. This device meets the SAR exemption threshold listed in KDB447498 and is authorized for portable or mobile operation. Installers and end-users must be provided with transmitter installation and operation conditions for satisfying RF exposure compliance. The antenna(s) used for this transmitter must not transmit simultaneously with any other antenna or transmitter, except in accordance with FCC multi- transmitter product procedures. Grantee must provide installation and operating instructions for complying with FCC multi-transmitter product procedures and RF exposure compliance.
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:  Steve Koster
Title of authorized signature: 

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: RBVSAW
Unique Application Identifier: lwkZSEUWNzEwpE6BbOn1ZA==
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: hotline@acbcert.com
TCB Scope: A4: UNII devices & low power transmitters using spread spectrum techniques

FCC ID
Grantee Code: RBV
Product Code: -SAW

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
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):   09/24/2020
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?  No

Modular Equipment
Modular Type:  Does not apply

Application Purpose
Application is for:   Class II permissive change or modification of presently authorized 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?   No


Test Firm Information
Name of test firm and contact person on file with the FCC:
Firm Name:   Washington Laboratories, Ltd.
First Name:   Elmer
Last Name:   Rodriguez
Telephone Number: 301-216-1500 Extension:
Fax Number:  301-216-1590
E-mail:  elmerr@wll.com

Grant Comments
Enter any text that you would like to appear at the bottom of the Grant of Equipment Authorization:
Class II Permissive Change. Output power is conducted. This device meets the SAR exemption threshold listed in KDB447498 and is authorized for portable or mobile operation. Installers and end-users must be provided with transmitter installation and operation conditions for satisfying RF exposure compliance. The antenna(s) used for this transmitter must not transmit simultaneously with any other antenna or transmitter, except in accordance with FCC multi-transmitter product procedures. Grantee must provide installation and operating instructions for complying with FCC multi-transmitter product procedures and RF exposure compliance.
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:  Kimberly Colbert Davis
Title of authorized signature: 

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

Grants

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

  ACB, Inc.
6731 Whittier Avenue Suite C110
McLean, VA 22101
 Date of Grant: 04/16/2020

Application Dated: 04/15/2020
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-SAW
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 0.0019  

Output power is conducted. This device meets the SAR exemption threshold listed in KDB447498 and is authorized for portable or mobile operation. Installers and end-users must be provided with transmitter installation and operation conditions for satisfying RF exposure compliance. The antenna(s) used for this transmitter must not transmit simultaneously with any other antenna or transmitter, except in accordance with FCC multi- transmitter product procedures. Grantee must provide installation and operating instructions for complying with FCC multi-transmitter product procedures and RF exposure compliance.

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: 04/16/2020

Application Dated: 04/15/2020
 
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-SAW
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 0.0019  

Output power is conducted. This device meets the SAR exemption threshold listed in KDB447498 and is authorized for portable or mobile operation. Installers and end-users must be provided with transmitter installation and operation conditions for satisfying RF exposure compliance. The antenna(s) used for this transmitter must not transmit simultaneously with any other antenna or transmitter, except in accordance with FCC multi- transmitter product procedures. Grantee must provide installation and operating instructions for complying with FCC multi-transmitter product procedures and RF exposure compliance.



Mail To:


EA872831
TCB GRANT OF EQUIPMENT
AUTHORIZATION		 TCB
Certification
Issued Under the Authority of the
Federal Communications Commission
By:

  ACB, Inc.
6731 Whittier Avenue Suite C110
McLean, VA 22101
 Date of Grant: 09/01/2020

Application Dated: 09/01/2020
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-SAW
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 0.0019  

Class II Permissive Change. Output power is conducted. This device meets the SAR exemption threshold listed in KDB447498 and is authorized for portable or mobile operation. Installers and end-users must be provided with transmitter installation and operation conditions for satisfying RF exposure compliance. The antenna(s) used for this transmitter must not transmit simultaneously with any other antenna or transmitter, except in accordance with FCC multi-transmitter product procedures. Grantee must provide installation and operating instructions for complying with FCC multi-transmitter product procedures and RF exposure compliance.

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: 09/01/2020

Application Dated: 09/01/2020
 
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-SAW
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 0.0019  

Class II Permissive Change. Output power is conducted. This device meets the SAR exemption threshold listed in KDB447498 and is authorized for portable or mobile operation. Installers and end-users must be provided with transmitter installation and operation conditions for satisfying RF exposure compliance. The antenna(s) used for this transmitter must not transmit simultaneously with any other antenna or transmitter, except in accordance with FCC multi-transmitter product procedures. Grantee must provide installation and operating instructions for complying with FCC multi-transmitter product procedures and RF exposure compliance.



Mail To:


EA688206

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