User's Manual

Page 36 of 38
7 COMPLIANCE INFORMATION STATEMENTS
7.1 FCC Declaration of Conformity
We Sorrel Medical Ltd. declare:
Type of equipment: Infusion Pump
Brand name or trademark: Wearable Infusion Pump
Product Identification number: SORREL V04 | FCC ID: 2AR6L-SORRELWIP
Applicable Compliance Statements: (e.g. for part 15 devices see §15.19(a)(3))
Country of origin: Israel
Manufacturer: Sorrel Medical Ltd.
Responsible Party name (IN USA): Z & B Enterprises, Inc.
Address: 12154 Darnestown Road, #236, Gaithersburg, MD 20878, USA
Telephone: [phone]
Internet E-Mail: [e-mail]
Standards applied:
● FCC Part 15B - For Unintentional radiators; ( test report number: XXX)
● FCC Part 15C - For Intentional radiators; ( test report number: XXX)
Test reports/ certificates issued by: TBD
Telecom Certification Body by: TBD
As manufacturer/ manufacturer's authorized representative within the USA, we declare under our sole of
responsibility that the equipment follows the provisions of FCC Equipment Authorization Procedures under
CERTIFICATION (47 CFR Section 2.907) and / or SUPPLIER’S DECLARATION OF CONFORMITY (47 CFR Section
2.906) as stated above.
Thus, is placed on the product
Date of issue: December 28, 2018
Place of issue: Israel
(Signature & Name of authorized person) (Company Stamp)