APPENDIX

STRUCTURED MATERIAL

FOR

SERVICE TESTS & APPROVAL

lgsue: Sept 009.

l. FoIm - 'A'

2. Document Verification Sohodule

3.

4.

5.

7.

8.

Calculatiqn of Telt FseForm - 'B'

Afiidavit Format

Actlvlty Rgport

Service Tqst R$UltAnnsxureiA

CONTENTS

Page 3

Page 5

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Pags l0

Page 12

Page'14

DEPARTMENT OF TELECOMMUNICATIONSTELECOM ENFORCEMENT, RESOURCE AND MONITORING CELL

APPLICATION FOR SERVICE TEST & APPROVAL

1. Name of Licensed Service Provider

2. Licensee Address(as mentioned inIicense agreement)

Telephone No. FAX No.Operation HQ Address

Telephone No. FAx No.3. Company Registration No.4. ServiceParticulars:

(i) Type of License / Service(s)(ii) Coveragearea(Metro/DHe/Town)(ii0 Dishict(iv) License Service Area

5. Llcense Agreement No.(Copy to be attached)

Enclose Annexure, if required

8. SACFA clearance (enclose details):9. The application for this Service is submitted for:

i. First Time :

6. Due Date of Roll-out obligation(as per license agreement/ or any other communication from DoT) :7. Make, Model, Software Version ofequipments utitized(MSC/MGC/MG, BSC, BTS and TX equipment)

Enclosed / not enclosed

YES/NOii. Resubmission /Augmentation of network YES/NOiii. Earlier Ref if any:

iv. Modification Attached yES / NO / NtL(ln case of resubmission/augmentation)

10. Document vedfication schedule:

11. Declaration:

| (Name of siqnatorv)

Enclosed / not enclosed

DesignationCertify that the above stated information is aorrect, complEG andEe.

Signature of the Authorized signatoryDated:

At (Place):

(For Office Use)Received application from.

ACK No,

Signature of recaiving officer

Name:

Date:

OFFICE STAMP

DOCUMENT VERIFICATION SCHEDULE

The following schedule shall be completed and submitted by the Service provider(applicant) along with FormrA' and shall be checked by TERM.Noto:Alldocuments /refercnce/results shali be properly numbered/ indexed and mentioned in ihe Inoex cotumn

st.No.

Document / item Submitted Index1 Forwarding letter Yes/No2 FormrA' (duly signed by authorized signatory) along with

Affldavit.Yes/No

3 ls name of service provider in Form-A' same as serviceprovider in the license agreement? (lf not, applicant has toprovrde necessary approval/document)

Yes/No

4 Copy of License Aqreement Yes/No5 Block schematic of the netwo*/system offered for

showing MSC, BSCS, BTSS, with their tocations,interconnection and their connectivitv to other networks

metrYes/No

6 The Municapal map (drawn to the scale) of DHQ/DHQTown/City (Showing the area boundary, att major roads,minor roads, commercial area, uninhabited land marks, ifany), duly authenticated, clearly indicating all the BTS siteswith Droper numberino.

Yes/No

7 Vector Map showing the coverage based on the drive testconducted by the operator for each BTS(Map is obtained by super imposing the drive test results onthe city map).

Yes/No

8 (a) List of BTSS with valid SACFA ctearancetuatidOperating license indicating the validity period (Enctosedetails).(b) List of BTSS whose SACFA clearance /Operatinglicense validity has expired. (Enclose details)(c) Undertaking from the applicants that "the frequencyspots being used by them are as per the assignment byWPC Wing and that the details of the spot frequenciesBTS-wise are enclosed.'

Yes/No

9 Indicate the number ofIJequencies.(enclose List )

carflers at eacn BTS1 0 Valid calibration certificate for the test mobile

available? (Date ofvalidity to be indicated).Availability of Test Mobiles, Drive Test Toot, Watk

Test Kit (or suitable alternate arrangement), postProcessing Tool etc. to conduct tests as per TSTP.

(a)(b)

Yes/No

Yes/No

1 1 Certificate of Interface Approval of MSC/MG Yes/No(i) Information on Number of 2 Mbps streams with eachinterconnecting operator, including for emergency andpublic utility services.

Yes/No

System ldentification Numbers and International RoamingMobile ldentification Number (MlN)/lRM being used in theoffered network (Applicable only for CDMA networks)

Yes/No

1 4 Undertaking stating compliance to "clauses and sub-clauses in the license agreement and its amendmentsrelated to installation of BTS and providing mobile servicesnear the international border".(Clause numbers in the license agreement andamendments should be mentioned clearly while givingcompliance and non-corlpliance)

Yes/No

1 5 a) Undertaking stating compliance to "all clauses and suLclauses, related to LaMul Interception and Monitoring inthe license agreement and its amendments".

b) Certificate of clearance from LEA for LaMul Interceptionand Monitoring submitted.

'whee an apptcat@n for LIM tasting has b@n nade boto@ 30 days, so.t@ teshg w tnot be held ua Ho@vet 4 ,s nEndatory tot the stu@ p@vdd to @rpry t i t tM

_reaui6nfils 6nd &fr,encv tou^g dunng Isr snstt b6 bn1vatl 4fi4 7 davs

Yes/No

Yes/"No

1 6 Undertaking stating compliance to lall clauses and sr,tclauses in the license agreement and its amendmentsrelated to Calling Line ldentification Restriction (CLtR),'.(Clause numbers in the license agreement andamendments should be mentioned clearly while givingcompliance and non-compliance)

Yes/No

1 7 Encryption:(a) Whether Encryption equipment is used and

Connected to the network. ( Declaration fromService provider to be obtainedJ.(b) if yes, whether it has been evaluated andwritten approval gltained from authority

Yes/No

Yes/No'18 Clause-wise compliance statemenilo tSIp Yes/No'19 Each page of all the Oocuments suOhitteO are stamoeO

and signed by the authorized signatoryYes/No

20 Self-test results and aetailed-est reports foi-overage anOother tests as per Test Schedule and Test procedure,bas-ed on tests conducted by the appjicant. along wirhCDRS. Loos etc

Yes/No

Self-Test result for street level coverage --%

DatelSignature of authorized signatoryName & Designatjon:

Signature of TERM officerName & Designation:

Date;

Calculation of Test Fee

1. Service Testing =Rs. 1,05,000/-(For each MSC)2. Coverage Tests for network having BTS upto 4 = Rs. 35,000/-

Coverage Tests for each additional 2 BTS or part thereof = Rs. '17.SOO/-

(Clubbing of BTS is allowed only at the same station)

DEPARTMENT OF TELECOMMUNICATIONSTELECOM ENFORCEMENT, RESOURCE AND MONITORING CELL

lTo be submitted in duplicatel

TERM Refurence No. & Dato:

1. Applicant's Namei

2. Any status change in Form 'A' YES/NO(lf YES, attach details-item wise)

3. Service Particulars:(i) Type of License / Service(s)

(v) Coveragearea(Metro/DHQ/Town)(vi) District(vii) Service Area (Circle)

4. Fee Remittance details:

Payment Mode: (Cheque/Demand Draft) No.Dated:

Bank:

Amount:

srgnatoryDate :

Signature of the authorized

Name :Desig

Office seal

(For Use in TERM)Registation No.:

Signature of receivingofficer

Name :

Date :

1 .

AFFIDAVIT(To be submitted atong with Form Aby the Licensed Service provider,

in Stamp paper of Rupees One Hundred only ). . . . . . . . . . . . . . . . . . s o n / d a u g h t e r o f . . . . . . . . . . . . . . . . . . . . . . . . . . . r e s i d e n t o f

2. That I amname and style

...... do solemnly declare and affirm as follows.me............... (Designation) of the servjce provider operating in the

as having its headquarter

3. That I am competent to sign this affidavit on behatf of the company... , whom I represent has been

issued l icense for prov id ing serv ices in the c i rc |e . . . . . . . . . . . . . . . . . . . . . . . . . . . by Depanment o fTelecommunications vide the license No. Dated ...............5. That we affirm and declare that we shall be responsible for any dispute arising outof the testing of service cases as mentioned above and shall bear the cost ot any titigationand loss/damage caused to DOT.6. That M/s . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . , whom I represent has canjed out the test ingas stipulated by DoT/TERM ln TSTP No.__*:_*___- and there is noalteration/manipulation in the test resurts/drive plots/ca detaired record(cDR) andsubmitted the same as per actuals.7 . That M/s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , wnom I represent agree to re_test ing of thenetwork by DoT/TERM. DoT/TERM shall havethefull right to repeat the tests as per theTSTP No.8. That we indemnify the Department of Telecommunications (DoT) and TelecomEnforcement, Resource and Monitoring (TERir) against any adverse effecvdeteriorationof the tested/approved sites for radio coverage/performance parameters.

I s ign th is Af f idav i t on the. . . . . . . . . . . . . . . . .day of . . . . . . . . . . . . . . . . .a t

DEPONENT

Vvitness 1

Wtness 2

Departsnent of Telecommunications

TELECOM ENFORCEMENT. RESOURCE AND MONITORING CELL

Activity Report of Service Tests

A

lase Registered by TERM, -

2 File No.

Iest Schedule & TestProcdure (TSTP) No.

Name & Address of the Service Providellsame as in license agreement)

icense agreement no.

2

a) Type of License/Serviceb) Area (DHQ/Town)c) Districtd) Circle

Number of BTSS Tested

nterconnectivity Details betweenrervice provider switch & other networks

POI details (submitted by the SeNiceProvider) to be attached as Annexure

5.aDoes the test results/comply with alltheolauses of the TSTP

VES/NO

lf nol, whether the Relaxation / Devlationapproved by the Competent Aulhority(enclose copy of app.oval)

c. 1 )ate of receipt of Form A

2 )ate of receipt of Form B /Registration Oate3 (D Date of .egisfation with TERM Cell(ii) Date(s) of BTS verifcation by

TERM(iiD Date(s) of Coverage (Drive ) test b)TERM:(iv) Date(s) of other tests by TER[4:

E1 est fees demand draft no. and date.2 \mount of test fee collected Rs.

l 0

3 \ certificate that no fees /cha.gesrendinq and all duea collected. \ll dues CollectedE :TCL:

lopy of the drafr Test Result (in prescribedormat) :nclosed\nnexures to T*t Result duly signed in inkin duplicate) =nclosure

lignatu.e of the conlblling officer. Signature of the testing olfcer withlesignation-

tame)esiE

\ameiJesio :

)ate: )ate:

Sionature with stamDDOG {TERM)

Date :

(For use at lssuing Authority)1. Date of issue of Test resulucertificate:

2. Test Resuluoertificate No.:

Signatur of ADG(TERM)

l l

Ret. No. :

1. General

DEPARTMENT OF TELECOMMUNICATIONS

TELECOM ENFORCEMENT, RESOURCE AND MONITORING CELL

SERVICE TEST RESULT

Dated:

1 . 1 Name & address of the ServiceProvider.

(As given in Form-A')

License No.

1 . 3 a) Type of License/Serviceb) Area (Metro/DHQ/Town)c) Diskictd) Circle

'1.4 Date of submission of self testresult & reqistration bv TERM

1 . 5 Test conducted bv TERM. ------------

1 . 6 Test Schedule No.

1 . 7 Make, l\4odel, Version of MSC,MG, BSC. BTS

As per Annexure-A

1 . 8 SACFA clearance details As Der Annexurel of part-l of test schedule

1 . 9 Number of BTSS tested' 1 . '10Drive Test Plot Attach the Annexure

Contd. on page-2

t2

Area (Metro/DHQ/Town)Circle

2. Covrage :Besed on lhe RF ddve test cAried out as per Test Schedute mentiond above,Level Radio Coverago provided in lhe municipallifiils ofthe area under test is%

3, Devhdom w,r.L Tert Schdulo(D(iD(tD

4. Tho lionlee ghalltake nece$ary actlon for removlng the non-compliences indicated above.

Page-2Service Tsst Result (Ref No.) Date:

DIRECTOR (TERflID

To:

(Ian & Add.cr of Srvlca Provlder a8 glv.n in Form.A)

Copy to:L DDG (AS.ll), DOT, t{.w Delhl2. ODG (Secu.lty), DoT, N6w Dolhl

Annexure-A

Make, Model, Version of Equipment Used(MSC. BSC. BTS. Microwave. etc.)Srvice Provider Name: DHe/Town

Name:

st.No.

Site Name &ID

Address Equipment Vendor Make/Model swver.

1 .

2.

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. . n

t4