APPENDIX

STRUCTURED
MATERIAL
FOR

SERVICETESTS& APPROVAL

lgsue:Sept 009.

CONTENTS
l. FoIm - 'A'

Page3

2. DocumentVerificationSohodule

Page5

3. Calculatiqn
of Telt Fse

Page7

4. Form- 'B'

Page8

5. Afiidavit Format

Page9

Actlvlty Rgport

Pagsl0

7. ServiceTqst R$Ult

Page12

8. AnnsxureiA

Page'14

DEPARTMENT
OFTELECOMMUNICATIONS
TELECOMENFORCEMENT,
RESOURCEAND MONITORINGCELL
APPLICATIONFORSERVICETEST& APPROVAL

1.

Nameof Licensed
ServiceProvider

2.

Licensee
Address
(asmentioned
in
Iicenseagreement)

Telephone
No.

FAX No.

Operation
HQAddress

Telephone
No.

FAxNo.

3.

Company
Registration
No.

4.

ServiceParticulars:
(i) Typeof License/ Service(s)
(ii) Coveragearea(Metro/DHe/Town)
(ii0

Dishict

(iv)
5.

LicenseServiceArea
LlcenseAgreement
No.
(Copyto be attached)

6.

DueDateof Roll-out
obligation
(asperlicenseagreement/
or anyothercommunication
fromDoT):

7.

Make,Model,Software
Versionofequipments
utitized
(MSC/MGC/MG,
BSC,BTSandTXequipment)
Enclose
Annexure,
if required

8.

SACFAclearance
(enclose
details):

9.

Theapplication
forthisServiceis submitted
for:
i.

FirstTime:

ii.

Resubmission
/Augmentation
of network
EarlierRefif any:

iii.
iv.

ModificationAttached
(ln caseof resubmission/augmentation)

Enclosed
/ notenclosed

YES/NO
YES/NO

yES / NO / NtL

10.

Document
vedfication
schedule:

11.

Declaration:

| (Nameof siqnatorv)

Enclosed
/ notenclosed

Designation

Certify
thattheabovestatedinformation
isaorrect,
complEG
andEe.

Signature
oftheAuthorized
signatory
Dated:
At (Place):

Received
application
from.

(ForOfficeUse)

ACKNo,
Signature
of recaiving
officer
Name:
Date:

OFFICE STAMP

DOCUMENT
VERIFICATION
SCHEDULE
The followingscheduleshall be completedand submittedby the Serviceprovider
(applicant)
alongwithFormrA'andshallbe checkedbyTERM.
Noto:
Alldocuments/refercnce/results
shalibe properlynumbered/indexedand mentionedin ihe Inoexcotumn

st.

Document
/ item

Submitted Index

No.
1

Forwardingletter

FormrA'(dulysignedby authorized
signatory)alongwith Yes/No
Affldavit.
ls nameof serviceproviderin Form-A'sameas service Yes/No
providerin the licenseagreement?
(lf not,applicanthasto
provrde
necessary
approval/document)

3
4

5
6

Yes/No

Copyof LicenseAqreement
Yes/No
Block schematic of the netwo*/system offered for
Yes/No
showing MSC, BSCS, BTSS, with their tocations,metr
interconnection
and theirconnectivitv
to othernetworks
The Municapal
map (drawnto the scale)of DHQ/DHQYes/No

Town/City(Showingthe area boundary,att majorroads,

minorroads,commercial
area,uninhabited
landmarks,if
any),dulyauthenticated,
clearly
indicating
alltheBTSsites
withDroper
numberino.
7
VectorMapshowingthe coveragebasedon the drivetest
conducted
by theoperator
foreachBTS
Yes/No
(Mapis obtained
bysuperimposing
thedrivetestresults
on
thecitymap).
8
(a) List of BTSS with valid SACFA ctearancetuatid
Yes/No
Operating
licenseindicating
the validityperiod(Enctose
details).
(b) List of BTSSwhose SACFAclearance/Operating
license
validity
hasexpired.
(Enclose
details)
(c) Undertaking
from the applicants
that "the frequency
spotsbeingusedby themare as per the assignment
by
WPC Wing and that the detailsof the spot frequencies
BTS-wise
areenclosed.'
9
Indicatethe number of carflers at eacn BTS
List)
IJequencies.(enclose
(a) Valid calibrationcertificatefor the test mobile Yes/No
10
available? (Dateofvalidity
to beindicated).
(b) Availability
of Test Mobiles,DriveTest Toot,Watk Yes/No
post
Test Kit (or suitablealternatearrangement),
Processing
Tooletc.to conducttestsas perTSTP.
1 1 Certificate
of Interface
Approval
of MSC/MG
Yes/No
(i) Information
on Numberof 2 Mbpsstreamswith each
interconnecting
operator,includingfor emergencyand Yes/No
publicutilityservices.

14

15

Systemldentification
Numbersand International
Roaming
Mobileldentification
Number(MlN)/lRMbeingusedin the Yes/No
offerednetwork(Applicable
onlyforCDMAnetworks)
Undertakingstating complianceto "clausesand sub- Yes/No
clausesin the licenseagreementand its amendments
relatedto installation
of BTSandproviding
mobileservices
neartheinternational
border".
(Clause numbers in the license agreement and
amendmentsshould be mentionedclearlywhile giving
compliance
andnon-corlpliance)
a) Undertaking
statingcompliance
to "allclausesand suL Yes/No
clauses,relatedto LaMulInterception
and Monitoring
in
thelicenseagreement
andits amendments".
b) Certificate
of clearance
fromLEAfor LaMulInterceptionYes/"No
and
Monitoring
submitted.
'whee

an apptcat@nfor LIM tasting has b@n nade boto@30 days, so.t@ teshg w t
not be held ua Ho@vet 4 ,s nEndatory tot the stu@ p@vdd to @rpry t i t tM
6nd &fr,encv tou^g dunng Isr snsttb6 bn1vatl 4fi4 7 davs
_reaui6nfils

Undertaking
statingcompliance
to lall clausesand sr,t Yes/No
clausesin the licenseagreement
and its amendments
relatedto CallingLineldentification
(CLtR),'.
Restriction
(Clause numbers in the license agreementand
amendments
shouldbe mentioned
clearlywhilegiving
compliance
andnon-compliance)
1 7 Encryption:
(a)WhetherEncryption
equipment
is usedand
Yes/No
Connected
( Declaration
to thenetwork.
from
Serviceprovider
to be obtainedJ.
(b)if yes,whetherit hasbeenevaluated
and
writtenapproval
gltainedfromauthority
Yes/No
'18 Clause-wise
compliance
statemenilotSIp
Yes/No
16

'19 Eachpageof
all the Oocuments
suOhitteO
are stamoeOYes/No
andsignedby theauthorized
signatory
20 Self-testresultsand aetailed-estreportsfoi-overageanO Yes/No
other tests as per Test Scheduleand Test procedure,
bas-edon testsconductedby the appjicant.alongwirh
CDRS.
Loosetc
Self-Test
resultfor streetlevel coverage
--%

Datel

Signature
of authorized
signatory
Name& Designatjon:

Date;

Signature
of TERMofficer
Name& Designation:

Calculationof Test Fee

1. ServiceTesting=Rs. 1,05,000/(ForeachMSC)
2. Coverage
Testsfor networkhavingBTSupto4 = Rs.35,000/Coverage
Testsforeachadditional
2 BTSor partthereof= Rs.'17.SOO/(Clubbing
of BTSis allowedonlyat thesamestation)

DEPARTMENT
OFTELECOMMUNICATIONS
TELECOM
ENFORCEMENT,
RESOURCE
ANDMONITORING
CELL
be
in
duplicatel
submitted
lTo
TERMRefurenceNo. & Dato:
1.

Applicant's
Namei

2.

Anystatuschangein Form'A'
(lf YES,attachdetails-item
wise)

3.

ServiceParticulars:
(i) Typeof License/ Service(s)
(v) Coveragearea(Metro/DHQ/Town)
(vi)

YES/NO

District

(vii) ServiceArea(Circle)
4.

FeeRemittance
details:
Payment
Mode:(Cheque/Demand
Draft)No.
Dated:
Bank:
Amount:
Signatureof the authorized

srgnatory
Date:

Name:
Desig
Office seal

(ForUsein TERM)
Registation
No.:
Signature
of receiving
officer
Name:
Date :

AFFIDAVIT
(To be submittedatongwith FormA
by the LicensedServiceprovider,
in Stamppaperof RupeesOneHundredonly )
1.

. . . . . . . . . . . . . . . . . . s o n / doaf u. .g. .h.t.e. .r. . . . . . . . . . . .r .e. s. .i .d. e. onft

......do solemnly
declareandaffirmas follows.

2.

That I am me...............
(Designation)
of the servjceprovider
operating
in the
name and style as
having its headquarter
3.

ThatI amcompetent
to signthisaffidavit
on behatfof thecompany.

.. , whom I representhas been

i s s u e ldi c e n sfeo r p r o v i d i nsge r v i c ei n
s t h ec i r c | e . . . . . . . . . . . . . . . . . . .b. .y. D
. . .e.p. a n m eonft
Telecommunications
videthelicense
No.
Dated...............
5.
Thatwe affirmanddeclarethatwe shallbe responsible
for anydisputearisingout
of thetestingof servicecasesas mentioned
aboveandshallbearthecostot anytitigation
andloss/damage
causedto DOT.
6.
T h a tM / s. . . . . . . . . . . . . . . . . . . .. . . . . . . .w. .h, o mI r e p r e s ehnat sc a n j e do u t
t h et e s t i n g
as stipulatedby DoT/TERM ln
TSTP No.__*:_*___- and there is no
alteration/manipulation
in the test resurts/drive
plots/ca detairedrecord(cDR)and
submitted
thesameas peractuals.
7.
T h a tM / s . . . . . . . . . . . . . . . . . . . . . . . . . .w. .n. .o. m
. ,I r e p r e s e n
a tg r e et o r e _ t e s t ionfgt h e
networkby DoT/TERM.DoT/TERM
shallhavethefullrightto repeatthetestsas perthe

TSTPNo.

8.

That we indemnifythe Department

of Telecommunications
(DoT)and Telecom
Enforcement,
Resourceand Monitoring
(TERir)againstany adverseeffecvdeterioration
of thetested/approved
sitesfor radiocoverage/performance
parameters.
I s i g nt h i sA f f i d a voint t h e . . . . . . . ...... . . d aoyf . . . . .... .. . . . . . . a t
DEPONENT

Vvitness1
Wtness2

Departsnent
of Telecommunications
ANDMONITORING
CELL
RESOURCE
TELECOMENFORCEMENT.
ActivityReportof ServiceTests
A
lase Registered
by
2

TERM,
-

FileNo.
Iest Schedule
& Test
(TSTP)No.
Procdure
Name& Addressof theServiceProvidel
lsameas in licenseagreement)
icenseagreement
no.
a)
b)
c)
d)

Typeof License/Service
Area(DHQ/Town)
District
Circle

Numberof BTSSTested
(submitted

POIdetails
bytheSeNice
nterconnectivity
Detailsbetween
Provider)
to
be
attached
asAnnexure
provider
rervice
switch
& othernetworks

5.a

Doesthetestresults/comply
withallthe VES/NO
olauses
of theTSTP
lf nol, whether
theRelaxation
/ Devlation
approved
by theCompetent
Aulhority
(enclose
copyof app.oval)

c.

)ate of receiptof FormA

)ate of receiptof FormB /Registration

Oate

(D
(ii)
(iiD
(iv)

Dateof .egisfationwithTERMCell
Date(s)of BTSverifcation
by
TERM
Date(s)of Coverage
(Drive) testb)
TERM:
Date(s)of othertestsby TER[4:

E
1
2

estfeesdemand
draftno.anddate.
\mountof testfeecollected

Rs.

l0

\ certificatethat nofees/cha.ges
rendinqandall dueacollected.

\ll duesCollected

E :TCL:
lopy of the drafrTestResult (in prescribed
:nclosed
ormat)
\nnexures
to T*t Resultdulysignedin ink =nclosure
in duplicate)
lignatu.eof the conlbllingofficer.

Signatureof the testingolfcer with

lesignation-

tame
)esiE

\amei
Jesio:

)ate:

)ate:

Sionature
withstamD
DOG{TERM)
Date:

(Foruseat lssuingAuthority)
1.Dateof issueofTestresulucertificate:
2.TestResuluoertificate
No.:
Signatur
ofADG(TERM)

ll

DEPARTMENT
OF TELECOMMUNICATIONS
TELECOMENFORCEMENT,
RESOURCE
AND MONITORING
CELL

SERVICETESTRESULT
Ret. No. :

Dated:

1.General
1.1

Name& addressof theService (Asgivenin Form-A')

Provider.
LicenseNo.

1.3

a) Typeof License/Service
b) Area(Metro/DHQ/Town)
c) Diskict
d) Circle

'1.4 Dateof submission

of selftest
result& reqistration
bv TERM
1 . 5 Testconducted
bv

TERM.------------

1 . 6 TestSchedule
No.
1 . 7 Make,l\4odel,
Versionof MSC, As perAnnexure-A
BTS
MG,BSC.
1 . 8 SACFAclearance
details

As DerAnnexurelof part-lof testschedule

1 . 9 Numberof BTSStested
' 1 . ' 1 0DriveTestPlot

AttachtheAnnexure
Contd.on page-2

t2

Page-2
ServiceTsst Result(RefNo.)

Date:

Area(Metro/DHQ/Town)
Circle
2.

Covrage:
Besed on lhe RF ddve test cAried out as per Test Schedute mentiond above,
Level RadioCoveragoprovidedin lhe municipallifiilsofthe areaundertest is
%

3,

Devhdom w,r.L Tert Schdulo

(D
(iD
(tD
4.

Tholionleeghalltakenece$aryactlonforremovlng
thenon-compliences
indicated
above.

DIRECTOR(TERflID

To:
(Ian & Add.cr of SrvlcaProvldera8glv.n in Form.A)
Copyto:
L DDG(AS.ll),
DOT,t{.w Delhl
2. ODG(Secu.lty),DoT,N6wDolhl

Annexure-A
Make,Model,Versionof EquipmentUsed
(MSC.BSC.BTS.Microwave.
etc.)
Name:

st. SiteName&
No.

ID

SrviceProviderName:

Address

Equipment

DHe/Town

Vendor

Make/Model

sw

ver.

1.

2.
?

..n

t4