Physio Control, Inc/Fire/Adl Serv/2,064/Maintenance AgreementPhysio Control, Inc.
Fire Department - 2018
Appropriation # 43-515.01 Fund; P.O. #101850 oU
Contract Not To Exceed $2,064.00
�J PO
ADDITIONAL SERVICES AMENDMENT TO
AGREEMENT FOR PURCHASE OF GOODS AND SERVICES
THIS AMENDMENT TO THE GOODS AND SERVICES AGREEMENT ("Agreement') entered into by and
between the City of Carmel and Physio Control, Inc. (the "Vendor"), as City Contract dated July 15, 2015 shall amend
the terms of the Agreement by adding the additional services to be provided by Vendor consistent with the Scope of
Work attached hereto and incorporated herein as Exhibit "A". The terms and conditions of the Agreement shall not
otherwise be affected by this Additional Services Amendment and shall remain in full force and effect.
IN WITNESS WHEREOF, the parties hereto have made and executed this Amendment as follows:
CITY OF CARMEL, INDIANA
by and through its Board of Public
Works and Safety
B:
�Q ^
James Brainard, Presiding Officer
Date: _ A
Maty An Surke, MVp/
Date: / S"
Lori S Wat �ember
Date: 1-5- /i g�
ATTEST:
Christine Pauley, Clerk -Treasurer
Date:
MlCfttu Wrd..Sv k C-6 SmTlre DepW13 pia CmuvL 1— ASA I doa3=13 1:16 PK
Physio Control, Inc.
By:
Authorized Signature
��c� e cSt '-'d
Printed Name
Se,v-,1 �Un S 5y(�2ryl�Of
Title
FIDfrIN: `19 $ 0 Z- t, 0 6 cl 7 6 -
Last Four of SSN if Sole Proprietor:N11A
Date: A�4 , 7 Z.D! 8
..1
rnysru Loniroi, inc. Quote Number 00115902
M11811 Willows Road NE Create Date 2/27/2018 8:54 AM
P.O. Box 97006 Quote Expiration Date 04/30/2018
Redmond, WA 98073-9706 U.S.A Quote Consultant Zachary Fluhr
www.physio-control.com 623-377-6193
tel (800) 442.1142 EALL71
fax (800) 772.3340
Service Plan Quote
Account: 10774201
Service Plan Detail
Tom Small
Type
Renewal
CARMEL FD
Service Plan Start Date
05/01/2018
2 CIVIC SQUARE
Service Plan End Date
04/30/2021
CARMEL, IN 46032
Reference Plan
PB18S636
(317) 571-2663
Billing Frequency
Annual
tsmall@carmel.in.gov
15
5,292.00 l 15.00
1,499.40
Terms
All quotes subject to credit approval and the
POS Renewal
following terms and conditions
Net Terms
NET 30
Promotion
LP12-OSCOMP-1
05/01/2018
Covera g eDetails-Brochure
.ri%,%%, or.•,sic c �r� Gn . er•; _� v • c F:ar
Notes
1,548.00
1,548.00
Service plan customers receive 15% discount on Accessories and Disposables
Product Descriptions provided below signature fine
Subtotal
Estimated Tax
Estimated Shipping & Handling
Grana total
List Price Total
Total Discount
Estimated Tax + S&H
USD 70,569.00
USD 0.00
USD 0.00
USD 70,569.00
Pricing Summary Totals
USD 82,476.00
USD -11,907.00
USD 0.00
Tax will be calculated at time of invoice and is based on the Ship To location where product will be shipped.
GRAND TOTAL FOR THIS QUOTE
USD 70,569.00
Year 2 - J'Z Z � y& 1- �
`fear 3 "!5 ZZ, `lq1 0()
Exhibit
Ctuote Number 5i 911* Ji__1 kloAr kv 0UNOMT Page 1 V(q
00115902
Term List Disc
Annual Net
Term Net
Extended
Product
Start Date
End Date
Qty
Price %
Price Per Unit
Price Per Unit
Term Net Price
LP15-OSCOMP-3-
05/01/2018
04/30/2021
15
5,292.00 l 15.00
1,499.40
4,498.20
67,473.00
POS Renewal
LP12-OSCOMP-1
05/01/2018
04/30/2019
2
1,548.00 i 0.00
1,548.00
1,548.00
3,096.00
Product Descriptions provided below signature fine
Subtotal
Estimated Tax
Estimated Shipping & Handling
Grana total
List Price Total
Total Discount
Estimated Tax + S&H
USD 70,569.00
USD 0.00
USD 0.00
USD 70,569.00
Pricing Summary Totals
USD 82,476.00
USD -11,907.00
USD 0.00
Tax will be calculated at time of invoice and is based on the Ship To location where product will be shipped.
GRAND TOTAL FOR THIS QUOTE
USD 70,569.00
Year 2 - J'Z Z � y& 1- �
`fear 3 "!5 ZZ, `lq1 0()
Exhibit
Ctuote Number 5i 911* Ji__1 kloAr kv 0UNOMT Page 1 V(q
00115902
Please provide a company issued Purchase Order that includes Billing and Shipping Address.
PO must reference payment terms of Net 30 days.
-OR—
Required information if no Purchase Order is provided
Billing Address C same as address on quote Shipping Address ❑ same as Billing Address
Account Name Account Name
Address Address
City City
State Zip Code
Accounts Payable Contact Information
Accounts Payable Contact
Accounts Payable Email
Authorized Customer Signature
State
Zip Code
Accounts Payable Phone Number
Customer is Tax Exempt? UI Yes C No
Name Signature
Title Date
Optional information:
Special Ship to Address
Comments
For Multiple End Users, please attach a supporting document with End User name, physical location, product type and quantity
To update any customer information, please complete form at ::. _ L _ _ _ . W _+_,
Reference Number LS/10774201/156138/00115902
Product
Product Description
LP15.OSCOMP-3-POS
LIFEPAK 15 Service - 3 YEAR.
Renewal
On-site Comprehensive Coverage. Annual Payments.
Includes:
-Services performed at customer's location by a Physio -Control Technical Specialist
-Parts and labor necessary to restore device to original specifications
-Annual Preventive Maintenance and inspections including quality assurance documentation
-Discounts on accessories, disposables, and upgrades
Updates to the latest software version
-Preconfigured loaner device provided if needed
-Battery Replacement Service
LP12-OSCOMP-1
LIFEPAK 12 Service - 1 YEAR.
On -Site Comprehensive Coverage. On-site Comprehensive Coverage for LIFEPAV 12 Includes:
-Services performed at customer's location by a Physio -Control Technical Specialist
-Parts and labor necessary to restore device to original specifications
-Annual Preventative Maintenance and Inspections including quality assurance documentation
-Discounts on accessories, disposables
-Updates to the latest software version
-Preconfigured loaner device provided if needed
Battery replacement service
Quote Number
00115902
l-iA111 V+� '
Page 2 ON
Service Plan Summary
List of covered equipment by location will be provided upon Customer's signature of this quote.
Exhibit A
Quote Number TAIDIS" z ' l T' lr' Page 3 CF -I
� �„ J�,1Ji4i'Pra1;�103J"J� ��
00115902
General Terms for all Products, Services and Subscriptions.
Physio -Control. Inc ('Physio) accepts Buyers order expressly
conditioned on Buyer's assent to the terms set forth in this document
Buyer's order and acceptance of any portion of the goods. services or
subscriptions shall confirm Buyer's acceptance of these terms Unless
specified otnerwise herein. these terns constitute the complete
agreement between the parties Amendments to this document shall be
in writing and no prior or subsequent acceptance by Seller of any
purchase order. acknowledgment. or other document from Buyer
specify ng different and/or additional terms shall be effective unless
signed by both parties
Pricing. Prices do not include freight insurance. freight forwarding fees.
taxes, duties, import or export permit fees or any other similar charge of
any kind applicable to the goods and services Sales or use taxes on
domestic (USA) deliveries will be invoked in addition to the price of the
goods and services unless Physio receives a copy of a valid exemption
certificate prior to delivery Discounts may not be combined with other
special terms. discounts and/or promotions
Payment. Payment for goods and services shall be subject to approval
of credit by Physio Unless otherwise specified by Physio in writing the
entire payment of an invoke is due thirty (30) days after the invoice date
for deliveries in the USA, and sight draft or acceptable (confirmed)
irrevocable letter of credit is required for sales outside the USA
Minimum Order Quantity. Physio reserves the right to charge a
service fee for any order less than 5200 00
Patent Indemnity. Physio shall indemnify Buyer and hold it harmless
from and against all demands. claims. damages. losses and expenses.
arising out of or resulting. from any action by a third party against Buyer
that is based on any claim that the services infringe a United States
patent, copyright, or trademark, or violate a trade secret or any other
proprietary right of any person or entity. Physio's indemnification
obligations hereunder will be subject to (i) receiving prompt written
notice of the existence of any claim. (it) being able to, at its option.
control the defense and settlement of such claim (provided that without
obtaining the prior written consent of Buyer. Physio will enter into no
settlement involving the admission of wrongdoing) and pip receiving full
cooperation of Buyer in the defense of any claim
Limitation of Interest Through the purchase of Physio products,
services, or subscriptions. Buyer does not acqu re any Interest in any
tooting, drawings, design Information, computer programming. patents or
copyrighted or confidential Information related to said products or
services and Buyer expressly agrees not to reverse engineer or
clecomplle such products or related software and information
Delays. Physio will net be liable for any loss or damage of any kind due
to its failure to perform or delays in its performance resulting from an
event beyond Its reasonable control. including but not limited to acts of
God laoor disputes the requirements of any governmental authority
war. civil unrest, terrorist acts, delays in manufacture obtaining any
required license or permit. and Physio inability to obtain goods from its
usual sources
Limited Warranty. Physio warrants its products and services in
accordance with the terms of the Ilm,ted warranties located at
The remedies provided
under such warranties shall be Buyer's sole and exclusive remedies
Physio makes no other warranties express or implied, including. without
limitation. NO WARRANTY OF MERCHANTABILITY OR FITNESS
FOR A PARTICULAR PURPOSE, AND IN NO EVENT SHALL PHYSIO
BE LIABLE FOR INCIDENTAL, CONSEQUENTIAL, SPECIAL OR
OTHER DAMAGES
Compliance with Confidentiality Laws. Both parties acknowledge
their respective obligations to maintain the security and confidentiality of
individually identifiable health information and agree to comply with
applicable federal and state health information confidentiality laws
Compliance with Law. The parties agree to comply with any and all
laws rules, regulations. licensing requirements or standards that are
now or hereafter promulgated by any local, state. and federal
governmental authoritylagency or accrediting/administrative body that
governs or applies to their respective duties and obligations hereunder
Regulatory Requirement for Access to Information. In the event 42
USC § 1395x(v)(1)(1) is applicable. Physio shat make available to the
Secretary of the United States Department of Health and Human
Seances. the Comptroller General of the United States General
Accounting Office. or any of their duly authorized representatives. a copy
of these terms. such books. documents and records as are necessary to
certify the nature and extent of the costs of the products and services
provided by Physio
No Debarment. Physio represents and warrants that it and its directors
officers. and employees (i) are not excluded debarred or otherwise
ineligible to participate in the Federal health care programs as defined in
42 USC § 1320a-7bi (n) have not been convicted of a criminal offense
related to the provision of heahhcare items or services and (iii) are not
under investigation which may result in Pnysio being excluded from
participation in such programs
Choice of Law. The rights and obligations of Physio and Buyer related
to the purchase and sale of products and services described in this
document shall be governed by the laws of the state where Buyer is
located All costs and expenses incurred by the prevailing party related
to enforcement of its rights under this document, including reasonable
attorneys fees shall be reimbursed by the other party
Additional Terms for Purchase and Sale of Service Plans.
In addition to the General Terms above the following terms apply to all
Physio Service Plans
Service Plans Physio shall provide services according to the
applicable Seance Plan purchased by Buyer and described at
C= , :-r c for the length of
the subscription purchased and for the devices specified as covered by
the Service Plan ('Covered Equipment-)
Pricing. If the number or configuration of Covered Equipment changes
during the Service Plan subscription. pricing shall be pro -rated
accordingly For Preventabve Maintenance, Inspection Only
Comprehensive. and Repair & Inspect Service Plans. Buyer is
responsible to pay for preventative maintenance and inspections that
have been performed since the last anniversary of the subscription start
date and such services shall not be pro -rated
Device Inspection Before Acceptance. All devices that are not
covered under Physio's Limited Warranty or a current Service Plan must
be inspected and repaired (if necessary) to meet specifications at then -
current list paces prior to being covered under a Service Plan
Unavailability of Covered Equipment. If Covered Equipment Is not
made available at a scheduled service visit Buyer is responsible to
reschedule with the Physio Service Technician. or ship -in the Equipment
to a Physio service depot Physio reserves the right to charge Buyer a
surcharge for a return visit Surcharges will be based on then -current
Physio list price of desired services. less 10% for labor and 15% for
parts, plus applicable travel costs The return visit surcharge will be in
addition to the subscription price of the Service Plan To avoid the
surcharge Buyer may ship devices to a Physio service depot Buyer
shall be responsible for round-trip freight for ship -in service
Unscheduled or Uncovered Services. If Buyer requests services to
be performed on Covered Equipment which are not covered by a
Service Plan or are outside of designated Services frequency or hours.
Physio -Control will charge Buyer for such services at 10% off Physio -
Control's standard rates (including overtime if appropriate) and
applicable travel charges Repair parts required for such repairs will be
made available at 15% off the then -current list price
Loaners. If Covered Equipment must be removed from service to
complete repairs Physio will provide Buyer with a loaner device. if one is
available Buyer assumes complete responsibility for the loaner and
shall return the loaner to Physio in the same condition as received
normal wear and tear exempted, upon the earlier of the return of the
removed Covered Equipment or Physio's request
Cancellation. Buyer may cancel a Service Plan upon sixty (601 days
written notice to Physio In the event of such cancellation Buyer shall
be responsible for the portion of the designated price which corresponds
to the portion of the Service Plan subscription prior to the effective tla:e
of termination and the list -price cost of any preventative maintenance
inspections or repairs rendered after the last anniversary date of the
subscription start date
No Solicitation. During the Senace Plan subscription and for one (1)
year following its expiration Buyer agrees to not to actively and
intentionally solicit anyone who is employed by Physa to provide
services such as those described in the Service Plan
Exhibit
Quote Number �_#�iJ��411�%�[v0;; i,� Page r�C�
00115902
City
(f Carmel
INDIANA RETAIL TAX EXEMPT
to CERTIFICATE NO. 003120155 002 0
JL FEDERAL EXCISE TAX EXEMPT
ONE CIVIC SQUARE 35-6000972
CARMEL, INDIANA 46032-2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
PURCHASE ORDER DATE I DATE REQUIRED I REQUISITION NO. VENDOR NO.
8/7/2018 242000
Page 1 of 1
PURCHASE ORDER NUMBER
101850
THIS NUMBER MUST APPEAR ON INVOICES, AIP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE
-------------- ---
DESCRIPTION
Additional costs for Defibrillator Maintenance
PHYSIO CONTROL CORP Fire Department
VENDOR 12100 COLLECTIONS CENTER DRIVE SHIP 2 Civic Square
TO Carmel, IN 46032.
CHICAGO, IL 60693 -
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
28338
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSK)N
Department: 1120 Fund. 101 General Fund
Account: 43-515.01
1 Each Maintenance Agreement - Additional Costs - Old Defibs $2,064.00 $2,064.00
Sub Total $2,064.00
Send Invoice To:
Fire Department
2 Civic Square
Carmel, IN 46032 -
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $2,064.00
SHIPPING INSTRUCTIONS 'Alp VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
'C.O.D. SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL c -
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY ---
Denise Snyder
TITLE Budget 8 Accreditation Manager
CONTROL N0. 101850 CLERK -TREASURER