Medtronic/CFDContract Number:
End User # 10774201
CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE
CARMEL, IN 46032
aff cA/o. O zo.O . O+
BillTo# 10774201
CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE
CARMEL, IN 46032
FORill
This Technical Service Support Agreement begms on 03/01/2001 end expires on 10/31/2003.
The designated Covered Equipment and/or Software is listed on Schedule A. This Technical Service Agreement
is subject to the Terms and Conditions on the re~'erse side of this document and any Schedule B, ff attached.
If eny Data Management Support and Upgrade Service is included on Schedule A then this Technical Service
Support Agreement is also subject to Medtronic Physio-Control Corp.'s Data Management Support end Upgrade
Service Terms and Conditions, rev 7/99-1.
Price of coverage specified on Schedule A is $20,749.71 per term, payable in Annual installmems.
Special Terms
10% Discount on accessories
5% Discount on defib pads
Accepted: MEDTRONIC PHYSI0-CONTROL CORP. Customer:
Title: Print:
Date: /' ~ -0 7
Terntory Rep: WEMM54
JASON MCW1LLIAMS
Phone: 800442-1142 X2963
FAX: 800-772-3340
Title:
Date:
Customer Contact:
TomSmall
Phone: 317-571-2663
FAX: 317-571-2615
Reference Number: M54-1450 New Printed: 01/22/2002 Page 1 of 6
MEDTRONIC PHYSIO-CONTROL CORn
SERVICE ORDER TERMS AND CONDITIONS
TERMS
MedtronicPhysi~C~ntr~s(``Physi~)acceptance~fCust~mer~sService~rderisexpress~yc~nditi~ned~nCust~mer~sassentt~thetermssetf~rfhinth~ document
and its attachments. Physio agrees to furnish the services ordered by Customer only on these terms, and Customer's acceptance of any portion of the g, ~ods and ser-
Vices covered by this document shall confirm their acceptance by Customer. These terms constitute the complete agreement between the parties and tl' ey shal~ gov-
ern any conflicting or ambiguous terms on Customer's purchase order or on other documents submitted to Physio by Customer. These terms may not b~. revised
m any manner without the pdor written consent of an officer of Physio.
REPAIR SERVICES
If "Repair" services are designated, subject to the Exclusions identified below, they shall include, for the designated Covered Equipment, all repair parts and materials
required, all required Physio service technician labor, and aH related travel expenses. For offsite (ship-in) services, Units will be returned to Customer by Physio freight
prepaid.
INSPECTION SERVICES
If "Inspection" services are designated, subject to the Exclusions identified below, they shall include, for the designated Covered Equipment, Verification of proper
instrument calibration, verification that instrument mechanical operations and output measurements am consistent with applicable product specifications, performance
of an electrical safety check in accordance with National Fire and Protection Guidelines, all required Physio service technician labor and all related travel expenses.
For offsite (ship-in) services, units wilt be returned to Customer by Physio freight prepaid.
DOCUMENTATION
Following each Repair and/or Inspection, Physio will provide Customer with a written report of actions taken or recommended and identification of any materials
replaced or recommended for replacement.
LOANERS
If a Physio product is designated as a unit of Covered Equipment for Repair Services and needs to be removed from service to complete repairs, an appropriate
Loaner unit will be provided, if aveliable, until the removed unit is returned. Customer assumes complete responsibility for the Loaner and shall return the Loaner to
Physio in the same condition as received, at Customer's expense, upon the earlier of the return of the removed unit or Physio's request.
EXCLUSIONS
This Service Order does not include: supply or repair of accessories or disposables (e.g., patient cables, recorder paper, etc.); repair of damage caused by misuse,
abuse, abnormal operating conditions. operator errors, and/or acts of God; repairs to return an instrument to normal operating equipment at the time of initial service by
Physio under this Service Order; case changes; repair or replacement of items not originally distributed or installed by Physio; and exclusions on Schedule B to this
Service Order. if any, which apply to Covered Equipment.
SCHEDULE SERVICES
Designated Repair and Inspections Services will be performed at the designated service frequency and during designated service hours. Customer is to ensure
Covered Equipment is available for Repair and/or Inspection at scheduled times. If Covered Equipment is not available as scheduled and Customer requests
additional services to be performed or if Physio is requested to perform Repair or Inspection services not designated in this Service Order (due to the nature of
services selected, instruments involved not being Covered Equipment, request being outside of designated service frequency or hours, or application of the
Exclusions); Customer shall reimburse Physio at Physio's standard labor rates less 10% (including overtime, if appropriate), plus standard list prices for related parts
and materials less 15%, plus actuat travel costs incurred.
PAYMENT
The cost of services performed by Physio shall be payable by Customer within thirty (30) days of Customer's receipt of Physio's Invoice (or such other terms as Physio
confirms to Customer in writing). In addition to the cost of services performed, Customer shall pay or reimburse Physio for any taxes assessed Physio. If the number
or configuration of Covered Equipment is altered during the Term of this Service Order, the price of Services shall be adjusted accordingly.
WARRANTY
Physio Warrants Services performed under this Service Order and replacement parts provided in performing such Services against defects in matedal and Workman-
ship for ninety (90) days from the date a Service was performed or a part was provided. Customer's sole remedy shall be reservicing the affected unit and/or replace-
ment of any part determined to be defective, without any additional Customer charge, provided Customer notifies Physio of any allegedly defective condition within ~
:D~2~'l'e~rcalendardaysofitsdiscoverybyCustomer. Physi~makesn~therwarracties~express~rimp~ied~inc[uding~with~ut~imitati~n~N~WARRANTY~FMER- '7~.~.-~/
CHANTABILITY OF FITNESS FOR A PART[CULAR PURPOSE, AND IN NO EVENT SHALL PHYSIO BE LIABLE FOR INCIDENTAL, -rz-~f
CONSEQUENTIAL, SPECIAL, OR OTHER DAMAGES.
TERMINAT!_ON
Either party may terminate this Service Order at any time upon sixty (60) days prior wdtten notice to the other, except that Physio may terminate this Service Order
immediate~yup~n Cust~mer~sfai~uret~maketime~ypaymentsf~rservicesrenderedunderthisSerVice~rder. Inthe eventoftermination, Custornershall be obligated
to reimburse Physio for that portion of the designated price which corresponds to that portion of the Term and the scope of Services provided pdor to the effective date
of termination.
DELAYS
Physio wili not be liable for any loss or damage of any kind due to its failure to perform or delays in its performance resulting from any cause beyond its reasonable con-
trol, including, but not limited to, acts of God, labor disputes, labor shorfages, the requirements of any governmental authority, war, civil unrest, delays in manufa~ure,
obtaining any required license of permit, and Physio's inability to obtain goods from its usual sources. Any such delay shall not be considered a breach
of Physio's obligations and the performance dates shall be extended for the length of such delay.
MISCELLANEOUS
a) Customer agrees to not employ or offer employment to anyone performing Services on Physio's behalf during the Term of this Service Order or for one (1)
year following its expiration without Physio's prior written consent.
b) This Service Order, and any related obligation of other party, may not be assigned in whole or in parf without the prior written consent of the other party.
c) The rights and obligations of Physio and Customer under this Service Order shall be governed by the laws of the State of Washington. All costs and
expenses incurred by Physio related to enforcement of its rights under this document, including masonable attorney's fees, shall be reimbursed by
Customer.
Rev 7/99-1
MEDTRONIC PHYSIO-CONTROL CORP.
TECHNICAL SERVICE SUPPORT AGREEMENT
SCHEDULE A
Contract Number:
Servicing Rep:
District:
Phone:
FAX:
Equipment Location:
Scope Of Service
JASON MCWILLIAMS, WEMM54
MIDWEST
800442-1142 X2%3
800472-3340
CARMEL FIRE DEPARTMENT, 10774201
On Site Repmr and 2 On Site Inspection per Year:M-F/8-5
Ref, Effective
Model Part Number Serial Number Ume Date
LIFEPAK{ 10 804200-49 11984880 12 4/1/2001
LIFEPAK® 10 804200-60 070423 14 4/1/2001
L1FEPAK® 10 804200-49 11989922 13 4/1/2001
POS LP500 1 On Site Inspection per Year with 1 Litltium BaR
Ref. Effective
Pint Number Serial Numbe~ Lh~e Date
3011790-000113 13736715 20 11/1/2001
30117%-000113 13736714 19 11/1/2001
3011790-000113 13736713 16 11/1/2001
3011790-000113 13736712 17 11/l/2001
3011790-000113 13736711 16 11/1/2001
3011790-000113 13736710 15 11/1/2001
3011790-000113 13736716 21 11/1/2001
Scope Of Service
POS On Site Replflr and 1 Inspection per Year:M-F/8-5
Model Part Number
BATTERY SUPPORT SYSTEM 2 V88S2-02.000009
B~FIERY SUPPORT SYSTEM 2 VBSS2-02-000009
BATTERY SUPPORT SYSTEM 2 VBS82-02-000009
BAI IERY SUPPORT SYSTEM 2 V8882-02.000009
BATTERY SUPPORT SYSTEM2 V8882.02-000009
LIFEPAK® 12 VLP12-02-001385
LITEPAK® 12 VLPI2-02-001385
LIFEPAK® 12 VLP12-02-001385
LIFEPAK® 12 U~7,PI2-02-000476
L1TEPAKC~ 12 VLPI2-02-001385
LIFEPAK~ 12 VLPI2-02-001385
SefiflNumb~
12951657
12951661
12959332
12959340
12959341
12984816
12984817
12984818
11870820
13044135
13044134
Expiration Total
Date inspedions
10/31/2003 5
10/31/2003 5
10/31/2003 5
Expiration Total
Date fnspections
10/31/2003 2
10/31/2003 2
10/31/2003 2
10/31/2003 2
10/31/2003 2
10/31/2003 2
10/3t/2003 2
Ref, Effective Expiration Total
Ume Date Date Inspections
2 3/1/2001 10/31/2003 3
3 3/1/2001 10/31/2003 3
4 3/1/2001 10/31/2003 3
5 3/1/2001 10/31/2003 3
6 3/1/2001 10/31/2003 3
7 3/1/2001 10/31/2003 3
8 3/1/2001 10/31/2003 3
9 3/1/2001 10/31/2003 3
1 7/13/2001 10/31/2003 2
11 3/l/2001 10/31/2003 2
10 3/1/2001 10/31/2003 2
Reference Number: M54-1450 New Printed: 01/22/2002 Page 2 of 6
Reference Number: M54-1450 New Printed: 01/22/2002 Page 3 of 6
MEDTRONIC PHYSIO-CONTROL CORP.
TECHNICAL SERVICE SUPPORT AGREEMENT
SCHEDULE B
LIFEPAK® 10 DEFIBRILLATOR/MONITOR/PACEMAKER
· Paddle repairs ere included. (Paddle attachments are exclude~, i.e. pedialric and anterior attachments).
· Auxiliap7 Power Supply included when listed on equipment inventory (Schedule A).
· Pacemaker repair is included.
· Case changes ere excluded.
· Pacing end patient cables ere excluded.
· FAST-PATCH® adapters end QUIK-COMBOTM pacing/ddibrillaften adapters ere included.
. Medtxonic Physio-Control® Battery Support System included when listed en equipment invento~ (Schedule A).
· Repair coverage for Medtxonic Physio-Centxol® ECG, Pacing and Defibrillation Simulators included.
Medtrhmc Physio-Centrol® Battery Pak
· Customer re,ms the responsibility to perform the battery mamtonance end evaluation procedures outlined in the
serwce manual and to replace batteries that do not pass the condltiens ou~ined under "Discarding/Recycling Batteries."
Batteries faffmg to meet battery performance tests should be removed from service and properly discarded (recycled).
. If customer provides evidence that a Medtrhmc Physio-Cenlrol Batte~ Pak fails to meet the performance tests
noted above end/or the Battery Pak age exceeds 2 yeers, Medtronic Physio-Centrol shall replace said Medtxenic
Physio-Centrol Bat~ry Pak (Fdce for F~ce) i.e. FASTPAK fer FASTPAK, up to a taximum of 4 Medtronic Physio-Control
Battery Paks every two yeers (including prier Support Plen periods ) per LIFEPAK® 10 defibrillater/momter/pacemaker
(listed on Schedule A). To assist in proper recycling end removal of low capacity batteries, replaced Battery Paks
become the property of Medtroinc Physio-Control and must be returned at the Curie of exchange.
Reference Number: M54-1450 New Printed: 01/22/2002 Page 4 of 6
MEDTRONIC PHYSIO-CONTROL CORP.
TECHNICAL SERVICE SUPPORT AGREEMENT
SCHEDULE B
LIFEPAK® 12 DEFIBRILLATOR/MONITOR
. Battery Support System included when listed on equipment mvento~y (Schedule A).
· Battery Support System 2 included when listed on equipment inventory (Schedule A).
. AC Power Adapter included when listed on equipment inventory (Schedule A).
· DC Power Adapter included when listed on equipment inventory (Schedule A).
, Defibrillater paddle ~pairs ere included (excludes internal, stcrilizablc end pediatric paddles).
· Communications and Patient cables ere excluded.
. PCMCIA Moderns ere excluded.
· Therapy cables ere excluded.
. SpO2 Sensors ere excluded.
· Case Changes ere excluded.
. Discount of 17% from the field installed list price for any current and/er future avifiable LIFEPAK®I2 upgrade is
included when installed by Med~roulc Physie-CenB:ol Technical Services.
. Discount of 17% from list price for any Medtroinc Physic-Control® Data Management Feeduct is included,
· Discounts may not be combined with any other special terms, discounts and/or Feemotions.
Medtroinc Physio-Control Fastpak®, Fastpak 2, Lifepak SLA and Lifepak NiCd Battery
· Customer retains the responsibility to perform the battery n~mtemmce and evaluation procedures outlined in the
operafrog instruction manual end to replace batteries that do not pass the conditions ouffmed under "Discarding/
RecyclingBatteries." Batteriesfai~ingtomeetbattoryperf~n~ancetestssh~u~dberem~ved~mserv~ceandFe~per~y
discarded (recycled).
. If customer provides evidence that a Medtxoulc Physio-Conttol Battery Pak fails to meet the performance tests nol~l
above and/or the Battery Pak age exceeds 2 years, Medtromc Physio-Contml shall replace said Medtronic
Phy(~o-Centrol Battery Pak (like for like) i.e. FASTPAK for FASTPAK, FASTPAK2 for FASTPAK2, LIFEPAK SLA for
LIFEPAK SLA, or LIFEPAK NiCd for LIFEPAK NiCd, up to a maximera of 4 MedtroWm Physio--Contxol Battery Paks
every two yeers (including prier Support Plan periods ) per LIFEPAK® 12 defibrillater/mointor (listed on Schedule A).
To assist in proper recycling end removal of low capacity batteries, replaced Batter/Paks become the property of
Medtronic Physio-Control and must be returned at the rune of exchange.
Lifepak®12 Sofnvere Updates
· If combined Repair end Inspectien services ere designated on the Technical Service Support Ag-eement inventory
for Lifepak 12 units, at the customer's request, a Medttoulc Physio-Conttol Teclufical Services Representative will
install Lifepal{ 12 softwere updates at ue additional charge provided it is installed at the time of a mgulerly scheduled
inspection. In addifien during the term of this agreement, where an assembly such as a printed (trcult boerd must be
replaced in order to install the new softwere, these assemblies may be purchased by the customer at a 50% discount
off the current list price of a new assembly. Solonere updates requested to be installed at a time other than the regulerly
scheduled Inspection will be billed at $205 per unit per soflware update. The cost of the soft:wase update will be billed
on a separate invoice.
· If Repair_Only services ere designated on the Service Order inventory for Lifepak 12 units, at the custemer's request
a Medtronic Phy(to-Control Teclufical Services Representative will install a Lifepak 12 soilwere update at a discounted
price of $205 per unit per software update. In addition during the term of this agreement, where an assembly such as a
printed (trcint board must be replaced in order to Install the new software, these assemblies may be purchased by the
customer at a 50% discount off the current list price of a new assembly. The cost of the seRwere update will be billed
on a seperate invoice.
· Discounts may not be combined with any other special terms, discounts and/or promotions.
Reference Number: M54-1450 New Printed: 01/22/2002 Page 5 of 6