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HomeMy WebLinkAboutContracts & Agreements_101-2018June 1, 2018 Redlands Fire Department Attn Chief Rich Sessler 35 Ca on Street, Suite 12 Redlands, CA 92373 Dear Chief Rich Sessler ' � J We appreciate your selection of ZOLLO products for Redlands Fire Department and your interest in AutoPulseO Non-invasive Cardiac Support Pump a revolutionary new resuscitation system that offers the promise of normal blood flow during sudden cardiac arrest This letter serves as confirmation that ZQLLO Medical Corporation located at 269 Mill Road in Chelmsford, Massachusetts, is the sole manufacturer and source of X Series® Moni€orsl Defibrillators for the EMS Market Z01-1-0 or Bryan Pank, Senior EMS Account Executive, will not sell an X Series® MonitorlDefibrillator to Redlands Fire Department through any vendor or dealer Additionally, please be aware that Z©LL(8) Medical Corporation is the only company that manufactures and markets the AutoPulse No other organization is authorized to sell the product in the United States Further there are no other devices on the market today that can mimic the AutoPulse's unique mechanism of action and achieve its unprecedented clinical results Lastly, there are multiple ancillary items that are unique to the AutoPulse and its functionality Like the AutoPulse, no other organization is authorized to sell these products which include but are not limited to the following • AutoPulse LifeBands # 8700-0706-01 • AutoPulse Lithium ion Batteries 9 8700-0752-01 • AutoPulse SurePower Charger 9 8700-0753-01 • AutoPulse Soft Carry Case # 8700-000758-01 • AutoPulse Soft Stretcher 4 8700-0712-01 Should you have any questions or require additional information please don t hesitate to contact meat (800) 3 48-901 1 x 9439 Sincerely, e0d: �Vodgurski Coluracly Specialist i0 Redlands Fire Department 35 Caton Street Suite 12 Redlands, CA 92373 Attn Bot) Tyson ematf btyson oonflre.arq Tet ZOLL Medical Corporation Worldwide HeadQuarters 269 Milt Rd Chelmsford, Massachusetts 01824 4105 (978) 421 9655 Main (800) 348 9011 (978) 421 0015 Customer Support FEDERAL 10# 04 2711626 QUOTATION 272743 V 3 DATE June 04, 2018 TERMS Net 34 Days FOS Shipping Point FREIGHT Free F=reight ITEF4l MODEL NUMNER DESCRIPTION CITY UNIT PRICE ©IBC PRICE TOTAL. PRICE Masjmo Pulse Oximetry SP02 & speo $+4,540 Signal Extraction Technology (SET} Rainbow SET ( for SpCO & SpMel) NIBP Welch Allyn Includes. $3495 Smartcufl 10 foot Dual Lumen hose SureHP Reusable Adult Medium Cult End Tidal Carbon Dioxide mcinhoring (IETCa2y $4995 Orldlan Microstream Technology' Order required Microstream tubing sets separately Interpretative 92- Lead ECG $8,450 92 Lead one step ECG cable includes 4. Lead limb lead cable and removable precordtat 6- Lead set 2 8778- t3 9 1 4 i Year l Preventative Maintenance (At time of sale) 4 $23000 S23000 `&2313 00 3 Estimated Sales Tax at 7 75% $2,10905 "Reflects National Purchasing Partners (NPP) Contract Pricing To the eetent that ZOLL. and Customer or CustomaCs Representative have rregotlatod and exozuted oveMding terms TOTAL $29,652.65 . .... this quote Is made subject to ZOLL's Slandard Commercial Terms and Conditlonst"ZOLL T's & C's") which accompany thss quote Except in the case} of overriding T's and C'ts, any Purchase Order ("PO"I lasued it, response to this quolation wlII be doomed to Incorporate ZOLL ra & C's, anti any other terms and conditions shall have no force or effect oxcapt to the oxtont agreed in writing by ZOLL. 9 DELIVERY WILL BE MADE 60 90 HAYS AFTER RECEIPT OF ACCEPTED PURCHASE ORDER 2 PRICES OUOTED ARE VALID FOR 60 DAYS 3 APPLICABLE TAX, SHIPPING & HANDLING WILL BE ADDED AT THE TIME OF INVOICING 4 ALL PURCHASE ORDERS ARE SUBJECT TO CREDIT APPROVAL BEFORE ACCEPTABLE BY ZOLL 5 FAX PURCHASE: ORDER AND QUOTATION TO ZOLL CUSTOMER SUPPORT AT 976.421-0095 OR EMAIL TO ESALES@ZOLL.COM 6 ALL DISCOUNTS OFF LIST PRICE ARE CONTINGE=NT UPON PAYMENT WITHIN AGREED UPON TERMS 7 PLACE YOUR ACCESSORY ORDERS ONLINE BY VISITING www.zollwebstore corn Page 2 Bryan Pank Sr EMS Account Executive 800 242 9150 x9298 ? C[7= or POW" C A n t r• s x t A POBm 3DOS - ids. CA 42373 Phone M9) 7"-7S2S VAX (KS) 741-9522 TO: J ZOLL MEDICAL CGRP 269 MILL ROAD OUMMSFORD, MA 01524 L r FIRE DEPARTMENT 35 CWON STREET SUITE 12 REDLANDS. CA 92373 01 I j,J ren 0- - 7-7t e PURCHASE ORDER PO NUMB P01343 UAM 25 18 Qr;LDMRY DATE DC1R !. ( iSMC)N NC476987 OUR PURCHASEORDIR NUMMMMUST A"EARGUALLINV00O3PACIMIG LISTAIDCORM ONIMICL P013431 CITY OF REDLANDS ATTN: ACCOUNTS PAYABLE P.O. BOX 3005 REDLANDS, CA 92373 PtMMS£ ORDER AS PER ATTACHED QUOTE #272743 V.2 DATED JUNE 4, 2018 AND CITY COUNCIL APPROVAL DATED JUNE 19, 2018 01 X -SERIES MANUAL 1 EA 27,213 6 27,213.60 MMITOR/DIFIBRILLATOR WITH 4 TRACE TRI MODE DISPLAY MONITOR-DIFBRILLA`FOR-PR324TE R, A CCESSORIES INCLUDED MFC CABLE, MFC CFR CONNECTOR. AJC POWER ADAPTER/BATTERY CHARGER, A/C POWER CORD, ONE(1) ROLL PRIMER PAPER, 6.6 AH LI -ION JUN 2018 BATTERY, CARRY CASE, DECLARATION OF CONFORMITY, OPERATOR'S MANUAL, QUICK REFERENCE GUIDE, ONE (1) YEAR f3)r EMS WARRANTY )02 1 YEAR PREVENTIVE MAINTENANCE 1 LOT 230.04 230 0( ATTENTION REFERENCING * �k �rnnrrirarr TOTAL THE ARTICLES SPECIFIED ARE SLI JECf TO THE FOLLOiNINGb CONDITIONS: 1 hoods ~ fluke those spedried as this ander mint rot be skal:rit MM of Prices Ctmged wthmA wAmilntlan. 2 The ti@M bt esmIINion I t ease at long delay in sh*rmo Is rsawv L 3. It the qu#Mdtty rhlpped Is shad at *a puirhm order qk odit spscltyon the paeklrkq slip ETihst quskktlty Is txk back code d Cancelled. 4. PNM stilWng chsqPt, H anY. and add W t9vOl t:. ti. Snip "apsrt Acca re Ho C.O.R's wW be scceptad AUTHORMM 3IGNATURE i I cattily that the Articles andlar Services have bew received and that same haft been Inspected and acceptmdas envlse lndicslect he yam? tt Da E i Signed• . �' ,�� CITY or B999C A L t 7 0 R N A A POD= 301ii • Redisnds, CA 92373 Pimc ()09)'798 7525 FAX (909) 748 7522 TO: IZOLL MEDICAL CORP 269 MILL ROAD CHELMSFORD, MA 01824 PURCHASE ORDER P.O. NUMBER DAIE06 2 18 VENDOR I.Q. V EMLIVERY DATE FOB E4ti1SMON N 76967 OUR PURCHASEORMNUMM MUST APPEAR ON ALL INVOICES, PACiaNG 4tSTAi+W t:ol�€sror+oEa+ct; ? 05 29,552 65 1 Goads other than Ihose spwxktj on this ordet trust not k* subsWuled or pftn changed wllhout wthwintloM t Thr timet of cameltatlon h+caseal Wg delay In shlpnMnt Is reserved. 3. S Use gssantlly shipped is short of the purchase order quaatlty spedry on the paokkV app It 111MquartI tv iz an creat older or ng chlled f .1 Prtpay shipptttiq r.IiatQts, if any, and add to knroice. ���// S. ShIp "Open Account" bbo QOAL a WM be acccgtsd t certify that the Atttcks anchor Ser0mr, have baen received and that same hiwe been Inspected and accepted as ottmrMse Indicated hereon Date Signed' Worldwide Headquarters 269 RAi#t Road Chelmsford, AAA 01824-4105 Phone: 978-421-9655 Toll Free- 800-348-9011 Bill Attn Accounts Payable REDLANDS FIRE DEPT PO BOX 3005 C17Y OF RMLANDS REDLANDS. CA 92373 PaynMtT4rmz NET 30 DAYS [fern $01-2231011-01 tnv Data Due Date 27 -JUN -18 27-JUL-18 Ship Date Ship Via Description Invoice Invoice Sect PO Number 1904446 1 P013431 Shy REDLANDS FIRE DEPT 35 CAJON STREET SUITE 12 REDLANDS, CA 92373 Sales Order Number Customer Number 1904446 186760 Shipping Reference Sales Person X SEMES MON(TOMEFIBRILiATOR 12 LD WANTERP, ECG. PACING, NtBp, SPO2, SPCO, CM MANSION PACK. ETCO2. MAST PANK, BRYAN QTY Unit Price Amami 1 27,213 60 27,213.60 2 8T7"114 i YEArt, i PREvENTiVE MNNTE NNE 1 230,00 r Pb Remit for ZOLL Medical Corparalion Sub -Total, PO Box 27028 Tax Total. NEW YORK NY 100387-7028 Invoice Total. Currency. EFT or ACH Information AccWS0084320 ASA IVtM1000138 Pis -ase email EFTfACii remittances to EFT-ABArwnitQzalt coat 230A00 27.44360 60 2,10905 29.552.66,1'� -`' USD TAX REGISTRATION NUMBER: 04-2711626 Ali discounts off list price are c orkongent upon payment within agmed upon terms Any invoice cliscrepencleas must be reported to ZOLL In writing within 7 business days at receipt Otherw€se, the customer deems all charges terms and conditions valid For invoice terms and conditions go to - httn.11wrww Zoll aomlinvo€ce-terms-and-conditions! ZOLL Medical has gone Green if you wish to receive your invoices via email instead of mail, please contact us at ZOLLinvoice@zoll.com We vAll be happy to make this change for you. Page 1 of 1 TQ• Redlands Fire Department 35 Cajon SLMBL Suite 12 Redlands, CA 32373 Attn Bob Tyson ZOLL Medical Corporation Woridwit* HeadQuarter4 Z69 !till Rd Cht:"ord, HassacrmSeUS 01824-410S (978) 4219655 MOM (BD0) 348.9011 (978) aZ1.0015 Customer Support FEDEFLAL IO P 04 2711626 (3UOTA*naN 272743 V:3 Pxp i DATB. gine 04 2018 emall. b aol TERte9 Net 30 Clays 'rel FOB. Shippitiq Point PnDam free Fret9m CFLrt IAC10@LNUata@1t Oi5C1i1 NP OTY tlnrP#fafi'fl SLfl tDTALPA]CE 1 601 2231011 01 X soft$ 0 mmom MMIMPUNRUMaw $14,8$6 $2721360 527'213 fi0 wr h 4 It= tri-� #splay montmrl deOkelRator/ P%fnter corMes With Real CPR Help+$; advisory 81906thm, ativaru ed communieafWng padtage (tlyrFt. ftetooth USE cellular modem cepa We) USS data transfer capable and tatge 6.5'(16.5em) diagonal germ full 12 ECG lead view with both dynamic and SWIG 12 Wd mode display hst. • MFC cable MFC CPR eanneetar • AJC per adapter/ battery ChMer • AJC ponowCord • One (t) cod adntar papas 6.8 Ah L14on battery • Carry Mase + Dacfarailon at Cardomrtty Operator`s Manual Quick Reference GtMe .One (1)-yaarEMS wwnalry Raaf CPR HOP WWW04 Pack /995 CPR Dashboard quantitive dWh and rale In real time, relam incfiratar fntemrpttnn timer. perfusion performance hftator (PP4 See Thru CPR arlifaci fillermg ZOLL Pacitrp T $fix To the extent that ZOLL and Custemw, or caalom et Rmnreeent0tve hev* negatwed and suculed orarridkrp terms an4 cdmdlUaht l"Ororetdhrg T'a t C`a"j, ttuxa unm artd eandNians wotdd apgklr 40 this quolairas to all oiriaresses init quota is made subka to W a Standard Cormtna=W Tarn& ug CuaditionarZOLt. rt a Cf.) rostra acebrairw nda quarts. Exctpt in Un sass of"ankling T's and C'a, env Pert:hase Onlay ("PO") tatue4 in responss to" gvataflw sdl tm dotmed to ixorpwxm ZCPLL'rti C'e amd an7r tresar taarra amtl tondiUorrs tfrair he rn na kma or 011W wacept to itta extent agreed In %#.Kh 9 by TOLL 9ryatt Pat1k 1 DELIVERY WILL BE MADE 6080 DAYS AFTER RECEIPT OF ACCEPTED PURCHASE ORDER 5( EMS A=ourd ExeCuUve 2 PRICES QUOTED ARE VALID FOR 60 DAYS W(1I 242 9150 )r911 B 3 APPLICABLE TAX, SHIPPING & HANDLING WILL BE ADDED AT THE TIME OF INVOICING 4 ALL PURCHASE ORDERS ARE SUBJECT TO CREDIT APPROVAL BEFOREACCEPTABLE BY ZOLL 5 FAX PURCHASE ORDER AND OWTATION TO ZOLL LUSYOMERSUPPORT AT910421.0816 OR EMAIL TO ESALE$QtOLLCOM 6 ALL DISCOUNTS OFF LIST PRICE ARE CONTINGENTPON PAYMENT "THIN AGR;== UPON TERMS. 7 PLACE YOUR ACCES5ORYORDERS ONLINE BYVISITING 2a=.Zo11websiare-ggm Pxp i TO Redlands Fire Department 35 Cajm $"eL Stats 12 Redlands CA 92373 Atin Bob Tyson ZOLL Medical Corporation Worldwide HeadQuarters 269 MIE Rd Chetmootd, ma=ChuorM 01824.410$ (978) 42t 96551datn (800)348 9013 (476) 421 0015 Customer SUPPM FBDEML IDs 04 2731626 QUOTATION 272743 V'3 oalTE June 04 2018 email hNsonMeoftl1m.0yq TERIAS NeI 30 Days Tel FOS ShiMing Pmr;t mleo tT Fres Freght rTEW 4kfAEtttUlk tR OESCIbMN CTY uwPWE piSCPSttct! TOTAL PRI Mezlirlw Ptd fifty SM & Spc* $4.540 sow Ex mown TochnoiM (SE -10. Aoinbow SET( to SPCO & Sph1®1) Neap Wakh AOyp h $9495 SmantcuN 10 int Dual Lu=n host SweBP ReuseW Adult Medium Cuff Eras Tidal Catbon DiaxWe ffonbxkv (ETCOi S4.69S Orklien Nikaustrem Tasltna ' 011ier Mqulmd Mktostresm Wng sets sepamleiv W&qnajhm 12- Lzd EM Sk4: 0 • t Z.Lead one step ECG cable- ktcIod9S 4. Load Ymh Lead cable and mmovable precardial it Leaf set 2 0778 0114 1 Year 1 Preventme Mainlawk;* (At time rjt sats) 1 $23000 5230 00 $23000 3 Estimated Sales Tax at 7 7S% S2.1 D9 D5 •ReSecls NallonalPumhattng?ae9nere (NPP) Contract Prwno Ta too- astantttett mt.i. aawRCan== orCuataMek Repaeser"lve be" mgzg atsd and esetutso aystttding terms TOTAL, S29.SS7.65 and ZoAdlikm (,0W*"tfep T'a &1:11), tlmea loan and eenrndent WUN ggAY to (hit qJOU�a alb osner cleat this quote is mode oub*t tk ZDLLs Staedsrd C*rM%MW Sean* tad C0n4nl)r%rZOLLT't s C%-) Whkh atttmFany eats quote Exespi IH ihs eats 4f ovarrtrllrq Tse earl t: s, trey Pnrusese t3rdar f"Ffl'i taawd In setpansa rnthia q,,"tion v&j ba do-erae4 to Incomo#te ZOLL T's & C,4 and any atAsr teant and tppdi'la ra thou hx" no faits w Met# oxtAptt4 the aatsM agmd Ln w by Z(H I_ Bryan Pank 1 DELIVERY OLL BE MADE 60.90 DAYSAFTER RECEIPT OF ACCEPTED PURCHASE ORDER St EARS A=urd Executive 2. PRICES moTED ARE VALID FOR 6D DAYS 804242 9150.%9218 3 APPLICABLE TAX SHIPPING & HANDLING WILL SE AMSDAT THE TIME OF INVOICING 4 ALL pURCHASE ORDERS ARE SU&iECT TO CREDIT APPROVAL BEFORE ACCEPTABLE BY ZOLL. 5 FA% PURCHASE ORDER AND CWOTATM 1t3 ZOLL. CUSTOMER SUPPORT AT 979421-0015 OR EMAIL TQ EBALESOZOLt-CONL 6 ALL OFF LIST PRtCE ARE COWIN GENT UPCN.f PAYMENT WITHIN AGREED UPON TERMS 7 PLACE YOURACCESSORY ORDERS ONLINE BY VISITING MW zo lw hsstate Eco Pa1t 2 CITE' OF REDLANDS PURCHASE ORDER TERMS AND CONDITION 1. It4VOICRES. Each purchase order is to be invoiced separately and be to the billing address as shown on the 8 TIME IS OF THE ESSENCE In the CVent that the supplier'contractor fails to perform this Purcha_sc Order within the time all invoices shall submitted front of the Purchase Order All Invoices, shipping documents specified, the Purchasing Agent may by wrtuen notice order the to cease further deliveries and may hold the correspondence. and -related paper's must have the purchase order number and consignee shown clearly in their face supplier contractor supplier'contractor liable for any damages caused to the City by reason 2 PACIsAGING AND DRAYAGE. Unless so specified on the Purchase Order and evidenced by a copy of the freight bill attached to of such delay if no time is specified, it is expected that the supplierlconiractor shall begin performance within a reasonable time the Invoice, there shall be no charge to the City for either packaging after placement of the order. The City may extend periods of performance If the facts as to the cause of the delay, in We opinion of and/or drayage 3 INSPECTION All materials and worl.manship prodded under the terms of the Purchase Order are subject to inspection and test by the Purchasing Agcnt, justify such an extension 9 L tABILT[Y- The suppliericommcior shall defend, indemnify and the City to ensure compliance with the requirements and hold harmless the City, its elected oflicrals, officers employees, and agents from all claims, losses, damages, costs expenses and suits, in specifications contained therein In the event that the goods or delivered are defecuve, or are not in conformity smith the lay. or in equity, because of personal injury, property damage, or alleged services Purchase Order, the City shall have the ngbi to either reject said or actual patent infringements based on the performance of this goods or services, or require that they be corrccied or otherwise brought into conformity with the terms set forth in the P=hzsconkr Purchase Order or asserted against it Further, suppi ter contractor warrants that the City shall not Lc responsible for any damages that may 4 RESPONSIBILITIES Unless otherwise specified in the purchase be claimed by reason or death injury of the person of the s officer agents, etnplovees mvitees or licensees or Order the suppiier�contractor shall be responsible for all items in said Purchase Order until delivered at the designated supplier/comructor for damage to any property of the supplier,contractor or any oilier cohered delivery point and thereafter accepted by the City Supplierrcomractor damage that may arise or result at anytime because of personal injury or sustained by any other person or persons. which shall bear all risks as the goods and services provided until they are finalh accepted by the Citi Upon the City s notice to damage to propeny may have been caused or contributed by proximately or otherwise by supplier -contractor of its rejection of The goods or services provided reason of or in course of carrying out this Purchase Order 10 DISPUTES, All disputes concerning questions of fact which may or the need for the correction thereof All such defective goods or shall be removed from City premism and any and all arise under this Purchase Order under this Purchase Order, and not ,services expenses incurred in the removal and -or correction of such defective disposed of by mutual agreement and•or consent, shall be decided by the discretion of the Purchasing Agent All disputes concerning goods or smices shall be borne entirely by the suppher1contractor S ACCEPTANCE- The Cin s rural acacp%nce of the goods or sole questions of law which may arise under this Purchase Order, shall be services provided under the Purchase Order shall be conclusive in those instances where a laient defect or fraud is decided under applicable iaws of the State of California 11 PAI-MENTS Payments shall be trade upon submission of an except subsequently discovered, or when a supplier contractor has committed itemized invoice, presented in duplicate of the prices stipulated in the Purchase Order and within 30 days of becoming due for supplies such gross rrustaWs that thL% are tantamount to a fraud The CM S failure to inspect and either accept or reject the goods or semices delivered and accepted or services rendered and accepted less delivered shall not relieve the supplter'contmetor for the responsibdiry for stnct compliance with the terms and spenifrcauons deductions if any When requested by the suppher,contractor payment on partial deliveries may be made whenever, in the sole discrztion of the of the Purchase Order be Purchasing Agent, the surrounding circumstances warrant such par'ttal In the event and, irfor any reason, an overpayment is made, 6 CHANGES This Purchase Order may, at any time, changed with regard to the materials or services to be furnished, the quantity payment the City requires prompt refund of said overpayment by way of ordered, the unit price, discount, delivery point or arrangements, terms or any other matters affecting a valid order however. in order supplceticontaetor s props rl} referenced check 12 LICENSOR All supplier 'contractors who perform work within the to be effective any such change or amendment causes an increase or City, must have on file at the Redlands City Revenue Office, a current decrease in the cost of performance hereunder, an equitable adjustment shall be made to reflect the increase or the decrease in the and valid city business license 13 CONFORRMM WITH SAFETY ORDERS. The goods anftr cost thereof Any such adjustment shall be subject to the wnitcn scrvices covered by this Purchtise Order or contract must conform to the safety order of OSHA, CAL-OSRA, andlor N1OSIiA and any and all approval of the Purchasing Agent No t ariation in the quality, or coat of any item called for by this Purchase Order Shall applicable material safety data sheets (MSDS) quantity, be acceptable by the City except to pursuance of a written Change 14 PREVAILING WAGES- When applicable, the City is subject to the State of California prevailing wage laws as set forth in Califoritin Order approved by the Purchasing Agent. T TERMINATION- This Purchase Order may be terminated, in labor Code Section 1770 ct seq The contractor is responsible for determining the appropriate Depxtzment of Industrial Relations (DIR) whole or in part.. at any time, by written notice to the supplier contractor Such termination shall be effective with respect to classification for the various employees and subcontractors used for a the quantity, manner, and time specified in such notice The City particular project or service The rates for each classification are posted All shall be liable at the stipulated price only for such materials andr'or services as have been delivered and=or rendered and accepted as of on the DIR website at bT12 : sea w -din . Uotd t ea contractors performing work for the City are responsible for abiding by the effective date of said written notice The City shall not be liable all applicable prevailing wage laws, and must furnish the City with for any excess cost ansi ng out of such termination, and failure of the Certified Payroll Rcc€+rds upon request supplier%conimctor to cease delivery and.1or work upon receipt of such termination notice shall not occasion a claim for extra costs .. Requesting Dept. Fire Prepared by Diane Rivera-Sedgwick f Date 6/1/2018 Authorized by �:' _ �. Date 6/1/2018 Person to contact if questions arise Dian6 Eat x-7600 Delivery address- 35 Calan Street #12, Redlands, CA 92373 Dept Fire W9 xlOn rile Attached .............. . ............ ................. Purchase Requisition # 76967 Vendor Zoll Corp Address 269 hill Road Chelmsford, Mass 01824 4105 Phone #l- 978 421 9655 Fax Email boankOzoll.com For use by Purchasing Department only. Purchasing Agent/ City Manager Approval Insurance E]On rile OAttached x]NA Business License [=On file =Attached x]NA Annual PC) Terra N/A Q NA Account Number. 101255-6590 PCI# Date 11 ITEM DESCRIPTION QTY UNIT PRICE TOTAL 1 Invoice it Quote i1Z72743 V 2 X Series Manual Monitor/DifibriIla Lor 1 S27,213.60 $27213.60 2 with 4 Trace Tri Morse Dispiay DisplayMonitor defibrillator printer, Accessories Included $0.00 3 MFC cable MFC CPR connector A/C Power Adapter/battery charger, A/C Power cord, One (1) $0.00 4 roll primer. paper; 6.6 Ali Li-ion BaneEX Carry Case Declaration of ConformILY O erator s 5 Manual, Quick Reference Guide, One (1) year EMS Warran $000 6 #8778 0114 1 zear Preventive Maintenance 1 $ 23000 S23000 7 $0.00 8 50.00 9 $000 10 $0.00 11 so. a0 12 $000 13 $000 14 Sole Source Letters Attached Estimated Tax $2 109 05 Discount Estimated Total $29,552.65 N©TE PLEASE PROVIDE ALL QUOTES YOU MAY HAVE White Copy-Purchasing Yellow Copy Remains in Boob EXCEPTION TO BIDDING ANIS DISCLOSURE STATEMENT 2 Page INSTRUCTIONS I Please check all applicable categories (a through i ) below and provide additional information where indicated ❑ a The requested product is an integral repair part or accessory compatible with existing equipment Existing Equipment Manufacturer/ Model Number Age Current Estimated Value• ❑ b The requested product has unique design/performance specifications or quality requirements that are not available in comparable products ❑ c I have standardized the requested product and the use of another brand/model would require considerable time and funding to evaluate. d The requested product is one in which I (and/or my staff} have specialized training and/or extensive expertise Retraining would incur substantial cast in time and/or funding ❑ e The requested product is used or demonstration equipment available at a lower -than - new cost ❑ f Repair/Maintenance service is available only from manufacturer or designated service representative ❑ g Upgrade to or enhancement of existing software is available only from manufacturer ❑ h Service proposed by vendor is unique, therefore, competitive bids are not available or applicable ❑ i Other factors (provide detailed explanation in #2 below) Provide a detailed explanation and pertinent documentation for each categot-31 checked in item I above Attach additional sheets if necessary This purchase works in conjunction with our newly acquired relationship with Zoll Medical Corp as our new provider of Monitor/Defibrillator/Printer with Accessories Rvv 7,,7' 14