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FY2010-2012 2nd Renewal 10/19/2011DANNY L. KOLHA GE CLERK OF THE CIRCUIT COURT DATE: October 31, 2011 TO: Fire Chief James Callahan Fire -Rescue Department ATTN: Darice Hayes FROM: Pamela G. Hanco�&C. At the October 19, 2011, Board of County Commissioner's meeting the Board granted approval and authorized execution of Item G4 Renewal Agreement between Physio-Control, Inc. and the Monroe County Board of Governors of Fire and Ambulance District 1, effective November 1, 2011 for the preventative inspection and maintenance of biomedical equipment which is used for the cardiac monitoring of patients. Enclosed is a duplicate original of the above -mentioned for your handling. Should you have any questions, please do not hesitate to contact this office. cc: County Attorney w/o document Finance File RENEWAL AGREEMENT The RENEWAL AGREEMENT dated the 19 tt day of OCTOBER 2011 by and between the Board of Governors of Fire and Ambulance District I of Monroe County, Florida, hereinafter called the "COUNTY" and Physio-Control, Inc., hereinafter referred to as "CONTRACTOR ". WITNESSETH WHEREAS, on October 21, 2009, the COUNTY entered into an Agreement with Physio-Control, Inc. for the preventative inspection and maintenance of biomedical equipment for the Board of Governors of Fire and Ambulance District l; and WIffiREAS, said Agreement provided an initial term of one (1) year with an option to the COUNTY to renew the contract for two (2) additional one (1) year terms; and WHEREAS, the COUNTY wishes to exercise said second one (1) year renewal option for the continuation of preventative inspection and maintenance of biomedical equipment for the Board of Governors of Fire and Ambulance District 1; and NOW THEREFORE, IN CONSIDERATION of the mutual covenants and obligations contained herein, the parties agree to the following changes: 1. The COUNTY renews its election to exercise the second of two renewal terms pursuant to paragraph 4(a) of the original Agreement. 2. The effective date of the Renewal Agreement is November 1, 2011. 3. The tern of the Agreement, as renewed, runs from November 1, 2011 to October 31, 2012. 4. The first sentence of paragraph 2 of the original Agreement is revised to read as follows: `°The COUNTY shall pay to the CONTRACTOR a total amount of $17,670.78 for faithful performance of the Contract, in lawful money of the United States." A new Exhibit B, attached to this Renewal Agreement, is hereby adopted in place and instead of bit B attached to the Agreement dated October 20, 2010. ' ther respects, the terms and conditions of the Agreement dated October 21, 2009 remain in e and effect. y BOARD OF GOVERNORS, t • y L. Kolhage, Clerk FIRE AND AMBULANCE DISTRICT 1 OF • MONROE COUNTY, FLORIDA o By: puty Jerk Mayor (CORPORATE SEAL) PHYSIO- CONTROL, C. Attest: �` �tn�nu►►i���� Q o r` X By: c — Title , F S Print Name: �r 2 L LA o 1gea1 / 6 6 ? Title: �s5a CiAt t f fa f ' .tQ1 Cn c ` << ��i►�t ► ►t'`���� MO OE COUNTY ATTORNEY M: L. HALL — ASSTS AN C UNTY ATTORNEY Date EXHIBIT B TECHNICAL SERVICE SUPPORT AGREEMENT Contract Number: End User # 03189501 Bill To # 03189501 MONROE COUNTY FIRE RESCUE MONROE COUNTY FIRE RESCUE 490 63RD ST OCEAN 490 63RD ST OCEAN MARATHON, FL 33050 MARATHON, FL 33050 This Technical Service Support Agreement begins on 11/1/2011 and expires on 10/31/2012. 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 reverse side of this document and any Schedule B, if attached If any Data Management Support and Upgrade Service is included on Schedule A then this Technical Service Support Agreement is also subject to Physio- Control's Data Management Support and Upgrade Service Terms and Conditions, rev 7/99 -1. Price of coverage specified on Schedule A is 517,670.78 per tern, payable in Monthly in arrears installments. Special Terms 10% DISCOUNT ON ACCESSORIES Acce Physio- Control, Inc. Customer. BY r l� rG ( By: Title: 14550 6 01- ��- G ( /�✓�Gt t4 5� Print: Date: '( ILII Title: Date: Purchase Order Nu Territory Rep: EAW67 Customer Contact: Miguel Rodriguez Darice Hayes Phone: 800 -442 -1142 x2412 Phone: 305- 289 -6004 FAX: 800 -772 -3340 FAX: 305- 289 -6013 MONROE COUNTY ATTO EY — 6 PRO FD CO l T F \� 3 • Ty ATT RNEY ASSIS ANT Date___._ ---- - •o rti •WhMOfl* C �f 1091 Renewal. Page 1 of 9 DEPI)TY Cl-i:PW PHYSIO- CONTROL, INC. TECHNICAL SERVICE SUPPORT AGREEMENT TERMS AND CONDITIONS RENEWAL TERMS Physio - Control, Inc.'s ( "Physio-Control ") acceptance of Customers Technical Service Support Agreement is expressly conditioned on Customers assent to the terms set forth in this document and its attachments. Physio-Control agrees to fumish the services ordered by Customer only on these terms, and Customers acceptance of any portion of the goods and services covered by this document shall confine their acceptance by Customer. These leans constitute the complete agreement between the parties and they shall govem any conflicting or ambiguous teens on Customers purchase order or on other documents submitted to Physio- Control by Customer. These terms may not be revised in any manner without the prior written consent of an officer of Physio- Control. 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 Physic- Control service technician labor, and all related travel expenses. For offsite (ship -in) services, units will be retumed to Customer by Physio-Control 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 are consistent with applicable product specifications, performance of an electrical safety check in accordance with National Fire and Protection Guidelines, all required Physic- Control service technician labor and aft related travel expenses. For offsite (ship -in) services, units will be returned to Customer by Physio- Control freight prepaid. DOCUMENTATION Following each Repair and /or Inspection, Physio-Control will provide Customer with a written report of actions taken or recommended and identification of any materials replaced or recommended for replaaemenL LOANERS If a Physio- Control 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 available, until the removed unit is returned. Customer assumes complete responsibility for the Loaner and shah return the Loaner to Physio- Control in the some condition as received, at Customers expense, upon the earlier of the return of the removed unit or Physio- Control's request. EXCLUSIONS This Technical Service Support Agreement 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-Control under this Technical Service Support Agreement; case changes; repair or replacement of items not originally distributed or installed by Physio-Contol; and exclusions an Schedule B to this Technical Service Support Agreement, 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 except where service technicians are rendered unavailable due to mandatory training commitments, in which case Physio- Control will provide alternate coverage. 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- Control is requested to perform Repair or Inspection services not designated in this Technical Service Support Agreement (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-Control at Physio- Control's standard labor rates less 10% (including overtime, if appropriate), plus standard list prices for related parts and materials less 15 %, plus actual travel costs incurred. PAYMENT The cost of services performed by Physio-Control shall be payable by Customer within thirty (30) days of Customers receipt of Physio- Control's Invoice (or such other terms as Physio - Control confirms to Customer in writing). In addition to the cost of services performed, Customer shall pay or reimburse Physio-Controi for any taxes assessed Physio- Control. If the number or configuration of Covered Equipment is altered during the Tenn of this Technical Service Support Agreement, the price of Services shall be adjusted accordingly. Reference Number. V67 -1091 Renewal Printed: 9/30/2011 Page 2 of 9 WARRANTY Physio- Control warrants Services performed under this Technical Service Support Agreement and replacement parts provided in performing such Services against defects in material and workmanship for ninety (90) days from the data a Service was performed or a part was provided. Customer's sole remedy shall be reservicing the affected unit and/or replacement of any part determined to be defective, without any additional Customer charge, provided Customer notifies Physio- Control of any allegedly defective condition within ten (10) calendar days of its discovery by Customer. Physio-Control 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-CONTROL BE LIABLE FOR INCIDENTAL, CONSEQUENTIAL, SPECIAL, OR OTHER DAMAGES. TERMINATION Either party may terminate this Technical Service Support Agreement at any time upon sixty (60) days prior written notice to the other, except that Physio-Control may terminate this Technical Service Support Agreement immediately upon Customer's failure to make timely payments for services rendered under this Technical Service Support Agreement In the event of termination. Customer shad be obligated to reimburse Physio-Control for that portion of the designated price which corresponds to that portion of the Tenn and the scope of Services provided prior to the effective date of termination. DELAYS Physio - Control will 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 control, including, but not limited to, ads of God, labor disputes, labor shortages, the requirements of any governmental authority, war, civil unrest, delays in manufacture, obtaining any required license or permit, and Physio- Control's inability to obtain goods from its usual sources. Any such delay shall not be considered a breach of Physio - Control'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-Control's behalf during the Tenn of this Technical Service Support Agreement or for one (1) year following ifs expiration without Physio- Control's prior written consent b) This Technical Service Support Agreement, and any related obligation of other party, may not be assigned in whole or in part without the prior written consent of the other party. c) The rights and obligations of Physio-Control and Customer under this Technical Service Support Agreement shall be governed by the laws of the State in which the service is provided. All costs and expenses incurred by the prevailing party related to the enforcement of its rights under this document, including reasonable altomey's fees, shad be reimbursed by the other party. ............................................................................................................................................... ............................... ..................................................... ............................... END..................................................... ............................... Reference Number: V67 -1091 Renewal Printed: 9/30/2011 Page 3 of 9 PHYSIO- CONTROL, INC. TECHNICAL SERVICE SUPPORT AGREEMENT SCHEDULE A Contract Number. Servicing Rep: Miguel Rodriguez, EAVV67 District: SOUTHEAST Phone: 800 -442 -1142 x2412 FAX: 800 -772 -3340 Equipment Location: MONROE COUNTY FIRE RESCUE, 03189501 490 63RD ST OCEAN MARATHON, FL 33050 Scope Of Service Ship In Repair - 1 On Site Inspection per year.M -F/8 -5 Model Part Number um eriai N Ref. Line Effective Exp Total LIFEPAK® 12 VLP12 -02- 002269 13451834 1 Date 11/1/2011 Date Inspections 10/31/2012 1 — LIFEPAK ®12 VLP12 -02- 002269 13451839 2 ] I /1/2011 10/31/2012 ] LIFEPAK 4D 12 VLP12 -02- 002269 13451840 3 11/1/2011 10131/2012 1 LIFEPAK4D 12 VLP12 -02- 002269 13451841 4 11/1/2011 10/31/2012 ] LIFEPAK® 12 VLP12 -02- 002269 13451842 5 11/1/2011 10/31/2012 1 LIFEPAK 4D 12 VLP12 -02-002269 13451843 6 I I /1/2011 10/31/2012 ] LIFEPAK® 12 VLP12-02- 005013 32624452 7 11 /1/2011 10/31/2012 I LIFEPAK® 12 VLP12-02- 007228 37050535 8 1111 /2011 10/31 /2012 I LIFEPAK® 12 VLP12 -02- 007228 38338813 9 11 /l /2011 10/31/2012 1 LIFEPAK ®12 VLP12 -02-007228 38338814 10 I I/1 /2011 10/31 /2012 ] LIFEPAK® 12 VLP12 -02-007228 38338815 11 11 /l /2011 10/31/2012 1 LIFEPAK® 12 VLP12 -02- 007228 38338816 12 11 /I /2011 10/31 /2012 1 LDFEPAK4D 12 VLP12 -02- 007228 38338817 13 1111 /2011 10/31 /2012 1 LIFEPAK® 12 VLP12 -02- 007228 38338818 14 11 /l /2011 10/31 /2012 1 LIFEPAK4D 15 V15 -2- 000050 38538983 15 11 /1 /2011 10/31 /2012 ] LIFEPAK4D Is V15 -2- 000050 39530548 16 3/19/2012 10/31 /2012 1 •• Denotes an inventory line that has changed since the last contract revision or addendum. Reference Number. V67 -1091 Renewal Printed: 9/30/2011 Page 4 of 9 MEDTRONIC EMERGENCY RESPONSE SYSTEMS, INC. TECHNICAL SERVICE SUPPORT AGREEMENT SCHEDULE A Contract Number: Additional Items Service Type Item Quantity Start Date End Date CASE CHANGE LP 12/15/20 CASE CHG 1 -9 1 11/1/2011 10/31/2012 Denotes an additional item line that has changed since the last contract revision or addendum. Reference Number: V67 -1091 Renewal Printed: 9/30/2011 Page 5 of 9 PHYSIO- CONTROL, INC. TECHNICAL SERVICE SUPPORT AGREEMENT SCHEDULE B LIFEPAK® 12 (LP 12) Defibrillator/Monitor Service includes: • Standard detachable hard paddle repair; • LP 12 upgrade installed by Physio -Control Technical Services Representative at a rate of 17% less than the then- current field- installed list price • All Physio-Control battery charging systems owned by contract end user, up to a one - for -one basis with the total number of LP12 defibrillator /monitor's listed in Schedule A. • AC Power Adapter repair /replacement • DC Power Adapter repair /replacement • Replacement of Physio-Control FASTPAKV, FASTPAK 2, LIFEPAK SLA, LIFEPAK NiCd Battery, and LIFEPAK Li -ion Battery Battery maintenance, performance testing, evaluation, removal, recycling, and replacement are the Customer's responsibility and should be performed in accordance with the LP 12 Series Operating Instructions section entitled Discarding/Recycling Batteries. Battery replacement is available upon completion of the second year of use on a one - for -one basis, up to the number of devices listed in Equipment Inventory, Schedule A. Replacement batteries shall be like- for -like (i.e. FASTPAK for FASTPAK, LIFEPAK LI -ion for LIFEPAK LI -ion, etc.). One - for -one, tike- for -like battery replacement is available prior to the completion of second year of use upon battery failure as determined by Customer's performance testing and evaluation in accordance with the LP 12 Operating Instructions section entitled Discarding/Recycling Batteries. During the Term of this Agreement, no- charge replacement for battery failure shall occur no more than four (4) times per two -year period for Physio - Control FASTPAKO, FASTPAK 2, LIFEPAK SLA, LIFEPAK NiCd Battery, and no more than three (3) times per two-year period for Li -ion batteries, regardless of any terms in prior Support Plans. Battery replacement is dependent upon Customer's notice to Physio - Control of the completion of the second year of use or battery failure as determined by Customer's performance testing and evaluation At the discretion of Physio - Control, battery replacement shall be accomplished by shipment to Customer and replacement by Customer, or by on -site delivery and replacement by a Physio- Control Service Technician Upon Customer's receipt of replacement battery, the battery being replaced becomes the property of Physio-Control, and Customer must return the battery being replaced to Physio - Control for proper disposal. If Physio - Control does not receive the battery Customer will be charged at the then - current rate for the replacement battery. Only batteries manufactured by Physio-Control are covered under this Service Agreement Batteries not manufactured by Physio - Control are expressly excluded from coverage under this Service Agreement. Physio- Control does not guarantee the operation, safety, and/or perfomrance of our product when operating with a battery not manufactured by Physio - Control. Repairs and inspections performed under this Agreement meet original equipment manufacturer's product specifications only when operating with a battery manufactured by Physio-Control. Any repairs, as determined by a Physio-Control Service Representative, resulting from the use of a battery not manufactured by Physio- Control, will be billed at Physio-Control lIs then current standard list prices for parts and labor, including actual travel costs incurred • LIFEPAK 12 Software Updates If combined Repair and Inspection services are designated for LP 12 units listed in Schedule A, a Physio- Control Technical Services Representative will install LP 12 software updates at no additional cost, provided they are installed at the time of a regularly scheduled inspection. In addition, during the Term of this Agreement, where an assembly, i.e., printed circuit board, must be replaced to accommodate installation of new software, such assembly may be purchased by the Customer at a rate of 50% less than the then- current list price. Software updates, when installed at a time other than the regularly scheduled inspection, will be billed at the rate of $205.00 per unit per software update. The cost of such software update will be billed in a separate invoice. If Repair -Only services are designated for LP 12 units listed in Schedule A, a Physio - Control Technical Services Representative will install a LP 12 software update at the rate of $205.00 per unit per software update. In addition, during the Term of this Agreement, where an assembly, i.e., printed circuit board, must be replaced to accommodate installation of new software, such assembly may be purchased by the Customer at a rate of 50% less than the then - current list price. The cost of such software update will be billed in a separate invoice. - Coin Cell Battery Replacement Reference Number: V67 -1091 Renewal Printed: 9/30/2011 Page 6 of 9 PHYSIO- CONTROL, INC. TECHNICAL SERVICE SUPPORT AGREEMENT SCHEDULE B • Coin Cell Battery Replacement Physio-Control will replace the internal coin cell battery according to the number of such batteries listed in the Additional Items section of Schedule A. It is the Customer's responsibility to request such coin cell battery replacement, gather in a single location the devices that will receive such battery replacement, and to provide to the Physio - Control Technical Services Representative access to those devices. Coin cell battery replacement will take place during the Term of this Agreement, according to the number of coin cell batteries listed in the Additional Items section of Schedule A. LP 12 Defibrillator/Monitor Service does not include repair or replacement of the following: • Internal, steriliaable and pediatric paddles • SpO2 sensors and cables • Communication cables • Therapy cables • Patient cables • PCMCIA modems • Case changes Discounts will not be combined with other special terms, discounts, and/or promotions Reference Number: V67 -1091 Renewal Printed: 9/30/2011 Page 7 of 9 PHYSIO - CONTROL, INC. TECHNICAL SERVICE SUPPORT AGREEMENT SCHEDULE B LIFEPAK® 15 (LP 15) Defibrillator/Monitor Service includes: • Standard detachable hard paddle repairs • LP15 upgrade installed by Physio-Control Technical Services Representative at a rate of 17% less than the then current field - installed list price • All Physio-Control battery charging systems owned by contract end user, up to a one - for -one basis with the total number of LP15 Defibrillator/Monitor's listed in Schedule A. • Power Adapter Physio - Control LIFEPAK® 15 Battery Battery maintenance, performance testing, evaluation, removal, recycling, and replacement are the Customer's responsibility and should be performed in accordance with the LP 15 Series Operating Instructions section entitled Discarding/Recycling Batteries. Battery replacement is available upon completion of the second year of use on a one- for -one basis, up to the number of devices listed in Equipment Inventory, Schedule A. Replacement batteries shall be like- for -like (i.e. LIFEPAK LI -ion for LIF'EPAK LI -ion, etc.). One - for -one, like- for -like battery replacement is available prior to the completion of second year of use upon battery failure as determined by Customer's performance testing and evaluation in accordance with the LP 15 Operating Instructions section entitled Discarding/Recycling Batteries. During the Term of this Agreement, no- charge replacement for battery failure shall occur no more than three (3) times per two-year period, regardless of any terms in prior Support Plans. Battery replacement is dependent upon Customer's notice to Physio - Control of the completion of the second year of use or battery failure as determined by Customer's performance testing and evaluation. At the discretion of Physio-Control, battery replacement shall be accomplished by shipment to Customer and replacement by Customer, or by on -site delivery and replacement by a Physio-Control Service Technician. Upon Customer's receipt of replacement battery, the battery being replaced becomes the property of Physio- Control, and Customer must return the battery being replaced to Physio-Control for proper disposal. If Physio - Control does not receive the battery Customer will be charged at the then - current rate for the replacement battery. Only batteries manufactured by Physio-Control are covered under this Service Agreement. Batteries not manufactured by Physio-Control are expressly excluded from coverage under this Service Agreement. Physio- Control does not guarantee the operation, safety, and/or performance of our product when operating with a battery not manufactured by Physio- Control. Repairs and inspections performed under this Agreement meet original equipment manufacturer's product specifications only when operating with a battery manufactured by Physio-Control. Any repairs, as determined by a Physio- Control Service Representative, resulting from the use of a battery not manufactured by Physio- Control, will be billed at Physio-Control's then current standard list prices for parts and labor, including actual travel costs incurred. • LIFEPAKO 15 Software Updates If combined Repair and Inspection services are designated for LP 15 units listed in Schedule A, a Physio - Control Technical Services Representative will install LP 15 software updates at no additional cost, provided they are installed at the time of a regularly scheduled inspection. In addition, during the Tenn of this Agreement, where an assembly, i.e., printed circuit board, must be replaced to accommodate installation of new software, such assembly may be purchased by the Customer at a rate of 50% less than the then- current list price. Software updates, when installed at a time other than the regularly scheduled inspection, will be billed at a rate of $205.00 per unit per software update. The cost of such software update will be billed in a separate invoice. If Repair -Only services are designated for LP 15 units listed in Schedule A, a Physio - Control Technical Services Representative will install a LP 15 software update at the rate of $205.00 per unit per software update. In addition, during the Tenn of this Agreement, where an assembly, i.e., printed circuit board, must be replaced to accommodate installation of new software, such assembly may be purchased by the Customer at a rate of 50% less than the then- current list price. The cost of such software update will be billed in a separate invoice. LP 15 Defibrillator/Monitor does not include repair or replacement of the following: Reference Number: V67 -1091 Renewal Printed: 9/30/2011 Page 8 of 9 PHYSIO - CONTROL, INC. TECHNICAL SERVICE SUPPORT AGREEMENT SCHEDULE B LP 15 Defibrillator/Monitor does not include repair or replacement of the following: • Internal, sterilizable and pediatric paddles • Communications cables • Therapy cables • Patient cables • SpO2 sensors • Case changes Discounts may not be combined with other special terms, discounts and/or promotions. Reference Number. V67 -1091 Renewal Printed: 9/30/2011 Page 9 of 9 Aco ° CERTIFICATE OF LIABILITY INSURANCE DATE 28 1201DDIYYYY o3;zo11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THI CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIE BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEI REPRESENTATIVE OR PRODUCER, AND THE C IMPORTANT: If the certificate holder is an AD TIONAL lip IN y(ies) mu t be endorsed. If SUBROGATION IS WAIVED, subject t the terms and conditions of the policy, certain p licies may require an endorsement. A statement on this certificate does not confer rights to th certificate holder in lieu of such endorsement(s). PRODUCER o TACT Marsh (JSA Inc P ? NE FAX 333 South 71h Street, Suile 16(X) VVr_ RQ. Eat)_ - 1 [ruc N1 - Minneapolis, MN 55402 -2400 E -MAIL ADDRESS: 43840 MEDTR GAWP - 10/11 INSURED Medtronic, Inc and all its subsidiaries 710 Medtronic Parkway M S LC310 Minneapolis, MN 55432 MO`7ROE CO 'CUMiiiQ#_ ;ISK�ANAG •N. INSURER S - AFFORDING COVERAGE NAIC N INSURER A ACE American Insurance Company 22667 INSURER B; INSURER C : INSURER D: INSURER E: COVERAGES CFRTIFICATF NI IMRFR• rlli 1vwec7ne7 nc oc v101nu Lill-1 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIO[ INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI: CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSION AND CONDITIONS OF SUCH POLIC LIMITS SHOWN MAY HAV BEEN REDUCED BY PAID CLAIMS INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MM /DDIYYYY ) IMMIDDIYYYYI I LIMITS A GENERAL LIABILITY SPLG 24561288WI 05/01/2010 05/01/2012 EACH OCCURRENCE 15 X COMMERCIAL GENERA_ L_LIABILITY _ _ DAMAGE TO RENTED PREMISES. _$ - 1,000 $_______________ -- X l CLAIMS MADE [ OCCUR - -) MEO EXP (Any one person) $ 10 PER SONAL & ADV INJURY $ 1, GENERAL AGGR EGATE $ 15,000 PRODU - COMP /OP AGG -- GEN'L AGGREGATE LIMIT APPLIES PER - - - -- - -- $ 15,000 X POLICY PRO- LOC 0510112011 05/0112012 -- --- - - - - -- COMBINED COMBINED LE E LIMI LIMIT ED SINGLE - - -- -- -- - -- - - -- $ A AUTOMOBILE LIABILITY - ---- - - ISA H0963 X I (Ea accident) $ 1 ANY AUTO r -- - ALL OWNED AUTOS BODILY INJURY (Per person) $ - - SCHEDULED AUTOS I` '�/` • U�l� ��� !%b BODILY INJURY (Per accident) --- - -- -- - - - -- -- $ - -- - - - - - - -- - 1. PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON -OWNED AU TOS )I ( $ 1 $ _ UMBRELLA LIAB OCCUR \t7 / EACHOCCURRENCE ) $- EXCESS LIAR CLAIMS -MADE AGGREGATE $- DEDUCTIBLE j - I / "�' - $ RETENTION $- - $ A WORKERS COMPENSATION WLR 046478307 (AOS) 05101/2011 05/0112012 X WC STATU OTH AND EMPLOYERS' LIABILITY YIN I -- -L4.HY L1M1Ta __ _Eg _ A ANY PROPRIETOR/PARTNER/EXECUTIVE WLR 046478277 (MO NC, NE 8 OK) 105/0112011 05/01/2012 E L EACH ACCIDEN T 1 ' $ � A OFFICER /MEMBER EXCLUDED? a N/A -__ -__ - (Mandatory in NH) SCF C46478289 (NJ) 0510112011 05101/2012 E L DISEASE EA FMPLOYEE $ A If yes describe under DESCRIPTION OF OPERATIONS below ISCF C46478290(WI) 050112011 1 05101/2012 -- - - -- - - -- E L DISEASE POLICY LIMIT i $ A ( Professional Health SPLG 2456128x3111)1 0510112010 050112012 Each Claim 2,'•FAi i ..��.... , — na imnacn A�uKU ivi, Aaonional Kemarus scneawe, if more space Is required) Waver of Subrogation andior Adddienal Insured status applies ci:ly f d is reflected in your written contract For hospdal credenhaling purposes. Medtronic employees are covered under Prrfessional Health Care Liabddy noted above WeJtronic ,ncludes but is not limited to the following entities_ Physic - Control, Inc Medtronic Sofanior Ddnek Inc Medtronic Spne t L C ;rncluding Cslec!ech nc) Wined Distribution Ccrporahrn ,ind %ledlronic AT S MedH;al, Inc CERTIFICATE HOLDER CANCELLATION MONROE 1.OIJN [ Y POARO Gr COUNTY T Rd M(,NIGUE GIAZ 1 1 JO :-IMON TON S i REE r ELY 'NEST FL 33(140 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Katey E Jones V -, K. W-1- � © 1988 -2009 ACORD CORPORATION. All rights reserve( ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD ADDITIONAL INFORMATION DATE(MWDOrYY) CHI.003451047 05 PRODUCER I Q3281Zp11 Marsh USA Inc. 333 South 71h .Street, Sulte 1600 Minneapolis, MN 554022400 43&10 MEDTR GAWP 1011 INSURED INSURERS AFFORDING COVERAGE NAIC # NS;iRER G L ._...__. _.. _._.._.._....__ _... Medtronic, Inc and all �ls subsidiaries 710 Medtronic Parkway M S LC310 INSURER H Minneapolis, MN 55432 INSURER I INSURER -- J " TEXT Other , Policy Covers Cate Liability Lurils Aggregate 15 000,000 MONROE COUNTY BOARD OF COUNTY COMMISSIONERS IS INCLUDED AS ADDITIONAL INSURED UNDER GENERAL LIABILITY AS REQUIRED BY WRITTEN CON TRACT. i CERTIFICATE HOLDER ONROE COUN rY BOARD Or COuFrrY COMMISSIONERS AT TN MONIQUE DIAZ 1100 fi1MON rON STRE ET KEY WEST. FL 33040 Pa