FY2013-2015 2nd Renewal 10/17/2014 -' Y NLI N,
CLERK OF CIRCUIEAVIT COURT & COMPCPARTROLLE
MONROEAM COUNTY,FLORIDA
DATE: November 10, 2014
TO: Chief Callahan
ATTN: Holly Pfiester
FROM: Lindsey Ballard, DC
At the October 17, 2014 Board of County Commissioner's meeting the Board granted the approval and
execution of Item F3 Exercise the second (2nd) and final renewal option of the original agreement
between Physio-Control, Inc. and Board of Governors Fire, Ambulance District 1 of Monroe County,
Florida, for sole-source preventative maintenance and inspection of medical LifePak equipment; and
authorization for Mayor to execute same, along with revised Technical Service Support Agreement with
- - Physic-Control, Inc.
Attached is a duplicate original of the above-mentioned for your handling. Should you have any
questions,please feel free to contact our office.
CC: County Attorney (electronic copy)
Finance (electronic copy)
✓File
Box
500 Whitehead Street
83117 Overseas 8820 Overseass Highway
SCANNED Plantation
nt ton Key,FL 33070 Phone:852-7145 Fax:305-852-7146
Ii• 1O.
•
RENEWAL AGREEMENT
THE BOARD OF GOVERNORS OF FIRE AND AMBULANCE DISTRICT I
AND
PHYSIO CONTROL, INC.
This RENEWAL AGREEMENT is dated the 1°'day of November 2014, by and between The Board of Governors of Fire
and Ambulance District I of Monroe County Florida, hereinafter referred to as the"COUNTY",and Physio Control,
Inc.,hereinafter referred to as"CONTRACTOR".
WITNESSETH
WHEREAS,the parties hereto did enter into an agreement dated November I,2012 through October 31,2013 to provide
sole source preventative maintenance and inspection on medical LifePak equipment,owned and operated by Fire and
Ambulance District 1;and
WHEREAS, said agreement provided an option to the County to renew the contract for two(2)additional one(1)year
terms; and
WHEREAS,the parties hereto did enter into the first(1")renewal option dated November I,2013 through October 31,
2014; and
WHEREAS,the County has elected to exercise the second(2nd)renewal option for the continuation of providing sole
source preventative maintenance and inspection on medical LifePak equipment: and
NOW THEREFORE,
INCONSIDERATION of the mutual covenants and obligations contained herein,the parties agree as follows:
1. The County elects to exercise the second(2n8)renewal of the agreement for one(1)additional year pursuant to
Article 4 of the agreement.
2. The effective date of the renewal agreement is November 1,2014 extending through October 31,2015.
3. The first sentence of paragraph 2 of the agreement is revised to read as follows:"The COUNTY shall pay to the
CONTRACTOR a total amount of$18,651.00 for the faithful performance of the Contract,in lawful money of the
United States."
.4.. .A new Technical Service Support Agreement,attached to this renewal agreement, is hereby adopted in place,and
instead of,the Technical Service Support Agreement attached to the Agreement dated November 1,2012. All other
termsapd conditions of the Agreement dated November 1,2012 shall remain in full force and effect.
(SEAL), ';i BOARD OF GOVERNORS OF FIRE AND
:'ATTEST: :AMY HEAVILIN, CLERK AMBULANCE DISTRICT 1 OF MONROE
COUNTY,FL
•
:... By �ir+A"�^ 7t OC--
H By:
r*�� DeputyClerk Q Mayon
PHYSIO CONTROL,INC.
MONROE COUNTY ATTORNEY
APP,fgj�'O{VEDw TQ FARI'l'J
By: 51NTH XH tt-N
NTHIA L. ALL
Date: n ;A ASSISTA ToC�COSI TTQ NTYARNEY
Date 33 odC CAI YY
TECHNICAL SERVICE SUPPORT AGREEMENT PHYSIO
CONTROL
Contract Number:
End User# 03189501 Bill To# 03189501
MONROE CTY FIRE RESCUE MONROE CTY FIRE RESCUE
490 63RD ST OCEAN 490 63RD ST OCEAN
EMS SUPPLIES EMS SUPPLIES
MARATHON,FL 33050 MARATHON,FL 33050
This Technical Service Support Agreement begins on I I/1/2014 and expires on 10/31/2015.
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 $18,651.00 per term,payable in Annual in arrears installments.
Special Terms
15%DISCOUNT ON ACCESSORIES
15%DISCOUNT ON ALL ELECTRODES
Accepted: r�lfirControl, Inc. Customer:
•iraf•
By: A/� By:
Title: ccNrawc.T A-.JAty6T Print:
Date: O q t%/LJ I V- Title:
Date:
Purchase Order Number:
Territory Rep: EAVV67 Customer Contact:
Miguel Rodriguez Holly Pfiester
Phone: Phone: 305-289-6088
FAX- 800-772-3340 FAX: 305-289-6007
MONROE COUNTY ATTORNEY
APP�OV Ty F�,RNy.i
CAI d •
'rft(J`r Reference Number: V67-1145 Renewal
C NTHIA L. HALL Printed:9/10/2014 Page I of 7
ASSISTANT COUNTY ATTORNEY
Date 9 - ,23 - Re/f
PHYSIO-CONTROL,INC.
TECHNICAL SERVICE SUPPORT AGREEMENT TERMS AND CONDITIONS
Customer's signature on this Agreement or a valid purchase order referencing this Technical Service Support Agreement is required
prior to Physio-Control's acceptance and performance of this Agreement.This Agreement covers only the equipment listed on
Schedule A(Covered Equipment.).These terms constitute the complete agreement between the parties and they shall govern over
any other documents,including Customer's purchase order.These terms may not be revised in any manner without the prior written
consent of Physio-Control.
SERVICES.The Services provided under this Agreement are set forth on Schedule A.Physio-Control strives,but does not guarantee,
to return service calls within two(2)hours and to resolve service issues within twenty-four(24)hours.Following Services,
Physio-Control will provide Customer with a written report of actions taken or recommended and identification of any materials
replaced or recommended for replacement.The following Services are available and further described as they relate to each specific
Physio-Control device on Schedule B:
"Repair Plus Service"or"Repair Only Service"means repairs,Battery Replacement Service,parts and labor necessary to
restore Covered Equipment to original specifications,subject to Exclusions(as set forth below).
"Preventative Maintenance"or"Inspection Only Service means inspection and adjustment to maintain Covered Equipment in
satisfactory operating condition. Inspections include tests,measurements,and a thirty-point evaluation of Covered Equipment.
Covered Equipment is properly calibrated,mechanical operations are checked and adjusted,if necessary,and output
measurements are verified to function properly.Electrical safety checks are also performed in accordance with National Fire
Protection Association(NFPA)guidelines.Preventative Maintenance and Inspection Only Service are subject to Exclusions.
"Comprehensive Service"or"Repair 6 Inspect Service"means repairs,Battery Replacement Service,parts and labor necessary
to restore Covered Equipment to original specifications,and inspections to verify proper device calibration,mechanical
operations and output measurements,electrical safety check in accordance with NFPA guidelines,and Updates(as set forth
below),subject to Exclusions.
"Battery Replacement Service means replacement of batteries on a one-for-one,like-for-like basis,up to the number of batteries
and/or devices listed in Schedule A.Only batteries manufactured or distributed by Physio-Control are eligible for replacement.
Battery replacement is available upon Customer notification to Physio-Control of the occurrence of:(i)battery failure as
determined by Customers performance testing and evaluation in accordance with the applicable Operating Instructions;or(ii)the
end of the useful life of the battery as set forth in the applicable Operating Instructions.
Ailirediscretion of Physio-Control,battery replacement shall be effected by shipment to Customer and replacement by
Customer,or by on-site delivery and replacement by a Physio-Control Service Technician.Upon Customers receipt of a
replacement battery,the battery being replaced shall become the property of Physio-Control,and Customer must return the
battery being replaced to Physio-Control for proper disposal.In the event that Physio-Control does not receive the battery being
replaced.Physio-Control will invoice Customer the then-current rate for the replacement battery.
"On-Site Service"means that a Physio-Control factory-trained technician will provide Services at Customers location.Services
will be performed between 8:00am and 5:00pm local time,Monday through Friday,excluding holidays.Customer is to ensure
Covered Equipment is available for Services at scheduled times.Some Services may not be completed On-Site.Physio-Control
will cover travel and/or round-trip freight for Covered Equipment that must be sent to our designated facility for repair.
"Ship-In Service"means that Services will be performed at Physio-Control's designated facility.Physio-Control will cover
round-trip freight for Covered Equipment that is sent to our designated facility for Services.
If Covered Equipment is not available when Services are scheduled or Customer requests services or goads not covered by this
Agreement or outside of designated Services frequency or hours,Physio-Control will charge Customer for such services at 10%off
Physio-Control's standard rates(including overtime,if appropriate)and applicable travel costs in addition to the contract price.Repair
parts required for such repairs will be made available at 15%off the then-current list price.
EXCLUSIONS.Unless otherwise specified,Services do not include the following Exclusions:
supply or repair of accessories or disposables
repair of damage caused by misuse,abuse,abnormal operating conditions,operator errors,acts of God,and use of
batteries,electrodes,or other products not distributed by Physic-Control
case changes
repair or replacement of items not originally distributed or installed by Physio-Control
Upgrades,and installation of Upgrades
battery maintenance,performance testing,evaluation,removal,and recycling
LOANERS.If Covered Equipment must be removed from use to complete Services,Physio-Control will strive to provide Customer
with a similar loaner device until the Covered Equipment is returned.Customer assumes complete responsibility for the loaner and
shall return the loaner at Customer's expense to Physio-Control in the same condition as received,upon the earlier of the return of the
Reference Number: V67-1145 Renewal
Printed:9/10/2014 Page 2 of 7
removed Covered Equipment or Physio-Control's request.
UPDATES."Update"means a change to a device to enhance its current features,stability,or software.If Comprehensive Service or
Repair&Inspect Service is designated for Covered Equipment on Schedule A,Physio-Control will install Updates at no additional
cost,provided such Updates are installed at the time of regularly scheduled Services,Updates installed on Covered Equipment
designated on Schedule A as Repair Plus Service.Repair Only Service,Preventative Maintenance Service,Inspection Only Service,
or at a time other than regularly scheduled Comprehensive Service or Repair&Inspect Service,will be billed on a separate invoice at
20%off the then-current list price of the Update.For all Service plans,if parts must be replaced to accommodate installation of new
software,such pans may be purchased at a rate of 30%off the then-current list price.
UPGRADES."Upgrade"means a major,standalone version of software or the addition of features or capabilities to a device.For all
Service plans,Upgrades must be purchased separately and are not provided under this Agreement.Upgrades are available at a rate
of 17%off the then-current list price.
PRICING.Pricing is set forth on the first page of this Agreement,on the Quote for Services,and/or on the Invoice for the Services
purchased.Prices do not include taxes.Sales,service or use taxes will be invoiced in addition to the price of the goods and Services
covered by this Agreement unless Physio-Control receives a copy of a valid exemption certificate.If the number or configuration of
Covered Equipment changes during the Term,pricing shall be pro-rated accordingly.For Preventative Maintenance Service,
Inspection Only Service,Comprehensive Service,and Repair&Inspect Service,no pricing deduction will be made for removal of
Covered Equipment if preventative maintenance and inspection have already been performed during the Term and no further
preventative maintenance and inspection are scheduled to occur.Discounts may not be combined with other special terms,discounts,
and/or promotions.
PAYMENT,Payment is due within thirty(30)days of invoice date.
WARRANTY.Physio-Control warrants Services performed under this Agreement and repair/replacement parts provided in performing
such Services against defects in material and workmanship for ninety(90)days from the date Services were performed or a
repair/replacement part was provided.Customers sole remedy shall be reservicing the affected Covered Equipment and/or
replacement of any part determined to be detective,without additional 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.
TERM.The Term of this Agreement is set forth on the first page of this document,or in the Quote and/or Invoice for the Services
purchased.This Agreement shall automatically renew unless terminated by either party with written notice thirty(30)days prior to the
expiration of the then-current Term.Prices are subject to change upon renewal.
TERMINATION.Either party may terminate this Agreement for material breach by the other party by providing thirty(30)days'written
notice to the other party,and provided such breach is not cured within the notice period.In addition,either party may terminate this
Agreement at any time upon sixty(60)days'prior written notice to the other party.In the event of such early termination by Customer.
Customer shall be responsible for the portion of the designated price which corresponds to the portion of the Term prior to the
effective date of termination and the list-price cost of any preventative maintenance,inspections,or repairs rendered during the Term.
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,acts 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.My 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.
DEVICE INSPECTION BEFORE ACCEPTANCE.My device that is not covered by either a Physio-Control Limited Warranty or a
current Physio-Control Technical Service Support Agreement must be inspected and repaired(if necessary)to meet original
specifications at customers cost at the then-current list prices prior to being covered under a Technical Service Support Agreement.
Physio-Control reserves the right to refuse to support any device that has been remanufactured by a company other than
Physio-Control.
MISCELLANEOUS.(a)During the Term of this Agreement and for one(1)year following its expiration,without Physio-Control's prior
written consent,Customer agrees to not to solicit or offer employment to anyone who is employed by Physio-Control to provide
Services such as those described in this Agreement;(b)this 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)this Agreement shall be governed by the laws of the
State in which the Services are provided;(d)all costs and expenses incurred by the prevailing party related to the enforcement of its
rights under this Agreement,including reasonable attorneys fees,shall be reimbursed by the other party.
Reference Number: V67-I145 Renewal
Printed:9/10/2014 Page 3 of 7
PHYSIO-CONTROL, INC.
TECHNICAL SERVICE SUPPORT AGREEMENT
SCHEDULE A
Contract Number:
Servicing Rep: Miguel Rodriguez,EAVV67 •
District: SOUTHEAST
Phone:
FAX: 800-772-3340
Equipment Location: MONROE CTY FIRE RESCUE,03189501
490 63RD ST OCEAN
EMS SUPPLIES
MARATHON,FL 33050
Scope Of Service On Site Preventative Maintenance; Ship In Repair Plus
Ref. Effective Expiration Total
Model Part Number Serial Number Line Date Date Insoectionc
LIFEPAK®12 VLP12-02-002269 13451843 5 11/1/2014 /0/312015 I
LIFEPAK®12 VLP12-02-005013 32624452 6 11/1/2014 10/31/2015 I
LIFEPAK®12 VLP12-02-007228 37050535 7 11/1/2014 10/31/2015 1
LIFEPAK®12 V1912-02-00228 38338813 8 11/12014 10/31/2015 I
LIFEPAK®12 V1912-02-007228 38338814 9 11/1/2014 10/312015 1
LIFEPAK® 12 VI.P12-02-007228 38338815 10 11/1/2014 10/312015 1
LIFEPAK®12 VLPI2-02-007228 383311816 11 II/1/2014 10/31/2015 1
LIFEPAK®12 VLPI2-02-007228 38338817 12 11/1/2014 10/31/2015 1
LIFEPAK®12 VLPI2-02-007228 38338818 13 11/1/2014 10/312015 1
LIFEPAK®15 VI5-2-001602 41131794 14 11/1/2014 10/312015 I
LIFEPAK®15 VI 5-2-001602 41131966 15 11/1/2014 10/31/2015 I
LIFEPAK®15 VI 5-2-000050 38538983 1 11/1/2014 10/31/2015 1
LIFEPAK®15 V15-2-000050 39530548 2 11/1/2014 10/312015 I
LIFEPAK®15 V15-2-000050 40140404 3 11/1/2014 10/31/2015 I
LIFE141(14 15 V15-2-001602 40404625 4 11/1/2014 10/31/2015 1
"Denotes an Inventory line that has changed since the last contract revision or addendum.
Reference Number: V67-1145 Renewal
Printed:9/10/2014 Page 4 of 7
MEDTRONIC EMERGENCY RESPONSE SYSTEMS, INC.
TECHNICAL SERVICE SUPPORT AGREEMENT
SCHEDULE A
Contract Number:
Additional Items
Service Type hem Quantity Start Date End Date
CASE CHANGE LP12/15/20 CASE CHG 1-9 I 11/1/2014 10/31/2015
Denotes an additional item line that has changed since the last contract revision or addendum.
Reference Number: V67-1145 Renewal
Printed:9/10/2014 Page 5 of 7
r
PHYSIO-CONTROL, INC.
TECHNICAL SERVICE SUPPORT AGREEMENT
SCHEDULE B
LIFEPAK®15 Monitor/Defibrillator Services
LIFEPAK®15 Monitor/Defibrillator Comprehensive Service
•Inspections at intervals set forth on Schedule A
•Pans and labor necessary to restore device to original specifications,subject to Exclusions
•Standard detachable hard paddles repair or replacement
•REDI-CHARGE®battery charger(Catalog# 11141-000115)repair or replacement of one for each LIFEPAK 15
Monitor/Defibrillator listed in Schedule A and as determined necessary by Physio-Control
•Power Adapter repair or replacement
•Battery Replacement Service
o Replacement of three(3)LIFEPAK Lithium-ion batteries every two(2)years,or upon battery failure
•Updates installed at no additional cost,provided such Updates are installed at the time of regularly scheduled Services.If
parts must be replaced to accommodate installation of new software,such parts may be purchased at a rate of 30%off the
then-current list price.
LIFEPAK®IS Monitor/Defibrillator Repair Plus Service
•Parts and labor necessary to restore device to original specifications,subject to Exclusions
•Standard detachable hard paddles repair or replacement
•REDI-CHARGE®battery charger(Catalog#11141-000115)repair or replacement of one for each LIFEPAK 15
Monitor/Defibrillator listed in Schedule A and as determined necessary by Physio-Control
•Power Adapter repair or replacement
•Battery Replacement Service
o Replacement of three(3)LIFEPAK Lithium-ion batteries every two(2)years,or upon battery failure
•Updates installed at 20%off the then-current list price provided such Updates are installed at the time of regularly
scheduled Services.If parts must be replaced to accommodate installation of new software,such pans may be purchased at a rate of
30%otithe then-current list price.
LIFEPAK®15 Monitor/Defibrillator Preventative Maintenance Service
•Inspections at intervals set forth on Schedule A
•Updates installed at 20%off the then-current list price provided such Updates are installed at the time of regularly
scheduled Services.If pans must be replaced to accommodate installation of new software,such parts may be purchased at a rate of
30%off the then-current list price.
Reference Number: V67-1145 Renewal
Printed: 9/10/2014 Page 6 of 7
PHYSIO-CONTROL, INC.
TECHNICAL SERVICE SUPPORT AGREEMENT
SCHEDULE B
LIFEPAK® 12 Defibrillator/Monitor Services
LIFEPAK® 12 Defibrillator/Monitor Comprehensive Service
•Preventative maintenance and inspections at intervals set forth on Schedule A
•Parts and labor necessary to restore device to original specifications,subject to Exclusions
•Standard detachable hard paddles repair or replacement
•REDI-CHARGE®battery charger(Catalog# 11141-000115)repair or replacement of one for each LIFEPAK 12
Defibrillator/Monitor listed in Schedule A and as determined necessary by Physio-Control
•Power Adapter repair or replacement
•Battery Replacement Service
o Replacement of failed internal coin cell batteries;and
o Replacement of four(4)Physio-Control FASTPAK®batteries,FASTPAK 2 batteries,LIFEPAK SLA batteries,
LIFEPAK NiCd batteries every two years,or upon battery failure;or
o Replacement of three(3)LIFEPAK Lithium-ion batteries every two years,or upon battery failure
•Updates installed at no additional cost,provided such Updates arc installed at time of regularly scheduled Services.
If parts must be replaced to accommodate installation of new software,such pans may be purchased at a rate of 30%off the
then-current list price.
LIFEPAK® 12 Defibrillator/Monitor Repair Plus Service
•Parts and labor necessary to restore device to original specifications,subject to Exclusions
•Standard detachable hard paddles repair or replacement
•REDI-CHARGE®battery charger(Catalog# 11141-000115)repair or replacement of one for each LIFEPAK 12
Defibrillator/Monitor listed in Schedule A and as determined necessary by Physio-Control
•Power Adapter repair or replacement
•Battery Replacement Service
o Replacement of failed internal coin cell batteries;and
o Replacement of four(4)Physio-Control FASTPAK®batteries.FASTPAK 2 batteries,LIFEPAK SLA batteries,
LIFEPAK NiCd batteries every two years,or upon battery failure every two years,or upon battery failure;or
o Replacement of three(3)LIFEPAK Lithium-ion batteries every two years,or upon battery failure
•Updates installed at 20%off the then-current list price provided such Updates are installed at the time of regularly
scheduled Services.If parts must be replaced to accommodate installation of new software,such parts may be purchased
at a rate of 30%off the then-current list price.
LIFEPAK®12 Defibrillator/Monitor Preventative Maintenance Service
•Preventative maintenance and inspections at intervals set forth on Schedule A
•Updates installed at 20%off the then-current list price provided such Updates are installed at the lime of regularly
scheduled Services.If pans must be replaced to accommodate installation of new software,such parts may be purchased
at a rate of 30%off the then-current list price.
Reference Number: V67-1145 Renewal
Printed: 9/10/2014 Page 7 of 7
PHYS10
CONTROL
Physio-Control, Inc. I Lifesaving starts here-
ADDRESS September 19, 2014 RECEIVED
11811 Willows Road NE
Redmond WA 98052 20):I
PHONE Holly PfiesterGENERAL
425 887 4000 Executive Assistant Emergency Services
BOOF4421142 Monroe County
490 63rd Street Ocean, Suite 140
www.physlo-control.com Marathon, FL 33050
RE: Service Agreement
Dear Ms. Pfiester,
Per your request, please find the following documents enclosed:
1. Two (2) original copies of the Renewal of the Service Agreement partially
executed. Please sign and return one (1) soft copy of the Agreement fully
executed to the email below.
2. Sole Source Letter
3. Certificate of Insurance
If you have any questions, please don't hesitate to reach me at 425-867-4003.
Sincerely,
I II
A -xa •r. Carvalho
Physi. Control, Inc.
11811 Willows Road NE
Redmond, WA 98052-2003
rs.physiocontracts-south @ physio-control.com
PHYSIO
CONTROL
Physio-Control, Inc. I Lifesaving starts borer
ADDRESS September 19, 2014
11811 Willows Road NE
Redmond,WA 98052
Holly Pfiester
PHONE Executive Assistant Emergency Services
RAL
4258W 4000 Monroe County
TOLL FREE 490 63rd Street Ocean, Suite 140
800 442 1142
Marathon, FL 33050
www.physio-control.com pfiester-holly@ monroecounty-fl.aov
(305) 289-6088 Tel
Dear Ms. Pfiester,
In response to your recent request, I am writing to confirm that Physio-Control,
Inc. is the sole source provider in your marketplace for:
• New LIFEPAK® 15, 20e, and 1000 devices
• Our factory refurbished line of RELI devices
• LIFENET® Data Management Solutions
• The LUCAS®2 Chest Compression System
• Factory-authorized inspection and repair services which include repair
parts, upgrades, inspections, and repairs
• The PulsePoint Agency System
Physio-Control does not authorize any resellers to sell these products or services
in your marketplace. We will not fulfill orders placed by non-authorized
businesses seeking to resell our products. If you have questions, please feel free
to contact your local Physio-Control sales representative or 1-800-442-1142.
Best regards,
x r Carvalho
Contr t Analyst
Physio Control, Inc.
11811 Willows Road NE
Redmond, WA 98052-2003
rs.ohysiocontracts-south@physio-control.com
A✓ CERTIFICATE OF LIABILITY INSURANCE °A'�'/2014 "'
W 1912014
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
Marsh USA,Inc NAME...
1301 5th Avenue,Suite 1900 PHONE FAX
Seattle,WA 98101 E-MAIL
_ INC.xog _.
Atln'.Seattle CertRequesl@marsh.com/F:212-948-4326 ADDRESS:
INSURERISI AFFORDING COVERAGE _ NAICI
184424-STND-GAWUp-14-15 INSURER A:Continental Casualty Company 20443
INSURED INSURER B:National Foe Insurance of Hallfot 20478
Physio-Control lnlemMional,Inc. - -
1.Coniml,Inc. INSURER C:NIA N/A
I181
11611 Willows Road NE INSURER D'.
Redmond WA 98052 -
INSURERE:
INSURER F:
COVERAGES CERTIFICATE NUMBER: SEA-002496329-01 REVISION NUMBER:2
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
!NM INS
Lm TYPE OF INSURANCE INSR WVD POLICY NUMBER IMM/DCWYWY) IMMJ OV/YnnI - LIMITS-
A GENERAL LIABILITY 4030507381 05/01(2014 05/012015 EACH OCCURRENCE $ 1'000'000
XLOMMERGIAL OENERAL LIgBILITY DAMAGE TO RENTED I,OW,000
PREMISES{Ea occurrence) S
CLAIMS-MADE i OCCUR MED EXP(Any one person) E 5,000
PERSONAL 8 ADV INJURY _S 1,000,000
GENERAL AGGREGATE S 2.000,000
GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OPAGG S EXCLUDED
% I PRO-
POLICY
FCT LOC $
B AUTOMOBILE LIABILITY 4029265138 05/012014 05/01/2015 COMBINED SINGLE LIMIT 1,000,000
(Ea;K idenl) $-
X ANY AUTO I BODILY INJURY(Perperson) $
ALL OWNED SCHEDULED - - -
AUTOS __ AUTOS BODILY INJURY(Per accioet) S
NON-OWNED PROPERTY DAMAGE —
AUTOS 1 _LTacadenp E
HIRED AUTOS _
'
COMP/COLL DED. $ 1,000
UMBRELLA LIAB I OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE
AGGREGATE E
•
DED RETENTIONS S
A ,WORKERS COMPENSATION 4030507378 (ADS) 05/01/2014 05/0112015 X NC STATU- I co-H-
AND EMPLOYERS'LIABILITY YI N liTORY I IMITS' FR : __
A ANY PROPRIETOR/PARTNER/EXECUTIVE 4030507364 (CA) 05/01/2014 05/01/2015 E L.EACH ACCIDENT $ 1,000,000
OFFICER/MEMBER EXCLUDED? N N'A
(Mandatory In NM) E.L.DISEASE-EA EMPLOYEE $ 1,000'000
O ESCRIPTION OF OPERATIONS below I I 1,IHIO,OW
E L DISEASE-POLICY LIMIT[E
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACO0.0 I el.Additional Remarks Schedule.If more apace Is nyulred/
Additional Insured status(except workers'compensator()applies only',ills reflected in your soften contract.
CERTIFICATE HOLDER CANCELLATION
Monroe County Are Rescue SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Ann''Holly Pfiester THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
490 63rd Steel Ocean.Suite 140 ACCORDANCE WITH THE POLICY PROVISIONS.
Marathon,FL 33050
AUTHORIZED REPRESENTATIVE
of Minh USA Inc.
1 Cheryl Bemlutlez Celleseeai R.Hrs '.
®1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD