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HomeMy WebLinkAbout2013-415 EMS - Physio-Control Inc for Defibrillator Service and Maintenance $16,083 TECHNICAL SERVICE SUPPORT AGREEMENT PHYSIO CONTROL Contract Number: End User# 00300503 Bill To# 00300502 ORANGE CTY EMERGENCY MEDICAL ORANGE CTY EMERGENCY MGMT SERVICES PO BOX 8181 510 MEADOWLAND DR HILLSBOROUGH,NC 27278 HILLSBOROUGH,NC 27278 This Technical Service Support Agreement begins on T V2013 and expires on 663012014. The designated Covered Equipment and/or Software is listed on Schedule A.This Technical Service Agreement is subject to the Tenns 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 $16,083.00 per term,payable in Annual installments. Special Terns 15%DISCOUNT ON ACCESSORIES .01 oe Accepted:P ysio-Co I Customer By: y B Title: C. "_ 1 P nt. Date: /��� Title: Date: Purchase Order Number. Territory Rep: EAAA60 Customer Contact: Lane Rushing James Grove Phone: Phone: (919)245.6100 FA 8 0-772-3340 FAX: This instrume. as�een re-audited in the manner required by tl�e Local Govern ent F cal and Control Act. CfJ' Reference Number: A60-3184 Renewal Printed:71962013 Page 1 of 9 Clarence G. Grier, Assistant County Manager/CFO PHYSIO-CONTROL,INC. TECHNICAL SERVICE SUPPORT AGREEMENT TERMS AND CONDITIONS Customers signature or purchase order referencing this Technical Service Support Agreement we required prior to Physio-Control`s acceptance of this Agreement. TMs 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.These terms may not be revised In any manner without the prior written consent of Physio-Coned. SERVICES.The services provided under this Agreement are set forth on Schedule A.Physio-Control strives to return service calls within two(2)hours,and strives to resolve service issues within twenty--four(24)hours.Following service.Physio-Conirol 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 "Repair Only Service"means repairs.Battery Replacement Service.parts and labor necessary to restore Covered Equipment to original specifications,subject to Exclusions. "Inspection Only Service"means inspections of Covered Equipment to verify proper device calibration,mechanical operations and output measurements,electrical safely check In accordance with National Fire Protection Association(HFPA)guidelines and labor,subject to Exclusions. "Repair and Inspect Serv/oe"means repairs,Battery Replacement Service,parts and labor necessary to restore Covered Equipment to original specifications.and Inspections to verify proper device calibration,mechanicni operations and output measurements,electrical safety check in accordance with NFPA guidelines and Updates(as set forth below).subject to Exclusions. "Battery Raplecernent Service"means replacement of batteries on a one•for-one,tike-for-like basis,up to the number of batteries and/or devices listed at Schedule A. Orgy batteries manufactured or distributed by Physio-Control are eligible for replacement Battery replacement is available upon Customer notification to Physio-Control of pre occurrence of: (1) Battery fatkrre as determined by Customers performance testing and evaluation in accordance with the applicable Operating Instructions:or (il) The end of the useful life of the battery as Set forth in the applicable Operating Instruction At the discretlon of Physio-Conlyd,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 Customer's 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 Physlo-Control for proper disposal.In the event that Physio-Control does not receive the battery, Customer will be charged at the Ilan-axrent rate for the replacement batNry. `On-S/ta Service"means Ihat a Physio-Control factory-trained technician will provide service at Customers location. Services will be performed between 8:OOsm and 5:00prn local time,Monday through Friday,excluding holidays. Customer is to ensure Covered Equipment is available for service at scheduled times. Some service 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 service facility for repair. 24-hour On-Sine Service'means prat a Physio-Control factory-trained Winician will provide service at Customer's location at any time,except on the holidays fitted above. Customer Is to ensure Covered Equipment is available for service at scheduled tunes. Some service may not be completed On-Ske- Physio-Control will cover travel and/or round-trip freight for Covered Equipment that must be Sent to our designated service facility for repair. "Ship-in Service•means that service will be performed at Physio-Controfs designated service facility. Physio-Control will cover round-trip freight for Covered Equipment that is sent to our designated service facility for repair. If Covered Equipment is not available as Scheduled or Customer requests services or goods not covered by this Agreement or outside of designated service frequency or hours.Physlo-Control will charge Customer at Physio-Control's standard labor rates less 10% (Including overtime,If appropriate)and applicable travel costs. Parts required for Such repairs will be made available at 15%off the then-current list price. EXCLUSIONS.Unless otherwise specified,this Agreement does not include: supply or repair of accessories or disposables repair of damage caused by misuse,abuse,abnormal operating conditions,use of batteries or other products not distributed by Physio-Control,operator errors,or acts of God case changes repair or replacement of Means not originally distributed or installed by Physw-Control Upgrades and installation o(Upgrsdes battery maintenance,performance tesfarg,evaluation,removal and recyding Reference Number: A60-3184 Renewal Printed:719/2013 Page 2 of 9 LOANERS.If Covered Equipment must be removed from service to complete repairs,Physio-Control will provide Customer with a loaner device,if one is available,until the Covered Equipment is returned.Customer assumes complete responsibility for the loaner and shah return the loaner at Customer's expense to Physio-Control in the same condition as received.upon the earlier of the return of the removed Covered Equipment or Physio-Contrors request. UPDATES."Update'means a change to a device to enhance Its current features,stability,or software. If Repair and 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 service If parts must be replaced to accommodate installation of new software,such parts may be purchased M a rate of 30%less than the then-current list price.Updates installed on Covered Equipment designated as Repair Only Service,Inspect Only Service,or at a time other then regularly scheduled Repair and Inspect Service will be billed on a separate Invoice at the then-current list price less 20%. UPGRADES."Upgrade"means a major,standalone version of software or the addition of features or capabilities to a device. Upgrades must be purchased separately,and are not provided under this Agreement,Upgrades are available at a rate of 17%Was than the then-current list price. PRICING. Pr icirrg Is set forth on the front page of this Agreement. 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-Conlrol receives a copy of a valid exemption certificate. If the number or configuration of Covered Equipment changes during the Term,pricing shag be pro-rated accordingly. For Inspection Only Service and Repair and Inspect Service,no pricing deduction will be made for removal of Covered Equipment it an inspection has already been performed during the Term. Discounts will not be combined with other special terns, 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 replacement parts provided in performing such services against defacs it material and workmanship for ninety(90)days from the date a service was performed or a part was provided.Customer's sob remedy shall be res i vlcing the affected unit and/or replacement of any part determined to be defective. without additional c srge.provided Customer no ies 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 imitation,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 initial Term Is set forth on the iron!page of this Agreement.This Agreement shall automatically renew unless terminated by either parry with written notice thirty(30)days prior to the expiration of the l hen-current term. Prices we 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$ixty(80)days'prior written notice to the other party,M the evert of such early termination.Customer shall be responsible for the portion of the designated price wt* h corresponds to the portion of the Tenn prior to the effective date of termination and the cost of any services 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-Contrors inability to obtain goods from its usual sources.Any such delay shall not be considered a breach of Physb-Con lrol's obligations and the performance dales shall be extended for the length of such delay, DEVICE INSPECTION BEFORE ACCEPTANCE.AN devices that are not under Physio-Control Limited Warranty or a current Technical Service Support Agreamert must be inspected and repaired Of necessary)to meet original specifications at then-current list prices prior to being covered under a Technical Service Support Agreement. MISCELLANEOUS,(a)Customer agrees to not employ or offer employment to anyone performing servioes on Physio-Control's behalf during the Tenn of this Agreement or for one(1)year following its expiration without Physio-Control's prior written consent;(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 tine State in which the service is provided;(d)all costs and expenses Incurred by the prevaih'rg party related to the enforcement of its rights under this Agreement.Including reasonable attorney's fees,shall be reimbursed by the other party Reference Number: A60-3184 Renewal Printed: 719/2013 Page 3 of 9 PHYSIO-CONTROL, INC. TECHNICAL SERVICE SUPPORT AGREEMENT SCHEDULE A Contract Number: Servicing Rep: Lane Rushing,EAAA60 District: MID-ATLANTIC Phone: FAX: 800-772-3340 Equipment Location: ORANGE CTY EMERGENCY MEDICAL,00300503 SERVICES 510 MEADOWLAND DR HILLSBOROUGH,NC 27278 Scope Of Service AED l On Site Inspection per Year with I Lithium Battery Ref Effective Expiration Total mmel Part Numher Serial NumhLr Line Date Date Inspections LIFLPAK0 500 3011790-000113 13161556 7 7/1/2013 6502014 I LIFLPAK0500 3011790-000113 13161557 8 711)2013 6/30/2014 1 LIFEPAK0 500 3011790-000113 13161565 9 7/1/2013 6.130/2014 1 LIFEPAK+D 500 3011790-000113 13161366 10 7/1/2013 6/30/2014 1 LIFLPAK0 500 3011790-000127 13326103 13 7112013 6/302014 1 LIMPAK0 5W 3011790-000113 13993444 14 711/2013 6130/2014 1 LIFLPAKO 500 3011790.001129 33127344 25 7112013 6/3042014 1 LIFEPAK®500 3011790-001129 33127343 26 7/112013 6/302014 1 MEMO 500 3011790-001129 33127346 27 71112013 W302014 1 MEMO 500 3011790-001129 33127347 28 711/2013 11302014 1 LIFEPAK®500 3011790-001129 33127349 29 7/12013 6/302014 1 LIFEPAK!D 500 3011790.001129 33127350 30 7/112013 6130/2014 1 LIMPAKID 500 3011790.001129 33127351 31 7112013 6/3042014 1 I.IFEPAK0 500 3011790-001 129 33127352 32 7/12013 61302014 I 1.11FEPAKQt1500 3011790.001129 33125844 18 7112013 6/302014 1 LI1FEPAK0 500 3011790.001 129 33125847 20 7112013 6/3012014 1 I.IFEPAK+D 500 3011790-00 1 129 33125848 21 7/12013 6/302014 1 LIFEPAKO 500 3011790-001 129 33127342 23 7/12013 6/30/2014 1 LIFEPAK+D 500 3011790-001502 34395096 36 7112013 6/3002014 I 1IFEPAK0500 3011790-001129 30811669 38 7/1/2013 6/30/2014 1 Equipment Location: CHAPEL HILL FD, 13903401 403 MLK)R BLVD CHAPEL HILL,NC 27514 Scope Of Service AED I On Site Inspection per Year with 1 Lithium Battery Ref. Effective Expiration Total Model Pan Number Sena)Numher LOW Date Date hisoections LIFEPAK9,500 3011790-001129 32690608 41 7?112013 6`30'2014 I Reference Number: A60-3184 Renewal Printed:719/2013 Page 4 of 9 LIFIPAKi 500 3011790-001129 32690609 42 W112013 6130!2014 l 1-1FEPAKI500 3011790.000113 14317095 37 WV2013 6!3012014 1 LIFEPAK0 500 3011790-001502 34101784 33 7;112013 6!30!2014 1 I-IFEPAK*500 3011790-000113 12683185 6 71:2013 61302014 1 UMIAK* 3011790-OM 113 13281257 12 7°112013 6130/2014 1 Scope Of Service On Site Inspection Only- t Inspection per Year:M-F18-5 Ref Effective Expiration Total N-twel Part Numhrr S211W Number Line Datc Dare Insoed ons I.IFrPAK4A1000 320371500023 37351831 2 TV2013 63x2014 I I.IFI--PAK9)1000 320371500093 37881608 3 7112013 6'30,2014 1 LIFI-PAKrD1000 320371500229 38560716 4 7412013 630;2014 1 LIMPAK41000 320371500229 39389843 46 711;2013 6`30!2014 1 L1FFIRAK41000 320371500229 39389844 44 71 1;2013 6:'30,'2014 1 Equipment Location: ORANGE RURAL FIRE DEPT, 14376401 206 S CHATALON ST HILLSBOROUGH,NC 27278 Scope Of Service AED I On Site Inspection per Year with I Lithium Battery Ref Effective Expiation Total MG& Pan Number Serial Number Lme Date Dale IrlXMWRns _ I,IFFPAK'D 500 3011790-001129 32779691 43 7112013 6-1)0,'20 14 1 l.IFFPAK*50O 3011790-000113 13216812 11 79112013 &3d"2014 I Equipment Location: CARRBORO FD, 16148501 301 W MAIN ST CARRBORO,NC 27510 Scope Of Service AED I On Site Inspection per Year with I Lithium Battery Rat. Effective Expketian Total model Pen Number Serial Number 1 inc flare Date Inspections LIFEPAKD500 3011790-001569 35201273 17 7!'11013 6130;2014 1 LIFEPAKI500 3011790-001129 33125846 19 7);2013 613012014 1 LIFEPAKID 500 3011790-001129 30929147 39 71.+2013 6'3x2014 I Scope Of Service On Site Inspection Only- 1 Inspection per Year:M-Fi8-5 Ref. Effective Expiration Total Model Part Number Scriat Number I ine Dale Dale Inspections LIFEPAK01000 320371500245 39578500 45 7`112013 6'30+2014 1 LIFEPAK401000 320371500023 34692730 5 71112013 6130,2014 1 Equipment Location: ORANGE GROVE FIRE DEPARTMENT, 16828101 6800 ORANGE GROVE ROAD HILLSBOROUGH,NC 27278 Reference Number: A60-3184 Renewal Printed:7819:2013 Page 5 of 9 Scope Of Service AED 1 On Site Inspection per Year with t Lithium Battery Rol. Effective Expiration Total Model hart Numb f Serial Number Lute Date Date Inspections LIFEPAK4:RM 3011790-001129 31608167 40 711.=2013 630,2014 1 Equipment Location: CALDWELL FIRE DEPT, 190)5201 7020 GUESS ROAD ROUGEMONT,NC 27572 Scope Of Service AED I On Site Inspection per Year with I Lithium Battery Ref. Effective Expiration Total Model Pan Number Serial Number Ltne Date Date Inspections LIFEPAK'e 500 3011790-001502 34359081 34 711?2013 6,10,2014 l LIFEPAU SUt 3011790-001502 34359082 35 711+2013 6130+2014 1 Equipment Location: MEBANE FD, 19284001 405 N 1ST ST MEBANE,NC 27302 Scope Of Service On Site Inspection Only- I Inspection per Year:M-F/8-3 Rai Effective Expiration Total MOM__ Pan Number Serial Number Unr Date Date Insoactlons LIFEPAK01000 320371500243 39489346 47 7'1x2013 6;302014 1 LIFLPAK 9 1000 320371500245 39489547 48 7112(113 6613Gb2014 I LIFLPAK11)1000 320371SM243 39489348 40 7'12013 6;;2014 1 Equipment Location: WHITE CROSS FIRE DEPT,20392101 5722 OLD GREENSBORO HWY CHAPEL HILL,NC 27516 Scope Of Service AED I On Site Inspection per Year with 1 Lithium Battery Ref. Effective Expiration Total Model Pan Ntunbel Serial Number Line Date Date Inspections I.IMPAKR 500 3011790.001129 33127343 24 71'1/2013 613&2014 1 Equipment Location: ENO FD,20500641 5019 US HWY 70 DURHAM,NC 27705 Scope Of Service AED 1 On Site Inspection per Year with 1 Lithium Battery Model Ref. Efective Expiration Total m Lane Date DO-- Inspections t,IFFPAKB$00 3011790.001129 33127341 22 7:112013 630:2014 1 LIFEPAK*$06 3011790-001502 34768948 15 7112013 613012914 1 LIP PAK1c$00 3011790001502 34768949 16 7L2013 6130,2014 I Reference Number: A60-3184 Renewal Printed,71aO13 Page 6 of 9 Scope Of Service On Site Inspection Only- I Inspection per Year:M-F/8-5 Ret. Effective Expiration Total Model Part Nunibv Serial Number Line bate Date Inspections LIVEPAK-41000 320371500021 37275549 1 7:1x2013 6'301014 t LIFE PAK41000 320371500245 40054648 50 7;112013 6t3M014 1 Equipment Location: CEDAR GROVE FD,21150301 720 HAWKINS RD CEDAR GROVE.NC 27231 Scope Of Service On Site Inspection Only- I Inspection per Year:M-F18-5 Rel. Effective Expiration Total Model Pan Number Serial Number 1 me Date hate Inspections LIFFPAK 1sIOW 320371500245 39621656 51 7+2013 6130;2014 1 1,11Ft:PAK,*1000 320371500245 39621635 52 7%1.2013 63;;x2014 I •'Denotes an inventor)line that has changed since the last contract ret iston or addendum Reference Number: A60-3184 Renewal Printed:71912013 Page 7 of 9 PHYSIO-CONTROL, INC. TECHNICAL SERVICE SUPPORT AGREEMENT SCHEDULE B LI I PAKID 500 AE D Inspection-OnI% ttith Batter% Replacement Service includes: •Periodic inspections as set forth on Schedule A. •updates installed at no additional cost provided such Ipdatcs are installed at the time of regularly scheduled set ice.If pans must be replaced to accommodate installation of nett sotl%%vre.such parts may.be purchased at a rate of 50%less than the then-current list price.Updates installed at a time other than regularh scheduled service will be billed on a separate invoice at the lhcn-current list price less 20,i. •Battery Coverage o Replacement of up to two(2)LIFEPAK 500 SLA Battery Paks every two(2)years.or upon bauer) failure: OR o Replacement of up to one(1)LIFITAK 500 Li-ion Battery Pak every five(5)years for each LIFE TAK 500 AE=U listed on Schedule A.or upon battery failure. Reference Number: A60.3184 Renewal Printed:W912013 Page 8 of 9 PHYSIO-CONTROL, INC. TECHNICAL SERVICE SUPPORT AGREEMENT SCHEDULE B 1,11-fPAK00 1000 AFD inspection-Onl)%viih Batter)Replacement Sere ice includes: •Periodic inspections asset forth on Schedule A. •Updates installed a no additional cost provided such Updates are installed at the time ofregularl) scheduled scn ice If parts must be replaced to accommodate installation of neAN softwam.such parts ma) be purchased at a rate of 50'b less than the then-current list price.Updates installed at a time other than regularl)scheduled service will he billed on a separate invoice at the then-current list price less 20%. •Batter)Co%crage o Replacement of up to one(t)1.1ITPAK 1000 Rechargeable Batter)Pak c%cr) 1%o(2))cars.or upon failure: OR o Replacement of up to one(I)L1r1 PAK 10001.1-ion Batter)Pak ever) fl%a(5))curs foreach I-IFITAK 1000 AI;D listed on Schedule A.or upon failure. Reference Number: A60-3184 Renewal Printed:7/9?2013 Page 9 of 9 ,aco CERTIFICATE OF LIABILITY INSURANCE DATE 1DD/YYYY) 09/27//202013 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(ies)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 (A/C.No Ext: IAIC No Seattle,WA 98101 E-MAIL Attn:Seattle.CegRequest @marsh.com/F:212-948-4326 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# 184424-IS5-CAS-13-14 INSURER A:Valley Forge Insurance Cc 20508 INSURED INSURER B: National Fire Insurance Co Of Hartford 20478 Physio-Control International,Inc. Physio-Control,Inc. INSURER C: N/A N/A 11811 Willows Road NE INSURER D; Redmond,WA 98052 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: SEA-002432364-01 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MMIDDY� MM/DDY� LIMITS A GENERAL LIABILITY 4030507381 05101/2013 05/01/2014 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 1 000 000 PREMISES Ea occurrence $ CLAIMS-MADE 1XI OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ EXCLUDED X POLICY PRO- LOC $ 8 AUTOMOBILE LIABILITY 4029265138(AOS) 05/01/2013 05101/2014 (CEO,accMBINED ident S INGLE LIMIT T $ 1,000,000 B X ANY AUTO 4029265172(MA) 05/01/2013 05/0112014 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident COMP I COLL DED. $ 1,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION 4030507378(AOS) 05/01/2013 05/01/2014 X WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY I IMITS FIR B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 4030507364(CA) 05/01/2013 05/01/2014 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? � N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Additional Insured status applies only if it is reflected in your written contract. CERTIFICATE HOLDER CANCELLATION Orange County Emergency Medical Services SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn:Chris Pope THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 510 Meadowland Dr. ACCORDANCE WITH THE POLICY PROVISIONS. Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Cheryl Bermudez G --.*c �.✓�'�� @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD