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Agenda 12/11/2018 Item #16E 412/11/2018 EXECUTIVE SUMMARY Recommendation to authorize the purchase of Zoll Cardiac Monitors under a Request for Proposal (“RFP”) and an Agreement issued and approved by Volusia County (RFP 16-P-64AK), and to approve a Budget Amendment in the amount of $1,450,956.55. OBJECTIVE: To replace current cardiac monitors that have reached the end of their lifespan with new monitors that have upgraded technology. CONSIDERATIONS: Cardiac monitors are used by EMS to evaluate and monitor patient’s heart rhythms and to provide defibrillation and invasive cardiac procedures as needed. The cardiac monitors currently in use were purchased in 2013 (Agenda Item 11A, November 12, 2013). With evolving technology and increased need for maintenance it is important to upgrade the c ardiac monitors every 3-5 years. EMS is currently working on an upgraded patient care reporting system and the improved cardiac monitors will allow for a seamless syncing of cardiac rhythms and patient vital signs to be uploaded into the reporting system from the cardiac monitor. It is important to have the most up-to-date technology to provide the best patient care. Currently only two companies manufacture cardiac monitors for first responders. Staff discovered that Volusia County recently issued RFP 16-P-64AK for Cardiac Monitors and Cardiac Monitor Preventative Maintenance in 2016, which met all the solicitation criteria that Collier County Procurement would have included were it to conduct its own competitive solicitation. Further, the Volusia County agreement included at section 13.17, “Other Agencies,” a provision that allows other governmental agencies to participate in its Agreement (“piggyback”), under “the same prices, terms, and conditions.” Under that section, each agency issues its own purchase order to the Contractor. Because of the savings in time and staff resources in utilizing the Volusia County competitive solicitation process, staff recommends utilizing Zoll Medical Corporation, the vendor approved by Volusia County on September 8, 2016. In addition to the efficiency of utilizing the Volusia County RFP and Agreement, after field testing the Zoll monitors to ensure its product would perform to Collier County standards compared to the County’s current Physio monitor, staff found that the Zoll monitors provide better features than the Physios. Staff’s testing found: The Zoll monitors are lighter in weight without compromising ruggedness. The Zoll monitors show the 12 lead ECG on the display without the need to print it. The Zoll monitors automatically change default settings for adult and pediatric readings. Blood pressures are measured on inflation instead of deflation, giving faster and more accurate readings. The Zoll monitors have CPR feedback. The patient’s data can be extracted via three different methods as opposed to the one method utilized by the Physio monitor. Based on all the above reasons, staff recommends that the Board approve the acquisition of Zoll Cardiac Monitors through the issuance of a Purchase Order by utilizing Volusia County RFP 16-P-64AK and its Board approved attached Agreement. FISCAL IMPACT: A Budget Amendment is necessary to transfer funds from EMS Fund 490 Reserves in the amount of $1,450,956.66. 16.E.4 Packet Pg. 2456 12/11/2018 LEGAL CONSIDERATIONS: This item is approved as to form and legality and requires majority vote for Board approval. -SRT GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact resulting from this action. RECOMMENDATION: To authorize the purchase of Zoll Cardiac Monitors via the issuance of a Collier County Purchase Order, by utilizing an approved cooperative purchase agreement with Volusia County under its RFP 16-P-64AK, and to authorize a Budget Amendment in the amount of $1,450,956.55 Prepared by: Artie Bay, Supervisor, Emergency Medical Services Admin. ATTACHMENT(S) 1. 151 Piggyback - Volusia County FL - Zoll Medical r-1 (PDF) 2. [Linked] Cardiac Monitors Complete Package (PDF) 3. Insurance Certr-1 (PDF) 4. Modified Acknowledgement signed by ZOLL 11-7-18 and CAO (PDF) 5. Collier County EMS285935Version 2 (PDF) 16.E.4 Packet Pg. 2457 12/11/2018 COLLIER COUNTY Board of County Commissioners Item Number: 16.E.4 Doc ID: 7349 Item Summary: Recommendation to authorize the purchase of Zoll Cardiac Monitors under a Request for Proposal (“RFP”) and Agreement issued and approved by Volusia County (RFP 16-P-64AK) and to approve a Budget Amendment in the amount of $1,450,956.55 Meeting Date: 12/11/2018 Prepared by: Title: Supervisor - Accounting – Emergency Medical Services Name: Artie Bay 11/14/2018 11:58 AM Submitted by: Title: Division Director - EMS Operations – Emergency Medical Services Name: Tabatha Butcher 11/14/2018 11:58 AM Approved By: Review: Procurement Services Opal Vann Level 1 Purchasing Gatekeeper Completed 11/14/2018 12:36 PM Administrative Services Department Paula Brethauer Level 1 Division Reviewer Completed 11/14/2018 1:33 PM Emergency Medical Services Tabatha Butcher Additional Reviewer Completed 11/14/2018 3:18 PM Procurement Services Sara Schneeberger Additional Reviewer Completed 11/15/2018 9:34 AM Procurement Services Ted Coyman Additional Reviewer Completed 11/15/2018 5:41 PM Procurement Services Catherine Bigelow Additional Reviewer Completed 11/16/2018 8:43 AM Administrative Services Department Len Price Level 2 Division Administrator Review Completed 11/19/2018 4:22 PM County Attorney's Office Scott Teach Level 2 Attorney Review Completed 11/20/2018 9:45 AM Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 11/20/2018 11:03 AM County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 11/20/2018 11:18 AM Office of Management and Budget Laura Wells Additional Reviewer Completed 11/20/2018 1:47 PM County Attorney's Office Emily Pepin CAO Preview Completed 11/20/2018 3:43 PM County Manager's Office Nick Casalanguida Level 4 County Manager Review Completed 12/03/2018 8:04 AM Board of County Commissioners MaryJo Brock Meeting Pending 12/11/2018 9:00 AM 16.E.4 Packet Pg. 2458 Instructions Requester Name:Division: Vendor Name:Requested Items: Sponsor Agency/Contact: Contract Name and Number: Aw ard Date:Expiration Date:Renewals: Backup Documents: Additional Documents/Commentary: Website of Contract: Scope of Services in Contract: Competitive Event: Summary of Competition: Piggyback Clause: (listed in solicitation or Contract) Rationale for Use Collier County Cooperative Purchasing Request Form Artie Bay EMS Zoll Cardiac Monitors and Maintenance Volusia County,FL /Andrew Kokitus (akokitus@volusia.org) Contract for cardiac monitors and cardiac monitor preventative maintenance RFP 16-P-64AK. 9/8/2016 9/7/2019 Two one year renewals www.volusia.org/purchasing The purpose of the Agreement is for the purchase of Zoll X-Series cardiac monitor/defibrillators for the Emergency Medical Services (EMS), service agreement and training and preventative maintenance. Yes,RFP No.16-P-64AK The county received two sealed proposals and awarded to ZOLL Medical Corporation. Piggyback clause is 13.17 on page 23 of the contract. There are currently only two companies manufacturing cardiac monitors for first responder use. Artie Bay Artie Bay Digitally signed by Artie Bay Date: 2018.09.07 10:44:55 -04'00' Tabatha Butcher ButcherTabatha Digitally signed by ButcherTabatha Date: 2018.09.17 12:11:15 -04'00' Sara Schneeberger SchneebergerSar a Digitally signed by SchneebergerSara DN: dc=net, dc=colliergov, dc=bcc, ou=Divisions, ou=ASD, ou=ASD Purchasing, ou=Purchasing User Accounts, cn=SchneebergerSara, email=SaraSchneeberger@colliergov.net Date: 2018.09.25 11:20:10 -04'00' Catherine Bigelow Cat Bigelow Digitally signed by Cat Bigelow DN: cn=Cat Bigelow, o=Collier County Government, ou=Procurement Services, email=catherinebigelow@colliergov.net, c=US Date: 2018.10.08 09:42:57 -04'00' 16.E.4.a Packet Pg. 2459 Attachment: 151 Piggyback - Volusia County FL - Zoll Medical r-1 (7349 : Zoll Monitor Purchase) 16.E.4.c Packet Pg. 2460 Attachment: Insurance Certr-1 (7349 : Zoll Monitor Purchase) 16.E.4.c Packet Pg. 2461 Attachment: Insurance Certr-1 (7349 : Zoll Monitor Purchase) 16.E.4.dPacket Pg. 2462Attachment: Modified Acknowledgement signed by ZOLL 11-7-18 and CAO (7349 : Zoll Monitor Purchase) 16.E.4.dPacket Pg. 2463Attachment: Modified Acknowledgement signed by ZOLL 11-7-18 and CAO (7349 : Zoll Monitor Purchase) 16.E.4.dPacket Pg. 2464Attachment: Modified Acknowledgement signed by ZOLL 11-7-18 and CAO (7349 : Zoll Monitor Purchase) Attn: (239) 252-3763Tel: Noemi Garcia TO: Shipping PointFOB: Net 45 DaysTERMS: DATE: QUOTATION (978) 421-0015 Customer Support (800) 348-9011 (978) 421-9655 Main Chelmsford, Massachusetts 01824-4105 269 Mill Rd Worldwide HeadQuarters ZOLL Medical Corporation DESCRIPTION QTY.UNIT PRICE DISC PRICE TOTAL PRICE email:noemi.garcia@colliercountyfl.gov Free FreightFREIGHT: 8075 Lely Cultural Parkway, Suite #267 Naples, FL 34113 ITEM MODEL NUMBER 285935 V:2 Collier County EMS October 17, 2018 FEDERAL ID#: 04-2711626 1 6 0 1 - 2 2 3 1 0 1 1 - 0 1 X Series ® Manual Monitor/Defibrillator $14,995 with 4 trace tri-mode display monitor/ defibrillator/ printer, comes with Real CPR Help®, advisory algorithm, advanced communications package (Wi-Fi, Bluetooth, USB cellular modem capable) USB data transfer capable and large 6.5"( 16.5cm) diagonal screen, full 12 ECG lead view with both dynamic and static 12-lead mode display. Accessories Included: • MFC cable • MFC CPR connector • A/C power adapter/ battery charger • A/C power cord • One (1) roll printer paper • 6.6 Ah Li-ion battery • Carry case • Declaration of Conformity • Operator's Manual • Quick Reference Guide • One (1)-year EMS warranty Advanced Options: Real CPR Help Expansion Pack $995 CPR Dashboard quantitive depth and rate in real time, release indicator, interruption timer, perfusion performance indicator (PPI) • See - Thru CPR artifact filtering ZOLL Noninvasive Pacing Technology: $2,550 qq 53 $40,020.00 $27,199.99 $1,441,599.47 * To the extent that ZOLL and Customer, or Customer’s Representative have negotiated and executed overriding terms and conditions (“Overriding T’s & C’s”), those terms and conditions would apply to this Diego Mauri this quotation. In all other cases, this quote is made subject to ZOLL’s Standard Commercial Terms and Conditions (“ZOLL T’s & C’s”) which for capital equipment, accessories and consumables can be found at http://www.zoll.com/GTC and for software products can be found at http://www.zoll.com/SSTC. Except in the case of overriding T’s and C’s, any Purchase Order (“PO”) issued in response to this quotation will be deemed to incorporate ZOLL T’s & C’s, and any other terms and conditions presented shall have no force or effect except to the extent agreed in writing by ZOLL.Territory Manager 404-886-80791. DELIVERY WILL BE MADE 90-120 DAYS AFTER RECEIPT OF ACCEPTED PURCHASE ORDER. 2. PRICES QUOTED ARE VALID UNTIL DECEMBER 31, 2018. 3. APPLICABLE TAX 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 978-421-0015 OR EMAIL TO ESALES@ZOLL.COM. 6. ALL DISCOUNTS OFF LIST PRICE ARE CONTINGENT UPON PAYMENT WITHIN AGREED UPON TERMS. 7. PLACE YOUR ACCESSORY ORDERS ONLINE BY VISITING www.zollwebstore.com. Page 1 of 6 16.E.4.e Packet Pg. 2465 Attachment: Collier County EMS285935Version 2 (7349 : Zoll Monitor Purchase) Attn: (239) 252-3763Tel: Noemi Garcia TO: Shipping PointFOB: Net 45 DaysTERMS: DATE: QUOTATION (978) 421-0015 Customer Support (800) 348-9011 (978) 421-9655 Main Chelmsford, Massachusetts 01824-4105 269 Mill Rd Worldwide HeadQuarters ZOLL Medical Corporation DESCRIPTION QTY.UNIT PRICE DISC PRICE TOTAL PRICE email:noemi.garcia@colliercountyfl.gov Free FreightFREIGHT: 8075 Lely Cultural Parkway, Suite #267 Naples, FL 34113 ITEM MODEL NUMBER 285935 V:2 Collier County EMS October 17, 2018 FEDERAL ID#: 04-2711626 Masimo Pulse Oximetry SP02 & SpCO $4,540 • Signal Extraction Technology (SET) • Rainbow SET ( for SpCO & SpMet) NIBP Welch Allyn includes: $3495 • Smartcuff 10 foot Dual Lumen hose • SureBP Reusable Adult Medium Cuff End Tidal Carbon Dioxide monitoring (ETCO2) $4,995 Oridion Microstream Technology: Order required Microstream tubing sets separately Interpretative 12- Lead ECG: $8,450 • 12-Lead one step ECG cable- includes 4- Lead limb lead cable and removable precordial 6- Lead set To the extent that ZOLL and Customer, or Customer’s Representative have negotiated and executed overriding terms and conditions (“Overriding T’s & C’s”), those terms and conditions would apply to this Diego Mauri this quotation. In all other cases, this quote is made subject to ZOLL’s Standard Commercial Terms and Conditions (“ZOLL T’s & C’s”) which for capital equipment, accessories and consumables can be found at http://www.zoll.com/GTC and for software products can be found at http://www.zoll.com/SSTC. Except in the case of overriding T’s and C’s, any Purchase Order (“PO”) issued in response to this quotation will be deemed to incorporate ZOLL T’s & C’s, and any other terms and conditions presented shall have no force or effect except to the extent agreed in writing by ZOLL.Territory Manager 404-886-80791. DELIVERY WILL BE MADE 90-120 DAYS AFTER RECEIPT OF ACCEPTED PURCHASE ORDER. 2. PRICES QUOTED ARE VALID UNTIL DECEMBER 31, 2018. 3. APPLICABLE TAX 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 978-421-0015 OR EMAIL TO ESALES@ZOLL.COM. 6. ALL DISCOUNTS OFF LIST PRICE ARE CONTINGENT UPON PAYMENT WITHIN AGREED UPON TERMS. 7. PLACE YOUR ACCESSORY ORDERS ONLINE BY VISITING www.zollwebstore.com. Page 2 of 6 16.E.4.e Packet Pg. 2466 Attachment: Collier County EMS285935Version 2 (7349 : Zoll Monitor Purchase) Attn: (239) 252-3763Tel: Noemi Garcia TO: Shipping PointFOB: Net 45 DaysTERMS: DATE: QUOTATION (978) 421-0015 Customer Support (800) 348-9011 (978) 421-9655 Main Chelmsford, Massachusetts 01824-4105 269 Mill Rd Worldwide HeadQuarters ZOLL Medical Corporation DESCRIPTION QTY.UNIT PRICE DISC PRICE TOTAL PRICE email:noemi.garcia@colliercountyfl.gov Free FreightFREIGHT: 8075 Lely Cultural Parkway, Suite #267 Naples, FL 34113 ITEM MODEL NUMBER 285935 V:2 Collier County EMS October 17, 2018 FEDERAL ID#: 04-2711626 2 6 0 1 - 2 2 4 1 0 1 1 - 0 1 X Series ® Manual Monitor/Defibrillator $14,995 with 4 trace tri-mode display monitor/ defibrillator/ printer, comes with Real CPR Help®, advisory algorithm, advanced communications package (Wi-Fi, Bluetooth, USB cellular modem capable) USB data transfer capable and large 6.5"( 16.5cm) diagonal screen, full 12 ECG lead view with both dynamic and static 12-lead mode display. Accessories Included: • MFC cable • MFC CPR connector • A/C power adapter/ battery charger • A/C power cord • One (1) roll printer paper • 6.6 Ah Li-ion battery • Carry case • Declaration of Conformity • Operator's Manual • Quick Reference Guide • One (1)-year EMS warranty Advanced Options: Real CPR Help Expansion Pack $ 995 CPR Dashboard quantitive depth and rate in real time, release indicator, interruption timer, perfusion performance indicator (PPI) • See - Thru CPR artifact filtering ZOLL Noninvasive Pacing Technology: $2,550 qq 2 $42,375.00 $28,801.39 $57,602.78 * To the extent that ZOLL and Customer, or Customer’s Representative have negotiated and executed overriding terms and conditions (“Overriding T’s & C’s”), those terms and conditions would apply to this Diego Mauri this quotation. In all other cases, this quote is made subject to ZOLL’s Standard Commercial Terms and Conditions (“ZOLL T’s & C’s”) which for capital equipment, accessories and consumables can be found at http://www.zoll.com/GTC and for software products can be found at http://www.zoll.com/SSTC. Except in the case of overriding T’s and C’s, any Purchase Order (“PO”) issued in response to this quotation will be deemed to incorporate ZOLL T’s & C’s, and any other terms and conditions presented shall have no force or effect except to the extent agreed in writing by ZOLL.Territory Manager 404-886-80791. DELIVERY WILL BE MADE 90-120 DAYS AFTER RECEIPT OF ACCEPTED PURCHASE ORDER. 2. PRICES QUOTED ARE VALID UNTIL DECEMBER 31, 2018. 3. APPLICABLE TAX 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 978-421-0015 OR EMAIL TO ESALES@ZOLL.COM. 6. ALL DISCOUNTS OFF LIST PRICE ARE CONTINGENT UPON PAYMENT WITHIN AGREED UPON TERMS. 7. PLACE YOUR ACCESSORY ORDERS ONLINE BY VISITING www.zollwebstore.com. Page 3 of 6 16.E.4.e Packet Pg. 2467 Attachment: Collier County EMS285935Version 2 (7349 : Zoll Monitor Purchase) Attn: (239) 252-3763Tel: Noemi Garcia TO: Shipping PointFOB: Net 45 DaysTERMS: DATE: QUOTATION (978) 421-0015 Customer Support (800) 348-9011 (978) 421-9655 Main Chelmsford, Massachusetts 01824-4105 269 Mill Rd Worldwide HeadQuarters ZOLL Medical Corporation DESCRIPTION QTY.UNIT PRICE DISC PRICE TOTAL PRICE email:noemi.garcia@colliercountyfl.gov Free FreightFREIGHT: 8075 Lely Cultural Parkway, Suite #267 Naples, FL 34113 ITEM MODEL NUMBER 285935 V:2 Collier County EMS October 17, 2018 FEDERAL ID#: 04-2711626 Masimo Pulse Oximetry SP02, SpCO & SpMet $6,895 • Signal Extraction Technology (SET) • Rainbow SET ( for SpCO & SpMet) NIBP Welch Allyn includes: $3,495 • Smartcuff 10 foot Dual Lumen hose • SureBP Reusable Adult Medium Cuff End Tidal Carbon Dioxide monitoring (ETCO2) Oridion Microstream Technology: $4,995 Order required Microstream tubing sets separately Interpretative 12- Lead ECG: $8,450 • 12-Lead one step ECG cable- includes 4- Lead limb lead cable and removable precordial 6- Lead set 3 8 0 0 0 - 0 5 8 0 - 0 1 Six hour rechargeable Smart battery qq 88 $495.00 $371.25 $32,670.00 * 4 REUSE- 0 9 - 2 MQ Cuff, Child, 2-Tube, Twist lock connector qq 55 $52.50 $39.38 $2,165.90 * 5 REUSE- 1 2 - 2 MQ Cuff, Lg Adult, 2-Tube, Twist lock connector qq 55 $52.50 $39.38 $2,165.90 * To the extent that ZOLL and Customer, or Customer’s Representative have negotiated and executed overriding terms and conditions (“Overriding T’s & C’s”), those terms and conditions would apply to this Diego Mauri this quotation. In all other cases, this quote is made subject to ZOLL’s Standard Commercial Terms and Conditions (“ZOLL T’s & C’s”) which for capital equipment, accessories and consumables can be found at http://www.zoll.com/GTC and for software products can be found at http://www.zoll.com/SSTC. Except in the case of overriding T’s and C’s, any Purchase Order (“PO”) issued in response to this quotation will be deemed to incorporate ZOLL T’s & C’s, and any other terms and conditions presented shall have no force or effect except to the extent agreed in writing by ZOLL.Territory Manager 404-886-80791. DELIVERY WILL BE MADE 90-120 DAYS AFTER RECEIPT OF ACCEPTED PURCHASE ORDER. 2. PRICES QUOTED ARE VALID UNTIL DECEMBER 31, 2018. 3. APPLICABLE TAX 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 978-421-0015 OR EMAIL TO ESALES@ZOLL.COM. 6. ALL DISCOUNTS OFF LIST PRICE ARE CONTINGENT UPON PAYMENT WITHIN AGREED UPON TERMS. 7. PLACE YOUR ACCESSORY ORDERS ONLINE BY VISITING www.zollwebstore.com. Page 4 of 6 16.E.4.e Packet Pg. 2468 Attachment: Collier County EMS285935Version 2 (7349 : Zoll Monitor Purchase) Attn: (239) 252-3763Tel: Noemi Garcia TO: Shipping PointFOB: Net 45 DaysTERMS: DATE: QUOTATION (978) 421-0015 Customer Support (800) 348-9011 (978) 421-9655 Main Chelmsford, Massachusetts 01824-4105 269 Mill Rd Worldwide HeadQuarters ZOLL Medical Corporation DESCRIPTION QTY.UNIT PRICE DISC PRICE TOTAL PRICE email:noemi.garcia@colliercountyfl.gov Free FreightFREIGHT: 8075 Lely Cultural Parkway, Suite #267 Naples, FL 34113 ITEM MODEL NUMBER 285935 V:2 Collier County EMS October 17, 2018 FEDERAL ID#: 04-2711626 6 8 3 0 0 - 0 5 0 0 - 0 1 SurePower 4 Bay Charging System including 4 Battery Charging adaptersqq 14 $2,583.00 $1,937.25 $27,121.50 * 7 8 2 0 0 - 0 0 0 1 0 0 - 0 1 Single Bay Charger for the SurePower and SurePower II batteries. qq 32 $945.00 $708.75 $22,680.00 * 8 8 9 0 0 - 0 4 0 0 CPR stat•padz HVP Multi-Function CPR Electrodes - 8 pair/caseqq 38 $560.00 $420.00 $15,960.00 * 9 8 9 0 0 - 2 0 6 5 pedi•padz Pediatric Liquid Gel Multi-Function Electrodes - 6 pair/caseqq 12 $249.00 $186.75 $2,241.00 * 10 8 0 0 0 - 0 0 0 9 1 0 - 0 1 X Series 80mm Thermal Paper with Grid (pack of 6 rolls)qq 50 $24.00 $18.00 $900.00 * 11 8 7 7 8 - 0 1 1 7 4 Year, 1 Preventative Maintenace (at time of equipment sale)qq 55 $920.00 $920.00 $50,600.00 12 8 7 7 8 - 0 1 0 7 4 Year Extended Warranty At Time of Equipment Sale ( Depot). qq 55 $3,550.00 $3,550.00 $195,250.00 13 7 8 0 0 - 0 4 1 2 LifePak 15 Biphasic w/Pacing, 12 lead + 3 parameters or more Trade-In qq 50 ($8,000.00)($400,000.00)** To the extent that ZOLL and Customer, or Customer’s Representative have negotiated and executed overriding terms and conditions (“Overriding T’s & C’s”), those terms and conditions would apply to this Diego Mauri this quotation. In all other cases, this quote is made subject to ZOLL’s Standard Commercial Terms and Conditions (“ZOLL T’s & C’s”) which for capital equipment, accessories and consumables can be found at http://www.zoll.com/GTC and for software products can be found at http://www.zoll.com/SSTC. Except in the case of overriding T’s and C’s, any Purchase Order (“PO”) issued in response to this quotation will be deemed to incorporate ZOLL T’s & C’s, and any other terms and conditions presented shall have no force or effect except to the extent agreed in writing by ZOLL.Territory Manager 404-886-80791. DELIVERY WILL BE MADE 90-120 DAYS AFTER RECEIPT OF ACCEPTED PURCHASE ORDER. 2. PRICES QUOTED ARE VALID UNTIL DECEMBER 31, 2018. 3. APPLICABLE TAX 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 978-421-0015 OR EMAIL TO ESALES@ZOLL.COM. 6. ALL DISCOUNTS OFF LIST PRICE ARE CONTINGENT UPON PAYMENT WITHIN AGREED UPON TERMS. 7. PLACE YOUR ACCESSORY ORDERS ONLINE BY VISITING www.zollwebstore.com. Page 5 of 6 16.E.4.e Packet Pg. 2469 Attachment: Collier County EMS285935Version 2 (7349 : Zoll Monitor Purchase) Attn: (239) 252-3763Tel: Noemi Garcia TO: Shipping PointFOB: Net 45 DaysTERMS: DATE: QUOTATION (978) 421-0015 Customer Support (800) 348-9011 (978) 421-9655 Main Chelmsford, Massachusetts 01824-4105 269 Mill Rd Worldwide HeadQuarters ZOLL Medical Corporation DESCRIPTION QTY.UNIT PRICE DISC PRICE TOTAL PRICE email:noemi.garcia@colliercountyfl.gov Free FreightFREIGHT: 8075 Lely Cultural Parkway, Suite #267 Naples, FL 34113 ITEM MODEL NUMBER 285935 V:2 Collier County EMS October 17, 2018 FEDERAL ID#: 04-2711626 **Trade value guaranteed only through December 31, 2018. **Trade-In Value valid if all equipment purchased is in good operational and cosmetic condition, and includes all standard accessories. Customer assumes responsibility for shipping trade-in equipment to ZOLL Chelmsford within 60 days of receipt of new equipment. Customer agrees to pay cash value for trade-in equipment not shipped to ZOLL on a timely basis. *This pricing is contingent upon customer signing Volusia County Contract. Per Volusia Contract, ZOLL is to pay for the return of the trade in's. To the extent that ZOLL and Customer, or Customer’s Representative have negotiated and executed overriding terms and conditions (“Overriding T’s & C’s”), those terms and conditions would apply to this $1,450,956.55 TOTAL Diego Mauri this quotation. In all other cases, this quote is made subject to ZOLL’s Standard Commercial Terms and Conditions (“ZOLL T’s & C’s”) which for capital equipment, accessories and consumables can be found at http://www.zoll.com/GTC and for software products can be found at http://www.zoll.com/SSTC. Except in the case of overriding T’s and C’s, any Purchase Order (“PO”) issued in response to this quotation will be deemed to incorporate ZOLL T’s & C’s, and any other terms and conditions presented shall have no force or effect except to the extent agreed in writing by ZOLL.Territory Manager 404-886-80791. DELIVERY WILL BE MADE 90-120 DAYS AFTER RECEIPT OF ACCEPTED PURCHASE ORDER. 2. PRICES QUOTED ARE VALID UNTIL DECEMBER 31, 2018. 3. APPLICABLE TAX 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 978-421-0015 OR EMAIL TO ESALES@ZOLL.COM. 6. ALL DISCOUNTS OFF LIST PRICE ARE CONTINGENT UPON PAYMENT WITHIN AGREED UPON TERMS. 7. PLACE YOUR ACCESSORY ORDERS ONLINE BY VISITING www.zollwebstore.com. Page 6 of 6 16.E.4.e Packet Pg. 2470 Attachment: Collier County EMS285935Version 2 (7349 : Zoll Monitor Purchase) File Number: 4061 Page 1 of 2 Budget 4-4 Date: 09/08/2016 AGENDA ITEM Item: 34 [] Ordinance [] Resolution [] Budget Resolution [X] Other Department: Public Protection Division: Emergency Medical Services Subject: Contract for cardiac monitors and cardiac monitor preventative maintenance, RFP 16- P-64AK. Terry Boczkus Proxy for Terry Sanders Director Public Protection Department Approval Jeaniene Jennings Director Purchasing Approved in Accordance with Purchasing Policies and Procedures John Robert Zaragoza Director Emergency Medical Services Division Approval Tammy Bong Director Management and Budget Approved as to Budget Requirements Legal Michael G.Moore Approved as to Form and Legality County Manager’s Office Donna de Peyster Deputy County Manager Council Action: Modification: Fund Number(s):Description:Amount: 002 Emergency Medical Services 002-555-1000-6430-Other Equipment $1,560,000.00 140 Fire Services 140-540-8000-6430 -Other Equipment $864,000.00 002 Emergency Medical Services 002-555-1000-4760-Maint.-Other Equipment (fiscal year 2018) $72,410.00 140 Fire Services 140-540-8000-4670 -Maint -Other Equipment (fiscal year 2018) $40,382.00 Total Item Budget: $2,536,792.00 Staff Contact(s):Phone:Ext. Terry Sanders 386 740 5120 16620 John Zaragoza 386 236 3510 26653 Jeff B Smith 386 736 5940 12479 Summary/Highlights: The county solicited proposals for cardiac monitors and cardiac monitor preventative maintenance. The county received two proposals as shown on the attached tabulation sheet. An evaluation committee comprised of John Gamble, operations manager, public works; Dona D. Butler, director, community services; Laura Bounds, sheriff's office program manager; Rhonda Orr, director, business services; and Terry Sanders, director, public protection, reviewed the responses. The committee recommends award to Zoll Medical Corporation, Chelmsford, Mass. A proposed contract, including exhibits, is attached. The county will issue a purchase order for the cardiac monitors. For the cardiac monitor Approved as recommended. File Number: 4061 Page 2 of 2 Budget 4-4 preventative maintenance, staff is requesting approval to issue a master agreement for three years with two one-year renewals (contingent upon county council approval). The cost of the cardiac monitors is approximately $2,424,000 and estimated annual cost of the preventative maintenance is $112,792. Recommended Motion: Approval. 16-P-64AK, Cardiac Monitors Page 1 of 53 REQUEST FOR PROPOSAL FOR Cardiac Monitors RFP NO. 16-P-64AK Closing Date: March 22, 2016 DO NOT RESPOND TO THIS SOLICITATION ON LINE SEE SECTION 1.3.4, DELIVERY OF PROPOSALS Purpose of RFP The purpose of this Request for Proposal (RFP) is to solicit competitive sealed proposals for Cardiac Monitors for the County of Volusia, Florida. 16-P-64AK, Cardiac Monitors Page 2 of 53 TABLE OF CONTENTS 1.0 PURPOSE & OVERVIEW................................................................................................. 4 2.0 SCOPE OF SERVICES ...................................................................................................... 4 2.1 Specifications ................................................................................................................. 4 2.2 Pricing ............................................................................................................................ 5 2.3 Delivery .......................................................................................................................... 6 2.4 Service Agreement ......................................................................................................... 6 2.5 Preventative Maintenance .............................................................................................. 6 2.6 Warranty ......................................................................................................................... 7 2.7 Acceptance Criteria ........................................................................................................ 7 2.8 Functional Testing .......................................................................................................... 7 3.0 GENERAL TERMS & CONDITIONS .............................................................................. 8 3.1 Definitions ...................................................................................................................... 8 3.2 RFP Closing Date ........................................................................................................... 9 3.3 Proposed Schedule ......................................................................................................... 9 3.4 Delivery of Proposals ..................................................................................................... 9 3.5 Pre-proposal Conference .............................................................................................. 10 3.6 Public RFP Opening ..................................................................................................... 10 3.7 Public Records .............................................................................................................. 11 3.8 Proposal Form .............................................................................................................. 12 3.9 Questions, Exceptions, and Addenda Concerning RFP 16-P-64AK............................ 13 3.10 Award ........................................................................................................................... 13 3.11 Other Agencies ............................................................................................................. 14 3.12 F.O.B. Point .................................................................................................................. 14 3.13 Use of County Logo ..................................................................................................... 14 3.14 Assignment ................................................................................................................... 14 3.15 Contract ........................................................................................................................ 15 3.16 Disclosure of Proposal Content .................................................................................... 15 3.17 Respondent's Responsibility ......................................................................................... 16 3.18 Payment Terms ............................................................................................................. 16 3.19 Conflict of Interest Form .............................................................................................. 17 3.20 Licenses and Certificates .............................................................................................. 17 3.21 Minor Irregularities ...................................................................................................... 17 3.22 Venue and Governing Law ........................................................................................... 17 3.23 Insurance ...................................................................................................................... 18 3.24 Award Term ................................................................................................................. 23 3.25 Price Redeterminations ................................................................................................. 24 3.26 Unusual Costs ............................................................................................................... 26 3.27 Waiver of Claims .......................................................................................................... 27 3.28 Evaluation Criteria ....................................................................................................... 27 3.29 Termination .................................................................................................................. 28 3.30 Incurred Expenses ........................................................................................................ 30 3.31 Post-Proposal Discussions with Respondents .............................................................. 30 3.32 Presentations by Respondents ...................................................................................... 30 16-P-64AK, Cardiac Monitors Page 3 of 53 3.33 Minimum Specifications .............................................................................................. 31 3.34 Compliance with Laws and Regulations ...................................................................... 31 3.35 Limitation of Liability and Indemnification of County ................................................ 31 3.36 Records & Right to Audit ............................................................................................. 32 3.37 Change in Scope of Services/Work .............................................................................. 32 3.38 Modifications Due to Public Welfare or Change in Law ............................................. 33 3.39 Safety ............................................................................................................................ 33 3.40 Right to Require Performance ...................................................................................... 33 3.41 Force Majeure ............................................................................................................... 34 3.42 Contractor’s Personnel ................................................................................................. 34 3.43 Disadvantaged Business Enterprise Program ............................................................... 35 3.44 Claim Notice ................................................................................................................. 36 3.45 County/Contractor Relationship ................................................................................... 36 3.46 New Material ................................................................................................................ 36 3.47 Damages ....................................................................................................................... 37 3.48 Proposal Acceptance/Rejection .................................................................................... 37 3.49 Proposal Acceptance Period ......................................................................................... 37 4.0 SUBMITTAL REQUIREMENTS .................................................................................... 37 5.0 PROPOSAL FORM .......................................................................................................... 42 6.0 REFERENCES ................................................................................................................. 45 7.0 NOTIFICATION REGARDING PUBLIC ENTITY CRIME & DISCRIMINATORY VENDOR LIST REQUIREMENTS & DISQUALIFICATION PROVISION ................ 46 8.0 PROOF OF EXEMPTION ............................................................................................... 47 9.0 HOLD HARMLESS AGREEMENT ............................................................................... 48 10.0 CONFLICT OF INTEREST FORM ................................................................................. 50 11.0 DRUG-FREE WORK PLACE ......................................................................................... 51 12.0 CERTIFICATION REGARDING DEBARMENT (PRIME) .......................................... 52 13.0 CERTIFICATION REGARDING DEBARMENT (SUB) .............................................. 53 16-P-64AK, Cardiac Monitors Page 4 of 53 RFP 16-P-64AK Cardiac Monitors 1.0 PURPOSE & OVERVIEW The purpose of this Request for Proposals (RFP) is to solicit competitive sealed proposals for a contract for the purchase of cardiac monitor/defibrillators for the Emergency Medical Services (EMS) and the Volusia County Fire Rescue (VCFR) Divisions. As part of this RFP, the Department of Public Protection will be trading in existing cardiac monitors/defibrillators, chargers, and batteries. The EMS Division is seeking to purchase up to 52 Cardiac Monitors/Defibrillators and the Fire Rescue Division is seeking to purchase up to 27 Cardiac Monitors/Defibrillators. This is an estimate only and in no way represents a guarantee of future expenditures. 2.0 SCOPE OF SERVICES 2.1 Specifications A. The cardiac monitor/defibrillators shall, at a minimum, have the ability to perform the following functions: 1. Monitor, print, and visually display 4-lead EKG rhythms; 2. Monitor and print 12-lead EKG rhythms; 3. Monitor and visually display continuous, real-time peripheral capillary oxygen saturation (SpO2); 4. Monitor and visually display continuous, real-time end tidal carbon dioxide readings (ETCO2); 5. Monitor and display carbon monoxide (SpCO) readings; 6. Perform Non-Invasive Blood Pressure Monitoring (NIBP): 7. Perform synchronized cardioversion based on current American Heart Association recommendations; 8. Perform unsynchronized defibrillation based on current American Heart Association recommendations; 9. Perform Transcutaneous Pacing (TCP); 16-P-64AK, Cardiac Monitors Page 5 of 53 10. Transmit electrocardiograms (EKG) directly from the cardiac monitor to a receiving hospital with the use of a wireless card (i.e. from a remote location away from response vehicle) and via a secured Wi-fi network (when in range of response vehicle’s wireless network); 11. Upload complete full-disclosure case reports to an electronic patient care report (ePCR) solution (current solutions in use by Volusia County are Zoll ePCR and FireHouse). Respondent shall provide a list of all ePCR solutions that can facilitate a direct upload with their product; and, 12. Ability to upload complete full-disclosure case reports to a repository (client based and/or cloud based) to ensure all patient reports are stored; B. The cardiac monitor/defibrillators shall be approved for use by the Food and Drug Administration (FDA) in a pre-hospital setting; C. The end-user shall be able to view the entire case report after upload and it shall have the ability to be viewed in real-time. This ability can be either built into the ePCR or can be a standalone product that can be installed on the ePCR tablet; D. The cardiac monitor shall have the ability to be secured to the stretcher for continuous patient monitoring while moving the patient from one location to another on the stretcher. The Contractor shall provide assurance that the cardiac monitor can be secured to a FERNO™ brand stretcher for patient movement; E. The cardiac monitor shall have the ability to be secured inside the patient compartment of a transport vehicle in accordance to National Fire Protection Association standards. 2.2 Pricing Respondent shall complete and submit Attachment A – Pricing. Please complete all five (5) tabs of Attachment A. It is the intent of the County of Volusia to issue a purchase order for the initial purchase of the cardiac monitors/defibrillators and associated accessories. A master agreement will be issued for the purchase of accessories and components and ongoing maintenance. The master agreement will be issued for three years with the option for two one-year renewals. A. Respondent shall provide the County with pricing (or a percentage discount off of list pricing) on accessories that are not covered under the preventative maintenance plan. 1. Limb Lead Cables 2. 12-Lead Cables 3. SpO2/SpCO sensors/probes/cables (both pediatric and adult) 4. NIBP hoses 5. NIBP cuffs 6. Replacement carrying cases 16-P-64AK, Cardiac Monitors Page 6 of 53 7. Factory Direct replacement batteries. 2.3 Delivery A. Respondent shall include the estimated time frame for delivery of the cardiac monitors/defibrillators. All cardiac monitors/defibrillators shall be delivered at the same time and the price shall include all freight and delivery charges. The units shall be shipped to Volusia County Emergency Medical Services facility, 112 Carswell Avenue, Holly Hill, Florida 32117. B. The intent of the County is to trade-in the current cardiac monitor/defibrillators at the conclusion of the training and installation of mounts/brackets/chargers. Respondent shall provide information on how they want the trade in equipment returned and all shipping/freight charges for the returned equipment is the responsibility of the Respondent. Please see Attachment A – Pricing (tab labeled Trade-In Value) for an estimated number of units available for trade-in. This is an estimate only and in no way represents a guarantee of units available for trade- in. 2.4 Service Agreement A. The Contractor shall provide an on-going non-warranty service agreement to include training for field personnel for initial deployment and provide any additional updates that are required of the manufacturer. Details of this service agreement shall be included with each proposal. There shall be no additional charge to the County for this service agreement. B. Respondent shall provide the length of training recommended by the manufacturer as well as a timeline of when the training will be performed. Respondent shall provide an overview of training for the end-user as well as an overview of training for administrative personnel (approximately 300 end users and 50 administrative staff). C. Respondent shall note the maximum number of days they will provide roll-out specialists to help get field staff trained for the new equipment. The County and Contractor will agree on a training schedule based on the proposed number of days. 2.5 Preventative Maintenance A. Respondent shall include their recommended maintenance plan for the cardiac monitor/defibrillators listing all correlating costs the County will be charged for this service. This plan shall include the cost of expedited loaner equipment, weekly on- site repair visits, bi-annual (two (2) times per year) preventative maintenance/quality assurance checks, and replacement parts/accessories. The maintenance plan shall be comprehensive in nature. 16-P-64AK, Cardiac Monitors Page 7 of 53 B. It is preferred that battery replacement is part of the maintenance plan and the Contractor shall specify if that is included in the plan. If battery replacements are part of the maintenance plan please specify the frequency of battery replacement. C. All repairs and preventative maintenance shall be performed at one of the following locations (subject to change in the future): 1. Volusia County Emergency Medical Services facility located at 112 Carswell Avenue, Holly Hill, Florida. 2. Volusia County Fire Rescue Logistics facility located at 1970 South Volusia Avenue, Orange City, Florida 2.6 Warranty A. The warranty shall be the manufacturer’s standard warranty. All warranty work shall be performed at one of the locations listed in §2.5(C) above. B. Warranty shall include, at a minimum: 1. One (1) year parts and labor warranty against manufacturing defects affecting the performance of the unit, to include transport of affected unit(s); 2. Two (2) year components warranty against manufacturer defects affecting the performance of the components. 2.7 Acceptance Criteria Respondent shall be required to demonstrate the cardiac monitor and its features for verification of functional requirements as defined in the scope of work. The County’s role will be to provide the necessary personnel to support the demonstration and ensure availability of external systems.. The County will confirm that each Proposer utilizes mutually agreed upon test scenarios and test data in the demonstration. The demonstration shall be considered complete when the Proposer has demonstrated, and the County has confirmed, the functionality of all requirements have been met and the County’s project manager has accepted the corrective action plan for any outstanding defects or errors. Demonstrations shall be scheduled after the closing of this RFP. 2.8 Functional Testing A. Upon the County’s approval of the Proposer’s functional demonstration, the County will be provided sufficient time to conduct additional testing of the product using varying test scenarios and to identify any undiscovered discrepancies with regard to the requirements in the scope of work. The amount of time provided for the period of functional testing shall be up to three (3) consecutive days so a sufficient number of field staff can testing the equipment in a non-clinical setting. 16-P-64AK, Cardiac Monitors Page 8 of 53 B. Part of the testing will include the use of the product in a transport vehicle. The product will be required to perform and transmit 12-lead EKG’s to area hospitals and be able to obtain vital signs and continuous monitoring of 4-lead rhythms over different road conditions that are representative of all parts of Volusia County (i.e. paved roads and dirt roads). C. Respondent shall have a representative on site for functional testing to assist with troubleshooting and provide an overview of the product to the end-users prior to testing. The timing of the functional testing will be mutually agreed upon by the Proposer and the County and shall take place at the Volusia County Fire Rescue Training Center located at 3889 Tiger Bay Road, Daytona Beach, Florida. The functional testing shall be complete after the mutually agreed upon amount of time has elapsed and the County’s project manager has accepted the corrective action plan for any outstanding defects or errors. 3.0 GENERAL TERMS & CONDITIONS 3.1 Definitions As used in this RFP, the following terms shall have the meanings set forth below: Contract: The document resulting from this solicitation between the County and the awarded Respondent, including this RFP, and the awarded Respondent’s response along with any written addenda and other written documents, which are expressly incorporated by reference. Contractor: That person or entity duly authorized, upon award of a contract, to have a Contract with the County to provide the product and/or services set forth herein and incurring liability for the same. Contract Administrator: The. Director of Purchasing and Contracts or designee shall serve as Contract Administrator. The Contract Administrator shall be responsible for addressing any concerns within the scope of the Contract. Any changes to the resulting Contract shall be done in writing and authorized by the Director of Purchasing and Contracts. County: The word County refers to the County of Volusia, Florida. County’s Project Manager(s): The Project Manager(s) have responsibility for the day to day administration of the resulting Contract for the County and will be designated prior to award of Contract. Day: The word “day” means each calendar day or accumulation of calendar days. Director: The Director is the Director of Purchasing and Contracts for the County of Volusia. 16-P-64AK, Cardiac Monitors Page 9 of 53 Person or Persons: An individual, firm, partnership, corporation, association, executor, administrator, trustee or other legal entity, whether singular or plural, masculine or feminine, as the context may require. Proposal: The document submitted by the Consultant in response to a formal solicitation used to determine if the Consultant is highly qualified. Protest: See process at www.volusia.org/purchasing. Respondent: One who submits a response to a request for proposal (RFP). Respondent’s Project Manager: The Project Manager has responsibility for administering this Contract for the Respondent and will be designated prior to execution of the Contract. 3.2 RFP Closing Date Proposals (also referred to herein as “Submittals,” “Offers,” or “Responses”) must be received by the Volusia County Purchasing and Contracts Office, Room 302, Third Floor, 123 West Indiana Avenue, DeLand, FL, 32720-4608, no later than 3:00 p.m., local time, on Tuesday, March 22, 2016. Proposals received after this time will not be considered. 3.3 Proposed Schedule February 16, 2016 ............Release date for Request for Proposal March 1, 2016 ..................Pre-proposal Conference March 8, 2016 ..................Final date to receive written questions March 15, 2016 ................Release date for answers to written questions March 22, 2016 ................Closing Date 3.4 Delivery of Proposals DO NOT RESPOND TO THIS SOLICITATION ON LINE All proposals shall be sealed and delivered or mailed to (faxes/e-mails will not be accepted): County of Volusia, Florida Purchasing and Contracts Office, Room 302 123 West Indiana Avenue, 3rd floor DeLand, Florida 32720-4608 Mark package(s) “RFP # 16-P-64AK” Note: Please ensure that if a third party carrier (Federal Express, UPS, USPS, etc.) is used, that they are properly instructed to deliver your proposal only to Room 302, in the 16-P-64AK, Cardiac Monitors Page 10 of 53 Purchasing Office on the third (3rd) floor at the above address. To be considered, a proposal must be received and accepted in the Purchasing and Contracts Office before the RFP Closing Date and Time. 3.5 Pre-proposal Conference A. A pre-proposal conference will be held in the Purchasing Conference Room at 123 W. Indiana Avenue, Room 300, DeLand, FL, at 1:30 p.m., EST, on Tuesday, March 1, 2016. While this is not mandatory, all interested parties are encouraged to attend and participate. B. In accordance with the American Disabilities Act and Section 286.26, Florida Statutes, persons with disabilities needing a special accommodation to participate in the proceedings, or an interpreter to participate in any proceedings, should contact the County’s ADA Coordinator at 386-248-1760 for assistance, at least two (2) business days before any meeting date. Assisted listening system receivers are available for the hearing impaired, and can be obtained from the Deputy Clerk by contacting the County’s ADA Coordinator at 386-248-1760. Read the full ADA Notice under The American with Disabilities Act (Title II), at www.volusia.org/core/fileparse.php/4175/urlt/ADANotice.pdf. Read the County of Volusia Grievance Procedure under The Americans with Disabilities Act (Title II). 3.6 Public RFP Opening A. Pursuant to Section 119.071, Florida Statutes, Bids or proposals (“responses”) and the completed tabulation are exempt from disclosure as a public record until such time as the agency provides notice of an intended decision or until thirty (30) days after opening the Bids, proposals or final replies, whichever is earlier. Names only of firms submitting proposals will be read aloud at the RFP opening. Contact the Purchasing and Contracts Office during regular business hours to inspect responses and the completed tabulation or, to inspect the completed tabulation, go to www.volusia.org/purchasing. The foregoing notwithstanding, if, prior to the County’s making responses available for inspection, the County rejects all responses and concurrently provides notice of the County’s intent to reissue the solicitation, then the County may avail itself of the exemption for rejected responses set forth in Section 119.071, Florida Statutes, to the extent such exemption may apply. B. In accordance with the American Disabilities Act and Section 286.26, Florida Statutes, persons with disabilities needing a special accommodation to participate in the proceedings, or an interpreter to participate in any proceedings, should contact the County’s ADA Coordinator at 386-248-1760 for assistance, at least two (2) business days before any meeting date. 16-P-64AK, Cardiac Monitors Page 11 of 53 Assisted listening system receivers are available for the hearing impaired, and can be obtained from the Deputy Clerk by contacting the County’s ADA Coordinator at 386-248-1760. Read the full ADA Notice under The American with Disabilities Act (Title II), at www.volusia.org/core/fileparse.php/4175/urlt/ADANotice.pdf. Read the County of Volusia Grievance Procedure under The Americans with Disabilities Act (Title II). 3.7 Public Records Public Records - § 119.0701, Florida Statutes. Contractor acknowledges that the services and work to be performed pursuant to this Contract may be performed by the County itself as a political subdivision of the State of Florida, which is subject to the public records requirements of Chapter 119, Florida Statutes and Article I, § 24 of the Florida Constitution. Given the foregoing, the Contractor hereby agrees to: A. Keep and maintain public records that ordinarily and necessarily would be required by the County to perform the services and work provided pursuant to this Contract; B. Provide the public with access to public records on the same terms and conditions that the County would provide the records and at a cost that does not exceed the cost provided in Chapter 119, Florida Statutes, or as otherwise may be provided by law; C. Ensure that public records that are statutorily exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law; D. Meet all requirements for retaining public records and transfer, at no cost, to the County all public records in the possession of the Contractor upon termination of the Contract and destroy any duplicate public records that are statutorily exempt or confidential and exempt from statutory public records disclosure requirements. For the purposes of complying with this paragraph, all records stored electronically must be provided to the County in a format that is compatible with the information technology systems of the public agency; E. In responding to any public records request, Contractor shall (i) notify the County of the request and the Contractor’s intentions with regard to such request and (ii) provide the County with copies of all records requested and produced, as well as copies of all correspondence between the Contractor and the requestor. Contractor further agrees not to release any records that are statutorily exempt from disclosure or statutorily confidential and exempt without first receiving prior written authorization from the County, it being understood that the legislature has 16-P-64AK, Cardiac Monitors Page 12 of 53 designated such records exempt or otherwise confidential based upon important public policy or safety reasons. Contractor shall indemnify the County for and hold the County harmless against any and all claims, damage awards, and causes of action arising from the Contractor’s failure to perform or otherwise adhere to the requirements of this Section 3.7, including, but not limited to, any third party claims or awards for attorneys fees and costs arising therefrom, claims for negligent disclosure of confidential or exempt records, and claims for failure to produce or otherwise timely produce records subject to disclosure. County shall further be authorized to seek declaratory, injunctive, or other appropriate relief from a court of competent jurisdiction on an expedited basis to enforce the requirements of this Section 3.7, it being understood that the maintenance and production of public records is of paramount public importance under Florida law. Regardless of the foregoing, the enumeration of the remedies recited herein shall not be interpreted to limit or otherwise restrict the County from seeking any other appropriate cause of action against or remedy from the Contractor, whether in law or in equity, in the County’s enforcement of the requirements of this Section 3.7. 3.8 Proposal Form A. See Submittal Requirements for complete details B. Each Respondent shall submit twelve (12) complete sets of the RFP Submittal: • One (1) hard copy marked “ORIGINAL” • Ten (10) hard copies marked “COPY” Note: It is not necessary to return every page of the original solicitation document with the hard copies of the RFP Submittal ORIGINAL and COPY(ies); return only the pages that require signatures or information as detailed in Section 4.0. • One (1) COMPLETE electronic copy on a CD or USB drive in PDF format (Excel spreadsheets shall not be recorded in PDF). The electronic copy of the RFP Submittal shall include ALL submittal requirements, as detailed in Section 4.0. Note the solicitation number and name of company on the CD or USB drive. Do not send confidential information, proprietary information, or trade secrets. C. Terms and conditions differing from those in this RFP may be cause for disqualification of the RFP Proposal. D. The Proposal Form (Section 4.0) shall be signed by an authorized agent of the firm with documentation, such as a Memorandum of Authority, that the individual is authorized to commit the firm to a contract. E. Failure to provide the required information may result in the proposal not being considered. Submittals shall be clear, concise, indexed by subject, typed on letter size paper, and individually bound. Submittals shall be mailed or delivered in a 16-P-64AK, Cardiac Monitors Page 13 of 53 sealed package clearly marked on the outside with the project name, invitation number, and due date. Packages shall be received in the Volusia County Purchasing Office by the advertised deadline. 3.9 Questions, Exceptions, and Addenda Concerning RFP 16-P-64AK A. It is incumbent upon each Respondent to carefully examine this solicitation’s specifications, scope of work/service, terms, and conditions. Questions and exceptions concerning any Section of this RFP shall be directed by letter, facsimile transmission, or e-mail to the Procurement Analyst named in item B (below), who shall be the official point of contact for this RFP. Questions and exceptions shall be submitted no later than fourteen (14) days before the closing date. Thereafter, no further questions or exceptions will be accepted or reviewed by the County and Respondents’ right to submit questions or exceptions will terminate and any questions or exceptions not previously made shall be deemed waived. The issuance of a written addendum is the only official method by which interpretation, clarification, or additional information can be given and oral representations will not be binding on the County. B. Mark cover page or envelope(s) “Questions, Exceptions and Addenda Concerning RFP # 16-P-64AK, “Cardiac Monitors.” Submit questions to: Andrew G. Kokitus, Procurement Analyst Telephone:..................386-943-7009 Fax: ............................386-740-5158 E-mail:........................akokitus@volusia.org C. If it becomes necessary for the County to revise any part of this RFP, an addendum will be posted on the County’s web site. It is each Respondent’s responsibility to check the Volusia County web site for any addenda at www.volusia.org/bidlist. Each Respondent should ensure that they have received all addenda to this RFP before submitting their proposal. In their proposals, Respondents must provide proof of receipt of each addendum by signing each addendum and returning each addendum to the County. Failure to provide this proof may cause Respondent’s proposal to be rendered non-responsive. D. Each addendum issued by the County shall become a material part of this solicitation and the resulting Contract. 3.10 Award The County reserves the right to award the Contract to the Respondent(s) that the County deems to offer the best overall proposal or solution, as defined in Section 3.28, Evaluation Criteria in this solicitation. The County is therefore not bound to accept a proposal based only on lowest price. In addition, the County has the sole discretion and reserves the right to cancel this RFP, to reject any/all proposals, to waive any/all 16-P-64AK, Cardiac Monitors Page 14 of 53 informalities and/or irregularities, or to re-advertise with either the identical or revised specifications if it is deemed to be in the best interest of the County to do so. Nothing prohibits the County from rejecting and re-soliciting when responses exceed budget and the County must change the solicitation to lower costs. The County also reserves the right to make multiple awards based on experience and/or qualifications of Respondents and to award only a portion of the items and/or services specified, if deemed to be in the County’s best interest. 3.11 Other Agencies A. All Respondents awarded Contracts from this solicitation may, upon mutual agreement, permit any municipality or other governmental agency to participate in the Contract under the same prices, terms, and conditions. B. It is understood that at no time will any city or municipality or other agency be obligated for placing an order for any other city, municipality, or agency, nor will any city, municipality, or agency be obligated for any bills incurred by any other city, municipality, or agency. Further it is understood that each agency will issue its own purchase order to the awarded Respondent(s). 3.12 F.O.B. Point The F.O.B. points for the Contract and for all purchases made under it shall be as specified by the using department (in accordance with the RFP proposal form), in Volusia County, Florida. Delivery will not be complete until the using department has accepted each item. Delivery to a common carrier shall not constitute delivery to the ordering agency. All disputes shall be between the Seller/Respondent and the carrier. 3.13 Use of County Logo The County owns and retains all proprietary rights in its logos, trademarks, trade names, and copyrighted images (Intellectual Property). As such, nothing in this solicitation permits or shall be construed as authorizing Respondent to use or display County's Intellectual Property on Respondents submittal documents or proposal (including any exhibits attached thereto) submitted to County by or on behalf of Respondent in response to this solicitation. The County has the right to redact the County Logo displayed on any proposal submitted. 3.14 Assignment Contractor may not assign or otherwise convey Contractor’s rights and/or obligations under this Contract without obtaining County’s prior written consent, which consent County may withhold, limit and/or condition in County’s sole discretion, including, but not limited to posting a performance bond. Any consent by the County under this Section 0 shall be by written amendment to the Contract in a form and substance specified by the County in its sole discretion. If Contractor desires to assign or otherwise convey its rights and/or obligations under this Contract, Contractor no less than thirty (30) days 16-P-64AK, Cardiac Monitors Page 15 of 53 prior to the assignment’s proposed effective date, provide County with a written request for County’s consent. Failure to provide such notice may result in the County assessing a processing fee of Five Hundred Dollars (US $500.00). Failure by the Contractor to obtain the County’s consent in accordance with this Section prior to assignment or other conveyance shall: 1) constitute a material breach of the Contract; and 2) entitle the County to retain any and all legal rights, claims and defense to enforce this Section 0, including, but not limited to, injunctive, declaratory, damages and attorney’s fees and costs. Payment of any sum by the County in accordance with the Contract to the Contractor or any person or entity prior to the Contractor obtaining the County’s consent to the assignment shall not constitute a waiver of the rights of the County under this Section 0. Nothing herein shall preclude the right of the County to waive its rights under this Section 0 but no waiver shall be granted by the County without amendment to the Contract. 3.15 Contract A. The contents of this RFP and all provisions of the successful Proposal deemed pertinent by the County may be, at the sole discretion of the County, incorporated into a Contract and become legally binding on the selected proposer. The content of the Contract may contain changes as a result of the RFP process and the content of the submittal received. The Contract shall, at minimum, include the substantive terms and conditions as outlined in the RFP and be subject to review by the County attorney or designee prior to approval and execution for determination of legal form and substantive sufficiency, and may contain those additional terms and conditions that the County deems in its best interest. B. The Director of Purchasing and Contracts, County Manager, and County Chair are the sole Contracting Officers for the County of Volusia, Florida, and only they or their designees are authorized to make changes to any Contract. C. The County shall be responsible for only those orders placed by the County on an authorized signed Purchase Order or Master Agreement. The County shall not be responsible for any order, change substitution or any other discrepancy from the Purchase Order or Master Agreement. If there is any question about the authenticity of a Purchase Order, Master Agreement, or change order, the Respondent should promptly contact the Purchasing Office at 386-736-5935. 3.16 Disclosure of Proposal Content A. All material submitted becomes the property of the County and may be returned only at the County's option. The County has the right to use any or all ideas presented in any reply to this RFP. Selection or rejection of any submittal does not affect this right. 16-P-64AK, Cardiac Monitors Page 16 of 53 B. The County of Volusia, Florida, is governed by the Public Record Law, Chapter 119, FS, (as amended). 3.17 Respondent's Responsibility Respondent, by submitting a proposal, represents that: A. The Respondent has read and understands the RFP in its entirety and that the proposal is made in accordance therewith; B. The Respondent possesses the capabilities, resources, and personnel necessary to provide efficient and successful service to the County; C. Before submitting its proposal, the Respondent has made all investigations and examinations necessary to ascertain site and/or local conditions and requirements affecting the full performance of the Contract and has verified any representations made by the County of Volusia, Florida, upon which the Respondent has relied; D. The Respondent understands and agrees that if the Respondent receives an award, failure to have made such investigations pursuant to Respondent’s proposal to the RFP will in no way relieve the Respondent from its obligations to comply in every detail with all provisions and requirements of the Contract, nor will a plea of ignorance of such conditions and requirements be accepted as a basis for any claim by the Respondent for additional compensation or relief; and E. The Respondent understands and accepts that it will be held responsible for any and all discrepancies, errors, etc., in discounts or rebates which are discovered during the Contract term or up to and including three (3) fiscal years following the County’s annual audit. 3.18 Payment Terms A. The County will remit full payment on all undisputed invoices within forty-five (45) days from receipt by the appropriate person(s) (to be designated at time of Contract) of the invoice(s) or receipt of all products or services ordered. B. Pursuant to Chapter 218, Florida Statutes, the County will pay interest not to exceed one percent (1%) per month on all undisputed invoices not paid within thirty (30) days after the due date. C. The County has the capabilities of Electronic Fund Transfer (EFT). List any discounts for prompt payment and/or willingness to accept Electronic Funds Transfer (EFT) and the discount to be applied to such payments. Vendors offering prompt payment discounts, for example 1% - net 10, the discount shall be taken if the check issue date is within specified time period from date of invoice. D. By submitting a proposal to the County of Volusia, Florida, the Respondents expressly agree that, if awarded a Contract, the County may withhold from any 16-P-64AK, Cardiac Monitors Page 17 of 53 payment monies owed by the Respondent to the County for any legal obligation between the Respondent and the County, including but not limited to real property taxes, personal property taxes, fees, and commissions. 3.19 Conflict of Interest Form All Respondents shall properly complete, have notarized, and include with their submittal the attached form disclosing any potential conflict of interest that the Respondent may have due to ownership, other clients, Contracts, or interests associated with this project. 3.20 Licenses and Certificates A. The County reserves the right to require proof that each Respondent is an established business and is abiding by the ordinances, regulation, and laws of its community and the state of Florida, such as but not limited to: Business Tax Receipts, business licenses, Florida sales tax registration, Federal Employers Identification Number; and B. The Respondent shall be required, upon notification of recommendation of award, to register with the Florida Department of State Division of Corporations at www.sunbiz.org in order to provide services under the resulting Contract. C. If a license is required, the Respondent shall be licensed to perform the required work in accordance with the laws of the State of Florida and local ordinances. Respondents shall also verify that their Subcontractors are licensed to perform the work in accordance with the laws of the State of Florida and local ordinances. D. Each Respondent shall submit with their proposal a copy of, and upon award of Contract, the Contractor shall maintain the appropriate licenses and certificates during the term of the Contract and any extensions. Failure to maintain these requirements shall be cause for immediate termination of the Contract. 3.21 Minor Irregularities The County reserves the right to waive minor irregularities in proposals, providing such action is in the best interest of the County. Minor irregularities are defined as those that have no adverse effect on the County’s best interests, and will not affect the outcome of the selection process by giving any Respondent an advantage or benefit not enjoyed by other Respondents. 3.22 Venue and Governing Law All legal proceedings brought in connection with the Contract executed for the services provided as award under this RFP Contract shall only be brought in a state or federal court located in the State of Florida. Venue in state court shall be in Volusia County, Florida. Venue in federal court shall be in the United States District Court, Middle District of Florida, Orlando division. Each Respondent agrees to submit to the personal 16-P-64AK, Cardiac Monitors Page 18 of 53 jurisdiction of these courts for any lawsuits filed there against Respondent. In the event of a legal proceeding, the action shall be by non-jury trial for the adjudication of such suit. All questions concerning the validity, operation, interpretation, construction and enforcement of any terms, covenants or conditions of this Contract shall in all respects be governed by and determined in accordance with the laws of the State of Florida without giving effect to the choice of law principles thereof and unless otherwise preempted by federal law. 3.23 Insurance A. Required Types of Insurance The Contractor shall purchase and maintain at its own expense, during the term of this Contract the following types and amounts of insurance with limits no less than those shown below, in the form and from companies satisfactory to the County: SCHEDULE LIMITS Workers’ Compensation Florida Statutory Coverage Commercial General Liability ............ $2,000,000. General Aggregate ............................................................. $1,000,000. Personal/Advertising Injury Blanket Contractual Liability .............. $1,000,000. Each Occurrence (The County of Volusia shall be named as an additional insured under all of the above Commercial General Liability coverage.) Auto Liability ...................................... $1,000,000. CSL All autos-owned, hired or no-owned (Symbol 1 Coverage) Excess Liability ................................... $5,000,000. Per Occurrence Professional Liability .......................... $1,000,000. (Project Specific) (Errors & Omissions) Products Liability ................................ $1,000,000. Per Occurrence 1. Minimum underlying coverages shall include Commercial General Liability, Automobile Liability and Workers’ Compensation/Employer’s Liability. (Umbrella liability limit will not be required to be carried by Subcontractors.) 16-P-64AK, Cardiac Monitors Page 19 of 53 (If the services provided require the disposal of any hazardous or non- hazardous materials off the job site, the disposal site operator must furnish a certificate of insurance for Pollution Legal Liability with coverage for bodily injury and property damage for losses that arise from the facility that is accepting the waste under this contract). 2. Umbrella or Excess Liability policies may be used to obtain the total limits of liability required to meet the required limits of coverage stated above. Evidence of such coverage should clearly demonstrate the underlying coverages/policies that are included. 3. Workers’ Compensation Insurance. Per Section 3.23, A, Workers’ Compensation insurance is required for all employees of the Contractor, employed or hired to perform or provide work or services under this Contract or that is in any way connected with work or services performed under this Contract, without exclusion for any class of employee, and shall comply fully with the Florida Workers’ Compensation Law (Chapter 440, Florida Statutes, Workers’ Compensation Insurance) and include Employers’ Liability Insurance with limits no less than the statutory amount shown above per occurrence. a. Contractor and its Subcontractors, or any associated or subsidiary company doing work on County property or under this Contract must be named in the Workers’ Compensation coverage or provide proof of their own Workers’ Compensation coverage, without exclusion of any class of employee, and with a minimum of the statutory limits per occurrence for Employer’s liability coverage. Further, if the Contractor's Subcontractors fail to obtain Workers’ Compensation insurance and a claim is made against the County by the uncovered employee of said Subcontractor of the Contractor, the Contractor shall indemnify, defend, and hold harmless the County from all claims for all costs including attorney’s fees and costs arising under said employee(s) Workers’ Compensation insurance claim(s). 4. Commercial General Liability Insurance. Per Section 3.23, A, Commercial General Liability insurance, with a limit of not less than the amounts shown above with an aggregate limit and per occurrence basis, including coverage for the Contractor’s operations, independent Contractors, Subcontractors and “broad form” property damage coverages protecting itself, its employees, agents, Contractors or subsidiaries, and their employees or agents for claims for damages caused by bodily injury, property damage, or personal or advertising injury, products liability/completed operations including what is commonly known as groups A, B, and C (libel, false arrest, slander). Such policies shall include coverage for claims by any person as a result of actions directly or indirectly related to the employment of such person or entity by the Contractor or by any of its Subcontractors arising from work or services performed under this Contract. Public liability coverage shall include 16-P-64AK, Cardiac Monitors Page 20 of 53 either blanket contractual insurance or a designated Contract contractual liability coverage endorsement, indicating expressly the Contractor’s contract to indemnify, defend and hold harmless the County as provided in this Contract. The commercial general liability policy shall be endorsed to include the County as an additional insured. The commercial general liability policy shall provide exclusive coverage for the location or project site where the work or services are to be performed under this Contract. In the alternative, the commercial general liability policy shall be endorsed to provide the designated aggregate per location endorsement or equivalent on a form approved or requested by the County Risk Manager. 5. Excess/Umbrella Liability. Per Section 3.23, A, the Contractor shall obtain an excess liability policy in addition to the scheduled underlying policies (commercial general liability, business auto liability, professional, and employers' liability) with a limit of no less than the amount shown above. This insurance shall name the County as an additional insured and include either blanket contractual or a designated contract contractual coverage endorsement, indicating expressly the Contractor’s agreement to hold the County harmless. The excess/umbrella liability policy shall provide exclusive coverage for the location or project site where the work or services are to be performed under this Contract. In the alternative, the excess/umbrella liability policy shall be endorsed to provide the designated aggregate per location endorsement or equivalent on a form approved or requested by the County Risk Manager. 6. Motor Vehicle Liability. Per Section 3.23, A, the Contractor shall secure and maintain during the term of this Contract, motor vehicle coverage in the split limit amounts of no less than the amounts shown above per person, per occurrence for bodily injury and for property damage or a combined single limit of the amount shown above with “Any Auto”, Coverage Symbol 1, providing coverage for all autos operated regardless of ownership, and protecting itself, its employees, agents or lessees, or subsidiaries and their employees or agents against claims arising from the ownership, maintenance, or use of a motor vehicle. 7. Professional Liability. Per Section 3.23, A, the Contractor shall ensure that it secures and maintains, during the term of this Contract, Professional Liability insurance with limits of no less than the amount shown contemplated by this Contract. Such policy shall cover all the Contractor’s or its Subcontractor’s professional liabilities whether occasioned by the Contractor or its Subcontractors, or their agents or employees [and broad enough to include errors and omissions specific to Contractor’s professional liability for direct and contingent design errors and Architect’s/Engineers professional liability with no exclusions for design-build work]. a. If the Contractor fails to secure and maintain the professional liability insurance coverage required herein, the Contractor shall be liable to 16-P-64AK, Cardiac Monitors Page 21 of 53 the County and agrees to indemnify, defend, and hold harmless the County against all claims, actions, losses or damages that would have been covered by such insurance. b. The Contractor must maintain a retroactive date prior to or equal to the effective date of this Contract. The Contractor shall purchase a Supplemental Extended Reporting Period (“SERP”) with a minimum reporting period of not less than three (3) years in the event a Subcontractor’s policy is canceled, not renewed, switched to occurrence form, or any other event which requires a purchase of SERP to cover a gap in insurance for claims which may arise under or related to this Contract. The Contractor’s purchase of the SERP shall not relieve the Contractor of the obligation to provide replacement coverage. In addition, the Contractor shall require that the Subcontractor’s carrier immediately inform the Contractor, the County of Volusia’s Risk Management Division, and the Purchasing and Contracts Division of any contractual obligations that may alter its professional liability coverage under this Contract. 8. Coverages for professional and pollution liability shall be provided on an occurrence form or a claims made form with a retroactive date equal to at least the first date of this Contract and with a three (3) year reporting option beyond the expiration date of this Contract including any amendments to the Contract term. County shall be included as an additional named insured under the pollution liability insurance policy. 9. Primary and Excess Coverage. Any insurance required may be provided by primary and excess insurance policies. B. General Insurance Requirements 1. All insurance policies shall be issued by insurers licensed and/or duly authorized under Florida Law to do business in the State of Florida and all insuring companies are required to have a minimum rating of A- in the "Best Key Rating Guide" published by A.M. Best & Company, Inc. 2. Approval by County of any policy of insurance shall not relieve Contractor from its responsibility to maintain the insurance coverage required herein for the performance of Work or Services by the Contractor or its Subcontractors for the entire term of this Contract and for such longer periods of time as may be required under other clauses of this Contract. 3. Waiver of Subrogation. The Contractor hereby waives all rights against the County and its Subcontractors to the extent of the risk coverage by any insurance policy required hereunder for damages by reason of any claim, demand, suit, or settlement (including workers’ compensation) for any claim for injuries or illness of anyone, or perils arising out of this 16-P-64AK, Cardiac Monitors Page 22 of 53 Contract. The Contractor shall require similar waivers from all its Subcontractors. This provision applies to all policies of insurance required under this Contract (including Workers’ Compensation, and general liability). 4. County Not Liable for Paying Deductibles. For all insurance required by Contractor, the County shall not be responsible or liable for paying deductibles for any claim arising out of or related to the Contractor’s business or any Subcontractor performing Work or Services on behalf of the Contractor or for the Contractor’s benefit under this Contract. 5. Cancellation Notices. During the term of this Contract, Contractor shall be responsible for promptly advising and providing County of Volusia’s Risk Management Division and the Purchasing and Contracts Division with copies of notices of cancellation or any other changes in the terms and conditions of the original insurance policies approved by the County under this Contract within two (2) business days of receipt of such notice or change. 6. For any on-site Work performed by or on behalf of Contractor on County property, the County shall be named as an additional insured or additional named insured subject to review and determination by County’s Risk Manager on all policies required under this Contract except professional liability and workers compensation. 7. Deductibles. Contractors that maintain and administer a self-insured retention or a large deductible program exceeding the insurance requirements listed in this solicitation using a formal program to fund either program may submit an exception in accordance with Section 3.9, Questions, Exceptions, and Addenda Concerning RFP #16-P-64AK to be considered for this solicitation. The request must include a summary of the program’s design, funding method, and the program’s supporting financial information. If additional information is necessary, the County will request more specific information, which must be provided by the Contractor. The County’s Risk Manager will review the information submitted and determine whether the program is acceptable to the County. Contractor with no formal risk management program in place to manage and fund deductibles or self-insured retentions may not be considered. Subject to County approval, Contractor may obtain a letter of credit in the amount equivalent to the deductible, which shall remain in effect during the term of the Contract at no additional cost to the County. C. Proof of Insurance 16-P-64AK, Cardiac Monitors Page 23 of 53 1. The Contractor shall be required to furnish evidence of all required insurance in the form of certificates of insurance which shall clearly outline all hazards covered as itemized herein, the amounts of insurance applicable to each hazard, and the expiration dates. 2. The Contractor shall furnish proof of insurance acceptable to the County prior to or at the time of execution of this Contract and the Contractor shall not commence Work or provide any Service until the Contractor has obtained all the insurance required under this Contract and such insurance has been filed with and approved by the County. Upon request from the County, the Contractor shall furnish copies of the following types of insurance policies and any changes or amendments thereto, immediately, to the County and County’s Risk Management and Purchasing and Contracts Divisions prior to the commencement of any contractual obligations. This Contract may be terminated by the County, without penalty or expense to County if at any time during the term of this Contract proof of any insurance required hereunder is not provided to the County. 3. All certificates of insurance shall clearly indicate that the Contractor has obtained insurance of the type, amount and classification required by this Article. No Work or Services by Contractor or its Subcontractors shall be commenced until County has approved these policies or certificates of insurance. Further, the Contractor agrees that the County shall make no payments pursuant to the terms of this Contract until all required proof or evidence of insurance has been provided to the County. This Contractor may be terminated by the County, without penalty or expense, if proof of any insurance required hereunder is not provided to the County. 4. The Contractor shall file replacement certificates with the County at the time of expiration or termination of the required insurance occurring during the term of this Contract. In the event such insurance lapses, the County expressly reserves the right to renew the insurance policies at the Contractor’s expense or terminate this Contract but County has no obligation to renew any policies. D. The provisions of this Article shall survive the cancellation or termination of this Contract. 3.24 Award Term The County is looking to promote partnership relationships within the policies and procedures of public procurement. Pursuant toward that end, the successful Respondent(s) shall be awarded a Contract for an initial three (3) year term with two (2) subsequent one (1) year renewals. It is the intent of the County of Volusia to issue a purchase order for the initial purchase of the cardiac monitors/defibrillators and associated accessories. A master agreement will be issued for the purchase of accessories 16-P-64AK, Cardiac Monitors Page 24 of 53 and components and ongoing maintenance. The master agreement will be issued for three years with the option for two one-year renewals. All renewals will be contingent upon mutual and written agreement and, when applicable, approval of County Council. 3.25 Price Redeterminations Once each year during the term of the Contract, including any extension or renewal periods thereof, the Contractor may, but is not obligated to, petition the Director of Purchasing and Contracts for one or more price redeterminations where such price redetermination(s) is/are necessitated by documented increases in the cost of wages, fuel, or materials. Petitions for price redeterminations must be made within thirty (30) days of the anniversary date of the Contract (i.e., the calendar day and month when the Contract became effective) and only after the Contract has been in effect for at least one year. Any such petition must be made pursuant to the provisions of this Section 3.25 and only for those price redetermination categories specified herein. Unless otherwise expressly set forth in this Agreement, no other price redeterminations shall be allowed. All price redeterminations, once issued, shall be prospective from the date of approval unless otherwise approved by a duly executed amendment to this Contract. A. Basis for Price Redeterminations. The Contractor may petition the Director of Purchasing and Contracts for price redetermination based on the increased costs of wages, fuel, or materials. Price redeterminations must be based solely upon changes in pricing or costs documented by either the Employment Cost Index (ECI) or Producer Price Index (PPI), whichever is applicable, as published by the Bureau of Labor Statistics. The base index number for the ECI will be for the quarter in which the RFP opens. The base index number for the PPI will be for the month the RFP opens. Any subsequent price redeterminations shall use the last price redetermination approved for that price redetermination category as the “base index number.” The County shall have the right to audit the Contractor’s records, including, but not limited to, payroll, materials, and fuel cost records, to verify or otherwise investigate the validity of any price redetermination request. B. Wage Price Redetermination. When requesting a price redetermination based upon an increase in wage costs, the Contractor shall refer to and utilize the Employment Cost Index, Total Compensation, Private Industry, Index Number and Occupational Group at http://data.bls.gov/PDQ/outside.jsp?survey=ci, as prepared by the Bureau of Labor Statistics in the U.S. Department of Labor. The base figure will be tied to Trade, transportation, and utilities under the heading Service Providing Industries. Wage price redetermination increases shall be granted only by reason of wage increases associated with the Contractor’s employees or subcontractors performing work or services pursuant to the Contract. C. Minimum Wage Price Redetermination. If the minimum wage increases during the term of the Contract, including any renewal or extension period thereunder, the Contractor may petition the Director of Purchasing and Contracts for price 16-P-64AK, Cardiac Monitors Page 25 of 53 redetermination for those job categories where the pay to the Contractor’s employee(s) is the current minimum wage. Upon verification of the information provided, the County will grant an increase of exactly the amount of the minimum wage increase (not the percentage increase). The Contractor must increase the pay to the employee(s) by the amount the Contractor has requested, which shall not exceed the amount of the minimum wage increase. The amount paid to the Contractor will be the increase plus any written and documented increase in FICA, Medicare, and Workers' Compensation insurance. The Contractor must supply written documentation of any other increase that is beyond the scope and control of the Contractor. All written documentation must satisfy the reasonable expectations of the Director of Purchasing and Contracts and Internal Auditor. i) Example: Minimum wage increases from $7.31 to $7.56 per hour. The Contractor may petition for an increase of $0.25 per hour to be paid to the affected employee(s) and shall provide written and documented cost increases for FICA, Medicare and Workers' Compensation. The resulting increase in costs shall be incorporated into fees/rates billed to the County. If the Contractor bills the County at a higher price according to any price redetermination granted by the County, and the Contractor fails to increase the hourly rate paid to the employee for the same period, the Contractor will be considered in Contract default and the Contract will be immediately terminated. D. Fuel Price Redetermination. If/when the price of fuel increases by a minimum of ten (10%) percent, the Contractor may petition the Director of Purchasing and Contracts for a fuel price redetermination. As a condition of petitioning for a fuel price increase, the Contractor shall be required to petition for a fuel price redetermination decrease if/when the price of fuel decreases by a minimum of ten (10%) percent. Failure to make such petition may be grounds for Contract termination and shall entitle the County to a refund of the cumulative increase in pay to the Contractor due to any prior fuel price redetermination increase(s). Fuel price redetermination must be based solely upon changes as documented by the Producer Price Index (PPI) for the commodities “Unleaded Gasoline - WPU057104” or “#2 diesel fuel - WPU057303,” as such may be applicable to the Contractor’s operations in connection with the Contractor’s performance of the Contract. E. Materials Price Redetermination. At the anniversary date of the Agreement, the Contractor may petition the Director of Purchasing and Contracts for a materials price redetermination. As a condition of petitioning for a materials price increase, the Contractor shall be required to petition for a materials price redetermination decrease if/when the price of materials used by the Contractor in connection with the Contract decreases. Failure to make such petition may be grounds for Contract termination and shall entitle the County to a refund of the cumulative increase in pay to the Contractor due to any prior materials price redetermination increase(s). Materials price redetermination must be based solely upon changes as documented by the Producer Price Index (PPI) for the commodity “Medical 16-P-64AK, Cardiac Monitors Page 26 of 53 equipment & supplies manufacturing (PCU33911-33911)”, as published by the Bureau of Labor Statistics. F. Price Redetermination Calculation. All Price Redeterminations shall be calculated as follows: Example: Contractor indicated on the Submittal Form that thirty percent (30%) of the cost to provide the product/service is directly attributed to the redetermination category (wages, fuel, or materials). Base index PPI = ......................................................$179.20 Current applicable PPI = ......................................................$200.50 PPI increased by $10.30 ($200.5 – $179.2 = $21.30) or (21.3 ÷ $179.2 = .1188) ................. .11.9% Unit cost of the service is ........................................................................$100.00 30% of $100.00 is directly attributed to the redetermination category.....$30.00 $30.00 X 11.9% = ..........................................................$3.57 New unit price for the product/service is ($100 + $3.57) .......................$103.57 G. Expiration Upon Failure to Agree to Price Redetermination. If the County and the Contractor cannot agree to a price redetermination pursuant to the terms and conditions of this Section 3.25, then the Contract will automatically expire without penalty or further expense to either party after a period of six (6) months following the Contractor’s initial request for such price redetermination. Requests for price redeterminations not made in accordance with the provisions of this Section 3.25 shall be deemed null and void and shall not be a valid reason or pretext for expiration or termination of the Contract. If the contract expires pursuant to the terms and conditions of this Section 3.25, the County reserves the right, at no expense, penalty, or consequence to the County, to award any remaining tasks thereunder to the next available most responsive and responsible Contractor. 3.26 Unusual Costs The Contractor may petition the County at any time for an additional rate adjustment on the basis of extraordinary and unusual changes in the costs of operation that could not reasonably be foreseen by a prudent operator and which, by all reasonable expectations, will continue for at least one (1) year. If the Contractor petitions for such in increase, the Contractor shall also petition for a rate reduction on the basis of extraordinary and unusual changes in the costs of operation that could not reasonably be foreseen by a prudent operator and which, by all reasonable expectations, will continue for at least one (1) year; failure to make such petition may be grounds for Contract termination. The Contractor’s request shall contain substantial proof and justification to support the need for the rate adjustment. The County may request from the Contractor and the Contractor shall provide such further information as may be reasonably necessary in making its determination. The County shall approve or deny the request, in whole or in 16-P-64AK, Cardiac Monitors Page 27 of 53 part, within sixty (60) days of receipt of the request and all other additional information required by the County. Any price redetermination shall be solely based upon the documentation provided and the County reserves the right to rescind any price relief granted should the circumstances change and prices decrease. 3.27 Waiver of Claims Once the Contract expires, or final payment has been requested and made, the Contractor shall have no more than thirty (30) calendar days to present or file any claims against the County concerning the Contract. After that period, the County will consider the Contractor to have waived any right to claims against the County concerning the Contract. 3.28 Evaluation Criteria Each proposal shall be evaluated using the following criteria: A. That all proposal documentation was submitted timely and in conformance with all requirements of the RFP. B. That the following elements of Contractor’s proposal meet or exceed the requirements of this RFP and cumulatively provide the service and benefits to the County deemed to be in the best interest of the public: 1. Cost Proposal – As noted in Tab 7; 2. Firm qualifications - As noted in Tabs 1, 6, 7 and 9. Availability of sufficient qualified, experienced staff to perform implementation, training, product maintenance and support; adequate organizational structure; financial stability; adequate capital resources to maintain and support the hardware and software product(s) for a preferred five (5) year period. Support capabilities of staff and resources available for hardware and software maintenance, support and training; types and available hours of support services; general overview of hardware and software and associated training methods; 3. Capabilities of the proposed cardiac monitors – As noted in Tabs 6 and 7. The ability of the cardiac monitors to provide the features as defined in Attachment B; ease of use – intuitive functions and tools; flexibility; 4. Service Agreement (including training), Preventive Maintenance, and Warranty – As noted in Tab 9. 5. Delivery Plan – As noted in Tab 8 6. References – As noted in Tab 3. 16-P-64AK, Cardiac Monitors Page 28 of 53 7. Overall project methodology/approach to support the needs and objectives of the project; and 8. Financial Stability – As noted in Tab 4. 3.29 Termination A. The resulting Contract may be terminated by either party upon the material breach by the other party if such breach is not cured within thirty (30) days written notice from the non-breaching party. B. County may terminate the resulting Contract for convenience or non- appropriation upon at least thirty (30) calendar days’ prior written notice to Contractor. C. The Contractor may cancel the resulting Contract with one-hundred eighty (180) days written notice to the Director of Purchasing and Contracts. Failure to provide proper notice to the County may result in the Contractor being barred from future business with the County. D. After Contractor’s receipt of a notice of termination pursuant to Paragraph A above (or to the extent Contractor has not cured a material breach within thirty (30) days notice from County), and except as otherwise directed by the County, the Contractor shall: 1. Stop work under the Contract or applicable statement of work on the date specified in the notice of termination. 2. Place no further orders or subcontracts for materials, services or facilities. 3. Terminate all orders and subcontracts to the extent that they relate to the performance of work or services terminated by the notice of termination. 4. With the approval of the County and to the extent required by the County, settle all outstanding liabilities and all claims arising out of such termination of orders and subcontracts. County's approval of such settlements shall be final for all the purposes of Section 3.29, Termination. E. After receipt of a notice of termination, the Contractor shall submit to the County its termination claim for amounts owed by County (which shall include, without limitation, all amounts due for work or services performed through the date of termination), in the form and with a certification as prescribed by the County. Such claim shall be submitted promptly but in no event later than thirty (30) days from the effective date of termination, unless one or more extensions in writing are granted by the County, upon request of the Contractor made in writing within such thirty (30) days period or authorized extension thereof. Upon failure of the Contractor to submit its termination claim within the time allowed, the County may determine on the basis of information available to it, the amount, if any, due 16-P-64AK, Cardiac Monitors Page 29 of 53 to the Contractor by reason of the termination and shall thereupon pay to the Contractor the amount so determined. In the event County terminates for convenience or non-appropriation, Contractor shall not be obligated to refund to County any prepaid fees. F. Non-Appropriation. The resulting Contract may be terminated by the County or Contractor if the County does not appropriate the funding in any fiscal year necessary to pay the compensation set forth in the Article entitled Compensation in the resulting Contract. G. In the event that the resulting Contract is terminated by the County or Contractor for non-appropriation, Contractor shall be paid in accordance with terms of the Article entitled Compensation in the resulting Contract. Contractor shall be paid (a) to the date of termination on a prorated basis for any work or deliverable that has been completed but not yet been paid. County’s obligation to pay Contractor under this Section 3.29, Termination, and the resulting Contract is limited to the budgeted amount for the fiscal year approved by the Volusia County Council for the then current fiscal year of the resulting Contract. Contractor shall have no right to compel the Volusia County Council to appropriate funds for any fiscal year to pay the compensation. H. Upon being notified of County’s election to terminate for default of Contractor, non-appropriation or convenience, Contractor and its Subcontractors shall refrain from performing further work or incurring additional expenses under the terms of the resulting Contract which is not specifically authorized in the notice of termination. I. If termination of the resulting Contract occurs for any reason: 1. Except as otherwise provided in the resulting Contract, Contractor shall return to the County, or destroy, all County confidential information in Contractor’ possession and shall certify the destruction or return of said information in a written document signed by the duly authorized representative of the Contractor that all such information has been destroyed or returned, provided that Contractor shall be permitted to retain an archival copy of any such confidential information (provided it continues to maintain the confidentiality of such as prescribed herein) to the extent necessary to have a record of the work or service performed hereunder. 2. For all undisputed outstanding invoices submitted to the County for Work completed or deliverables delivered prior to the effective date of the termination, the County shall cause payments to be made to Contractor within forty-five (45) days of receipt of invoice. Contractor shall invoice the County for any sums Contractor claims to be owed by County under the resulting Contract for work performed from the last invoice to the effective date of termination. County shall review such invoice for payment within fifteen (15) days of receipt and County shall pay any 16-P-64AK, Cardiac Monitors Page 30 of 53 undisputed amount within forty-five (45) days, subject to the Article entitled Compensation in the resulting Contract. Any disputed amounts on any invoices shall be subject to the dispute resolution process set forth in the Article entitled Dispute Resolution in the resulting Contract. J. In the event of termination by the County for non-appropriation, for all items or products ordered by Contractor before receipt by Contractor of the Notice of Termination which Contractor could not cancel without imposition of a fee, the County shall cause payments to be made to Contractor within forty-five (45) days of receipt of an undisputed invoice for all cancellation, restocking or residual fees resulting from the cancellation or return of third party products ordered from or shipped by the vendor thereof prior to the effective date of the termination. 3.30 Incurred Expenses This RFP does not commit the County of Volusia to award a Contract, nor shall the County of Volusia be responsible for any cost or expense which may be incurred by any Respondent in preparing and submitting a proposal in response to this RFP, or any cost or expense incurred by any Respondent prior to the execution of a Contract. 3.31 Post-Proposal Discussions with Respondents It is the County’s intent to award a Contract(s) to the Respondent(s) deemed most advantageous to the County in accordance with the evaluation criteria specified in this RFP. The County reserves the right, however, to conduct post-closing discussions with any Respondent who has a realistic possibility of Contract award including, but not limited to, requests for additional information and competitive negotiations. 3.32 Presentations by Respondents A. The County of Volusia, at its sole discretion, may ask individual Respondents to make oral presentations and/or demonstrations without charge to the County. B. The County reserves the right to require any Respondent to demonstrate to the satisfaction of the County that the Respondent has the fiscal and managerial abilities to properly furnish the services proposed and required to fulfill the requirements of the RFP. The demonstration must satisfy the County and the County shall be the sole judge of compliance. C. Respondents are cautioned not to assume that presentations will be required and should include all pertinent and required information in their original proposal package. 16-P-64AK, Cardiac Monitors Page 31 of 53 3.33 Minimum Specifications The specifications listed in the Scope of Service are the minimum required performance specifications for this RFP. They are not intended to limit competition nor specify any particular Respondent but to ensure that the County receives quality services. 3.34 Compliance with Laws and Regulations Contractors shall be responsible to know and to apply all applicable federal, state, and local laws, ordinances, rules, regulations, and all orders and decrees of bodies or tribunals having jurisdiction or authority which in any manner affect the work, or which in any way affect the conduct of the work. Contractor shall always observe and comply with all such laws, ordinances, rules, regulations, orders, and decrees. The awarded Contractor shall protect and indemnify the County and all its officers, agents, servants, or employees against any claim or liability arising from or based on the violation of any such law, ordinance, rule, regulation, order, or decree caused or committed by Contractor, its representatives, Subcontractors, sub-consultants, professional associates, agents, servants, or employees. At time of submittal, Contractors must hold the required licensure to be the prime Contractor for all work to be performed under this RFP. If any Contractor proposes to use a Subcontractor or sub-consultant to perform any work under this RFP, such Subcontractor and/or sub-consultant shall, at the time of submittal, hold the required licensure for all work to be performed under this Contract as a Subcontractor and shall maintain such license(s) in full force and effect during the term of the awarded Contract. All licenses and permits required to perform Contractor’s duties under this RFP, whether such license or permit is required by the federal government, State of Florida, Volusia County, or any municipality, shall be at each Contractor’s sole cost and expense, and shall not be a cost of the County. All required licenses and permits shall be maintained in full force and effect during the term of the awarded Contract. 3.35 Limitation of Liability and Indemnification of County A. The Contractor shall, at its own expense, indemnify, defend, and hold harmless the County and its public officials (elected and appointed), successors and assigns, agents, officers, and employees, from and against all claims of every kind and nature (including losses incurred or suffered in consequences either of bodily injury to a person or damage to property), damages, losses and expenses, including, but not limited to attorney’s fees, arising out of or resulting from the performance of this Agreement provided that the claim, damage, loss and expense is caused by any negligent act or omission of the Contractor, or anyone directly or indirectly employed by Contractor, except that the Contractor will not be required to indemnify, defend and hold harmless the County if such claim, damage, loss and expense is the result of the sole negligence of the County, or of anyone directly or indirectly employed by the County or anyone for whose acts the County may be liable. 16-P-64AK, Cardiac Monitors Page 32 of 53 B. Sovereign Immunity. County expressly retains all rights, benefits and immunities of sovereign immunity in accordance with Section 768.28, Florida Statutes (as amended). Notwithstanding anything set forth in any Section of this Agreement to the contrary, nothing in this Agreement shall be deemed as a waiver of immunity or limits of liability of the County beyond any statutory limited waiver of immunity or limits of liability which may have been or may be adopted by the Florida Legislature and the cap on the amount and liability of the County for damages, regardless of the number or nature of claims in tort, equity, or contract, shall not exceed the dollar amount set by the legislature for tort. Nothing in this Agreement shall inure to the benefit of any third party for the purpose of allowing any claim against the County, which claim would otherwise be barred under the doctrine of sovereign immunity or by operation of law. 3.36 Records & Right to Audit County shall have the right to audit the books, records, and accounts of Contractor and its Subcontractors that are related to the resulting Contract. Contractor and its Subcontractors shall keep such books, records, and accounts as may be necessary in order to record complete and correct entries related to the resulting Contract. Contractor shall preserve and make available, at reasonable times for examination and audit by County, all financial records, supporting documents, statistical records, and any other documents pertinent to this Contract for a retention period of five (5) years after completion or termination of the Contract, and any renewals, as required by Item 65, General Records Schedule GS1-SL for State and Local Government Agencies, effective February 19, 2015 and the Florida Public Records Act (Chapter 119, Florida Statutes). Contractor shall, by written Contract, require its Subcontractors to agree to the requirements and obligations of this Section 3.36, Audits will be subject to applicable privacy and confidentiality laws and regulations and Contractor’s privacy and confidentiality policies and procedures. 3.37 Change in Scope of Services/Work A. The County may order changes in the work consisting of additions, deletions, or other revisions within the general scope of the awarded Contract. No claims may be made by the Contractor that the scope of the project or of the Contractor’s services has been changed, requiring changes to the amount of compensation to the Contractor or other adjustments to the Contract, unless such changes or adjustments have been made by written amendment or change order to the Contract signed by the County Representative, County’s Director of Purchasing and Contracts, and the Contractor. B. If the Contractor believes that any particular work is not within the Statement of Work of the Contract, is a material change, or will otherwise require more compensation to the Contractor, the Contractor must immediately notify the County’s Representative in writing of this belief. If the County’s Representative believes that the particular work is within the scope of the Contract as written, the Contractor will be ordered to and shall continue with the work as changed and at the cost stated for the work within the Statement of Work. The Contractor must 16-P-64AK, Cardiac Monitors Page 33 of 53 assert its right to an adjustment under this clause within thirty (30) days from the date of receipt of the written order. C. The County reserves the right to negotiate with the awarded Contractor(s) without completing the competitive RFP process for materials, products, and/or services similar in nature to those specified within this RFP for which requirements were not known when the RFP was released. 3.38 Modifications Due to Public Welfare or Change in Law The County shall have the power to make changes in the Contract as the result of changes in law and/or Ordinances of Volusia County to impose new rules and regulations on the Contractor under the Contract relative to the scope and methods of providing services as shall from time-to-time be necessary and desirable for the public welfare. The County shall give the Contractor notice of any proposed change and an opportunity to be heard concerning those matters. The Statement of Work and method of providing services as referenced herein shall also be liberally construed to include, but is not limited to the manner, procedures, operations and obligations, financial or otherwise, of the Contractor. In the event any future change in Federal, State, or County law or the Ordinances of Volusia County materially alters the obligations of the Contractor, or the benefits to the County, then the Contract shall be amended consistent therewith. Should these amendments materially alter the obligations of the Contractor, then the Contractor or the County shall be entitled to an adjustment in the rates and charges established under the Contract. Nothing contained in this Contract shall require any party to perform any act or function contrary to law. The County and Contractor agree to enter into good faith negotiations regarding modifications to the Contract which may be required in order to implement changes in the interest of the public welfare or due to change in law. When such modifications are made to the Contract, the County and the Contractor shall negotiate in good faith, a reasonable and appropriate adjustment for any changes in services or other obligations required of the Contractor directly and demonstrably due to any modification in the Contract under this clause. 3.39 Safety The Contractor shall take the necessary precautions and bear the sole responsibility for the safety of the methods employed in performing the work. The Contractor shall at all times comply with the regulations set forth by federal, state, and local laws, rules, and regulations concerning "OSHA" and all applicable state labor laws, regulations, and standards. The Contractor shall indemnify and hold harmless the County from and against all liabilities, suits, damages, costs, and expenses (including attorney's fees and court costs) which may be imposed on the County because of the Contractor, Subcontractor, or supplier's failure to comply with the regulations. 3.40 Right to Require Performance A. The failure of the County at any time to require performance by the Contractor of any provision hereof shall in no way affect the right of the County thereafter to enforce same, nor shall waiver by the County of any breach of any provision 16-P-64AK, Cardiac Monitors Page 34 of 53 hereof be taken or held to be a waiver of any succeeding breach of such provision or as a waiver of any provision itself. B. In the event of failure of the Contractor to deliver services in accordance with the Contract terms and conditions, the County, after due written notice, may procure the services from other sources and hold the Contractor responsible for any resulting additional purchase and administrative costs. This remedy shall be in addition to any other remedies that the County may have. 3.41 Force Majeure Neither party shall be liable for any failure or delay in the performance of its obligations under the Contract to the extent such failure or delay necessarily results from the occurrence of a Force Majeure Event beyond the control or reasonable anticipation of either party, including, but not limited to, compliance with any unanticipated government law or regulation not otherwise in effect at the time of execution of this Contract, acts of God, unforeseeable governmental acts or omissions, fires, strikes, natural disasters, wars, riots, transportation problems, and/or any other unforeseeable cause whatsoever beyond the reasonable control of the parties (and such cause being referred to as a “Force Majeure Event”). Accordingly, the parties further agree that: A. Upon the occurrence of Force Majeure Event, the non-performing party shall be excused from any further performance of those obligations under this Contract that are affected by the Force Majeure Event for as long as (a) the Force Majeure Event continues; and (b) the non-performing party continues to use commercially reasonable efforts to recommence performance whenever and to whatever extent possible without delay. B. Upon the occurrence of a Force Majeure Event, the non-performing party shall notify the other party of the occurrence of such event and describe in reasonable detail the effect(s) of such event upon the party’s performance of its obligations and duties pursuant to this Contract. Such notice shall be delivered or otherwise communicated to the other party within two (2) business days following the failure or delay caused by the Force Majeure Event, or as soon as possible after such failure or delay if the Force Majeure Event precludes the non-performing party from providing notice within such time period. C. In the event of a Force Majeure Event, the time for performance by the parties under the applicable statement of work shall be extended for a period of time equal to the time lost by reason of such cause through execution of a Change Order pursuant to the terms of the Contract. 3.42 Contractor’s Personnel The Contractor shall be responsible for ensuring that its employees, agents, and Subcontractors comply with all applicable laws and regulations and meet all federal, state, and local requirements related to their employment and position. 16-P-64AK, Cardiac Monitors Page 35 of 53 By submission of a proposal, each Contractor certifies that it does not knowingly or willingly and will not during the performance of the resulting Contract employ illegal alien workers (i.e., non-U.S. citizens who have not been issued valid, appropriate, and current non-immigrant work visas, Form I-551s, or other similar governmental documentation necessary to authorize such persons to reside and perform compensated work or services, whether temporarily or permanently, within the United States) or otherwise violate the provisions of the Federal Immigration Reform and Control Act of 1986, as amended. During the performance of the Contract, the Contractor shall agree to the following: • The Contractor shall not discriminate against any employee or applicant for employment because of race, religion, color, sex, age, handicap, or national origin, except when such condition is a bona fide occupational qualification reasonably necessary for the normal operations of the Contractor. The Contractor agrees to post in conspicuous places, visible to employees and applicants for employment, notices setting forth the provisions of this nondiscrimination clause. • The Contractor, in all solicitations or advertisements for employees placed by or on behalf of the Contractor, shall state that such Contractor is an Equal Opportunity Employer. Notices, advertisements, and solicitations placed in accordance with federal law, rule, or regulation shall be deemed sufficient for the purpose of meeting the requirements of this Section 3.42. The Contractor shall include the provisions of the foregoing paragraphs above in every subcontract or purchase order so that the provisions will be binding upon each Subcontractor. The Contractor and any Subcontractor shall pay all employees working on the awarded Contract not less than minimum wage specified in the Fair Labor Standards Act (29 CFR 510-794), as amended. Any information concerning the County, its products, services, personnel, policies, or any other aspect of its business learned by the Contractor or personnel furnished by the Contractor in the course of providing services pursuant to the Contractor, shall be held in confidence and shall not be disclosed by the Contractor or any employee or agents of the Contractor or personnel furnished by the Contractor, without the prior written consent of the County. 3.43 Disadvantaged Business Enterprise Program The County Council has adopted policies which assure and encourage the full participation of Disadvantaged Business Enterprises (DBE) in the provision of goods and services. The County encourages joint ventures between majority-owned firms and qualified disadvantaged / minority / women-owned firms. 16-P-64AK, Cardiac Monitors Page 36 of 53 3.44 Claim Notice The Contractor shall immediately report in writing to the County’s designated representative or agent any incident that might reasonably be expected to result in any claim under any of the coverage mentioned herein. The Contractor agrees to cooperate with the County in promptly releasing reasonable information periodically as to the disposition of any claims, including a résumé of claims experience relating to all Contractor operations at the County project site. The designated representative for the County shall be: Name: County of Volusia, Florida Personnel/Risk Management Division Address: 230 North Woodland Boulevard, Suite 250 DeLand, Florida 32720 Telephone: 386-736-5963 Fax: 386-822-5006 3.45 County/Contractor Relationship The County of Volusia reserves the right to award one or more Contracts to provide the required services as deemed to be in the best interest of the County. Any awarded Contractor shall provide the services required herein strictly under a Contractual relationship with the County and is not, nor shall be, construed to be an agent or employee of the County. As an independent Contractor the awarded Contractor shall pay any and all applicable taxes required by law; shall comply with all pertinent Federal, State, and local statutes including, but not limited to, the Fair Labor Standards Act, the Americans with Disabilities Act, the Federal Civil Rights Act, and any and all relevant employment laws. The Contractor shall be responsible for all income tax, FICA, and any other withholdings from its employees or Subcontractor’s wages or salaries. Benefits for same shall be the responsibility of the Contractor including, but not limited to, health and life insurance, mandatory social security, retirement, liability/risk coverage, and worker's and unemployment compensation. The independent Contractor shall hire, compensate, supervise, and terminate members of its work force; shall direct and control the manner in which work is performed including conditions under which individuals will be assigned duties, how individuals will report, and the hours individuals will perform. 3.46 New Material Unless otherwise provided for in this specification, the awarded Contractor represents and warrants that the goods, materials, supplies, or components offered to the County under this RFP solicitation are new, not used or reconditioned. The Contractor represents that these goods, materials, supplies, or components are not of such age or so deteriorated as to impair their usefulness or safety and that the goods, materials, supplies, or components offered are current production models of the respective manufacturer. If the Contractor believes that furnishing used or reconditioned goods, materials, supplies, or 16-P-64AK, Cardiac Monitors Page 37 of 53 components will be in the County’s interest, the Contractor shall so notify the County Procurement Analyst in writing no later than ten (10) working days prior to the date set for opening of proposals. The notice shall include the reasons for the request and any benefits that may accrue to the County if the Procurement Analyst authorizes the inclusion of used or reconditioned goods, materials, supplies, or components. 3.47 Damages Due to the nature of the services to be provided and the potential impact to the County for loss, the Contractor cannot disclaim consequential or special damages related to the performance of this Contract. The Contractor shall be responsible and accountable for any and all damages, directly or indirectly, caused by the actions or inaction of its employees, staff, or Subcontractors. There are no limitations to this liability. 3.48 Proposal Acceptance/Rejection The County reserves the right to accept or reject any or all proposals received as a result of this RFP, or to negotiate separately with competing Respondents, and to waive any informalities, defects, or irregularities in any proposal, or to accept that proposal or proposals, which in the judgment of the proper officials, is in the best interest of the County. 3.49 Proposal Acceptance Period Any Proposal in response to this RFP shall be valid through August 22, 2016. At the end of this time the proposal may be withdrawn at the written request of the Respondent if no award has been made. If the Proposal is not withdrawn at that time it remains in effect until an award is made or the solicitation is canceled regardless of the status of the proposal bond. The County reserves the right to request an extension of the proposals if a Contract has not been executed by August 22, 2016. 4.0 SUBMITTAL REQUIREMENTS It is not necessary to return every page of this document with the Proposal; return only the pages that require signatures or information as listed below. Proposals shall include all of the information solicited in this RFP, and any additional data that the Respondent deems pertinent to the understanding and evaluating of the proposal. Proposals shall be organized in sections tabbed in the order described below. The Respondent should not withhold any information from the written response in anticipation of presenting the information orally or in a demonstration, since oral presentations or demonstrations may not be solicited. All proposals shall include at minimum: Submittal Format – Material shall be submitted in a loose leaf binder format, not as bound documents or with coil spines (plastic or metal). Respondents shall not submit 16-P-64AK, Cardiac Monitors Page 38 of 53 material in any binder that exceeds two inches (2"); provide proposal in multiple binders if required. NOTE: Failure of the Respondent to clearly and specifically address each of the items listed below may result in the Proposal not being evaluated or considered for award. All proposals shall include at a minimum: Tab 1 – Respondent’s Profile and Submittal Letter A. A submittal letter signed by an authorized agent of the firm, as listed on the Florida Department of State, Division of Corporations’ Sunbiz report available at www.sunbiz.org (Sunbiz), shall be required. If anyone other than the officers listed on the Sunbiz website will be signing this RFP, a memorandum of authority signed by an officer of the firm allocating authorization shall be required. If firm is not currently registered as a vendor in the State of Florida (Sunbiz), include documentation designation of contracting authority. The memorandum of authority shall be on the firm’s letterhead and shall clearly state the name, title and contact information for the individual designated by the firm. B. A brief profile of the firm, including: 1. A brief history of the business; 2. Organizational structure of business; 3. Designation of the legal entity by which the business operates (i.e., sole proprietorship, partnership, limited liability partnership, corporation, limited liability corporation, etc.) including documentation from the appropriate state’s agency confirming firm’s legal entity type. For non-Florida businesses, submit documentation from the state in which the business was formed and documentation from the State of Florida providing authorization to perform business in the state of Florida; 4. A Florida Department of State, Division of Corporations’ Sunbiz report available at www.sunbiz.org; 5. Ownership interests; 6. Active business venues (counties, states, etc.); 7. Present status and projected direction of business; 8. The overall qualifications of the business to provide the services requested; 9. The qualifications of the firm’s employees who will work on the Contract; 10. Federal Identification Number of firm. 16-P-64AK, Cardiac Monitors Page 39 of 53 Tab 2 - Completed Proposal Form (use attached form Section 5.0) Tab 3 – References Provide three (3) references of the same or similar magnitude to this solicitation request where the proposed product has been used within the past five (5) years, including company name, contact person, phone number and e-mail address. Unless specifically asked by the County, the County of Volusia shall not be listed as a reference. (see Section 5.0) Tab 4 – Financial Statement A Dun and Bradstreet report may be used by the County to evaluate Respondent’s financial stability. All Respondents shall be prepared to supply a financial statement upon request, preferably a certified audit of the last available fiscal year. Tab 5 – Forms A. Business Tax Receipt (BTR) To be responsive to this solicitation, each Respondent who is currently required to have a Business Tax Receipt (BTR) at the time of submittal shall provide a copy of their current BTR in their response to this solicitation. There are two exceptions to this requirement: 1. If Respondent’s business does not have a physical location in Volusia County, no submission is required, OR 2. If Respondent’s business type is exempt, submit a Proof of Exemption approved by the Volusia County Revenue Director (see Section 8.0). Reference: Chapter 114, Article I, Section 114-1 of the Volusia County Code of Ordinances: www.volusia.org/revenue/local-business-tax/business-tax-frequently-asked-questions.stml B. Insurance Attach evidence of required insurance coverage or proof of insurability in the amounts indicated. If available, a properly completed ACORD Form is preferable. Final forms must contain the correct solicitation and/or project number, name the Volusia County contact person, and show the County of Volusia as additional named insured. 16-P-64AK, Cardiac Monitors Page 40 of 53 Firms that have owner/operators that have filed a "Notice of Election to be Exempt" shall submit a copy with the proposal. (see Section 9.0) Incorporated and unincorporated firms that qualify for an exemption under the Florida Worker’s Compensation law in Chapter 440 Florida Statutes shall submit an executed waiver relieving the County of liability in the event they are injured while providing goods and/or services to the County. C. Conflict of Interest Form All Respondents shall properly complete, have notarized, and include with their proposal the attached statement disclosing any potential conflict of interest that the Respondent may have due to ownership, other clients, contracts, or interests associated with this project. (see Section 10.0) D. Taxpayer Identification Number (TIN) and Certification Form Include a completed TIN form. If the firm is not registered with Volusia County, on-line registration is available at www.volusia.org/purchasing under Vendor Self Service, which links to the registration site and the TIN form can be accessed through this site as well. E. Addenda Any addenda issued subsequent to the release of this solicitation must be signed and returned with the firm’s proposal. Failure to return signed addenda may be cause for the proposal to be considered non-responsive. F. Drug-Free Work Place Form (see Section 11.0) G. Certification Regarding Debarment (Prime) Form (see Section 12.0) H. Certification Regarding Debarment (Sub) Form (see Section 13.0) Tab 6 - Additional Information (25 pages max.) All supporting information, report, and screen formats that Respondent believes relevant to understanding the Cardiac Monitor and its software shall be included and referenced. Also, give a sample of some of the key outputs (reports and screens) that the system can generate. Tab 7 – Attachments A and B All Respondents shall complete Attachment A – Pricing (all 5 tabs) and Attachment B – Cardiac Monitors Specifications and Functionality. Include a 16-P-64AK, Cardiac Monitors Page 41 of 53 hard copy in Tab 7. Respondents shall print all 5 tabs of Attachment A – Pricing and include in Tab 7. Additionally, Attachments A and B shall be included in the electronic copy (see §3.16) in their native format. Tab 8 - Delivery All Respondents shall supply a delivery plan that shall include estimated time frame for delivery and provide information on how they want the trade in equipment returned. Please refer to §2.3 Tab 9 - Service Agreement (including training), Preventive Maintenance, and Warranty All Respondents shall describe their service agreements, preventive maintenance, and warranty agreements. List all items that are included and excluded. Include a training schedule. Please refer to §2.4, §2.5 and §2.6. [REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK] 16-P-64AK, Cardiac Monitors Page 42 of 53 ___________________, 2016 5.0 PROPOSAL FORM TO: County of Volusia, Florida Office of Purchasing and Contracts Director 123 W. Indiana Avenue, 3rd Floor DeLand, FL 32720-4608 The undersigned hereby declare(s) that [firm name] ____________________________________ has carefully examined the specifications to furnish: Cardiac Monitors for which proposals were advertised to be received no later than 3:00 p.m., local time, Tuesday, March 22, 2016, and further declare that [firm name] ____________________________________ will furnish the Cardiac Monitors according to specifications. The County reserves the right to negotiate with the award vendor(s) for additional items similar in nature not known at time of closing. Sole Proprietor:  YES  NO Total number employees: _______ The following information is required in order to be granted a price redetermination. Assuming that the prices quoted include costs for vehicles, maintenance, repair, insurance, fuel, wages, insurances and other employee benefits, materials, overhead, operating expenses, etc., what percentage of the rate is directly attributed to the cost of fuel? ..............................______% Which does the firm use:  Diesel fuel or  Gasoline? Assuming that the prices quoted include costs for vehicles, maintenance, repair, insurance, fuel, wages, materials, overhead, operating expenses, etc., what percentage of the rate is directly attributed to the cost of wages? ..........................................................................................______% Assuming that the prices quoted include costs for vehicles, maintenance, repair, insurance, fuel, wages, insurances and other employee benefits, materials, overhead, operating expenses, etc., what percentage of the rate is directly attributed to the cost of materials? ..........................______ F.O.B. Destination Prompt payment discount, if applicable: __________ % __________ Days; Net 45 Days Do you accept electronic funds transfer (EFT)?  YES  NO Do you offer a discount for electronic funds transfer (EFT)?  YES, ____ %  NO 16-P-64AK, Cardiac Monitors Page 43 of 53 Have you supplied all the Submittal Requirements outlined below?  Tab 1 – Submittal Letter including the Memorandum of Authority, if required  Tab 1 – Respondent’s Profile  Tab 2 - Completed and executed RFP Proposal form  Tab 3 - References, in accordance with requirements of Tab 3  Tab 4 – Financial Statement, upon request  Tab 5 – Forms  If you have a physical location in Volusia County, submit one of these:  Current Business Tax Receipt, OR  Proof of Exemption Form  Proof of Insurance  Hold Harmless Agreement and/or Notice of Election to be Exempt, if required  Conflict of Interest form  Tax Identification Number Form  Any addenda pertaining to this RFP  Drug Free Workplace  Certification Regarding Debarment (Prime)  Certification Regarding Debarment (Sub)  Tab 6 – Additional Information  Tab 7 – Attachments A and B  Tab 8 – Delivery Plan  Tab 9 – Service Agreement (including training), Preventive Maintenance, and Warranty information  Did you include a CD or USB drive, as required in Section 3.8, Proposal Form? The County of Volusia reserves the right to reject any or all proposals, to waive informalities, and to accept all or any part of any proposal as they may deem to be in the best interest of the County. 16-P-64AK, Cardiac Monitors Page 44 of 53 I hereby certify that I have read and understand the requirements of this Request for Proposal No. 16-P-64AK and, that I, as the Respondent, will comply with all requirements, and that I am duly authorized to execute this proposal/offer document and any Contract(s) and/or other transactions required by award of this RFP. Further, as attested to by below signature, I will provide the required insurance, per §3.23, Insurance, upon notification of recommendation of award. The vendor acknowledges that information provided in this proposal is true and correct:  Authorized Signature Printed Name Title Date Company Name Full Address Telephone Fax E-mail Address Dun & Bradstreet # Federal I.D. # [REMAINDER OF THIS PAGE INTENTIONALLY LEFT BLANK] 16-P-64AK, Cardiac Monitors Page 45 of 53 6.0 REFERENCES Agency #1 Address City, State, ZIP Contact Person E-mail Phone: Date(s) of Service Type of Service Comments: Agency #2 Address City, State, ZIP Contact Person E-mail Phone: Date(s) of Service Type of Service Comments: Agency #3 Address City, State, ZIP Contact Person E-mail Phone: Date(s) of Service Type of Service Comments: 16-P-64AK, Cardiac Monitors Page 46 of 53 7.0 NOTIFICATION REGARDING PUBLIC ENTITY CRIME & DISCRIMINATORY VENDOR LIST REQUIREMENTS & DISQUALIFICATION PROVISION A. Pursuant to Florida Statutory requirements, potential Respondents are notified: 287.133(2)(a) A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a Bid, proposal, or reply on a Contract to provide any goods or services to a public entity; may not submit a Bid, proposal, or reply on a Contract with a public entity for the construction or repair of a public building or public work; may not submit Bids, proposals, or replies on leases of real property to a public entity; may not be awarded or perform work as a Contractor, supplier, subcontractor, or consultant under a Contract with any public entity; and may not transact business with any public entity in excess of the threshold amount provided in s. 287.017 for CATEGORY TWO for a period of 36 months following the date of being placed on the convicted vendor list. 287.133(2)(b) A public entity may not accept any Bid, proposal, or reply from, award any Contract to, or transact any business in excess of the threshold amount provided in s. 287.017 for CATEGORY TWO with any person or affiliate on the convicted vendor list for a period of 36 months following the date that person or affiliate was placed on the convicted vendor list unless that person or affiliate has been removed from the list pursuant to paragraph (3)(f). A public entity that was transacting business with a person at the time of the commission of a public entity crime resulting in that person being placed on the convicted vendor list may not accept any Bid, proposal, or reply from, award any Contract to, or transact any business with any other person who is under the same, or substantially the same, control as the person whose name appears on the convicted vendor list so long as that person's name appears on the convicted vendor list. 287.134(2)(a) An entity or affiliate who has been placed on the discriminatory vendor list may not submit a Bid, proposal, or reply on a Contract to provide any goods or services to a public entity; may not submit a Bid, proposal, or reply on a Contract with a public entity for the construction or repair of a public building or public work; may not submit Bids, proposals, or replies on leases of real property to a public entity; may not be awarded or perform work as a Contractor, supplier, subcontractor, or consultant under a Contract with any public entity; and may not transact business with any public entity. 287.134(2)(b) A public entity may not accept any Bid, proposals, or replies from, award any Contract to, or transact any business with any entity or affiliate on the discriminatory vendor list for a period of 36 months following the date that entity or affiliate was placed on the discriminatory vendor list unless that entity or affiliate has been removed from the list pursuant to paragraph (3)(f). A public entity that was transacting business with an entity at the time of the discrimination resulting in that entity being placed on the discriminatory vendor list may not accept any Bid, proposal, or reply from, award any Contract to, or transact any business with any other entity who is under the same, or substantially the same, control as the entity whose name appears on the discriminatory vendor list so long as that entity's name appears on the discriminatory vendor list. B. By submitting a proposal, the Respondent represents and warrants that the submission of its proposal does not violate Section 287.133, Florida Statutes (2005), nor Section 287.134, Florida Statutes (2005). C. In addition to the foregoing, the Respondent represents and warrants that Respondent, Respondent’s subcontractors and Respondent’s implementer, if any, is not under investigation for violation of such statutes. D. Respondent should read carefully all provisions of 287.133 and 287.134, Florida Statutes (2005). 16-P-64AK, Cardiac Monitors Page 47 of 53 8.0 PROOF OF EXEMPTION BUSINESS SERVICES REVENUE DIVISION 123 W. INDIANA AVE. • ROOM 103 • DELAND, FL 32720-4602 PHONE: 386-736-5938 • FAX: 386-822-5729 www.volusia.org/revenue I certify that the business known as (business name) ___________________________________________________, providing ___________________________ services, which is located at (street address) _______________________ ____________________, (city) _________________________, falls under the business tax exemption described in:  Florida Statute 205. 063  Florida Statute 205. 065  Florida Statute 205. 191  Florida Statute 205. 064  Florida Statute 205. 162  Florida Statute 205. 192  Florida Statute 205. 171 www.volusia.org/revenue/local-business-tax/business-tax-frequently-asked-questions.stml OR is the type of business indicated below:  Child Care – Residential  Insurance Adjuster,  Radio/Television Station  Commercial Rentals Agent, or Company  Religious Institution  Door to Door/Peddler Sales  Pharmacist/Pharmacy  Residential Rentals over 6months (Prescription Drugs Only)  Sale of Alcoholic Products only _____________________________________ _____________________________________ (Authorized Signature) (Printed Name) STATE OF _____________________________ COUNTY OF ___________________________ Sworn to and subscribed before me this ______ day of __________________, 20______, by ________________________________________________________, who is/are personally known to me or who has/have produced ____________________________________ as identification. _______________________________________ NOTARY PUBLIC – STATE OF _____________ Type or print name: _______________________________________ Commission No.: _________________________ (Seal) Commission Expires: ______________________ A business that falls under one of the exempt classifications listed above is not required to have a Volusia County Business Tax Receipt. _____________________________________ Revenue Director/Designee 16-P-64AK, Cardiac Monitors Page 48 of 53 9.0 HOLD HARMLESS AGREEMENT I, _______________________________________, (print owner’s name), am the owner of ________________________________________________________ (print company name), an incorporated/unincorporated business operating in the State of Florida. As such, I am bound by all laws of the state of Florida, including but not limited to those regarding the workers’ compensation law. I hereby affirm that I or [the above-named business] employs fewer than four employees, all of whom are listed below, including myself, and therefore, the business is exempt from the statutory requirement for workers’ compensation insurance for its employees. I certify that I will provide the County of Volusia with the name of each new employee together with all required waivers and releases for each prior to any employee being allowed to work to provide services under the Contract set forth below. If any such employee is allowed to work without a signed waiver and release, such action will be a material breach of this Agreement. All signed waivers and releases shall be furnished before the commencement of any work by an employee or the undersigned to the County Project Manager or designated county representative. On _________________, 2016, the County of Volusia and I or (the above-named business) entered into a Contract for ___________________________________________ (please insert name of Contract) (hereinafter “Agreement”) which is incorporated by reference herein. On behalf of myself, my business, and the employees listed below, I and they hereby agree to waive and release any and all workers’ compensation claims or liens under Chapter 440, Florida Statutes, against the County of Volusia and its agents, officials and employees, arising from any work or services provided under the Agreement whether or not it shall be alleged or determined that the act was caused by intention, or through negligence or omission of the County of Volusia or its agents, officials and employees or subcontractors. In the event that a workers’ compensation claim or lien is made against the County of Volusia and/or its agents, officials or employees by myself or my employees or agents as a result of any work or services performed under the Agreement, I agree to indemnify, keep and hold harmless the County of Volusia, Florida, its agents, officials and employees, against all injuries, deaths, losses, damages, claims, liabilities, judgments, costs and expenses, direct, indirect or consequential (including, but not limited to, fees and charges of attorneys and other professionals) arising out of the Agreement with the County of Volusia, whether or not it shall be alleged or determined that the act was caused by intention or through negligence or omission of the County of Volusia or its employees, agents, or subcontractors. I or the above-named business shall pay all charges of attorneys and all costs and other expenses incurred in connection with the indemnity provided herein, and if any judgment shall be rendered against the County of Volusia in any action indemnified hereby, I or the above-named business shall, at my or its own expense, satisfy and discharge the same. The foregoing is not intended nor should it be construed as, a waiver of sovereign immunity of the COUNTY OF VOLUSIA under Section 768.28, Florida Statutes. 16-P-64AK, Cardiac Monitors Page 49 of 53 Owner: ___________________________ (print name)___________________________ (signature) Employee 1: ___________________________ (print name)___________________________ (signature) Employee 2: ___________________________ (print name)___________________________ (signature) Employee 3: ___________________________ (print name)___________________________ (signature) STATE OF _____________________________ COUNTY OF ___________________________ Sworn to and subscribed before me this ____ day of ________________, 20____, by _____________________________________________________, who is/are personally known to me or who has/have produced ____________________________________ as identification. ______________________________________________ NOTARY PUBLIC – STATE OF __________________ Type or print name: _____________________________________________ Commission No.: __________________________ (Seal) Commission Expires: __________________________ 16-P-64AK, Cardiac Monitors Page 50 of 53 10.0 CONFLICT OF INTEREST FORM I HEREBY CERTIFY that: 1. I, (printed name) ___________________________________________________________, am the (title) _________________________________________ and the duly authorized representative of the firm of (Firm Name) ___________________________________________ whose address is ____________________________________________________________, and that I possess the legal authority to make this affidavit on behalf of myself and the firm for which I am acting; and, 2. Except as listed below, no employee, officer, or agent of the firm have any conflicts of interest, real or apparent, due to ownership, other clients, Contracts, or interests associated with this project; and, 3. This proposal is made without prior understanding, agreement, or connection with any corporation, firm, or person submitting a proposal for the same services, and is in all respects fair and without collusion or fraud. EXCEPTIONS to items above (List): ___________________________________________________ ______________________________________________________________________________________ Signature: ______________________________________________________________ Printed Name: ______________________________________________________________ Firm Name: ______________________________________________________________ Date: ___________________ STATE OF _____________________________ COUNTY OF ___________________________ Sworn to and subscribed before me this ____ day of ________________, 20____, by _____________________________________________________, who is/are personally known to me or who has/have produced ____________________________________ as identification. ______________________________________________ NOTARY PUBLIC – STATE OF __________________ Type or print name: ______________________________________________ Commission No.: _____________________________ (Seal) Commission Expires: ____________________________ 16-P-64AK, Cardiac Monitors Page 51 of 53 11.0 DRUG-FREE WORK PLACE The undersigned firm, in accordance with Florida statute 287.087, hereby certifies that _______ ___________________________________________does: (Name of Firm) 1. Publish a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession, or use of a controlled substance is prohibited in the workplace and specifying the actions that will be taken against employees for violations of such prohibition. 2. Inform employees about the dangers of drug abuse in the workplace, the business’s policy of maintaining a drug-free workplace, any available drug counseling, rehabilitation, and employee assistance programs, and the penalties that may be imposed upon employees for drug abuse violations. 3. Give each employee engaged in providing the commodities or contractual services that are proposed a copy of the statement specified in subsection (1). 4. In the statement specified in subsection (1), notify the employees that, as a condition of working on the commodities or contractual services that are under proposal, the employee will propose by the terms of the statement and will notify the employer of any conviction of, or plea of guilty or nolo contender to, any violation of Chapter 893 or of any controlled substance law of the United States or any state, for a violation occurring in the workplace no later than five (5) days after such conviction. 5. Impose a sanction on, or require the satisfactory participation in a drug abuse assistance or rehabilitation program if such is available in the employee’s community, by any employee who is so convicted. 6. Make a good faith effort to continue to maintain a drug-free workplace through implementation of this section. As the person authorized to sign the statement, I certify that this firm complies fully with the above requirements. ______________________________________ __________________ Name and Title Date _____________________________________ Signature ______________________________________ Firm ______________________________________ Street address ______________________________________ City, State, Zip 16-P-64AK, Cardiac Monitors Page 52 of 53 12.0 CERTIFICATION REGARDING DEBARMENT (PRIME) Certification Regarding Debarment, Suspension, And Other Responsibility Matters Primary Covered Transactions TO BE COMPLETED BY PRIME CONTRACTOR A. The prospective primary participant (contractor) certifies to the best of its knowledge and belief, that it and its principals (subcontractors and suppliers): 1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; 2. Have not within a three (3) year period preceding this bid proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property. 3. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification; and 4. Have not within a three-year period preceding this bid proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. B. Where the prospective primary participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this bid proposal. ______________________________________ __________________ Name and Title Date _____________________________________ Signature ______________________________________ Firm ______________________________________ Street address ______________________________________ City, State, Zip 16-P-64AK, Cardiac Monitors Page 53 of 53 13.0 CERTIFICATION REGARDING DEBARMENT (SUB) Certification Regarding Debarment, Suspension, Ineligibility And Voluntary Exclusion TO BE COMPLETED BY ALL SUB-CONTRACTORS A. The prospective participant (sub-contractor) certifies to the best of its knowledge and belief, that it and its principals (subcontractors and suppliers): 1. Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any Federal department or agency; 2. Have not within a three (3) year period preceding this bid proposal been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or contract under a public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property. 3. Are not presently indicted for or otherwise criminally or civilly charged by a government entity (Federal, State, or local) with commission of any of the offenses enumerated in paragraph (1) (b) of this certification; and 4. Have not within a three-year period preceding this bid proposal had one or more public transactions (Federal, State, or local) terminated for cause or default. B. Where the prospective participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this bid proposal. ______________________________________ __________________ Name and Title Date _____________________________________ Signature ______________________________________ Firm ______________________________________ Street address ______________________________________ City, State, Zip Attachment A—Pricing (Please complete all five tabs) RFP 16-P-64AK Page 1 of 9 Description Cost a. One (1) limb lead cable; b. One (1) 12-lead cable; c. One (1) Patient Therapy/Defibrillation Cable; d. One (1) NIBP Hose; e. One (1) each of the following NIBP cuffs – Infant, Child, Adult, Large Adult; f. One (1) User Test module (if required to perform daily user tests); g. One (1) Adult SpO2/SpCO reusable sensor w/ extension cable (must be at least 5’ in length); h. One (1) Pediatric SpO2/SpCO reusable sensor w/extension cable (must be at least 5’ in length); i. Three (3) factory direct batteries; j. One (1) standard/premium (pathogen resistant) carry case with shoulder strap; k. One (1) storage card or internal memory that will save a minimum of 15 patient encounters and/or 6 hours of continuous data for upload; l. One (1) wireless card that will allow for transmission of EKG’s. Vendor shall provide a list of data carriers with the pricing option for data plans. Total Cost (per unit) Pricing shall be inclusive of the cardiac monitor and the following accessories. Prices shall include all delivery costs. Please provide pricing on a per-unit basis: Cardiac Monitor, Brackets, and Charger Pricing Please complete page 2 below and the other four tabs. Attachment A—Pricing (Please complete all five tabs) RFP 16-P-64AK Page 2 of 9 Cardiac Monitor, Brackets, and Charger Pricing Description Cost per Unit Mobile charging station that can charge a minimum of one (1) battery. These charging stations shall be able to be hardwired in the emergency vehicle. Pricing shall include installation by the contractor or their representative. The estimated number of mobile charging station is fifty-four. Approval of installation plan must be approved by Volusia County Fleet Services prior to installation. Please price per unit. -$ Station charger that shall be able to charge a minimum of four (4) batteries at once. The estimated number of station chargers is twenty-sever (27). Please price per unit.-$ Ambulance mounts/brackets for cardiac monitors. Mounts/brackets shall be installed by the contractor or their representative. The estimated number of mounts/brackets is fifty-four (54). Approval of plan to install mounts/brackets must be approved by Volusia County Fleet Services prior to installation. Please price per unit. -$ Attachment A—Pricing RFP 16-B-64AK Page 3 of 9 Description Cost per Unit a. Methemoglobin $0.00 b. Invasive/Core Temperature Testing $0.00 c. Arterial Line Monitoring $0.00 Optional Items The Vendor shall provide pricing for the following optional items (per unit): Attachment A—Pricing RFP 16-P-64AK Page 4 of 9 Description Estimated Number of Units Trade-In Value (per unit) 55 $0.00 15 $0.00 70 $0.00 70 $0.00 Zoll E-Series Cardiac Monitor/Defibrillators (includes ETCO2, with 12-lead, SpO2, NIBP) Zoll M-Series Cardiac Monitor/Defibrillators (includes ETCO2, with 12-lead, SpO2, NIBP) Chargings Units Batteries Trade-In Value As part of this RFP, the Department of Public Protection will be trading in the following equipment. Please price per unit. Attachment A—Pricing RFP 16-P-64AK Page 5 of 9 Year 1 Summary Annual Cost $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Year 1 Cost $0.00 Year 2 Summary Annual Cost $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Year 2 Cost $0.00 List all annual maintenance and support costs associated with the cardiac monitors.Identify and itemize all hardware and software maintenance costs. Please complete all three pages. Annual Maintenance and Support Attachment A—Pricing RFP 16-P-64AK Page 6 of 9 Annual Maintenance and Support Year 3 Summary Annual Cost $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Year 3 Cost $0.00 Year 4 Summary Annual Cost $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Year 4 Cost $0.00 Attachment A—Pricing RFP 16-P-64AK Page 7 of 9 Annual Maintenance and Support Year 5 Summary Annual Cost $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Total Year 5 Cost $0.00 Attachment A—Pricing RFP 16-P-64AK Page 8 of 9 Description of Accessories and Components Discount off List Price Cost 1. Limb Lead Cables $0.00 2. 12-Lead Cables $0.00 3. SpO2/SpCO sensors/probes/cables (both pediatric and adult)$0.00 4. NIBP hoses $0.00 5. NIBP cuffs $0.00 6. Replacement carrying cases $0.00 7. Factory Direct replacement batteries.$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 List costs of Accessories and Components. If priced at list minus discount, please list discount amount. Include any other accessories or components not listed below. Please complete second page, if needed. Attachment A—Pricing RFP 16-P-64AK Page 9 of 9 Description of Accessories and Components Discount off List Cost $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Attachment B CARDIAC MONITORS SPECIFICATIONS AND FUNCTIONALITY RFP 16-P-64AK Page 1 of 2 RESPONSE 1 Each Respondent shall describe the specifications and functionality of the proposed Cardiac Monitor as outlined in the following sub-sections. All responses need to be detailed and direct. For functionality responses, a full description of the proposed feature is required; a simple affirmative response (e.g. yes, meets, etc.) will not suffice. Failure to fully provide a response to all of the requested information may be cause for the proposal to be rendered non-responsive. 1.1 1 Internal memory or storage card shall be able to save a minimum of 15 patient encounters and/or 6 hours of continuous data for upload. J.Ability to perform Transcutaneous Pacing (TFP) K. L.Ability to upload complete full-disclosure case reports to an ePCR solution (current solutions in use by The County of Volusia are Zoll ePCR and FireHouse). The vendor shall list all ePCR solutions that can facilitate a direct upload with their product M. Ability to transmit electrocardiograms (EKG) directly from the cardiac monitor to a receiving hospital with the use of a wireless card (i.e. from a remote location away from response vehicle) Ability to upload complete full-disclosure case reports to a repository (client based and/or cloud based) to ensure all patient reports are stored REQUIRED INFORMATION Approved for use by the Food and Drug Administration (FDA) in a pre-hospital setting Ability to monitor and print 12-lead EKG rhythms A. C. SPECIFICATIONS AND FUNCTIONALITY PROPOSED cardiac monitor B.Ability to monitor, print and visually display 4-lead EKG rhythms Ability to monitor and visually display continuous, real-time peripheral capillary oxygen saturation (SpO2) D. E. H. Ability to perform Unsynchronized Defibrillation based on current American Heart Association recommendations Ability to monitor and visually display continuous, real-time end tidal carbon dioxide readings (ETCO2) F. G. I. Ability to perform Synchronized Cardioversion based on current American Heart Association recommendations Ability to monitor and display carbon monoxide (SpCO) readings Ability to perform non-invasive blood pressure monitoring (NIBP) Attachment B CARDIAC MONITORS SPECIFICATIONS AND FUNCTIONALITY RFP 16-P-64AK Page 2 of 2 RESPONSEREQUIRED INFORMATION 1.2 1.3 N. O. The cardiac monitor must be able to be secured inside the patient compartment of a transport vehicle in accordance with National Fire Protection Association standards. The cardiac monitor must be able to be secured to the stretcher for continuous patient monitoring while moving the patient from one location to another on the stretcher. The vendor shall provide Ability for the end-user to be able to view the entire case report after upload and shall be able to be viewed in real-time. This ability can be either built into the ePCR or can be a standalone product that can Preventative Maintenance. The preventative maintenance plan shall include: The cost of expedited loaner equipment; Weekly on-site repair visits; P. Bi-Annual (2 times per year) preventative maintenance/quality assurance checks; Replacement parts/accessories. A. B. C. D. Warranty. The warranty shall include: A. One (1) year parts and labor warranty against manufacturing defects affecting the performance of the unit, to include transport of affected unit (s); B. Two (2) year components warranty against manufacturing defects affecting the performance of the components. COUNTY OF VOLUSIA PURCHASING & CONTRACTS DIVISION 123 West Indiana Avenue, Room 302 DeLand, Florida 32720-4608 (386) 736-5935  Fax: (386) 736-5972 www.volusia.org March 18, 2016 ADDENDUM NO. 2 RFP No. 16-P-64AK, Cardiac Monitors The purpose of this addendum is to provide the following clarifications, changes, modifications and/or additions to the solicitation documents. This addendum is an integral part of the Solicitation/Contract Documents. The following questions have been received: Q1. Will you verify that tab four may be left blank? A1. Yes. However, all Respondents shall be prepared to supply a financial statement upon request, preferably a certified audit of the last available fiscal year. Q2. Please verify that for tab 6, 25 pages is a general number and it is acceptable to go over by a couple of pages? A2. Yes, it is acceptable to go over by a couple of pages. Q3. Please provide an exact quantity of trades and battery charges to be quoted? A3. Volusia County Emergency Medical Services (VCEMS) will be trading in a total of 38 E- Series cardiac monitors (bi-phasic) as long as 38 new cardiac monitors can be purchased (based on prices). VCEMS will be trading in 8 multi bay (4 batteries per charger) unless new device can utilize the same chargers. Volusia County Fire Rescue (VCFR) will be trading in a total of 10 E-Series cardiac monitors with Rainbow technology (bi-phasic), 7 E-Series monitors with CAPNO (bi-phasic), 15 M- Series monitors with CAPNO (bi-phasic). VCFR currently has 26 multiple well chargers (4 battery wells). Q4. Please break down which chargers are to be 1 bay chargers versus multi bay chargers? A4. VCEMS will need 50 1 bay chargers (1 per ambulance) and will need to have the ability to charge 50% of all batteries issued with cardiac monitors (dependent on if monitor takes 1 or 2 batteries). VCFR will need five (5) one well chargers and will need twenty-five (25) multiple bay chargers, minimum of two well to a maximum of four well chargers. Q5. Does there need to be a charger in the ambulance or will AC Power (standard on the X series) suffice as a charging method on an ambulance? A5. VCEMS would prefer to have a battery charger in each ambulance. This means a purchase of 1 battery charger per monitor with the intent of purchasing a charger for each ambu lance (50 total for VCEMS). Addendum No. 2 RFP 16-P-64AK, Cardiac Monitors Page 2 of 14 VCFR would prefer to have a 1 well battery charger in each of our transport units (Total of 5). Q6. Are we still to quote mounting brackets even though we discussed that the county could possibly get a better price through the bracket manufacturers? A6. The County of Volusia would prefer the vendor provide a quote for a bracket including the brand/model for the bracket. The County may choose not to purchase the bracket depending on price. Q7. Will you please clarify the “annual maintenance” tab on attachment A? Are you asking what the service agreement costs during each year? Or are you asking for us to guess what repair costs would be outside of a service agreement in those years? A7. Annual maintenance shall be what is provided for preventative maintenance and what would be covered under that agreement. If normal wear/tear (not intentional damage) is covered then that should be included in the price. It is important for the vendor to advise what will be covered under the annual maintenance. No estimates for damage are needed; those would have to be handled by each division. Q8. On the “pricing of cardiac monitors” tab of attachment A, letter “l”, you ask for pricing of wireless cards. We would be providing the cost of a cell modem and data plans. Will this suffice? A8. The ability to provide a recommended vendor for wireless cards/data plans will be sufficient for bid purposes as that would be budgeted through other means. Q9. Who is going to be on the TEAC? A9. The TEAC will comprise of County of Volusia employees. Q10. Are the trade-in cardiac monitors monophasic or biphasic? A10. All of the monitors are bi-phasic. Q11. For the software, how many computer licenses does the County need? A11. The County of Volusia will need a total of 8 licenses. Q12. Do you require four-well charges or do you want other options? A12. VCEMS does not have a preference but would like the vendor to provide pricing on multi bay chargers. VCEMS would like the ability to charge 50% of all batteries at one time. VCFR would prefer to have multiple battery charger; minimum of two-well to maximum of four-well charger. These would be located at the fire stations, training facility and logistical depot. VCFR would need twenty-five (25) multiple well chargers. Q13. How many mobile charging stations does the County need? A13. VCEMS needs 50 single bay chargers; one for each ambulance. VCFR needs 25 multiple well chargers and 5 single well chargers. Q14. In regards to the transmitting EKG, do you want pricing plans? A14. Transmitting of EKGs are required; monitors should be capable of performing this function. If there is an additional cost associated with transmitting EKGs, please provide the cost. Q15. In regards to securing to the stretchers, what type of stretchers does the County have? A15. VCEMS currently has Ferno PowerFLEXX stretchers. VCFR currently has Ferno 35X Series PROFlexx but will soon be changing stretchers. The new stretchers have not been purchased as of this date. Addendum No. 2 RFP 16-P-64AK, Cardiac Monitors Page 3 of 14 Q16. Will there be multi bay charges in the stations? A16. VCEMS would like to secure enough station chargers to charge 50% of all batteries per ambulance. VCFR will need multiple well chargers at the fire stations; total of 25. Q17. Do you require new equipment? A17. Yes. Q18. Will you be trading in one for one? A18. VCEMS will be trading one-for-one up to 38 monitors. Additional monitors purchased will not have a trade in available. VCFR will be trading in 17 E-Series and 15 M-Series; purchasing a total of 27 new monitors. Q19. Please list the trade in equipment (Make/Model). A19. VCEMS has 38 E-Series Cardiac monitors with ETCO2, SPo2, NIBP, 4-lead/12-lead, Multi- Function Cable (Defibrillation). VCFR - 17 E-Series cardiac monitors with 4-lead/12-lead, SpO2, ETCO2,NIBP, BT/GPS, Multi-Function Cable for pacing & defibrillation. 10 E-Series cardiac monitors with 4- lead/12-lead, SpO2, SpCO, ETCO2, NIBP, BT/GPS, Multi-Function Cable for pacing & defibrillation, (Rainbow Tech). 15 M-Series with 4-lead/12-lead, SpO2, ETCO2, Multi- Function Cable for pacing & defibrillation. Q20. Will the County be buying the monitors all at once? A20. No, the County anticipates purchasing the monitors over several fiscal years. VCEMS would like to purchase a minimum of 38 this year; a grant is outstanding for an additional fourteen (14) cardiac monitors for a total 52 monitors. VCFR would like to purchase 27 monitors this year. Q21. Do we need to include Section 9.0 Hold Harmless Agreement if it does not apply to our company? A21. If Section 9.0 Hold Harmless Agreement does not apply to your company, you do not need to submit the form with your proposal. Q22. In the pricing attachment for brackets and chargers, it discusses “Mobile charging station.” Shall be able to be hardwired in the emergency vehicle” Does a power cord classify as hard wired in addition to the fact that the charger can be mounted in the vehicle? A22. There are outlets available for a power cord for a charger. VCEMS would consider a charger with a power cord of at least 5' in length. If the new monitor has an external connection for an A/C power source, then VCFR requires a power cord of at least 5 ft in length to power the monitors. There are 110V outlets in the patient compartment of the transport units. Q23. Preventative Maintenance question: OEM/Physio only recommends one Preventative Maintenance per year. We can offer a program where you can get 2 PM’s per year, as it states on SPECS, but it will add cost to your service. Would you like us to include 2 PMs per year or just the standard one per year? (Every single time our technician touches a device, even if it is to just look at a battery or a cable, he performs a PM on that device-included in the service plan). A23. Based on the expectation that the technician would be performing a "PM" on any monitor with an issue VCEMS and VCFR are comfortable with a single PM. If the technician doesn't Addendum No. 2 RFP 16-P-64AK, Cardiac Monitors Page 4 of 14 perform a PM on a monitor when there is an issue then bi-annual PM's would be requested. The vendor needs to recommend the number of PM per year for the units and price accordingly. Define what is included in the PM; service of components, calibration, software updates and etc. Will the PM be conducted “on-site” or will the units have to be sent out for PM? Q24. On the pricing matrix: you ask for the unit cost to include a Pediatric SPO2 and CO/Rainbow sensor in addition to an adult Rainbow sensor. The Rainbow sensors are costly and most customers get a Rainbow sensor (capable of reading both Met and CO-if included on devices) for the adult and then use a Pediatric SPO2 only sensor for the peds. The assumption is that if the accompanying adult is CO positive, then the child is too. (it will save $’s by only having an adult Rainbow sensor). Do you still want us to quote Rainbow for Adult and Pedi? A24. The County of Volusia would like to have pricing on both Adult and Pediatric Rainbow sensors. The vendor may also offer pricing on pedi SPO2 sensors as an option for consideration. Q25: Will the County of Volusia accept the following exceptions and clarifications to the Request for Proposal for Cardiac Monitors RFP No. 16-P-64AK? A25: Please see the County’s response for each exception below (bold and underlined). 2.6 Warranty A. The warranty shall be the manufacturer’s standard warranty. All warranty work shall be performed at one of the locations listed in §2.5(C) above. Products purchased pursuant to this proposal are subject to the terms set forth in the Physio-Control Standard Limited Warranty, enclosed in this response. B. Warranty shall include, at a minimum: 1. One (1) year pParts and labor are covered by a ninety (90) day limited warranty against manufacturing defects affecting the performance of the unit, to include transport of affected unit(s); 2. Two (2) year components The LIFEPAK ® 15 monitor/defibrillator is covered by a one (1) year limited warranty against manufacturer defects affecting the performance of the device components. The County of Volusia will accept the manufacturer’s standard warranty. Section 2.6(B) is hereby deleted. 3.12 F.O.B. Point The F.O.B. points for the Contract and for all purchases made under it shall be F.O.B. Physio-Control’s shipping point, and title shall pass to Customer on delivery to a shipper. as specified by the using department (in accordance with the RFP proposal form), in Volusia County, Florida. Delivery will not be complete until the using department has Addendum No. 2 RFP 16-P-64AK, Cardiac Monitors Page 5 of 14 accepted each item. Delivery to a common carrier shall not constitute delivery to the ordering agency. All disputes shall be between the Seller/Respondent and the carrier. The County of Volusia does not accept this exception and §3.12 remains the same. 3.14 Assignment Contractor may not assign or otherwise convey Contractor’s rights and/or obligations under this Contract without obtaining County’s prior written consent, which consent County may withhold, limit and/or condition in County’s sole discretion, including, but not limited to posting a performance bond. Any consent by the County under this Section 0 3.14 shall be by written amendment to the Contract in a form and substance specified by the County in its sole discretion. If Contractor desires to assign or otherwise convey its rights and/or obligations under this Contract, Contractor no less than thirty (30) days for County’s consent. Failure to provide such notice may result in the County assessing a processing fee of Five Hundred Dollars (US $500.00). Notwithstanding the foregoing, Physio-Control may assign this Agreement without such consent to any person, firm or corporation succeeding to its business and also to any parent, subsidiary or affiliated company of Physio-Control. Failure by the Contractor to obtain the County’s consent in accordance with this Section prior to assignment or other conveyance shall: 1) constitute a material breach of the Contract; and 2) entitle the County to retain any and all legal rights, claims and defense to enforce this Section 0 3.14, including, but not limited to, injunctive, declaratory, damages and attorney’s fees and costs. Payment of any sum by the County in accordance with the Contract to the Contractor or any person or entity prior to the Contractor obtaining the County’s consent to the assignment shall not constitute a waiver of the rights of the County under this Section 0 3.14. Nothing herein shall preclude the right of the County to waive its rights under this Section 0 3.14 but no waiver shall be granted by the County without amendment to the Contract. All references to Section 0 are hereby changed to Section 3.14. The County of Volusia does not accept the other exceptions and §3.14 remains the same, except for the corrected section numbers. Section 3.15 Contract has been revised to read: 3.15 Contract A. The contents of this RFP and all provisions of the successful Proposal deemed pertinent by the County may be, at the sole discretion of the County, incorporated into a Contract and Addendum No. 2 RFP 16-P-64AK, Cardiac Monitors Page 6 of 14 become legally binding on the selected proposer. The content of the Contract may contain changes as a result of the RFP process and the content of the submittal received. The Contract shall, at minimum, include the substantive terms and conditions as outlined in the RFP and be subject to review by the County attorney or designee prior to approval and execution for determination of legal form and substantive sufficiency, and may contain those additional terms and conditions that both parties have agreed on. Section 3.16 Disclosure of Proposal Content has been revised to read: 3.16 Disclosure of Proposal Content A. All material submitted becomes the property of the County and may be returned only at the County's option. Please refer to §3.7, Public Records (§119.0701, Florida Statutes). 3.17 Respondent's Responsibility E. The Respondent understands and accepts that it will be held responsible for any and all discrepancies, errors, etc., in discounts or rebates which are discovered during the Con tract te rm o r up t o a n d in clud ing t h ree (3) f iscal ye a rs fo llo wing t h e Cou n ty’s annual audit. The County of Volusia does not accept this exception and §3.17 remains the same. Section 3.23(A)(5) and §3.23(A)(7)(b) have been revised to read: 3.23 Insurance A. Required Types of Insurance 5. Excess/Umbrella Liability. Per Section 3.23, A, the Contractor shall obtain an excess liability policy in addition to the scheduled underlying policies (commercial general liability, business auto liability, professional, and employers' liability) with a limit of no less than the amount shown above. This insurance shall name the County as an additional insured and include blanket contractual coverage endorsement. The excess/umbrella liability policy shall provide exclusive coverage for the location or project site where the work or services are to be performed under this Contract. Addendum No. 2 RFP 16-P-64AK, Cardiac Monitors Page 7 of 14 7. Professional Liability: b. The Contractor must maintain a retroactive date prior to or equal to the effective date of this Contract. In addition, the Contractor shall require that the Subcontractor’s carrier immediately inform the Contractor, the County of Volusia Risk Management Division, and the Purchasing and Contracts Division of any contractual obligations that may alter its professional liability coverage under this Contract. 3.27 Waiver of Claims Once the Contract expires, or final payment has been requested and made, the Contractor shall have no more than thirty (30) calendar days reasonable time to present or file any claims against the County concerning the Contract. After that period, the County will consider the Contractor to have waived any right to claims against the County concerning the Contract. The County does not accept this exception and §3.27 remains the same. 3.40 Right to Require Performance B. In the event of failure of the Contractor to deliver services in accordance with the Contract terms and conditions, the County, after due written notice, may procure the services from other sources and hold the Contractor responsible for any resulting additional purchase and administrative costs. This remedy shall be in addition to any other remedies that the County may have. The County of Volusia does not accept this exception and §3.40(B) remains the same. Section 3.23 Insurance has been revised to read: 3.23 Insurance A. Required Types of Insurance The Contractor shall purchase and maintain at its own expense, during the term of this Contract the following types and amounts of insurance with limits no less than those shown below, in the form and from companies satisfactory to the County: SCHEDULE LIMITS Workers’ Compensation Florida Statutory Coverage Commercial General Liability ............ $2,000,000. General Aggregate ............................................................. $1,000,000. Personal/Advertising Injury Blanket Contractual Liability.............. $1,000,000. Each Occurrence Addendum No. 2 RFP 16-P-64AK, Cardiac Monitors Page 8 of 14 (The County of Volusia shall be named as an additional insured under General Liability-Premises/Operations Auto Liability...................................... $1,000,000. CSL All autos-owned, hired or no-owned (Symbol 1 Coverage) Excess Liability................................... $5,000,000. Per Occurrence Products Liability................................ $1,000,000. Per Occurrence 1. Minimum underlying coverages shall include Commercial General Liability, Automobile Liability and Workers’ Compensation/Employer’s Liability. (Umbrella liability limit will not be required to be carried by Subcontractors.) (If the services provided require the disposal of any hazardous or non- hazardous materials off the job site, the disposal site operator must furnish a certificate of insurance for Pollution Legal Liability with coverage for bodily injury and property damage for losses that arise from the facility that is accepting the waste under this contract). 2. Umbrella or Excess Liability policies may be used to obtain the total limits of liability required to meet the required limits of coverage stated above. Evidence of such coverage should clearly demonstrate the underlying coverages/policies that are included. 3. Workers’ Compensation Insurance. Per Section 3.23, A, Workers’ Compensation insurance is required for all employees of the Contractor, employed or hired to perform or provide work or services under this Contract or that is in any way connected with work or services performed under this Contract, without exclusion for any class of employee, and shall comply fully with the Florida Workers’ Compensation Law (Chapter 440, Florida Statutes, Workers’ Compensation Insurance) and include Employers’ Liability Insurance with limits no less than the statutory amount shown above per occurrence. a. Contractor and its Subcontractors, or any associated or subsidiary company doing work on County property or under this Contract must be named in the Workers’ Compensation coverage or provide proof of their own Workers’ Compensation coverage, without exclusion of any class of employee, and with a minimum of the statutory limits per occurrence for Employer’s liability coverage. Further, if the Contractor's Subcontractors fail to obtain Workers’ Compensation insurance and a claim is made against the County by the uncovered employee of said Subcontractor of the Contractor, the Contractor shall indemnify, defend, and hold harmless the County from all claims for all costs Addendum No. 2 RFP 16-P-64AK, Cardiac Monitors Page 9 of 14 including attorney’s fees and costs arising under said employee(s) Workers’ Compensation insurance claim(s). 4. Commercial General Liability Insurance. Per Section 3.23, A, Commercial General Liability insurance, with a limit of not less than the amounts shown above with an aggregate limit and per occurrence basis, including coverage for the Contractor’s operations, independent Contractors, Subcontractors and “broad form” property damage coverages protecting itself, its employees, agents, Contractors or subsidiaries, and their employees or agents for claims for damages caused by bodily injury, property damage, or personal or advertising injury, products liability/completed operations including what is commonly known as groups A, B, and C (libel, false arrest, slander). Such policies shall include coverage for claims by any person as a result of actions directly or indirectly related to the employment of such person or entity by the Contractor or by any of its Subcontractors arising from work or services performed under this Contract. Public liability coverage shall include either blanket contractual insurance or a designated Contract contractual liability coverage endorsement, indicating expressly the Contractor’s contract to indemnify, defend and hold harmless the County as provided in this Contract. The commercial general liability policy shall be endorsed to include the County as an additional insured under Premises/Operations. The commercial general liability policy shall provide exclusive coverage for the location or project site where the work or services are to be performed under this Contract. 5. Excess/Umbrella Liability. Per Section 3.23, A, the Contractor shall obtain an excess liability policy in addition to the scheduled underlying policies (commercial general liability, business auto liability, professional, and employers' liability) with a limit of no less than the amount shown above. This insurance shall follow the underlying and include either blanket contractual or a designated contract contractual coverage endorsement, indicating expressly the Contractor’s agreement to hold the County harmless. 6. Motor Vehicle Liability. Per Section 3.23, A, the Contractor shall secure and maintain during the term of this Contract, motor vehicle coverage in the split limit amounts of no less than the amounts shown above per person, per occurrence for bodily injury and for property damage or a combined single limit of the amount shown above with “Any Auto”, Coverage Symbol 1, providing coverage for all autos operated regardless of ownership, and protecting itself, its employees, agents or lessees, or subsidiaries and their employees or agents against claims arising from the ownership, maintenance, or use of a motor vehicle. Addendum No. 2 RFP 16-P-64AK, Cardiac Monitors Page 10 of 14 7. Primary and Excess Coverage. Any insurance required may be provided by primary and excess insurance policies. B. General Insurance Requirements 1. All insurance policies shall be issued by insurers licensed and/or duly authorized under Florida Law to do business in the State of Florida and all insuring companies are required to have a minimum rating of A- in the "Best Key Rating Guide" published by A.M. Best & Company, Inc. 2. Approval by County of any policy of insurance shall not relieve Contractor from its responsibility to maintain the insurance coverage required herein for the performance of Work or Services by the Contractor or its Subcontractors for the entire term of this Contract and for such longer periods of time as may be required under other clauses of this Contract. 3. Waiver of Subrogation. The Contractor hereby waives all rights against the County and its Subcontractors to the extent of the risk coverage by any insurance policy required hereunder for damages by reason of any claim, demand, suit, or settlement (including workers’ compensation) for any claim for injuries or illness of anyone, or perils arising out of this Contract. The Contractor shall require similar waivers from all its Subcontractors. This provision applies to all policies of insurance required under this Contract (including Workers’ Compensation, and general liability). 4. County Not Liable for Paying Deductibles. For all insurance required by Contractor, the County shall not be responsible or liable for paying deductibles for any claim arising out of or related to the Contractor’s business or any Subcontractor performing Work or Services on behalf of the Contractor or for the Contractor’s benefit under this Contract. 5. Cancellation Notices. During the term of this Contract, Contractor shall be responsible for promptly advising and providing County of Volusia’s Risk Management Division and the Purchasing and Contracts Division with copies of notices of cancellation or any other changes in the terms and conditions of the original insurance policies approved by the County under this Contract within two (2) business days of receipt of such notice or change. 6. For any on-site Work performed by or on behalf of Contractor on County property, the County shall be named as an additional insured under Contractor’s General Liability Premises/Operations Coverage 7. Deductibles. Contractors that maintain and administer a self- Addendum No. 2 RFP 16-P-64AK, Cardiac Monitors Page 11 of 14 insured retention or a large deductible program exceeding the insurance requirements listed in this solicitation using a formal program to fund either program may submit an exception in accordance with Section 3.9, Questions, Exceptions, and Addenda Concerning RFP #16-P-64AK to be considered for this solicitation. The request must include a summary of the program’s design, funding method, and the program’s supporting financial information. If additional information is necessary, the County will request more specific information, which must be provided by the Contractor. The County’s Risk Manager will review the information submitted and determine whether the program is acceptable to the County. Contractor with no formal risk management program in place to manage and fund deductibles or self-insured retentions may not be considered. Subject to County approval, Contractor may obtain a letter of credit in the amount equivalent to the deductible, which shall remain in effect during the term of the Contract at no additional cost to the County. C. Proof of Insurance 1. The Contractor shall be required to furnish evidence of all required insurance in the form of certificates of insurance which shall clearly outline all hazards covered as itemized herein, the amounts of insurance applicable to each hazard, and the expiration dates. 2. The Contractor shall furnish proof of insurance acceptable to the County prior to or at the time of execution of this Contract and the Contractor shall not commence Work or provide any Service until the Contractor has obtained all the insurance required under this Contract and such insurance has been filed with and approved by the County. In the event of a claim to which the County is a party, at the request of the County, the Contractor shall furnish copies of the insurance policies and any changes or amendments thereto, immediately, to the County and County’s Risk Management and Purchasing and Contracts Divisions prior to the commencement of any contractual obligations. This Contract may be terminated by the County, without penalty or expense to County if at any time during the term of this Contract proof of any insurance required hereunder is not provided to the County. 3. All certificates of insurance shall clearly indicate that the Contractor has obtained insurance of the type, amount and classification required by this Article. No Work or Services by Contractor or its Subcontractors shall be commenced until County has approved these policies or certificates of insurance. Addendum No. 2 RFP 16-P-64AK, Cardiac Monitors Page 12 of 14 Further, the Contractor agrees that the County shall make no payments pursuant to the terms of this Contract until all required proof or evidence of insurance has been provided to the County. This Contractor may be terminated by the County, without penalty or expense, if proof of any insurance required hereunder is not provided to the County. 4. The Contractor shall file replacement certificates with the County at the time of expiration or termination of the required insurance occurring during the term of this Contract. In the event such insurance lapses, the County expressly reserves the right to renew the insurance policies at the Contractor’s expense or terminate this Contract but County has no obligation to renew any policies. D. The provisions of this Article shall survive the cancellation or termination of this Contract. 3.30 Termination C. The Contractor may cancel the resulting Contract with one-hundred eightysixty (1860) days written notice to the Director of Purchasing and Contracts. Failure to provide proper notice to the County may result in the Contractor being barred from future business with the County. The County of Volusia does not accept this exception and §3.30(C) remains the same. 3.36 Limitation of Liability and Indemnification of County A. The Contractor shall, at its own expense, indemnify, defend, and hold harmless the County and its public officials (elected and appointed), successors and assigns, agents, officers, and employees, from and against all claims of every kind and nature (including losses incurred or suffered in consequences either of bodily injury to a person or damage to tangible property), damages, losses and expenses, including, but not limited to reasonable attorney’s fees, to the extent arising out of or resulting directly from the performance of this Agreement provided that the claim, damage, loss and expense is caused by any negligent act or omission of the Contractor, or anyone directly or indirectly employed by Contractor, except that the Contractor will not be required to indemnify, defend and hold harmless the County if such claim, damage, loss and expense is the result of the sole negligence of the County, or of anyone directly or indirectly employed by the County or anyone for whose acts the County may be liable. The County of Volusia does not accept the word “directly” being inserted into §3.36(A). All other changes are acceptable and §3.36(A) shall now read as follows: A. The Contractor shall, at its own expense, indemnify, defend, and hold harmless the County and its public officials (elected and appointed), successors and assigns, agents, officers, and employees, from and against claims (including losses incurred or suffered in consequences either of bodily injury to Addendum No. 2 RFP 16-P-64AK, Cardiac Monitors Page 13 of 14 a person or damage to tangible property), damages, losses and expenses, including, but not limited to reasonable attorney’s fees, to the extent arising from the performance of this Agreement provided that the claim, damage, loss and expense is caused by any negligent act or omission of the Contractor, or anyone directly or indirectly employed by Contractor, except that the Contractor will not be required to indemnify, defend and hold harmless the County if such claim, damage, loss and expense is the result of the sole negligence of the County, or of anyone directly or indirectly employed by the County or anyone for whose acts the County may be liable. 3.37 Records & Right to Audit County shall have the right to audit the books, records, and accounts of Contractor and its Subcontractors that are related to the resulting Contract. Contractor and its Subcontractors shall keep such books, records, and accounts as may be necessary in order to record complete and correct entries related to the resulting Contract. Contractor shall preserve and make available, at reasonable times for examination and audit by County, all financial records, supporting documents, statistical records, and any other documents pertinent to this Contract for a retention period of five (5) years after completion or termination of the Contract, and any renewals, as required by Item 65, General Records Schedule GS1-SL for State and Local Government Agencies, effective February 19, 2015 and the Florida Public Records Act (Chapter 119, Florida Statutes), once annually. Contractor shall, by written Contract, require its Subcontractors to agree to the requirements and obligations of this Section 3.36, Audits will be subject to applicable privacy and confidentiality laws and regulations and Contractor’s privacy and confidentiality policies and procedures. The County of Volusia does not accept this exception and §3.37 remains the same. 3.48 Damages Due to the nature of the services to be provided and the potential impact to the County for loss, the Contractor cannot disclaim consequential or special damages related to the performance of this Contract. The Contractor shall be responsible and accountable for any and all damages, directly or indirectly, caused by the actions or inaction of its employees, staff, or Subcontractors. There are no limitations to this liability. The County of Volusia does not accept this exception and §3.48 remains the same. Tab 5 – Forms, B. Insurance has been revised to read as follows: Tab 5 – Forms B. Insurance Attach evidence of required insurance coverage or proof of insurability in the amounts indicated. If available, a properly completed ACORD Form is preferable. Final forms must contain the correct solicitation and/or project number, name the Volusia County contact person, and show the County of Volusia as additional named insured under General Liability- Premises/Operations. ZOLL Medical Corporation 269 Mill Road Chelmsford, MA 01824 (World-wide Headquarters) http://www.zoll.com/ DUNS # 05-536-3428 Rating: 5A1 = $50,000,000 and Over Composite Credit Appraisal: 1 = High ZOLL Medical – Exception In response to Addendum 4, ZOLL Medical emailed the following to the purchasing office on Tuesday, March 29th: “ZOLL Medical agrees to leave out the word “directly” from 3.36 if Volusia County would be willing to put a cap on consequential or special damages of $10M. Clause 3.48 would then read: Due to the nature of the services to be provided and the potential impact to the County for loss, the Contractor cannot disclaim consequential or special damages related to the performance of this Contract. The Contractor shall be responsible and accountable for any and all damages, directly or indirectly, caused by the actions or inaction of its employees, staff, or Subcontractors. There are no limitations to this liability. In no event shall the maximum liability exceed $10,000,000.” As of the date necessary to mail all RFP materials in order to be received in time for the April 5th deadline, ZOLL has not been given a response and would like the opportunity to discuss this point. X Series® Small, Light, and Powerful Xt r e me l y Because Medics Carry More These Days ALMoSt two tiMeS Lighter thAn other PoPuLAr MonitorS The X Series® extends the ZOLL legacy of smaller, lighter monitor/defibrillators. Pick it up. Feel the difference. At 11.7 pounds (6 kilograms), chances are it’s twice as light as what you’re carrying today. MoSt coMPAct, BeSt equiPPed Starting with a high-contrast, color display that simultaneously shows up to four waveforms, the X Series delivers the capabilities you expect from a full-featured monitor—for neonates through adults. And it can be equipped with a complete selection of best-in-class parameters, including Masimo® rainbow® SET pulse CO-Oximetry, Microstream® etCO2, and Welch Allyn NIBP, as well as three invasive pressures and two temperature channels. A MiLitAry heritAge of durABiLity Driven by requirements from air transport and field military operations, the X Series raises the bar for durability. It complies with standards requiring normal operation following multiple drops from a height of 6.5 feet (2 meters). An industry-best ingress protection rating of IP55 means no other monitor is protected from dust particles and water like the X Series. compact and lightweight without compromise in performance or durability “ Poor-quality CPR should be considered a preventable harm.” —AhA consensus Statement on cPr quality3 1 Bobrow BJ, et al. Annals of Emergency Medicine. 2013;62:47-56. 2 Cheskes, et al. Circulation. 2011;124:58-66. 3 Meaney PA, et al. Circulation 2013;128:417-35. MAking the difference for PAtientS When several Arizona fire departments deployed Real CPR Help® in combination with scenario-based training, the likelihood of patient survival nearly tripled.1 In a study involving 373 medics and 484 patients, the odds of surviving cardiac arrest were 2.7 times better when Real CPR Help was used. A tooL for Shortening PAuSeS Pre-shock pauses as brief as 10 seconds adversely impact survival.2 The X Series is equipped with industry-exclusive See-Thru CPR® filtering technology. It reduces the length of interruptions by removing compression artifact so that medics can look for organized electrical activity during compressions. BecAuSe cPr iS A teAM Activity Not everyone who works a code is an experienced responder. The CPR Dashboard™ is a real-time window that gives team leaders an at-a-glance look at the quality of first-responder CPR. even the BeSt reScuer fAtigueS Real CPR Help prompts by exception. This means when medics are fresh and delivering good compressions, it is silent. With repetitive two-minute cycles, even the most fit medic tires. When compressions fall out of range, it gently guides rescuers back to high-quality, Guidelines-compliant compressions. Signal filtered by See-Thru CPR Unfiltered ECG signal during CPR cPr dashboard is a real-time window on the key metrics of high-quality compressions. 4 Davis M, et al. Prehosp Emerg Care 2014;18:9-14. Reduce Time to Balloon with Advanced 12-Lead capabilities 12 LeAdS on Screen iMProve trAce quALity The STEMI View lets medics see trace quality simultaneously in all leads. Confidently record a 12-lead ECG with the expectation it will be clean the first time and ready for transmission without delay. A window to SeriAL ecg chAngeS Unstable patients call for extra- ordinary vigilance. Substantial ST changes can occur between the initial transmission and arrival at the hospital.4 The Split-Screen View keeps medics on top of the situation by displaying the real waveform next to one that was previously acquired. quicker, More confident deciSionS At 94% sensitivity for detection of early STEMI, the X Series 12-lead algorithm is unmatched by other popular monitors. Make that alert call knowing it is based on the best algorithm. oPen Architecture MAxiMizeS SteMi oPtionS The X Series puts medics in the best position to decide where to take a patient. Its open architecture means the X Series can transmit a 12-lead ECG into all of the leading STEMI and cardiology management systems. STEMI View Split-Screen View confident decisions from the field 12-leads—anywhere, anytime fast, efficient delivery to the cath lab Simplify charting with Advanced Communication deSigned with chArting in Mind The X Series is designed with electronic charting in mind. It redefines what a monitor should send to the patient record. The built-in memory ensures a complete patient record is transmitted by capturing 24 hours of event (ECG and vital signs) or trend data, and up to 1,000 time- stamped events. trAnSMit At the SPeed of wifi The X Series simplifies transmission. Its standard communication package makes wires, cables, and “dongles” a thing of the past. It is the first monitor to integrate WiFi, Bluetooth, and USB capabilities as part of the standard communication package. An oPen, univerSAL ePcr SoLution The X Series speeds medic charting by seamlessly uploading the event record. It automatically populates patient data fields in many of the leading ePCR systems. ZOLL’s open interface software development kit (SDK) is available to all ePCR vendors. the x Series redefines how a monitor should work with your charting system. Oridion Microstream® Capnography Visual Alarm Indicator Masimo® rainbow® Set Pulse CO-Oximetry View up to four waveforms of your choice. Switch from a brilliant color display to either high-contrast black- and-white or night-vision mode to ensure visibility under extreme conditions. Big Screen Small device X Series Welch Allyn NIBP with Sure BP® and SmartCuf® Ready-for-Use Indicator Preconnected CPR Stat-padz® for monitoring, pacing, defibrillation, and Real CPR Help® resuscitation view You get unequaled support for CPR. Display CPR Dashboard along with the real-time depth indicator and the filtered ECG that See-Thru CPR provides. SurePower System The lithium-ion SurePowerTM II battery delivers six hours of continuous run time. That’s enough power for even the busiest EMS operation. rescuenet® code review Conduct post-event analysis in support of QA, training, and documentation programs with this unparalleled software tool. Patient-Specific Settings Select the mode—Adult, Pediatric, or Neonate—and the alarm thresholds and energy levels will automatically adjust. Printed in U.S.A. MCN EP 1312 0018 ZOLL Medical Corporation | 269 Mill Road | Chelmsford, MA 01824 | 978-421-9655 | 800-804-4356 | www.zoll.com AdvAncing reSuScitAtion . todAy .® For subsidiary addresses and fax numbers, as well as other global locations, please go to www.zoll.com/contacts. Copyright © 2014 ZOLL Medical Corporation. All rights reserved. Advancing Resuscitation. Today., CPR Dashboard, LifeVest, Real CPR Help, RescueNet, See-Thru CPR, SurePower, X Series, and ZOLL are trademarks or registered trademarks of ZOLL Medical Corporation in the United States and/or other countries. All other trademarks are the property of their respective owners. SmartCuf and Sure BP are registered trademarks of Welch Allyn. Masimo, Rainbow, SET, SpCO, and SpMet are trademarks or registered trademarks of Masimo Corporation. Microstream is a registered trademark of Oridion Medical 1987 Ltd. eArLy intervention Immediate defibrillation is the single most important factor in saving an SCA victim’s life. ZOLL’s LifeVest® Wearable Defibrillator is the ultimate early intervention for high-risk patients. eArLy AcceSS A timely 911 response is critical to survival. ZOLL’s RescueNet® suite of call management products helps ensure the right resources get to the right place ASAP. eArLy cPr More than half of arrests involve non-shockable rhythms. Delivering consistent, high-quality CPR, whether manually using Real CPR Help or mechanically with the AutoPulse®, is the basis of treatment for these patients. eArLy defiBriLLAtion Patients benefit when AEDs are deployed. While the AED Plus® brings simplicity to the public responder, the AED Pro® delivers the durability expected for the first responding BLS provider. eArLy AcLS Whether it is ZOLL’s biphasic waveform, which is superior in high-impedance patients, an external pacing waveform that captures twice as often at half the current, or best-in-class patient monitoring, ZOLL ensures providers are equipped to deliver the best care possible. PoSt-reSuScitAtion cAre It is increasingly evident that post-resuscitation care is a vital link in the Chain of Survival. Goal-directed therapy, including fever control, fluid management, and glucose control, promise to improve outcomes. ZOLL has technologies for temperature management and delivery of fluid and blood products. data Management and Analysis early Access early intervention early cPr early AcLS Post-resus care early defibrillation Impacting Outcomes Link by Link Technical Specifications: X SeriesTM Xtremely Small, Light, and Power ful •At less than 12 pounds/6 kilograms, the X Series is about half the size and weight of other full-featured devices. •Its large, bright screen allows for simultaneous viewing of four traces, all 12 ECG leads, or static and dynamic 12-lead views on a “split screen”. •The device also incorporates the latest, most advanced and most complete monitoring capabilities, including “gold standard” Masimo®rainbow®SET Pulse CO-Oximetr y and Welch Allyn’s Rapid NIBP technology to improve accuracy and reliability. CPR with Confidence •CPR DashboardTM provides real-time numeric depth and rate values and has a CPR timer that switches to an idle timer when compressions are stopped. The release indicator and the per fusion performance indicator (PPI) also help maximize CPR per formance. •See-Thru CPR®(unique to ZOLL®) helps minimize the duration of interruptions by filtering out artifact, allowing you to see organized underlying rhythms during CPR. Unsurpassed 12-lead Data Collection and Communications Capabilities •The X Series is the first monitor/defibrillator with integrated WiFi. Bluetooth®and USB cellular modem capabilities are standard as well. •The X Series is designed to work in conjunction with the new RescueNet®Link EMS communications system.* With RescueNet Link, patient data can be automatically uploaded and streamed to remote displays in ambulances, hospitals, and communication centers while the rescuer cares for the patient on scene and in transit. •The X Series acquires, stores, and transmits 12-leads to ZOLL's easy-to-use and economical RescueNet 12-Lead and RescueNet MedGate 12-Lead management systems. OneStep Pediatric Electrode Pads enable the R Series to automatically adjust to proper pedi- atric energy levels. Specifications subject to change without notice. © 2012 ZOLL Medical Corporation. “Advancing Resuscitation. Today.”, CPR Dashboard, Rectilinear Biphasic, Real CPR Help, RescueNet, See-Thru CPR, X Series, and ZOLL are trademarks or registered trademarks of ZOLL Medical Corporation in the United States and/or other countries. Propaq, Smartcuf, and Sure BP are registered trademarks of Welch Allyn. Masimo, Rainbow, SET, SpCO, and SpMet are trademarks or registered trademarks of Masimo Corporation. All other trademarks are the property of their respective owners. Printed in U.S.A. 021210 9656-0235 Patient Modes User Selectable:Adult, Pediatric, Neonate. Automatically sets configurable defaults for alarm limits, defibrillation energy, and NIBP settings. Trends (on-screen) Tabular numeric format All parameters trended/viewable Trend Intervals: 1, 5, 10, 15, 30, 60 minutes Duration:24 hours at 1-minute intervals Snapshots:Minimum of 32 (12 seconds of pre- and post-button press) Quick-access trend display via quick- access button Memory Capacity A combination of 24 hours of trends at 1-minute intervals, 1000 time-stamped events, and 32 snapshots, including monitor, defibrillator, pacer, and treatment snapshots Pacer Type:External transcutaneous pacing Pulse Types:Rectilinear, constant current Pulse Width:40 ms ± 2 ms Pacer Rate:30 – 180 bpm ± 1.5% Output Current:0 – 140 mA ± 5% or 5 mA, whichever is greater Modes:Demand and Fixed CPR CPR Feedback Technology See-Thru CPR®:Artifact filtering Real CPR Help®: Real-time depth and rate feedback CPR Dashboard™: Numeric readout of depth and rate, release indicator, perfusion performance indicator (PPI) ECG Cable Detection:Automatic 3-, 5-, 12-lead ECG Input: 3-lead cable, 5-lead cable, 12-lead cable, paddles, therapy cable Leads: I, II, III, AVR, AVL, AVF, V1 – V6 Heart Rate Range:30 – 300 bpm Heart Rate Accuracy:± 3 bpm or 3% Pacer Detection and Display ECG Sizes:0.125, 0.25, 0.5, 1, 2, 4 cm/mV, and auto-ranging Sweep Speed:25 mm/sec, 50 mm/sec Masimo®SET SpO2 Saturation Range:1 – 100% Saturation Accuracy: Oxygen saturation during no-motion conditions: Adults, Pediatrics: 70 – 100%, ± 2 digits 0 – 69%, unspecified Neonates: 70 – 100%, ± 3 digits 0 – 69%, unspecified Oxygen saturation during motion conditions Adults, Pediatrics: 70 – 100%, ± 3 digits 0 – 69%, unspecified Neonates: 70 – 100%, ± 3 digits 0 – 69%, unspecified Oxygen saturation during low-perfusion conditions: Adults, Pediatrics 70 – 100%, ± 2 digits 0 – 69%, unspecified Neonates, 70 – 100%, ± 3 digits 0 – 69%, unspecified Pulse Rate Range: 25 – 240 bpm Pulse rate during no-motion conditions: Adults, Pediatrics, Neonates: 25 – 240 ± 3 digits Pulse rate during motion conditions Adults, Pediatrics, Neonates: 25 – 240 ± 5 digits SpO2 Average time setting: 4, 8 (default), 16 seconds Masimo rainbow®SET SpCO® Range: 0 – 99% Accuracy: 1 – 40% ± 3 digits Masimo rainbow®SET SpMet® Range: 0 – 99% Accuracy: 1 – 15% ± 1 digits Non-Invasive Blood Pressure (NIBP) Smartcuf®and Sure BP®NIBP technology Measurement Intervals:Automatic 1-, 2-, 3-, 5-, 10-, 15-, 30-, 60-minute, and manual quick-action NIBP Start/Stop button TurboCuf:5 min of repeated NIBP readings Display:Systolic, diastolic, mean. Viewable on-screen with large numerics. Cuff Overpressure Protection Typical Measurement Time: 30 – 45 sec (on deflation) 15 – 30 sec –Sure BP (on inflation) Standard Cuff Sizes: Neonate #1 – #5, Infant, Small Child, Small Adult, Adult Long, Large Adult, Thigh Default Cuff Inflation Pressure: Adults:160 mmHg Pediatrics:120 mmHg Neonates: 90 mmHg Pressure Measurement Range: Systolic:20 – 260 mmHg Diastolic:10 – 220 mmHg Mean: 13 – 230 mmHg Maximum Cuff Inflation Pressure: Adults: 270 mmHg Pediatrics: 170 mmHg Neonates: 130 mmHg EtCO2 Range: 0 – 150 mmHg Accuracy: 0 – 38: ± 2 mmHg 39 – 150: ± 5% + .08% mmHg >38 Respiration Range:0 – 149 breaths per minute Respiration Rate Accuracy: 0 – 70 bpm ± 1 bpm 71 – 120 bpm ± 2 bpm 121 – 149 bpm ± 3 bpm Flow rate:50 ml/min -7.5 + 15 ml/min Typical response time:2.9 seconds Maximum response time:3.9 seconds Impedance Pneumography Displayed Data: Numeric breath rate, Impedance waveform Breath Rate Range:Adult, Pediatric: 2 to 150 breaths/minute. Neonates:3 to 150 breaths/minute. Breath Rate Accuracy: 2% or ± 2, whichever is greater Displayed Breath Rate: Average of last 10 breath-to-breath rates Leads:Lead I (RA – LA), Lead II (RA – LL) Sweep Speed:3.13, 6.25, 12.5 mm/sec Alarm Settings:High, low, and no breath rate alarm Invasive Pressure Three Channels Pressure Range:-30 – 300 mmHg Pulse Rate Measurement Range: 25 – 250 bpm Formats:S/D, S/D (M), (M) user selectable User-Selectable Labels:P1, P2, P3, ABP, AO, ART, CVP, BAP, FAP, LAP, PAP, RAP, UAP, UVP, ICP Transducer Requirements: 5M µV/V/mmHg Zero Adjustment:± 200 mmHg Numeric Pressure Accuracy:± 2 mmHg or 2% reading, whichever is greater of reading, plus transducer error Transducer Connector:Standard 6-pin AAMI Temperature Two YSI 400/700 series-compatible channels Range:0 – 50°C (32 –122°F) Units:°C or °F Display:T1, T2, and Delta temp Accuracy:± 0.1°C (± 0.06°F) from 10 – 50°C (50 –122°F) ± 0.2°C (± 0.11°F) from 0 – 10°C (32 –50°F) Printer Type:High-resolution thermal array Annotation:Time, date, ECG lead, ECG gain, heart rate, defibrillation, and pacing parameters and treatment summary events Paper Width:80 mm Paper Speed:25 mm/sec, 50 mm/sec Delay:6 seconds Frequency Response: Automatically set to monitor’s frequency response Record Modes:Manual and automatic (user configurable) Print Option Single waveform or a combina- tion up to 3, on alarm, snapshots, treatment summary report, and trend summary Battery Type:Rechargeable lithium-ion, 11.1 Vdc, 6.6 Ah, 73 Wh Capacity:With a new, fully charged battery operating at room temperature: At least 6 hours of continuous monitoring of ECG, SpO2, CO2, 3 invasive pressure channels, and 2 channels of temperature, with NIBP measurements every 15 minutes and 10 200-joule shocks. 300 shocks at 200 joules with fully charged new battery at room temperature. At least 3.5 hours pacing, with ECG, SPO2, CO2, three invasive pressures, temperature, NIBP every 15 minutes and pacing at 180 ppm, and 140 mA. AC Power Adapter:100 – 240 VAC 50, 60 Hz, 2A 100 –115 VAC 400Hz, 2AA D V A N C I N G R E S U S C I T A T I O N. T O D A Y.® ZOLL Medical Corporation Worldwide Headquarters 269 Mill Road Chelmsford, MA 01824 978-421-9655 800-348-9011 www.zoll.com For subsidiary addresses and fax numbers, as well as other global locations, please go to www.zoll.com/contacts. General Weight: 11.7 lbs. (5.3 kg) with battery and paper Dimensions: 8.9 in (22.6 cm) x 10.4 in (26.4 cm) x 7.9 in (20.1 cm) Enclosure Protection: Solid Foreign Object: IEC 60529, IP5X Water: IEC 60529, IPX5 Operating:Temperature: 0 to 50°C Humidity:15 to 95% RH (non-condensing) Vibration:MIL-STD 810G, Method 514.6, 4.4.2 Procedure II EN ISO 9919 (per IEC 60068-2.64) EN 1789 for ambulance. RTCA/DO-160G (multiple helicopter frequencies) Shock:IEC 60068-2-27, 100g, 6 ms half sine Drop:EN 1789, 30-inch functional drop, IEC 60601-1, tested at 2 meters Altitude: -170 m to 4572 m (-557 feet to 15,000 feet) Monitor/Display Size:6.5 in (16.56 cm) diagonal Input:3-lead, 5-lead, or 12-lead patient cable, paddles, or multifunction electrodes Type:Color LCD, 640 x 480 pixels, 800 MCD Sweep Speed:25 mm/sec or 50 mm/sec (user selectable) Lead Selections:Paddles (Pads), I, II, III, AVR, AVL, AVF, V1-6 Frequency Response: (user selectable) 0.67 –20 Hz Limited mode 0.67 –40 Hz Monitor mode 0.25 –40 Hz Filtered diagnostic mode 0.05 –150 Hz Diagnostic mode Defibrillator Waveform:Rectilinear Biphasic™ Energy Selections:1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 30, 50, 70, 85, 100, 120, 150, 200 joules Energy Display:Display indicates selected and delivered energy Charge Time:Less than 7 seconds with a new, fully charged battery Charge Controls:Front panel and on apex paddle Pads/Paddles:Hands-free pads and external adult and pediatric paddles. Adult paddles slide off to expose pediatric paddles. Synchronized Mode:Synchronizes defibrillator pulse to patient’s R wave. “SYNC” message displayed on monitor and markers shown on both monitor and recorded ECG. Meets Clause 104 of AAMI DF80. *This functionality will be available in future updates. X SERIES® Durability Beyond Compare TESTED TO THE MOST DEMANDING STANDARD MEETS THE EMS CHALLENGE, NO MATTER WHAT When it comes to durability, the X Series® is tested to a more challenging standard than any other monitor on the market. That’s because its durability is measured against the most current military-specified standards. Withstanding multiple 6.5 feet (2 meters) drops, the X Series exceeds the IEC failsafe standard. There’s a reason hospital equipment doesn’t make it in the EMS world. Monitors are rained on, snowed on, bled on, and worse. Originally developed to survive the extreme conditions of the battlefield, the X Series is more than up to the EMS challenge. The X Series holds an industry-best ingress protection (IP) rating. At IP55, the X Series is virtually immune to the onslaught of water, dust, and body fluids your equipment faces in the field. ZOLL X Series Physio-Control Lifepak 151 Philips MRx2 Size 731 cubic inches 1796 cubic inches 1204 cubic inches Weight 11.7 lbs.20.1 lbs.13.2 lbs. Drop-Test IEC 60601-1 at 6.5 feet: 26 drops EN 1789: 30-inch drop onto each of 6 surfaces; 5 drops on each side from 18 inches onto a steel surface IEC 68-2-32 free fall onto a steel surface, 30 inches with carrying case Operating Temperature 0-60°C 0-45°C 0-45°C Shock 100 g 40 g 30 g Ingress Protection Rating IP 55 IP 44 IP 24 X Series Excels in Every Critical Comparison Ingress Protection (IP) Rating 55 Notprotected >50 mm >12.5 mm >2.5 mm >1.0 mm Dustprotected Dusttight Notprotected Drippingwater Drippingwatertilted upto15° N Sprayingwater Splashingwater WaterJets Heavyseas Immersion Submersion 0 1 2 3 4 6 0 1 2 3 4 5 6 7 8 5First digit Second digit Protection against foreign objects Protection against moisture When asked to name the number one attribute they look for in a monitor, EMS professionals are consistent. They put size and weight at the top of their list. Back injuries are the most common reason medics leave EMS. One in four EMS practitioners experiences a career-ending injury within the first four years of service3 because of the cumulative weight they lift. And every year, half of all EMS workers report suffering back pain. That’s why ZOLL continually focuses on reducing monitor weight. At 11.7 pounds (6 kilograms), the X Series is probably twice as light as what you carry today. Pick it up; it’s likely 7 pounds lighter. Get that Boeing off your back. By switching to the X Series, you’ll be carrying 112,000 less pounds over the course of your career—that’s more than the weight of a Boeing 737! *7 lbs. x 4 uses/shift x 2 lifts/use x 2 shifts/week x 50 weeks/year x 20 years/career = 112,000 lbs.1 cumulative lifting Don’t believe us? Here’s the math: 7 POUNDS LESS PER LIFT More Than the Weight of a Boeing over Your Career* 7 Pounds Less Per Lift Than Most Monitors What Would You Rather Carry? 1LifePak 15 Instructions for Use on www.physio-control.com as of 6/18/14. 2Philips MRx M3536A Instructions for Use on www.philips.com as of 6/18/14. 3Merrill, S., & Green, D. (2012). Task performance and health improvement recommendations for emergency medical service practitioners. San Diego, Calif.: American Council on Exercise. Your Back Is Your Livelihood MCN EP 1406 0056 © 2014 ZOLL Medical Corporation. All rights reserved. X Series and ZOLL are trademarks or registered trademarks of ZOLL Medical Corporation in the United States and/or other countries. All other trademarks are the property of their respective owners. ZOLL Medical Corporation | 269 Mill Road | Chelmsford, MA 01824 | 978-421-9655 | 800-804-4356 | www.zoll.com The days of the “work alone” monitor/defibrillator are rapidly a thing of the past. An EMS monitor must connect. And that interface is expected to be seamless. Today, time-sensitive STEMI programs and ePCR systems drive communication needs. Mobile integrated health care, community paramedicine, and health information exchanges are on the horizon. Real-time streaming data and video are inevitable. The monitor you buy today must anticipate these needs. Communications are not an afterthought for the X Series®. It is designed to embrace these needs. The X Series comes standard with a communication package rivaled only by those of the latest smart phones. It stands ready for these new challenges. The X Series is the first monitor to integrate a complete array of communications technology. The approach not only delivers an added layer of protection for the demands of the pre-hospital environment, it eliminates the need for cables and dongles. Every X Series comes with the following communications capabilities: • WiFi • Bluetooth • USB 2.0 • Ethernet The X Series anticipates this future with its integrated WiFi transmitter. Compatible with the 802.11 a, b, g, and n standards, it delivers the speed required, and security expected, for sending large amounts of sensitive patient-care information. THE FULL COMPLEMENT OF INTEGRATED TECHNOLOGY WIFI – YOUR GATEWAY TO THE FUTURE OPEN ARCHITECTURE PUTS PATIENTS FIRST Open Architecture Maximizes STEMI Options Internet EncryptedTransmission WiFi Bluetooth USB PhoneEmail ZOLLOnline MUSE TM LifeNetRescueNet® 12-Lead IntelliSpace The focus on “time to treatment” is all about process improvement. Sending a patient’s 12-lead is its foundation in many places. The open architecture philosophy embodied by the X Series design gives services, and ultimately patients, a path to improvements that can’t be matched by other monitors. X Series 12-leads can be sent to all leading STEMI and cardiology management systems. A medic’s transport decision can now be driven by the shortest time instead of compatibility with a hospital’s system. X SERIES® Forward-Thinking Communication for the New Frontier of EMS FAST, SEAMLESS DATA UPLOAD SIMPLIFIES CHARTING The X Series redefines what a monitor should collect and send to the patient record. Its built-in memory ensures the complete patient record is transmitted by capturing 24 hours of event or trend data, and up to 1,000 time-stamped events. The X Series simplifies medic charting by seamlessly uploading the event record with the speed of a WiFi connection. It will automatically populate patient data fields for many of the leading ePCR systems. RescueNet ePCR SDK Partners Software Development Kit (SDK) ZOLL Online ePCR Partner Server RescueNet ePCR Partner ePCR WiFiUSB WiFi USB Direct Transmission Cloud-to-Cloud Transmission The use of ePCR systems has dramatically increased the size of the files transmitted. And consider what’s around the corner. The demands for real-time streaming waveforms and video will magnify the bandwidth requirements by more than ten-fold. ZOLL’s open architecture makes it possible to send event files to all ePCR systems. In line with ZOLL’s commitment to open architecture, a Software Development Kit (SDK) is available to any ePCR vendor desiring to complete the interface. MCN EP 1406 0051 © 2014 ZOLL Medical Corporation. All rights reserved. LifeNet, RescueNet, X Series, and ZOLL are trademarks or registered trademarks of ZOLL Medical Corporation in the United States and/or other countries. All other trademarks are the property of their respective owners. ZOLL Medical Corporation | 269 Mill Road | Chelmsford, MA 01824 | 978-421-9655 | 800-804-4356 | www.zoll.com Designed for eCharting RescueNet® CaseReview QA THE WAY YOU IMAGINE IT Event reports are a click away. Choose a case from the list display in your browser, open it, and examine the case. Key QA elements presented in colorful graphics make reviewing simple. Debriefing medics can be a same-day matter. Event-specific reports are easily distributed with a few clicks. Crews can review their own performance while the event is fresh in their minds. Simplified Data Collection A New Standard: Same Day Debriefing Gone are the days of chasing crews to download case files from their monitors. Instead, with the push of a button, medics now directly send X Series® files from the field to your system at the end of a call and move on with their shift. Data cards and cables are a thing of the past. With RescueNet® CaseReview, access to case files is as fast as opening the browser of any web-enabled device. Case files are immediately available moments after their transmission. One hundred percent case review is within reach. “This technique can be very effective for achieving improved performance; CPR quality is reviewed while the resuscitation is fresh in the rescuer’s mind.”1 The AHA On Debriefing FILES IMMEDIATELY AVAILABLE CUSTOMIZED SUMMARIES SAME-DAY DEBRIEFING NO DATA CARDS OR CABLES RescueNet CaseReview makes it possible to answer questions such as: The real power of RescueNet CaseReview comes from its ability to collectively summarize system-wide performance. This next-generation tool delivers the capability to summarize the full set of event files in order to recommend quality and system-level improvements. Pre-configured reports, in combination with tag-and-query filter capabilities that produce customized summaries, shed light on system trends and advanced processes. • What do system-wide CPR pauses look like for intubated patients? • How do CPR fractions differ between peak staffing and off-hours? • What do post-shock pause times look like in the system? Turn Case Files Into Actionable Information ACCESS FROM ANY WEB-ENABLED DEVICE CLOUD BASED At-a-glance dashboards simplify a complete review of individual cases. RescueNet CaseReview puts 100% of your cases within reach. Compression Quality Compressions in Target - 22.91% Depth and Rate out of Target - 26.93% Rate out of Target - 16.72% Depth out of Target - 33.44% 33% 23% 27% 17% CPR Fraction Insufficient Rate - 37.64% Intubation - 2.53% Moving Patient - 3.09% Switching Compressors - 5.62% Time with Compressions - 51.12% 51% 38% 6% Put this all in place without the need for a network or IT specialist. No special hardware is required to use RescueNet CaseReview’s capabilities. A service’s secure account can be accessed from any web-enabled device. The cloud-to-cloud interface makes ePCR integration more stable. When CaseReview is updated, ePCR devices no longer need to be modified. Putting CaseReview in place gives you IT independence. IT and Platform Independence Optimizing the QA Process 1Meaney PA, et al. Circulation. 2013 Jul 23;128(4):417–35. Printed in U.S.A. MCN EP 1505 0098 ZOLL Medical Corporation | 269 Mill Road | Chelmsford, MA 01824 | 978-421-9655 | 800-804-4356 | www.zoll.com ADVANCING RESUSCITATION . TODAY .® For subsidiary addresses and fax numbers, as well as other global locations, please go to www.zoll.com/contacts. Copyright © 2015 ZOLL Medical Corporation. All rights reserved. Advancing Resuscitation. Today., RescueNet, X Series, and ZOLL are trademarks or registered trademarks of ZOLL Medical Corporation in the United States and/or other countries. All other trademarks are the property of their respective owners. Immediate File Access • Review all files from browser • Use any web-connected device Service-wide Views • Create system-focused reports • Populate pre-configured reports • Customize reports with file tags, query filters IS Independence (hosted version) • No support required since tool not tied to specific hardware • Compatible with mobile devices (Windows, iOS, Android) • Includes file archive, backup, upgrades, and system maintenance Instantaneous Debriefing Debrief while medics still on shift, following AHA recommendation to review while resuscitation is fresh in rescuer’s mind1 Open Architecture Any ePCR can receive event reports Patient ChartZOLL Online Case Review Simplified Data Collection • Medics push case file at end of call, move on with shift • No need to track down data cards or USB sticks in field ZOLL® X Series® Defibrillator 12-Lead Report2013-06-27 13:34:28Page 1 of 2Prepared by RescueNet Code Review™, Enterprise Edition PATIENT NAME:PATIENT ID:PATIENT AGE:45PATIENT SEX:Male Vent Rate:0*** STEMI ***P Duration:0 msAbnormal finding for 40+ malePR Interval:149 msSinus bradycardiaQRS Duration:97 msAcute ST elevation inferoapical infarct [marked STE in II/aVF/III, ST dep in aVL/aVR]QT/QTc:472/388 msP-R-T Axis:63 52 60 DEVICE ID:TESTRECORDED:2013-06-27 13:35:54 V6V5V4V3V2V1aVFaVLaVRIIIIII25 mm/s 10 mm/mV 0.05-150 HzGrid size is 0.20 s x 0.50 mV2013-06-27 13:35:54 ZOLL® X Series® Defibrillator 12-Lead Report2013-06-27 13:34:28Page 2 of 2Prepared by RescueNet Code Review™, Enterprise EditionPAPPAQAQDRARDSASDRPARPDSPASTJSTMSTETATPAV100000000000120000V20000000000060000V30000000000030000V40000000000030000V500000000000-40000V600000000000-100000I00000000000-150000aVL00000000000-1110000II000000000001920000aVF000000000001990000III000000000002060000aVR00000000000-900000 ZOLL® X Series® Defibrillator CPR Analysis2013-06-27 13:34:28Page 1 of 3Prepared by RescueNet Code Review™, Enterprise EditionShock Summary0.02.04.0Depth (in)Compression Quality13:34:2813:39:320140Rate (cpm) ZOLL® X Series® Defibrillator CPR Analysis2013-06-27 13:34:28Page 2 of 3Prepared by RescueNet Code Review™, Enterprise Edition Key IndicatorsManualAutoPulseTime to first compression:00:02:37---Average time to shock after compressions stopped:00:00:01---Average time to compressions after shock delivered:00:00:00---Mean compression depth:2.33 inMean compression rate:103.68 cpm Entire Case Case duration:00:05:04Time in CPR:00:02:26(48.03 %)Time not in CPR:00:02:38(51.97 %) CPR PeriodsManualAutoPulseTime in compressions:00:02:21(96.58 %)---Time not in compressions:00:00:05(3.42 %)---Compressions in target:82.92 % Depth (target zone from 2 to 4 in): Standard deviation:0.30 inAbove target zone:1(0.42 %)In target zone:230(95.83 %)Below target zone:9(3.75 %) Rate (target zone from 90 to 110 CPM): Standard deviation:11.14 cpmAbove target zone:23(9.58 %)In target zone:208(86.67 %)Below target zone:9(3.75 %)Individual shock times: ZOLL® X Series® Defibrillator CPR Analysis2013-06-27 13:34:28Page 3 of 3Prepared by RescueNet Code Review™, Enterprise EditionCompression to shock: 1: 1 sec.Shock to compression: 1: 0 sec. ZOLL® X Series® Defibrillator Trend Report2013-06-27 13:34:28Page 1 of 1Prepared by RescueNet Code Review™, Enterprise EditionDateTimeHR/PRSpO2SpCOSpMetNIBP(mmHg)EtCO2RRTemp.(°F)DD-MMM-YYHH:MMBPM%%%SysDiaMmmHgT1T2∆T27-Jun-1313:3972------------------0------------27-Jun-1313:38174------------------0------------27-Jun-1313:37176------------------3619---------27-Jun-1313:364098---0.7---------3518---------27-Jun-1313:354097---0.9---------3815---------27-Jun-1313:354098---1135871033818---------27-Jun-1313:354098---------------3820---------27-Jun-1313:34------------------------------------ The Heart of the Matter ZOLL MEDICAL CORPORATION What Really Defibrillates the Heart? 2015 Introduction There has been a lot of discussion about “low-energy” biphasic defibrillation versus “high-energy” biphasic as well as average current versus peak current. This document is intended to provide clarity around the terminology by reviewing the scientific literature. High Current or High Energy—Which One Matters? The term “low energy” has contributed to misunderstandings and has fueled a fear that ”low energy” means less efficacy. In the case of the ZOLL Rectilinear Biphasic™ waveform, “low energy” actually means “high current” and “high efficacy.” The American Heart Association Scientific Guidelines for Resuscitation clearly state that “Modern defibrillators deliver current based on stored energy. Because it is accepted that defibrillation is accomplished by the passage of sufficient current through the heart, the concept of current-based defibrillation is appealing. Energy is a nonphysiologic descriptor of defibrillation despite its entrenchment in traditional jargon.”1 All ZOLL defibrillators deliver a Rectilinear Biphasic waveform (RBW) that provides more current than the “high-energy” biphasic others use. This capability is particularly important for the difficult-to-defibrillate, high-impedance patient. This “high-current” RBW is the only biphasic waveform that was developed specifically for external defibrillation. It has been studied extensively in over 7,000 patients and shown to be superior to monophasic. Both high- and low-energy biphasic truncated exponential (BTE) waveforms were adapted from internal defibrillation. The high-current ZOLL biphasic waveform is the only one that the FDA has cleared to claim superiority* over monophasic waveforms. The Scientific Evidence Is Clear RBW Is Superior* to Monophasic The FDA has cleared ZOLL to label its biphasic waveform as superior to monophasic for defibrillation of high-impedance ventricular fibrillation (VF) and cardioversion of atrial fibrillation (AF):2,3 “ The data also demonstrate the superior efficacy of low-energy [ZOLL RBW] biphasic shocks compared to standard high-energy monophasic shocks in patients with high transthoracic impedance.” RBW has been studied in more than 7,000 patients in over 14 separate clinical trials. RBW Is Superior to BTE Biphasic in Pediatrics “ The ZOLL RLB [Rectilinear Biphasic] waveform provided a superior ability to defibrillate a porcine pediatric model in terms of energy dose per body weight (J/kg) and per heart weight (g) when compared to the Medtronic Physio-Control BTE waveform.”4 RBW Is Superior in Out-of-Hospital Cardiac Arrest The ZOLL ORBIT trial represents the largest clinical trial on biphasic waveforms ever conducted for out-of -hospital cardiac arrest (OHCA). The ORBIT trial is the only OHCA study conducted in an ALS (Advanced Life Support) environment and the only biphasic study that included all presenting rhythms (not just VF or VT).5 The ORBIT results showed ZOLL RBW superior to monophasic in patients with shockable rhythms: 52% to 33.7%, P=0.01 1. Link MS, Atkins DL, et al. Automated external defibrillators, defibrillation, cardioversion, and pacing. 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010;122(suppl 3):S706 –S719. 2. Mittal, S, Ayati S, et al. Comparison of a rectilinear biphasic waveform with a damped sine wave monophasic waveform for transthoracic conversion of ventricular fibrillation. J Am Coll Cardiol. 1999;34(5):1595-601. 3. Mittal S, Ayati S, et al. Transthoracic cardioversion of atrial fibrillation: comparison of rectilinear biphasic versus damped sine wave monophasic shocks. Circulation. 2000;101:1282-1287. 4. W Tang, J Wang, C Young. Comparison of rectilinear biphasic defibrillation to biphasic truncated exponential defibrillation for pediatric cardiac life support in a porcine model. Abstract presented at Cardiostim 2004. 5. Morrison I, Dorian P, et al. Out-of-hospital cardiac arrest rectilinear biphasic to monophasic damped sine defibrillation waveforms with advanced life support intervention trial (ORBIT) Resuscitation. 2005;66:149-157. 6. Niebauer MJ, Brewer JE, et al. Comparison of rectilinear biphasic waveform with monophasic damped sine waveform for external cardioversion of atrial fibrillation and flutter. Am J Cardiol. 2004;93:1495-1499. *The data demonstrate the equivalent efficacy of low-energy (aka, high-current) rectilinear biphasic shocks compared to standard high-energy monophasic shocks for transthoracic defibrillation for all patients at the 95% confidence level. The data also demonstrate the superior efficacy of low-energy rectilinear biphasic shocks compared to standard high-energy monophasic shocks in patients with high transthoracic impedance at the 90% confidence level. There were no unsafe outcomes or adverse events due to the use of the Rectilinear Biphasic waveform. RBW Is Superior for Cardioversion of Atrial Fibrillation6 RBW Is Superior for Long-Duration V F5 The ORBIT study also shows that ZOLL’s RBW demonstrated even greater improvements over monophasic as downtimes decreased. In Figure 1, 24-hour survival is plotted as a function of downtime. The ZOLL biphasic waveform is the upper curve (circles), while the monophasic waveform is the lower curve (squares). • Nearly double the survival rate at 4 min. downtime • Relevant especially for AED defibrillation and in-hospital resuscitation RBW Is Superior for High-Impedance Patients7 7. Li Y, Ristagno, G et al. A comparison of defibrillation efficacy between different impedance compensation techniques in high impedance porcine model. Resuscitation. 2009;80:1312-1317. 8. Niebauer MJ, Brewer JE, et al. Rectilinear biphasic: defibrillation of patients with weight greater than 100 Kg. Abstract from the 7th Congress of the ERC. 2004. 9. Ristagno G, Yu T, et al. Current is better than energy as a predictor of shock success for biphasic defibrillation shocks in a porcine model of ventricular fibrillation. Resuscitation. 2013;84:678-683. 10. Chen B, Yu T, et al. Average current is better than peak current as therapeutic dosage for biphasic waveforms in a ventricular fibrillation pig model of cardiac arrest. Resuscitation. 2014;85(10:1399- 1404. 11. Stiell IG, Walker RJ, et al. BIPHASIC Trial. A Randomized Comparison of Fixed Lower Versus Escalating. Circulation. 2007;115(12):1511-7. 12. Koster RW, Walker RD, van Alem AP. Definition of successful defibrillation. Crit. Care Med. 2006 Dec;34 (12 Suppl):S423-6. 13. Stothert JC, Hatcher TS, et al. Rectilinear biphasic waveform defibrillation of out of hospital cardiac arrest Pre-hospital Emergency Care. 2004;8(4):388-92. 14. Edelson DP, Abella BS, Kramer-Johansen J, et al. Effects of compression depth and pre-shock pauses predict defibrillation failure during cardiac arrest Resuscitation. 2006;71:137-145. 15. Kramer-Johansen, J, Myklebust H, et al. Quality of out-of-hospital cardiopulmonary resuscitation with real time automated feedback: A prospective interventional study Resuscitation. 2006;71:283-292. 15% 25% 35% 45% 55% 65% 2 1210468 Time (minutes)Survival Likelihood (%)Figure 1 Figure 2 Figure 3 Figure 4 RBW Delivers More Current Figure 4 shows a comparison of the average current delivered at maximum energy by various defibrillators.Average Current (amps)10.0 0.0 15.0 25.0 20.0 30.0 5.0 ZOLL R 200J Physio 360J Philips 200J 28.2 50 Ohms 75 Ohms 100 Ohms 125 Ohms 150 Ohms 27.5 24.0 17.8 20.0 20.5 13.6 15.9 17.3 10.7 13.5 18.0 9.5 11.5 16Shock Successp <0.0001 MDS 200J RBW 100 J 100% 90% 92% 94% 96% 98% 88% A-Fib A Flutter THE HEART OF THE MATTER RBW Is Superior in Obese Patients8 In 140 obese patients weighing more than 135 kg (range: 155 kg – 194 kg), all patients were successfully cardioverted and the average energy required was less than 200 joules (J). 100 0 20 40 60 80 <120 Defibrillator B (LifePack 12)Defibrillator A (ZOLL) (p <0.01) (p <0.01) (NS) (p <0.01) (p <0.05) <120 –150 <150–180 <180–210 <210 Pathway Impedance (Ohm)Success Rate (%)In a study by Niebauer, et al. that included 4,000 external cardioversion procedures, the ZOLL RBW was more effective in terminating atrial fibrillation than a monophasic damped sine (MDS) waveform, 99.1% versus 92.4% (Figure 2). Both waveforms were equally effective in terminating atrial flutter. A 2009 study compared impedance compensation techniques in two defibrillators. Defibrillator A used RBW and controlled current with fixed shock duration, while defibrillator B used a BTE waveform and prolonged the shock duration. The current-based technique was more effective, as shown in Figure 3. 16. White RD, Hankins DG, et al. Patient outcomes following defibrillation with a low energy biphasic truncated exponential waveform in out of hospital cardiac arrest. Resuscitation. 2001;49(1):9-14. 17. Schneider T, Maartens PR, et al. Multicenter, randomized, controlled trial of 150-J biphasic shocks compared with 200- to 360-J monophasic shocks in the resuscitation of out-of-hospital cardiac arrest victims. Circulation. 2000;102:1780-1787. 18. Koster RW, Walker RG, Chapman FW. Recurrent ventricular fibrillation during advanced life support care of patients with prehospital cardiac arrest. Resuscitation. 2008;78:252-257. 19. Walker RG, Koster RW, et al .Defibrillation probability and impedance change between shocks during resuscitation from out-of-hospital cardiac arrest. Resuscitation. 2009;80:773-777. Figure 5 THE HEART OF THE MATTER Two recent studies, one by Ristagno, et al.9 and one by Chen, et al.10 showed that average current is better than peak current as a therapeutic dosage for biphasic waveforms during VF. The Chen paper involved two separate protocols: Study A and Study B. This study compared a defibrillator using RBW to one utilizing the BTE waveform, where impedance levels ranged from 49 to 184 ohms. The RBW delivered more peak current and more average current but less energy, as shown in Figures 5A and 5B. The success rate of converting ventricular fibrillation was significantly higher, at 55% versus 30.7% (Figure 5C). This paper also reported that the success rate of VF conversion was significantly lower with the BTE waveform when the impedance was over 90 ohms (24% versus 57.1%). Study B was limited to BTE waveforms, and it suggested that extending both a wide and narrow BTE waveform duration to achieve higher energy delivered may contribute to the reduction in shock success due to the decreased average current. Although RBW was not included in this part of the study, it is important to note that RBW does not alter the duration; therefore, it is not a factor when using a defibrillator with RBW. Because the RBW peak current is very close to the average current in the leading pulse, both can be used to predict shock success. BTE waveforms have an average current that is significantly lower than peak current, especially when the impendance falls below 90 ohms, so only average current can be used as a predictor of shock success. Average Current Versus Peak Current —Which Matters Most? <90 >13090-130 Pathway Impedance (Ω) (B)Average Current (A)5 10 15 20 25 Rectilinear BTE *** *** <90 >13090-130 Pathway Impedance (Ω) (C)Success Rate (%)0 20 40 80 60 100 Rectilinear BTE ***** ** p < 0.01 *** p < 0.001 compared with rectilinear waveform <90 >13090-130 Pathway Impedance (Ω) (A)Peak Current (A)5 10 15 25 20 30 Rectilinear BTE*** *** THE HEART OF THE MATTER ©2014 ZOLL Medical Corporation. All rights reserved. Printed in U.S.A. MCN HP 1409 0075 Some Statements Require a Second Look No One Type of Waveform Is More Effective than Another Up to 200 J ZOLL’s RBW delivers significantly more current than high- energy biphasic up to 200 J. ZOLL delivers more current at 200 J than high-energy defibrillators deliver at 360 J. A Biphasic Device that Can Reach 360 J Can Increase Rates of VF/VT Termination A study by Stiell, et al. generally cited as proof of this compares only suboptimal dosing with a high-energy waveform starting at 150 J versus a high-energy waveform at escalating energy beginning at 200 J.11 The correct adult dose for high-energy biphasic defibrillation is 200 J, 300 J, 360 J. This study demonstrates that when giving multiple shocks with a high-energy defibrillator, you should to be using a protocol of 200 J, 300 J, and 360 J and should not reduce the dose below effective levels. Now that Biphasic Shocks Are More Widely Used, Clinical Data Show that Biphasic Shocks Are Not as Successful as Previously Reported, with Many Systems Reporting Shock Success of <75%12 Studies showing first-shock success rates below 75% combine both in-hospital and OHCA data—mixing two very different patient populations—or comparison data against monophasic in a single population.13, 14, 15 In addition, studies cited with lower efficacy include patients presenting in asystole and PEA who are returned to a shockable rhythm. Studies showing 92%-plus efficacy are all in OHCA patients presenting in VF.16, 17, 18 Repeating the Same Shock Dosage after a First Shock Failed Offers Diminishing Returns While Escalating Increases Success11 The supporting data, which was not statistically significant, only compares a high-energy waveform at 200 J, not a high-current waveform. Two hundred-joule high-energy waveforms deliver significantly less current than the 200-J ZOLL high-current RBW. In VF Defibrillation, the Probability of Success Increases with Each Increase in Energy18, 19 Defibrillation likelihood increases not because of increased energy, but increased current. A 200-J high-energy waveform delivers an amount of current similar to a ZOLL defibrillator that delivers 120 joules. As you escalate ZOLL’s high-current waveform from 120 to 200 J, you are stepping up current in the same fashion, and in the end, delivering more current. Independent Studies Show the Efficacy of High-Energy Defibrillation in Atrial Fibrillation None of the studies typically cited shows a statistically significant difference in outcomes, yet there are definite shock protocol differences: Kim: 4 shocks RBW, 5 shocks BTE on crossover—no reverse crossover data available. Successful cardioversion may only be the next shock away.20 Alatawi: 6 shocks RBW, 8 shocks BTE before crossover—difference clearly stated as NOT significant.21 Neal: All patients who received the RBW converted by the first 200-J shock—one patient failed 360 J (fifth shock) and did not convert with 200 J. Conversion required simultaneous 200-J shocks from both defibrillators.22 Khaykin: This study compares the monophasic waveform to the high-energy biphasic waveform; it does not compare it to low-energy biphasic.23 It demonstrates that to achieve maximum efficacy with a high-energy defibrillator, you need to go to 360 J. BTE Delivers More Peak Current than RBW The study by Chen, et al. shows that BTE waveforms have a lower average current than peak current—it is average current that is better for therapeutic dosage.9 RBW has similar average and peak currents. Conclusion Biphasic defibrillators on the market today still use energy as a descriptor for therapeutic doses, despite the fact that it is known that it is current that defibrillates the heart, a fact that is not likely to change in the near future. Therefore, it is important to understand that the RBW used in all ZOLL defibrillators provides the most current available, with peak and average current rates approximately the same values. 20. Kim ML, Kim SG, et al. Comparison of rectilinear biphasic waveform energy versus truncated exponential biphasic waveform energy for transthoracic cardioversion of atrial fibrillation American Journal of Cardiology, 2004;94(11):1438-40. 21. Alatawi F, Gurevitz O, et al. Prospective, randomized comparison of two biphasic waveforms for the efficacy and safety of transthoracic biphasic cardioversion of atrial fibrillation. Heart Rhythm. 2005;2:382-387. 22. Neal S, Ngarmukos T, et al. Comparison of the efficacy and safety of two biphasic defibrillator waveforms for the conversion of atrial fibrillation to sinus rhythm. Am J Cardiol. 2003;92:810-814. 23. Khaykin Y, Newman D, et al. Biphasic versus monophasic cardioversion in shock resistant Atrial Fibrillation. J Cardiovasc Electrophysiology. 2003;14:862-872. I N T E G R A T I N G R E S U S C I T A T I O N S O L U T I O N S ZOLL_Corp_Brochurev3_Layout 1 1/17/11 3:11 PM Page 1 Leader in Resuscitation Technologies Named after founder Paul M. Zoll, M.D., a pioneer in cardiac pacing and defibrillation, ZOLL Medical was built on a strong foundation of clinical care and innovation that has continued for three decades. A world leader in resuscitation and critical care technologies, ZOLL has steadily developed and offered best-in-class, technically superior products to offer the world’s most integrated system of resuscitation solutions, as well as complementar y products and ser vices in data management and temperature management. Solutions that Strengthen the Chain of Sur vival Advances in resuscitation are linked to providing rescuers with superior products that work together to improve outcomes. ZOLL has delivered many product innovations and “firsts” that have become standards of care: External non-invasive pacing. Multi-function electrodes. Single-cable monitoring, pacing, and defibrillation. The only biphasic waveform reviewed by the FDA and allowed to have a claim of superiority to monophasic*. A full-rescue AED with CPR help and electronic code data for review and analysis. ECG filtering to minimize CPR interruptions. Electrode compatibility. A revolutionary cardiac support pump that uses a unique load-distributing band. A wearable defibrillator. A miniature pump for fluid resuscitation. Over the years ZOLL has continued to add capabilities, such as powerful and precise intravascular temperature management, and robust data management and analysis software that delivers complete end-to-end resuscitation information. One of ZOLL’s latest innovations will bring together for the first time real-time clinical information to caregivers throughout the continuum of emergency care by integrating data from multiple sources. ZOLL’s Broad Product Portfolio Supports Ever y Link in the Chain of Sur vival Early Intervention, Early Access, Early CPR, Early Defibrillation, and Early Advanced Care (ACLS), Post Resuscitation Care, and Data Management and Analysis. All of our products are designed to work together and strengthen the Chain, regardless of whether care is delivered pre-hospital, in hospital, or post-hospital. ZOLL_Corp_Brochurev3_Layout 1 1/17/11 3:11 PM Page 2 The Dependable Partner ZOLL has an ever-expanding market presence in nearly all continents, delivering leading-edge resuscitation solutions for: •Professionals •Lay Rescuers •Physicians managing high risk patients We recognize the unique challenges faced by each of the markets we ser ve, and work with our customers to address their particular clinical and business needs. From our ability to capture performance data for quality assurance, to the ease of use provided by the universal operating system of our products, ZOLL offers a number of ways to help our customers reduce costs, enhance operational efficiency and productivity, and manage assets more effectively. Distinguished by Financial Strength and Stability ZOLL’s ongoing investment in developing standards of care based on clinical expertise has resulted in a financially strong public company (NASDAQ GS: ZOLL). Throughout 30 years in business, we have had consistent ownership and management with an unwavering commitment to being the world leader in resuscitation. We regularly end each fiscal year with no debt and substantial assets. ZOLL is committed to ensuring high quality, clinically superior products for customers who rely on them to save lives. Our stringent quality control and regulator y compliance programs have enabled us to have an unmatched trackrecord in uninterrupted product delivery. On the Forbes Top 100 Most Trustworthy Companies list in 2007, 2008 and 2009. One of only 15 healthcare organizations to make the 2009 list of Fortune Magazine’s 100 Fastest-Growing Companies. Recipient of Frost & Sullivan’s 2009 North American Healthcare Innovation Award. Nine consecutive Omega NorthFace ScoreBoard AwardsSM for excellence in customer service and support. Recognized for Leadership and Innovation ZOLL has received numerous accolades for our leadership, advances, and dedication to the industry and our customers, including: ZOLL Fiscal Year Consolidated Revenue (in Millions) ’00 ’01 ’02 ’03 ’04 ’05 ’06 ’07 ’08 ’09 ’10 $256 $218$219 $190 $156 $124$110 $309 $398 $385 $444 ZOLL_Corp_Brochurev3_Layout 1 1/17/11 3:11 PM Page 3 P rinted in U.S.A. 111 020 9656 -0180 ZOLL Medical Corporation Worldwide Headquarters 269 Mill Road Chelmsford, MA 01824 978-421-9655 800-804-4356 For the ZOLL representative or distributor nearest you, visit www.zoll.com/contacts. ©ZOLL Medical Corporation 2010. All Rights Reserved. ZOLL is a registered trademark of ZOLL Medical Corporation in the United States and/or other countries. All other trademarks are the property of their respective owners. *To claim superiority over monophasic in high transthoracic impedance patients at 90% confidence level. Data demonstrated equivalent efficacy for all patients at a 95% confidence level. 1 J Electrocardiol. 2007 Nov-Dec;40(6 Suppl):S118-22. http://www.ncbi.nlm.nih.gov/pubmed/17993308 Solving Resuscitation Challenges Worldwide While significant industry-wide progress has been made in solving the challenges of resuscitation, there is still much work to be done. Across the globe, more than one million sudden cardiac deaths occur each year, many of them preventable. The survival rate from sudden cardiac arrest is less than 1% worldwide and on average less than 7% in the United States. Sur vival can be as high as 50%, however, with improvements in care1. ZOLL is committed to addressing these challenges with solutions that range from proven technologies such as defibrillators to new standards of care like our revolutionar y cardiac support pump, plus seamless data that brings all the pieces of the resuscitation puzzle together to improve outcomes all over the world. ZOLL markets and sells its products in more than 140 countries and has direct operations, distributor networks, and business partners throughout the world. More than 200,000 of our AEDs and 100,000 of our ALS defibrillators are installed across the globe. Connect with the World Leader in Resuscitation To learn more about ZOLL or to schedule a meeting to discuss how our solutions can address your specific needs, please visit us today at visit www.zoll.com. ZOLL_Corp_Brochurev3_Layout 1 1/17/11 3:12 PM Page 4 Pricing Options for Data Plans Cellular Modem • Volusia County can utilize current county contracts and data plans with the cellular modem. • Volusia County has the option to purchase data plans through M2M Air. Benefits include: o Significant cost savings o Customizable plan sizes (3 MB and up) with data pooling o Pooling allows a customer with 10 -3MB plans to share 30MB of data between devices o Online dashboard allows tracking and allocation of cell modems to devices o Daily email account alerts (email) for data usage o Month-to-month data plans o 24x7 support o U.S. Customers can have accounts with both AT&T and Verizon and only receive one bill • Data plan costs: USA Pricing: Verizon CDMA Plan Size Charge/modem Transmissions/Month 3 MB $6.99/mo ~ 60 12-leads 5 MB $8.49/mo ~ 100 12-leads 10 MB $11.99/mo ~ 200-12 leads USA Pricing: AT&T GSM Plan Size Charge/modem Transmissions/Month 3 MB $6.99/mo ~ 60 12-leads 5 MB $8.49/mo ~ 100 12-leads 10 MB $11.99/mo ~ 200-12 leads Attn: 386-943-7009Tel: Andrew G. Kokitus Procurement Analyst II TO: DestinationFOB: Net 45 DaysTERMS: DATE: QUOTATION (978) 421-0015 Customer Support (800) 348-9011 (978) 421-9655 Main Chelmsford, Massachusetts 01824-4105 269 Mill Rd Worldwide HeadQuarters ZOLL Medical Corporation DESCRIPTION QTY.UNIT PRICE DISC PRICE TOTAL PRICE email:akokitus@volusia.org Free FreightFREIGHT: 123 West Indiana Avenue Room 302 DeLand, FL 32720 ITEM MODEL NUMBER 212521 V:3 Volusia County Purchasing & Contracts March 23, 2016 FEDERAL ID#: 04-2711626 ** 1 6 0 1 - 2 2 3 1 0 1 1 - 0 1 X Series ® Manual Monitor/Defibrillator $14,995 with 4 trace tri-mode display monitor/ defibrillator/ printer, comes with Real CPR Help®, advisory algorithm, advanced communications package (Wi-Fi, Bluetooth, USB cellular modem capable) USB data transfer capable and large 6.5"( 16.5cm) diagonal screen, full 12 ECG lead view with both dynamic and static 12-lead mode display. Accessories Included: • Six (6) foot 3- Lead ECG cable • MFC cable • MFC CPR connector • A/C power adapter/ battery charger • A/C power cord • One (1) roll printer paper • 6.6 Ah Li-ion battery • Carry case • Declaration of Conformity • Operator's Manual • Quick Reference Guide • One (1)-year EMS warranty Advanced Options: Real CPR Help Expansion Pack $995 CPR Dashboard quantitive depth and rate in real time, release indicator, interruption timer, perfusion performance indicator (PPI) • See - Thru CPR artifact filtering ZOLL Noninvasive Pacing Technology: $2,550 qq 79 $40,020.00 $27,199.99 $2,148,799.21 * This quote is made subject to ZOLL’s standard commercial terms and conditions (ZOLL T’s + C’s) which accompany this quote. Any purchase order (P.O.) issued in response to this quotation will be deemed to Subtotal $2,148,799.21 Page 1 Zandra Evans incorporate ZOLL T’s + C’s. Any modification of the ZOLL T’s + C’s must be set forth or referenced in the customer’s P.O. No commercial terms or conditions shall apply to the sale of goods or services governed by this quote and the customer’s P.O unless set forth in or referenced by either document. EMS Territory Manager 800-242-9150, x9710 1. DELIVERY WILL BE MADE 60-90 DAYS AFTER RECEIPT OF ACCEPTED PURCHASE ORDER. 2. PRICES QUOTED ARE VALID UNTIL JUNE 30, 2016. 3. APPLICABLE TAX 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 978-421-0015 OR EMAIL TO ESALES@ZOLL.COM. 6. ALL DISCOUNTS OFF LIST PRICE ARE CONTINGENT UPON PAYMENT WITHIN AGREED UPON TERMS. 7. PLACE YOUR ACCESSORY ORDERS ONLINE BY VISITING www.zollwebstore.com. Page 1 Attn: 386-943-7009Tel: Andrew G. Kokitus Procurement Analyst II TO: DestinationFOB: Net 45 DaysTERMS: DATE: QUOTATION (978) 421-0015 Customer Support (800) 348-9011 (978) 421-9655 Main Chelmsford, Massachusetts 01824-4105 269 Mill Rd Worldwide HeadQuarters ZOLL Medical Corporation DESCRIPTION QTY.UNIT PRICE DISC PRICE TOTAL PRICE email:akokitus@volusia.org Free FreightFREIGHT: 123 West Indiana Avenue Room 302 DeLand, FL 32720 ITEM MODEL NUMBER 212521 V:3 Volusia County Purchasing & Contracts March 23, 2016 FEDERAL ID#: 04-2711626 ** Masimo Pulse Oximetry SP02 & SpCO $4,540 • Signal Extraction Technology (SET) • Rainbow SET ( for SpCO & SpMet) NIBP Welch Allyn includes: $3495 • Smartcuff 10 foot Dual Lumen hose • SureBP Reusable Adult Medium Cuff End Tidal Carbon Dioxide monitoring (ETCO2) $4,995 Oridion Microstream Technology: Order required Microstream tubing sets separately Interpretative 12- Lead ECG: $8,450 • 12-Lead one step ECG cable- includes 4- Lead limb lead cable and removable precordial 6- Lead set 2 8 0 0 0 - 0 0 0 3 7 1 SpO2/SpCO/SpMet Rainbow DCI Adult Reusable Sensor with connector (3 ft) qq 79 $845.00 $633.75 $50,066.25 * 3 8 0 0 0 - 0 0 0 3 7 2 SpO2/SpCO/SpMet Rainbow DCI Reusable Sensor, Pediqq 79 $845.00 $633.75 $50,066.25 * 4 8 0 0 0 - 0 3 4 2 SpO2/SpCO/SpMet Rainbow Patient Cable: Connects to Single Use Sensors (12 ft)qq 79 $295.00 $221.25 $17,478.75 * This quote is made subject to ZOLL’s standard commercial terms and conditions (ZOLL T’s + C’s) which accompany this quote. Any purchase order (P.O.) issued in response to this quotation will be deemed to Subtotal $2,266,410.46 Page 2 Zandra Evans incorporate ZOLL T’s + C’s. Any modification of the ZOLL T’s + C’s must be set forth or referenced in the customer’s P.O. No commercial terms or conditions shall apply to the sale of goods or services governed by this quote and the customer’s P.O unless set forth in or referenced by either document. EMS Territory Manager 800-242-9150, x9710 1. DELIVERY WILL BE MADE 60-90 DAYS AFTER RECEIPT OF ACCEPTED PURCHASE ORDER. 2. PRICES QUOTED ARE VALID UNTIL JUNE 30, 2016. 3. APPLICABLE TAX 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 978-421-0015 OR EMAIL TO ESALES@ZOLL.COM. 6. ALL DISCOUNTS OFF LIST PRICE ARE CONTINGENT UPON PAYMENT WITHIN AGREED UPON TERMS. 7. PLACE YOUR ACCESSORY ORDERS ONLINE BY VISITING www.zollwebstore.com. Page 2 Attn: 386-943-7009Tel: Andrew G. Kokitus Procurement Analyst II TO: DestinationFOB: Net 45 DaysTERMS: DATE: QUOTATION (978) 421-0015 Customer Support (800) 348-9011 (978) 421-9655 Main Chelmsford, Massachusetts 01824-4105 269 Mill Rd Worldwide HeadQuarters ZOLL Medical Corporation DESCRIPTION QTY.UNIT PRICE DISC PRICE TOTAL PRICE email:akokitus@volusia.org Free FreightFREIGHT: 123 West Indiana Avenue Room 302 DeLand, FL 32720 ITEM MODEL NUMBER 212521 V:3 Volusia County Purchasing & Contracts March 23, 2016 FEDERAL ID#: 04-2711626 ** 5 8 0 0 0 - 0 5 8 0 - 0 1 Six hour rechargeable Smart battery qq 158 $495.00 $371.25 $58,657.50 * 6 REUSE- 0 7 - 2 MQ Welch Allyn REUSE-07-2MQ Cuff, Infant, 2-Tube, Twist lock connectorqq 79 $52.50 $39.38 $3,111.02 * 7 REUSE- 0 9 - 2 MQ Welch Allyn Cuff, Child, 2-Tube, Twist lock connector qq 79 $52.50 $39.38 $3,111.02 * 8 REUSE- 1 2 - 2 MQ Welch Allyn REUSE-12-2MQ Cuff, Lg Adult, 2-Tube, Twist lock connector qq 79 $52.50 $39.38 $3,111.02 * 9 8 2 0 0 - 0 0 0 1 0 0 - 0 1 Single Bay Charger for the SurePower and SurePower II bateries qq 55 $945.00 $708.75 $38,981.25 * 10 8 3 0 0 - 0 5 0 0 - 0 1 SurePower 4 Bay Charging System including 4 Battery Charging adaptersqq 25 $2,583.00 $1,937.25 $48,431.25 * 11 8 0 0 0 - 0 0 0 4 7 2 - 0 1 Multi- Tech Cell Modem Kit, CDMA, Verizon, US qq 79 $595.00 $446.25 $35,253.75 * 12 8 0 0 0 - 0 6 0 9 - 0 1 RescueNet Code Review - Enterprise Edition. Software for Windows designed for advance responder (ALS) and mixed responder (ALS/ILS/BLS) programs. Also embedded in this program is ZOLL Data Relay Server Software. Includes technical support and upgrades for the first 12 months. qq 1 $2,495.00 $2,495.00 $2,495.00 This quote is made subject to ZOLL’s standard commercial terms and conditions (ZOLL T’s + C’s) which accompany this quote. Any purchase order (P.O.) issued in response to this quotation will be deemed to Subtotal $2,459,562.27 Page 3 Zandra Evans incorporate ZOLL T’s + C’s. Any modification of the ZOLL T’s + C’s must be set forth or referenced in the customer’s P.O. No commercial terms or conditions shall apply to the sale of goods or services governed by this quote and the customer’s P.O unless set forth in or referenced by either document. EMS Territory Manager 800-242-9150, x9710 1. DELIVERY WILL BE MADE 60-90 DAYS AFTER RECEIPT OF ACCEPTED PURCHASE ORDER. 2. PRICES QUOTED ARE VALID UNTIL JUNE 30, 2016. 3. APPLICABLE TAX 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 978-421-0015 OR EMAIL TO ESALES@ZOLL.COM. 6. ALL DISCOUNTS OFF LIST PRICE ARE CONTINGENT UPON PAYMENT WITHIN AGREED UPON TERMS. 7. PLACE YOUR ACCESSORY ORDERS ONLINE BY VISITING www.zollwebstore.com. Page 3 Attn: 386-943-7009Tel: Andrew G. Kokitus Procurement Analyst II TO: DestinationFOB: Net 45 DaysTERMS: DATE: QUOTATION (978) 421-0015 Customer Support (800) 348-9011 (978) 421-9655 Main Chelmsford, Massachusetts 01824-4105 269 Mill Rd Worldwide HeadQuarters ZOLL Medical Corporation DESCRIPTION QTY.UNIT PRICE DISC PRICE TOTAL PRICE email:akokitus@volusia.org Free FreightFREIGHT: 123 West Indiana Avenue Room 302 DeLand, FL 32720 ITEM MODEL NUMBER 212521 V:3 Volusia County Purchasing & Contracts March 23, 2016 FEDERAL ID#: 04-2711626 ** 13 5 0 0 1 - 9 9 2 8 ZOLL E Series w/Pacing, 12 lead + 3 parameters or more Trade-In qq 55 ($2,000.00)($110,000.00)** 14 4 0 0 1 - 9 9 3 4 ZOLL M-Series Biphasic w/Pacing, 12 lead + 3 parameters or more (includes CCT) Trade-In qq 15 ($500.00)($7,500.00)** "Trade in value is only guaranteed through June 30, 2016." **Trade-In Value valid if all equipment purchased is in good operational and cosmetic condition, and includes all standard accessories. Customer assumes responsibility for shipping trade-in equipment to ZOLL Chelmsford within 60 days of receipt of new equipment. Customer agrees to pay cash value for trade-in equipment not shipped to ZOLL on a timely basis. *Reflects Discount Pricing. This quote is made subject to ZOLL’s standard commercial terms and conditions (ZOLL T’s + C’s) which accompany this quote. Any purchase order (P.O.) issued in response to this quotation will be deemed to $2,342,062.27 TOTAL Zandra Evans incorporate ZOLL T’s + C’s. Any modification of the ZOLL T’s + C’s must be set forth or referenced in the customer’s P.O. No commercial terms or conditions shall apply to the sale of goods or services governed by this quote and the customer’s P.O unless set forth in or referenced by either document. EMS Territory Manager 800-242-9150, x9710 1. DELIVERY WILL BE MADE 60-90 DAYS AFTER RECEIPT OF ACCEPTED PURCHASE ORDER. 2. PRICES QUOTED ARE VALID UNTIL JUNE 30, 2016. 3. APPLICABLE TAX 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 978-421-0015 OR EMAIL TO ESALES@ZOLL.COM. 6. ALL DISCOUNTS OFF LIST PRICE ARE CONTINGENT UPON PAYMENT WITHIN AGREED UPON TERMS. 7. PLACE YOUR ACCESSORY ORDERS ONLINE BY VISITING www.zollwebstore.com. Page 4 ZOLL QUOTATION GENERAL TERMS & CONDITIONS 1. ACCEPTANCE. This Quotation constitutes an offer by ZOLL Medical Corporation to sell to the Customer the equipment (including a license to use certain software) listed in this Quotation and described in the specifications either attached to or referred to in this Quotation (hereinafter referred to as Equipment). Any acceptance of such offer is expressly limited to the terms of this Quotation, including these General Terms and Conditions. Acceptance shall be so limited to this Quotation notwithstanding (i) any conflicting written or oral representations made by ZOLL Medical Corporation or any agent or employee of ZOLL Medical Corporation or (ii) receipt or acknowledgement by ZOLL Medical Corporation of any purchase order, specification, or other document issued by the Customer. Any such document shall be wholly inapplicable to any sale made pursuant to this Quotation, and shall not be binding in any way on ZOLL Medical Corporation. Acceptance of this Quotation by the Customer shall create an agreement between ZOLL Medical Corporation and the Customer (hereinafter referred to as the “Contract” the terms and conditions of which are expressly limited to the provisions of this Quotation including these Terms and Conditions. No waiver change or modification of any of the provisions of this Quotation or the Contract shall be binding on ZOLL Medical Corporation unless such waiver, change or modification (i) is made in writing (ii) expressly states that it is a waiver, change or modification of this Quotation or the Contract and (iii) is signed by an authorized representative of ZOLL Medical Corporation. 2. DELIVERY AND RISK OF LOSS. Unless otherwise stated, all deliveries shall be F.O.B. ZOLL Medical Corporation’s facility. Risk of loss or damage to the Equipment shall pass to the Customer upon delivery of the Equipment to the carrier. 3. TERMS OF PAYMENT. Unless otherwise stated in its Quotation payment by Customer is due thirty (30) days after the ship date appearing on ZOLL Medical Corporation invoice. Any amounts payable hereunder which remain unpaid after the date shall be subject to a late charge equal to 1.5% per month from the due date until such amount is paid. 4. CREDIT APPROVAL. All shipments and deliveries shall at all times be subject to the approval of credit by ZOLL Medical Corporation. ZOLL Medical Corporation may at any time decline to make any shipment or delivery except upon receipt of payment or security or upon terms regarding credit or security satisfactory to ZOLL Medical Corporation. 5. TAXES & FEES. The pricing quoted in its Quotation do not include sales use, excise, or other similar taxes or any duties or customs charges, or any order processing fees. The Customer shall pay in addition for the prices quoted the amount of any present or future sales, excise or other similar tax or customs duty or charge applicable to the sale or use of the Equipment sold hereunder (except any tax based on the net income of ZOLL Medical Corporation), and any order processing fees that ZOLL may apply from time to time. In lieu thereof the Customer may provide ZOLL Medical Corporation with a tax exemption certificate acceptable to the taxing authorities. 6. WARRANTY. (a) ZOLL Medical Corporation warrants to the Customer that from the earlier of the date of installation or thirty (30) days after the date of shipment from ZOLL Medical Corporation’s facility, the Equipment (other than accessories and electrodes) will be free from defects in material and workmanship under normal use and service for the period noted on the reverse side. Accessories and electrodes shall be warranted for ninety (90) days from the date of shipment. During such period ZOLL Medical Corporation will at no charge to the Customer either repair or replace (at ZOLL Medical Corporation’s sole option) any part of the Equipment found by ZOLL Medical Corporation to be defective in material or workmanship. If ZOLL Medical Corporation’s inspection detects no defects in material or workmanship, ZOLL Medical Corporation’s regular service charges shall apply. (b) ZOLL Medical Corporation shall not be responsible for any Equipment defect failure of the Equipment to perform any specified function, or any other nonconformance of the Equipment caused by or attributable to (i) any modification of the Equipment by the Customer, unless such modification is made with the prior written approval of ZOLL Medical Corporation: (ii) the use of the Equipment with any associated or complementary equipment accessory or software not specified by ZOLL Medical Corporation, or (iii) any misuse or abuse of the Equipment: (iv) exposure of the Equipment to conditions beyond the environmental, power or operating constraints specified by ZOLL Medical Corporation, or (v) installation or wiring of the Equipment other than in accordance with ZOLL Medical Corporation’s instructions. (c) Warranty does not cover items subject to normal wear and burnout during use, including but not limited to lamps, fuses, batteries, cables and accessories. (d) The foregoing warranty does not apply to software included as part of the Equipment (including software embodied in read-only memory known as “firmware”). (e) The foregoing warranty constitutes the exclusive remedy of the Customer and the exclusive liability of ZOLL Medical Corporation for any breach of any warranty related to the Equipment supplied hereunder. THE WARRANTY SET FORTH HEREIN IS EXCLUSIVE AND ZOLL MEDICAL CORPORATION EXPRESSLY DISCLAIMS ALL OTHER WARRANTIES WHETHER WRITTEN, ORAL, IMPLIED, OR STATUTORY, INCLUDING BUT NOT LIMITED TO ANY WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. 7. SOFTWARE LICENSE. (a) All software (the “Software” which term shall include firmware) included as part of the Equipment is licensed to Customer pursuant to a nonexclusive limited license on the terms hereinafter set forth, (b) Customer may not copy, distribute, modify, translate or adapt the Software, and may not disassemble or reverse compile the Software, or seek in any manner to discover, disclose or use any proprietary algorithms, techniques or other confidential information contained therein, (c) All rights in the Software remain the product of ZOLL Medical Corporation, and Customer shall have no right or interest therein except as expressly provided herein. (d) Customer’s right to use the Software may be terminated by ZOLL Medical Corporation in the event of any failure to comply with terms of this quotation, (e) Customer may transfer the license conferred hereby only in connection with a transfer of the Equipment and may not retain any copies of the Software following such transfer. (f) ZOLL Medical Corporation warrants that the read-only memory or other media on which the Software is recorded will be free from defects in materials and workmanship for the period and on terms set forth in section 6. (g) Customer understands that the Software is a complex and sophisticated software product and no assurance can be given that operation of the Software will be uninterrupted or error-free, or that the Software will meet Customer’s requirements. Except as set forth in section 7(f), ZOLL MEDICAL CORPORATION MAKES NO REPRESENTATIONS OR WARRANTIES WITH RESPECT TO THE SOFTWARE AND IN PARTICULAR DISCLAIMS ANY IMPLIED WARRANTIES OR MERCHANTABILITY OR FITNESS OF A PARTICULAR PURPOSE WITH RESPECT THERETO. Customer’s exclusive remedy for any breach of warranty or defect relating to the Software shall be the repair or replacement of any defective read-only memory or other media so that it correctly reproduces the Software. This License applies only to ZOLL Medical Corporation Software. 8. DELAYS IN DELIVERY. ZOLL Medical Corporation shall not be liable for any delay in the delivery of any part of the Equipment if such delay is due to any cause beyond the control of the ZOLL Medical Corporation including, but not limited to acts of God, fires, epidemics, floods, riots, wars, sabotage, labor disputes, governmental actions, inability to obtain materials, components, manufacturing facilities or transportation or any other cause beyond the control of ZOLL Medical Corporation. In addition ZOLL Medical Corporation shall not be liable for any delay in delivery caused by failure of the Customer to provide any necessary information in a timely manner. In the event of any such delay, the date of shipment or performance hereunder shall be extended to the period equal to the time lost by reason of such delay. In the event of such delay ZOLL Medical Corporation may allocate available Equipment among its Customers on any reasonable and equitable basis. The delivery dates set forth in this Quotation are approximate only and ZOLL Medical Corporation shall not be liable for or shall the Contract be breached by, any delivery by ZOLL Medical Corporation within a reasonable time after such dates. 9. LIMITATIONS OF LIABILITY. IN NO EVENT SHALL ZOLL MEDICAL CORPORATION BE LIABLE FOR INDIRECT SPECIAL OR CONSEQUENTIAL DAMAGES RESULTING FROM ZOLL MEDICAL CORPORATIONS PERFORMANCE OR FAILURE TO PERFORM PURSUANT TO THIS QUOTATION OR THE CONTRACT OR THE FURNISHING, PERFORMANCE, OR USE OF ANY EQUIPMENT OR SOFTWARE SOLD HERETO, WHETHER DUE TO A BREACH OF CONTRACT, BREACH OF WARRANTY, THE NEGLIGENCE OF ZOLL MEDICAL CORPORATION OR OTHERWISE. 10. PATENT INDEMNITY. ZOLL Medical Corporation shall at its own expense defend any suit that may be instituted against the Customer for alleged infringement of any United States patents or copyrights related to the parts of the Equipment or the Software manufactured by ZOLL Medical Corporation, provided that (i) such alleged infringement consists only in the use of such Equipment or the Software by itself and not as a part of or in combination with any other devices or parts, (ii) the Customer gives ZOLL Medical Corporation immediate notice in writing of any such suit and permits ZOLL Medical Corporation through counsel of its choice, to answer the charge of infringement and defend such suit, and (iii) the Customer gives ZOLL Medical Corporation all requested information, assistance and authority at ZOLL Medical Corporation’s expense, to enable ZOLL Medical Corporation to defend such suit. In the case of a final award of damages for infringement in any such suit, ZOLL Medical Corporation will pay such award, but it shall not be responsible for any settlement made without its written consent. Section 10 states ZOLL Medical Corporation’s total responsibility and liability’s, and the Customer’s sole remedy for any actual or alleged infringement of any patent by the Equipment or the Software or any part thereof provided hereunder. In no event shall ZOLL Medical Corporation be liable for any indirect, special, or consequential damages resulting from any such infringement. 11. CLAIMS FOR SHORTAGE. Each shipment of Equipment shall be promptly examined by the Customer upon receipt thereof. The Customer shall inform ZOLL Medical Corporation of any shortage in any shipment within ten (10) days of receipt of Equipment. If no such shortage is reported within ten (10) day period, the shipment shall be conclusively deemed to have been complete. 12. RETURNS AND CANCELLATION. (a) The Customer shall obtain authorization from ZOLL Medical Corporation prior to returning any of the Equipment. (b) The Customer receives authorization from ZOLL Medical Corporation to return a product for credit, the Customer shall be subject to a restocking charge of twenty percent (20%) of the original list purchase price, but not less than $50.00 per product. (c) Any such change in delivery caused by the Customer that causes a delivery date greater than six (6) months from the Customer’s original order date shall constitute a new order for the affected Equipment in determining the appropriate list price. 13. APPLICABLE LAW. This Quotation and the Contract shall be governed by the substantive laws of the Commonwealth of Massachusetts without regard to any choice of law provisions thereof. 14. COMPLIANCE WITH LAWS. (a) ZOLL Medical Corporation represents that all goods and services delivered pursuant to the Contract will be produced and supplied in compliance with all applicable state and federal laws and regulations, including the requirements of the Fair Labor Standards Act of 1938, as amended. (b) The Customer shall be responsible for compliance with any federal, state and local laws and regulations applicable to the installation or use of the Equipment furnished hereunder, and will obtain any permits required for such installation and use. 15. NON-WAIVER OF DEFAULT. In the event of any default by the Customer, ZOLL Medical Corporation may decline to make further shipments or render any further warranty or other services without in any way affecting its right under such order. If despite any default by Customer, ZOLL Medical Corporation elects to continue to make shipments its action shall not constitute a waiver of any default by the Customer or in any way affect ZOLL Medical Corporation’s legal remedies regarding any such default. No claim or right arising out of a breach of the Agreement by the Customer can be discharged in whole or in part by waiver or renunciation of the claim or right unless the waiver or renunciation is supported by consideration and is in writing signed by ZOLL Medical Corporation. 16. ASSIGNMENT. This Quotation, and the Contract, may not be assigned by the Customer without the prior written consent of ZOLL Medical Corporation, and any assignment without such consent shall be null and void. 17. TITLE TO PRODUCTS. Title to right of possession of the products sold hereunder shall remain with ZOLL Medical Corporation until ZOLL Medical Corporation delivers the Equipment to the carrier and agrees to do all acts necessary to perfect and maintain such right and title in ZOLL Medical Corporation. Failure of the Customer to pay the purchase price for any product when due shall give ZOLL Medical Corporation the right, without liability to repossess the Equipment, with or without notice, and to avail itself of any remedy provided by law. 18. EQUAL EMPLOYMENT OPPORTUNITY / AFFIRMATIVE ACTION. VETERAN’S EMPLOYMENT - If this order is subject to Executive Order 11710 and the rules, regulations, or orders of the Secretary of Labor issued thereunder the contract clause as set forth at 41 CFR 60-250.4 is hereby included as part of this order. EMPLOYMENT OF HANDICAPPED - if this order is subject to Section 503 of the Rehabilitation Act of 1973, as amended and the rules, regulations or orders of the Secretary of Labor as issued thereunder, the contract clause at 41 CFR 60-741.7 is hereby included as part of this order. EQUAL OPPORTUNITY EMPLOYMENT - if this order is subject to the provisions of Executive Order 11246, as amended, and the rules, regulations or orders of the Secretary of Labor issued thereunder, the contract clause set forth at 41 CFR 60-1.4 (a) and 60-1.4 (b) are hereby included as a part of this order and Seller agrees to comply with the reporting requirements set forth at 41 CFR 60-1.7 and the affirmative action compliance program requirements set forth as 41 CFR 60-1.40. 19. VALIDITY OF QUOTATION. This Quotation shall be valid and subject to acceptance by the Customer, in accordance with the terms of Section 1 hereof for the period set forth on the face hereof. After such period, the acceptance of this Quotation shall not be binding upon ZOLL Medical Corporation and shall not create a contract, unless such acceptance is acknowledged and accepted by ZOLL Medical Corporation by a writing signed by an authorized representative of ZOLL Medical Corporation. 20. GENERAL. Any Contract resulting from this Quotation shall be governed by and interpreted in accordance with the laws of the Commonwealth of Massachusetts. This constitutes the entire agreement between Buyer and Supplier with respect to the purchase and sale of the Products described in the face hereof, and only representations or statements contained herein shall be binding upon Supplier as a warranty or otherwise. Acceptance or acquiescence in the course of performance rendered pursuant hereto shall not be relevant to determine the meaning of this writing even though the accepting or acquiescing party has knowledge of the nature of the performance and opportunity for objection. No addition to or modification of any of the terms and conditions specified herein shall be binding upon Supplier unless made in writing and signed by a duly authorized representative of Supplier. The terms and conditions specified shall prevail notwithstanding any variance from the terms and conditions of any order or other form submitted by Buyer for the Products set forth on the face of this Agreement. To the extent that this writing may be treated as an acceptance of Buyer’s prior offer, such acceptance is expressly made conditional on assent by Buyer to the terms hereof, and, without limitation, acceptance of the goods by Buyer to the terms hereof, and, without limitation, acceptance of the goods by Buyer shall constitute such assent. All cancellations and reschedules require a minimum of thirty (30) days notice. ZOLL Medical Corporation Page 5 Attn: 386-943-7009Tel: Andrew G. Kokitus Procurement Analyst II TO: DestinationFOB: Net 45 DaysTERMS: DATE: QUOTATION (978) 421-0015 Customer Support (800) 348-9011 (978) 421-9655 Main Chelmsford, Massachusetts 01824-4105 269 Mill Rd Worldwide HeadQuarters ZOLL Medical Corporation DESCRIPTION QTY.UNIT PRICE DISC PRICE TOTAL PRICE email:akokitus@volusia.org Free FreightFREIGHT: 123 West Indiana Avenue Room 302 DeLand, FL 32720 ITEM MODEL NUMBER 213284 V:1 Volusia County Purchasing & Contracts March 21, 2016 FEDERAL ID#: 04-2711626 ** 1 8 7 7 8 - 2 0 0 0 4 4 4 yrs Extended warranty, 1 PM per year, Battery replacement qq 79 $5,570.00 $5,570.00 $440,030.00 This quote is made subject to ZOLL’s standard commercial terms and conditions (ZOLL T’s + C’s) which accompany this quote. Any purchase order (P.O.) issued in response to this quotation will be deemed to $440,030.00 TOTAL Zandra Evans incorporate ZOLL T’s + C’s. Any modification of the ZOLL T’s + C’s must be set forth or referenced in the customer’s P.O. No commercial terms or conditions shall apply to the sale of goods or services governed by this quote and the customer’s P.O unless set forth in or referenced by either document. EMS Territory Manager 800-242-9150, x9710 1. DELIVERY WILL BE MADE 60-90 DAYS AFTER RECEIPT OF ACCEPTED PURCHASE ORDER. 2. PRICES QUOTED ARE VALID UNTIL JUNE 30, 2016. 3. APPLICABLE TAX 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 978-421-0015 OR EMAIL TO ESALES@ZOLL.COM. 6. ALL DISCOUNTS OFF LIST PRICE ARE CONTINGENT UPON PAYMENT WITHIN AGREED UPON TERMS. 7. PLACE YOUR ACCESSORY ORDERS ONLINE BY VISITING www.zollwebstore.com. Page 1 ZOLL QUOTATION GENERAL TERMS & CONDITIONS 1. ACCEPTANCE. This Quotation constitutes an offer by ZOLL Medical Corporation to sell to the Customer the equipment (including a license to use certain software) listed in this Quotation and described in the specifications either attached to or referred to in this Quotation (hereinafter referred to as Equipment). Any acceptance of such offer is expressly limited to the terms of this Quotation, including these General Terms and Conditions. Acceptance shall be so limited to this Quotation notwithstanding (i) any conflicting written or oral representations made by ZOLL Medical Corporation or any agent or employee of ZOLL Medical Corporation or (ii) receipt or acknowledgement by ZOLL Medical Corporation of any purchase order, specification, or other document issued by the Customer. Any such document shall be wholly inapplicable to any sale made pursuant to this Quotation, and shall not be binding in any way on ZOLL Medical Corporation. Acceptance of this Quotation by the Customer shall create an agreement between ZOLL Medical Corporation and the Customer (hereinafter referred to as the “Contract” the terms and conditions of which are expressly limited to the provisions of this Quotation including these Terms and Conditions. No waiver change or modification of any of the provisions of this Quotation or the Contract shall be binding on ZOLL Medical Corporation unless such waiver, change or modification (i) is made in writing (ii) expressly states that it is a waiver, change or modification of this Quotation or the Contract and (iii) is signed by an authorized representative of ZOLL Medical Corporation. 2. DELIVERY AND RISK OF LOSS. Unless otherwise stated, all deliveries shall be F.O.B. ZOLL Medical Corporation’s facility. Risk of loss or damage to the Equipment shall pass to the Customer upon delivery of the Equipment to the carrier. 3. TERMS OF PAYMENT. Unless otherwise stated in its Quotation payment by Customer is due thirty (30) days after the ship date appearing on ZOLL Medical Corporation invoice. Any amounts payable hereunder which remain unpaid after the date shall be subject to a late charge equal to 1.5% per month from the due date until such amount is paid. 4. CREDIT APPROVAL. All shipments and deliveries shall at all times be subject to the approval of credit by ZOLL Medical Corporation. ZOLL Medical Corporation may at any time decline to make any shipment or delivery except upon receipt of payment or security or upon terms regarding credit or security satisfactory to ZOLL Medical Corporation. 5. TAXES & FEES. The pricing quoted in its Quotation do not include sales use, excise, or other similar taxes or any duties or customs charges, or any order processing fees. The Customer shall pay in addition for the prices quoted the amount of any present or future sales, excise or other similar tax or customs duty or charge applicable to the sale or use of the Equipment sold hereunder (except any tax based on the net income of ZOLL Medical Corporation), and any order processing fees that ZOLL may apply from time to time. In lieu thereof the Customer may provide ZOLL Medical Corporation with a tax exemption certificate acceptable to the taxing authorities. 6. WARRANTY. (a) ZOLL Medical Corporation warrants to the Customer that from the earlier of the date of installation or thirty (30) days after the date of shipment from ZOLL Medical Corporation’s facility, the Equipment (other than accessories and electrodes) will be free from defects in material and workmanship under normal use and service for the period noted on the reverse side. Accessories and electrodes shall be warranted for ninety (90) days from the date of shipment. During such period ZOLL Medical Corporation will at no charge to the Customer either repair or replace (at ZOLL Medical Corporation’s sole option) any part of the Equipment found by ZOLL Medical Corporation to be defective in material or workmanship. If ZOLL Medical Corporation’s inspection detects no defects in material or workmanship, ZOLL Medical Corporation’s regular service charges shall apply. (b) ZOLL Medical Corporation shall not be responsible for any Equipment defect failure of the Equipment to perform any specified function, or any other nonconformance of the Equipment caused by or attributable to (i) any modification of the Equipment by the Customer, unless such modification is made with the prior written approval of ZOLL Medical Corporation: (ii) the use of the Equipment with any associated or complementary equipment accessory or software not specified by ZOLL Medical Corporation, or (iii) any misuse or abuse of the Equipment: (iv) exposure of the Equipment to conditions beyond the environmental, power or operating constraints specified by ZOLL Medical Corporation, or (v) installation or wiring of the Equipment other than in accordance with ZOLL Medical Corporation’s instructions. (c) Warranty does not cover items subject to normal wear and burnout during use, including but not limited to lamps, fuses, batteries, cables and accessories. (d) The foregoing warranty does not apply to software included as part of the Equipment (including software embodied in read-only memory known as “firmware”). (e) The foregoing warranty constitutes the exclusive remedy of the Customer and the exclusive liability of ZOLL Medical Corporation for any breach of any warranty related to the Equipment supplied hereunder. THE WARRANTY SET FORTH HEREIN IS EXCLUSIVE AND ZOLL MEDICAL CORPORATION EXPRESSLY DISCLAIMS ALL OTHER WARRANTIES WHETHER WRITTEN, ORAL, IMPLIED, OR STATUTORY, INCLUDING BUT NOT LIMITED TO ANY WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. 7. SOFTWARE LICENSE. (a) All software (the “Software” which term shall include firmware) included as part of the Equipment is licensed to Customer pursuant to a nonexclusive limited license on the terms hereinafter set forth, (b) Customer may not copy, distribute, modify, translate or adapt the Software, and may not disassemble or reverse compile the Software, or seek in any manner to discover, disclose or use any proprietary algorithms, techniques or other confidential information contained therein, (c) All rights in the Software remain the product of ZOLL Medical Corporation, and Customer shall have no right or interest therein except as expressly provided herein. (d) Customer’s right to use the Software may be terminated by ZOLL Medical Corporation in the event of any failure to comply with terms of this quotation, (e) Customer may transfer the license conferred hereby only in connection with a transfer of the Equipment and may not retain any copies of the Software following such transfer. (f) ZOLL Medical Corporation warrants that the read-only memory or other media on which the Software is recorded will be free from defects in materials and workmanship for the period and on terms set forth in section 6. (g) Customer understands that the Software is a complex and sophisticated software product and no assurance can be given that operation of the Software will be uninterrupted or error-free, or that the Software will meet Customer’s requirements. Except as set forth in section 7(f), ZOLL MEDICAL CORPORATION MAKES NO REPRESENTATIONS OR WARRANTIES WITH RESPECT TO THE SOFTWARE AND IN PARTICULAR DISCLAIMS ANY IMPLIED WARRANTIES OR MERCHANTABILITY OR FITNESS OF A PARTICULAR PURPOSE WITH RESPECT THERETO. Customer’s exclusive remedy for any breach of warranty or defect relating to the Software shall be the repair or replacement of any defective read-only memory or other media so that it correctly reproduces the Software. This License applies only to ZOLL Medical Corporation Software. 8. DELAYS IN DELIVERY. ZOLL Medical Corporation shall not be liable for any delay in the delivery of any part of the Equipment if such delay is due to any cause beyond the control of the ZOLL Medical Corporation including, but not limited to acts of God, fires, epidemics, floods, riots, wars, sabotage, labor disputes, governmental actions, inability to obtain materials, components, manufacturing facilities or transportation or any other cause beyond the control of ZOLL Medical Corporation. In addition ZOLL Medical Corporation shall not be liable for any delay in delivery caused by failure of the Customer to provide any necessary information in a timely manner. In the event of any such delay, the date of shipment or performance hereunder shall be extended to the period equal to the time lost by reason of such delay. In the event of such delay ZOLL Medical Corporation may allocate available Equipment among its Customers on any reasonable and equitable basis. The delivery dates set forth in this Quotation are approximate only and ZOLL Medical Corporation shall not be liable for or shall the Contract be breached by, any delivery by ZOLL Medical Corporation within a reasonable time after such dates. 9. LIMITATIONS OF LIABILITY. IN NO EVENT SHALL ZOLL MEDICAL CORPORATION BE LIABLE FOR INDIRECT SPECIAL OR CONSEQUENTIAL DAMAGES RESULTING FROM ZOLL MEDICAL CORPORATIONS PERFORMANCE OR FAILURE TO PERFORM PURSUANT TO THIS QUOTATION OR THE CONTRACT OR THE FURNISHING, PERFORMANCE, OR USE OF ANY EQUIPMENT OR SOFTWARE SOLD HERETO, WHETHER DUE TO A BREACH OF CONTRACT, BREACH OF WARRANTY, THE NEGLIGENCE OF ZOLL MEDICAL CORPORATION OR OTHERWISE. 10. PATENT INDEMNITY. ZOLL Medical Corporation shall at its own expense defend any suit that may be instituted against the Customer for alleged infringement of any United States patents or copyrights related to the parts of the Equipment or the Software manufactured by ZOLL Medical Corporation, provided that (i) such alleged infringement consists only in the use of such Equipment or the Software by itself and not as a part of or in combination with any other devices or parts, (ii) the Customer gives ZOLL Medical Corporation immediate notice in writing of any such suit and permits ZOLL Medical Corporation through counsel of its choice, to answer the charge of infringement and defend such suit, and (iii) the Customer gives ZOLL Medical Corporation all requested information, assistance and authority at ZOLL Medical Corporation’s expense, to enable ZOLL Medical Corporation to defend such suit. In the case of a final award of damages for infringement in any such suit, ZOLL Medical Corporation will pay such award, but it shall not be responsible for any settlement made without its written consent. Section 10 states ZOLL Medical Corporation’s total responsibility and liability’s, and the Customer’s sole remedy for any actual or alleged infringement of any patent by the Equipment or the Software or any part thereof provided hereunder. In no event shall ZOLL Medical Corporation be liable for any indirect, special, or consequential damages resulting from any such infringement. 11. CLAIMS FOR SHORTAGE. Each shipment of Equipment shall be promptly examined by the Customer upon receipt thereof. The Customer shall inform ZOLL Medical Corporation of any shortage in any shipment within ten (10) days of receipt of Equipment. If no such shortage is reported within ten (10) day period, the shipment shall be conclusively deemed to have been complete. 12. RETURNS AND CANCELLATION. (a) The Customer shall obtain authorization from ZOLL Medical Corporation prior to returning any of the Equipment. (b) The Customer receives authorization from ZOLL Medical Corporation to return a product for credit, the Customer shall be subject to a restocking charge of twenty percent (20%) of the original list purchase price, but not less than $50.00 per product. (c) Any such change in delivery caused by the Customer that causes a delivery date greater than six (6) months from the Customer’s original order date shall constitute a new order for the affected Equipment in determining the appropriate list price. 13. APPLICABLE LAW. This Quotation and the Contract shall be governed by the substantive laws of the Commonwealth of Massachusetts without regard to any choice of law provisions thereof. 14. COMPLIANCE WITH LAWS. (a) ZOLL Medical Corporation represents that all goods and services delivered pursuant to the Contract will be produced and supplied in compliance with all applicable state and federal laws and regulations, including the requirements of the Fair Labor Standards Act of 1938, as amended. (b) The Customer shall be responsible for compliance with any federal, state and local laws and regulations applicable to the installation or use of the Equipment furnished hereunder, and will obtain any permits required for such installation and use. 15. NON-WAIVER OF DEFAULT. In the event of any default by the Customer, ZOLL Medical Corporation may decline to make further shipments or render any further warranty or other services without in any way affecting its right under such order. If despite any default by Customer, ZOLL Medical Corporation elects to continue to make shipments its action shall not constitute a waiver of any default by the Customer or in any way affect ZOLL Medical Corporation’s legal remedies regarding any such default. No claim or right arising out of a breach of the Agreement by the Customer can be discharged in whole or in part by waiver or renunciation of the claim or right unless the waiver or renunciation is supported by consideration and is in writing signed by ZOLL Medical Corporation. 16. ASSIGNMENT. This Quotation, and the Contract, may not be assigned by the Customer without the prior written consent of ZOLL Medical Corporation, and any assignment without such consent shall be null and void. 17. TITLE TO PRODUCTS. Title to right of possession of the products sold hereunder shall remain with ZOLL Medical Corporation until ZOLL Medical Corporation delivers the Equipment to the carrier and agrees to do all acts necessary to perfect and maintain such right and title in ZOLL Medical Corporation. Failure of the Customer to pay the purchase price for any product when due shall give ZOLL Medical Corporation the right, without liability to repossess the Equipment, with or without notice, and to avail itself of any remedy provided by law. 18. EQUAL EMPLOYMENT OPPORTUNITY / AFFIRMATIVE ACTION. VETERAN’S EMPLOYMENT - If this order is subject to Executive Order 11710 and the rules, regulations, or orders of the Secretary of Labor issued thereunder the contract clause as set forth at 41 CFR 60-250.4 is hereby included as part of this order. EMPLOYMENT OF HANDICAPPED - if this order is subject to Section 503 of the Rehabilitation Act of 1973, as amended and the rules, regulations or orders of the Secretary of Labor as issued thereunder, the contract clause at 41 CFR 60-741.7 is hereby included as part of this order. EQUAL OPPORTUNITY EMPLOYMENT - if this order is subject to the provisions of Executive Order 11246, as amended, and the rules, regulations or orders of the Secretary of Labor issued thereunder, the contract clause set forth at 41 CFR 60-1.4 (a) and 60-1.4 (b) are hereby included as a part of this order and Seller agrees to comply with the reporting requirements set forth at 41 CFR 60-1.7 and the affirmative action compliance program requirements set forth as 41 CFR 60-1.40. 19. VALIDITY OF QUOTATION. This Quotation shall be valid and subject to acceptance by the Customer, in accordance with the terms of Section 1 hereof for the period set forth on the face hereof. After such period, the acceptance of this Quotation shall not be binding upon ZOLL Medical Corporation and shall not create a contract, unless such acceptance is acknowledged and accepted by ZOLL Medical Corporation by a writing signed by an authorized representative of ZOLL Medical Corporation. 20. GENERAL. Any Contract resulting from this Quotation shall be governed by and interpreted in accordance with the laws of the Commonwealth of Massachusetts. This constitutes the entire agreement between Buyer and Supplier with respect to the purchase and sale of the Products described in the face hereof, and only representations or statements contained herein shall be binding upon Supplier as a warranty or otherwise. Acceptance or acquiescence in the course of performance rendered pursuant hereto shall not be relevant to determine the meaning of this writing even though the accepting or acquiescing party has knowledge of the nature of the performance and opportunity for objection. No addition to or modification of any of the terms and conditions specified herein shall be binding upon Supplier unless made in writing and signed by a duly authorized representative of Supplier. The terms and conditions specified shall prevail notwithstanding any variance from the terms and conditions of any order or other form submitted by Buyer for the Products set forth on the face of this Agreement. To the extent that this writing may be treated as an acceptance of Buyer’s prior offer, such acceptance is expressly made conditional on assent by Buyer to the terms hereof, and, without limitation, acceptance of the goods by Buyer to the terms hereof, and, without limitation, acceptance of the goods by Buyer shall constitute such assent. All cancellations and reschedules require a minimum of thirty (30) days notice. ZOLL Medical Corporation Page 2 ZOLL Medical – Delivery Plan DELIVERY: ZOLL Medical will deliver, free of freight and delivery charges, all cardiac monitors/defibrillators and accessories at the same time to the Volusia County Emergency Medical Services facility, 112 Carswell Avenue, Holly Hill, Florida 32117 within 60-90 days after receipt of accepted purchase order. If 60-90 days is too soon, ZOLL Medical will work with Volusia EMS to determine a date that the county would like for delivery to coincide with clinical training. TRADE-INS: ZOLL Medical will accept trade-ins (see Tab A for values) and accepts responsibility for the cost of the returns. Trade-ins will be expected to be available for return within 30 days of completion of training and installation of all new defibrillators. It is preferred that the county makes all trades available for pick-up from one location. 16-P-64AK 269 Mill Raod, Chelmsford, MA 01824 800-348-9011 Fax: 978-421-0005 mtrotter@zoll.com Physio-Control, Inc. David T. Stafford, Jr., EVP & CFO 11811 Willows Road NE, Redmond, WA 98052 800-442-1142 Fax: 800-732-0956 rs.physiocontracts-south@phyio-control.com Zoll Medical Corporation Michael Trotter, EMS Group VP of Sales ALL BIDS ACCEPTED BY THE COUNTY OF VOLUSIA ARE SUBJECT TO THE COUNTY’S TERMS AND CONDITIONS. ANY AND ALL ADDITIONAL TERMS AND CONDITIONS SUBMITTED BY THE BIDDERS ARE REJECTED AND SHALL HAVE NO FORCE AND EFFECT. BIDS FROM THE VENDORS LISTED HEREIN ARE THE ONLY BIDS RECEIVED TIMELY AS OF THE CLOSING DATE AND TIME. ALL OTHER BIDS SUBMITTED IN RESPONSE TO THIS SOLICITATION, IF ANY, ARE HEREBY REJECTED AS LATE. Tabulation Cardiac Monitors Bid opened by Andrew Kokitus, Procurement Analyst Bid opening witnessed by John Duckworth, Procurement Analyst Bid Tabulated by Andrew Kokitus, Procurement Analyst Bid opened on April 5, 2016 at 3:00 p.m. 16-P-64AK Recommendation of Award: Zoll Medical Corporation, Chelmsford, MA County Council date: September 8, 2016 Physio-Control, Inc. David T. Stafford, Jr., EVP & CFO 11811 Willows Road NE, Redmond, WA 98052 800-442-1142 Fax: 800-732-0956 rs.physiocontracts-south@phyio-control.com Zoll Medical Corporation Michael Trotter, EMS Group VP of Sales 269 Mill Raod, Chelmsford, MA 01824 800-348-9011 Fax: 978-421-0005 mtrotter@zoll.com Evaluation committee met on July 11, 2016. Recommendation of Award post on July 12, 2016 ALL BIDS ACCEPTED BY THE COUNTY OF VOLUSIA ARE SUBJECT TO THE COUNTY’S TERMS AND CONDITIONS. ANY AND ALL ADDITIONAL TERMS AND CONDITIONS SUBMITTED BY THE BIDDERS ARE REJECTED AND SHALL HAVE NO FORCE AND EFFECT. BIDS FROM THE VENDORS LISTED HEREIN ARE THE ONLY BIDS RECEIVED TIMELY AS OF THE CLOSING DATE AND TIME. ALL OTHER BIDS SUBMITTED IN RESPONSE TO THIS SOLICITATION, IF ANY, ARE HEREBY REJECTED AS LATE. Recommendation of Award Cardiac Monitors Bid opened by Andrew Kokitus, Procurement Analyst Bid opening witnessed by John Duckworth, Procurement Analyst Bid Tabulated by Andrew Kokitus, Procurement Analyst Bid opened on April 5, 2016 at 3:00 p.m. Exhibit A-Scope of Work Page 1 of 7 Cardiac Monitors 1.0 PURPOSE & OVERVIEW The purpose of the Agreement is for the purchase of Zoll X-Series cardiac monitor/defibrillators for the Emergency Medical Services (EMS) and the Volusia County Fire Rescue (VCFR) Divisions. As part of this Agreement, the Department of Public Protection will be trading in existing cardiac monitors/defibrillators, chargers, and batteries. The EMS Division will purchase up to fifty two (52) cardiac monitors/defibrillators and the Fire Rescue Division will purchase up to twenty seven (27) cardiac monitors/defibrillators. 2.0 SCOPE OF SERVICES 2.1 Specifications A. The cardiac monitor/defibrillators shall, at a minimum, perform the following functions: 1. Monitor, print, and visually display 4-lead EKG rhythms; 2. Monitor and print 12-lead EKG rhythms; 3. Monitor and visually display continuous, real-time peripheral capillary oxygen saturation (SpO2); 4. Monitor and visually display continuous, real-time end tidal carbon dioxide readings (ETCO2); 5. Monitor and display carbon monoxide (SpCO) readings; 6. Perform Non-Invasive Blood Pressure Monitoring (NIBP): 7. Perform synchronized cardioversion based on current American Heart Association recommendations; 8. Perform unsynchronized defibrillation based on current American Heart Association recommendations; 9. Perform Transcutaneous Pacing (TCP); 10. Transmit electrocardiograms (EKG) directly from the cardiac monitor to a receiving hospital with the use of a wireless card (i.e. from a remote location away from response vehicle) and via a secured Wi-fi network (when in range of response vehicle’s wireless network); 11. Upload complete full-disclosure case reports to an electronic patient care report (ePCR) solution (current solutions in use by Volusia County are Zoll ePCR and FireHouse); and, 12. Ability to upload complete full-disclosure case reports to a repository (client based and/or cloud based) to ensure all patient reports are stored. Exhibit A-Scope of Work Page 2 of 7 B. The cardiac monitor/defibrillators shall be approved for use by the Food and Drug Administration (FDA) in a pre-hospital setting. C. The end-user shall be able to view the entire case report after upload and it shall have the ability to be viewed in real-time. D. The cardiac monitor shall be secured to the stretcher for continuous patient monitoring while moving the patient from one location to another on the stretcher. The cardiac monitor shall be secured to FERNO™ and/or STRYKER brand stretchers. E. The cardiac monitor shall be secured inside the patient compartment of a transport vehicle in accordance to National Fire Protection Association standards. F. The cardiac monitors shall include power cords. 2.2 Delivery A. Cardiac Monitors shall be received within 60-90 days after receipt of accepted purchase order. All cardiac monitors/defibrillators shall be delivered at the same time and the prices indicated on Exhibit B – Price Sheet. The units shall be shipped to Volusia County Emergency Medical Services facility, 112 Carswell Avenue, Holly Hill, Florida 32117. B. The County will trade-in the current cardiac monitor/defibrillators at the conclusion of the training and installation of mounts/brackets/chargers. Trade-ins will be available for return within thirty (30) days of completion of training and installation of all new defibrillators. Contractor accepts responsibility for the cost of the returns. 2.3 Service Agreement & Training A. The Contractor shall provide an on-going non-warranty service agreement to include training for field personnel for initial deployment and provide any additional updates that are required of the manufacturer. B. The Contractor shall provide the length of training recommended by the manufacturer for approximately 300 end users and 50 administrative staff. C. Proposed Training Plan 1. First Week a. Equipment setup and education for training staff. b. Super-user Training for Clinical and Supervisory Staff/4 training sessions - 3 hours per session. 2. Weeks 2+ Exhibit A-Scope of Work Page 3 of 7 a. Contractor’s staff will provide end-user training in conjunction with service's clinical training staff. b. End-user Equipment Training (recommended 2-3 end users per/device) - 90-120 minutes per session. D. Training Schedule Training Schedule #1: 1 Clinical Deployment Specialist on site for 4 - 6 weeks i. 3-4 training sessions per day I 4 training days per week ii. 60 - 80 providers trained per day iii. 250 - 300 providers trained per week E. County will have full access to Contractor’s online training program as an adjunct to deployment services provided. 2.4 Preventative Maintenance A. Contractor’s maintenance plan for the cardiac monitor/defibrillators, listing all correlating costs, is listed in Exhibit B-Pricing. This plan includes the cost of expedited loaner equipment, weekly on-site repair visits, annual preventative maintenance/quality assurance checks, and replacement parts/accessories. The maintenance plan shall be comprehensive in nature. B. Battery replacement program shall be part of the maintenance plan. C. All repairs and preventative maintenance shall be performed at one of the following locations (subject to change in the future): 1. Volusia County Emergency Medical Services facility located at 112 Carswell Avenue, Holly Hill, Florida. 2. Volusia County Fire Rescue Logistics facility located at 1970 South Volusia Avenue, Orange City, Florida 3. Repairs that cannot be made at one of the above locations shall be shipped (at Contractor’s cost) to the manufacturer’s repair facility. D. Contractor will provide technical assistance through their Technical Support Department. Should the equipment require service, County will contact the Technical Support Department directly. E. Technical Support Hours of Coverage 1. Technical support is available to the County free of charge through Contractor’s technical support help desk by calling 1 - 800-348-9011, Monday through Friday from 8:30 AM to 6:00 PM EST. Exhibit A-Scope of Work Page 4 of 7 2. The technical support representative will require the following pertinent information to open a service request: a. Unit serial number; b. Description of the complaint; c. Department where the equipment is being used; d. Patient information if applicable; e. ECG strips if available; and, f. Master Agreement number if the device is out of warranty. 3. This information will assist Contractor in performing a full evaluation when the product is received at Contractor’s repair facility. County will be given a returned merchandise authorization number to track the return of the product. F. Emergency Service Outside the coverage identified above, technical support is available to the County on an emergency basis seven (7) days a week. Emergency support Contractor’s off hours dispatch system. During weekends and evenings, Contractor’s on call technical support representative will return the call within four (4) hours. G. Response Time 1. The technical support help desk answers support inquiries in real time. If the County prefers to leave a voicemail, the technical support team will return the call within one (1) hour during business hours. The County will work with the technical support representative to troubleshoot the issue. 2. Technical support help desk may dispatch a service loaner to our facilities (listed in Section 2.4(C). A service loaner is available at no charge during the repair analysis process and will be shipped to arrive before 10 AM the next business day. H. On-Site Service If the inquiry is not resolved during the phone call, a local field support technician will be dispatched. I. Terms 1. Within forty eight (48) hours of contact to technical support, a Field Support Representative will be on-site during normal business hours to respond to the County's needs. 2. In the event of a device problem, the device should be made available to the Contractor’s field support technician during the scheduled on-site visit at one of the two locations listed in §2.4(C). Exhibit A-Scope of Work Page 5 of 7 3. A primary and back-up contact will be provided to the Contractor’s field support technician for all communication. 4. Only closed box repairs will be completed on-site (i.e. software updates, software reloading, handle replacement, external cable replacement). J. Service Provided by On-Site Service 1. The following services will be provided by a Contractor’s field technician during the scheduled on-site visit: a. Troubleshoot device(s) and/or accessories under contract; b. Place calls with the technical support help desk to open service requests and obtain a return authorization number for devices requiring repair/evaluation; c. Coordinate service loaner deployments with Contractor's technical support help desk; d. Functionally test and assist in the deployment of service loaners or customer devices, including: i. loading custom device configurations; ii. attaching carrying cases/ bags; iii. attaching mounting brackets; iv. connecting accessories; and v. establishing communications (pairing BT, Wi-Fi , etc .); e. Perform authorized on-site device repairs; f. Package (or un-package) service loaners and customer units under contract for shipment to (or returned from) Contractor; g. Provide answers or guidance to assure that any issues or questions County staff may have are addressed; h. Provide product training as required; i. Perform device software updates with the permission of the County; and, j. Review battery chargers and battery management. Cycle batteries as required. K. Contractor’s Depot Repairs 1. Repairs are performed in the Contractor’ Service Depot located at. 2. Contractor’s service technicians are highly skilled individuals that are trained in accordance with the technical service standard operating procedures. Training is required to be completed prior to evaluating and repairing any device. Technicians are also required to be trained on any updates to these procedures as they occur. 3. Training requirements, procedures and records are retained electronically in the Contractor’s database. Exhibit A-Scope of Work Page 6 of 7 4. All repaired products will go through an integral recertification process prior to being returned to the County. This includes devices that undergo a repair or an evaluation which determines that a repair is not required, as the evaluation may include disassembly of the product. This process recertifies device for clinical use. L. On-Site Service for Preventive Maintenance 1. Contractor’s factory trained PM and Deployment Technician will be scheduled to provide annual on-site preventive maintenance at the locations listed in §2.4(C). Primary and back-up contact information will provided to the Contractor’s field support technician for all communication and scheduling. Contractor will work with County Project Manager to coordinate the Preventive Maintenance. 2. Performance of Preventive Maintenance Includes: a. Clean all exterior surfaces of unit; b. Perform visual inspection to ensure integrity of the unit; c. Test Power Supply, ECG, Pacer Outputs & Rates, Defib Times and Output Energy; d. Test of MFC functions; e. Test Real Time Clock of the system; f. Perform operational check of all system level functions per device Service Manual; and, g. Recertify device for clinical use. M. Battery Replacement Program 1. Batteries will be maintained per Contractor's recommended maintenance program. 2. Batteries will be replaced, one for one, throughout the Extended Warranty period on an as needed basis, should the SurePower battery or SurePower Charger display a fault. • 3. Battery replacement program will only apply to batteries included with the original shipment of the devices. 4. Batteries will be returned to the Contractor for evaluation and confirmation of failure. 2.5 Warranty A. The warranty shall be the manufacturer’s standard warranty. All warranty work shall be performed at one of the locations listed in §2.4(C) above. B. Warranty shall include, at a minimum: Exhibit A-Scope of Work Page 7 of 7 1. One (1) year parts and labor warranty against manufacturing defects affecting the performance of the unit, to include transport of affected unit(s); and, 2. Ninety (90) days warranty for accessories (i.e. EKG cables, sensor probes, etc.). Exhibt A-1 Functional Requirements Matrix RFP 16-P-64AK Page 1 of 3 RESPONSE 1 1.1 The X Series is intended for use by trained medical personnel who are familiar with basic monitoring, vital sign assessment, emergency cardiac care, and the use of the X Series. The X Series is also intended for use by (or on the order of) physicians at the scene of an emergency or in a hospital emergency room, intensive care unit, cardiac care unit, or other similar areas of a hospital. The usage may be in an ambulance or at the scene of an emergency. It is-also intended to be used during the transport of patients. The X Series will be used primarily on patients experiencing symptoms of cardiac arrest or in post trauma situation. It may also be used whenever it is required to monitor any of those functions that are included (as options) in the device. The X Series unit can be used on neonate patients and on adult patients (21 years of age or older) with and without heart dysfunction. Full FDA approval documentation is available. The X Series has the ability to monitor, print, display and/or record 4-lead ECG waveform and heart rate, and to alarm when heart rate is above or below limits set by the operator. The patient population will range from newborn (neonate) to adult, with and without heart dysfunction. The X Series has the ability to monitor, print, display and/or record 12-lead ECG waveform and heart rate, and to alarm when heart rate is above or below limits set by the operator. The patient population will range from newborn (neonate) to adult, with and without heart dysfunction. The 12-lead ECG Analysis is intended for use in acquiring, analyzing and reporting ECU data, and to provide interpretation of the data for consideration by caregivers. The X Series pulse CO-oximeter, with Masimo Rainbow SET technology and the Rainbow series of sensors, is intended for use for continuous noninvasive monitoring of functional oxygen saturation of arterial henmoglobin (SpO2), pulse rate, carboxyhemoglobin saturation (SpCO), and/or methemoglobin saturation (SpMet). The pulse CO-oximeter and accessories are indicated for use on adult, pediatric, and neonatal patients during both no motion and motion conditions, and for patients who are well or poorly perfused, in hospitals, hospital-type facilities,or in mobile environments. Saturation Range: 1 – 100%; Pulse Rate Range: 25 – 240 bpm The X Series is intended for use to make continuous noninvasive measurement and monitoring of carbon dioxide (CO2) concentration of the expired and inspired breath and breath rate. The patient population will range from newborn (neonate) to adult. Range: 0 – 150 mmHg; Respiration Range: 0 – 149 breaths per minute; Flow rate: 50 ml/min -7.5 + 15 ml/min; Typical response time: 2.9 seconds; Maximum response time: 3.9 seconds The X Series pulse CO-oximeter, with Masimo Rainbow SET technology and the Rainbow series of sensors, is intended for use for continuous noninvasive monitoring of functional oxygen saturation of arterial henmoglobin (SpO2), pulse rate, carboxyhemoglobin saturation (SpCO), and/or methemoglobin saturation (SpMet). The pulse CO-oximeter and accessories are indicated for use on adult, pediatric, and neonatal patients during both no motion and motion conditions, and for patients who are well or poorly perfused, in hospitals, hospital-type facilities,or in mobile environments. Range: 0 – 99%; Accuracy: 1 – 40% ± 3 digits The X Series is intended for use to make non-invasive measurements of arterial pressure and heart rate, and to alarm if either parameter is outside of the limits set by the user. Measurements are made using an inflatable cuff on the patient's arm or leg. The patient population will range from newborn (neonate) to adult. Utilizes Smartcuf® and Sure BP® technology. Measurement Intervals: Automatic 1-, 2-, 3-, 5-, 10-, 15-, 30-, 60-minute, and manual quick-action NIBP Start/Stop button; TurboCuf: 5 min of repeated NIBP readings; Display: Systolic, diastolic, mean. Viewable on-screen with large numerics. Cuff Overpressure Protection; Typical Measurement Time: 30 – 45 sec (on deflation) 15 – 30 sec – Sure BP (on inflation) Standard Cuff Sizes: Neonate #1 – #5, Infant, Small Child, Small Adult, Adult Long, Large Adult, Thigh REQUIRED INFORMATION Approved for use by the Food and Drug Administration (FDA) in a pre-hospital setting Ability to monitor and print 12-lead EKG rhythms A. C. SPECIFICATIONS AND FUNCTIONALITY PROPOSED cardiac monitor B.Ability to monitor, print and visually display 4-lead EKG rhythms Ability to monitor and visually display continuous, real-time peripheral capillary oxygen saturation (SpO2) D. E.Ability to monitor and visually display continuous, real-time end tidal carbon dioxide readings (ETCO2) F. G. Ability to monitor and display carbon monoxide (SpCO) readings Ability to perform non-invasive blood pressure monitoring (NIBP) Exhibt A-1 Functional Requirements Matrix RFP 16-P-64AK Page 2 of 3 RESPONSEREQUIRED INFORMATION The X Series can be used for synchronized cardioversion of certain atrial or ventricular arrhythmias. Qualified medical personnel must decide when synchronized cardioversion is appropriate. The patient population will range from newborn (neonate) to adult. Synchronizes defibrillator pulse to patient’s R wave. “SYNC” message displayed on monitor and markers shown on both monitor and recorded ECG. Meets Clause 104 of AAMI DF80. The X Series can be used for external defibrillation for victims of cardiac arrest where there is apparent lack of circulation as indicated by: unconsciousness, absence of breathing, and absence of pulse. Waveform: Rectilinear Biphasic™ Energy Selections: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 30, 50, 70, 85, 100, 120, 150, 200 joules. Charge Time: Less than 7 seconds with a new, fully charged battery. The X Series can be used for transcutaneous pacing in conscious or unconscious patients as an alternative to endocardial stimulation. Pulse Types: Rectilinear, constant current; Pulse Width: 40 ms ± 2 ms; Pacer Rate: 30 – 180 bpm ± 1.5%; Output Current: 0 – 140 mA ± 5% or 5 mA, whichever is greater; Modes: Demand and Fixed The X Series is the first monitor to integrate a complete array of communications technology. The approach not only delivers an added layer of protection for the demands of the pre-hospital environment, it eliminates the need for cables and dongles. Every X Series comes with the following communications capabilities: WiFi, Bluetooth, USB 2.0 that can be used to wirelessly transmit 12-lead EKGs. The open architecture philosophy embodied by the X Series design gives services, and ultimately patients, a path to improvements that can’t be matched by other monitors. X Series 12-leads can be sent to all leading STEMI and cardiology management systems, such as: ZOLL's RescueNet 12 Lead; Physio Control's LifeNet; Philips' IntelliSpace; GE's MUSE as well as email and smartphones/tablets. The X Series simplifies medic charting by seamlessly uploading the event record with the speed of a WiFi connection. It will automatically populate patient data fields for many of the leading ePCR systems. Some examples of ePCR vendors are ZOLL ePCR, ESO Solutions, ImageTrend, EMS Charts, and Documed. ZOLL’s open architecture makes it possible to send event files to all ePCR systems. In line with ZOLL’s commitment to open architecture, a Software Development Kit (SDK) is available to any ePCR vendor desiring to complete the interface. 1 Internal memory or storage card shall be able to save a minimum of 15 patient encounters and/or 6 hours of continuous data for upload. The X Series redefines what a monitor should collect and send to the patient record. Its built-in memory ensures the complete patient record is transmitted by capturing 24 hours of event or trend data, and up to 1,000 time-stamped events. The X Series simplifies medic charting by seamlessly uploading the event record with the speed of a WiFi connection. It will automatically populate patient data fields for many of the leading ePCR systems. The X Series can upload complete full-disclosure case reports to RescueNet Code Review. This software captures all clinical defibrillator and vital sign information for quality review and analysis, delivering the complete picture to reviewers. RescueNet Code Review provides ECG, vital sign data, and CPR rate and depth of compressions for a complete review of the rescue. End-users can view entire case reports after upload from the X Series within RescueNet Code Review, software provided by ZOLL. Code Review provides ECG, vital sign data, and CPR rate and depth of compressions for a complete review of the rescue. X Series can also, with the push of a button, send files to your system. With RescueNet CaseReview, access to case files is as fast as opening your web browser. RescueNet Case Review provides: Simplified data collection: access files without delay, same-day debriefing, system-wide performance analytics, IS and network independence The X Series can be secured to FERNO brand stretchers for patient movement. ZOLL does not manufacture mounting brackets. However, there are many companies that specialize in the production of mounting brackets that will secure the X Series inside the compartment of a transport vehicle in accordance with National Fire Protection Association standards. An example is FERNO's D360 Swivel Defibrillator Mount for the X Series. J.Ability to perform Transcutaneous Pacing (TFP) K. L.Ability to upload complete full-disclosure case reports to an ePCR solution (current solutions in use by The County of Volusia are Zoll ePCR and FireHouse). The vendor shall list all ePCR solutions that can facilitate a direct upload with their product M. N. O. Ability to transmit electrocardiograms (EKG) directly from the cardiac monitor to a receiving hospital with the use of a wireless card (i.e. from a remote location away from response vehicle) The cardiac monitor must be able to be secured inside the patient compartment of a transport vehicle in accordance with National Fire Protection Association standards. Ability to upload complete full-disclosure case reports to a repository (client based and/or cloud based) to ensure all patient reports are stored The cardiac monitor must be able to be secured to the stretcher for continuous patient monitoring while moving the patient from one location to another on the stretcher. The vendor shall provide assurance that the cardiac monitor can be secured to a FERNO brand stretcher for patient movement Ability for the end-user to be able to view the entire case report after upload and shall be able to be viewed in real-time. This ability can be either built into the ePCR or can be a standalone product that can be installed on the ePCR tablet. H. Ability to perform Unsynchronized Defibrillation based on current American Heart Association recommendations I. Ability to perform Synchronized Cardioversion based on current American Heart Association recommendations P. Exhibt A-1 Functional Requirements Matrix RFP 16-P-64AK Page 3 of 3 RESPONSEREQUIRED INFORMATION 1.2 No cost. This is included in the first year standard warranty as well as extended warranty and PM as outlined in the "Technical Support and Onsite Services" and "EMS One Year Product Warranty" documents located in Tab 9. ZOLL Medical agrees to make on-site repair services as part of the extended warranty. This is outlined in the "Technical Support and Onsite Services" document located in Tab 9 ZOLL recommends that only 1 PM per year is necessary as outlined in the "Technical Support and Onsite Services" document located in Tab 9 This is covered as part of the standard warranty as well as extended warranty and PM as outlined in the "Technical Support and Onsite Services" and "EMS One Year Product Warranty" documents located in Tab 9. 1.3 Per addendum, Volusia County will accept the manufacturer's standard warranty. Please see "EMS One Year Product Warranty" located in Tab 9 Per addendum, Volusia County will accept the manufacturer's standard warranty. Please see "EMS One Year Product Warranty" located in Tab 9 Preventative Maintenance. The preventative maintenance plan shall include: The cost of expedited loaner equipment; Weekly on-site repair visits; Bi-Annual (2 times per year) preventative maintenance/quality assurance checks; Replacement parts/accessories. A. B. C. D. Warranty. The warranty shall include: A. One (1) year parts and labor warranty against manufacturing defects affecting the performance of the unit, to include transport of affected unit (s); B. Two (2) year components warranty against manufacturing defects affecting the performance of the components. Exhibit B-Pricing Page 1 of 1 Description Cost a. One (1) limb lead cable; b. One (1) 12-lead cable; c. One (1) Patient Therapy/Defibrillation Cable; d. One (1) NIBP Hose; e. One (1) each of the following NIBP cuffs – Infant, Child, Adult, Large Adult; f. One (1) User Test module (if required to perform daily user tests); g. One (1) Adult SpO2/SpCO reusable sensor w/ extension cable (must be at least 5’ in length); h. One (1) Pediatric SpO2/SpCO reusable sensor w/extension cable (must be at least 5’ in length); i. Three (3) factory direct batteries; j. One (1) standard/premium (pathogen resistant) carry case with shoulder strap; k. One (1) storage card or internal memory that will save a minimum of 15 patient encounters and/or 6 hours of continuous data for upload; l. One (1) wireless card that will allow for transmission of EKG’s. M. Power Cord $29,995.63 Description Cost per Unit a. Methemoglobin $1,601.40 b. Invasive/Core Temperature Testing $676.60 c. Arterial Line Monitoring*$2,546.60 *X Series units that have Arterial Line Monitoring must also have Invasive/Core Temperature Testing, this price is inclusive of both parameters. Description Estimated Number of Units Trade-In Value (per unit) Zoll E-Series Cardiac Monitor/Defibrillators (includes ETCO2, with 12-lead, SpO2, NIBP)55 $2,000.00 Zoll M-Series Cardiac Monitor/Defibrillators (includes ETCO2, with 12-lead, SpO2, NIBP)15 $500.00 Annual Cost *Year One Includes ONE (1) Year of Factory Warranty at No Additional Charge $0.00 *Preventive Maintenance Recommended After Year One, N/A.$0.00 *Hardware Would be Covered Under the Warranty and Sotware is at No Charge. $0.00 *Exclusions for Hardware Would be Accidental Damage/Abuse That is Not Covered Under the Warranty. $0.00 $0.00 Annual Cost *Year two: $1,392.50 per unit, per year, for Extended Warranty with 1 PM & Battery Replacement, On-Site (for 70 X Series )$97,475.00 Annual Cost *Year three: $1,392.50 per unit, per year, for Extended Warranty with 1 PM & Battery Replacement, On-Site (for 70 X Series )$97,475.00 Annual Cost *Year four: $1,392.50 per unit, per year, for Extended Warranty with 1 PM & Battery Replacement, On-Site (for 70 X Series )$97,475.00 Description of Accessories and Components Discount off List Price Cost 1. Limb Lead Cables 25%$221.25 2. 12-Lead Cables 25%$243.75 3 SpO2/SpCO patient cables 25%$221.25 4. SpO2/SpCO sensors (both pediatric and adult)25%$633.75 5. NIBP hoses 25%$48.75 6. NIBP cuffs 25%$39.38 7. Replacement carrying cases 25%$371.25 8. Factory Direct replacement batteries.25%$371.25 9. ETCO2 Filterline Set Adult/Pediatric Case of 25 (For Intubations)25%$206.25 10. ETCO2 Smart CapnoLine, Oral/Nasal w/ O2 tubing for supplemental oxygen.Case of 25 (For Respira 25%$266.25 11. Paper (Pack of 6)25%$18.00 12. RescueNet Code Review Software (there are NO restrictions on the number of computers that softwa 0%$2,495.00 13. Adapters for existing chargers (80 adapters)0%No Charge Total Year 1 Cost Total Cost (per unit) Year 1 Summary Year 2 Summary Year 3 Summary Year 4 Summary Trade-In Value Optional Items Pricing is inclusive of the cardiac monitor and the following accessorie and include all delivery costs. Cardiac Monitor, Brackets, and Charger Pricing The following pricing is for optional items: Annual Maintenance and Support Annual maintenance and support costs associated with the cardiac monitors are listed below. File Number: 4061 Page 1 of 2 Budget 4-4 Date: 09/08/2016 AGENDA ITEM Item: 34 [] Ordinance [] Resolution [] Budget Resolution [X] Other Department: Public Protection Division: Emergency Medical Services Subject: Contract for cardiac monitors and cardiac monitor preventative maintenance, RFP 16- P-64AK. Terry Boczkus Proxy for Terry Sanders Director Public Protection Department Approval Jeaniene Jennings Director Purchasing Approved in Accordance with Purchasing Policies and Procedures John Robert Zaragoza Director Emergency Medical Services Division Approval Tammy Bong Director Management and Budget Approved as to Budget Requirements Legal Michael G.Moore Approved as to Form and Legality County Manager’s Office Donna de Peyster Deputy County Manager Council Action: Modification: Fund Number(s):Description:Amount: 002 Emergency Medical Services 002-555-1000-6430-Other Equipment $1,560,000.00 140 Fire Services 140-540-8000-6430 -Other Equipment $864,000.00 002 Emergency Medical Services 002-555-1000-4760-Maint.-Other Equipment (fiscal year 2018) $72,410.00 140 Fire Services 140-540-8000-4670 -Maint -Other Equipment (fiscal year 2018) $40,382.00 Total Item Budget: $2,536,792.00 Staff Contact(s):Phone:Ext. Terry Sanders 386 740 5120 16620 John Zaragoza 386 236 3510 26653 Jeff B Smith 386 736 5940 12479 Summary/Highlights: The county solicited proposals for cardiac monitors and cardiac monitor preventative maintenance. The county received two proposals as shown on the attached tabulation sheet. An evaluation committee comprised of John Gamble, operations manager, public works; Dona D. Butler, director, community services; Laura Bounds, sheriff's office program manager; Rhonda Orr, director, business services; and Terry Sanders, director, public protection, reviewed the responses. The committee recommends award to Zoll Medical Corporation, Chelmsford, Mass. A proposed contract, including exhibits, is attached. The county will issue a purchase order for the cardiac monitors. For the cardiac monitor Approved as recommended. File Number: 4061 Page 2 of 2 Budget 4-4 preventative maintenance, staff is requesting approval to issue a master agreement for three years with two one-year renewals (contingent upon county council approval). The cost of the cardiac monitors is approximately $2,424,000 and estimated annual cost of the preventative maintenance is $112,792. Recommended Motion: Approval. Exhibit A-Scope of Work Page 1 of 7 Cardiac Monitors 1.0 PURPOSE & OVERVIEW The purpose of the Agreement is for the purchase of Zoll X-Series cardiac monitor/defibrillators for the Emergency Medical Services (EMS) and the Volusia County Fire Rescue (VCFR) Divisions. As part of this Agreement, the Department of Public Protection will be trading in existing cardiac monitors/defibrillators, chargers, and batteries. The EMS Division will purchase up to fifty two (52) cardiac monitors/defibrillators and the Fire Rescue Division will purchase up to twenty seven (27) cardiac monitors/defibrillators. 2.0 SCOPE OF SERVICES 2.1 Specifications A. The cardiac monitor/defibrillators shall, at a minimum, perform the following functions: 1. Monitor, print, and visually display 4-lead EKG rhythms; 2. Monitor and print 12-lead EKG rhythms; 3. Monitor and visually display continuous, real-time peripheral capillary oxygen saturation (SpO2); 4. Monitor and visually display continuous, real-time end tidal carbon dioxide readings (ETCO2); 5. Monitor and display carbon monoxide (SpCO) readings; 6. Perform Non-Invasive Blood Pressure Monitoring (NIBP): 7. Perform synchronized cardioversion based on current American Heart Association recommendations; 8. Perform unsynchronized defibrillation based on current American Heart Association recommendations; 9. Perform Transcutaneous Pacing (TCP); 10. Transmit electrocardiograms (EKG) directly from the cardiac monitor to a receiving hospital with the use of a wireless card (i.e. from a remote location away from response vehicle) and via a secured Wi-fi network (when in range of response vehicle’s wireless network); 11. Upload complete full-disclosure case reports to an electronic patient care report (ePCR) solution (current solutions in use by Volusia County are Zoll ePCR and FireHouse); and, 12. Ability to upload complete full-disclosure case reports to a repository (client based and/or cloud based) to ensure all patient reports are stored. Exhibit A-Scope of Work Page 2 of 7 B. The cardiac monitor/defibrillators shall be approved for use by the Food and Drug Administration (FDA) in a pre-hospital setting. C. The end-user shall be able to view the entire case report after upload and it shall have the ability to be viewed in real-time. D. The cardiac monitor shall be secured to the stretcher for continuous patient monitoring while moving the patient from one location to another on the stretcher. The cardiac monitor shall be secured to FERNO™ and/or STRYKER brand stretchers. E. The cardiac monitor shall be secured inside the patient compartment of a transport vehicle in accordance to National Fire Protection Association standards. F. The cardiac monitors shall include power cords. 2.2 Delivery A. Cardiac Monitors shall be received within 60-90 days after receipt of accepted purchase order. All cardiac monitors/defibrillators shall be delivered at the same time and the prices indicated on Exhibit B – Price Sheet. The units shall be shipped to Volusia County Emergency Medical Services facility, 112 Carswell Avenue, Holly Hill, Florida 32117. B. The County will trade-in the current cardiac monitor/defibrillators at the conclusion of the training and installation of mounts/brackets/chargers. Trade-ins will be available for return within thirty (30) days of completion of training and installation of all new defibrillators. Contractor accepts responsibility for the cost of the returns. 2.3 Service Agreement & Training A. The Contractor shall provide an on-going non-warranty service agreement to include training for field personnel for initial deployment and provide any additional updates that are required of the manufacturer. B. The Contractor shall provide the length of training recommended by the manufacturer for approximately 300 end users and 50 administrative staff. C. Proposed Training Plan 1. First Week a. Equipment setup and education for training staff. b. Super-user Training for Clinical and Supervisory Staff/4 training sessions - 3 hours per session. 2. Weeks 2+ Exhibit A-Scope of Work Page 3 of 7 a. Contractor’s staff will provide end-user training in conjunction with service's clinical training staff. b. End-user Equipment Training (recommended 2-3 end users per/device) - 90-120 minutes per session. D. Training Schedule Training Schedule #1: 1 Clinical Deployment Specialist on site for 4 - 6 weeks i. 3-4 training sessions per day I 4 training days per week ii. 60 - 80 providers trained per day iii. 250 - 300 providers trained per week E. County will have full access to Contractor’s online training program as an adjunct to deployment services provided. 2.4 Preventative Maintenance A. Contractor’s maintenance plan for the cardiac monitor/defibrillators, listing all correlating costs, is listed in Exhibit B-Pricing. This plan includes the cost of expedited loaner equipment, weekly on-site repair visits, annual preventative maintenance/quality assurance checks, and replacement parts/accessories. The maintenance plan shall be comprehensive in nature. B. Battery replacement program shall be part of the maintenance plan. C. All repairs and preventative maintenance shall be performed at one of the following locations (subject to change in the future): 1. Volusia County Emergency Medical Services facility located at 112 Carswell Avenue, Holly Hill, Florida. 2. Volusia County Fire Rescue Logistics facility located at 1970 South Volusia Avenue, Orange City, Florida 3. Repairs that cannot be made at one of the above locations shall be shipped (at Contractor’s cost) to the manufacturer’s repair facility. D. Contractor will provide technical assistance through their Technical Support Department. Should the equipment require service, County will contact the Technical Support Department directly. E. Technical Support Hours of Coverage 1. Technical support is available to the County free of charge through Contractor’s technical support help desk by calling 1 - 800-348-9011, Monday through Friday from 8:30 AM to 6:00 PM EST. Exhibit A-Scope of Work Page 4 of 7 2. The technical support representative will require the following pertinent information to open a service request: a. Unit serial number; b. Description of the complaint; c. Department where the equipment is being used; d. Patient information if applicable; e. ECG strips if available; and, f. Master Agreement number if the device is out of warranty. 3. This information will assist Contractor in performing a full evaluation when the product is received at Contractor’s repair facility. County will be given a returned merchandise authorization number to track the return of the product. F. Emergency Service Outside the coverage identified above, technical support is available to the County on an emergency basis seven (7) days a week. Emergency support Contractor’s off hours dispatch system. During weekends and evenings, Contractor’s on call technical support representative will return the call within four (4) hours. G. Response Time 1. The technical support help desk answers support inquiries in real time. If the County prefers to leave a voicemail, the technical support team will return the call within one (1) hour during business hours. The County will work with the technical support representative to troubleshoot the issue. 2. Technical support help desk may dispatch a service loaner to our facilities (listed in Section 2.4(C). A service loaner is available at no charge during the repair analysis process and will be shipped to arrive before 10 AM the next business day. H. On-Site Service If the inquiry is not resolved during the phone call, a local field support technician will be dispatched. I. Terms 1. Within forty eight (48) hours of contact to technical support, a Field Support Representative will be on-site during normal business hours to respond to the County's needs. 2. In the event of a device problem, the device should be made available to the Contractor’s field support technician during the scheduled on-site visit at one of the two locations listed in §2.4(C). Exhibit A-Scope of Work Page 5 of 7 3. A primary and back-up contact will be provided to the Contractor’s field support technician for all communication. 4. Only closed box repairs will be completed on-site (i.e. software updates, software reloading, handle replacement, external cable replacement). J. Service Provided by On-Site Service 1. The following services will be provided by a Contractor’s field technician during the scheduled on-site visit: a. Troubleshoot device(s) and/or accessories under contract; b. Place calls with the technical support help desk to open service requests and obtain a return authorization number for devices requiring repair/evaluation; c. Coordinate service loaner deployments with Contractor's technical support help desk; d. Functionally test and assist in the deployment of service loaners or customer devices, including: i. loading custom device configurations; ii. attaching carrying cases/ bags; iii. attaching mounting brackets; iv. connecting accessories; and v. establishing communications (pairing BT, Wi-Fi , etc .); e. Perform authorized on-site device repairs; f. Package (or un-package) service loaners and customer units under contract for shipment to (or returned from) Contractor; g. Provide answers or guidance to assure that any issues or questions County staff may have are addressed; h. Provide product training as required; i. Perform device software updates with the permission of the County; and, j. Review battery chargers and battery management. Cycle batteries as required. K. Contractor’s Depot Repairs 1. Repairs are performed in the Contractor’ Service Depot located at. 2. Contractor’s service technicians are highly skilled individuals that are trained in accordance with the technical service standard operating procedures. Training is required to be completed prior to evaluating and repairing any device. Technicians are also required to be trained on any updates to these procedures as they occur. 3. Training requirements, procedures and records are retained electronically in the Contractor’s database. Exhibit A-Scope of Work Page 6 of 7 4. All repaired products will go through an integral recertification process prior to being returned to the County. This includes devices that undergo a repair or an evaluation which determines that a repair is not required, as the evaluation may include disassembly of the product. This process recertifies device for clinical use. L. On-Site Service for Preventive Maintenance 1. Contractor’s factory trained PM and Deployment Technician will be scheduled to provide annual on-site preventive maintenance at the locations listed in §2.4(C). Primary and back-up contact information will provided to the Contractor’s field support technician for all communication and scheduling. Contractor will work with County Project Manager to coordinate the Preventive Maintenance. 2. Performance of Preventive Maintenance Includes: a. Clean all exterior surfaces of unit; b. Perform visual inspection to ensure integrity of the unit; c. Test Power Supply, ECG, Pacer Outputs & Rates, Defib Times and Output Energy; d. Test of MFC functions; e. Test Real Time Clock of the system; f. Perform operational check of all system level functions per device Service Manual; and, g. Recertify device for clinical use. M. Battery Replacement Program 1. Batteries will be maintained per Contractor's recommended maintenance program. 2. Batteries will be replaced, one for one, throughout the Extended Warranty period on an as needed basis, should the SurePower battery or SurePower Charger display a fault. • 3. Battery replacement program will only apply to batteries included with the original shipment of the devices. 4. Batteries will be returned to the Contractor for evaluation and confirmation of failure. 2.5 Warranty A. The warranty shall be the manufacturer’s standard warranty. All warranty work shall be performed at one of the locations listed in §2.4(C) above. B. Warranty shall include, at a minimum: Exhibit A-Scope of Work Page 7 of 7 1. One (1) year parts and labor warranty against manufacturing defects affecting the performance of the unit, to include transport of affected unit(s); and, 2. Ninety (90) days warranty for accessories (i.e. EKG cables, sensor probes, etc.). Exhibt A-1 Functional Requirements Matrix RFP 16-P-64AK Page 1 of 3 RESPONSE 1 1.1 The X Series is intended for use by trained medical personnel who are familiar with basic monitoring, vital sign assessment, emergency cardiac care, and the use of the X Series. The X Series is also intended for use by (or on the order of) physicians at the scene of an emergency or in a hospital emergency room, intensive care unit, cardiac care unit, or other similar areas of a hospital. The usage may be in an ambulance or at the scene of an emergency. It is-also intended to be used during the transport of patients. The X Series will be used primarily on patients experiencing symptoms of cardiac arrest or in post trauma situation. It may also be used whenever it is required to monitor any of those functions that are included (as options) in the device. The X Series unit can be used on neonate patients and on adult patients (21 years of age or older) with and without heart dysfunction. Full FDA approval documentation is available. The X Series has the ability to monitor, print, display and/or record 4-lead ECG waveform and heart rate, and to alarm when heart rate is above or below limits set by the operator. The patient population will range from newborn (neonate) to adult, with and without heart dysfunction. The X Series has the ability to monitor, print, display and/or record 12-lead ECG waveform and heart rate, and to alarm when heart rate is above or below limits set by the operator. The patient population will range from newborn (neonate) to adult, with and without heart dysfunction. The 12-lead ECG Analysis is intended for use in acquiring, analyzing and reporting ECU data, and to provide interpretation of the data for consideration by caregivers. The X Series pulse CO-oximeter, with Masimo Rainbow SET technology and the Rainbow series of sensors, is intended for use for continuous noninvasive monitoring of functional oxygen saturation of arterial henmoglobin (SpO2), pulse rate, carboxyhemoglobin saturation (SpCO), and/or methemoglobin saturation (SpMet). The pulse CO-oximeter and accessories are indicated for use on adult, pediatric, and neonatal patients during both no motion and motion conditions, and for patients who are well or poorly perfused, in hospitals, hospital-type facilities,or in mobile environments. Saturation Range: 1 – 100%; Pulse Rate Range: 25 – 240 bpm The X Series is intended for use to make continuous noninvasive measurement and monitoring of carbon dioxide (CO2) concentration of the expired and inspired breath and breath rate. The patient population will range from newborn (neonate) to adult. Range: 0 – 150 mmHg; Respiration Range: 0 – 149 breaths per minute; Flow rate: 50 ml/min -7.5 + 15 ml/min; Typical response time: 2.9 seconds; Maximum response time: 3.9 seconds The X Series pulse CO-oximeter, with Masimo Rainbow SET technology and the Rainbow series of sensors, is intended for use for continuous noninvasive monitoring of functional oxygen saturation of arterial henmoglobin (SpO2), pulse rate, carboxyhemoglobin saturation (SpCO), and/or methemoglobin saturation (SpMet). The pulse CO-oximeter and accessories are indicated for use on adult, pediatric, and neonatal patients during both no motion and motion conditions, and for patients who are well or poorly perfused, in hospitals, hospital-type facilities,or in mobile environments. Range: 0 – 99%; Accuracy: 1 – 40% ± 3 digits The X Series is intended for use to make non-invasive measurements of arterial pressure and heart rate, and to alarm if either parameter is outside of the limits set by the user. Measurements are made using an inflatable cuff on the patient's arm or leg. The patient population will range from newborn (neonate) to adult. Utilizes Smartcuf® and Sure BP® technology. Measurement Intervals: Automatic 1-, 2-, 3-, 5-, 10-, 15-, 30-, 60-minute, and manual quick-action NIBP Start/Stop button; TurboCuf: 5 min of repeated NIBP readings; Display: Systolic, diastolic, mean. Viewable on-screen with large numerics. Cuff Overpressure Protection; Typical Measurement Time: 30 – 45 sec (on deflation) 15 – 30 sec – Sure BP (on inflation) Standard Cuff Sizes: Neonate #1 – #5, Infant, Small Child, Small Adult, Adult Long, Large Adult, Thigh REQUIRED INFORMATION Approved for use by the Food and Drug Administration (FDA) in a pre-hospital setting Ability to monitor and print 12-lead EKG rhythms A. C. SPECIFICATIONS AND FUNCTIONALITY PROPOSED cardiac monitor B.Ability to monitor, print and visually display 4-lead EKG rhythms Ability to monitor and visually display continuous, real-time peripheral capillary oxygen saturation (SpO2) D. E.Ability to monitor and visually display continuous, real-time end tidal carbon dioxide readings (ETCO2) F. G. Ability to monitor and display carbon monoxide (SpCO) readings Ability to perform non-invasive blood pressure monitoring (NIBP) Exhibt A-1 Functional Requirements Matrix RFP 16-P-64AK Page 2 of 3 RESPONSEREQUIRED INFORMATION The X Series can be used for synchronized cardioversion of certain atrial or ventricular arrhythmias. Qualified medical personnel must decide when synchronized cardioversion is appropriate. The patient population will range from newborn (neonate) to adult. Synchronizes defibrillator pulse to patient’s R wave. “SYNC” message displayed on monitor and markers shown on both monitor and recorded ECG. Meets Clause 104 of AAMI DF80. The X Series can be used for external defibrillation for victims of cardiac arrest where there is apparent lack of circulation as indicated by: unconsciousness, absence of breathing, and absence of pulse. Waveform: Rectilinear Biphasic™ Energy Selections: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 15, 20, 30, 50, 70, 85, 100, 120, 150, 200 joules. Charge Time: Less than 7 seconds with a new, fully charged battery. The X Series can be used for transcutaneous pacing in conscious or unconscious patients as an alternative to endocardial stimulation. Pulse Types: Rectilinear, constant current; Pulse Width: 40 ms ± 2 ms; Pacer Rate: 30 – 180 bpm ± 1.5%; Output Current: 0 – 140 mA ± 5% or 5 mA, whichever is greater; Modes: Demand and Fixed The X Series is the first monitor to integrate a complete array of communications technology. The approach not only delivers an added layer of protection for the demands of the pre-hospital environment, it eliminates the need for cables and dongles. Every X Series comes with the following communications capabilities: WiFi, Bluetooth, USB 2.0 that can be used to wirelessly transmit 12-lead EKGs. The open architecture philosophy embodied by the X Series design gives services, and ultimately patients, a path to improvements that can’t be matched by other monitors. X Series 12-leads can be sent to all leading STEMI and cardiology management systems, such as: ZOLL's RescueNet 12 Lead; Physio Control's LifeNet; Philips' IntelliSpace; GE's MUSE as well as email and smartphones/tablets. The X Series simplifies medic charting by seamlessly uploading the event record with the speed of a WiFi connection. It will automatically populate patient data fields for many of the leading ePCR systems. Some examples of ePCR vendors are ZOLL ePCR, ESO Solutions, ImageTrend, EMS Charts, and Documed. ZOLL’s open architecture makes it possible to send event files to all ePCR systems. In line with ZOLL’s commitment to open architecture, a Software Development Kit (SDK) is available to any ePCR vendor desiring to complete the interface. 1 Internal memory or storage card shall be able to save a minimum of 15 patient encounters and/or 6 hours of continuous data for upload. The X Series redefines what a monitor should collect and send to the patient record. Its built-in memory ensures the complete patient record is transmitted by capturing 24 hours of event or trend data, and up to 1,000 time-stamped events. The X Series simplifies medic charting by seamlessly uploading the event record with the speed of a WiFi connection. It will automatically populate patient data fields for many of the leading ePCR systems. The X Series can upload complete full-disclosure case reports to RescueNet Code Review. This software captures all clinical defibrillator and vital sign information for quality review and analysis, delivering the complete picture to reviewers. RescueNet Code Review provides ECG, vital sign data, and CPR rate and depth of compressions for a complete review of the rescue. End-users can view entire case reports after upload from the X Series within RescueNet Code Review, software provided by ZOLL. Code Review provides ECG, vital sign data, and CPR rate and depth of compressions for a complete review of the rescue. X Series can also, with the push of a button, send files to your system. With RescueNet CaseReview, access to case files is as fast as opening your web browser. RescueNet Case Review provides: Simplified data collection: access files without delay, same-day debriefing, system-wide performance analytics, IS and network independence The X Series can be secured to FERNO brand stretchers for patient movement. ZOLL does not manufacture mounting brackets. However, there are many companies that specialize in the production of mounting brackets that will secure the X Series inside the compartment of a transport vehicle in accordance with National Fire Protection Association standards. An example is FERNO's D360 Swivel Defibrillator Mount for the X Series. J.Ability to perform Transcutaneous Pacing (TFP) K. L.Ability to upload complete full-disclosure case reports to an ePCR solution (current solutions in use by The County of Volusia are Zoll ePCR and FireHouse). The vendor shall list all ePCR solutions that can facilitate a direct upload with their product M. N. O. Ability to transmit electrocardiograms (EKG) directly from the cardiac monitor to a receiving hospital with the use of a wireless card (i.e. from a remote location away from response vehicle) The cardiac monitor must be able to be secured inside the patient compartment of a transport vehicle in accordance with National Fire Protection Association standards. Ability to upload complete full-disclosure case reports to a repository (client based and/or cloud based) to ensure all patient reports are stored The cardiac monitor must be able to be secured to the stretcher for continuous patient monitoring while moving the patient from one location to another on the stretcher. The vendor shall provide assurance that the cardiac monitor can be secured to a FERNO brand stretcher for patient movement Ability for the end-user to be able to view the entire case report after upload and shall be able to be viewed in real-time. This ability can be either built into the ePCR or can be a standalone product that can be installed on the ePCR tablet. H. Ability to perform Unsynchronized Defibrillation based on current American Heart Association recommendations I. Ability to perform Synchronized Cardioversion based on current American Heart Association recommendations P. Exhibt A-1 Functional Requirements Matrix RFP 16-P-64AK Page 3 of 3 RESPONSEREQUIRED INFORMATION 1.2 No cost. This is included in the first year standard warranty as well as extended warranty and PM as outlined in the "Technical Support and Onsite Services" and "EMS One Year Product Warranty" documents located in Tab 9. ZOLL Medical agrees to make on-site repair services as part of the extended warranty. This is outlined in the "Technical Support and Onsite Services" document located in Tab 9 ZOLL recommends that only 1 PM per year is necessary as outlined in the "Technical Support and Onsite Services" document located in Tab 9 This is covered as part of the standard warranty as well as extended warranty and PM as outlined in the "Technical Support and Onsite Services" and "EMS One Year Product Warranty" documents located in Tab 9. 1.3 Per addendum, Volusia County will accept the manufacturer's standard warranty. Please see "EMS One Year Product Warranty" located in Tab 9 Per addendum, Volusia County will accept the manufacturer's standard warranty. Please see "EMS One Year Product Warranty" located in Tab 9 Preventative Maintenance. The preventative maintenance plan shall include: The cost of expedited loaner equipment; Weekly on-site repair visits; Bi-Annual (2 times per year) preventative maintenance/quality assurance checks; Replacement parts/accessories. A. B. C. D. Warranty. The warranty shall include: A. One (1) year parts and labor warranty against manufacturing defects affecting the performance of the unit, to include transport of affected unit (s); B. Two (2) year components warranty against manufacturing defects affecting the performance of the components. Exhibit B-Pricing Page 1 of 1 Description Cost a. One (1) limb lead cable; b. One (1) 12-lead cable; c. One (1) Patient Therapy/Defibrillation Cable; d. One (1) NIBP Hose; e. One (1) each of the following NIBP cuffs – Infant, Child, Adult, Large Adult; f. One (1) User Test module (if required to perform daily user tests); g. One (1) Adult SpO2/SpCO reusable sensor w/ extension cable (must be at least 5’ in length); h. One (1) Pediatric SpO2/SpCO reusable sensor w/extension cable (must be at least 5’ in length); i. Three (3) factory direct batteries; j. One (1) standard/premium (pathogen resistant) carry case with shoulder strap; k. One (1) storage card or internal memory that will save a minimum of 15 patient encounters and/or 6 hours of continuous data for upload; l. One (1) wireless card that will allow for transmission of EKG’s. M. Power Cord $29,995.63 Description Cost per Unit a. Methemoglobin $1,601.40 b. Invasive/Core Temperature Testing $676.60 c. Arterial Line Monitoring*$2,546.60 *X Series units that have Arterial Line Monitoring must also have Invasive/Core Temperature Testing, this price is inclusive of both parameters. Description Estimated Number of Units Trade-In Value (per unit) Zoll E-Series Cardiac Monitor/Defibrillators (includes ETCO2, with 12-lead, SpO2, NIBP)55 $2,000.00 Zoll M-Series Cardiac Monitor/Defibrillators (includes ETCO2, with 12-lead, SpO2, NIBP)15 $500.00 Annual Cost *Year One Includes ONE (1) Year of Factory Warranty at No Additional Charge $0.00 *Preventive Maintenance Recommended After Year One, N/A.$0.00 *Hardware Would be Covered Under the Warranty and Sotware is at No Charge. $0.00 *Exclusions for Hardware Would be Accidental Damage/Abuse That is Not Covered Under the Warranty. $0.00 $0.00 Annual Cost *Year two: $1,392.50 per unit, per year, for Extended Warranty with 1 PM & Battery Replacement, On-Site (for 70 X Series )$97,475.00 Annual Cost *Year three: $1,392.50 per unit, per year, for Extended Warranty with 1 PM & Battery Replacement, On-Site (for 70 X Series )$97,475.00 Annual Cost *Year four: $1,392.50 per unit, per year, for Extended Warranty with 1 PM & Battery Replacement, On-Site (for 70 X Series )$97,475.00 Description of Accessories and Components Discount off List Price Cost 1. Limb Lead Cables 25%$221.25 2. 12-Lead Cables 25%$243.75 3 SpO2/SpCO patient cables 25%$221.25 4. SpO2/SpCO sensors (both pediatric and adult)25%$633.75 5. NIBP hoses 25%$48.75 6. NIBP cuffs 25%$39.38 7. Replacement carrying cases 25%$371.25 8. Factory Direct replacement batteries.25%$371.25 9. ETCO2 Filterline Set Adult/Pediatric Case of 25 (For Intubations)25%$206.25 10. ETCO2 Smart CapnoLine, Oral/Nasal w/ O2 tubing for supplemental oxygen.Case of 25 (For Respira 25%$266.25 11. Paper (Pack of 6)25%$18.00 12. RescueNet Code Review Software (there are NO restrictions on the number of computers that softwa 0%$2,495.00 13. Adapters for existing chargers (80 adapters)0%No Charge Total Year 1 Cost Total Cost (per unit) Year 1 Summary Year 2 Summary Year 3 Summary Year 4 Summary Trade-In Value Optional Items Pricing is inclusive of the cardiac monitor and the following accessorie and include all delivery costs. Cardiac Monitor, Brackets, and Charger Pricing The following pricing is for optional items: Annual Maintenance and Support Annual maintenance and support costs associated with the cardiac monitors are listed below.