HomeMy WebLinkAboutPhysio-Control - 2017 Agreement" i r
AGREEMENT FOR SERVICES
(For contracts over $5.000 — NON - DESIGN, NON - ENGINEERING TYPE CONTRACTOR)
This AGREEMENT made this 1 Ith day of September, 2017, between:
CITY: City of Gilroy, having a principal place of business at
7351 Rosanna Street, Gilroy, California
and CONTRACTOR. Physio- Control. Inc., having a principal place of business at 11811
Willows Road NE. Redmond. WA 98052.
ARTICLE 1. TERM OF AGREEMENT
This Agreement will become effective on 8/3/2017 and will continue in effect through 8/2/2021
unless terminated in accordance with the provisions of Article 7 of this Agreement.
Any lapse in insurance coverage as required by Article 5, Section D of this Agreement shall
terminate this Agreement regardless of any other provision stated herein. A4
Initial
ARTICLE 2. INDEPENDENT CONTRACTOR STATUS
It is the express intention of the parties that CONTRACTOR is an independent contractor and
not an employee, agent, joint venturer or partner of CITY. Nothing in this Agreement shall be
interpreted or construed as creating or establishing the relationship of employer and employee
between CITY and CONTRACTOR or any employee or agent of CONTRACTOR. Both parties
acknowledge that CONTRACTOR is not an employee for state or federal tax purposes.
CONTRACTOR shall not be entitled to any of the rights or benefits afforded to CITY'S
employees, including, without limitation, disability or unemployment insurance, workers'
compensation, medical insurance, sick leave. retirement benefits or any other employment
benefits. CONTRACTOR shall retain the right to perform services for others during the term of
this Agreement.
ARTICLE 3. SERVICES TO BE PERFORMED BY CONTRACTOR
A. Specific Services
CONTRACTOR agrees to: Perform the services as outlined in Exhibit "A ".
B. Method of Performing Services
CONTRACTOR shall determine the method, details and means of performing the above -
described services. CITY shall have no right to, and shall not, control the manner or determine
the method of accomplishing CONTRACTOR'S services.
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C. Employment of Assistants
CONTRACTOR may, at the CONTRACTOR'S own expense, employ such assistants as
CONTRACTOR deems necessary to perform the services required of CONTRACTOR by this
Agreement, subject to the prohibition against assignment and - subcontracting contained in
Article 5 below. CITY may not control, direct, or supervise CONTR'ACTOR'S assistants in the
performance of those services. CONTRACTOR assumes full and sole responsibility for the
payment of all compensation and expenses of these assistants and; for all state and federal income
tax, unemployment insurance, Social Security, disability insurance and other applicable
withholding.
D. Place of Work
CONTRACTOR shall perform the services required by this Agreement at any place or location
and at such times as CONTRACTOR shall determine is necessary to ,properly and timely
perform CONTRACTOR'S services.
ARTICLE 4. COMPENSATION
A. Consideration
In consideration for the services to be performed• by CONTRACTOR, CITY agrees to pay
CONTRACTOR the amounts set forth in Exhibit "A ". In no event however shall the total
compensation paid to CONTRACTOR exceed $41,031.00.
B. Invoices
CONTRACTOR shall submit invoices for all services pursuant to Exhibit "A ".
C. Payment
No payment will be made unless CONTRACTOR has first provided City with a written receipt
of invoice describing, the work and any approved direct expenses (as provided for in
Exhibit "A ") incurred during the preceding period. If CITY objects to all or any portion of any
invoice, CITY shall notify CONTRACTOR of the objection within thirty (30), days from receipt
of the invoice, give reasons for the objection, and pay that portion of the invoice not in dispute.
It shall not constitute a default or breach of this Agreement for CITY not to pay any, invoiced
amounts to which it has objected until the objection has been resolved by, mutual agreement of
the parties. Payment is due thirty (30) days from invoice date.
D. Expenses
CONTRACTOR shall be responsible for all costs and expenses incident to the performance of
services for CITY, including but not limited to, all costs of equipment used or provided by
CONTRACTOR, all, fees,_ fines, licenses, bonds or taxes required of or imposed against
CONTRACTOR and al_I other of CONTRACTOR'S costs of doing business. CITY shall not be
responsible for any expenses incurred by CONTRACTOR in performing services for CITY,
4835- 2267 -0361 v1
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except for those expenses constituting "direct expenses" referenced on Exhibit "A" and their
own applicable taxes.
ARTICLE 5. OBLIGATIONS OF CONTRACTOR
A. Tools and Instrumentalities
CONTRACTOR shall supply all tools and instrumentalities required to perform the services
under this Agreement at its sole cost and expense. CONTRACTOR is not required to purchase
or rent any tools; equipment or services from CITY.
B. Workers' Compensation
CONTRACTOR agrees to provide workers' compensation insurance for CONTRACTOR'S
employees and agents and agrees to hold harmless. defend with counsel acceptable to CITY and
indemnify CITY, its officers, representatives, agents and employees from and against any and all
claims, suits, damages. costs, fees, demands, causes of action, losses, liabilities and expenses,
including without limitation reasonable attorneys' fees, arising out of any injury, disability; or
death of any of CONTRACTOR'S employees.
C. Indemnification of Liability, Duty to Defend
As to all liability, to the fullest extent permitted by law. CONTRACTOR shall defend, through
counsel approved by CITY (which approval shall not be unreasonably withheld), indemnify and
hold harmless CITY, its officers, representatives, agents and employees against any and all suits,
damages, costs, fees, claims, demands, causes of action, losses, liabilities and expenses,
including without limitation reasonable attorneys' fees, arising or resulting directly or indirectly
from any act or omission of CONTRACTOR or CONTRACTOR'S assistants, employees or
agents, including all claims relating to the injury or death of any person or damage to any
property in the performance of the services hereunder.
D. Insurance
In addition to any other obligations under this Agreement. CONTRACTOR shall. at no cost to
CITY, obtain and maintain throughout the term of this Agreement: (a) Commercial Liability
Insurance on a per occurrence basis, including coverage for owned and non -owned automobiles,
with a minimum combined single limit coverage of $1,000,000 per occurrence for all damages
due to the negligent acts or omission of the CONTRACTOR. As a condition precedent to
CITY'S obligations under this Agreement,. CONTRACTOR shall furnish written evidence of
such coverage (listing the CITY, its officers and employees as additional insureds on the
Comprehensive Liability insurance policy. CONTRACTOR shall provide thirty (30) days
written notice of policy lapse or cancellation. or of a material change in policy terms.
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E. Assignment
Notwithstanding any other provision of this Agreement, neither this Agreement nor any duties or
obligations of CONTRACTOR under this Agreement may- be assigned, or subcontracted by
CONTRACTOR without the prior written consent of CITY-, which CITY may withhold in its
sole and absolute discretion.
F. State and Federal Taxes
As CONTRACTOR is not CITY'S employee, CONTRACTOR shall be responsible for paying
all required state and federal taxes: "Without limiting the foregoing, CONTRACTOR
acknowledges and agrees that:
• CITY will not withhold FICA (Social Security) from CONTRACTOR'S
payments;
• CITY will not make state or, federal unemployment insurance contributions on
CONTRACTOR'S behalf;
• CITY will not withhold state or federal income tax from - payment to
CONTRACTOR;
• CITY will not make disability insurance contributions on-behalf of
CONTRACTOR;
• CITY will not obtain workers' compensation insurance on behalf o_ f
CONTRACTOR.
ARTICLE 6. OBLIGATIONS OF CITY
A. Cooperation of City
CITY agrees to respond to all reasonable requests of CONTRACTOR and provide access, at
reasonable times following receipt by CITY of reasonable notice, to all documents reasonably
necessary to the performance of CONTRACTOR'S duties under this Agreement.
B. Assignment
CITY may assign this Agreement or any duties or obligations thereunder to a successor
governmental entity without the consent of CONTRACTOR. Such assignment shall not release
CONTRACTOR from any of CONTRACTOR'S duties or obligatidris:under this Agreement.
ARTICLE 7. TERMINATION OF AGREEMENT -
A. Termination by City for Default of CONTRACTOR
'Should CONTRACTOR default in the performance of this Agreement or materially breach any
of its provisions, CITY, at CITY'S option, may terminate this Agreement by giving written
notification to CONTRACTOR if CONTRACTOR fails to cure such breach within thirty (30)
4835 - 2267 -0361 v1
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days from the date the breach was notified to CONTRACTOR in writing. For the purposes of
this section, material breach of this Agreement shall include. but not be limited to the following:
CONTRACTORS breach of any of its representations, warranties or covenants
contained in this Agreement.
CONTRACTOR shall be entitled to payment only for work completed in accordance with the
terms of this Agreement through the date of the termination notice, as reasonably determined by
CITY, provided that such payment shall not exceed the amounts set forth in this Agreement for
the tasks described on Exhibit C° which have been fully; competently and timely rendered by
CONTRACTOR.
B. Termination for Failure to Make Agreed -Upon Payments
Should CITY fail to pay CONTRACTOR all or any part of the compensation set forth in Article
4 of this Agreement on the date due, then if and only if such nonpayment constitutes a default
under this Agreement, CONTRACTOR, at the CONTRACTOR'S option, may terminate this
Agreement if such default is not remedied by CITY within thirty (30) days after demand for such
payment is given by CONTRACTOR to CITY.
C. Transition after Termination
Upon termination. CONTRACTOR shall immediately stop work, unless cessation could
potentially cause any damage or harm to person or property, in which case CONTRACTOR shall
cease such work as soon as it is safe to do so. CONTRACTOR shall incur no further expenses in
connection with this Agreement. CONTRACTOR shall promptly deliver to CITY all work done
toward completion of the services required hereunder, and shall act in such a manner as to
facilitate an), the assumption of CONTRACTOR's duties by any new CONTRACTOR hired by
the CITY to complete such services.
ARTICLE 8. GENERAL PROVISIONS
A. Amendment & Modification
No amendments. modifications, alterations or changes to the terms of this Agreement shall be
effective unless and until made in a writing signed by both parties hereto.
B. Americans with Disabilities Act of 1990
Throughout the term of' this Agreement. the CONTRACTOR shall comply fully with all
applicable provisions of the Americans with Disabilities Act of 1990 ("the Act ") in its current
form and as it may be amended from time to time. CONTRACTOR shall also require such
compliance of all subcontractors performing work under this Agreement, subject to the
prohibition against assignment and subcontracting contained in Article 5 above. The
CONTRACTOR shall defend with counsel acceptable to CITY, indemnify and hold harmless the
CITY OF GILROY, its officers, employees. agents and representatives from and against all suits.
claims, demands. damages, costs, causes of action; losses, liabilities, expenses and fees,
including without limitation reasonable attorneys' fees; that may arise out of any violations of
4835 - 2267- 0361v1 5
LAC104706083
the Act by the CONTRACTOR, its subcontractors, or the.,officers, employees, agents or
representatives of either.
C. Attorneys' Fees
If any action at law or in equity.. including an action for decla yatory relief, is brought to enforce
or interpret the provisions of this Agreement, the prevailing party will be'
.entitled'.to reasonable
attorneys' fees, which may be set by the court in the same action -or in a separate- action brought
for that purpose, in addition to any other relief to which that,party may be entitled.
D. Captions
The captions and headings of the various sections, paragraphs and subparagraphs of the
Agreement are for convenience only and' shall not 'be considered �rior referred to for resolving
questions of interpretation:
E. Compliance with Laws
The CONTRACTOR shall keep itself informed of all State and National laws and, all municipal
ordinances and regulations of the CITY which in any manner affect those engaged or employed
in the work, or the materials used in the work, or which in any way affect -the conduct of the
work, and of all such orders and decrees of bodies or tribunals having any jurisdiction or
authority over the same. Without limiting the foregoing, CONTRACTOR, agrees to observe the
provisions of the Municipal Code of.the CITY OF GILROY, obligating every contractor or
subcontractor under a contract or subcontract to the CITY OF GILROY for public works or for
goods or services to refrain from discriminatory employment or subcontracting practices on the
basis of the race, color, sex, religious creed, national origin, ancestry of any employee, applicant
for employment, or any potential subcontractor.
F. Conflict of Interest
CONTRACTOR certifies that to the best of its knowledge, no CITY employee or office of any
public agency interested in this Agreement has any pecuniary, interest in the business of
CONTRACTOR and that no person associated with CONTRACTOR has any interest that would
constitute a conflict of interest in any manner or degree as to the execution or performance of
this Agreement.
G. Entire Agreement
This Agreement supersedes any and all prior agreements, whether, orall or written, 'between the
parties hereto with respect to the rendering of services by CONTRACTOR for CITY and
contains all the covenants and agreements between the parties with respect to the rendering of
such services in any manner whatsoever. Each party to this Agreement acknowledges that no
representations, inducements, promises or agreements, orally or otherwise, have been made by
any party, or anyone acting on behalf of any party, which Are ,not embodied herein, and that no
other agreement, statement or promise not contained in, this Agreement shall be valid or binding.
4835- 2267 - 03610' _
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No other agreements or conversation with any officer, agent or employee of CITY prior to
execution of this Agreement shall affect or modify any of the terms or obligations contained in
any documents comprising this Agreement. Such other agreements or conversations shall be
considered as unofficial information and in no way binding upon CITY.
H. Governing Law and Venue
This Agreement shall be governed by and construed in accordance with the laws of the State of
California without regard to the conflict of laws provisions of any jurisdiction. The exclusive
jurisdiction and venue with respect to any and all disputes arising hereunder shall be in state and
federal courts located in Santa Clara County, California.
I. Notices
Any notice to be given hereunder by either party to the other may be effected either by personal
delivery in writing or by mail, registered or certified, postage prepaid with return receipt
requested. Mailed notices shall be addressed to the parties at the addresses appearing in
Exhibit "A ", Section V.H. but each party may change the address by written notice in
accordance with this paragraph. Notices delivered personally will be deemed delivered as of
actual receipt.
J. Partial Invalidity
If any provision in this Agreement is held by a court of competent jurisdiction to be invalid, void
or unenforceable, the remaining provisions will nevertheless continue in full force without being
impaired or invalidated in any way.
K. Waiver
CONTRACTOR agrees that waiver by CITY of any one or more of the conditions of
performance under this Agreement shall not be construed as waiver(s) of any other condition of
performance under this Agreement.
Executed at Gilroy, California, on the date and year first above written.
CONTRACTOR:
By: _
Name: urc;e s4oe sel
Title: cv ?cc. C.,,r -Js S- p-c"[W
Social Security or Taxpayer
Identif cation Number q1-06q-71b
4835 - 2267 -03610
LAD04706083
-7-
CITY:
CITY OF GILROY
By:
Name: Alan Anderson
Title: Fire Chief
Approved as to Form
k�=
City Attorney
4835 - 2267 -0361 v1
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EXHIBIT "A"
E
Physio- Control, Inc
11811 Willows Road NE
P O Box 97006
_
Redmond, WA 98073 -9706 U S A
-
www physio- control com -
w o _=
tel 800 442 1142
Sales Order fax 800 732 0956
Service Plan fax 800 772 3340
To Mary Gutierrez
Quote Number
00072387
GILROY FD
a y" ,Revision #
RENEWAL
7070 CHESTNUT ST
GILROY, CA 95020
Created Date
3/3/2017
(408) 846 -0396
Sales Consultant
KurtisMoore
mary gutierrez@cityofgilroy org
209 - 535 -4883
FOB
Redmond, WA
Terms
All quotes subject to credit approval and the
following terms and conditions
•
NET Terms
NET 30
Renewal of PB17K546
Coverage Dates •8 3 2017 - 8 2 2021 -
Payable,in ANNUAL installments
15% discount,on accessories and electrodes
FAX 800 -772 -3340
HARD COPY PO REQUIRED
Expiration Date 8/2/2017
'Product .® ® . _ e
LP15- OSCOMP -4 LIFEPAK 15 Service - 4 YEAR 700 6,896 00 1,03440
On -site Comprehensive Coverage
I
Subtotal
Estimated Tax
EstimatedrShipping & Handling
Grand, Total
List Price Total
Total Contract Discounts Amount
Total Discount
Trade In (Discounts
Tax,+ S&H
Quote Number 00072387
5,861 60 41,031 =20
USD 41;031'20
USD 0,00
USD 0 00,
•USD 41,031 ,20' -
Pricing Summary Totals
USD 48,27200
USDIO 00
USD -7,240 80
,USD 0 00�
USD 0 00,
-% 1.
GRAND TOTAL FOR THIS QUOTE
USD 41,031.20
PHYSIO- CONTROL, INC. REQUIRES WRITTEN VERIFICATION OF e1
THIS ORDER. A PURCHASE ORDER IS REQUIRED ON ALL CUSTOMER APPROVAL (AUTHORIZED SIGNATURE;
ORDERS $5,000 OR GREATER BEFORE APPLICABLE FREIGHT - „ ✓ _ _ _ c Q -.00'0
AND TAXES. THE UNDERSIGNED 15 AUTHORIZED TO ACCEPT
THIS ORDER IN ACCORDANCE WITH THE TERMS AND PRICES NAME
DENOTED HEREIN. 014E ell14or
TIT'__
DATE
Reference Number AC/15815901/126692
General Terms forall Products. Services and Subscriptions.
Physio - Control, Inc. i'Physio') accepts Buyer's order expressly conditioned on Buyers assent to the terms set forth in this
document. Buyers order and acceptanceof any portion of the goods, services or subscriptions shall confirm Buyer's acceptance of
these terms. Unless specified otherwise herein, these terms constitute the complete agreement between the parties. Amendments
to this document shall be in - writing and no prior or subsequent acceptance by Seller Of any purchase order, acknoWedgment, or
other document fro m Bu y e r specifying different an dior additional terms shall be effective un les s s i gned by both p arties.
Pricing. Prices do not include freight insurance, freight fonrarding fees, taxes, duties, import or export permit fees, or any other
similar charge of any kind applicable to the goods and services. Sala or use taxes on domestic (USA.) deliveries vAll be invoiced In
addition to the price Of tie goods and services unless Physio receives a copy of a valid exemption cerrificate prior to delivery .
Discounts may not be co m biped with other s pecia I terms , discounts, a n d•'or p r omoti ons,
Payment. Payment for goods and services shall be subject to approval of credit by Physio. Unless otherrAse specified by Physio in
w;ritnc, tie entee payment of an invoice is due thirty (30) days after the invoice date for deliveries in tie USA,. and sight draft or
acceptable ( confirmed) irrevocable letterof credit is requiredfor sales outside the USA.
Min imum Order Quantity. Physic reservestherightto charge aservice fee for any order less thanS20D.00.
Patent Indemnity. Physio shall indemnify Buyer and hold it harmless from and against all demands. claims, damages. losses, and
expenses. arising out of or resulting, from any, action by a third party against Buyer that is based on any claim that the services
infringe a. United States patent, copyright, or trademark, or violate a trade secret or any other proprietary right of any person or
entity. Fhysio's indemnification obligations hereunder will be subject to ill receiving prompt written notice of the existence of any
claim; (iii being able to, at its option. control the defense and settlement of such claim (provided that, without obtaining the prior
written consent of Buyer. Physic will enter into no settlement involving the admission of wrongdoing): and (ill) receiving full
cooperation of Buyer in the defense of any claim.
Limitation of Interest. Through the purhaseof Physic products, services. orsubscriptons. Buyer does not acquire any interest in
any tooling, drawings, design information. computer programming. patents or copyrighted or confidental information related to said
products or services. and Buyer expressly agrees not to reverse engineer or deoompile such products or related software and
information.
Delays. Physic will not be liable for any loss or damage Of any kind due to its failure to perform or delays in its performance
resulting from an event beyond its reasonable control, including but not limited to. acts of God. labor disputes, the requirements of
any governmental authority, war, civil unrest, terrorist acts, delays in manufacture, obtaining any required license or permit. and
Physic inability to obtain goods from its usual sources.
Limited Warranty.. Plnysio warrants its products and services in accordance with the terms of the limited warranties located at
htto: lAvv ,v.Dtwsio- control.com/Documants/. The remedies provided under such warranties shall be Buyers sole and exclusive
remedies. Physic, makes no other warranties, express or implied, including, without limitation. NO WARRANTY OF
MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. AND IN NO EVENT SHALL PHYSIO BE LIABLE FOR
INCIDENTAL, CONSEQUENTIAL, SPECIAL OR OTHER DAMAGES.
Compliance with Confidentiality Laws. Both parties acknowledge their respective obligations to maintain the security and
confidentiality of individually identifiable health information and agree to comply with applicable federal and state health information
confidentiality laws.
Compliance with Law. The parties agree to comply wrath any and all laws, rules, regulations, licensing requirements or standards
that are now or hereafter promulgated by any local, state, and federal govemmental authority�sgency or accreditinnladministrstive
body that governs orappliesto their respective duties and obligations hereunder.
Regulatory Requirement for Access to Infoenation. In the event 42 USC § 139Sx(v;K1 i(I i is applicade, Physio shall make
available to the Secretary of the United States Department of Health and Human Services, the Comptroller General of the United
States General Accounting Office, or any of their duly authorized representatives. a copy of these terms, such books, documents
and records as are necessary to ce rtify th a nature and extent o f the costs of th a products a n d s ery ices provided by Physic.
No Debarment. Physic represents and warrants that it and its directors, officers, and employees (i) are not excluded, debarred, or
otherwise ineligible to participate in the Federal health care programs as defined in 42 USG § 1320a- 71o(f); (ii) have not been
convicted of a criminal offense related to the provision of healthcare items or services: and (iii) are not under investigation which
may result in Physic being excluded from participation in such programs.
Choice of Law. The rights and obligatons of Physio and Buyer related to the purchase and sale of products and services
described in this document shall be governed by the lawis of the state where Buyer is located. All costs and expenses incurred by
the prevailing party related to enforcement of its rights under this document, including reasonable attorney's fees, shall be
reimbursed by the other party.
Ouote Number: 000 238-1
Additional Terms for Purchase and sale of Service Plana,
In- addition to the Gener al Terms abo,e -the following terms-apply to all Physlo Service Plans
Service Plana Physio shall provide sertrces according to the applicable Service Plan purchased by Elyer and cleScrlbecl at
htio JA-,p hvsio -control r m ;5erviceProoramc a px for tine Idlgth of the subscription purchased and for the de-ces specified as
covered by the Service Plan ('Covered Equipment*) -
Pricing. If the number or configuration of Covered Equipment changes _during the. Serice Plan subscription pricing shall bepro_
rated accordingly For Preventative Maintenance, Inspection Only, Coniprehensl�e„ end Repair &Inspect Service Plans, Buyer is
responslble to pay for preventative ineinfenanc- and Inspections that have been parforuhed since the fast anniversary of the
subscription start date and such services s ha II not be pro -rated
Device Inspection Before Acceptance All devices that are not covered under �J, Jy510.5 Limped 'Alsmanty or a current Service
Plan must be Inspected and repaired trf necessary) to meet specifications at tlien- current list prices prior to being covered under a
Service Plan
Unavailability ot_Covered Equgament If Covered Equipment is not made available at a scheduled service visit, Buyer is
responsible to reschedule with the Phy sio Service Technician, or shlp -in the Equipment to a Physlo service depot Physio reserves
the right to-charge Buyer a surcharge for a return visit Surcharges will be based on then- current Physio list price of desired
services, lass 10% for labor and IS% for parts, plus applicable travel costs The return visit surcharge hull be In addition to the
subscription puce of the Service Plan To avoid the s_urchang e, E_ uyer may ship devices to a Physio service depot 6u; er shall be
responsible for round -trip freight fors hip. In s erwl ce
Unscheduled or Uncovered Services. If Etc ;er requests services to be performed on Covered Equipment Winch are not covered
by a Service Ran, or are outsideof designated Services fregtrency or hours, Rlyslo- Control will charge Egger for such services at
C m
10% off Physio- Control's standard rates (Including overte, if appropriate) end, applicable travel charges Repair parts required for
such repairsvnllbe made availablest 1S %offlhe then - current list puce "
Loaners. If Covered Equipment must be removed from service to complete repairs, Physro will provide Buyer vrith a loaner device,
if one Is available Buyer assumes complete responsibility for the loaner and shall return the loaner to Physio In the same condition
as receK ed, nor oral .near and tear exempted, upon the earlier of the return ofth erenhoted Covered Equipin errt or Rbys),gs request
Conce_Ila`lon Buyer may cancel a Ser ice Plan upon s-ty (fie) de;s' vwntten notice to Physio In the &went of such cancellation,
Beyer shall be responsible for tie poiton of the designated price .which corresponds to the portion of tine Service Plan subscription
prior to the effective date of termination and the list-price cost of any preventative msintenance, inspections, or repairs rendered
after the last enrr_iversary date of the s ubscrlption start date
No Soncttation During the Service Plan subscription and for orie (1) year following Its expiration Buyer agrees to not to active,
and intentionally solicit anyone who is employed by Physio to provide services s uch as those described In the Service Plan
Quote Nurnber. 00072387
14C-� ®
� CERTIFICATE OF LIABILITY INSURANCE
DAT 01252017
-THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE_ HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT- CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
_RE_PRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. _
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED; the- policy(ies) must have_ ADDITIONAL INSURED provisions -or be endorsed:
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A'statement on
this certificate does not confer rights to the certificate holderin fieu_of such endorsement(s).
PRODUCER -
Aon Risk Services centrali, Inc_.
Grand Rapids MI'Office
CONTACT
NAME
(616) 456 -5366 FAx (616) 456 -7451
(AIC No E :t) VC No -
E -MAIL -
ADDRESS
50 Louis street NW
Suite 200
INSURER(S) AFFORDING COVERAGE
NAIC #
Grand Rapids MI 49503 USA
INSURED
INSURER A. Old Republic insurance Company _124147
X
strvker Corporation & Subsidiaries
INSURE RB
-
2825 AirvleWiBOulevard
Kal amaZ00 MI 49002 USA
INSURER C
INSURER D -- - - - - - - - - - -
- -
INSURER E
CLAIMS -MADE X❑ OCCUR
INSURER F _
COVERAGES CERTIFICATE NUMBER: 570065353867 REVISION (NUMBER:
d
c
0)
9
m
0
—THIS IS TO- CERTIFY THAT THE POLICIES OF INSURANCE LISTED,BE LOW, HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
EXPIRATION ,DATE-THEREOF, NOTICE WILL BE D_E__L_NE_R_ED_ IN ACCORDANCE WITH THE
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
POLICY PROVISIONS
EXCLUSIONS AND CONDITIONS OF SUCRPOLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS Limits shovm are as requested
AUTHORIZED REPRESENTATIVE
INSR LTR
- _ 'TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
MM/DDIYYYY
MMIDD
_LIMITS _
X
OOMMERCIAL GENERAL LIABILITY
-
MWZY -
EACH OCCUR_ RENCE
$5,000,000
CLAIMS -MADE X❑ OCCUR
_
__$500-' 000
- - -
PREMISES Ea oc`wvenrs -
MED EXP_ Any one person)_
Excluded
PERSONAL&'ADV INJURY
$1;000,000
N
GENT AGGREGATE LIMIT APPLIES PER
GENERAL - AGGREGATE
- $5,000,006
X POLICY ❑ T - LOC
PRODUCTS - COMPIOP AGG
$5,000,000
_
OTHER
A
AUTOMOBILE LIABILITY
MWTB 309916
0.2/01/ 2.01702%01'/2018
COMBINED SINGLE LIMIT
Ea "a'nden
$1,000,000
N
BODILY INJURY ( Per person)
ANY AUTO
Z
BODILY INJURY (Per accident)_
OWNED SCHEDULED
— AUTOS ONLY AUTOS
PROPERTY DAMAGE
- - --
kIREDAUTOS NON -OWNED
-
Pereeudem
ONLY AUTOS ONLY
— - -
-
--
X Phys -Dmge -_Self Ins
'
d
UMBRELLA LIAB
-
OCCUR
EACH OCCURRENCE
-
V
AGGREGATE
EXCESS LIAB
CLAIMS -MADE
D_ED RETENTION
A
WORKERS COMPENSATION AND
MWC 309915 00
02/01 2017
02/0172018
X
PER
STATUTE
OTH-
-
- - - -
EMPLOYERVI UIBWTY
YIN
AOS
EL EACH ACCIDENT -
�_ $1, 000 , 00,0
A
ANY PROPRIETOR / PARTNER I EXECUTIVE
OFFICERIMEMBEREXCLUDED4 �
NIA
MWXS 309917
02/01/2017
02/01/2018
EL DISEASE -EA EMPLOYEE
_ $1,000,000
(Mandatory In NH), "�
Excess we - MI
Ues, desultie under
SCRIPTION OF OPERATIONS below
-
EL DISEASE - POLICY LIMIT
$1,000,000
a
_
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached U more space is rogwmd)
Physio- Control, inc. and its affiliated companies are named under the referenced policy(s).
-
Governmental Entity (Form G- 56015 -B)
City of Gilroy, its officers, officials and employees are included as additional insured (form CG_2026 0413), where required by
written contract, in accordance with the policy provisions of the commercial - general liability policy.
CERTIFICATE HOLDER
61988 -2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION ,DATE-THEREOF, NOTICE WILL BE D_E__L_NE_R_ED_ IN ACCORDANCE WITH THE
POLICY PROVISIONS
City of Gilroy
AUTHORIZED REPRESENTATIVE
Attn: Jennifer Baker
- -
7351 Rosanna-St.
Gilroy CA 95020 USA
/e% Alf- p «% W.V ' QL
61988 -2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD