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Proposal 20283FA 4/3/2018 solely Amount Company on be Annual $11,450 Electric ID: expires imaging will General Service Quote Quote your terms 8AM- AM for and MON-FRI, COVERAGE 4-Hours MON-FRI, 10:30 Day 2 of 1 Imaging quote pricing NO Time: Support Next Updates 97% Page preliminary Final Features Weekdays: Weekend: 30 HOURS/DAYS: Included, Quality Response Phone Line Commitment Diagnostic a offerings. Coverage Coverage OnsIte Response: Coverage Parts: and Answer is rvice FE 9PM FE FIRS FE iCenter InSite InSite/Tech PM 8AM-9PM Repair LST-GDXR Software TiP Uptime following • • • • • • • • • • • Se The proposed MIN. SUPPLY WF: needs. 30 20283fa, the TIME: POWER service of Options DEVICES DETECTOR 550212066423 description RESPONSE COVERAGE UNINTERRUPTED WORKSTATION Imaging INCLUDED: IUNQ TABLE EXCLUDED: PERIPHERAL Printers TUBE WIRELESS Q20189116, general • • • • • • • • Health Diagnostic eP820180122, a your only Offering AssurePoint Standard - Public of contains 2018.02.02 all of of for and Effective Date of End Warranty through Months End System Warranty you 60 After with purposes 1-0 Department partnering Agreement. XR XR646 P41) budgetary GE OPTIMA (X#7 Confidential about for executed I and County excited is an ADD POS Proprietary is quote in Healthcare The - TBD1 TBD Company Maricopa Healthcare contained Equipment Identifiers LC): Acct GE equipment. Loc GE GE those iSystem XR646 Phy 20283FA Amount Company Proposal $10,000 $21,450 Electric ID: Annual General Service Quote SAM- to Due 10:30 AM Loss, 10:30 MON-FRI, COVERAGE 4-Hours Day MON-FR1, Day Theft, 2 of 2 Imaging NO Time: Support Replacements Next Next Abuse, Updates 97% Page Features Weekdays: Weekend: Included, HOURS/DAYS: Included, to Due Quality Response Phone Unlimited &Tear Line Commitment Diagnostic Coverage Coverage Onsite 01: Wear Shipping: LST-GENERAL Coverage Parts: Replacements Excluded and Answer FE 5PM FE HRS FE iCenter InSite/Tech Note Normal Parts PM RAM-9PM Repair LST-GDXR Fire: Software TIP Uptirne • • • • • • • AM • • • • • • WF: COVERAGE accidental 20283fa, Included per Options REPLACEMENT Coverage: $5,000 550212066423 pays Replacement INCLUDED: BATTERY Detector (customer Grid Q20180115, • • drop) • eP520180112, .0ffering . . AssurePoint Complete - 2018.02.02 Effectiv e .. .oate..: of End Warranty through Months of End System Warranty 60 After Digital Detector .Equipment XR GE - 1X#OD7A1 FlashPad Wireless Confidentiol ; : and Type ADD POS Proprietary Trans Healthcare . - TBD1 TBD Company :Equipment Identifiers ID: Acct GE System Loc TOTAL GE FP1 Phy Date: 06-28-2018 Quote #: PR1-C127098 Version #: 5 Q-Exp-Date: 09-19-2018 GE Healthcare Issued By: Customer Address: Attention: GE Healthcare Maricopa County Department of Public Mr. Angelito Bravo FEIN: 14-0689340 Health Program Manager # TB and Refugee 1645 [Roosevelt St Phoenix AZ 85006-3638 The terms of the Master Purchasing Agreement, Strategic Alliance Agreement or GPO Agreement referenced below as the Governing Agreement shall govern this Quotation. No additional or different terms shall apply unless agreed to in writing by authorized representatives of both parties. Governing Agreement: Novation - Vizient Supply LLC Customer Number: 1-240D8X Terms of Delivery: FOB Destination Billing Terms: 80% delivery / 20% Installation Payment Terms: Net Due in 45 Days Total Quote Net Selling Price: $274,191.80 Sales And Use Tax Status: No Exemption Certificate on File " The following ship to states do not impose a sales/use tax (AK, DE, MT, NH, OR). No exemption certificate required. NDICATE FORM OF PAYMENT: If "GE HEE Loan" or "GE HEF Lease" is NOT selected at the lime of signature, then you may NOT elect to seek financing with GE Healthcare Equipment Finance (GE HEF) to fund this arrangement after shipment. Cash/Third Party Loan/Check GE HEF Loan GE HEF Lease Third Party Lease(please identify financing company) By signing below, each party certifies that it has not made any handwritten modifications. Manual changes or mark-ups on this Agreement (except signatures in the signature blocks and an indication in the form of payment section below) will be void. Each party has caused this agreement to be executed by its duly authorized representative as of the date set forth below. CUSTOMER GE HEALTHCARE Scott Fin kelmeyer 06-28-2018 Authorized Customer Signature Dote Signature Date Print Name Print Title Senior Account Manager Email: scott.finkelmeyer©ge.com Purchase Order Number (If applicable) Mobile: +1 480 521 5832 1/8 GE Healthcare Confidential and Proprietary General Electric Company, GE Healthcare Division Date: 06-28-201B Quote #: PR1-C127098 Version #: 5 Q-Exp-Date: 09-19-2018 GE Healthcare Total Quote Selling Price $279,191.80 Trade-In and Other Credits $5000.00 Total Quote Net Selling Price $274,191.80 To Accept this Quotation Payment Instructions Please sign and return this Quotation together with Please Remit Payment for invoices associated your Purchase Order To: with this quotation to: Scott Finkelmeyer Mobile: +1 480 521 5832 GE Healthcare Email: scott.finkelmeyer@ge.com P.O. Box 96483 Chicago, IL 60693 To Accept This Quotation • Please sign the quote and any included attachments (where requested, • If requested, please indicate, your form of payment. • If you include the purchase order, please make sure it references the following information • The correct Quote number and version number above • The correct Remit To information as indicated in "Payment Instructions" above • The correct SHIP TO site name and address • The correct BILL TO site name and address • The correct Total Quote Net Selling Price as indicated above Upon submission of a purchase order in response to this quotation, GE Healthcare requests the following to evidence agreement to contract terms. Signature page on (quote filled out with signature and P.O. number. ***************...**.fr.****0 ,C1-* WA.****************************. Verbiage on the purchase order must stole one af the following: Li) Per the terms of Quotation # ; 011 Per the terms of GPO# (ill Per the terms of MPA or NI Per the terms of SAA # Include the applicable quote/agreement number with the reference on the purchase order In addition, source of funds Ichoice of: Cash/Third Party Loan or GE HEF Lease or GE FIEF Loon or Third Party Lease through I, must be indicated, which may be done on the quote signature page (for signed quotesl, on the purchase order Cwhere quotes are not signed] or via a separate written source of funds statement lif provided by GE HealthcareL" 2/8 GE Healthcare Confidential and Proprietary General Electric Company, GE Healthcare Division Date: 06-28-2018 Quote #: PR1-C127098 Version #: 5 Q-Exp-Date: 09-19-2018 GE Healthcare 06-28-2018 GPO Agreement Reference Information Customer: Mr. Angelito Bravo Contract Number: PLEASE SEE NOVATION CONTRACT # BELOW Start Date: End Date: 12/31/2021 Biffing Terms: 80% delivery / 20% Installation Payment Terms: Net Due in 45 Dogs Shipping Terms: FOB Destination This product offering is made per the terms and conditions of Novation/GE Healthcare GPO Agreement # XR0380 (RAD/R and F) and XR0342 (MAM MO). For access to the applicable Novation Agreement and Contract Summary, please login to the Novation Marketplace website. If you require assistance or are experiencing issues please contact one of the following for support: Novation Customer Service l888) 7-NOVATE NOVCustomerService@novationco.com Web Site Technical Support (8001327-8116 NovationTechSupoort@novationco,com 3/8 GE Healthcare Confidential and Proprietary General Electric Company, GE Healthcare Division Date: 06-28-2018 Quote #: PR1-C127098 Version #: Q-Exp-Date 09-19-2018 GE Healthcare Item No, Qtg Catalog No. Description Optima XR646 WS0 1 1 S1204..V XR646 1D BASE W 6:1 GRID Digital RAD 1 Detector Base System • System PC • Auto Detector Tracking • Systems Cabinet • Tissue Equalization • Window/Level, Smart Windowing, Zoom/Roam, Contrast Invert • Intelligent Collimator Edge Detection • Patient Edit! Image Foldering • Patient Management Via HIS/RIS Connectivity • Calculated Dose information • DICOM Connectivity, HIPAA, M PPS • Ethernet Network Link DICOM 3.0 Compliant • DICOM Patient Orientation Quality Assurance (QAPI with QAP Phantom • Broadband Connectivity for InSite • Multilingual Operator Manual • TIB Box Kit • Wireless Digital Detector (Qtg. 1) • Batterg with Cap (Qtg, 2) • Battery Charger(Qtg. 1) • Medium Tether (Qty. 1) • Overhead Tube Suspension 6:1 Clip on Grid Wireless DR detector snap on grid • 130cm (51in) focus grid • 6:1 ratio, 70 lines/cm 2 1 S1200WT Required Language Labels Required Sustem Language Labels - English 3 1 S1201KA 65kW High Frequency Generator 65kW High Frequency Generator, 50 or 50Hz The high frequency 65kW power unit is designed for radiographic applications and utilizes microprocessor controlled power 4/8 GE Healthcare Confidential and Proprietary General Electric Compang, GE Healthcare Division Date: 06-28-2018 Quote #: PR1-C127098 Version #: 5 Q-Exp-Date: 09-19-2018 GE Healthcare Item No, Qty Catalog No. Description and parameter adjustment Specifications: • 800 mA at 80 kVp • 630 rnA at 100 kVp Input Power: 360-480VAC, 3 Phase, 60Hz kVp Range: 40-150 kVp, 1 kVp increments kVp Accuracy; 3% +/-2 kVp mA Range: • Small Focal Spot: 10-320mA • Large Focal Spot: 160-800mA 4 1 S39262JP Table Top FlashPad Lateral Detector Holder Table Top Lateral Detector Holder Wireless DR detector holder, designed specifically for GE, secures the detector in a vertical position on the tabletop for cross-table imaging. 5 1 51700JM Portable Carbon Fiber Table with Fixed Top Portable Carbon Fiber Table with Fixed Top Table - Fixed Height Carbon Fiber Top • Table top 25.6 x 86.6 in. 165 x 220 cm) • Useful imaging area 25.6 x 76.4 in. (65 x 19.4 cm) • Table top height from the floor 27.6 in. 170 cm) • Table weight 66.1 lbs (30kg) • Patient weight limit 441 lbs. (200kg) 6 1 S1204JL XR646 E WSTND W 3 GRIDS Extended length wallstord 100 cm Focus Wallstand Grid (Additional) - 100 cm (40 inch) focus - 13:1 ratio, 70 lines/cm 180 cm Focus Wollstand Grid (Additional) - 180 cm (72 inch) focus Wadstand Grid - 13:1 ratio, 70 lines/cm VVallstand Mid-Range Crosstoble Grid - 130 cm (51 inch) focus - 10;1 ratio, 70 lines/cm - Used for SID ranges from 90 to 190 cm 1 S1200YR Grid Holder Assembly 5/8 GE Healthcare Confidential and Proprietary General Electric Company, GE Healthcare Division Dote: 06-28-2018 Quote #: PR1-C127098 Version #: 5 Q-Exp-Dcite: 09-19-2018 GE Healthcare Item No. OW Catalog No, Description Grid Holder Assembly • Extra Wall Mounting Grid Holder for up to 4 Grids 8 1 51200TZ Infrared Remote Infrared Remote Control The infrared remote optionally allows remote control of several system features (e.g., collimator light, FOV selection, wallstand and OTS motorization), 9 1 S1201KK Repeat and Reject Analysis Repeat and Reject Analysis The Repeat and Reject Analysis IRRA) software package is a quality control (0C) application available that allows for repeat or reject images to be captured and categorized by technologist. It is designed to help track and analyze the X-ray repeat rate • The easy-to-use operator interface helps technologists classify each image they reject and to select a specific reason for the repeat /image rejection. • RRA can be a helpful teaching tool because it includes links to actual JPEGs of the rejected images to help the user analyze why the image was rejected. • The RRA application tracks the rejected image data by operator, exam type, date and reason code. • Reports can be exported in DVD, CD or USB format for ease of use. 10 1 51201KM Auto Protocol Assist Auto Protocol Assist Auto-Protocol Assist - the system will automatically transition directly to the Acquire screen when the protocol code downloaded from the HIS/R1S (automatically performed with worklist refresh) matches the exam code contained in the protocol database. This tool eliminates the user steps required to select patient exam types and initiate an exam, 11 1 539212UP UPS Uninterrupted Power Supply 6/8 GE Healthcare Confidential and Proprietary General Electric Company, GE HeaSthcare Division Date: 06-28-2018 Quote #: P81-C127098 Version #: 5 Q-Exp-Date: 09-19-2018 GE Heafthca re item No. Qty Catalog No, Description 12 1 S1205KE XR646 TECH PUB MANUALS XR646 Technical manuals 13 1 S1201KR PATIENT ORI-TAG PERMANENT PO TAG REMOVE PERMANENT 14 1 S1200YJ Mid-Range 130cm Focus Grid Mid-Range Wallstand Grid - 130 cm151 inch) focus - 10:1 ratio, 70 lines/cm - Used for SID ranges from 90 to 190 CM 15 1 E4502ST 25 KAIC X-Ray Main Disconnect Panel 80 Amp, 480 V / 208 V 25 KAIC X-Ray Main Disconnect Panel 80 Amp, 480 V / 208 V FEATURES/BENEFITS • Serves as the main power disconnect between the X-Ray system and the facility 480V or 208V power source • Provides emergency shut down, undervoltage protection and overcurrent protection for the X-Ray power distribution cabinet • Standardized design provides a platform for future upgrades of the system • Offers a number of advantages by combining a variety of individual components into a single pre-engineered and factory tested panel • UL and cUL listed for compliance with NEC Article 100 and Article 110-3 • Remote emergency off pushbutton located by X-Ray control provides immediate shut down of the entire system to comply with NEC required disconnecting means • Surface or semi-flush mounting SPECIFICATIONS • Dimensions (H x W x D): 48" x 20" x 6.68' 1 • Weight: 80 lbs. • Mounting: via keyhole slots: Width is 16" on centers, Height is 455r centers COMPATIBILITY • GE Three Phase X-Ray generators NOTES: • Customer is responsible for rigging and arranging for installation with a certified 7/8 GE Healthcare Confidential and Proprietary General Electric Company, GE Healthcare Division Date: 06-28-2018 Quote #: PR1-C127098 Version #: 5 Q-Exp-Date: 09-19-2018 GE Healthcare Itern No. Qty Catalog No. Description electrician • ITEM IS NON-RETURNABLE AND NON-REFUNDABLE 16 1 W0004RA X-ray Training, 4 Consecutive Days Onsite X-ray TIP Training, 4 Consecutive Days Onsite Four Days X-ray Onsite Training provided from 8AM to 5PM, Monday through Friday. Includes Ta expenses. Days provided consecutively. This training program must be scheduled and completed within 12 months after the date of product delivery. 17 1 539212KY WALLSTAND CABLE SELECT Connection cables for the wallstand 18 1 S39232KZ Table cable select Table cable select 19 1 S1204BJ 3M OTS BRIDGE OPTIMA 3M OTS BRIDGE 20 1 S2103MF OPTIMA 3M OTS BRIDGE CABL OPTIMA 3M OTS BRIDGE CABLE 21 1 S2104JC 4M OTS RAIL 4M OTS Rail Select 1 NonProducts 22 1 60 Months Of Service Quote Summary: XRd Trade In ($5,000.00) Total Quote Net Selling Price $274,191.80 IQuoted prices do not reflect state and local taxes if applicable. Total Net Selling Price Includes Trade In allowance, if applicable. I 818 GE Healthcare Confidential and Proprietary General Electric Company, GE Healthcare Divisbn