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DocuSign Envelope ID: BA4A68D9-A6AC-48D0-A9C1-D50BFBB7B826 <br /> PHYSIO-CONTROL, INC. <br /> TECHNICAL SERVICE SUPPORT AGREEMENT <br /> SCHEDULE A <br /> Contract Number: <br /> Servicing Rep: Lane Rushing,EAAA60 <br /> District: MID-ATLANTIC <br /> Phone: <br /> FAX: 800-772-3340 <br /> Equipment Location: ORANGE CTY EMERGENCY MEDICAL,00300503 <br /> SERVICES <br /> 510 MEADOWLAND DR <br /> HILLSBOROUGH,NC 27278 <br /> Scope Of Service On Site Preventative Maintenance w Lithium Battery <br /> Ref. Effective Expiration Total <br /> Model Part Number Serial Number Line Date Date Inspections <br /> LIFLPAK®500 3011790-000113 13161560 29 7/1/2015 6/30/2016 1 <br /> LIFLPAK®500 3011790-000113 13161565 30 7/1/2015 6/30/2016 1 <br /> LIFLPAK®500 3011790-000113 13161566 31 7/1/2015 6/30/2016 1 <br /> LIFLPAK®500 3011790-001129 33125847 32 7/1/2015 6/30/2016 1 <br /> LIFLPAK®500 3011790-001129 33125848 33 7/1/2015 6/30/2016 1 <br /> LIFLPAK®500 3011790-001129 33125844 34 7/1/2015 6/30/2016 1 <br /> LIFLPAK®500 3011790-001129 30811669 35 7/1/2015 6/30/2016 1 <br /> LIFLPAK®500 3011790-001502 34675973 36 7/1/2015 6/30/2016 1 <br /> LIFLPAK®500 3011790-001129 33127342 43 7/1/2015 6/30/2016 1 <br /> Equipment Location: CHAPEL HILL FD, 13903401 <br /> 403 MLK JR BLVD <br /> CHAPEL HILL,NC 27514 <br /> Scope Of Service On Site Preventative Maintenance <br /> Ref. Effective Expiration Total <br /> Model Part Number Serial Number Line Date Date Inspections <br /> LIFLPAK 91000 320371500229 39382900 24 7/1/2015 6/30/2016 1 <br /> LIFLPAK 91000 320371500229 40696107 25 7/1/2015 6/30/2016 1 <br /> LIFLPAK 91000 320371500229 41554092 26 7/1/2015 6/30/2016 1 <br /> LIFLPAK 91000 320371500401 42457794 27 7/1/2015 6/30/2016 1 <br /> LIFLPAK 91000 320371500568 42819853 28 7/1/2015 6/30/2016 1 <br /> LIFLPAK 91000 320371500023 37351831 1 7/1/2015 6/30/2016 1 <br /> LIFLPAK 91000 320371500093 37881608 2 7/1/2015 6/30/2016 1 <br /> LIFLPAK 91000 320371500229 38560716 3 7/1/2015 6/30/2016 1 <br /> LIFLPAK 91000 320371500229 39389844 18 7/1/2015 6/30/2016 1 <br /> LIFLPAK 91000 320371500229 39389843 19 7/1/2015 6/30/2016 1 <br /> Reference Number: SC-1581 Renewal <br /> Printed: 6/9/2015 Page 4 of 9 <br />