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DocuSign Envelope ID:626CADB8-lD9F-499D-BB9E-85CF9853E35A
<br /> ZOLL Data Systems,Inc. Order No:0001.2406
<br /> Order Form Addendum
<br /> This Order Form is entered into as of September 1,2015(the"Effective Date"),executed subject to and made a part of that certain Master
<br /> Software License Agreement between ZOLL Data Systems,Inc.("ZOLL")and Orange County Emergency Services("Customer")(the"'MSLA")
<br /> previously executed.Unless explicitly stated otherwise in this Order Form,any capitalized terms shall have the meaning given to them in the MSLA.
<br /> Bill To: Orange County Emergency Services Ship To: Orange County Emergency Services
<br /> 510 Meadowlands Drive Attn:Felicia Williams, i�
<br /> fwilliams co.orange.Ile.LIS
<br /> Hillsborough,NC 27278 510 Meadowlands Drive
<br /> Iillsborough,NC 27278
<br /> Shipping:
<br /> Territory Manager: Edie Morales Expires: September 30,2015
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<br /> Annual
<br /> Item License Description Qty List Price Disc. Adj.Price Ext.Price Maint.
<br /> STECM PL Patient Invoice-Single Trip ECM 1 $3,000.00 15% $2,550.00 $2,550.00 $600.00
<br /> Comments:Trizetto SUBTOTAL SOFTWARE: $2,550.00
<br /> SUBTOTAL PROFESSIONAL,SERVICES:
<br /> TOTAL: $2,550.00
<br /> ANNUAL MAINTENANCE: $600.00
<br /> Payment Terms: The TOTAL amount specified above in this Order Form is due within 30 days of ZOLL's invoice for such amounts.
<br /> Maintenance Fees:Maintenance Fees specified in this Order Form will be prorated up to the next maintenance billing cycle and included as a line
<br /> itern in the invoice issued in connection with this Order Form.
<br /> Service Fees: Service Fees are specified in each SOW. Customer will also reimburse ZOLL for all reasonable out-of-pocket expenses(including
<br /> travel and accommodation expenses)incurred by ZOLL in providing the Services.
<br /> Scope of License: Software is licensed based upon the License Type and quantity purchased,as more particularly set forth above and in the attached
<br /> License Description Addendum.
<br /> Tax Exempt Status: If Customer is tax exempt or pays state taxes directly,then prior to invoicing,Customer must provide ZOLL with a copy of a
<br /> current tax exemption certificate issued by Customer's state taxing authority for the given jurisdiction.
<br /> The person signing below represents and warrants that she or he has the authority to bind Customer to the terms of this Order Fonn. By signing
<br /> below,the parties agree to the terns and conditions of this Order Form. Once sided,any reproduction of this Order Form,or any attachment or
<br /> exhibit hereto,made by reliable means(for example,photocopy or facsimile)is considered an original and all Software,Services and Maintenance
<br /> Services ordered and provided under this Order Form are subject to the terns of the MSLA.
<br /> ZOLL Data Systems,Inc. Orange County Emergency Services
<br /> S E-
<br /> sandy ttSbrL%Igned by:D68AD773926rar.King Bonnie Hammersley
<br /> Name: Name:
<br /> Title: Accounting operations Manager _ Title: county Manager
<br /> ...........-- .._...
<br /> Date: Date: 10/7/2015
<br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act.
<br /> DocuSigned by:
<br /> �� maw
<br /> 232DFFC2CFA847B...
<br /> Paul Laughton
<br /> Interim Finance Director
<br /> 10/4/2015 Ft�
<br /> Page I oft Customer Initials:
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