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Home My WebLink About1991-04 Bid Award to Physio Control for EMS Equipment• 1 1 1 RESOLUTION NO. 4-91 A RESOLUTION OF THE VILLAGE COUNCIL OF NORTH PALM BEACH, FLORIDA, ACCEPTING THE BID OF PHYSIO CONTROL, ATLANTA, GA, FOR EKG MONITOR/DEFIBRILLATOR/PACER IN THE AMOUNT OF $8,362.00, FUNDS TO BE EXPENDED FROM ACCOUNT NO. A6416-66490 (MACHINERY & EQUIPMENT). BE IT RESOLVED BY THE VILLAGE COUNCIL OF NORTH PALM BEACH, FLORIDA: Section 1. The bid of Physio Control, Atlanta, Georgia, copy of which is attached to this Resolution, is hereby accepted by the Village of North Palm Beach in accordance with its terms. The appropriate Village officials are hereby directed to advise said bidder of this acceptance. The monies are to be expended as follows: $8,362.00 from Account No. A6416-66490 (Machinery & Equipment). Section 2. This Resolution shall take effect immediately upon passage. PASSED AND ADOPTED THIS 24TH DAY OF JANUARY, 1991. ATTEST: at-4( 4. Village Clerk Mayor PROPOSAL TO THE VILLAGE:OF•NORTH PAI.M.BEACH, FLORIDA Gentlemen: The undersigned, as bidder, does declare that no other person other than the bidder herein named has any interest in this proposal or in the contract to be taken, and that it is made without any connection with any other person or persons making proposal for the same article, and is in all respects fair and without collusion or fraud. The undersigned further declares that he has carefully examined the specifications and is thoroughly familiar with its provisions and with the quality, type and grade of meterial called for. The undersigned further declares that he proposes to furnish the articles called for within specified time set in this proposal for the following price, and guarantees that parts and service for the arti- cles listed below are available within the State of Florida, to wit: DATE: November 29, 1990 MANUFACTURER: PHYSIO-CONTROL MODEL NO: 804200-28 LIFEPAK 10 WITH PACER DELIVERY: 45-60 Days ARO WARRANTY: 2 YEARS PRICE: $ .8,382.00 PRICING INCLUDES: LIFEPAK 10 with pacer - $7,762.50 t-kr,Cd.c_, FASTPATCH Adapter 135.00 PEDI PADDLES 99.00 � q CARRYING CASE 85.50 41e,a./ Pacing Electrodes 180.00 Defib Electrodes N/C Service Cable 100.00 Extended one yr. warranty N/C $8,362.00 -6- 1 SWORN STATEMENT UNDER SECTION 287.133(3)(a), FLORIDA STATUTES ON PUBLIC ENTITY CRIMES THIS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICER AUTHORIZED TO ADMINISTER OATHS. 1. This sworn statement is submitted with Bid, Proposal or Contract No. for Village of North Palm Beach, One (1) EKG Monitor/Defibrillator/Pacer 2. This sworn statement is submitted by PHYSIO-CONTROL CORPORATION (name of entity submitting sworn statement] Pkwy - Cnitn 11 n, Atlanta, GA 30349 whose business address is 1777 Phnpnly and (if applicable) its Federal Employer Identification Number (FEIN) 15 35-0470950 (If the entity has no FEIN, include the Social Security Number of the individual signing this sworn statement: 3. My name is [.inch C.ntmlev and my relationship to the [please print name of Individual signing] entity named above is Sales Administrator II 4. I understand that a 'public entity crime' as defined in Paragraph 287.133(1)(g), Elorida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transaction of business with any public entity or with an agency or political subdivision of any other state or with the United States, including, but not limited to, any bid or contract for goods or services to be provided to any public entity or an agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation. 5. I understand that "convicted' or 'conviction' as defined in Paragraph 287.133(1)(b), Florida Statutes means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a Jury verdict, nonjury trial, or entry of a plea of guilty or nolo contendere. 6. I understand that an 'affiliate as defined in Paragraph 287.133(1)(a), Florida Statutes means: 1. A predecessor or successor of a person convicted of a public entity crime: or 2. An entity under the control of any natural person who is active in the management of the entity and who has been convicted of a publlc entity crime. The term 'affiliate• includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or a pooling of equipment or income among persons when not for fair market value under an arm's length agreement, shall be a prima facie case that one person controls another person. A person who knowingly enters into a Joint venture with a person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an a ffiliate. 7. I understand that a "person' as defined in Paragraph 287.133(1)(e), Florida. Statutes, means any natural person or entity organized under the laws of any state or of the United States with the legal power to enter into a binding contract and which bids or applies to bid on contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "person" includes those officers, directors, executives, panners, shareholders, employees, members, and agents who are active in management of an entity. 8. Based on information and belief, the statement which I have marked below is true in relation to the entity submitting this sworn statement. [Please Indicate which statement applies.] -3a- • X Neither the entity submitting this sworn statement, nor any officers, directors, executives, partners, shareholders, employees, members, or agents who are active in management of the entity, nor any affiliate of the entity have been charged with and convicted of a public entity crime subsequent to July 1, 1989. The entity submitting this sworn statement, or one or more of the officers, directors, executives, partners, shareholders, employees, members, or agents who are active in management of the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989, 8ND (Please indicate which additional statement applies.] There has been a proceeding concerning the conviction before a hearing officer of the State of Florida, Division of Administrative Hearings. The final order entered by the hearing officer did not place the person or affiliate on the convicted vendor list. [Please attach a copy of the final order.] The person or affiliate was placed on the convicted vendor list. There has been a subsequent proceeding before a hearing officer of the State of Florida, Division of Administrative Hearings. The final order entered by the hearing officer determined that it was in the public interest to remove the person or affiliate from the convicted vendor list. [Please attach a copy of the final order,] The person or affiliate has not been placed on the convicted vendor list. (Please describe any action taken by or pending with the Department of General Services.] Date: [signature] Liner rumley November 29, 1990 STATE OF GEORGIA COUNTY OF CL.AYTON PERSONALLY APPEARED BEFORE ME, the undersigned authority, Linda Crumley [name of Individual signing] in the space provided above on this My commission expires: a Notary Public, Henry County, Georgia My Commission Expires Jan. 3,1994 Form PUR 7068 (Rev. 11/89) 29 who, after first being sworn by me, affixed his/her signature day of Novembf9 90 , 4.1 Oti NOTARYfPUBLIC -3b- PROPOSAL TO THE VILLAGE OF NORTH PALM BEACH, FLORIDA Gentlemen: The undersigned, as bidder, does declare that no other person other than the bidder herein named has any interest in this proposal or in the contract to be taken, and that it is made without any connection with any other person or persons making proposal for the same arti- cle, and is in all respects fair and without collusion or fraud. The undersigned further declares that he has carefully examined the specifications and is thoroughly familiar with its provisions and with the quality, type and grade of material called for. The undersigned further declares that he proposes to furnish the articles called for within specified time set in this proposal for the following price, and guarantees that parts and service for the articles listed below are available within the State of Florida, to wit: DATE: . ,3,/1?qD -6- PROPOSAL TO THE VILLAGE OF NORTH PALM. BEACH, FLORIDA (Continue(') REMARKS/EXCEPTIONS: Officers of Corporation or Members of Partnership: NAME TITLE ADDRESS Gilbert W. Anderson • President 11811 Willows Rd.. NL.• Redmond WA 13i11 Hawkins • Vice Pres. • • " " Christine S. Fields Secretary • " Thomas F. Obsitnik Treasurer V. " • le " FIRM: PHYSIO-CONTROL CORPORATION • U9 W1tPORATION 11 PARTNERSHIP 11 INDIVIDUAL SIGNED BY TITLE: WITNESSES: 11,14 (l � • C.rumley / s Administrator- I I / • PHYSIO-CONTROL CORPORATION 1777 Phoenix Pkwy., Suite 110 Atlanta, GA 30349 ADDRESS: PIIYSIO-CONTROL CORPORATION 1777 Phoenix Pkwv., Suite 110 Atlanta. GA 30349 -7- EKG MONITOR/DEFIBRILLATOR/PACER VILLAGE OF NORTH • PALM BEACH:'DECEMBER 5• 1990 MATRX Medical PHYSIO COMBO.MARQUETTE Co. Atlanta Milwaukee ..MENHIR . - Ballentine GA WI . . nFCriktrrnnn Matrix PhyskorControl Marquette i MANUFACTURER Medical LifePak..#10 Electronics,Inc 1 • iv/Parer 9114-0550 804200-28 1500-P MODEL NO. ail/Lois-1 • (battery support) Pending . arstavntx - 1s days-ARO 45-60 days(ARC) FDA approval WARRANTY TOTAL PRICE 2 years 2 years 2 years • • $7,195:00 $8,362.00 • • $17,289.00 Original bid sheet filed in bid folder and • contains gnaturre�of those _resent it opening.- 3:00 P.M. nrto/FRY