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<br /> QUOTE DATE QUOTE NUMBER PAGE <br />ePHILIPS 04/13/2011 2300175992 4/7 <br />LAST UPDATED TIME <br /> 04/1312011 17:51 :33 <br />Philips Healthcare EXPIRATION DATE INCOTERMS <br />3000 Minuteman Road,MS04OO <br />Andover, MA 0181()..1099 04126/2011 FOB destination <br /> FORMAL QUOTE <br /> UNIT OF UNIT AMOUNT TOTAL AMOUNT <br />ITEM PRODUCT DESCRIPTION QUANTITY MEASURE (USD) (USD) <br />Philips will work with the customers staff to reduce the downtime during <br />the system transition. <br />. <br />. <br />Products are for USA end-use only. Taxes. if applicable. are not <br />Included unless noted but will be added to the invoice. The Purchase <br />Order must reference the Quote Number and your Purchase Agreement. <br />Please Indicate your requested delivery date and your preference. if <br />any, to accept and pay for partial shipments. If this quote includes <br />Value-Added Services, they may be invoiced separately. Additional sold <br />training must be completed within twelve months of <br />deliverylinstallation. System cabling, if included, is specified at the <br />standard grade unless noted otherwise. <br />. <br />This quote specifically excludes Licensing & Permit Fees, Prevailing <br />Wage Compensation and Union Labor. <br />. <br />IMPORTANT NOTICE: Health cere providers are reminded that if the <br />transactions herein include or involve a loan or a discount (including a <br />rebate or other price reduction), they must fully and accurately report <br />such loan or discount on cost reports or other applicable reports or <br />claims for payment submitted under any federal or state health care <br />program, including but not limited to Medicere and Medicaid, such as may <br />be required by state or federal law, including but not limited to 42 CFR <br />1001.952(h). <br />. <br />If you do not issue formal purchase orders indicate by initialing <br />here <br />. <br />. <br />. <br />Tax Status: Taxable Tax Exempt <br />. <br />If Exempt, please indicate the Exemption Certification <br />Number: , and attach a copy of the certificate. <br />. <br />. <br />. <br />Delivery/lnstallatlon Address: <br />. <br />. <br />. <br />