HomeMy WebLinkAboutAgreement_General_06/08/2017 (6) I kQUES7,,
2017 Str~
FLU RESCUc
New Account/Change Request Form
❑ New Account ❑ New Sbill to ❑ UPdde an Existing AceounwUmound Number.
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Phone No
X(1!�Qf Tet�Lies�Ere-Rescue •,81 DWAKA(N Dilknrd from Corporals Narn )— _.__.....__. _._........_.__.... _..._. ._._._..__.._.._�.......__
Fax No - -....-__._........_._.._-
_ 561 768-0693
of Bculrrsas Please Chsdi ___.__.........__........_._...._..
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Federal Idantlaatlan Nsraber Duns Ntsnber Year Business Established -—_ _--....--.__.._._....__.__......._.__._....._._..
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Sales Tax Statue-Mandatory for apptlpUon ..._.__.........i.»......__._....._...._...........
__....._............_.approval _........_......................
Soles Taxable ❑Saks Tax Exwqt-Attach Resale/Exemption Certificate for each shlp.to stets
Abcourrt In at�ax�&�•�'.� -
Bang Name(M Dffrermd from Corporate Name)
_......__.._..._._._...._--.....................__........_.__.
BillingAddnas ....._._.............._...------........................_...._..._........._.. :..thy--.................................._._................. _....__
sty/ Zip Code
357 T uaata Drew _ Palm Beach Cty.,FL 33469
Shlppinp Namipf Diffirent hum CorPcrete Name)' : ...._._..T.. '!iefa .......................
_........__.-........ �..._._._....._._....
ipping Addrsm-Aliech saoarale sheaf If multlok lontlons ..._. ...._._........._........_..._;........
City i County/ _27p Code
357 Taq State
Drive i
_........__......-.._.__.-_........__. _..._._........_._. Tegtsssta FL
iPhana: ......._..............._._:....�......_..._._._.
Pat Nowrocid Fmc _..__...-__-••-
sai-76"559 b61-766-0693
....._....... -_...........-............................_..._...............y. prtawroekil� laeques org
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Ptxthasln Corded _...........»
Email:
James Trube' 1 561-768-0550 1 561-768-0693
itrubsQlatitiesto.org
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Name(Please attach a copy of your DEA CertNipee MApproabk) TiW
Name(Pkaw attadn a copy of your DEA Csrtlflpte if AppYeabk) ........................ __..._......__..................................
E_AAddl.tlonal Notes:CQ{lttt e nternal Mldals Cbsn 1# ,or;New AccoqWontldrIw A XIgn#WjVjs Re of _fi s -
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By aff tang their signatures,the Undersigned(or if a Corporation,the C
1. As a representative of this orauth officer/Agent)agrees:
arganiz of this hereby sign that I am audtorized to approve Stryker to process a cmdk check
and open a new account on behalf of this organization.
2. To pay all costs of collectlo t,Including a=al otit-of-pocket expenses and collections agency faas.
3. To hifon. Stryker knmedlaMly by written notice of any change In ownership,address,or form of business.
4. The contents and hrtannation on this credit application have not been altered in any way.
5. That the information conhkled heroin is accurate,complete,and true.
+ 6. 1 hereby ackmYarledge that 1 no an authorized signor of this company,and by signing,I ag to the terms a ondkions
listed on the back of this application.
A ha y
eL 9.Cdazo.Print
Name — Custormir Signature Tide to
The signing of this appiicatlon does not guarantee the opening of your account 1 fields must WcQh#leted in their
entirety with all required attachments included or the application will be denied. f J
Return completed forms to CDGO ker.com for approval. /
I.General."Seller"means Stryker Corporation,a Michigan corporation,and/or person,firm or corporation executing an order for goods supplied by Seller
any division or wbsidiary identified on the horn of this ievaice."Buyer'means the (hereinafter"Products•).Seller dull be bound by all terms and conditions of this
Credit Change Application(7/2014)
Last Updated: 1012015
invoice upoo the oecurrraha of any of the following:(a)an order or acceptance is value of any dameged or de&ehive part.THE EXPRESS WARRANTY SET
received flan Beyer in rosperosa to Seller's quotation,or(b)written acceptance of FORTH IN THIS SECTION 6IS THE ONLY WARRANTY APPLCABLE TO
Bayne's order is delivered to Boyer by Shcw,on(c)Seller doll not have leached THE PRODUCTS SOLD SUBJECT TO THESE TERMS AND CONDITIONS
rretftsaf of meh order to Buyer within thirty(30)days after mccipt by Seiler of such AND IS EXPRESSLY IN LIEU OF ANY OTHER WARRANTY BY SELLER,
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order.Then Terms sad condition wain lieu of arid replace any and all teams and EXPRESSED OR IMPLIED,INCLUDING ANY IMPLIED WARRANTY OF
conditions ad forth in my docommh issued by Boyer•Any additional,ddfweK or hMCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOS&
conflicting terms end conditions on any each document lamed by Bayer at any time (b)Stryker will hold Buyer harmlw from and wit indemnify Bayer for any and all
are hereby rejected by nikr and shall not be Lis any wry on Seiler. liability interred resulting directly from a defect in wainnnuhip or design of the
L Prise-(a)Unless otherwise indicated pl ims do not Include,and Bayer is product This indannifieation applies only N the instructions outlined in the
responsible for and no—to pry(mien Bayer steal provide Seller at the time on Isbelurg,manual,and/or iutructione for urn are followed.This indemnification will
order is submitted with an eacroom certificate or other documents sea pptable to not apply to soy liability awing item:(a)an ityury due to the negligence of any
taAing or-atom sudiciltias),all sales,or,value added,eact=and all other person other Ilan an employee or agent of Sbyke;(b)die f rilre of my pera I
federal,state or local or fereiga toes,impel t or cuasoms far and duties associated other than an employee or agent of Stryker to follow any instructions for use of the
with am ceder,however designated,except for Seller's franchise taxes and iota an product or(c)the ism of my product not purchased from Stryltar or product dud
Sends red MOOML If applicable,a separate riage for taxer wilt be shown am ban bee modified,diced er red royal by eery Pesos other than an eanployae or
Sellers invoc e.(b)The price shown an thin invoice is not of discounts provided at agent of Stryker.Buyer will told St
ryker harrrdea from and iadenmify Suylta for
due t®e ofPoarire.Sams of the?radials listed an this invoice may be subject to any dims or tow or tojuria arising now(al(b),or(a)arising¢ism the sus of
rebates or discounts,for whick separate dotammtuim is provided by Shce-Bayer the aegligest sots or omissions of Buyer ar its officers,amplayeas or agents.
most(i)claim the value of erg rebates at discounts in the buyer foal year erred or (c)In two event will Sncykee s liability arising in connection with or under this
the immediddy following fiscal your.(u)prey rapor and appropriately reflect invoice(whether miler the then a of breach of contract,tor;naiuciamen tiea,
discoonts and tebntn io MefiardMedcaid ant rayons and all claims fat payment fraud,warranty,w$igence,strict liability or any other thcay of lac)exceed the
tiled with third party pryera ac ngaired by law or omtrud,and(ui)provide agents pmehan price,correct maid valm or residual value of the Products whichever fs
of the United States or a state agency with access to an information frem Seller lace.BUYER WILL IN NO EVENT BE ENTITLED TO,AND STRYKER WiLL
contouring discounts and rebates ups-q--L(c)Stryker agrees to provide NOT BE LIABLE FOR,DIRECT,INDIRECT,SPECIAL,INCIDENTAL.
tech dal usining,mcbsibil both initial training far now users and mpplemeaw CONSEQUENTIAL OR PUNITIVE DAMAGES OF ANY NATURE,
training fer ehdst ig mass,u needed to p ornate the so*and effective use of the INCLUDING,BUT NOT LIMITED M.LOSS OF PROFIT OR REVENUE.
Produce sold under this Agmem m Such technical burning awl be provided for 7.Fora Malcom Neither Parry to this Agreement will be liable-fa any delay or
my health are practitioner who uses of moods to on the Product and is employed failure of
by,of is on the active medial stafyot the Buyer.I Stryker P tort it the rank of er ise beyond
it evert that avid not
Sfry provide the technical reasonably have been avoided or tut u otherwise beyond its control,provided that
training to a health cue professional.it may pry for or to reimburse the reasonable tie hindered or Party delayed immadiately,sotifla the other Party describing the
expenses,including masts,todgirrg and transportation.actually Inured by eligible circumstances causing delay.Such
recipiouts in connection with the technical training provided under this l disgs-order,
or events llio mrhde,but ewe be
3.PnysentTerws.Unless otherwise' hotted to,tamplisio act of war,riots,cavil diaada.rebellions,flee,flood,
tndieatad,this uewha shall be paid m frill by eatbgoakq explosion,action of the alenherts,acts of Oat,inability to Obtain or
Bayer net dirty(30)days.Any amount not paid on time may be subject to a late shortage of material,equ ipmient or transportation,governmental alders,restriction,
be of 1.5%per month prorated(1 S%per moats),or titre mCthmm incaeet rate priorities err rationing,accidents and strikes,lockouts or other labor troubb or
aflowable by law whichever is the highest Additionally.Buyer may be subject to a shortage.
fee of Fifty Dollars(S50.00)USD for any checits returned unpaid to Seiler for any L Delimit sod Caucdl%daL In the evert of Buyer's defcult in payment for the
erica.in the event an atlotsey is=played or expense is incased to compel Products purchased herennder open the terms and conditions agreed upon with
payment of the invoice or to declare any action or praceedmg is commenced,Bayer Seller,Bayer shag be mspmraible for all reasonable cents and expcoaes(Including
agrees to pay all oats and expense awocia W with collection of urmpaid ems, reasonable,atlamey's fees)incurred by Seller in collection of"sours owing by
including but not limited to amofnay'a fba.Seller,in its sole elsere ion,reserves die Buyer,and Seller alai not be obliveted to make any fbrther deiveries to Bayer.
right to charge tame of payment and/or discontinue hurter shipments,without Should Buyer dad to cancel its order,in whole or in pat Buyer shall be liable b-
PmJudiee b anY other lawthl remedy,until Put due payments are made and Seller for reasonable ancellatiat charges that shall include but not be limfted to at
satisfactory aanwra of Buyw%credit standing is received by Seller. costs and exp mn mooed by Selbr in connection with procuring and filling
4.DeYy sad Tide.Unless otherwise provided an fora oftda invoice, Buyers pnrcbue order.
ver
delivery' we FOB Sellers pled.Delivery shall be deemed to have been node 9.Retares.PmduW rct and by Buyer for credit,replacernent sad/or repair dull
when Buyers shipment has been delivered to a carrier,specified by Buyer on be in accasdelee with the return policy of Seller,a copy of which may be obtained
purchase order equivalent.In the event-that Buyer does not spar the carrier, upon written request to Seller.
the carrier may be at Sellers option.Tide of the Products add haaundar shall pass 10.Compliance with Law;Not For Resale or Export Buyer agrees to comply
to Buyer gone delivery by Sella.However.Boyer hereby agrees that Sutler shell with all applicable laws and regulations of tine various states and of the United
retain a pacbsse money security m1twect in the Products,and to any morcecds from State in the rase of tk Product.Buyer agrees and represents tint it is baying for
the disposition of sad Products,until the purchase price and other charges due its own internal use truly,and not for mule or export
Seller shall have been paid is full.Upon any defauh by Buyer hereunder,Seller 11.General.Excdp1 an provided below,neither Party may assign This Agyeeannt
shall have any and all tights and remedies of secured parry under the Uniformed without the prior wtitoen caused of the other Party,except that Stryker will have
Commend Code which right shall be cumulative. the right to assign this Agreemew or soy rights under or interests in this Agreement
S.leapoetlon and Aeoepfares.Upon raeeipt of the Pradocts,Boyar agree to to any parent;subsidiary or aillitiate of Stryker.All of lire terms and provtalons of
insped cruller tat de;Itodiccts.The Products shall be deemed teaeptd by Boyer this agreement will be binding upon,will lane to the benefit of,ad be enforceable
ustas Buyaprovida Seller a timely wriltea notice speCifially noting any ddJ ft by sacaenore and assigns of the Parties to this Agreement.This Agreement will not
or dinogramin in the quality or quntiry of the Products received.All entices confer any right err comedy upon any p—other then the Parties Ietdo and their
regarding nonoeot'ormiug Pmdocts,shortages,rejection or revocation of acceptance rapccfiw wcamms end pen nial d assigns.Ibis Agreement and doeummt
mast be made in writing and received by Seiler no later ton thirty(30)days flan referred herein constitution the entire agreement:hetweea sire Portia with respect to
do date of Sdkrti invoice,which Buyer-grew is a reasonable time frraa within this anb w muter,VA any Modification or amendments to this Agrameot met be
which to diigmtly inspect and provide notice to Seiler.Buyer waives any right to in writing and signed by both Parties.If my provision of this Agreement is deemed
reject die shipment or revoke acceptance thereafter. illegal,invalid or mhmfaaesble the Pates will asdeavor to replace it by another
i.Wrruttla,Indemnity and Llookotlnns of LlsbtNy. provision ihat will a&cbsdy u Possible reflect their t rigimal retention.No not of
(a)Unions o6wri isa provided in Sellers Price CoWM the Products are waranted remedy conferred in this Agre®an is intended b be exclusive of my other right
firas from maadectaring and material defects for a period of am yew after delivery or romody,and each and every right and seedy will be anmuLtve and in addition
of same.Any Products that become defective during this period thall be re shed or to any other right or remedy given now or existing in law or in equity or by statute.
replaced either at Seger&plant or Buyers locabo r.each determinmpon being at The valiotity,legality and enforceability of thhe ro unining provisions win not in any
Schaub wale diaerebasu AD wanmbw herenmder a s made subject to the proper use wry be atfeeced or impaired paired theroby.IN NO EVENT WILL EITHER PARTY BE
by Buyer to tee upptcation for which such prod sus were intended.The warranty LIABLE(WHETHER ARISING IN CON UCF,TORT,WARRANTY OR
provided heramder does not cover any Products(i)dust have been miscued, OTHERWISE)FOR ANY SPECIAL,INDIRECT.iNCIDEN'TAL.,
modified, oft biAW or repaired without the prior consent of Seler,(ii)that have EXEWLARY,PUNITIVE,OR CONSEQUENTIAL DAMAGES(INC LUDiNG,
boa sabjectod to unusual saes or have not berm IrWerly maintained or(it)on BUT NOT LIMITED TO,LASS OF ANTICIPATED PROFITS.This Agreement
which any original aerial ntmbas or other identification mats have bean removed will be govenad by end construed in accordance with the Ines of the Stan of
or datroys&in say even;Seller's liability shot be limited to the rapk=ncnt Michigan as applicable to contnl on;made and to be perfumed In that ante,without
regard to conflicts of Isere principle.
Credit Change Appkailon(7I2014)
Last Updated; 1012015
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PUBLIC RECORDS. In accordance with Sec. 119.0701, Florida Statutes,
CONTRACTOR must keep and maintain this Agreement and any other
records associated therewith and that are associated with the
performance of the work described in the Proposal or Bid. Upon request
from the Village's custodian of public records,CONTRACTOR must provide
the Village with copies of requested records, or allow such records to be
Inspected or copied,within a reasonable time in accordance with access
and cost requirements of Chapter 119, Florida Statutes, A CONTRACTOR
who fails to provide the public records to the Village,or fails to make them
available for inspection or copying, within a reasonable time may be
subject to attorney's fees and costs pursuant to Sec. 119.0701, Florida
Statutes;and other penalties under Sec.119.10,Florida Statutes. Further,
CONTRACTOR shall ensure that any exempt or confidential records
associated with this Agreement or associated with the performance of the
work described in the Proposal or Bid are not disclosed except as
authorized by law for the duration of the Agreement term, and following
completion of the Agreement if the CONTRACTOR does not transfer the
records to the Village. Finally, upon completion of the Agreement,
CONTRACTOR shall transfer,at no cost to the Village,all public records in
possession of the CONTRACTOR, or keep and maintain public records
required by the Village. If the CONTRACTOR transfers all public records to
the Village upon completion of the Agreement, the CONTRACTOR shall
destroy any duplicate public records that are exempt or confidential and
exempt from public records disclosure requirements. if the CONTRACTOR
keeps and maintains public records upon completion of the Agreement,
the CONTRACTOR shall meet all applicable requirements for retaining
public records. Records that are stored electronically must be provided to
the VILLAGE, upon request from the Village's custodian of public records,
In a format that is compatible with the Village's information technology
systems.
IF CONTRACTOR HAS QUESTIONS REGARDING THE APPLICATION OF
CHAPTER 119,FLORIDA STATUTES,TO CONTRACTOR'S DUTY TO PROVIDE
PUBLIC RECORDS RELATIN(J TO THIS AGREEMENT,PLEASE CONTACT THE
VILLAGE CLERK, RECORDS CUSTODIAN FOR THE VILLAGE; AT(561)768-
0685, OR AT Imcwiliiams teguesta� OR AT 345 TEQUESTA DRIVE,
TEQUESTA,FLORIDA 3SM.