33-22 Exhibit B-Zoll.pdf

ZOLL Medical Corporation 269 Mill Road Chelmsford, MA 01824-4105 @ Federal ID# 04-2711626 Phone: (800) 348-9011 Fax: (978) 421-0015 st O1 Fire D ‘tment West Orange Fire Department Email: esales@zoll.com Quote No: Q-14656 4, To place an order, please forward the purchase order with a copy of this quotation to esales@zoll.com or via fax to 978-421-0015. 5. All discounts from list price are contingent upon payment within the agreed upon terms. 6, Place your future accessory orders online by visiting www.zollwebstore.com. Order Information (to be completed by the customer) [ ] Tax Exempt Entity (Tax Exempt Certificate must be provided to ZOLL) [ | Taxable Entity (Applicable tax will be applied at time of Invoice) BILL TO ADDRESS SHIP TO ADDRESS. Name/Department: Name/Department: Address: Address: City / State / Zip Code: City / State / Zip Code: Is a Purchase Order (PO) required for the purchase and/or payment of the products listed on this quotation? [ ] Yes PO Number: PO Amount: (A copy of the Purchase Order must be included with this Quote when returned to ZOLL) [ ] No (Please complete the below section when submitting this order) For organizations that do not require a PO, ZOLL requires written execution of this order. The person signing below represents and warrants that she or he has the authority to bind the party for which he or she is signing to the terms and prices in this quotation West Orange Fire Department Authorized Signature: Name: Title: Date: Page 2of2