Olive View-UCLA Medical Center PO-HO-26007710

NO CHARGE Loan of Empower Laser and Related Equipment for Evaluation at Olive View-UCLA Medical Center

The Olive View-UCLA Medical Center, a public hospital in Sylmar, California, has executed a no-charge purchase order loaning advanced medical equipment from Olympus America, Inc. The loan agreement includes various laser systems and accessories: Empower Laser (PART#: SOLTSTD001, SERIAL#: MDUF190065, quantity 1), SOLTIVE PRO TOWER (PART#: TFL-SLS, SERIAL#: SOLTCART006, quantity 1), SOLTIVE CART TOWER (PART#: TC-L, quantity 1), and one set of UGN Laser accessories with multiple part numbers (#EMP-AFCC, #EMP-AWS, #EMP-ASGG, #EMP-SFB65, #EMP-AIL, #EMP-AHBS, #EMP-AK, #EMP-ASG, #EMP-AHFS2, #EMP-AHPC65US, #TFL-ABS, #TFL-AFSW, #TFL-AIC, #TFL-APCUS). The evaluation term for the equipment is from 12/01/2025 to 12/06/2025, and the equipment will be installed and operated at Surgery Room 3B101 within the Olive View-UCLA Medical Center premises. Olympus America, Inc. is the vendor providing the equipment, with Diana Svete as the vendor contact. Internal contacts at the hospital include Amandeep Ghotra and Chad Hazard. This transaction is classified as non-capital asset equipment and is a loan for evaluation purposes only, with zero dollar amount obligated or awarded.

Description

NO CHARGE PO - LOAN EQUIPMENT FOR EVALUATION PURPOSES ONLY PER ATTACHED LOAN AGREEMENT. -Empower Laser PART#: SOLTSTD001 SERIAL#: MDUF190065 QTY: 1 EACH -SOLTIVE PRO TOWER PART#: TFL-SLS SERIAL#: SOLTCART006 QTY: 1 EACH -SOLTIVE CART TOWER PART#: TC-L QTY: 1 EACH -1 EACH UGN LASER Accessory: #EMP-AFCC #EMP-AWS #EMP-ASGG #EMP-SFB65 #EMP-AIL #EMP-AHBS #EMP-AK #EMP-ASG #EMP-AHFS2 #EMP-AHPC65US #TFL-ABS #TFL-AFSW #TFL-AIC #TFL-APCUS EVALUATION TERM: 12/01/2025 - 12/06/2025 EQUIPMENT SHALL BE INSTALLED AND OPERATED AT: OLIVE VIEW-UCLA MEDICAL CTR SURGERY RM 3B101 14445 OLIVE VIEW DR SYLMAR CA 91342 VENDOR CONTACT: Diana Svete (805) 901-9754 diana.svete@olympus.com CUSTOMER CONTACTS: Amandeep Ghotra (747) 210-4516 AGhotra@dhs.lacounty.gov Chad Hazard (323) 388-3575 E-mail: chazard@dhs.lacounty.gov =============================================== FOR INTERNAL USE ONLY: DEPT Buyer: Graciela Santos REF. RQN #: RQN-HO-26016854 IRIS REQ #: 484-26174 FUND UNIT: 74211 REQUESTER: Aman Ghotra CUSTODIAN UNIT: : Surgery Dept WAREHOUSE USE ONLY: NON-CAPITAL ASSET EQUIPMENT ===============================================