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PRICE COST SCHEDULE (PRICING TEMPLATE)
For (Natus Medical Incorporated) Nerve Conduction Studies (NCS) / Electromyograph (EMG) Neurodiagnostic Systems
· Three (3) Natus UltraPro S100 Nerve Conduction Studies (NCS)/ Electromyograph (EMG) Neurodiagnostic Systems including a computer, control panel, Natus Elite Software, 4 channel amplifier, stimulus probe, NCS, EMG, UB3 cart, monitor arm, amplifier holder and arm, 115V Isobox, and 21.5” LCD monitor (for all three (3) systems)
· One (1) HL7 EMG interface with implementation labor
· One (1) EMG reader software
· Three (3) EMG workstation licenses.
The specific items, equipment, systems, and accessory break downs for the items referenced above is listed below.
SYS 1: MOD UltraPro S100 - Next Generation
Part Number
Description
Qty
Amount
| US-CONFIG |
| US Configuration |
| 1 |
| 982A0594 |
| UltraPro S100 US / Canada + Base Unit |
| 1 |
| 033100 |
| UltraPro S100 Windows 10 Desktop PC |
| 1 |
| 842-678300 |
| North AMERICAN POWER CORD |
| 1 |
| 033416 |
| Natus Elite Software - Viking |
| 1 |
| 9031UP742 |
| UltraPro S100 4 Channel Amplifier |
| 1 |
| 9031E0172 |
| Natus Stimulus Probe |
| 1 |
| 022330 |
| UltraPro UB3 Cart |
| 1 |
| 842-688300 |
| UB3 Monitor Arm Option |
| 1 |
| 022346 |
| Natus Amplifier Holder & Arm - UB3 Cart |
| 1 |
| 842-695200 |
| UltraPro S100 115V Isobox |
| 1 |
| 842-664600 |
| 21.5 Inch LCD Monitor |
| 1 |
Totals for this system
SYS 2: MOD UltraPro S100 - Next Generation
| US-CONFIG |
| US Configuration |
| 1 |
| 982A0594 |
| UltraPro S100 US / Canada + Base Unit |
| 1 |
| 033100 |
| UltraPro S100 Windows 10 Desktop PC |
| 1 |
| 842-678300 |
| North AMERICAN POWER CORD |
| 1 |
| 033416 |
| Natus Elite Software - Viking |
| 1 |
| 9031UP742 |
| UltraPro S100 4 Channel Amplifier |
| 1 |
| 9031E0172 |
| Natus Stimulus Probe |
| 1 |
| 022330 |
| UltraPro UB3 Cart |
| 1 |
| 842-688300 |
| UB3 Monitor Arm Option |
| 1 |
| 022346 |
| Natus Amplifier Holder & Arm - UB3 Cart |
| 1 |
| 842-695200 |
| UltraPro S100 115V Isobox |
| 1 |
| 842-664600 |
| 21.5 Inch LCD Monitor |
| 1 |
Totals for this system
SYS 3: MOD UltraPro S100 - Next Generation
| Part Number |
| Description |
| Qty |
| Amount Price |
| US-CONFIG |
| US Configuration |
| 1 |
| 982A0594 |
| UltraPro S100 US / Canada + Base Unit |
| 1 |
| 033100 |
| UltraPro S100 Windows 10 Desktop PC |
| 1 |
| 842-678300 |
| North AMERICAN POWER CORD |
| 1 |
| 033416 |
| Natus Elite Software - Viking |
| 1 |
| 9031UP742 |
| UltraPro S100 4 Channel Amplifier |
| 1 |
| 9031E0172 |
| Natus Stimulus Probe |
| 1 |
| 022330 |
| UltraPro UB3 Cart |
| 1 |
| 842-688300 |
| UB3 Monitor Arm Option |
| 1 |
| 022346 |
| Natus Amplifier Holder & Arm - UB3 Cart |
| 1 |
| 842-695200 |
| UltraPro S100 115V Isobox |
| 1 |
| 842-664600 |
| 21.5 Inch LCD Monitor |
| 1 |
Totals for this system
SYS 4: HL7 EMG Basic Interface
| 018853 |
| HL7 EMG Basic Interface |
| 1 |
| 018855 |
| HL7 EMG Workstation License |
| 3 |
| 018859 |
| HL7 EMG Implementation Labor - Advanced |
| 1 |
| 828-069700 |
| EMG Reader Software |
| 1 |
Totals for this system
SYS 5: Installation Included
Amount Price
SVC800INSTALL_
INC
SVC800TRAIN_
INC
| 019927 |
| Customer location additional Training 1- day - EMG |
| 1 |
Totals for this system
System Totals
Reference Number
Grand Total Amounts
| SYST 1 |
| MOD UltraPro S100 - Next Generation |
| SYST 2 |
| MOD UltraPro S100 - Next Generation |
| SYST 3 |
| MOD UltraPro S100 - Next Generation |
SYST 4
HL7 EMG Basic Interface HL7 EMG Workstation License HL7 EMG Implementation Labor - Advance EMG Reader Software
SYST 5
Installation Training Customer location additional Training 1-da
Grand Total (All Systems, All Items)
