I am pleased to present you with this proposal for Radiological/Health Physics services.

Bio-Med Associates will perform a Radiographic and or Fluoroscopic QC Survey on your equipment in full compliance with all State and FDA regulations. This will assure that the equipment complies with all radiation safety regulations, and equipment performance specifications and regulations. Measurements of radiation levels will be made inside and outside the room (if necessary), as well as measurements of all regulated machine parameters including kVp, mAs, focal spot size, radiation output, collimator alignment, phototimer reproducibility, etc.

General radiographic equipment can usually be completed in four hours; multiple tubes will require additional time. This estimate includes the medical physics requirements specified in the NJ Quality Assurance regulations (N.J.A.C. 7:28-22). To establish a new QA program an additional two to four hours may be required, depending on the level of training required by your staff. Please review the attached QA equipment you will need to implement the program. Please contact us if you have questions. A copy of the most recent radiation protection survey must be available for review. Additional visits may be necessary if the equipment or complete technologist's QC program is not available during the physicist's visit. A QA Manual with written procedures and sample forms will be provided if needed. Additional patient dosimetry measurements and calculations are optionally available upon request.

The fee for this service is $180.00 per hour. There is a three hour minimum for site visits. Routine service is 9 a.m. to 5 p.m., however, other times are available upon request. The physicist will prepare a handwritten, unofficial report during each visit and leave you a photocopy. An invoice will be presented following service; payment must be received within 30 days from receipt of invoice. Upon receipt of payment, a final processed report will be mailed. Payments made thirty days past the due date are subject to 1 1/2% per month finance charge. Accounts over ninety days will be considered delinquent. If collection becomes necessary, (Physician / Officer) will be responsible for all collection costs, interest from the date the account becomes delinquent, and a minimum of 25% attorney fees.

You will be advised of the date and time of each of the physicist's visits. If this needs to be changed, please provide two weeks notice. Cancellations are subject to a 3 hour fee. For new installations, the State of New Jersey requires that the report address the availability of existing structural shielding (e.g. Lead). The report will be rejected if the information is not provided. To expedite submission of the report, please have a detailed, scale drawing that specifies existing shielding for review at the time of the visit.

In addition, (Physician or Facility) agrees not to solicit or hire any employee or individual under contract with Bio-Med Associates, Inc., at any time for any service without written permission from Bio-Med Associates, Inc.

Please sign below and fax or mail at your earliest convenience to schedule service. This proposal is valid for 60 days.

Thank you for the opportunity of presenting this proposal. If I can be of further assistance, please feel free to contact me.

Sincerely,
BIO-MED ASSOCIATES, INC.



Jack J. Merkin, M.S.
President


Accepted by: ______________________________________, (Please sign here)

Title:    Date:    P.O.    Phone #:

QA Equipment
Radiographic: Sensitometer, Densitometer, Digital thermometer, Magnifying glass, Hypo test kit, Screen/film contact tool - 1/8" mesh, 14 x 17, Screen cleaning tools/solutions
Fluoroscopic: Fluoroscopic phantom, Resolution test patterns
Specific Manufacturer/model numbers available upon request