April 21, 2016

3720 PARITION ROAD

MISSISSAUGA, Ontario
L5N 8P4
Re:

LOCK BOX

Dear SYEDA NAIM,

Thank you for allowing Baxter Corporation (Baxter) to serve you, for all of your
Dialysis supply needs.
In order to facilitate the delivery of our products to your residence, we have provided you
with a lock box. The code is known only by you, the Baxter driver, and the Baxter
Customer Care Team. This will allow the driver to gain entry into your home for the
purpose of delivering dialysis supplies and Baxter solutions, in the event that you are not
available to personally accept delivery. Baxter is willing to agree to the terms and
conditions contained in the following release. Please review the release carefully. If you
agree with it, sign at the end of this letter and return it to the following address:
Baxter Corporation
7125 Mississauga Rd
Mississauga, ON
L5N 0C2

Very Truly Yours,

Baxter Corporation

Shawn N.
Customer Care Representative

Release
In consideration of Baxter Corporations agreement to provide Home Delivery (as herein
after defines) to the undersigned and the other good and valuable consideration, the
receipt of which is hereby acknowledged, the undersigned (referred to as I or me
below), intending to be legally bound, agrees as follows:
1. I hereby agree to release Baxter Corporation, its subcontractors and the employees
of Baxter Corporation (the Released Parties) from any and all liability for all
losses, costs, damages and expense, however caused, which may be incurred by
me or any person, resulting from the delivery of dialysis supplies and Baxter
solutions to my home, including delivery at such times as I am not available to
personally accept delivery (Home Delivery), including, but not limited to,
losses, costs, damages and expenses resulting from the negligence or fault of the
Releases Parties with respect to the Home Delivery. I acknowledge that, in order
to have dialysis supplies and Baxter solutions delivered when I am not available
to accept delivery, Baxter Corporation has provided me with a lock box at my
residence, the code for which is known to me, the driver, and the Customer Care
Team, and I agree that I will not provide the code to anyone else.
2. I agree to indemnify and save harmless the Released Parties from and against all
claims and demands which may be made against the Released Parties by any
person resulting from any Home Delivery, including, but not limited to, losses,
costs, damages and expenses resulting from the negligence or fault of the
Released Parties.
3. I acknowledge and agree that Baxter Corporations liability to me under these
arrangements shall be limited to the value of the dialysis products and supplies
delivered to me at the time any losses, costs, damages or expenses may be
incurred to me. In no event shall Baxter Corporation be liable for any incidental,
consequential, and indirect or punitive damages arising under or related to its
services of Home Delivery.
4. I may terminate unattended Home Delivery at any time by providing Baxter
Corporation written notice of my desire to do so. Upon termination of this
arrangement I will keep or dispose of the lock box as I see fit.
I hereby accept this agreement and acknowledge the terms and conditions set out above,
by signing my name below in the presence of a witness.
Patient Signature:

_____________________________

Patient Name:

_____________________________

Date:

_____________________________

Witness Signature:

_____________________________

Witness Name:

_____________________________