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HomeMy WebLinkAbout01-3142 PARTIES ~',tor name (last name first if individual) and mailing address: Endoscopy USA, Inc. 3607 Rosemont Avenue, Suite 201 Camp Hill, PA 17011 Debtor name (last name first if individual( and mailing address: Debtor name (last name first if individual) and mailing address: Ih Secured Party(les) names(s) (last name first if individual( and address for security interest information: Olympus America Inc. Two Corporate Center Drive Melville, NY 11747 Assignee(s) of Secured Party name(s) (last name first if individual) and address for security interest information: Special Types of Parties (check if applicable): E] The terms "Oebtor" and "Secured Party" mean "Lessee" and "Lessor," respectively. i~ The terms "Debtor" and "Secored Party" mean "Consignee" and "Consignor," respectively. ~ Debtor is a Transmitting utgit¥ SECURED PARTY SIGNATURE(S) Tbie statement is flied with only the Secured Party's signature to perfect a security interest in collateral (check applicable box(es))- a. [] acquired after a change of name, identity or corporate structure of the Debtor. b. [] as to which the filing has lapsed c. already subject to a security interest in another county in Pennsylvania- ~3when the collateral was moved to this county. ~wheo the Debtor's residence or place of business was moved to this county. d. already subject to a security interest in another jurisdiction- [3when the collateral was moved to Pennsylvania ~]when the Debtor's location was moved to Pennsylvania. e. ~ which is proceeds of the collateral described in block 9, in which a security interest was previously perfected (also describe proceeds in block 9, if purchased with cash proceeds and not adequately described on the original financing statement). FINANCING STATEMENT Uniform Commercial Code Form UCC- 1 IMPORTANT-Please read instructions on reverse side of page 4 before completing Secured Party Signature(s) (required on)y if box(es) is checked above): Olympus America Inc. Filing No. (stamped by filing officer): Date, Time, Filing Office (stamped by filing officer): la This Financing Statement is presented for filing pursuant to ~T~iJnifor~ Commerc~at:C. ode, 3 and is to be filed with the (check applicable box) ~] Secretary of the Commonwealth. ~ real estate records of Number of Additional Sheets (if any): I Optional Special Identification (Max. 10 characters): COLLATERAL Identify collateral by item and/or type: See Schedule C attached hereto and made a part hereof. Equipment to be located at 370 St. Charles Way York, PA 17402 E3 (check only if desired) Products of the collateral are also covered. 042301-1A 9 Identify related real estate, if applicable: The cogateral is, or includes Icheck appropriate boxtes))- a [] crops growing or to be grown on - b. [] goods which are or are to become fixtures on - c. [3 minerals or the like (including oil and gas) as extracted on d [] accounts resulting from the sale of minerals or the like (including oil and gas) at the wellhead ur minehead on the following real estate: Street Address: Described at: Gaok of (check one) E3 Deeds [] Mortgages, at Page(s) for County. Uniform Parcel identifier ~ Described on Additional Sheet. Name of record owner (required only if no Debtor has an interest of record): // "~ DEBTOR SIGNATURE(S) Debtor~~ndoscopy:~ ~ USA, IBc. la 10 lb RETURN RECEIPT TO: ff LEXIS Document Services P. O. Box 2969 Springfield, IHbois 62708 TANDARD FORM - FORM UCC- 1 (7-e9) ~pproved by Secretary of Commonwealth of Pennsylvania NOTE - This page will DOt be returned by the Depsrtmeot of State. (1) F~LING OFFICE ORIGINAL 12 This Schedule C is attached to and made part of Form UCC-1 for Endoscopy USA, Inc., as User, and Olympus Financial Services, a Division of Olympus America Inc. Agreement No. CPPO-042301-1A SCHEDULE C QUANTITY EQUIPMENT DESCRIPTION Two (2) Two (2) Two (2) Two (2) Two (2) Two (2) Two (2) One (1) CV-160 EVIS EXERA Videoprocessor with Microprocessor CLV-160 OES Xenon Light Source (300W) CF-Q160L Video Colonoscope with Wide Screen Image CF-Q160AL Adjustable Stiffness Video Colonoscope GIF-1T140 Therapeutic Video Gastroscope OEV-203 19in Olympus Color Monitor MA J-901 Water Container Set CD-P03 Class 2 Large Basin DSD Promotional Package Right And all substitutions, replacements, additions, attachments and accessories thereto and proceeds thereof, now owned or hereafter acquired. This financing statement is filed for notice purposes only & the filing thereof shall not be deemed evidence of any intention to create a security interest under the Uniform Commercial Code. Olympus Financial Services, a Division of Olympus America Inc. USER: Endoscopy USA, Inc. Name: John M. Tabone Title: Senior Vice President Name: Title: