Microsoft Volume Licensing
Program Signature Form
MBA/MBSA number Proposal ID
Agreement number 7756479
Note: Enter the applicable active numbers associated with the documents below. Microsoft requires the associated active number be indicated here, or listed below as new For enemen paste of stil for or el panty ang a the single sing program greeti.
This signature form and all contract documents identified in the table below are entered into between the Customer and the Microsoft Affiliate signing, as of the effective date identified below.
Contract Document Number or Code
<Choose Agreement> Document Number or Code
‹Choose Agreement> Document Number or Code
‹Choose Agreement> Document Number or Code
‹Choose Agreement> Document Number or Code
‹Choose Agreement> Document Number or Code
‹Choose Enrollment/Registration> Document Number or Code «Choose Enrollment/Registration> Document Number or Code < Choose Enrollment/Registration> Document Number or Code ‹Choose Enrollment/Registration> Document Number or Code Select Plus Affiliate Registration Form X20-11591
Document Description Document Number or Code
Document Description Document Number or Code
Document Description Document Number or Code
Document Description Document Number or Code
Document Description Document Number or Code
By signing below, Customer and the Microsoft Affiliate agree that both parties (1) have received, read and understand the above contract documents, including any websites or documents incorporated by reference and any amendments and (2) agree to be bound by the terms of all such documents.
Customer
Name of Entity (must be legal entity name)* City of Merced (CA) Signature*
Printed First and Last Name*
Printed Title
Signature Date*
Tax ID
* indicates required field
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Microsoft Affiliate
Microsoft Corporation
Signature
Printed First and Last Name
Printed Title
Signature Date
(date Microsoft Affiliate countersigns)
Agreement Effective Date
(may be different than Microsoft's signature date)
Optional 2nd Customer signature or Outsourcer signature (if applicable) Customer
Name of Entity (must be legal entity name)*
Signature*
Printed First and Last Name*
Printed Title
Signature Date*
* indicates required field
Outsourcer
Name of Entity (must be legal entity name)*
Signature*
Printed First and Last Name*
Printed Title
Signature Date*
* indicates required field
If Customer requires additional contacts or is reporting multiple previous Enrollments, include the appropriate form(s) with this signature form.
After this signature form is signed by the Customer, send it and the Contract Documents to Customer's channel partner or Microsoft account manager, who must submit them to the following address. When the signature form is fully executed by Microsoft, Customer will receive a confirmation copy.
Microsoft Corporation
Dept. 551, Volume Licensing
6880 Sierra Center Parkway
Reno, Nevada 89511
USA
APPROVED AS TO FORM:
In I. Sealant
3-3-22
Senior Deputy City Attorney Document X20-12883
Microsoft Volume Licensing
Select Plus Affiliate Registration Form State and Local legistration Typ ead Affilia A43515A8
eseller to complet dditional Affiliate D
Microson or Relent Completer 7756479
Queeling Compact May
3y registering, Registered Affiliate accepts and agrees to be bound by the terms of the agreement an vity the Agree attachments (the "Agreement), and will be allowed to acquire Products in accordanc If Registered Affiliate registers as an Additional Affiliate, Registered Affiliate represents that the Additional Affiliate is an eligible entity of the Lead Affiliate identified above.
This registration is valid when accepted by Microsoft and until it is terminated. Registered Affiliate will receive an acceptance notification confirming the effective date of this registration. Microsoft may refuse to accept a registration if there is a business reason for doing so. Either party may terminate this registration for any reason with 60 days advance written notice. Terminating this registration will terminate the Registered Affiliate's ability to place Orders under the Agreement.
Each Registered Affiliate may qualify for and receive additional benefits by electing Software Assurance membership. By electing Software Assurance membership, the Registered Affiliate is committing to include Software Assurance with every eligible Order. To make this election, complete and submit the Select Plus Software Assurance Membership Election Form.
In order to use a third party to reimage the Windows Operating System Upgrade, Registered Affiliate must certify that it has acquired qualifying operating system licenses. See the Product List for details.
1. Primary Contact Information.
Registered Affiliate must identify an individual from inside its organization to serve as the primary contact. This contact is also an Online Administrator for the Volume Licensing Service Center and may grant online access to others.
Name of entity* City of Merced (CA)
Contact name*: First Jeff Last Bennyhoff
Contact email address* [email protected]
Street address* 678 W 18th Street
City* Merced
State* CA
Postal code* 95340
Country* United States
Phone* 209-385-6829
Tax ID
* indicates required fields
2. Notices contact and online administrator.
This individual receives contractual notices. They are also the online Administrator for the Volume Licensing Service Center and may grant online access to others.
X Same as primary contact
Name of entity* City of Merced (CA)
Contact name*: First Jeff Last Bennyhoff
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Contact email address* [email protected]
Street address* 678 W 18th Street
City* Merced
Country* United States
Phone* 209-385-6829
• This contact is a third party (not the Registered Affiliate). Warning: This contact receives personally identifiable information of the Registered Affiliate.
* indicates required fields
3. Language preference.
Select the language for notices. English
4. Reseller information.
Reseller company name* Crayon Software Experts LLC
Street address (PO boxes will not be accepted)* 12221 Merit Drive, Suite 800 City* Dallas
State* TX
Postal code* 75251
Country* United States
Contact name* Greg Landry
Phone* 469-329-0290
Contact email address* [email protected]
* indicates required fields
The undersigned confirms that the information is correct.
Name of Reseller* Crayon Software Experts LLC
Signature*
Printed name* Greg Landry
Printed title* Ops Manager
Date*
* indicates required fields
Changing a Reseller. If Microsoft or Reseller chooses to discontinue doing business with one another, Registered Affiliate must choose a replacement Reseller. If Registered Affiliate or Resellers intends to terminate their relationship, the initiating party it must notify Microsoft and the other party, using a form provided by Microsoft at least 90 days prior to the date on which the change is to take effect.
5. Supplemental Contacts.
Customer's Notices Contact identified above is the default contact for administrative and other communications. However, Customer may designate additional contacts using the Supplemental Contact Information form.
6. Software Assurance Membership Election.
Each Registered Affiliate may qualify for and receive additional benefits with Software Assurance nembership. By electing Software Assurance membership below, Registered Affiliate is committing fo a minimum period of one year to include Software Assurance with every eligible Order, and to maintair Software Assurance for all copies of Products licensed under this program for at least one Product pool.
Product pools Yes No
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Document X20-11591
Applications L Note: If "Yes" is
marked, orders
Systems for Licenses
without Software
Assurance will
Servers not be accepted
Only valid if attached to a signature form.
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