HomeMy WebLinkAbout2016 - Microsoft Enterprise Agreementmo Microsoft
Program Signature Form
MSA/MBSA number
Agreement number 01E73529
Ovolume Licensing
000-smangum-SS0621
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 the purposes of this form, "Customer' can mean the signing entity, Enrolled Affiliate,
Government Partner, Institution, or other party entering into a volume licensing program agreement.
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.
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Enterprise Enrollment `X20-12057
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Product Selection Form 0410474.003 PSF
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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.
Name of Entity (must be
Signature*— N Lys
Printed First and Last NI
Printed Title Mayor
Signature Date"
Tax ID
entity name)' City of Auburn
Backus
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Optional 2nd Customer signature or Outsourcer signature (if applicable)
Name of Entity (must be legal entity name)* City of Auburn
Signature*
Printed First and Last Name* Nancy Backus
Printed Title Mayor -.
Signature Date*
indicates required field
Name of Entity (must be legal entity name)*
Signature*
Printed First and Last Name*
Printed Title
Signature Date'
rnorcares requirea new
If Customer requires physical media, 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
6100 Neil Road, Suite 210
Reno, Nevada 89511-1137
USA
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