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Home My WebLink About000197 Original ContractProgram Signature Form MBA/MBSA number Agreement number 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 .•Contract. Document.:, <Choose Agreement> .:Number or Code <Choose Agreement> <Choose Agreement> <Choose Agreement> <Choose Agreement> Select Enrollment <Choose Enrollrent/Affiliate Registration Form> <Choose Enrollment/Affiliate Registration Form> <Choose Enrollment/Affiliate Registration Form> 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. Microsoft Affiliate Name of Entity (must be legal entity name) CU D f Signature Signature h� l 0.t ProgramSignForm (MSSign)(NA)(ENG)(Oct2010) X20 -02347 City of Port Angeles Record #000197 Mictosoft Volume Licensing SGN- Proposal ID Microso GP Printed Name *E Zf} t7.a.A.,i Printed Nam es (�Qi/11S 0017 e Program er, Compyidtite Printed Title Printed Title Signature Date* 5 /Lo Signature Date 01 t) (date Microsoft Affiliate countersigns) Page 1 of 2 Tax ID N/A Effective Date (t (may be different than Microsoft's signatur dat indicates required field Optional 2 Customer signature or Outsourcer Signature (if applicable) 1Outsourcer Name of Entity (must be legal entity name) Name of Entity (must be legal entity name) Signature Printed Name Printed Title Signature Date Signature Printed Name Printed Title Signature Date If Customer requires physical media, additional contacts, or is reporting multiple previous Enrollments, include the appropriate form(s) with this signature form. If no media form is included, no physical media will be sent. 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 Licensing, GP Dept. 551, Volume Licensing 6100 Neil Road, Suite 210 Reno, Nevada 89511 -1137 USA Prepared By: Name of Preparer Email of Preparer ProgramSignForm (MSSign)(NA)(ENG)(Oct2010) Page 2 of 2 Select Enrollment Enrollment number (Microsoft Affiliate to complete) Previous Enrollment, agreement or auth number (if renewing Software Assurance)(Reseller to complete) Micr Volume Licensing Proposal ID (Resetler to complete) Earliest expiring previous Enrollment end date (Resetler to complete) State and Local If consolidating from multiple previous Enrollments with Software Assurance, complete the multiple previous Enrollment form and attach it to this Enrollment is 'En"roltment, must be- attach to a signature ,form to ,'valid. This Microsoft, Select Enrollment is entered into between the entities, as of the effective date identified on the signature form. This Enrollment consists of (1) This Enrollment, (2) the terms of the Select Agreement identified on the signature form and all attachments identified therein. =N„ Enrolled Affiliate agrees to purchase Licenses equal to at least 750•'pomts .during the initial term of this Enrollment. All terms used but not defined at htto /www.mlcrbsoft.com /licensing /contrracts.', Effective date. If Enrolled- Affiliate`is renewing Software Assurance coverage`from one `,or more previous Microsoft agreements, `then, the ,effective.date of this. Enrollment: will be�the, day: after the:earliest�,expiration -of such coverage: Otherwise the effective date will be the.date this_, Enrollment is, processed. by Microsoft. Term. This Enrollment will expire on the: date the, Microsoft Select'Agreement identified on the signature form expires. Qualifying systems Licenses. The operating sys'ter*Licenses,granted under this program are upgrade Licenses only. Full operating system Licenses are nOt.available under this program. If Customer selects the Windows Desktop Operating System Upgrade, all Qualified Desktops on' which the Customer runs the Windows Desktop Operrating System Upgrade must be licensed to run one of the qualifying operating systems identified in the Product List at htto /www.microsoft.com /Iicerisin'd /contracts. Exclusions are subject,to=change when new versions of Windows are released. In. :Order to use a third party to reimage the Windows Operating System Upgrade, Enrolled Affiliate must certify that it has acquired qualifying operating system licenses. See the Product List for details. 1. Contact information. Each party will notify the other in writing if any of the information in the following contact information page(s) changes. The asterisks indicate required fields. By providing contact information, Enrolled Affiliate consents to its use for purposes of administering this Enrollment by Microsoft, its Affiliates, and other parties that help administer this Enrollment. The personal information provided in connection with this Enrollment will be used and protected in accordance with the privacy statement available at httos: //I lcen s In a.m icrosoft.com. a. Primary contact information. Enrolled 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: (must be legal entity name)* City of Port Angeles Contact name First Elizabeth Last Strait Select2010Enr (US)SLG(ENG)(Oct2010) Page 1 of 3 Document X20 -02347 Contact email address* estrait @cityofpa.us Street address* 321 E 5 St City* Port Angeles State* WA Postal code* 98362 Country USA Phone* 360 417 -4722 Fax 360- 417 -4609 Tax ID b. Notices 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. Same as primary contact Name of entity (must be legal entity name)* Contact name First Last Contact email address* Street address* City* State* Postal code* Country* Phone* Fax c. Language preference. Select the.language for notices. English d. Microsoft account manager. Provide the 'Microsoft account Manager contact for this Enrolled Affiliate. Microsoft account manager name: Microsoft accburit manager email address: Reseller information. e. If .Enrolled' Affiliate requires a,..separate _contact for any of followiiig„ attach the ,Supplemental`Contact Information form. Otherwise, the notices contact remains.the default. Additional notices contact Software Assurance manager Subscription manager Online Services manager Custorner Support Manager (CSM) contact Is.a purchase under this Enrollment being financed through MS Financing? Yes, No. Reseller company name* CompuCom Systems, Inc Street address (PO boxes will not be accepted)* 7171 Forest Lane City* Dallas State* TX Postal Code* 75230 Country* USA Contact name* Bruce Valentin Phone* 972 856 -4617 Fax Contact email address* bvalenti @compucom.com Select2010Enr (US)SLG(ENG)(Oct2010) Page 2 of 3 Document X20 -02347 The undersigned confirms that the information is correct. Name of Reseller* CompuCom Systems, Inc. Signature Printed name* Bruce E. Valentin Printed title* Microsoft Licensing Specialist Date* 5/18/2011 Changing a Reseller. If Microsoft or the Reseller chooses to discontinue doing business with each other, Enrolled Affiliate must choose a replacement Reseller. If Enrolled Affiliate or the Reseller intends to terminate their relationship the initiating party, it must notify Microsoft and the former Reseller using a form provided by Microsoft at least 90 days prior to the date on which the change is to take effect. 2. Software Assurance Membership election. To become a Software Assurance Member, Enrolled Affiliate must agree to purchase and maintain Software Assurance for all copies of all Products licensed under this'Enrollment from at least one Product pool. For a description of benefits resulting from choosing one or ,more Product pools below and ,additional details regarding the Software Assurance Membership program,' please consult with the Reseller or Microsoft account manager. For each Product pool, mark "yes" or "no" to indicate whether Enrolled Affiliate:is committing` to purchase and maintain Software ,Assurance.ryfor all copies-Of all Products' 'Iieensed ;'from.- that. under this Enrollment. Product pools Applications Systems Servers 'Yes .No E Note: If "Yes" is: marked, all orders for Licenses must have Software ,Assurance. Renewing Software Assurance. If Enrolled Affiliate is renewing Software Assurance from multiple Select programs or consolidating other previous Enrollments or agreements (including Open authorizations) into this Enrollment please complete the multiple previous Enrollment form and attach it to this Enrollment. The earliest expiring previous Enrollment/agreement which contains Software Assurance is to be inserted on the signature form. If only one previous Enrollment/agreement is renewing, please insert that previous number on the signature form. Select2010Enr (US)SLG(ENG)(Oct2010) Page 3 of 3 Document X20 -02347