HomeMy WebLinkAboutContract 50659-A2 �t Microsoft Volume Licensing
CITY SECRETAR
Program Signature Form
CONTRACTNO.YSbWl plcZ
MBAIMBSA nu nnber 277077
Agreement ember 011273$35
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 Numberor Code
<Choose A reement> Document Number or Code
<Choose A reement> Document Number or Code
<Choose A reement> Document Number or Code
<Choose A reement> Document Number or Code
<Choose Agreement> Document Number or Code
<Choose Enrollment/Re istration> Document Number or Code
<Choose Enrollment/Re istration> Document Number or Code
<Choose Enrollment/Re istratiion> Document Number or Code
<Choose EnroilmenURe istrabon> Document Number or Code
<Choose EnrollmenURe istration> Document Number or Code
Amendment M130 75854034
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{m Is I entity a ' rty f Fort Worth
Signature'
Printed First and 44ame• gni Alanis
Printed Title Assistant Citi YAna9er
Signature Date' J l (4
Tax ID
indicates required freld
J B. S ng, If*MMUCY
Ash' tent Ci
OFFICIAL RECORD
V�
e,mSignForm(MSSionXNA,LatAm)E.BRA.MLI(ENG)(Aug2Ol4) P 1012
'��J o CIWt SECRETARY
FT. WORTH,TX
Microsoft
Microsoft Corporation
Signatur I!I® Kmrrosoft
Printed First a d Last Name Miicrosoft Corporation
Printed Title
Signature Date OCT 2 2 2018
(date Microsoft Affilate countersigns) Andran
9
Agreement Effective Date Duly Authorized on behalf o
(may be Meront than Microsoft's signature date) Microsoft Corporation
Optional 2nd Customer signature or Outsourcer signature(if applicable)
Customer
Name of Entity(must be legal entity nine)*
Signature*
Printed First and Last Name*
Printed Title
Signature Date*
•indicates required field
Outsourcer
Name of Entity(must be legal entity nami)*
Signature*
Printed First and Last Name*
Printed Title
Signature Date*
•indicates required field
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 wUl receive a confirmation copy.
Microsoft Corporation
Dept.551,Volume Ucensing
8100 Neil Road,Suite 210
Reno, Nevada 89511-1137
USA
OFFICIAL RECUkO
ProgramSlgnForm(MSSIgn)(NA,LatAm)ExBRA,MLI(ENG)(Aug2Oi4) Page 2 or t`'
Microsoft Program Signature Form Amendment M130(7584034)
CSC 50659
Contract Compliance Manager:
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, including
ensuring all performance and reporting requirements.
St ve Streiffert
Assistant Director,IT Solutions Department
ORT �V p
Attested b • oak
Mary k Kay i Secretary Wit`
OFF IAL RECORD
0TY SECRETARY
FT. WORTH,TX