HomeMy WebLinkAbout5423Contract Number:
Vendor:
Subject:
Department:
File Class:
Begin Date:
End Date:
Review Date:
Vault Date:
5423
MICROSOFT LICENSING, GP
Volume Licensing Agreement No. 6013310
M�Y
LEG 12-1
8/18/2014
9/1/2019
Comments :
,
:�� Microsoft
Program Signature Form
Vulur�e �icensing
Mf3AlME3SA number
Agreerncnt nianber 6013310
Note: Enter the applicabie 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 th�s form, 'Customer� can mean the s�gning erriity, Enrolled A�liate,
Govemment Partner, Instih�hon, or other party entering irrto a volume licensmg program
agreement.
This signature form and alf contract documerrts identified in the table below are entered into between
the Customer and the Microsofl Affiliate signing, as of the effective date idenfified below.
<Choose A reement>
<Choose Agreement>__ _ __ ____
Seleci Plus Affiliate Registration Form
<Choos EnrollmenF/R
<Choose Enrollm
�Choose EnrollmentlRegistration>
<C hoose_En rollmenURegistration>
---�
— 1
------- �
{
.. .
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 aA such documents.
X20-11591
ProgramSignForm(MSSign ) (NA,LatAm)ExBRA, MLI {ENG) (Ocl2013)
Pac�e 1 of 3
Name of Entity � ust b� legal ti me)" ��ty of Bremerton
�
Signature' �, �
Printed First nd Last Name* Kevin C Matthew
Printed Title Manager, fnformation Services
Signature Date• 8-15-14
Taa ID 91�00323i
�-- - — —
' indicates required field
Microsoft Licensing, GP
Signature
Printed First and Last Hame
I'rmted Title
Signature Date
(date Miaosofl AffiGate courrtersigns)
Agreement Effective Date � /��
(may be different than Nti�n�ofl's sig date) '
\„� i
Deb Forney
� onze on be alf of
>soft Licensing, GP
Optional 2"" Customer signature or Outsourcer signatLre (if applicabte)
� Name of Entity (rnust be legal entity name�`
Signature*
Prirtted First and Last Name*
Printed Title
Signatur+e Date*
' indicates requir�d �eld �
� Name of Entity (must be legal entity name)*
' Signature"`
Printed First and Last Name'
Printed Title
Signature Date*
* indicates required freld
ros ft LI sing, GP
AUG 8 20�
i
�
- -�
If Customer requires physical media, additional contacts, or is reporting multiple previous Enrotlments,
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
Custorr3er's channel partner or Microsoft account manager, uvho musQ submit them to the following
ProgramSignForm(MSSign)(NA,LatAm)ExBRA,MLI(ENG)(Oct2013) Page 2 of 3
address. When the signature form is fully executed by Microsoft, Customer will receive a confirmation
copy.
Microsoft Licensing, GP
Dept. 551, Volume Licensing
610Q Neil Road, Suite 210
Reno, Nevada 89511-1137
USA
ProgramSignForm(MSSign)(NA,LatAm}ExBRA,MLi(ENG}(Oct2013) Page 3 of 3
�/ficrosoft
Select Plus Affiiiate Registration Form
Registrahon TyPa
Hese�terfp complete
Agreement Nwnber
Micro.soft or ReseNerto oompk�te
Qualifying Cor�-ad
ReseHer fa carr�te
Lead Affiliate ❑
Additional Afl9liate �
6013310
Volume Licensing
State and Local
Lead Afiiliate Pubtic Customer
Nt�mber (PCN)
Reseller [o complete
Additional Afidiafe Public
Cusfomer Number (t'CN}
Reselres ro complete
Chat�qe Affiliate Anniversary
�bnth
Re�lfer to oomplete
By registenng, Registered Affiliate accepts and agrees to be bound by the terms of the agreement
and any applicable attachments (the "Agreement"), and will be atlowed to acquire Products in
accordance with the Agreement.
If Registered AKliate registers as an Additional Affiliate, Registered Affiliate represents that the
Additional Affiliate is an eligible entity of the Lead Aifiliate iderrtified above.
This registrat�on is vafid when accepted by MicrosoR and until it is terminated. Regisfered Affiliate will
receive an acceptance notifiptian confirming the effecfire date of th�s registrat+on. 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 advan�e written natice_ Te�rninating this registration will
terminate the Registered Af{iliate's ability to pface Orders under the Agreement_
Each Registered A#iiliate may qeaalify for and receive addrtional benefits by electing Software
Assurance membership. By electing Soflware Assurance membership, the Registered A�iliate is
committing to include Software Assurance with every eligible Order. To make this elecfion, complete
and submit the Select Plus 5oftware Assurance Membership Eledion Form.
In order to use a third party to reimage the Windows Operating System Upgrade, Registered A�liate
must certify that it has acquired qualifying operating system I�censes_ See the Product List for details.
1. Primary Contact Information.
Registered Affiliate must identify an indiwdual from ir�side its organizahon to serve as the primary
contact This contact is also an Oniine Administrator for the Volume Licensing Service Center and
may grant anl�ne access to others.
Name of entiiy' City of Breme�ton
Contact narne': First Kevin last AAatthew
Contact email address* ITManager@ci.bremerton.wa.us
Street address• 345 6�' St. Suite 600
City" Bremerton
State* WA •
Postal code* 98337-187�
Country" United States
Phone* (360) 473-5473
Tax ID 91-6001231
* indicates requrred frelds
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.
� Same as primary contact
Name of entity'
Contact name*: First Last
>II
�D SO ��3 D�
SeledP1us2013ARFGov(US}SLG(FNG)(Oct2D13) Page 1 of 3
Document X20-11591
Contact email address"
Street address"
City*
State'�
Postal code*
Country*
Phone'
❑ This contact is a third party (not the Registered Affiliate}.
personally identifiable information of the Registered Affiliate.
" indicates requ�red fields
3. Language preference_
Select the language for notioes. English
4. Resel/er information.
Warning: This contact reCeives
12eseller company narnex CompuCom Systems, Inc.
Street address (PO boxes will not be accepted)" 7171 Forest l.ane
City* Dallas
State* Texas
Postal code' 75230-2306
Country* United States
Contact name'� Bruce Valentin
Phone' 972-856-4677
Contact email address' msadmin@compucom.com
' i»dicates requrred frelds
The undersigned canfirms that the information �s correct.
Name of ReselleP CompuCom Systems, fnc.
Signature' �.i'"�z� � ,:i ' ;� - -.. ._.
; ��' _.
Pri =.
nted tklme Stac Pricc
Y
Printed title• Microsoft Licensing SpeciaEist
��* 8-15-14
' indicafes required �f�relds �
Changi�g a Reselier. If Microsoft or Reselter chooses to discon6nue doing busmess with one
another, Registered Af�iliate must choose a replacement Reseller. If RegisterecS Aftiliate or Resellers
intends to terminate their relationship, the initiating party it must notify Microsoft and the other party,
using a farm provided by llAicrosoft 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
communrcations. However, Customer may designate additional contacts using the Supplemental
Contact Information form.
6. Sofiware Assurance Membership Election.
Each Registered Affiliate may qualify for and receive additional benefits with Software Assurance
membership. By electing Software Assurance membership below, Registered Affiliate is committing
for a minimum period of one year to include Software Assurance with every eligible Order, and to
maintain Software Assurance for all copies of Products licensed under this program for at {east one
Product pool.
SeledPlus2U13ARFGov(US)SLG(ENG)(Oct2013) Page 2 of 3
Document X20.11591
� , r
�� �.�e ' i '. .:,{. M �i,,.;,•_� ��..-....s�,�:.�'...__ — ' j 1 •`` �s _.�:.
-� ' j Note: If "Yes" is
Applications � � ' marked, orders
for Licenses
Systems � � w�thout Software
Assurance will
not be accepted.
Servers ❑ �
---- -- - --- --�------- --- ---- ----------,
Oniy valid if attached to a signature form.
SelcctPlus2013ARFGov(US)S LG(E NG)(Oct2013)
Page 3 of 3
Document X20-11591