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Licensing Solution Provider Agreement Number PSA-0001530 <br />Exhibit C <br />Microsoft LSP Participation Form <br />DAVE ROGERS JENT'IFER14ILDER.ACIO <br />RCIT <br />Assistant Chiet Executive OIL= Enterprise tlpp Fications B..,. <br />Chief Istons.tim OLicer GUSTAVO VAZQUEZ, ACID <br />Converged Connmmieadons Btueau <br />JIM SMIT11 Pubhc Safety Enterprise Comrmnne.nions <br />ChWe Uce hnolaev Officer GIL hIEJl4 ACIO <br />Technology Servw,eEuteau <br />Microsoft LSP Participation Form <br />(RFQ #R1VC0-2020-RFQ-0000048 Attachment 3) <br />Complete this form and return to: Payment should be made to: <br />Riverside County Information Technology <br />Attention: RickHai 3450 14th Street, Fourth Floor <br />E-mail: RHai Cdrivice.ore Riverside, CA 92501 <br />County of Riverside TIN #: 95-6000930 <br />Company Name: Software One, Inc. <br />Name: <br />Title: SLED General Nhnuo�er <br />Address: 20875 Crossroads CirSTE 1 <br />City: Waukesha. WI Zip Code: 53186Telephoue #: 800-400-9852 <br />Fax #: Email, Shettv,Bodine i SofhvarcoNE cons <br />The County of Riverside is the host of the Microsoft Master Agreement No. 8084445. All questions regarding <br />the products and licensing should be directed to Microsoft. <br />By signing below, I am agreeing to pay the participation fees for each enrollment that is established by leveraging <br />the County of Riverside Master Agreement in accordance to the schedule referenced oil RFQ <br />#RIVCO-2020-RFQ-0000048 and any subsequent contracts and / or amendments. <br />By signing below, I also agree that all enrollments will be submitted to Microsoft direct, to report enrollment <br />activity and comply to the payment schedule per RFQ #RIVCO-2020-RFQ-0000048 to Riverside County <br />Information Technology. <br />Please reference the remittance information above for where to send the payment. Failure to comply may <br />result in the award being rescinded. <br />9I19/2019 <br />Signature Date <br />Shelly Bodine <br />Printed Name <br />SLED General Manager <br />I0r %O <br />