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a ' Mirroso t Voll.law Licensing Supplemental Contact Information Form This form can be used In combination with MBSA, Agreement, and Enrollment/Registratlon. However, a separate form must be submitted for each enrollment/registration, when more than one is submitted on a signature form. For the purposes of this form, 'entity" can mean the signing entity Cuslomer, Enrolled Affiliate, Goveinmenl Partner, Institution, or other party entering into a volume licensing program agreement. Primary arid Notices contacts in this form will not apply to enrollments or registrations. This form applies to: ❑ MBSA Agreement ❑ EnrollmentlAffiliale Registration Form Insert primary entily name if roore lhari one Enrollment/Registration Form Is submitted 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; if the entity chooses to designate other contact types, the same required fields rriusl be oorlipleled for each section. By providing contact information, entity consents to Its use for purposes of administering the Enrollment by Microsoft and other parties Ihal help -Microsoft administer this Enrollment. The personal information provided in connection with this agreement will be used and protected according to the privacy statement available at h1tos:Wcensing mIcrosoftcom. 9. Additional notices contact. This contact receives all notices that are sent from Microsoft. No online access is granted to this individual. Name of entity' County of Riverside Contact name': First Regina Last Funderburk Contact email address' RFundeiburl(@rlvco,org Street address* 3450 141h Street, 41h Floor City" Riverside statelProvince* California Postal code" 92501-3861 Country* USA Phone'951-955-2265 Fax ❑ This contact is a third party (flat the entity), Warning: '['his content receives personally identifiable information of the entity. r 2, Software Assurance manager. This contact will receive online permissions to manage the Software Assurance benefits under the Enrollment or Registration. Name of entity* County of Riverside Contact name': First Regina Last Funderburl( Contact email address* RFunderburl(@IiVC,o.org Street address* 3450 14th Street, 411) Floor, City"'Riverside State7Province* California (Postal code' 92501�3861 I I SunGrnuaUlnroFormp�n,LNo)lrnlc.NOo12P r a> Pn90 1 of J 25G-79