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&AVE <br />ROGERS <br />sistant Chief Executive Officer <br />WENNIFER HILBER, ACIO <br />Enterprise Applications Bureau <br />Chief Information Officer- � 1 M I� l I GUSTAVO VAZQUEZ, ACID <br />"":A Converged Communications Bureau <br />*,Lh!E!f <br />1M SMITH Public Safety Enterprise Communications <br />Technology Officer is GIL ME11A ACIO. <br />ee no gg Services Bureau <br />icrosoft LSP I tics a ion o d" <br />(RFQ 4RTVCO-2020-RFQ-0O00048 Attachment 3) <br />Complete this form and return to: Payment should be made to: <br />Riverside County Information Technology <br />Attention: Rick Hal. 3450 14th Street, Fourth Flocs <br />E-mail: RHai rivco.oi,Riverside, CA 925014 <br />County of Riverside TIN #: 95-6000930 <br />company Name: 5ottware one, Ins.,. <br />Name: Shelly Bodine Title: SLED General Mana er <br />Zip Code: 1,3186 Telephone#: <br />The Ceuntl of Riverside is the host of the Microsoft Master Agreement No. 8084445. All questions regarding <br />the products and licensing shoUd be directed to Microsoft. <br />By signiN below, I am agreeing to pay the participation fees fcc each emc4lment that is established by <br />leveraging the County of Riverside Master Agreement in accordance to the schedule referenced on RFQ <br />#Rl VCO-2020-RFQ-0C40048 and any subsequent contracts and I or amendments. <br />By signing below, I also agree that all enrollments wWl be submitted to Microsoft direct, to report enretlment <br />activity and comply to the payment schedule per RFQ #RIVCO-2020-RFQ-OCC0048 to Riverside County <br />Infcfmation Technology <br />rence the remittance <br />result in the award being rescinded. <br />'Signature <br />Wargacita Apodaca <br />Printed Name <br />for where to send the payment. Failure to comply may <br />iCi'96 <br />Date <br />jj �eratans nPys - <br />Title. <br />