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I • <br />C, r Mir:rosoft <br />Supplemental Contact Information Form <br />rolMir 1_ICnrl <br />This form can be used in cornbkialion with MBSA, Agreement, and Fnrollmosnt1Registratbn. <br />However, a separr}te form must be submitted for each cnrollmentlregistration, when male than one is <br />SLIN11itted on a signature form. For the purposes of this form, 'entity" can mean the signing entity, <br />Cuslorrler, Enrolled Afriicete, Government Pariner, Institution, or other party ertfering into a volume <br />licensing program agreement. Primary and Notices contacts in this fon-n will not apply to emolknents <br />or registrations. <br />Pr <br />to: •❑�'A I• <br />O Asycemenl <br />I <br />GrIrollntentlAffitiate Registration Forl <br />nsert primary entity name of more then one -nro men, Reg s ra on <br />FDrm is <br />Contact information. <br />Each pia ty will notify the c4her 111 of the i"nine, in A01101At infQrrrlaon <br />page(s) chanrjes_ The asterisks (') indicate required fiekds; if the entity chooses to designate other <br />contact tyspes, the same required fields musl be Coii�)Ieted For each section. By providing contact <br />information, entity consents to its use for purposes of adminlsterincd the Enrolisnent by Microsoft ac'Itd other <br />paltles that help'W1ir_rosoft adminisler this Enrollment. The personal information provided In connection <br />With Ilils agreement %vill be iised apd protected according to the privacy statement avayable -II. <br />Pittrr�c:lr'ti censing , m Icrosc�fl_com. <br />9. 9 Additional notices contact. • 0 <br />E his contact receives all notices that are sen from A,iicrosoft. a on 1nC' ac r? s is grvn e o his <br />individua <br />Name cf e l y""Ylver"d, <br />Contact name'Regina Lasr derburk <br />Contact email address* RFLkidet,burk@rlvco,or <br />Street address` 345.0 14th Street, 4lh Floor <br />City" Riverside 5tatelProvince" California (Postal code" h2501-3861 <br />Country* USA <br />Pfiorre" 951-955-2265 Fax <br />❑ This contact is a third party na Re!lity. nrng: con sic recc ves person.: y I l�& <br />information of the ertti; <br />"2.Softva�are Assurance manayel <br />TNs contact will receive online permission- to mans a the Software: A :siirEartee: benefits urxler the <br />EnrUlment or Registration. <br />Name of entity' Cwniy of R Ars1 2 <br />Contact name`: First Regina Last Funderburk <br />Contact email address' RFunderb4.irl[ VAivco.o10 <br />Street address* 3450 14th Street, 4th Floor, <br />City"Riverside StatelProvince' California �f ostal code' 92501-W I <br />i <br />ytt C4nirClMkaF.,r.A((NA, 13} PJgc 1 a[;i <br />