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Contract 2020-100ADocuSign Envelope ID: DD40A6B6-C93E-4344-8AC3-2811 E5AF1578 DocuSign, Inc. Offer Valid Through: Mar 24, DocuSign 221 Main Street, Suite 1000 2020 San Francisco, CA 94105 Prepared By: Donovan Ahern Quote Number: Q-00420817 ORDER FORM Address Information Bill To: City of Clermont 685 W Montrose St, Clermont, FL, 34711 United States Billing Contact Name: Freddy Suarez Billing Email Address: fsuarez@clermontfl.org Billing Phone: 352-241-7350 Order Details Order Start Date: Mar 24, 2020 Order End Date: Mar 23, 2021 Billing Frequency: Annual Products Ship To: City of Clermont P.O. BOX 120219, Clermont, FL, 34712-0219 United States Shipping Contact Name: Freddy Suarez Shipping Email Address: fsuarez@clermontfl.org Shipping Phone: 352-241-7350 Payment Method: Check Payment Terms: Net 30 Currency: USD Product Name Start Date End.. eSignature Business Pro Edition - Seat Subscription Mar 24, 2020 Mar 23, 2021 5 $2,290.00 Premier Support Mar 24, 2020 Mar 23, 2021 1 $343.50 Adoption QuickStart Mar 24, 2020 Mar 19, 2021 1 $0.00 Grand Total: $2,633.50 Product Details eSignature Seat Allowance: 5 eSignature Envelope Allowance: 500 DocuSign Envelope ID: DD40A6B6-C93E-4344-8AC3-2811 E5AF1578 Order Special Terms Terms & Conditions This Order Form is governed by the terms Master Services Agreement available online at: https://www.docusign.com/company/terms-and-conditions/msa and the applicable Service Schedule(s) and Attachments for the DocuSign Services described herein available online at https://www.docusign.com/company/terms-and-conditions/msa-service-schedules. Billing Information Prices shown above do not include any state and local taxes that may apply. Any such taxes are the responsibility of the Customer and will appear on the final Invoice. Is the contracting entity exempt from sales tax? Please select Yes or No: Yes If yes, please send the required tax exemption documents immediately to taxexempt(a)-docusign.com. Invoices for this order will be emailed automatically from invoicinqCa)-docusign.com. Please make sure this email is on an approved setting or safe senders list so notifications do not go to a junk folder or caught in a spam filter. Purchase Order Information Is a Purchase Order (PO) required for the purchase or payment of the products on this Order Form? Please select Yes or No: Yes If yes, please complete the following: PO Number: 2020-0120 PO Amount: $ 2,633.50 Page 2 of 3 DocuSign Envelope ID: DD40A6B6-C93E-4344-8AC3-2811 E5AF1578 By signing this Agreement, I certify that I am authorized to sign on behalf of the Customer and agree to the Terms and Conditions of this Order Form and any documents incorporated herein. Customer DocuSigned by: Signature: E6831vti,�,�, swt/i FCFD06874F3... Name: Freddy Suarez Job Title: Purchasing Director Date: March 24, 2020 DocuSign, Inc. Signature: DocuSigned by: 6685A52A083E408... Name: Beatriz Benjamin Job Title: Revenue operations Manager Date: March 24, 2020 DS � Page 3 of 3 Certificate Of Completion Envelope Id: DD40A6B6C93E43448AC32811 E5AF1578 Subject: [DocuSign] Request for eSignatures: City of Clermont - New Customer fcorg id : 00 D300000000bS4 EAI Source Envelope: Document Pages: 3 Signatures: 2 Certificate Pages: 5 Initials: 1 AutoNav: Disabled Envelopeld Stamping: Enabled Time Zone: (UTC-08:00) Pacific Time (US & Canada) Record Tracking Status: Original 3/23/2020 2:29:12 PM Signer Events Freddy Suarez fsuarez@clermontfl.org Purchasing Director Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Karen Bruce Karen.Bruce@docusign.com DocuSign, Inc. Signing Group: AOR Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 1 /16/2020 4:37:43 PM ID:92a517f4-cf2d-44a1-82ea-ec5649317673 Beatriz Benjamin Beatriz.Benjamin@docusign.com Revenue Operations Manager DocuSign, Inc. Signing Group: AOA Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 10/31/2019 8:13:51 PM ID:85bb52b3-3c10-4c12-86fb-9452d82abdc8 In Person Signer Events Editor Delivery Events Agent Delivery Events Intermediary Delivery Events Holder: Donovan Ahern Donovan.Ahern@docusign.com Signature ocuSigned by:��� j/y /L,ED �.��ss"�� / Signature Adoption: Pre -selected Style Using IP Address: 162.248.64.130 [ID Signature Adoption: Pre -selected Style Using IP Address: 73.158.101.77 EDocuSignetl by: � "amit& 6B85A52A083E408... Signature Adoption: Pre -selected Style Using IP Address: 12.202.171.35 Signature Status Status Status Docu5�". 6 S E C U R E 6 Status: Completed Envelope Originator: Donovan Ahern 221 Main Street Suite 1000 San Francisco, CA 94105 Donovan.Ahern@docusign.com IP Address: 13.108.254.8 Location: DocuSign Timestamp Sent: 3/23/2020 2:29:16 PM Viewed: 3/24/2020 6:03:29 AM Signed: 3/24/2020 7:46:39 AM Sent: 3/24/2020 7:46:42 AM Viewed: 3/24/2020 11:22:50 AM Signed: 3/24/2020 11:23:34 AM Sent: 3/24/2020 11:23:37 AM Viewed: 3/24/2020 12:02:39 PM Signed: 3/24/2020 12:03:06 PM Timestamp Timestamp Timestamp Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 3/24/2020 11:23:41 AM Certified Delivered Security Checked 3/24/2020 12:02:44 PM Signing Complete Security Checked 3/24/2020 12:03:06 PM Completed Security Checked 3/24/2020 12:03:06 PM Payment Events Status Timestamps Electronic Record and Signature Disclosure Electronic Record and Signature Disclosure created on: 10/17/2018 1:49:32 PM Parties agreed to: Karen Bruce, Beatriz Benjamin ELECTRONIC RECORD AND SIGNATURE DISCLOSURE From time to time, DocuSign, Inc. (we, us or Company) may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically through the DocuSign, Inc. (DocuSign) electronic signing system. Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to these terms and conditions, please confirm your agreement by clicking the `I agree' button at the bottom of this document. Getting paper copies At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. You will have the ability to download and print documents we send to you through the DocuSign system during and immediately after signing session and, if you elect to create a DocuSign signer account, you may access them for a limited period of time (usually 30 days) after such documents are first sent to you. After such time, if you wish for us to send you paper copies of any such documents from our office to you, you will be charged a $0.00 per -page fee. You may request delivery of such paper copies from us by following the procedure described below. Withdrawing your consent If you decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your decision to receive future notices and disclosure in paper format and withdraw your consent to receive notices and disclosures electronically is described below. Consequences of changing your mind If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. To indicate to us that you are changing your mind, you must withdraw your consent using the DocuSign `Withdraw Consent' form on the signing page of a DocuSign envelope instead of signing it. This will indicate to us that you have withdrawn your consent to receive required notices and disclosures electronically from us and you will no longer be able to use the DocuSign system to receive required notices and consents electronically from us or to sign electronically documents from us. All notices and disclosures will be sent to you electronically Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us. How to contact DocuSign, Inc.: You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows: To contact us by paper mail, please send correspondence to: DocuSign, Inc. 221 Main St., Suite 1000 San Francisco, CA 94105 To advise DocuSign, Inc. of your new e-mail address To let us know of a change in your e-mail address where we should send notices and disclosures electronically to you, you must send an email message to us at and in the body of such request you must state: your previous e-mail address, your new e-mail address. Please reach out to the sender of the envelope if you want to change your email address.. In addition, you must notify DocuSign, Inc. to arrange for your new email address to be reflected in your DocuSign account by following the process for changing e-mail in the DocuSign system. To request paper copies from DocuSign, Inc. To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an e-mail to and in the body of such request you must state your e-mail address, full name, US Postal address, and telephone number. We will bill you for any fees at that time, if any. Please reach out to the sender of the envelope if you want to request paper copies. To withdraw your consent with DocuSign, Inc. To inform us that you no longer want to receive future notices and disclosures in electronic format you may: i. decline to sign a document from within your DocuSign session, and on the subsequent page, select the check -box indicating you wish to withdraw your consent, or you may; ii. send us an e-mail to and in the body of such request you must state your e-mail, full name, US Postal Address, and telephone number. Please reach out to the sender of the envelope if you want to withdraw your consent.. The consequences of your withdrawing consent for online documents will be that transactions may take a longer time to process.. 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Acknowledging your access and consent to receive materials electronically To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please verify that you were able to read this electronic disclosure and that you also were able to print on paper or electronically save this page for your future reference and access or that you were able to e-mail this disclosure and consent to an address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format on the terms and conditions described above, please let us know by clicking the `I agree' button below. By checking the `I agree' box, I confirm that: I can access and read this Electronic CONSENT TO ELECTRONIC RECEIPT OF ELECTRONIC RECORD AND SIGNATURE DISCLOSURES document; and I can print on paper the disclosure or save or send the disclosure to a place where I can print it, for future reference and access; and • Until or unless I notify DocuSign, Inc. as described above, I consent to receive from exclusively through electronic means all notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to me by DocuSign, Inc. during the course of my relationship with you.