HomeMy WebLinkAbout26 - Amendments Amendment Number Unknown - Samsara - EXPANDED AUTOMATIC VEHICLE LOCATION SERVICES
First Amendment to Professional Services Agreement for Automatic Vehicle Location Services Across City Fleet
FY 2027 – FY 2031
Page 1 of 2
FIRST AMENDMENT TO PROFESSIONAL SERVICES AGREEMENT
THIS FIRST AMENDMENT TO THE PROFESSIONAL SERVICES AGREEMENT FOR EXPANDED
AUTOMATIC VEHICLE LOCATION SERVICES dated June 10th, 2025 (the “Agreement”) is made and
entered into this 14th day of July, 2026, by and between the CITY OF BOZEMAN, MONTANA, a
self governing municipal corporation organized and existing under its Charter and the laws of the
State of Montana, 121 North Rouse Street, Bozeman, Montana, with a mailing address of PO Box
1230, Bozeman, MT 59771, hereinafter referred to as “City,” and Samsara, hereinafter referred
to as “Contractor.”
In consideration of the mutual covenants and agreements herein contained, the receipt and
sufficiency whereof being hereby acknowledged, the parties hereto agree to amend the
Agreement as follows:
1. Scope of Services. Section 4 of the Agreement shall include Exhibit A, Exhibit D, and
Exhibit E. Expanding the scope of services provided by Samsara.
2. Representatives and Notices.
a. Section A of the agreement, the City’s Representative shall be Sam Bearzi, Fleet
Manager.
b. Section B of the agreement, the Contractor’s Representative shall be McKenzie
Wager.
3. Agreement still valid. All remaining terms and provisions of the Agreement remain in
effect.
**** END OF AGREEMENT EXCEPT FOR SIGNATURES ****
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
First Amendment to Professional Services Agreement for Automatic Vehicle Location Services Across City Fleet
FY 2027 – FY 2031
Page 2 of 2
IN WITNESS WHEREOF, the parties hereto have executed this instrument the day and
year first above written.
CITY OF BOZEMAN, MONTANA Samsara Inc.
By________________________________ By_____________________________
Chuck Winn, City Manager Adam Eltoukhy
Chief Legal Officer
APPROVED AS TO FORM
By_______________________________
Greg Sullivan, Bozeman City Attorney
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
Cost Overview
License Term: 49 Months
Total License Cost over 49 Months $28,652.26
Hardware and Accessories Included
Shipping and Handling* $157.14
Total Sales Tax* $0.00
Total Contract Value1 $28,809.40
First Invoice1 $7,174.02
Recurring Invoice2 $7,016.88
Quote #: Q-2721081
Issued Date: 07-07-2026
Expires 07-30-2026
Order Number: S-2858466
Prepared For:
City of Bozeman
814 N Bozeman Ave
Bozeman,
Montana
59715-2955
Bozeman, Montana
59715-2955
Prepared By:
McKenzie Wager
mckenzie.wager@samsara.com
Payment Information:Payment Method: Check/Wire
Payment Terms: Net 30Payment Frequency: Direct AnnualEstimated Ship Date: 07-17-2026
1Estimated value, actual invoice amount may change based on product fulfilment date, Includes estimated sales tax
2Amount displayed is for products purchased in this order only, Includes estimated sales tax
*If shipping is “Pending” - Amount is pending due to size of order; Shipping and Handling subject to change
*Sales tax subject to change: If Sales tax is “Pending” – Final amount will be provided prior to payment
3% fee only applies to US - (CAD, MX, EMEA are exempt)
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
Product Overview
SHIP TO Sam Bearzi
814 N Bozeman Ave
Bozeman, Montana, 59715-2955
United States
Hardware & Accessories Net Unit Price Total Price
Forward-facing dash-camera, Series 4
HW-CM33• QTY: 10
Included Included
Enhanced VG Series OBDII J1962 L-mount cable
CBL-VG-COBDII-Y1• QTY: 10
Included Included
Vehicle IoT Gateway, model VG55
HW-VG55-NA• QTY: 10
Included Included
Rear Camera
HW-MC31• QTY: 6
Included Included
5m GX12 Female to GX12 Male Cable
CBL-MC-GX5• QTY: 6
Included Included
AHD Camera Connector (1 camera)
HW-CM-AHD1• QTY: 6
Included Included
3m (10ft) USB Extension Cable
CBL-CM-B3AU• QTY: 6
Included Included
AG53 Powered Asset Gateway
HW-AG53• QTY: 2
Included Included
AG J1939 9pin Cable
CBL-AG-B9PIN• QTY: 2
Included Included
Vehicle IoT Gateway, model VG55
HW-VG55-NA• QTY: 1
Included Included
Enhanced VG Series OBDII J1962 L-mount cable
CBL-VG-COBDII-Y1• QTY: 1
Included Included
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
SHIP TO Sam Bearzi
814 N Bozeman Ave
Bozeman, Montana, 59715-2955
United States
Hardware & Accessories Net Unit Price Total Price
Total Price:Included
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
Licenses Annual Unit
Price
Total Annual
Price
License for Vehicle Gateways
LIC-VG-ENT• QTY: 10
$295.68 $2,956.80
License for HD Camera Connector (1 camera)
LIC-CM-AHD1• QTY: 6
$300.00 $1,800.00
License for Rear Camera
LIC-MC-R• QTY: 6
$81.00 $486.00
License for Forward-Facing Dash Camera
LIC-CM1-ENT• QTY: 4
$295.68 $1,182.72
Plus License for Powered Asset Gateways
LIC-AG-PWR-PLUS• QTY: 2
$147.84 $295.68
License for Vehicle Gateways
LIC-VG-ENT• QTY: 1
$295.68 $295.68
Total Price:$7,016.88
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
Billing Details:
Bill To:Billing Contact::
City of Bozeman
814 N Bozeman Ave
Bozeman, Montana, 59715-2955
Name: Sam Bearzi
Title:Fleet Manager
Billing Email: SBearzi@bozeman.net
Phone Number: 4065777406
Does your organization require a purchase order (PO) in order to process payment to vendors?
\Picklist_1\
If yes, please provide the PO Number: /PO_number_1/
If your organization requires invoice submission via an electronic invoice portal, please email any
e-invoicing requirements to billingsupport@samsara.com.
Please email any tax documentation to billingsupport@samsara.com.
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
Thank you for considering Samsara
Samsara provides real-time visibility, business- relevant tools, and powerful analytics that enable customers
to increase the productivity of their fleets and reduce operating costs. A solution for your fleet is proposed
below.
What is included?
Samsara fleet tracking solution include cellular gateways, hardware accessories, and a per-gateway license.
Gateway licenses provide all ongoing elements of the service, including:
-Real-time location and vehicle telematics
-Cellular data connectivity
-Dashboard access with unlimited administrator accounts
-Driver App for iOS and Android devices with unlimited driver accounts
-WiFi hotspot connectivity (VG34 gateways, 500 MB/mo capacity)
-Over-the-air software feature upgrades
-API access as it relates to safety features for integration with 3rd party systems
-Maintenance and phone support
Samsara does not charge per-feature license fees, or other hidden costs.
Payment Terms
This order form includes a license fee for the Samsara Software associated with the Hardware
to be paid annually beginning on the License Start Date and, if applicable, a one-time Hardware
cost to be paid upfront as of the license start date. The annual fees are payable by recurring
wire transfer. All transfers made by credit card are subject to a processing fee up to 3%, subject
to applicable law. Late payments are subject to a 1.5% per month late fee. If license payments
are delinquent by 30 days, Samsara may suspend the Service until late payments are remitted.
License Term
The license term for the Samsara Software licenses purchased under this Order Form begins on
the day Samsara activates the applicable Samsara Software license by providing you a claim
number and access to the Hosted Software (“License Start Date”). If Hardware associated with
a then-unactivated Samsara Software license will be shipped to you under this Order Form, such
Samsara Software license will be activated on the day the Samsara Hardware ships.
Notwithstanding the foregoing, if you are renewing the license term for a previously-activated
Samsara Software license under this Order Form, the License Start Date for the renewal license
term shall be the day that Samsara extends your access to the Hosted Software for the renewal
license term. Samsara Hardware requires a valid license to function.
Samsara may ship Hardware under this Order Form subject to a schedule as mutually agreed
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
between the Parties or as determined by Samsara. By signing this Order Form, you confirm that
each “Ship To” delivery address set forth herein is accurate and that any individual accepting
delivery at that address is authorized to do so on your behalf. To the extent such Hardware is
associated with then-unactivated Samsara Software licenses, the Samsara Software license
term for each such Hardware device will start on the day that device ships regardless of the
shipment schedule for the other such Hardware devices. If all such Hardware is shipped in one
shipment, the license term for all such Hardware will be the full license term under this Order
Form. If such Hardware is shipped in multiple shipments, only the license term of such
Hardware in the initial shipment will be such full license term. The license term of the remaining
such Hardware shipped after the initial shipment will be set to match the then-remaining license
term of the initial shipment, so that the license term for all such Hardware under this Order Form
expires on the same date. The total cost of the licenses for such Hardware shipped after the
initial shipment will be pro-rated based on their actual license term, rounded up to the nearest
month, as compared to the full license term under this Order Form. Certain payment amounts
under this Order Form assume that the entire order is fulfilled at the same time and are subject
to potential reduction based on the actual schedule of order fulfillment.
You agree that you will only use the features included with the Samsara Software licenses
purchased under this Order Form (“Licensed Scope”). Samsara reserves the right to audit usage
of Samsara Software and to remove your access to such features beyond the Licensed Scope
(for example, the licensed feature scope or licensed user count, as applicable) at any time. If
you would like to use features beyond the Licensed Scope, you are required to purchase the
applicable Samsara Software licenses and if applicable install the applicable Hardware that
include such scope. If Samsara becomes aware that you are using features beyond the
Licensed Scope, Samsara reserves the right to charge you for the applicable Samsara Software
licenses that include such Licensed Scope at list price, and you agree to immediately pay such
amounts. Samsara further reserves the right to change, discontinue, or remove features
included in a Samsara Software license at any time.
You acknowledge and agree that, during your license term, you may not downgrade your
Samsara Software license plan to a lower Samsara Software license plan (e.g., downgrading
your “Enterprise” license to a “Premier” license).
Support And Warranty
Samsara stands behind its Products. During the applicable warranty period, defective Hardware
will be remedied pursuant to our Hardware Warranty Policy at
www.samsara.com/support/hardware-warranty. Additional support information can be found at
www.samsara.com/support.
Terms
Unless otherwise set forth herein, your use and access of the Hardware, Products, and Services
specified herein are governed by Samsara’s standard terms of service found at
https://www.samsara.com/legal/public-sector-customers-platform-terms-of-service/, unless
the Parties have entered into a separate terms of service agreement and/or a separate terms of
service agreement is attached to the Order Form, in which case such separate terms of service
agreement shall govern (the 'Terms of Service') provided that notwithstanding anything stated
in the Terms of Service to the contrary, Customer agrees the following sections from Samsara’s
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
standard terms of service found at https://www.samsara.com/legal/public-sector-customers-
platform-terms-of-service/ shall apply: License (Section 4), Product Updates (Section 7), Data
Protection Addendum (Section 10.3), Non-Samsara Products (Section 14), and Hardware
Warranty (Section 17). You agree to be bound by the Terms of Service, and any capitalized
terms not defined herein shall have the meaning set forth in the Terms of Service. The terms
and conditions of the Terms of Service and this Order Form are the exclusive agreement of the
parties with respect to the subject matter hereof and no other terms or conditions, including
those associated with any Customer payment portal or onboarding of Samsara as a Customer
vendor, shall be binding upon Samsara or otherwise have any force or effect.
To the extent Samsara allows you to make subsequent purchases of Products via Purchase
Order without a corresponding Quote, you agree that (i) such Purchase Order shall be subject to
the terms and conditions of this Order Form, including with respect to payment and license
terms, as well as the applicable Terms of Service; and (ii) to the extent there is a conflict
between such Purchase Order and this Order Form, including with respect to payment and
license terms, as well as the applicable Terms of Service, the terms of this Order Form shall
prevail, and no additional terms included in such Purchase Order that are not included in this
Order Form shall apply. You acknowledge and agree that any reference to a Purchase Order in
this Order Form is solely for your convenience in record keeping, and the existence of a
Purchase Order or any delivery of Products to you following receipt of any Purchase Order shall
not be deemed an acknowledgement of or agreement to any terms or conditions associated
with any such Purchase Order or in any way be deemed to modify, alter, supersede or
supplement the Terms of Service or this Order Form.
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
Notification of Confidentiality
You agree that the pricing and payment terms specified in this Order Form shall (i) be held in
strict confidence; (ii) not be disclosed to any Samsara competitor or other entity, except as pre-
approved in writing by Samsara; and (iii) not be used except to evaluate the suitability of the
Samsara Products for your business. You will immediately notify Samsara in the event of any
unauthorized use or disclosure under these terms. Violation of these obligations will cause
irreparable harm to Samsara for which Samsara may obtain compensatory and timely injunctive
relief from a court, as well as any other remedies that may be available, including recovery of all
reasonable attorney’s fees and costs incurred in seeking such remedies. Your obligations
specified herein shall last until the pricing and payment terms herein are, through no fault or
action by you, public. This Order Form is a legally binding agreement between you (“Customer”)
and Samsara Inc. (“Samsara”). IN WITNESS WHEREOF, Customer has caused this Order Form to
be executed by its duly authorized representative.
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
I confirm acceptance of this Order Form on behalf of the Customer identified herein and represent and
warrant that I have full and complete authority to bind the Customer to this Order Form, including all
terms and conditions herein." "Please confirm acceptance of this Order Form by signing below:
Signature \s1\
Print Name:\n1\
Date:\d1\
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
Cost Overview
License Term: 49 Months
Total License Cost over 49 Months $13,884.64
Hardware and Accessories Included
Shipping and Handling* $0.00
Total Sales Tax* $0.00
Total Contract Value1 $13,884.64
First Invoice1 $3,400.32
Recurring Invoice2 $3,400.32
Quote #: Q-2687350
Issued Date: 07-08-2026
Expires 07-30-2026
Order Number: S-2615087
Prepared For:
City of Bozeman
814 N Bozeman Ave
Bozeman,
Montana
59715-2955
Bozeman, Montana
59715-2955
Prepared By:
Derek Newsome
derek.newsome@samsara.com
Payment Information:Payment Method: Credit Card/ACH Debit
Payment Terms: Net 30Payment Frequency: Direct AnnualEstimated Ship Date: 07-07-2026
1Estimated value, actual invoice amount may change based on product fulfilment date, Includes estimated sales tax
2Amount displayed is for products purchased in this order only, Includes estimated sales tax
*If shipping is “Pending” - Amount is pending due to size of order; Shipping and Handling subject to change
*Sales tax subject to change: If Sales tax is “Pending” – Final amount will be provided prior to payment
3% fee only applies to US - (CAD, MX, EMEA are exempt)
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
Product Overview
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
Licenses Annual Unit
Price
Total Annual
Price
License for Forward-Facing Dash Camera
LIC-CM1-ENT• QTY: 5
$295.68 $1,478.40
License for Vehicle Gateways
LIC-VG-ENT• QTY: 5
$295.68 $1,478.40
Plus License for Powered Asset Gateways
LIC-AG-PWR-PLUS• QTY: 3 $147.84 $443.52
Total Price:$3,400.32
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
Billing Details:
Bill To:Billing Contact::
City of Bozeman
814 N Bozeman Ave
Bozeman, Montana, 59715-2955
Name: Sam Bearzi
Title:Streets Operator Foreman
Billing Email: SBearzi@bozeman.net
Phone Number: 4064513247
Does your organization require a purchase order (PO) in order to process payment to vendors?
\Picklist_1\
If yes, please provide the PO Number: /PO_number_1/
If your organization requires invoice submission via an electronic invoice portal, please email any
e-invoicing requirements to billingsupport@samsara.com.
Please email any tax documentation to billingsupport@samsara.com.
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
Thank you for considering Samsara
Samsara provides real-time visibility, business-relevant tools, and powerful analytics that enable
customers to increase the productivity of their fleets and reduce operating costs. A solution for
your fleet is proposed below.
What is included?
Samsara’s fleet tracking solution includes hardware accessories and a per-gateway license.
Gateway licenses provide all ongoing elements of the service, including:
- Real-time location and vehicle telematics
- Dashboard access with unlimited administrator accounts
- Driver App for iOS and Android devices with unlimited driver accounts
- Over-the-air software feature upgrades
- API access as it relates to features for integration with 3rd party systems
- Maintenance and phone support
Samsara does not include hidden costs in its licenses. If you want access to Samsara’s full set of
fleet features--including but not limited to WiFi hotspot and ELD capabilities--you will need to
upgrade your license. Samsara reserves the right to audit usage of features unrelated to the
solution as well as remove them from the Samsara Dashboard.
Payment Terms
This order form includes a license fee for the Samsara Software associated with the Hardware to
be paid annually beginning on the License Start Date and, if applicable, a one-time Hardware cost
to be paid upfront as of the license start date. The annual fees are payable by recurring wire
transfer. All transfers made by credit card are subject to a processing fee up to 3%, subject to
applicable law. Late payments are subject to a 1.5% per month late fee. If license payments are
delinquent by 30 days, Samsara may suspend the Service until late payments are remitted.
License Term
The license term for the Samsara Software licenses purchased under this Order Form begins on
the day Samsara activates the applicable Samsara Software license by providing you a claim
number and access to the Hosted Software (“License Start Date”). If Hardware associated with a
then-unactivated Samsara Software license will be shipped to you under this Order Form, such
Samsara Software license will be activated on the day the Samsara Hardware ships.
Notwithstanding the foregoing, if you are renewing the license term for a previously-activated
Samsara Software license under this Order Form, the License Start Date for the renewal license
term shall be the day that Samsara extends your access to the Hosted Software for the renewal
license term. Samsara Hardware requires a valid license to function.
Samsara may ship Hardware under this Order Form subject to a schedule as mutually agreed
between the Parties or as determined by Samsara. By signing this Order Form, you confirm that
each “Ship To” delivery address set forth herein is accurate and that any individual accepting
delivery at that address is authorized to do so on your behalf. To the extent such Hardware is
associated with then-unactivated Samsara Software licenses, the Samsara Software license term
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
for each such Hardware device will start on the day that device ships regardless of the shipment
schedule for the other such Hardware devices. If all such Hardware is shipped in one shipment,
the license term for all such Hardware will be the full license term under this Order Form. If such
Hardware is shipped in multiple shipments, only the license term of such Hardware in the initial
shipment will be such full license term. The license term of the remaining such Hardware shipped
after the initial shipment will be set to match the then-remaining license term of the initial
shipment, so that the license term for all such Hardware under this Order Form expires on the
same date. The total cost of the licenses for such Hardware shipped after the initial shipment will
be pro-rated based on their actual license term, rounded up to the nearest month, as compared to
the full license term under this Order Form. Certain payment amounts under this Order Form
assume that the entire order is fulfilled at the same time and are subject to potential reduction
based on the actual schedule of order fulfillment.
You agree that you will only use the features included with the Samsara Software licenses
purchased under this Order Form (“Licensed Scope”). Samsara reserves the right to audit usage
of Samsara Software and to remove your access to such features beyond the Licensed Scope
(for example, the licensed feature scope or licensed user count, as applicable) at any time. If you
would like to use features beyond the Licensed Scope, you are required to purchase the
applicable Samsara Software licenses and if applicable install the applicable Hardware that
include such scope. If Samsara becomes aware that you are using features beyond the Licensed
Scope, Samsara reserves the right to charge you for the applicable Samsara Software licenses
that include such Licensed Scope at list price, and you agree to immediately pay such amounts.
Samsara further reserves the right to change, discontinue, or remove features included in a
Samsara Software license at any time.
You acknowledge and agree that, during your license term, you may not downgrade your Samsara
Software license plan to a lower Samsara Software license plan (e.g., downgrading your
“Enterprise” license to a “Premier” license).
Support And Warranty
Samsara stands behind its Products. During the applicable warranty period, defective Hardware
will be remedied pursuant to our Hardware Warranty Policy at
www.samsara.com/support/hardware-warranty. Additional support information can be found at
www.samsara.com/support.
Terms
Unless otherwise set forth herein, your use and access of the Hardware, Products, and Services
specified herein are governed by Samsara’s standard terms of service found at
https://www.samsara.com/legal/public-sector-customers-platform-terms-of-service/, unless the
Parties have entered into a separate terms of service agreement and/or a separate terms of
service agreement is attached to the Order Form, in which case such separate terms of service
agreement shall govern (the 'Terms of Service') provided that notwithstanding anything stated in
the Terms of Service to the contrary, Customer agrees the following sections from Samsara’s
standard terms of service found at https://www.samsara.com/legal/public-sector-customers-
platform-terms-of-service/ shall apply: License (Section 4), Product Updates (Section 7), Data
Protection Addendum (Section 10.3), Non-Samsara Products (Section 14), and Hardware
Warranty (Section 17). You agree to be bound by the Terms of Service, and any capitalized terms
not defined herein shall have the meaning set forth in the Terms of Service. The terms and
conditions of the Terms of Service and this Order Form are the exclusive agreement of the parties
with respect to the subject matter hereof and no other terms or conditions, including those
associated with any Customer payment portal or onboarding of Samsara as a Customer vendor,
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
shall be binding upon Samsara or otherwise have any force or effect.
To the extent Samsara allows you to make subsequent purchases of Products via Purchase
Order without a corresponding Quote, you agree that (i) such Purchase Order shall be subject to
the terms and conditions of this Order Form, including with respect to payment and license terms,
as well as the applicable Terms of Service; and (ii) to the extent there is a conflict between such
Purchase Order and this Order Form, including with respect to payment and license terms, as well
as the applicable Terms of Service, the terms of this Order Form shall prevail, and no additional
terms included in such Purchase Order that are not included in this Order Form shall apply. You
acknowledge and agree that any reference to a Purchase Order in this Order Form is solely for
your convenience in record keeping, and the existence of a Purchase Order or any delivery of
Products to you following receipt of any Purchase Order shall not be deemed an
acknowledgement of or agreement to any terms or conditions associated with any such
Purchase Order or in any way be deemed to modify, alter, supersede or supplement the Terms of
Service or this Order Form.
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
Notification of Confidentiality
You agree that the pricing and payment terms specified in this Order Form shall (i) be held in
strict confidence; (ii) not be disclosed to any Samsara competitor or other entity, except as pre-
approved in writing by Samsara; and (iii) not be used except to evaluate the suitability of the
Samsara Products for your business. You will immediately notify Samsara in the event of any
unauthorized use or disclosure under these terms. Violation of these obligations will cause
irreparable harm to Samsara for which Samsara may obtain compensatory and timely injunctive
relief from a court, as well as any other remedies that may be available, including recovery of all
reasonable attorney’s fees and costs incurred in seeking such remedies. Your obligations
specified herein shall last until the pricing and payment terms herein are, through no fault or
action by you, public. This Order Form is a legally binding agreement between you (“Customer”)
and Samsara Inc. (“Samsara”). IN WITNESS WHEREOF, Customer has caused this Order Form to
be executed by its duly authorized representative.
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1
I confirm acceptance of this Order Form on behalf of the Customer identified herein and represent and
warrant that I have full and complete authority to bind the Customer to this Order Form, including all
terms and conditions herein." "Please confirm acceptance of this Order Form by signing below:
Signature \s1\
Print Name:\n1\
Date:\d1\
Docusign Envelope ID: 52094A5D-83D9-85AC-80E9-EB1AC570B5C1