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MWOSOft I VOIL -ne Licensing <br />Supplemental Contact Information Form State and Local <br />This form can be used in combination with Agreement and Enrollment/Registi:bEbri. ti,owever,.;a <br />separate form must be s0mitted for each EnroilMontlRegistfation, wfien. more than oho is submMed <br />on a sigfiature fafin, For the purposes of this f6mi, "Entity" oan,mOan the slgrting 1' ptjty; Gtiaorner, <br />Enrolltd Affiliate, Government Partri , Institution, or- other party entering i.pto a Vol;tin$ Licensing <br />program agreatnent. Primary and Notices contacts in this form will not apply to Enrollments or <br />Registrations. <br />This form applies to; 0 Agreement <br />El Enroliment/Afflllate Registration Form <br />Insert,primary entity name if inore than one Enrolirmeat/Registration Form <br />is. sub.mItted <br />Contact Information. <br />Eachparty will notify the other in writing if any of the information 1Athe folio+uing contact information <br />pages) changes, The asterisks (") Indicate regi aired fields, if the t nEity chaises iQ designate other <br />bontact types, the sain6 required .fields nous( be cUtnpleteel for each section. By providing contact <br />infonriation, entity consents to its use far purposes of administering the each. <br />by Microsoft and other <br />parties that help Worosoft administer this Enrollment. The personal. informat"san provided €n oonneatign <br />with this agreement. +tiifi be used and Orotectad trccordlog to the privacy stateri1ont available at <br />Vjr2s-[Acenslnq,rnlorosoft.com. <br />1� Additional notices contact. <br />This contact receives all notices that are sent from Microsoft. No online access is granted to this <br />individual. <br />Name of Entity* County of Riverside <br />Contact names; r=irst Melissa Last Etter <br />Contact.OnOil* me€issa.etteru@7rivG9it.org <br />•Street adclress`.345f} 1�3tir�5treet <br />Gity" R1-verslde, Stata* C°F1 Postal code* 92601-38.62 <br />Craiarrtty� US <br />Phonal 959-955-7731 Fax <br />0 This contact Is a third'party (h it the Entity). Warning: This contact receives personally lden(fisble <br />information of the Entity. <br />2. Software .Assurance manager. <br />This contact will re0eive online permissions to manage Ilia. Software Assurance benefits tinder the <br />Enrollment or Registration, <br />Marne of Entity* <br />Contact name*, First last <br />Gontact emalt., <br />Street address" <br />City* State" Postal code' <br />Country" <br />Phone* Fax <br />SupCont�ci[nfof nim{US)SLG[f NG)(Ooi2010) rage -t of 3 <br />