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Home My WebLink AboutAdden 3DocuSign, Inc. 221 Main Street, Suite 1550 San Francisco, CA 94105 Offer Valid Through: Feb 21, 2022 Prepared By: Jennifer Drouillard Quote Number: Q-00730550 ORDER FORM Address Information Bill To: Ship To: City of Renton City of Renton 1055 S Grady Way, Renton, WA, 98057 United States 1055 S Grady Way, Renton, WA, 98057 United States Billing Contact Name: Shipping Contact Name: Tien Akutagawa Tien Akutagawa Billing Email Address: takutagawa@rentonwa.gov Shipping Email Address: takutagawa@rentonwa.gov Billing Phone: 425.430.6884 Shipping Phone: 425.430.6884 Order Details Order Start Date: Feb 21, 2022 Payment Method: Check Order End Date: Dec 4, 2022 Payment Terms: Net 30 Billing Frequency: Annual Currency: USD Products Product Name Start Date End Date Quantity Net Price eSignature Business Pro Edition - Envelope Subs. Feb 21, 2022 Dec 4, 2022 500 $2,205.00 eSignature Advanced Workflows Addon - Envelope Subs. Feb 21, 2022 Dec 4, 2022 500 $1,102.50 Premier Support Feb 21, 2022 Dec 4, 2022 1 $496.12 Grand Total: $3,803.62 Product Details eSignature Envelope Allowance: 500 CAG-21-283, Adden #3-22 Page 2 of 3 Overage/Usage Fees eSignature Business Pro Edition - Envelope Subs. (Per Transaction): $5.80 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: \tax1\ If yes, please send the required tax exemption documents immediately to taxexempt@docusign.com. Invoices for this order will be emailed automatically from invoicing@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: \por1\ If yes, please complete the following: PO Number: \po1\ PO Amount: $\pa1\ Page 3 of 3 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 DocuSign, Inc. Signature:\si1\Signature:\si3\ Name:\na1\Name:\na3\ Job Title:\ti1\Job Title:\ti3\ Date:\ds1\Date:\ds3\ \\in2\Signature: Email: Young Yoon IT Director 02/15/2022 yyoon@rentonwa.gov INVOICE DocuSign Inc. Remittance slips can be emailed to remittance@docusign.com Tax*-Taxation based on ‘Ship To’ address information. For additional information, including answers to frequently asked billing questions, please visit our Billing Support site at: https://www.docusign.com/support Invoice Date: Invoice #: Payment Terms: Due Date: Account Name: Feb 21, 2022 INV31376870 Net 30 Mar 23, 2022 City of Renton Billing Account #:A00346886 Bill To: City of Renton takutagawa@rentonwa.gov 1055 S Grady Way Renton Washington 98057 United States Ship To:City of Renton takutagawa@rentonwa.gov 1055 S Grady Way Renton Washington 98057 United States PO Number Description Service Period Quantity Tax Amount Extended Price eSignature Business Pro Edition - Envelope Subs.- Envelope 02/05/2022- 02/20/2022 51 0.00 0.00 eSignature Business Pro Edition - Envelope Subs.- Envelope Allowance -- Proration 02/21/2022- 12/04/2022 500 222.71 2,205.00 Premier Support-Premier Support -- Proration 02/21/2022- 12/04/2022 1 0.00 496.12 eSignature Advanced Workflows Addon - Envelope Subs.-eSignature Advanced Workflows Addon - Envelope Subs. -- Proration 02/21/2022- 12/04/2022 500 111.35 1,102.50 Subtotal:3,803.62 Tax*:334.06 Total:4,137.68 Currency:USD TRANSACTIONS ASSOCIATED TO THIS INVOICE Total Adjustments 0.00 Total Credits - 0.00 Total Payments - 0.00 Invoice Balance 4,137.68 Currency USD *PLEASE NOTE THE NEW REMIT TO BANKING INFORMATION BELOW* DocuSign Envelope ID: 0E82DDD4-4A64-4314-9F28-8BDF967B5B5ADocuSign Envelope ID: DC3997BD-D285-43C2-AB69-78A5E5263E90 INVOICE DocuSign Inc. Remittance slips can be emailed to remittance@docusign.com Tax*-Taxation based on ‘Ship To’ address information. For additional information, including answers to frequently asked billing questions, please visit our Billing Support site at: https://www.docusign.com/support Please remit electronic payments to: JPMorgan Chase New York, NY 10017 ACH Routing #: 322271627 Wire Routing #: 021000021 Account #: 623675136 Swift Code: CHASUS33 Please remit checks to: DOCUSIGN INC Lockbox P.O. Box 735445 Dallas, TX 75373-5445 For Courier Deposits (Fed EX, UPS, etc.): JPMorgan Chase (TX1-0029) Attn: DOCUSIGN INC Lockbox 735445 14800 Frye Road, 2nd Floor Ft Worth, TX 76155 DocuSign Envelope ID: 0E82DDD4-4A64-4314-9F28-8BDF967B5B5ADocuSign Envelope ID: DC3997BD-D285-43C2-AB69-78A5E5263E90 INVOICE DocuSign Inc. Remittance slips can be emailed to remittance@docusign.com Tax*-Taxation based on ‘Ship To’ address information. For additional information, including answers to frequently asked billing questions, please visit our Billing Support site at: https://www.docusign.com/support Dear Valued Customer, Please note: Our Lockbox Address has changed These new payment instructions are now provided on your invoice. Please update your records accordingly to ensure your payment is received and applied in a timely manner. This change will be effective as of September 1, 2020. Sincerely, Angela Pope Sr. Manager, Accounts Receivable DocuSign, Inc. DocuSign Envelope ID: 0E82DDD4-4A64-4314-9F28-8BDF967B5B5ADocuSign Envelope ID: DC3997BD-D285-43C2-AB69-78A5E5263E90