ORDER FORM - ENTERPRISE SaaS - STATE OF GEORGIA
| Provider | [PROVIDER LEGAL NAME] |
| Customer | [CUSTOMER LEGAL NAME] |
| Order Date | [DATE] |
| Product | [PRODUCT NAME] |
| Term | [X] months/years |
| Fees | $[AMOUNT] |
Payment: Net [30] days. Georgia sales tax (4% state + local).
Data Breach: O.C.G.A. § 10-1-912 compliance required.
Venue: [Fulton/DeKalb/Cobb] County, Georgia.
SIGNATURES
Provider: _________________ Date: _______
Customer: _________________ Date: _______