ORDER FORM - ENTERPRISE SaaS - STATE OF KANSAS
| Provider | [PROVIDER LEGAL NAME] |
| Customer | [CUSTOMER LEGAL NAME] |
| Product | [PRODUCT NAME] |
| Term | [X] months/years |
| Fees | $[AMOUNT] |
Payment: Net [30] days. Kansas sales tax: 6.5% state + local.
Data Breach: K.S.A. 50-7a01 et seq.
Venue: [Johnson/Sedgwick/Shawnee] County, Kansas.
SIGNATURES
Provider: _________________ Date: _______
Customer: _________________ Date: _______