ORDER FORM - ENTERPRISE SaaS - STATE OF MISSISSIPPI
| Provider | [PROVIDER LEGAL NAME] |
| Customer | [CUSTOMER LEGAL NAME] |
| Product | [PRODUCT NAME] |
| Term | [X] months/years |
| Fees | $[AMOUNT] |
Payment: Net [30] days. Mississippi sales tax: 7% state.
Data Breach: Miss. Code Ann. Section 75-24-29.
Venue: [Hinds/Harrison] County, Mississippi.
SIGNATURES
Provider: _________________ Date: _______
Customer: _________________ Date: _______