ORDER FORM - ENTERPRISE SaaS - STATE OF NORTH CAROLINA
| Provider | [PROVIDER LEGAL NAME] |
| Customer | [CUSTOMER LEGAL NAME] |
| Product | [PRODUCT NAME] |
| Term | [X] months/years |
| Fees | $[AMOUNT] |
Payment: Net [30] days. North Carolina sales tax: 4.75% state + local.
Data Breach: N.C.G.S. Section 75-61 et seq.
Venue: [Wake/Mecklenburg] County, North Carolina.
SIGNATURES
Provider: _________________ Date: _______
Customer: _________________ Date: _______