ORDER FORM - ENTERPRISE SaaS - STATE OF NEBRASKA
| Provider | [PROVIDER LEGAL NAME] |
| Customer | [CUSTOMER LEGAL NAME] |
| Product | [PRODUCT NAME] |
| Term | [X] months/years |
| Fees | $[AMOUNT] |
Payment: Net [30] days. Nebraska sales tax: 5.5% state + local.
Data Breach: Neb. Rev. Stat. Section 87-801 et seq.
Venue: [Douglas/Lancaster] County, Nebraska.
SIGNATURES
Provider: _________________ Date: _______
Customer: _________________ Date: _______