ORDER FORM - ENTERPRISE SaaS - STATE OF NEW MEXICO
| Provider | [PROVIDER LEGAL NAME] |
| Customer | [CUSTOMER LEGAL NAME] |
| Product | [PRODUCT NAME] |
| Term | [X] months/years |
| Fees | $[AMOUNT] |
Payment: Net [30] days. New Mexico gross receipts tax: 5.125% state + local.
Data Breach: NMSA Section 57-12C-1 et seq.
Venue: [Bernalillo/Santa Fe] County, New Mexico.
SIGNATURES
Provider: _________________ Date: _______
Customer: _________________ Date: _______