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Home My WebLink About2005-223 License Renewal - Ricoh CLA/MLA Partner Designation Form Customer designates the CLA/MLA Partner identified below to fulfill all future orders and collect all payments and reports Customer must submit to Novell. Customer gives Novell permission to disclose contract information to the designated partner. Where Customer has a Master License Agreement (MLA), the term "Partner" refers to the Software Services Agent (aka Fulfillment Agent). Where Customer has a Corporate License Agreement (CLA), "Partner" refers to a CLA reseller. Should the designated Partner fail to comply with its invoicing, collection or other obligations, Novell may accept orders, invoice and collect from Customer directly. If Customer is an MLA Customer selecting a different SSA, by signing below, Customer certifies that is has properly notified its current/former Fulfillment Agent/SSA of its selection of a different SSA to fulfill all future orders. The change will take effect upon acceptance of this Partner Designation Form by Novell. At that time Novell will notify the Customer and the new Partner via email or fax (provided such contact information is available) that the change is effective. Note: Customer and Partner e-mail and fax information must be provided below for Novell to process this form. Please send original, completed forms to Novell Contracts Department, 1800 South Novell Place, M/S PRY -D-231, Provo, UT 84606. Customer Information Customer MLA or CLA Number: Customer Name: 126480 City of Ashland Address: 90 N Mountain City/State: Country: Zip/Post Code: Ashland, OR USA 97520 Location Coordinator Name (person responsible for contract administration): Patrick Hopkins Telephone: Fax: E-mail: 541-488-5354 541-488-5320 hop kinsp(iVashland. or. us Desi nated Partner Information Reseller Name: RICOH dba: RICOH Business S stems Address: 4000 Kruse Wa Place Buildin 1 * Suite 300 City/State: Country: Lake Oswe 0 USA Reseller Contact Name: Warren Cox Telephone: 503 697-0207 Zip/Post Code: 97035 Fax: (503) 697-0234 Customer (signature required) Signature: Lfty( ~ Name: UL 7-~-A/A!.AG~_ Title: ~>I(/~C~ })//Z4~ Date: P'// 'l /~ S- f ,,' ~ n' CD III III ::J a. 't:I (3 a. c: o in III ;;; III c: C" iii' ~ o o :J' III ::J CQ !II ~ ~ n' CD III C" III III CD a. o ::J C ~ o ~ ;;; ::J o ~ () ~ () ~ m "U () Q sa ~ () ~ m '1J () sa () 0 "U () () sa )> () en :8 .-1 Z "C ~ ~ (') 0 0 CD 0 :3 :::r 0 -? 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No Novell MLA License Renewal FY 2005 - 2006 Per attached Schedule "C", Order Form, 2-Paqes, State of Oreqon Contract 5121-PA, Expiration date: 06/30/2006 16,488.82 BILL TO: Account Payable 20 EAST MAIN ST 541-552-2028 ASHLAND, OR 97520 SUBTOTAL TAX FREIGHT TOTAL 16488.82 0.00 0.00 16,488.82 16 488.82 ,#. ~ ~,j~ Authori Signature /~05 VENDOR COPY