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CUSTOMER ORDER FORM Dedicated Internet Access <br />North America — US- Enteclj solution, LLC <br />635 S Lafayette Blvd, Suite 1-211. <br />South Bend, IN 46601 <br />Customer Service Delivery Information <br />Tenant/Datacenter Name <br />City of South Bend <br />Node ID <br />227 W. Jefferson Blvd.m <br />Suite / Floor <br />City, State, Province <br />South Bernd, IN 46601 <br />Postal Code <br />46601 <br />Country <br />USA <br />Delivery Contact Name <br />Michael E. Sniadecki <br />Telephone <br />(574) 245-6004 <br />Cell Phone _ <br />Fax .' <br />Email <br />msniadec@southbendin.gov <br />Entech Solutions Contact Information <br />Location <br />south Bend <br />Contact Name <br />Michael N. Ssemwanga <br />Telephone <br />(574) 9685375 <br />Cell Phone <br />Fax <br />Entail <br />info entechsb.com <br />Contract Document <br />The entire Customer Service Agreement (CSA), entered into between <br />Customer and Entech Solutions,, is made up of the documents listed here. <br />Capitalized terms are defined in the text of the term or definition section of <br />the Terms. All prior agreements, proposals, representations, statements, or <br />understandings whether written or oral, concerning such services, are <br />superseded. Customer certifies that the documents constituting CSA are the <br />document and forms that have been supplied to Customer by Entech <br />Solutions and the Customer has made no changes to them. <br />Notes <br />Customer Contracting & Billing Information <br />Company Name; <br />City of South Bend <br />Billing Address <br />227 W. Jefferson Blvd. <br />Suite / Floor' <br />City, State, Province <br />South Bend, IN, 46601 <br />Postal Code <br />46601 <br />Country <br />USA <br />Company Reg. i <br />Tax/VAT ID Number <br />Request for consolidated billing (one account ,rinvoice tar muluple" <br />No <br />Billing Contact Warne <br />Michael E. Sniadecki <br />Telephone <br />(574) 245-6004 <br />Cell Phone <br />Fax <br />Email <br />msniadec@southbendin.gov <br />(1) order Form <br />(2) Terms, as attached (initialed by Customer) (For current customers,. <br />if terms are not attached, the current terms remain in force.. <br />(3) Any other addendum as attached (signed by customer) <br />Signatures <br />By signing below, Customer affirms and acknowledges that they have read the entire CSA and al7ces to be bound by the provisions thereof <br />rt n <br />For CUSTOMER: I ,t'a Y <br />Signature: _ fly 1441 W, V704.4- <br />Print Name: <br />AT <br />Title: <br />Date. / <br />For ENTECH SOLUTION LLC <br />Signature: _. <br />Print Name: <br />Date: <br />Order formgenerated on: 1/29/2018 '�"""�"�"" Page 2 of 2 <br />