Orange County NC Website
Browse       Search
DocuSign Envelope ID:97D49820-FEB8-4DCA-BA8C-7909CD9FA2F9 <br /> 2017 ACA Subscription Agreement <br /> This ACA Subscription Agreement('Agreement )is made by and between: <br /> Selerix Systems„ inc.„a Delaware Corporation, with its principal place of business located at 2851 <br /> Craig Drive. Suite 300, McKinney, TX 75070 (hereinafter referred to as l'SELERIX1) <br /> and <br /> Orange County.a North Carolina Government,with iits principal place of business Ilocated at 200 <br /> South Cameron St_ Hillsborough, NC, 27278 (hereinafter referred to as'SUBSCRIBER") <br /> as of <br /> 111/2017 ('Effective Date") <br /> WHEREAS, SELERIIX,as Licensor, has granted licenses in its Benefits-Selection software system,,and <br /> associated documentation (the'Licensed Product')to licensees ("Licensees")through SELERIX's <br /> execution of one or more software licensing agreements, as the same may be amended from time to time <br /> (each, a 'License Agreement%and coilectively, the'License Agreements ); <br /> WHEREAS, SUBSCRIBER has not entered into such a License Agreement with SELERIX but instead is <br /> an authorized user of the Licensed Product under a License Agreement that a third party has with <br /> SELERIIX; <br /> WHEREAS, SUBSCRIBER has requested that SELERIIX provide to SUBSCRIBER a certain add on <br /> optional feature described in this Agreement(the ACA Reporting Moduiell).Which can be used <br /> conjunction with the Licensed Product but such ACA Reporting Module is not included in and is outside <br /> the scope of the applicable License Agreement under which SUBSCRIBER is authorized to use the <br /> Licensed Product; <br /> WHEREAS, SELERIIX is willing to provide the ACA Reporting Module to SUBSCRiBER,and <br /> SUBSCRIBER is Wiling to accept the ACA Reporting Module from,, SELERM, on the terms and conditions <br /> described in this Agreement,: <br /> NOW THEREFORE,the parties further agree to the following: <br /> 1. ACA Reporting Module <br /> A. Purposes. SUBSCRIBER represents that to SUBSCRIBER's knowledge, SUBSCRIBER is <br /> an authorized user under a current, valid, and existing License Agreement. SUBSCRIBER <br /> ACKNOWLEDGES THAT THIS AGREEMENT DOES NOT GRANT A LICENSE TO THE <br /> LICENSED PRODUCT. This Agreement, however,, does permit the use of the ACA <br /> Reporting Module as described herein. SUBSCRIBER will utilize the ACA Reporting <br /> Module for the following purposes (the "Purposes"): <br /> 1) Production of IRS Forms 1094C and 1095C (coliectively,the'RS Forms')for <br /> SUBSCRIBER's individual employees and employer level filings when the appropriate,data is <br /> managed and uploaded by SUBSCRIBER. <br /> 2) Transmittal of the SUBSCRIBER's IRS Forms in the required XML format through the IRS <br /> AIR transmittal system. <br /> 3) Facilitation of SUBSCRIBER's tracking of medical eligibility as defined by <br /> SUBSCRIBER. This requires the SUBSCRIBER to either upload its employees' <br /> hours worked into the Licensed Product's system or to provide such data to <br /> SELERIX in the file format prescribed by SELERIX so that SELERIX can upload <br /> such data into the Licensed Product's system. <br /> 2017 ACA SUBSCRIPTION AGREEMENT FOR NON-LICENSEES <br />