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Technology Assessment Statement of Work # 31362 v 1.0 <br />Orange County Government May 11, 2021 <br />Rev. 09/20Q INSIGHT PROPRIETARY AND CONFIDENTIAL Page 9 of 10 <br />8. SIGNATURE BLOCK <br />By signing below, the undersigned agree they are bound by the terms of this SOW and the <br />Agreement. <br />Insight Client <br />By: <br /> <br />Authorized Representative <br />By: <br /> <br />Authorized Representative <br />Print <br />Name: <br /> Print <br />Name: <br /> <br />Title: Title: <br />Date: Date: <br />The following section must be completed before this SOW can be processed: <br />Invoicing Procedures: <br />1. Method (Client to select one option below): <br />☐ Mail Invoice – Hard copy invoice will be mailed to: <br />Company Full Name: <br />Address: <br />Attention: Accounts Payable or: <br />Accounts Payable Contact: <br />Phone: <br />☐ Email Invoice – Invoice copy will be sent electronically via email to: <br /> <br />2. PO Process (Client to select one option below): <br />☐ Client issues system-generated POs or internal reference numbers for service <br />engagements. <br />Please fill in the PO Number below and attach a hard copy of the PO to this signed <br />SOW. Note: Services cannot be performed until a hard copy of the PO is received, or <br />Billing Reference is provided. <br />PO Number: <br />PO Release Number (if applicable): <br />Internal Billing Reference Number/Name: <br />☐ Client does NOT issue system-generated PO for service engagements. <br />Accordingly, performance of and payment for any Services under this SOW do not <br />require, and are not contingent upon, the issuance of any PO or other similar <br />document. <br /> <br />DocuSign Envelope ID: 0CDC9D0A-E5D0-4A30-8BB9-83E7961EC2E2