Orange County NC Website
Browse       Search
<br />EA20201EnrGov(US)SLG(ENG)(Oct2019) Page 9 of 10 <br />Document X20-10635 <br /> <br /> Same as primary contact (default if no information is provided below, even if the box is not <br />checked). <br />Contact name* First David Last Mathias <br />Contact email address* dmathias@orangecountync.gov <br />Street address* 131 W. Margaret Lane Suite 300 <br />City* Hillsborough <br />State* NC <br />Postal code* 27278-2547- <br />(Please provide the zip + 4, e.g. xxxxx-xxxx) <br />Country* United States <br />Phone* 919-245-2272 <br />Language preference. Choose the language for notices. English <br /> This contact is a third party (not the Enrolled Affiliate). Warning: This contact receives <br />personally identifiable information of the Customer and its Affiliates. <br />* indicates required fields <br />c. Online Services Manager. This contact is authorized to manage the Online Services ordered <br />under the Enrollment and (for applicable Online Services) to add or reassign Licenses and <br />step-up prior to a true-up order. <br /> Same as notices contact and Online Administrator (default if no information is provided below, <br />even if box is not checked) <br />Contact name*: First Jim Last Northrup <br />Contact email address* jnorthrup@orangecountync.gov <br />Phone* 919-245-2276 <br /> This contact is from a third party organization (not the entity). Warning: This contact receives <br />personally identifiable information of the entity. <br />* indicates required fields <br />d. Reseller information. Reseller contact for this Enrollment is: <br />Reseller company name* SHI International Corp. <br />Street address (PO boxes will not be accepted)* 290 Davidson Ave <br />City* Somerset <br />State* NJ <br />Postal code* 08873-4145 <br />Country* United States <br />Contact name* Mary Ann Holland <br />Phone* 888-764-8888 <br />Contact email address* Maryann_holland@shi.com <br />* indicates required fields <br />By signing below, the Reseller identified above confirms that all information provided in this <br />Enrollment is correct. <br />Signature* Mary Ann Holland <br />Printed name* Mary Ann Holland <br />Printed title* <br />Date* <br />* indicates required fields <br />Changing a Reseller. If Microsoft or the Reseller chooses to discontinue doing business with <br />each other, Enrolled Affiliate must choose a replacement Reseller. If Enrolled Affiliate or the <br />Reseller intends to terminate their relationship, the initiating party must notify Microsoft and the <br />DocuSign Envelope ID: B85A9193-88B0-4814-AC1E-22E81BC064B3