FY16 Subscription “On-Azure and In-Office365 Promotion” Certification Form

Theundersigned services provider, [COMPANY NAME] (the “Partner”) certifies that,by ordering modules “FY16 On-Azure Promotion” or “FY16 In-O365 Promotion”, as defined in the FY16 Subscription “On-Azure and In-Office365” Promotion –Partner Terms (the “Promotion”), the customer qualifies for the Promotion.

If a customer no longer satisfies the eligibility terms outlined in the Promotion, Partner will immediately deactivate the ineligible promotion module(s) from Customer’s Subscription license. Partner acknowledges that if Microsoft discovers that Partner has made a false certification or has failed to notify Microsoft in a timely fashion of any Customer status change. Partner is liable to Microsoft for repayment of all discounts granted under this program for the Customer(s) in question, and Microsoft willrevoke thePartner’s FY16 Subscription “On-Azure and In-Office365 Promotion” Certification Formresulting in the immediate termination of all available discounts under thePromotion. Additionally, false certification or lack of timely notification may constitute a material breach of the SPA.

By signing below, you agree to be bound by the terms of this Certification Formand all the documents incorporated by reference above.

Agreed and accepted

Select applicable signing entity.
(please select the applicable signing entity from the drop down list – needs to be the same as the entity where you SPA is filled)
Company:
Signature:
Name: [NAME]
Title: [TITLE]
Date: [DATE]

Please return a signed original of this Addendum to the following address based on the signing entity:

Region / Address
Europe, Middle East, Africa (EOC) / Microsoft Ireland Operations Limited
Attn: MBS Contracts Team
Atrium Building, Carmenhall Road
Sandyford Industrial Estate
Dublin 18
Ireland
Email:
The Americas (AOC) / Microsoft Corporation
Attn: SPA Processing
One Lone Tree Road
Fargo ND 58104
USA
Email:
Asia, South Pacific (MRS) / Microsoft Regional Sales Corporation
Attn: Microsoft Dynamics Contracts Team
438B Alexandra Road, #04-09/12, Block B
Alexandra Technopark
Singapore 119968
Email:
China (MCCL) / Microsoft (China) Company Limited
Attn: Partner Development, Microsoft Dynamics Team
16th Floor, Microsoft Tower
LSH Plaza, 8 Wangjing Street
Chaoyang District, Beijing 100102
Email:
India (MCIPL) / Microsoft Corporation (India) Pvt. Ltd.
India Operations Centre
Ground Floor, Signature Building, Block E,
Embassy Golf Links Business Park,
Off Intermediate Ring Road,
Bangalore, 560 071
Japan (MSKK) / Microsoft Japan Co., Ltd.
Attn: Microsoft Dynamics Operation Team (Gyomu Kanri bu)
Shinagawa Grand Central Tower 2-16-3
Konan Minato-ku, Tokyo 108-0075 Japan
Email:

Subscription FY16 On-In Promotion Certification Form - July 2015- All ROCs – EnglishPage 1 of 2