User Account Activation Request

USER ACCOUNT ACTIVATION REQUEST

Requesting Party Information

Requestor Name:   Title:

RECITALS

WHEREAS, Client Name: (the "Client") requires creation or reactivation of an electronic account to access specified services maintained by Service Provider;

WHEREAS, Service Provider Name: (the "Provider") has the administrative authority and technical capacity to provision such account under the terms set forth herein;

WHEREAS, the parties wish to document the scope, responsibilities, fees and conditions governing activation and access to the account.

Account Details & Access Requested

Access Level Requested: Admin Standard User Read-Only

Multi-factor Authentication Required: Yes

Requested Activation Date:   Proposed Expiration Date:

Scope of Work

Payment Terms

One-time Activation Fee: $   Recurring Monthly Fee: $

Late Payment Charge:   and recovery of reasonable collection expenses.

Term and Termination

Term Commencement Date:   Term End Date:

Either party may terminate this request and any resulting account access for material breach or for convenience upon days' prior written notice. Provider may suspend access immediately where security or unauthorized activity is reasonably suspected.

Confidentiality

Each party shall maintain as confidential all account credentials, access logs, configuration details, and any non-public data accessed via the activated account, and shall not disclose such Confidential Information except to employees or contractors who have a strict need to know and are bound by obligations of confidentiality no less protective than this agreement. Confidential Information does not include information that is or becomes publicly available through no breach of this request.

Security and Compliance

Client agrees to (a) provide accurate identity information for each user, (b) ensure users comply with Provider's acceptable use policies, and (c) promptly report suspected compromise. Provider will provision access consistent with configured controls and will notify Client of any security incidents that materially affect Client's account.

Governing Law; Entire Agreement

This request and any account activation provided in reliance on it shall be governed by the laws of , without regard to conflict of law principles. This document constitutes the entire agreement between the parties with respect to account activation and supersedes all prior communications and proposals, whether oral or written, relating to the same subject matter.

Approvals and Certifications

By signing below, the Requestor certifies that the information contained herein is true and correct, that the requested access is required for legitimate business purposes, and that the Requestor has authority to request such access on behalf of the organization identified above.

Additional instructions or special conditions:

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