User Action Admin Form

USER ACTION ADMIN FORM

This User Action Administration Agreement (the Agreement) is entered into on Agreement Date: by and between Company Name: and User Name: .

WHEREAS

WHEREAS, Company Name is responsible for administration, provisioning and maintenance of user accounts, access rights, and system-level actions in connection with the Company's information systems and services; and

WHEREAS, User requires specified administrative actions be performed on the User's account and agrees to the terms governing such actions, including any required approvals, recordation, and auditability; and

WHEREAS, the parties desire to set forth the scope, payment, confidentiality and governance terms applicable to administrative actions requested by or on behalf of User.

SCOPE OF WORK

Company shall perform the administrative actions described in the Action Details section below and such additional administrative tasks as expressly authorized in writing by User. Services include execution, verification, documentation and logging of actions taken, and provision of confirmation to the designated approver.

ACTION DETAILS

Select the administrative actions to be performed (check all that apply). For actions requiring additional parameters, provide the requested values adjacent to the selection.

Suspend account    Effective date:    Duration (days):

Terminate account    Effective date:

Grant access / Provision role    Role/Group:    Access level:

Change role / Modify permissions    From:    To:

Other administrative action    Specify:

PAYMENT TERMS

Where administrative services are compensable, User agrees to pay Company the fees set forth below in accordance with the schedule and conditions described. Fees payable are non-refundable except as expressly set forth in writing.

TERM AND TERMINATION

This Agreement commences on Start Date: and, unless earlier terminated in accordance with this Section, continues until End Date: .

Either party may terminate this Agreement for convenience by providing written notice to the other party at least Notice Period (days): days prior to the effective termination date. Either party may terminate immediately for material breach by the other party that is not cured within 15 days after written notice specifying the breach.

CONFIDENTIALITY

"Confidential Information" means any non-public information disclosed by one party to the other in connection with this Agreement, whether oral, written or electronic, including system credentials, access logs, account details, security settings, and audit records. The receiving party shall: (a) use Confidential Information solely to perform its obligations hereunder; (b) protect Confidential Information with at least the same degree of care it uses to protect its own confidential information, but no less than reasonable care; and (c) not disclose Confidential Information to any third party except as required by law or with the disclosing party's prior written consent. Confidentiality obligations survive termination for a period of three (3) years, or longer to the extent required by applicable law.

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of Governing State: without regard to conflict of law principles. The parties submit to the exclusive jurisdiction of the courts located within that jurisdiction for any action arising out of or relating to this Agreement.

ENTIRE AGREEMENT

This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, proposals, and communications, whether written or oral. Any amendment or modification of this Agreement must be in writing and signed by authorized representatives of both parties.

AUTHORIZATION & RECORDS

By signing below, the signatories certify that they are authorized to request or approve the administrative actions described herein and that all information provided in this form is accurate. Company shall retain records of actions performed, approvals obtained, and notices issued for a period of not less than two (2) years and shall make such records available to User upon reasonable request.

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