DOC1709715168.pdf

Procure-to-Pay

3835 Holdrege Street | Lincoln, NE 68583-0742 | 402.472.2126 nebraska.edu/p2p

University of Nebraska Contract Summary

CONTRACTOR/COMPANY INFORMATION

Supplier QUALTRICS LLC Contact Alex Manning

Sourcing Agent Shanon Wright Email amanning@qualtrics.com

REQUESTING DEPARTMENT

Participating Campuses

UNL

Administrative Unit/Dept.

Academic Research

Department Contact Becky Zavala/Amy Barry

CONTRACT DESCRIPTION/INFORMATION

Contract Summary (brief description and/ or event name)

Qualtrics is UNL’s enterprise survey tool.

Contract Document Document Amt Total Amt Start Date End Date Notes

CW34950 $294,617.00 $294,617.00 12/12/2025 12/11/2028 3 year total

COMPETITION/BID INFORMATION

Bid Number

Competition NCPD

Contract Information

INTERNAL USE ONLY

CW34950

Qualtrics does not accept any changes to their General Terms and Conditions

University of Nebraska Non-Competitive Purchase Documentation

Board of Regents Policy 6.2.1.10 (b) provides that “except as otherwise provided in this purchasing policy, any purchase committing the University to an expenditure of $150,000 or more shall be made to the lowest responsible bidder.” Board of Regents Policy 6.2.1.7 provides that “If small purchase procedures are used, price or rate quotations must be obtained from an adequate number of qualified sources. There are exceptions allowed to this policy in 6.2.1.10 (f), which explains when competitive bidding is not required.

This form is designed to assist in complying with policy. It is to be used for purchases of $150,000 or more that are not competitively bid or small purchases where quotations are not obtained. It must be signed by the person seeking the non-competitive purchase, as well as the funding approver and returned to your campus procurement office or the Office of the Vice President for Business and Finance.

INSTRUCTIONS for Completion of this Form:

Please check the category below for which your particular transaction qualifies as a non-competitive purchase. The column § (subsection) refers to Board Policy 6.2.1.10 (f). Incomplete forms will be returned.

§ EXCEPTION TO COMPETITIVE PURCHASE

1. Purchase of unique or non-competitive articles or services (e.g., “Sole Source”). Without limiting the generality of the foregoing sentence, examples of unique or non-competitive articles and services are public utility services, regulated central office telephone services, books, pamphlets and periodicals, and specially designed business, research or scientific equipment and related software. This category of purchase shall be accompanied by a written justification from the requesting unit and must have the prior written approval by the principal business officer or their designee.

2. Contracts for professional services; provided, however, that any contract for architectural, engineering, land surveying or landscape architectural services shall be made in accordance with applicable law and Board of Regents policies requiring competitive negotiations for such services. “Professional Service” means (a) any type of service which requires a license or other legal authorization as a condition precedent to the rendering of the service, or (b) any other type of service commonly recognized as a professional service, including, but not limited to, accounting and auditing, actuarial, legal, personnel, financial, computing, management, marketing, educational program planning or evaluation, facilities planning or evaluation, insurance and risk management, or travel agency services. (See RP-6.2.1(4)(h))

3. Purchases necessary in emergency situations.

4. Contracts for maintenance or servicing of equipment with the manufacturer of the equipment or the manufacturer's authorized service agent, where in the judgment of the principal business officer such maintenance or service can be most effectively performed by the manufacturer or its authorized service agent.

5. Contracts on capital construction projects (a) for the services of a construction manager who may or may not at the discretion of the University also be engaged on the project as the general contractor or (b) for the services of a design/build contractor who will be engaged on the project to furnish design services by a qualified architect or engineer and to provide general contractor services; provided, the contracts shall be awarded in accordance with RP-6.3.7.

Additional Required Information:

Supplier Name: Amount of Purchase:

Description Supporting Non-Competitive Purchase Determination:

Check HERE if additional supporting documentation attached In accordance with Board of Regents Policy 6.2.1.16, Purchases Involving University Personnel, by signing below, you hereby affirm that you have no conflict of interest in the selection of this supplier, nor will you receive personal or financial benefit from this purchase.

Requestor’s Signature Requestor’s Name (Printed) Date

Funding Approver's Signature Funding Approver’s Name (Printed) Date

Submitted By (Procurement Services): Approved By:

Signature Date

Name (Printed): _________________________________ _____

Signature Date

Name (Printed): ______________________________________

Qualtrics $294,617 for 3 years

Amy Barry 8/12/25

It would be cost prohibitive to switch to a different product given all of the systems and departments currently set up and using Qualtrics with existing business processes.

Amy Barry on behalf of UNL Research

Shanon Wright

09/04/25 | 15:52 CDT

Lacey Rohe

09/05/25 | 10:46 CDT

Qualtrics offer more ways to collect data than just surveys. It can differentiate between gathering data around parameters we set. Qualtrics also offers more options for reporting and analyzing the data.

Qualtrics is more comprehensive and is geared towards research needs, unlike SurveyMonkey and other surveying tools, which are more simplistic, and are built to assist smaller businesses and organizations.

Order Form

QUALTRICS CONFIDENTIAL 006Ht00000x75dMIAQ

Qualtrics Customer

By (signature): \s2\ By (signature): \s1\

Name: \n2\ Name: \n1\

Title: \t2\ Title: \t1\

Date: \d2\ Date: \d1\

Qualtrics Primary Contact: Customer Primary Contact:

Name: Alex Manning Name: Amy Barry

Phone: Phone:

Email: amanning@qualtrics.com Email: amybarry@nebraska.edu

Parties: Qualtrics LLC 333 W River Park Drive, Provo, UT, 84604 United States (“Qualtrics”)

University Of Nebraska- Lincoln 100 Seaton Hall Lincoln NE 68588 United States (“Customer”)

Effective Date: The date signed by the last party to sign.

Governing Document:

This Order Form is subject to the Qualtrics General Terms and Conditions at https://www.qualtrics.com/legal/customers/gtcs/ (the "Agreement"). All capitalized terms used but not defined herein have the meanings given to them in the Agreement. If there is a conflict between the terms of the Agreement and this Order Form, this Order Form will control.

Additional Terms:

Customer Information:

Regional Data Center:

Will Customer send a purchase order (“PO”):*

\1_PO_Required\ PO#:

\1_Purchase_ Order_Numbe r\

Will the PO apply to the entire Subscription Term:

\1_Does_PO_cover_entire_contract_ter m\

Email Address for Invoice Submission:

rzavala2@unl.edu Billing Address to Reference on Invoice:

Attn:

The University of Nebraska Account Department 401 Canfield Admin Bldg PO Box 880439 Lincoln, NE 68588-0439 United States

Shipping Address:

Attn:

The University of Nebraska, Lincoln 100 Seaton Hall, University of Nebraska-Lincoln Lincoln, NE 68588 United States

*If Customer requires a PO to process the invoice related to this Order Form, Customer will provide the PO with this Order Form or through the Customer Success Hub or customer intake survey within five days after the effective date hereof. Customer’s failure or delay in providing a PO will not affect the payment terms herein.

09/05/25 | 10:46 CDT

Associate Vice Chancellor & Controller

Lacey RoheMark Creer

Deputy General Counsel

09/05/25 | 10:34 MDT

https://support-portal.qualtrics.com/my-information#billing-details https://qglobalops.co1.qualtrics.com/jfe/form/SV_5ubz352IHUNBSES

Order Form

QUALTRICS CONFIDENTIAL

CONFIDENTIAL

Subscription Term and Fees Exhibit Subscription Term

Initial Term

Start date: First date of the initial period in the fees table below

End date: Last date of the final period in the fees table below

Term in months: 36

Renewal Terms (not applicable to pilots or proofs of concept)

Type of renewal at the end of the initial term and each renewal term:

Automatic Renewal

Advance notice required to not renew or to request modification prior to the end of initial term or applicable renewal term:

90 days

Length of each renewal term in months: 12

Price increase at each renewal term for same Cloud Services:

5%

Fees for Initial Term

Period Services Price Estimated Invoice Date

Payment Terms from Invoice

License Configuration

12-Dec-2025 TO 11-Dec-

Cloud Professional

$87,892.00 $0.00

Subscription Start Date

Net 30 Q-111565

12-Dec-2026 TO 11-Dec-

Cloud Professional

$97,043.00 $0.00

12-Nov-2026 Net 30 Q-111565

12-Dec-2027 TO 11-Dec-

Cloud Professional

$109,682.00 $0.00

12-Nov-2027 Net 30 Q-111565

Total

USD $294,617.00

Prices shown do not include applicable taxes, which will be included on the invoice.

Excess Use Any use of the Cloud Service that exceeds the Usage Metrics and volumes set forth herein will incur additional fees from the date the excess use began based on Qualtrics’ prices as of that date. Customer will execute an Order Form for such excess use promptly upon Qualtrics’ request. Qualtrics will invoice Customer for such excess use on or about the end of the then-current annual period, and Customer will pay the invoiced amount in accordance with the applicable payment terms above.

CONFIDENTIAL

Cloud Service Exhibit

The Cloud Services purchased are subject to the Definitions and Product Terms located at: https://www.qualtrics.com/legal/customers/product-terms

Qualtrics permits Customer to process a limited number of characters (as defined at https://www.qualtrics.com/support/survey-platform/data-and-analysis-module/data/translate-text-responses) through its translation functionality per subscription year ("Translation Limit") at no charge. Qualtrics, at its discretion, reserves the right to strictly enforce this limit.

YEAR 1

Q-111565

CLOUD SERVICE

CoreXM Users - Academic Research Student Wide : 23,986 CoreXM Use-Case Academic Research CoreXM Responses - Academic Research Student Wide : 600,000

YEAR 2

YEAR 3

https://www.qualtrics.com/legal/customers/product-terms https://www.qualtrics.com/support/survey-platform/data-and-analysis-module/data/translate-text-responses https://www.qualtrics.com/support/survey-platform/data-and-analysis-module/data/translate-text-responses

QUALTRICS CONFIDENTIAL

Service Level Exhibit

Service Levels

1. Availability; Downtime. Qualtrics will ensure that the Cloud Service has an availability level of 99.93%, excluding when the Cloud Service is unavailable due to (a) required system maintenance as determined by Qualtrics for which Qualtrics provides at least five days’ advance notice to Customer; and (b) causes outside of the reasonable control of Qualtrics that could not have been avoided by its exercise of due care (“Availability”). “Downtime” means time during which the Cloud Service has no Availability.

2. Fee Credits. Customer will receive a fee credit (“Fee Credit”) for Downtime upon request based on the following formula: Fee Credit = fee credit percentage set forth below * (1/12 then-current annual fees paid for the Cloud Service affected by Downtime). All times listed below are per calendar month.

1. If Downtime is 30 minutes (=99.93%) or less, no fee credit percentage applies.

2. If Downtime is from 31 to 120 minutes, the fee credit percentage is 5%.

3. If Downtime is from 121 to 240 minutes, the fee credit percentage is 7.5%.

4. If Downtime is 241 minutes or greater, the fee credit percentage is 10.0%.

Certificate Of Completion Envelope Id: 2EB278DE-DFFF-463B-99CE-7A070B933AB5 Status: Completed

Subject: CW34950 - UNL Research Qualtrics Renewal

Source Envelope:

Document Pages: 8 Signatures: 4 Envelope Originator:

Certificate Pages: 5 Initials: 2 Shanon Wright

AutoNav: Enabled

EnvelopeId Stamping: Disabled

Time Zone: (UTC-08:00) Pacific Time (US & Canada)

1400 R Street

LINCOLN, NE 68588

shanonwright@nebraska.edu

IP Address: 35.223.106.21

Record Tracking Status: Original

9/3/2025 1:52:17 PM

Holder: Shanon Wright shanonwright@nebraska.edu

Location: DocuSign

Signer Events Signature Timestamp Shanon Wright shanonwright@nebraska.edu

Sourcing Agent

University of Nebraska - Lincoln

Security Level: Email, Account Authentication (None)

Signature Adoption: Pre-selected Style

Using IP Address:

2600:1014:a114:736a:6331:9f:c540:41a8

Sent: 9/4/2025 3:51:52 PM

Viewed: 9/4/2025 3:52:32 PM

Signed: 9/4/2025 3:52:44 PM

Electronic Record and Signature Disclosure:

Accepted: 11/28/2023 12:38:52 PM ID: 691a326d-dd56-4105-b93e-12492bfe4a95

Lynn McAlpine lynn.mcalpine@nebraska.edu

Assoc Chief Procurement Officer

University of Nebraska

Security Level: Email, Account Authentication (None)

Signature Adoption: Pre-selected Style

Using IP Address: 134.238.165.79

Sent: 9/3/2025 1:57:52 PM

Resent: 9/4/2025 3:52:46 PM

Viewed: 9/4/2025 3:04:39 PM

Signed: 9/4/2025 6:14:13 PM

Electronic Record and Signature Disclosure:

Accepted: 10/25/2023 3:31:56 PM ID: 62d90eb0-4212-41ee-8e59-ac437e4c21bf

Lacey Rohe laceyrohe@nebraska.edu

Associate Vice Chancellor & Controller

University of Nebraska

Security Level: Email, Account Authentication (None)

Signature Adoption: Pre-selected Style

Using IP Address: 216.147.122.176

Sent: 9/4/2025 6:14:14 PM

Viewed: 9/5/2025 10:12:09 AM

Signed: 9/5/2025 10:46:41 AM

Electronic Record and Signature Disclosure:

Accepted: 9/4/2025 12:17:27 PM ID: d59acc5c-0599-40d1-81a9-7087f09ef6a0

Mark Creer legal-sales@qualtrics.com

Deputy General Counsel

Qualtrics LLC

Security Level: Email, Account Authentication (None)

Signature Adoption: Pre-selected Style

Using IP Address: 209.133.72.26

Sent: 9/5/2025 10:46:43 AM

Viewed: 9/5/2025 11:34:51 AM

Signed: 9/5/2025 11:34:55 AM

Electronic Record and Signature Disclosure:

Accepted: 9/5/2025 11:34:51 AM ID: 76218433-1597-4327-a81f-24b1891616e2

In Person Signer Events Signature Timestamp

Editor Delivery Events Status Timestamp

Agent Delivery Events Status Timestamp

Intermediary Delivery Events Status Timestamp

Certified Delivery Events Status Timestamp

Carbon Copy Events Status Timestamp Amy Barry amybarry@nebraska.edu

University of Nebraska

Security Level: Email, Account Authentication (None)

Sent: 9/5/2025 11:34:57 AM

Viewed: 9/5/2025 11:37:49 AM

Electronic Record and Signature Disclosure:

Not Offered via Docusign

Witness Events Signature Timestamp

Notary Events Signature Timestamp

Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 9/3/2025 1:57:52 PM

Envelope Updated Security Checked 9/4/2025 2:04:38 PM

Envelope Updated Security Checked 9/4/2025 2:04:38 PM

Envelope Updated Security Checked 9/4/2025 2:07:01 PM

Envelope Updated Security Checked 9/4/2025 2:07:01 PM

Envelope Updated Security Checked 9/4/2025 3:51:51 PM

Envelope Updated Security Checked 9/4/2025 3:51:51 PM

Envelope Updated Security Checked 9/4/2025 3:51:51 PM

Envelope Updated Security Checked 9/4/2025 3:51:51 PM

Envelope Updated Security Checked 9/4/2025 3:51:51 PM

Certified Delivered Security Checked 9/5/2025 11:34:51 AM

Signing Complete Security Checked 9/5/2025 11:34:55 AM

Completed Security Checked 9/5/2025 11:34:57 AM

Payment Events Status Timestamps

Electronic Record and Signature Disclosure

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Electronic Record and Signature Disclosure created on: 5/16/2023 6:53:28 PM Parties agreed to: Shanon Wright, Lynn McAlpine, Lacey Rohe, Mark Creer

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