DOC2399178794.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 Jot Form Inc Contact Rasit Vardar

Sourcing Agent Email rvardar@jotform.com

REQUESTING DEPARTMENT

Participating Campuses

UNOP

Administrative Unit/Dept.

ITS

Department Contact John Ross

CONTRACT DESCRIPTION/INFORMATION

Contract Summary (brief description and/ or event name)

Renewal for 2026-2027 jotform license. Jotform is a web-based platform for managing and distributing digital forms.

Contract Document Document Amt Total Amt Start Date End Date Notes

Amend 1 5972.40 9/2021 9/2022

Amend 2 5972.40 9/2022 9/2023

Amend 3 276.50 9/2023 9/2024

Amend 4 6636.00 9/2024 9/2025

Amend 5 4200.00 9/2025 9/2026

Amend 6 4200.00 $27,257.30 9/2026 9/2027 Will negotiate a new MSA in 2027

COMPETITION/BID INFORMATION

Bid Number N/A

Competition NCPD

Contract Information

INTERNAL USE ONLY

CW49631

University of Nebraska Non-Competitive Procurement Documentation

RP-6.2.1.5.a requires small purchase procedures for purchases that equal or exceed the micro-purchase level and competitive proposals or bids for purchases of $250,000 or more. RP-6.2.1.5.b provides certain exceptions. This form must be approved by the Chief Procurement Officer for purchases of $250,000 or more where competitive proposals or bids are not obtained or by the Associate Chief Procurement Officer for small purchases where quotations are not obtained.

Requestor Name Requestor Email Non conflict statement: In accordance with RP-6.2.1.7, by submitting this form you 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.

Supplier Amount Contract, PR, or Invoice#

RP-6.2.1.5.b.1)iv Procurement by non-competitive proposals is procurement through solicitation of a proposal from only one source and may be used only when one or more of the following circumstances apply:

Select Circumstances for Procurement by Non-Competitive Proposals definitions for relevant capitalized terms are included on the following page

The Purchase of a unique Article or Service that is available only from a single source (without limiting the generality of the foregoing, examples include public utilities; books, periodicals, and other publications; and specially designed business, research, or scientific equipment and software). Unless an Article or Service is necessary for the operation of an existing Article or performance of an existing Service purchased by the University, a specification for a proprietary Article or Service does not justify a Purchase by noncompetitive proposal where there is more than a single source that can provide the Article or Service. See RP-6.2.1.5.b.1)iv.A.I; -6.2.1.5.b.1)iv.C.

The Purchase of an Article or Service that is necessary for the operation of an existing Article or performance of an existing Service purchased by the University. See RP-6.2.1.5.b.1)iv.A.II.

The Purchase is necessary to address an Emergency. See RP-6.2.1.5.b.1)iv.A.III.

The Purchase of Professional Services; provided, however, any contract for Licensed Professional Services, construction management, and design-build services shall be made in accordance with applicable law and Board of Regents policies. See RP-6.2.1.5.b.1)iv.A.IV; -6.2.1.5.b.1)iv.A.VII.

The Purchase is for maintenance or servicing of equipment made from the manufacturer of the equipment or the manufacturer's authorized service agent, where, in the judgment of the Authorized Signatory, such maintenance or service can be most effectively performed by the manufacturer or its authorized service agent.

See RP-6.2.1.5.b.1)iv.A.V.

The Purchase is to be made using federal funding and the federal awarding agency or pass-through entity expressly authorizes non-competitive proposals in response to a written request from the non-federal entity.

See RP-6.2.1.5.b.1)iv.A.VI.

This form must be accompanied by written justification for the non-competitive procurement from the requesting college, school, department, division, office, or other administrative subdivision.

Written Justification

Procurement Officer Approval Date

John Ross john.ross@nebraska.edu

Jotform $27,257.30 over 6 years CW49631

ITS Security and Systems teams have developed many workflows that rely on Jotform functionality. Chief among these is the Risk Classification Self Assessment, which cannot be migrated to TDX due to the form's complex logic and would require developer involvement to host directly on nebraska.edu.

09/15/26 | 15:02 CDT

Definitions

“Article” means any item of personal property, including all materials, products, supplies, furniture, equipment, printing, stationery, technology, and all other chattels, goods, wares, and merchandise.

“Authorized Signatory” means any person delegated signature authority to approve and execute a Contract pursuant to RP-6.3.1.

“Consideration” means the benefit or value, whether by promise, performance, or forbearance of a specific act, each party to a Contract bargains for and/or receives or expects to receive when entering the Contract.

“Contract” means any written agreement for a stated Consideration between the University and one or more other parties, creating obligations that are legally recognizable or enforceable.

“Emergency” means an event or occasional combination of circumstances that calls for immediate action or remedy, pressing necessity, exigency, a sudden or unexpected happening, or an unforeseen occurrence or condition where it is in the public interest for the University to take action and includes, but is not limited to, situations where the University must act to (i) avoid the loss of life, health, safety, or property; (ii) respond to a natural catastrophe, such as a tornado, storm, flood, snowstorm, manmade disaster, war, act of or serious threat of terrorism, or pandemic or widespread disease; (iii) respond to time limits established by a person or agency external to the University; or (iv) obtain cost savings for the University where the time constraints of Competitive Procurement would eliminate the cost savings.

"Licensed Professional Services" shall mean those services within the scope of the practice of architecture, professional engineering, landscape architecture, or registered land surveying as defined by the laws of the state of Nebraska, or those performed by any architect, professional engineer, landscape architect, or registered land surveyor in connection with his or her professional employment practice.

“Professional Service” means any Service that requires special knowledge as distinguished from skills and (i) requires a license or other legal authorization as a condition precedent to the rendering of the Service or (ii) is commonly recognized as a professional service. Examples of Professional Services include, but are not limited to, accounting and auditing; actuarial; legal;

personnel; financial; computing; management; marketing; educational program planning or evaluation; insurance and risk management; hotel booking; or travel booking. Examples of skilled professions not considered Professional Services include, but are not limited to, construction trades, cleaning, equipment operations or repair, fire or security systems, furniture repair or installation, landscaping, locksmith, moving, storage, painting, pest control, vehicle repair or maintenance, waste removal, recycling, printing, or catering.

“Purchase” means (i) the process of acquisition of any Article by the University by transfer of ownership or by lease or license for a stated Consideration paid to a Contractor; (ii) a Contract for any Service, including any Professional Service, to be provided by any Contractor for a stated Consideration; or (iii) a Contract for any labor, material, or equipment for construction, repair, alteration, remodeling, renovation, or demolition of any University building or other improvement to Real Property to be provided by a Contractor for a stated Consideration.

“Service” means the rendering of time or effort of a Contractor whose purpose is to perform an identifiable task rather than to furnish an Article.

ADDENDUM #6 - JOTFORM ENTERPRISE

This addendum (“Addendum 6”) is entered into by and between Jotform and the party identified in the signature block below (“Customer”). The effective date of this Addendum shall be the date of the last signature hereon.

This Addendum hereby modifies the Software License Agreement, dated September 17, 2020 (the “Agreement”) as follows - no changes to the Agreement not explicitly stated herein are being made:

1. Customer hereby agrees to extend the “Term” of the Agreement to September 17, 2027.

2. The following renewal costs shall apply to the above-described changes:

Renewal Costs (all amounts in USD$):

Jotform Enterprise Base Package (includes 5 Permitted Users): 1

Cost of Base Package: $6,000.00/year

Number of Additional Permitted Users, if any: 0

Cost Per Additional Permitted User: $948.00/year

Nonprofit Discount: 30%

Term: 12 months

Multiyear Upfront Payment Discount: N/A

Total Cost: $4,200.00

Customer agrees that, if during the Term, Customer exceeds its number of Permitted Users, Jotform shall invoice Customer for the additional users, and Customer agrees to pay the invoice, without the need for an addendum for the same.

ACCEPTED AND AGREED:

Customer: Board of Regents of the University of Nebraska

Jotform Inc.

Signature _____________________________________

Signature _____________________________________

Date Date

Name Name Tolga Sakman

Title Title VP of Enterprise Sales

Jon Watts

09/15/26 | 15:50 CDT

Sr. Assoc. VP - COO

09/15/26 | 13:55 PDT

Certificate Of Completion Envelope Id: 5B49283A-A4C4-889F-8194-44AEF96256EE Status: Completed

Subject: Complete with Docusign: Jotform Renewal UNOP

Source Envelope:

Document Pages: 4 Signatures: 3 Envelope Originator:

Certificate Pages: 5 Initials: 1 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

9/15/2026 2:54:56 PM

Holder: Shanon Wright shanonwright@nebraska.edu

Location: DocuSign

Signer Events Signature Timestamp 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: 134.238.171.101

Sent: 9/15/2026 2:59:27 PM

Viewed: 9/15/2026 3:02:18 PM

Signed: 9/15/2026 3:02:42 PM

Electronic Record and Signature Disclosure:

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

Jon Watts

JONWATTS@NEBRASKA.EDU

Sr. Assoc. VP - COO

University of Nebraska System

Security Level: Email, Account Authentication (None)

Signature Adoption: Uploaded Signature Image

Using IP Address: 129.93.161.221

Sent: 9/15/2026 3:02:44 PM

Viewed: 9/15/2026 3:49:24 PM

Signed: 9/15/2026 3:50:26 PM

Electronic Record and Signature Disclosure:

Accepted: 10/27/2023 1:29:03 PM ID: a1ef98be-f3d7-40bb-ac98-2d8b177c3284

Tolga Sakman tolga@jotform.com

VP of Enterprise

JotForm, Inc.

Security Level: Email, Account Authentication (None)

Signature Adoption: Pre-selected Style

Using IP Address: 2600:387:15:4c14::7

Signed using mobile

Sent: 9/15/2026 3:50:28 PM

Viewed: 9/15/2026 3:55:13 PM

Signed: 9/15/2026 3:55:36 PM

Electronic Record and Signature Disclosure:

Accepted: 9/15/2026 3:55:13 PM ID: 725f9a4f-dd27-47c5-ac7a-a40e2f0fa5bd

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 Rasit Vardar rasitvardar@jotform.com

Security Level: Email, Account Authentication (None)

Sent: 9/15/2026 3:55:38 PM

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 9/15/2026 2:59:28 PM

Certified Delivered Security Checked 9/15/2026 3:55:13 PM

Signing Complete Security Checked 9/15/2026 3:55:36 PM

Completed Security Checked 9/15/2026 3:55:38 PM

Payment Events Status Timestamps

Electronic Record and Signature Disclosure

ELECTRONIC RECORD AND SIGNATURE DISCLOSURE

From time to time, NU Contracts+Ariba (we, us or Company) may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically through the DocuSign system.

Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to this Electronic Record and Signature

Disclosure (ERSD), please confirm your agreement by selecting the check-box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system.

Getting paper copies

At any time, you may request from us a paper copy of any record provided or made available electronically to you by us. You will have the ability to download and print documents we send to you through the DocuSign system during and immediately after the signing session and, if you elect to create a DocuSign account, you may access the documents for a limited period of time

(usually 30 days) after such documents are first sent to you. After such time, if you wish for us to send you paper copies of any such documents from our office to you, you will be charged a

$0.00 per-page fee. You may request delivery of such paper copies from us by following the procedure described below.

Withdrawing your consent

If you decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. How you must inform us of your decision to receive future notices and disclosure in paper format and withdraw your consent to receive notices and disclosures electronically is described below.

Consequences of changing your mind

If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to receive required notices and consents electronically from us or to sign electronically documents from us.

All notices and disclosures will be sent to you electronically

Electronic Record and Signature Disclosure created on: 5/16/2023 6:53:28 PM Parties agreed to: Lynn McAlpine, Jon Watts, Tolga Sakman

Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through the DocuSign system all required notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given

us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us.

How to contact NU Contracts+Ariba:

You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows:

To contact us by email send messages to: richard.horner@nebraska.edu

To advise NU Contracts+Ariba of your new email address

To let us know of a change in your email address where we should send notices and disclosures electronically to you, you must send an email message to us at richard.horner@nebraska.edu and in the body of such request you must state: your previous email address, your new email address. We do not require any other information from you to change your email address.

If you created a DocuSign account, you may update it with your new email address through your account preferences.

To request paper copies from NU Contracts+Ariba

To request delivery from us of paper copies of the notices and disclosures previously provided by us to you electronically, you must send us an email to richard.horner@nebraska.edu and in the body of such request you must state your email address, full name, mailing address, and telephone number. We will bill you for any fees at that time, if any.

To withdraw your consent with NU Contracts+Ariba

To inform us that you no longer wish to receive future notices and disclosures in electronic format you may:

i. decline to sign a document from within your signing session, and on the subsequent page, select the check-box indicating you wish to withdraw your consent, or you may;

ii. send us an email to richard.horner@nebraska.edu and in the body of such request you must state your email, full name, mailing address, and telephone number. We do not need any other information from you to withdraw consent.. The consequences of your withdrawing consent for online documents will be that transactions may take a longer time to process..

Required hardware and software

The minimum system requirements for using the DocuSign system may change over time. The current system requirements are found here: https://support.docusign.com/guides/signer-guide-signing-system-requirements.

Acknowledging your access and consent to receive and sign documents electronically

To confirm to us that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please confirm that you have read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for your future reference and access; or (ii) that you are able to email this ERSD to an email address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receiving notices and disclosures exclusively in electronic format as described herein, then select the check-box next to ‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the DocuSign system.

By selecting the check-box next to ‘I agree to use electronic records and signatures’, you confirm that:

You can access and read this Electronic Record and Signature Disclosure; and

You can print on paper this Electronic Record and Signature Disclosure, or save or send this Electronic Record and Disclosure to a location where you can print it, for future reference and access; and

Until or unless you notify NU Contracts+Ariba as described above, you consent to receive exclusively through electronic means all notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to you by NU Contracts+Ariba during the course of your relationship with NU

Contracts+Ariba.

https://support.docusign.com/guides/signer-guide-signing-system-requirements https://support.docusign.com/guides/signer-guide-signing-system-requirements