Sandata_AHCCCS_IP_License_Agreement_for_Signature.pdf
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- Attached to
- Master Agreement AZ|CTR043946
- Contract number
- CTR043946
- Issued by
- Arizona
About this file
This document is an Intellectual Property (IP) License Agreement between Sandata Technologies, LLC (Licensor) and Arizona Health Care Cost Containment System (Licensee), effective September 24, 2025. The agreement covers licensing terms for specific technologies within the Territory, which includes the State of Arizona and the State of Hawaii, with provisions for AHCCCS's existing relationships and contracts.
The license grants AHCCCS a perpetual, non-exclusive, non-sublicensable license to use specific Licensed IP, including the Alternate EVV Base Specification v7.18, Alternate EVV Vendor Specification v2.0, and Confidential Licensed IP such as Claims Validation Specification v7.6 and Claims Validation Addendum v1.7. As part of the agreement, AHCCCS will pay Sandata Technologies a non-refundable, non-creditable payment of $100,000 within 30 days of executing the agreement. The license is limited to AHCCCS's internal business purposes, which includes cooperative usage agreements or relationships established under existing contracts or required by state or federal law, strictly within the defined Territory.
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IP License Agreement
This IP License Agreement (this "Agreement"), effective as of September 24, 2025 (the "Effective
Date"), is by and between Sandata Technologies, LLC, ("Licensor"), and Arizona Health Care Cost
Containment System ("Licensee") (collectively, the "Parties," or each, individually, a "Party").
WHEREAS, Licensee wishes to obtain, and Licensor is willing to grant to Licensee, a license under
Licensor's proprietary rights in and to such technology and information, including certain of Licensor's intellectual property and know-how on the terms and conditions set out in this Agreement.
NOW, THEREFORE, in consideration of the mutual covenants, terms, and conditions set forth herein, and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Parties agree as follows:
1. Definitions. Capitalized terms used but not defined elsewhere in this Agreement have the following meanings:
“Confidential Licensed IP” means the specifications, designs and other technology or know-how described on Schedule 1 and designated therein as “Confidential
Licensed IP.”
"Licensed IP" means all of the specifications, designs and other technology or know-how described on Schedule 1.
"Person(s)" means an individual, corporation, partnership, joint venture, limited liability company, governmental authority, unincorporated organization, trust, association, or other entity.
"Territory" means the State of Arizona, the State of Hawaii for purposes of
AHCCCS’s existing relationship and contracts with the State of Hawaii, and in any other location in which or to which AHCCCS is required by federal or state law or its existing relationship with
Hawaii to provide reporting or data.
2. License Grant. Subject to the terms set forth below, Licensor hereby grants to Licensee a perpetual, non-exclusive, non-sublicensable, and non-transferable license to use the Licensed IP in the
Territory solely for its internal business purposes. The AHCCCS “internal business purposes” include any cooperative or joint usage agreements or relationships established under its existing contracts or required by state or federal law, but solely to the extent use thereunder is limited to the Territory. No license or rights are granted to Licensee by implication, estoppel, or otherwise, other than as expressly granted by
Licensor under this Section 2, and Licensor retains all right, title, and interest in and to the Licensed IP delivered or otherwise made available to Licensee hereunder; provided, however, that nothing herein prevents, limits or restricts AHCCCS from making and employing in connection with its uses of the
Licensed IP hereunder any improvements, modifications, upgrades, updates, extensions, or enhancements of the Licensed IP, or design-arounds (collectively “modifications”) or constitutes any agreement by
AHCCCS to allow Licensor any rights, interests, licenses or other authority to obtain, use or convey any such modifications.
3. Payments. Within thirty (30) days after execution of this Agreement, Licensee shall pay to
Licensor a non-refundable, non-creditable payment of One Hundred Thousand US Dollars ($100,000).
Docusign Envelope ID: 8CFA4867-4BC3-447F-8C99-EFB10250CBB5
Doc ID: bb778673ad76583ba7c4497f5d5a9d15a1af9adf
4. Proprietary Rights.
(a) Preservation of Licensed IP.
(i) Licensee and Licensor acknowledge that: (A) the Confidential Licensed IP is subject to the confidentiality and non-disclosure obligations under Section 6; and (B) the
Confidential Licensed IP derives economic value, actual or potential, from not being generally known to, and not being readily ascertainable through proper means by, any other person or entity outside Licensee and Licensor. Licensee shall use reasonable best efforts to preserve the secrecy of the Confidential Licensed IP in accordance with Section 6 at all times.
(ii) Without limiting Section 4(a)(i), Licensee shall implement administrative, physical, and technical safeguards to protect the Licensed IP from unauthorized access, disclosure, destruction, alteration, accidental loss, misuse, or damage that are no less rigorous than accepted industry practices.
(b) Licensee shall not use the Licensed IP for any purpose beyond the scope of the license expressly granted to Licensee under Section 2. For clarity, except to the extent allowed by the scope of the license expressly granted to Licensee under Section 2, Licensee shall not (i) provide or make available to any other Person (other than its service providers who are bound by written agreements imposing restrictions no less stringent than this Agreement) with access to or use of the Confidential Licensed IP, or (ii) rent, lease, lend, sell, sublicense, assign, distribute, or transfer the Licensed IP.
(c) Filings. Licensee has no right to, and shall not, (i) file or prosecute any patent or copyright application or seek or obtain any patent or copyright for or including any Licensed IP;
or (ii) subject to the license granted to Licensee under Section 2, claim any ownership or other right, title, or interest in or to, or challenge Licensor's ownership or other right, title, or interest in or to, any Licensed IP.
(d) Enforcement. Licensee shall promptly notify Licensor in writing of any actual or suspected misappropriation or other unauthorized access, disclosure, or use of any Licensed IP
("Unauthorized Use") and shall provide Licensor with any known details of such Unauthorized
Use. Licensor has the sole right, in its discretion, to bring any action or proceeding with respect to such Unauthorized Use and to control its conduct (including any settlement).
5. Compliance with Laws. Licensee shall comply with all applicable laws and regulations in exercising its rights and performing its obligations under this Agreement.
6. Confidentiality. Licensor and Licensee acknowledge that Licensee contends that Licensor is unable to claim that certain aspects of the items designated in Schedule 1 as the Confidential Licensed
IP are either exclusively proprietary to Licensor or that Licensor has the right to exclude Licensee from the use of such disputed aspects at any time. Licensor disputes all such contentions by Licensee. Nothing in this Agreement constitutes a waiver of or limitation on the future assertion of Licensee’s or Licensor’s respective contentions on these points. Nevertheless, License agrees that it shall maintain the Confidential
Licensed IP in strict confidence and not disclose it to any other person or entity, except to (a) its employees who have a need to know such Confidential Licensed IP for Licensee to exercise its rights or perform its obligations hereunder and (b) agencies and their IT service providers utilizing Licensee’s proprietary EVV system for Medicaid claims, and who, in each case, are bound by written nondisclosure agreements.
Notwithstanding the foregoing, Licensee may disclose the Confidential Licensed IP to the limited extent required to comply with applicable law or a valid order issued by a court or governmental agency of competent jurisdiction; provided that Licensee shall first provide Licensor with: (i) prompt written notice of such requirement so that Licensor may seek, at its sole cost and expense, a protective order or other remedy; and (ii) reasonable assistance, at Licensor's sole cost and expense, in opposing such disclosure or seeking a protective order or other limitations on disclosure.
7. Representations.
(a) Mutual Representations. Each Party represents and warrants to the other Party that, as of the Effective Date: (i) it has the full right, power, and authority to enter into this Agreement and to perform its obligations hereunder; (ii) the execution of this Agreement by its representative whose signature is set forth at the end hereof has been duly authorized by all necessary action of such Party; and (iii) when executed and delivered by such Party, this Agreement will constitute the legal, valid, and binding obligation of that Party, enforceable against that Party in accordance with its terms.
(b) Disclaimer. WITH THE EXCEPTION OF THE REPRESENTATIONS
EXPRESSLY SET FORTH ABOVE IN SECTION 7(a), LICENSOR DISCLAIMS ALL
REPRESENTATIONS AND WARRANTIES OF ANY KIND, WHETHER EXPRESS,
IMPLIED, STATUTORY, OR OTHERWISE, CONCERNING THE LICENSED IP,
INCLUDING AS TO THE ACCURACY, COMPLETENESS, OR USEFULNESS FOR ANY
PURPOSE OF THE LICENSED IP. LICENSOR SPECIFICALLY DISCLAIMS ALL IMPLIED
WARRANTIES OF MERCHANTABILITY, QUALITY, FITNESS FOR A PARTICULAR
PURPOSE, AND NON-INFRINGEMENT AND WARRANTIES ARISING FROM A COURSE
OF DEALING, COURSE OF PERFORMANCE, USAGE, OR TRADE PRACTICE.
8. Limitation of Liability. EXCEPT FOR LIABILITY FOR MATERIAL BREACH OF
TERMS OF THIS AGREEMENT AS DEFINED BY APPLICABLE CONTRACT LAW, IN NO EVENT
WILL EITHER PARTY BE LIABLE TO THE OTHER PARTY UNDER OR IN CONNECTION WITH
THIS AGREEMENT FOR ANY LOSS OF USE, REVENUE, OR PROFIT OR FOR ANY
CONSEQUENTIAL, INCIDENTAL, INDIRECT, EXEMPLARY, SPECIAL, OR PUNITIVE
DAMAGES, WHETHER ARISING OUT OF BREACH OF CONTRACT, TORT (INCLUDING
NEGLIGENCE), OR OTHERWISE, REGARDLESS OF WHETHER SUCH DAMAGE WAS
FORESEEABLE AND WHETHER OR NOT SUCH PARTY HAS BEEN ADVISED OF THE
POSSIBILITY OF SUCH DAMAGES. NO LIABILITY FOR ANY MATERIAL BREACH SHALL
EXIST UNLESS AND UNTIL THE NON-BREACHING PARTY HAS PROVIDED THE OTHER
PARTY WITH SPECIFIC WRITTEN NOTICE DETAILING ALL FACTS CONSTITUTING ANY
PURPORTED MATERIAL BREACH AND ALLOWED THE PURPORTEDLY BREACHING PARTY
THIRTY (30) DAYS TO CURE ANY NOTICED BREACH, AND (2) THE PARTIES HAVE BEEN
UNABLE TO RESOLVE THE PURPORTED BREACH INSPITE OF ENGAGING IN GOOD FAITH,
PERSONAL CONSULTATION FOR TEN (10) DAYS FOLLOWING THE END OF THE
APPLICABLE CURE PERIOD.
9. Assignment. Licensee shall not assign or otherwise transfer any of its rights, or delegate or otherwise transfer any of its obligations or performance, under this Agreement, in each case whether voluntarily, involuntarily, by operation of law, or otherwise, without Licensor's prior written consent. No delegation or other transfer will relieve Licensee of any of its obligations or performance under this
Agreement. Any purported assignment, delegation, or transfer in violation of this Section 11 is void. This
Agreement is binding upon and inures to the benefit of the Parties and their respective permitted successors and assigns.
10. Miscellaneous.
(a) Release by AHCCCS: Licensee AHCCCS has advised Licensor by letter from
Licensee AHCCCS’s counsel dated September 15, 2025 of errors by Licensor related to programming modifications Licensee AHCCCS contracted with Licensor to provide in connection with technical specifications for live-in caregiver data that Licensee AHCCCS provided to
Licensor in June, 2025. The letter further advised Licensor that Licensee AHCCCS considered such programming errors to have caused significant harm to Licensee AHCCCS. The foregoing assertions from the September 15, 2025 letter are hereafter referred to as the “Modification
Claims”. Licensee AHCCCS hereby waives and releases Licensor and its affiliates from any and all claims, causes of actions, damages, losses or other demands, of every kind and nature whatsoever, whether now known or unknown, foreseen or unforeseen, matured or unmatured, suspected or unsuspected, in law or equity, which Licensee has or hereafter may have against
Licensor or its affiliates, for, upon, or by reason of or arising out of the Modification Claims that were the subject of the September 15, 2025 letter in consideration of the mutual covenants, terms, and conditions set forth in this agreement.
(b) Further Assurances. Each Party shall, upon the reasonable request, and at the expense, of the other Party, promptly execute such documents and take such further actions as may be necessary to give full effect to the terms of this Agreement.
(c) No Joint Enterprise. Nothing contained in this Agreement creates any agency, partnership, joint venture, or other form of joint enterprise, employment, or fiduciary relationship between the parties, and neither Party has authority to contract for or bind the other party in any manner whatsoever.
(d) No Public Statements. Neither Party may issue or release any announcement, statement, press release, or other publicity or marketing materials relating to this Agreement or, unless expressly permitted under this Agreement, otherwise use the other party's trademarks, service marks, trade names, logos, domain names, or other indicia of source, association, or sponsorship, in each case, without the other Party's prior written consent.
(e) Notices. All notices, requests, consents, claims, demands, waivers, and other communications hereunder (other than routine communications having no legal effect) must be in writing and sent to the respective Party at the addresses indicated below (or at such other address for a Party as may be specified in a notice given in accordance with this Section):
If to Licensor:
1180 Avenue of the Americas
Floor 20
New York, NY 10036
Email: legal@hhaexchange.com
Attention: Legal Department
If to Licensee:
Arizona Health Care Cost Containment System
150 N. 18th Avenue
Phoenix, AZ 85007
Email: meggan.laporte@azahcccs.gov
Attention: Chief Procurement Officer
Notices sent in accordance with this Section will be deemed effective: (a) when received, if delivered by hand (with written confirmation of receipt); (b) when received, if sent by a nationally recognized overnight courier (receipt requested); (c) on the date sent by facsimile or email (in each case, with confirmation of transmission), if sent during normal business hours of the recipient, and on the next day if sent after normal business hours of the recipient; or (d) on the second (2nd) day after the date mailed, by certified or registered mail, return receipt requested, postage prepaid.
(f) Interpretation. For purposes of this Agreement: (a) the words "include," "includes," and "including" will be deemed to be followed by the words "without limitation"; (b) the word
"or" is not exclusive; and (c) the words "herein," "hereof," "hereby," "hereto," and "hereunder" refer to this Agreement as a whole. Unless the context otherwise requires, references herein: (x) to
Sections and Schedules refer to the Sections of and Schedules attached to this Agreement; (y) to an agreement, instrument, or other document means such agreement, instrument, or other document as amended, supplemented, and modified from time to time to the extent permitted by the provisions thereof; and (z) to a statute means such statute as amended from time to time and includes any successor legislation thereto and any regulations promulgated thereunder. This
Agreement will be construed without regard to any presumption or rule requiring construction or interpretation against the Party drafting an instrument or causing any instrument to be drafted.
(g) Entire Agreement. This Agreement, together with all Schedules and any other documents incorporated herein by reference, constitutes the sole and entire agreement of the
Parties with respect to the subject matter contained herein, and supersedes all prior and contemporaneous understandings and agreements, both written and oral, with respect to such subject matter.
(h) No Third-Party Beneficiaries. Except as otherwise provided in this Agreement, this
Agreement is for the sole benefit of the Parties and their respective successors and permitted assigns and nothing herein, express or implied, is intended to or will confer upon any other Person any legal or equitable right, benefit, or remedy of any nature whatsoever, under or by reason of this Agreement.
(i) Amendment; Waiver. No amendment to this Agreement will be effective unless it is in writing and signed by both Parties. No waiver by any Party of any of the provisions hereof will be effective unless explicitly set forth in writing and signed by the waiving Party. Except as otherwise set forth in this Agreement, no failure to exercise, or delay in exercising, any rights, remedy, power, or privilege arising from this Agreement will operate or be construed as a waiver thereof; nor will any single or partial exercise of any right, remedy, power, or privilege hereunder preclude any other or further exercise thereof or the exercise of any other right, remedy, power, or privilege.
(j) Severability. If any term or provision of this Agreement is invalid, illegal, or unenforceable in any jurisdiction, such invalidity, illegality, or unenforceability will not affect any other term or provision of this Agreement or invalidate or render unenforceable such term or provision in any other jurisdiction.
(k) Governing Law; Submission to Jurisdiction. This Agreement is governed by and construed in accordance with the internal laws of the State of Arizona without giving effect to any choice or conflict of law provision or rule that would require or permit the application of the laws of any other jurisdiction.
(l) Counterparts. This Agreement may be executed in counterparts, each of which will be deemed an original, but all of which together will be deemed to be one and the same agreement.
[SIGNATURE PAGE FOLLOWS]
IN WITNESS WHEREOF, the Parties have caused this Agreement to be executed as of the date first written above by their respective officers thereunto duly authorized.
LICENSOR:
SANDATA TECHNOLOGIES, LLC
By_________________________________
Name:
Title:
LICENSEE:
ARIZONA HEALTH CARE COST
CONTAINMENT SYSTEM
By________________________________
Name:
Title:
Docusign Envelope ID: 8CFA4867-4BC3-447F-8C99-EFB10250CBB5
9/24/2025
7/23/2024
Kristen Challecombe
Chief Procurement Officer
9/24/2025
Meggan LaPorte
Stephen Vaccaro
President
SCHEDULE 1
LICENSED IP
1. Alternate EVV Base Specification v7.18
2. Alternate EVV Vendor Specification v2.0
CONFIDENTIAL LICENSED IP
1. Claims Validation Specification v7.6
2. Claims Validation Addendum v1.7
Certificate Of Completion Envelope Id: 8CFA4867-4BC3-447F-8C99-EFB10250CBB5 Status: Completed
Subject: Complete with Docusign: 2025-09-23 IP License Agreement Final.pdf
Source Envelope:
Document Pages: 8 Signatures: 2 Envelope Originator:
Certificate Pages: 5 Initials: 0 Meggan LaPorte
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-07:00) Arizona
801 E. Jefferson St.
Phoenix, AZ 85034
Meggan.LaPorte@azahcccs.gov
IP Address: 13.86.232.74
Record Tracking Status: Original
9/24/2025 3:45:54 PM
Holder: Meggan LaPorte
Meggan.LaPorte@azahcccs.gov
Location: DocuSign
Security Appliance Status: Connected Pool: StateLocal
Storage Appliance Status: Connected Pool: Arizona Health Care Cost Containment
System
Location: Docusign
Signer Events Signature Timestamp Kristen Challecombe kristen.challacombe@azahcccs.gov
7/23/2024
AHCCCS
Security Level: Email, Account Authentication (None)
Signature Adoption: Pre-selected Style
Using IP Address: 159.87.17.227
Sent: 9/24/2025 3:48:17 PM
Viewed: 9/24/2025 3:53:07 PM
Signed: 9/24/2025 3:53:23 PM
Electronic Record and Signature Disclosure:
Accepted: 9/23/2025 2:52:09 PM ID: 1b179c51-d998-4e65-8e34-f6050d45e354 Company Name: Carahsoft OBO Arizona Health Care Cost Containment System
Meggan LaPorte
Meggan.LaPorte@azahcccs.gov
Chief Procurement Officer
AHCCCS
Security Level: Email, Account Authentication (None)
Signature Adoption: Uploaded Signature Image
Using IP Address: 13.86.232.74
Sent: 9/24/2025 3:48:18 PM
Viewed: 9/24/2025 3:48:25 PM
Signed: 9/24/2025 3:48:34 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
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
Carbon Copy Events Status Timestamp Gina Relkin gina.relkin@azahcccs.gov
Deputy Assistant Director
AHCCCS
Security Level: Email, Account Authentication (None)
Sent: 9/24/2025 3:48:18 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 9/24/2025 3:48:18 PM
Certified Delivered Security Checked 9/24/2025 3:48:25 PM
Signing Complete Security Checked 9/24/2025 3:48:34 PM
Completed Security Checked 9/24/2025 3:53:23 PM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, Arizona Health Care Cost Containment System (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: 2/9/2023 8:44:33 AM Parties agreed to: Kristen Challecombe
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 Arizona Health Care Cost Containment System:
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: anthony.flot@azahcccs.gov
To advise Arizona Health Care Cost Containment System 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 anthony.flot@azahcccs.gov 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 Arizona Health Care Cost Containment System
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 anthony.flot@azahcccs.gov 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 Arizona Health Care Cost Containment System
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 anthony.flot@azahcccs.gov 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 Arizona Health Care Cost Containment System 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 Arizona Health Care Cost Containment System during the course of your relationship with Arizona Health Care Cost Containment
System.
Sandata/AHCCCS IP License Agreement for Signature
2025-09-24_IP_Lic...2023-4348_v.1.pdf bb778673ad76583ba7c4497f5d5a9d15a1af9adf
MM / DD / YYYY
Signed
09 / 25 / 2025
05:14:57 UTC-7
Sent for signature to Stephen Vaccaro
(svaccaro@hhaexchange.com) from brichards@rmazlaw.com
IP: 69.160.35.138
09 / 25 / 2025
05:31:07 UTC-7
Viewed by Stephen Vaccaro (svaccaro@hhaexchange.com)
IP: 71.114.62.252
09 / 25 / 2025
06:07:52 UTC-7
Signed by Stephen Vaccaro (svaccaro@hhaexchange.com)
IP: 68.161.219.140
The document has been completed.09 / 25 / 2025
06:07:52 UTC-7
| 2025-09-25T13:08:01+0000 | |
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