ORDER

FORM

Order Number
BV-076114BJ ~ 2

ServiceNow Nederland B.V.

Hoekenrode 3
1102 BR Amsterdam, Netherlands

Pricing Expiration: 29 Jun 2014

SNC Account Exec Berwyn Jones
E-mail berwyn.jones@servicenow.com

Customer Invoice Address:

Company Name
Address
Suite
City
State/Province
Zip/Postal Code
Country
Website

Customer Ship To Address:

Central London Community Healthcare NHS Trust

Western Pavilion, 1st floor Christopher Ward
St Charles Hospital, Exmoor Street
London

Company Name
Address
Suite
City
State/Province
Zip/Postal Code
Country
Website

W10 6DZ
United Kingdom
www.clch.nhs.uk
Parul Patel
ITIL Implementation Project Manager
020 8383 8655
parul.patel@clch.nhs.co.uk
0023042

AP Contact Name

Title
Phone
E-mail
Account #:

Business Contact

Title
Phone
E-mail
VAT/GST #

Reference Contract #(s) BV-076114BJ

Reference Statement of Work #(s) N/A

End User Address:

Central London Community Healthcare NHS Trust

Western Pavilion, 1st floor Christopher Ward
St Charles Hospital, Exmoor Street
London

Company Name
Address
Suite
City
State/Province
Zip/Postal Code
Country
Website

W10 6DZ
United Kingdom
www.clch.nhs.uk
Parul Patel
ITIL Implementation Project Manager
020 8383 8655
parul.patel@clch.nhs.co.uk

Business Contact

Title
Phone
E-mail

Central London Community Healthcare NHS Trust

Western Pavilion, 1st floor Christopher Ward
St Charles Hospital, Exmoor Street
London
W10 6DZ
United Kingdom
www.clch.nhs.uk
Parul Patel
ITIL Implementation Project Manager
020 8383 8655
parul.patel@clch.nhs.co.uk

PO #
Yes

Currency GBP
Subscription
Product Code
PROD00189

PL01

Subscription
Product Name

Type

ServiceNow IT Service Automation Suite (Platinum Edition)

Fulfiller User

Subscription
Units
Term

Subscription
Term
Start Date

Subscription
Term
End Date

34 months; 9
days

30 Jun 2014

8 May 2017

10

Net Price
(monthly)

Net Price
(annual)

Net Price
(total)

54.50 6,540.00 18,688.81

Subscription Product Subtotal: 6,540.00 18,688.81

Pre-tax Total 18,688.81
Estimated Grand Total 18,688.81
Invoice Schedule:
9 Months Subscription Fee
Annual Subscription Fee
Annual Subscription Fee

Invoice Date

Amount

Upon Signature
8 Apr 2015
8 Apr 2016

5,608.81
6,540.00
6,540.00

Est. Taxes

5,608.81
6,540.00
6,540.00

Grand Total

18,688.81

18,688.81

Payment Terms
Net 30 Days from Invoice Date
Customer shall issue a purchase order (PO), but the PO and any other ordering document submitted by Customer will not modify or add to the terms of this Order Form. No fewer than fifteen (15) days prior to each Invoice Date, please submit a PO for the amount set forth above
to accountsreceivablebv@servicenow.com or fax to +31 84 210 4908 or the ServiceNow address above.
PRICES ARE FINAL. THIS ORDER IS NON-CANCELLABLE AND NON-REFUNDABLE. Terms are payable net thirty (30) days from the date of invoice. The order is for the entire subscription term and is undividable. Payments are due as per the invoice schedule. All remaining fees are
due immediately if Customer fails to pay as stated.

Hosting Details
# of Instances: New Instance not Provided
Instance Names:
Customer ServiceNow Admin:
Email
Data Center EMEA
Notes:
Effective June 30, 2014 Customer purchased 10 additional ServiceNow IT Service Automation Suite (Platinum Edition) Fulfiller Users, making a total of 60 Fulfiller Users.
Terms and Conditions
ENTIRE AGREEMENT. This order is on terms consisting of the signed definitive agreement(s) with the reference number(s) set forth above and the same availability service level target and support terms in Customers last Order Form as supplemented
by this Order Form and the service descriptions for the purchased packaged professional services (Service Description). If not attached to this Order Form, the Service Description is as set forth on www.servicenow.com/schedules.do and is
INCORPORATED HEREIN BY THIS REFERENCE. Customer may request printed copies of the documents incorporated herein by reference by emailing us at legal.request@servicenow.com. Customer shall limit the types and number of ServiceNow
applications, Custom Applications, users and their permitted roles, and other use restrictions to those specified in this Order Form.

Additional Terms and Conditions

N/A

ServiceNow Order Form Product and Use Definitions

USER TYPE DEFINITIONS

User means any employee or contractor given access to the subscription service by Customer. Each User must be assigned a unique username and password that may not be shared or transferred. Only employees and contractors that have a user profile in the subscription
service which is designated as active may be given access to the subscription service.
Approver User is any User given the ServiceNow provided Approver role in the subscription service by Customer and no other role. An Approver User may only perform the functions set forth in the table below for Approver.
End User has the same use rights as Requester User.
Fulfiller User is any User given a role in the subscription service by Customer other than the Approver role. A Fulfiller User may only perform the functions set forth in the table below for Fulfiller.
Process User has the same use rights as Fulfiller User.
Requester User is any User without a role. A Requester User may perform only the functions defined in the table below for Requester.

FUNCTION
USER ROLE(S) DEFINED IN SERVICE

USER TYPES
APPROVER

REQUESTER

FULFILLER

None

Approver role only

Any role other than Approver

Create its own request

included

included

included

View its own request

included

included

included

Modify its own request

included

included

included

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Search the Service Catalog

included

included

included

Search the Knowledge Base

included

included

included

Access public pages

included

included

included

Take surveys

included

included

included

Approve requests by email that are routed to user

included

included

included

Set its own notification preferences

included

included

included

View assets assigned to user

included

included

included

Access and post to Live Feed

included

included

included

Initiate Chat sessions

included

included

included

Participate in a Watch List

included

included

included

View a report published to them

included

included

included

Approve requests routed to user via system

included

included

Create any record

included

Delete any record

included

Modify any record

included

Drill through any report

included

Create any report

included

Delete any report

included

Modify any report

included

Perform development activities

included (see below)

Perform administrative activities

included

CONFIGURATION AND CUSTOMIZATION

(1) Use of the ServiceNow platform for application configuration allows Customer to, with respect to the purchased ServiceNow application, change the values of pre-defined fields, add new fields to existing tables, add new tables that provide additional attributes around the
process, build workflow for the process, modify the UI and form layouts, create business rules, integrate with external data sources, and tailor the process through custom scripting. Application configuration is restricted to the process included in the ServiceNow application.
(2) Creation of new applications on the ServiceNow platform (Custom Applications) requires separate authorization. Custom Applications may not automate a process included in one or more applications in a ServiceNow IT application suite. Customer shall not access the
subscription service to develop or use a competing product or service. Custom application templates and other development materials are provided by ServiceNow without warranty and support.

PRODUCT DESCRIPTIONS
The ServiceNow applications and platform features are described in the Product Overview posted on www.servicenow.com/schedules.do.

Subscription
Product Code

PROD00189 ServiceNow IT Service Automation Suite

(Platinum Edition) - Fulfiller User

Subscription
Product Description

Incident Management; Problem Management; Change Management; Release Management; Configuration Management (CMDB); Asset Management; Request Management; IT Cost
Management; Work Management; Project Portfolio Management; Software Development Lifecycle (SDLC); IT Governance, Risk and Compliance (IT GRC); Vendor Performance
Management; and Resource Management.
Customer is granted the rights for Fulfiller User as defined in the User Type Definitions Section.

ACKNOWLEDGED AND AGREED:

Customer: Central London Community Healthcare NHS Trust

ServiceNow Nederland B.V.

Signature:

Signature:

Name:

Name:

Title:

Title:

Date:

Date:

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