IIT Bombay

Order Form
Parties: IIT Bombay

Maharashtra
India
(“Qualtrics”) (“Customer”)
Effective Date: The date signed by the last party to sign.
Governing https://www.qualtrics.com/legal/customers/gtcs/""""
Document:
Additional
Terms:
Customer Information:
Regional Data SIN Purchase Order Not Applicable
Center: Number (if
any):*
Email Address [email protected] Shipping
for Invoice Address:
Submission:
Invoicing Not Applicable Billing Address

Instructions (if for Invoice
applicable): Submission:
*If Customer requires a purchase order number (“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.
Qualtrics Customer
By (signature): \s2\ By (signature):

Name: \n2\ Name:
Title: \t2\ Title:
Date: \d2\ Date:
Qualtrics Primary Contact: Customer Primary Contact:
Name: Akshay Kumar Name: Raj Saroj
Phone: Phone: 9967614288
Email: [email protected] Email: [email protected]
QUALTRICS 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: 12
Renewal Terms
(not applicable to pilots or proofs of concept)
Type of renewal at the end of the initial
term and each renewal term:
Advance notice required to not renew or
to request modification prior to the end
of initial term or applicable renewal term:
Length of each renewal term in months: 12
Maximum price increase at each renewal 5%
term for same services:
Fees for Initial Term

Payment
Estimated
Period Services Price Terms from License Configuration
Invoice Date
Invoice
01-Nov-2024 TO 31-Oct- Cloud $12,000.00

Net 30 Q-183146
2025 Professional $0.00
USD $12,000.00
Total
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
YEAR 1
Q-183146
CLOUD SERVICE
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.
https://www.qualtrics.com/m/assets/wp-content/uploads/2023/03/Success-Packages-Terms.pdf
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%.
QUALTRICS CONFIDENTIAL

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Order Form

Parties: IIT Bombay

Invoicing Not Applicable Billing Address

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

Fees for Initial Term

01-Nov-2024 TO 31-Oct- Cloud $12,000.00

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