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v. Feb 2025 Page 1
AMENDMENT TO CONTRACT
BY AND BETWEEN
THE CITY OF SAN RAFAEL AND ________________________________
FOR ________________________________________________________
Original Contract Execution Date: ________________,
Contract No._______________________
Amendment No. ___
THE ABOVE-NAMED CONTRACT is hereby amended by the parties as set
forth herein by the checked boxes below and is effective on _____________________.
☐ SCOPE OF WORK: The Scope of Work is hereby amended in Exhibit A-__,
attached hereto and incorporated by reference.
☐ COMPENSATION: The parties agree to increase the not-to-exceed amount by
$____________, and to increase the total not-to-exceed amount under the Contract to
$_________________.
☐ TERM OF CONTRACT: For Contractor to perform the additional or amended
work described herein, the term of this Contract shall be extended to
______________________.
Except as specifically amended herein, all other provisions, terms and obligations
of the Contract between the parties shall remain valid and shall be in full force.
1
X
X
In the event of a conflict or inconsistency between the terms of the Contract and the
terms of this Amendment, the terms of this Amendment shall control solely with
respect to the subject matter hereof.
Contractor Contract No. Q-1222119
N/A
Fleet GPS Hardware Services
5/17/2024
For City Clerk use only: Exp: 5/17/2028
29,988.49
City
1
$98,744.74
Samsara, Inc.
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
October 29, 2025
L8.0074.A1
v. Feb 2025 Page 2
IN WITNESS WHEREOF, the parties have executed this Amendment on the day,
month, and year first specified below.
CITY OF SAN RAFAEL:
_________________________________
________________________________,
_________________________________
Executed on:_______________________
APPROVED AS TO FORM:
Office of the City Attorney
_________________________________
________________________________,
_________________________________
ATTEST:
City Clerk
_________________________________
________________________________,
_________________________________
CONTRACTOR:
__________________________________
By: ____________________________
Name: ____________________________
Title: ____________________________
[If Contractor is a corporation, second
corporate officer signature required]
__________________________________
By: ____________________________
Name: ____________________________
Title: _____________________________
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
Samsara Inc.
EVP, Chief Legal Officer
Adam Eltoukhy
Andrea Visveshwara
Chief Assistant City Attorney
Cristine Alilovich
October 29, 2025
City Manager
City Clerk
Lindsay Lara
EXHIBIT A - 1
SCOPE OF WORK AMENDED
The Parties hereby agree to amend the Scope of Work to add the following work:
1. Additional or Amended Services:
Based on the Contractor’s proposal submitted on October 21, 2025, Contractor
shall perform the following:
1.1 Task 1 – Provide additional hardware and accessories in the following
quantities:
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
1.2 Task 2 – Provide additional licenses as follows, for a term of 19 months
beginning on the day the hardware is delivered:
DELIVERABLES
The Scope of Work is amended to add the following:
2. Project Deliverables:
2.1 Provide additional hardware, and software licenses as detailed in
Tasks 1 and 2.
– END OF EXHIBIT A-1 –
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
CONTRACT ROUTING FORM
INSTRUCTIONS: Use this cover sheet to circulate all contracts for review and approval in the order shown
below.
All following documents are attached as reference material.
RESPONSIBLE PARTY DESCRIPTION COMPLETED
Project Manager Email PINS insurance request to Contractor ☐
City Attorney’s Office Review, revise as needed, and approve agreement as to
form
Department Director Review and approve agreement
Risk Management Confirm insurance documentation is complete
Finance Review and sign off on funding availability
TO BE COMPLETED BY INITIATING DEPARTMENT PROJECT MANAGER:
Contracting Department:
Project Manager:
Contractor Name:
Contractor’s Contact: Contact’s Email:
City Council Date: ☐ ___________________ or ☐ Not applicable
☐ FPPC: Check if Contractor must file Form 700
Richard Geck
Samsara Inc
X
richard.geck@samsara.com
Shannon Mackle (for Gerardo Paredes)
Public Works
X
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
Cost Overview
License Term: 19 Months
Total License Cost over 19 Months USD $31,875.98
Hardware and Accessories Included
Non Recurring Discount(s)
(First Invoice Only)
($5,033.05)
Shipping and Handling* USD $662.59
Total Sales Tax* USD $2,482.97
Total Contract Value1 $29,988.49
First Invoice1 $17,158.41
Recurring Invoice2 $12,830.09
Quote #: Q-2320937
Issued Date: 10-21-2025
Expires 10-29-2025
Order Number: S-2212801
Prepared For:
City of San Rafael
111 Morphew St
San Rafael,
California
94901
San Rafael, California
94901
Prepared By:
Richard Geck
richard.geck@samsara.com
Sourcewell Contract #: 102924-
SAM
Payment Information:
Payment Method: Credit Card/ACH Debit
Payment Terms: Net 30
Payment Frequency: Direct Annual
Estimated Ship Date: 10-23-2025
1Estimated value, actual invoice amount may change based on product fulfilment
date, Includes estimated sales tax
2Amount displayed is for products purchased in this order only, Includes estimated
sales tax
*If shipping is “Pending” - Amount is pending due to size of order; Shipping and
Handling subject to change
*Sales tax subject to change: If Sales tax is “Pending” – Final amount will be
provided prior to payment
3% fee only applies to US - (CAD, MX, EMEA are exempt)
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
Product Overview
SHIP TO Gerardo Paredes
111 Morphew St
San Rafael, California, 94901-5508
United States
Hardware & Accessories List Price Discount %Net Unit Price Total Price
Vehicle IoT Gateway, model VG55
HW-VG55-NA• QTY: 85
$0.00 0%Included Included
VG5x Aux Cable
CBL-VG-CAUX• QTY: 85
$0.00 0%Included Included
Enhanced VG Series OBDII J1962 L-
mount cable
CBL-VG-COBDII-Y1• QTY: 74
$0.00 0%Included Included
Enhanced VG Series J1939 or J1708
(9-pin)
CBL-VG-CJ1939• QTY: 11
$0.00 0%Included Included
VG54/55 kill switch bypass accessory
ACC-VG-CPWRBY• QTY: 11
$14.00 100%Included Included
Mounting Bracket for AG51, AG52,
and AG53
ACC-AG-BMNT• QTY: 6
$0.00 0%Included Included
AG53 Powered Asset Gateway
HW-AG53• QTY: 6
$0.00 0%Included Included
Cable for HW-AG53
CBL-AG-BPWR• QTY: 6
$0.00 0%Included Included
AG51 Unpowered Asset Gateway
HW-AG51• QTY: 1
$0.00 0%Included Included
Mounting Bracket for AG51, AG52,
and AG53
ACC-AG-BMNT• QTY: 1
$0.00 0%Included Included
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
SHIP TO Gerardo Paredes
111 Morphew St
San Rafael, California, 94901-5508
United States
Hardware & Accessories List Price Discount %Net Unit Price Total Price
Total Price:0
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
Licenses List Price Discount %Annual Unit
Price
Total
Annual Price
License for Vehicle Gateways - Public
Sector Only, No WiFi, No ELD
LIC-VG-PS• QTY: 85
$312.00 26.923%$228.00 $19,380.00
License for Basic Powered Asset
Tracker
LIC-AG-PWR-BASIC• QTY: 6
$204.00 46.337%$109.47 $656.83
License for Unpowered Asset Tracker
LIC-AG-UNPWR• QTY: 1
$144.00 33.772%$95.37 $95.37
Total Price:$20,132.20
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
Non Recurring Discount(s)Total Price
Free Months Rebate
DC-FUTURE-FREE-MONTHS
($5,033.05)
Total Price:
USD ($5,033.05)
Billing Details:
Bill To:Billing Contact::
City of San Rafael
111 Morphew St
San Rafael, California, 94901
Name: Gerardo Paredes
Title:Shop and Equipment Supervisor
Billing Email:
gerardo.paredes@cityofsanrafael.org
Phone Number: 4157259239
Does your organization require a purchase order (PO) in order to process payment to vendors?
\Picklist_1\
If yes, please provide the PO Number: /PO_number_1/
If your organization requires invoice submission via an electronic invoice portal, please email any
e-invoicing requirements to billingsupport@samsara.com.
Please email any tax documentation to billingsupport@samsara.com.
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
Thank you for considering Samsara
Samsara provides real-time visibility, business-relevant tools, and powerful analytics that enable
customers to increase the productivity of their fleets and reduce operating costs. A solution for
your fleet is proposed below.
What is included?
Samsara’s fleet tracking solution includes hardware accessories and a per-gateway license.
Gateway licenses provide all ongoing elements of the service, including:
- Real-time location and vehicle telematics
- Dashboard access with unlimited administrator accounts
- Driver App for iOS and Android devices with unlimited driver accounts
- Over-the-air software feature upgrades
- API access as it relates to features for integration with 3rd party systems
- Maintenance and phone support
Samsara does not include hidden costs in its licenses. If you want access to Samsara’s full set of
fleet features--including but not limited to WiFi hotspot and ELD capabilities--you will need to
upgrade your license. Samsara reserves the right to audit usage of features unrelated to the
solution as well as remove them from the Samsara Dashboard.
Payment Terms
This order form includes a license fee for the Samsara Software associated with the Hardware
to be paid annually beginning on the License Start Date and, if applicable, a one-time Hardware
cost to be paid upfront as of the license start date. The annual fees are payable by recurring wire
transfer. All transfers made by credit card are subject to a processing fee up to 3%, subject to
applicable law. Late payments are subject to a 1.5% per month late fee. If license payments are
delinquent by 30 days, Samsara may suspend the Service until late payments are remitted.
License Term
The license term for the Samsara Software licenses purchased under this Order Form begins on
the day Samsara activates the applicable Samsara Software license by providing you a claim
number and access to the Hosted Software (“License Start Date”). If Hardware associated with a
then-unactivated Samsara Software license will be shipped to you under this Order Form, such
Samsara Software license will be activated on the day the Samsara Hardware ships.
Notwithstanding the foregoing, if you are renewing the license term for a previously-activated
Samsara Software license under this Order Form, the License Start Date for the renewal license
term shall be the day that Samsara extends your access to the Hosted Software for the renewal
license term. Samsara Hardware requires a valid license to function.
Samsara may ship Hardware under this Order Form subject to a schedule as mutually agreed
between the Parties or as determined by Samsara. By signing this Order Form, you confirm that
each “Ship To” delivery address set forth herein is accurate and that any individual accepting
delivery at that address is authorized to do so on your behalf. To the extent such Hardware is
associated with then-unactivated Samsara Software licenses, the Samsara Software license
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
term for each such Hardware device will start on the day that device ships regardless of the
shipment schedule for the other such Hardware devices. If all such Hardware is shipped in one
shipment, the license term for all such Hardware will be the full license term under this Order
Form. If such Hardware is shipped in multiple shipments, only the license term of such
Hardware in the initial shipment will be such full license term. The license term of the remaining
such Hardware shipped after the initial shipment will be set to match the then-remaining license
term of the initial shipment, so that the license term for all such Hardware under this Order Form
expires on the same date. The total cost of the licenses for such Hardware shipped after the
initial shipment will be pro-rated based on their actual license term, rounded up to the nearest
month, as compared to the full license term under this Order Form. Certain payment amounts
under this Order Form assume that the entire order is fulfilled at the same time and are subject
to potential reduction based on the actual schedule of order fulfillment.
You agree that you will only use the features included with the Samsara Software licenses
purchased under this Order Form (“Licensed Scope”). Samsara reserves the right to audit usage
of Samsara Software and to remove your access to such features beyond the Licensed Scope
(for example, the licensed feature scope or licensed user count, as applicable) at any time. If
you would like to use features beyond the Licensed Scope, you are required to purchase the
applicable Samsara Software licenses and if applicable install the applicable Hardware that
include such scope. If Samsara becomes aware that you are using features beyond the Licensed
Scope, Samsara reserves the right to charge you for the applicable Samsara Software licenses
that include such Licensed Scope at list price, and you agree to immediately pay such amounts.
Samsara further reserves the right to change, discontinue, or remove features included in a
Samsara Software license at any time.
You acknowledge and agree that, during your license term, you may not downgrade your
Samsara Software license plan to a lower Samsara Software license plan (e.g., downgrading
your “Enterprise” license to a “Premier” license).
Support And Warranty
Samsara stands behind its Products. During the applicable warranty period, defective Hardware
will be remedied pursuant to our Hardware Warranty Policy at
www.samsara.com/support/hardware-warranty. Additional support information can be found at
www.samsara.com/support.
Terms
Unless otherwise set forth herein, your use and access of the Hardware, Products, and Services
specified herein are governed by Samsara’s standard terms of service found at
https://www.samsara.com/legal/public-sector-customers-platform-terms-of-service/, unless
the Parties have entered into a separate terms of service agreement and/or a separate terms of
service agreement is attached to the Order Form, in which case such separate terms of service
agreement shall govern (the 'Terms of Service') provided that notwithstanding anything stated in
the Terms of Service to the contrary, Customer agrees the following sections from Samsara’s
standard terms of service found at https://www.samsara.com/legal/public-sector-customers-
platform-terms-of-service/ shall apply: License (Section 4), Product Updates (Section 7), Data
Protection Addendum (Section 10.3), Non-Samsara Products (Section 14), and Hardware
Warranty (Section 17). You agree to be bound by the Terms of Service, and any capitalized terms
not defined herein shall have the meaning set forth in the Terms of Service. The terms and
conditions of the Terms of Service and this Order Form are the exclusive agreement of the
parties with respect to the subject matter hereof and no other terms or conditions, including
those associated with any Customer payment portal or onboarding of Samsara as a Customer
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
vendor, shall be binding upon Samsara or otherwise have any force or effect.
To the extent Samsara allows you to make subsequent purchases of Products via Purchase
Order without a corresponding Quote, you agree that (i) such Purchase Order shall be subject to
the terms and conditions of this Order Form, including with respect to payment and license
terms, as well as the applicable Terms of Service; and (ii) to the extent there is a conflict
between such Purchase Order and this Order Form, including with respect to payment and
license terms, as well as the applicable Terms of Service, the terms of this Order Form shall
prevail, and no additional terms included in such Purchase Order that are not included in this
Order Form shall apply. You acknowledge and agree that any reference to a Purchase Order in
this Order Form is solely for your convenience in record keeping, and the existence of a
Purchase Order or any delivery of Products to you following receipt of any Purchase Order shall
not be deemed an acknowledgement of or agreement to any terms or conditions associated
with any such Purchase Order or in any way be deemed to modify, alter, supersede or
supplement the Terms of Service or this Order Form.
Samsara is providing a one-time service credit in the amount of $5,033.05 ('Free Service
Credit') to be applied against the fees due for the licensed devices purchased during the Initial
Term under this Order Form. This Free Service Credit is non-recurring and applies only to the
licensed devices purchased herein. It will not be applied to any Renewal Term or for any add-on
purchases made by Customer, and the pricing and payment terms under this Order Form shall
not apply to any such other Order Forms.
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
Notification of Confidentiality
You agree that the pricing and payment terms specified in this Order Form shall (i) be held in
strict confidence; (ii) not be disclosed to any Samsara competitor or other entity, except as pre-
approved in writing by Samsara; and (iii) not be used except to evaluate the suitability of the
Samsara Products for your business. You will immediately notify Samsara in the event of any
unauthorized use or disclosure under these terms. Violation of these obligations will cause
irreparable harm to Samsara for which Samsara may obtain compensatory and timely injunctive
relief from a court, as well as any other remedies that may be available, including recovery of all
reasonable attorney’s fees and costs incurred in seeking such remedies. Your obligations
specified herein shall last until the pricing and payment terms herein are, through no fault or
action by you, public. This Order Form is a legally binding agreement between you (“Customer”)
and Samsara Inc. (“Samsara”). IN WITNESS WHEREOF, Customer has caused this Order Form to
be executed by its duly authorized representative.
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
I confirm acceptance of this Order Form on behalf of the Customer identified herein and represent and
warrant that I have full and complete authority to bind the Customer to this Order Form, including all
terms and conditions herein." "Please confirm acceptance of this Order Form by signing below:
Signature \s1\
Print Name:\n1\
Date:\d1\
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
samsara.com 1
Samsara Inc
1 De Haro Street
San Francisco, CA 94107
www.samsara.com
Quote Summary Subtotal
Hardware and Accessories $0.00
Licenses
License Term – 36
Months
Shipping and Handling $90.00
Total Savings: $21,711.60 Upfront Hardware Sales Tax $0.00
If shipping is "Pending" - Amount is pending due to size
of order; Shipping and Handling subject to change.
If Sales tax is “Pending” – Final amount will be provided
prior to payment
*3% fee
charged on non-ACH charges (Canada Exempt)
*Sales tax subject to change
Annual License Sales Tax $1,937.95
First Year Payment $22,978.75
Payments Beginning Year Two $22,888.75
Prepared For:
City of San Rafael
111 Morphew St
San Rafael, California
94901
Prepared By:
Richard Geck
richard.geck@samsara.com
Issued 04-23-2024
Expires 04-30-2024
Sourcewell Contract #: 020221-SAM
QUOTE #Q-1222119
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
samsara.com 2
Samsara Inc
1 De Haro Street
San Francisco, CA 94107
www.samsara.com
SHIP TO Gerardo Paredes
111 Morphew St
San Rafael, California, 94901-5508
United States
Hardware and Accessories Quantity List Price Discount %Net Unit
Price Total Price
Vehicle IoT Gateway, model VG54
HW-VG54-NA 76 $0.00 0%$0.00 $0.00
Enhanced VG Series OBDII J1962 L-mount
cable
CBL-VG-COBDII-Y1
73 $0.00 0%$0.00 $0.00
AG52 Powered Asset Gateway
HW-AG52 14 $0.00 0%$0.00 $0.00
CBL-AG-BPWR
CBL-AG-BPWR 14 $0.00 0%$0.00 $0.00
Vehicle IoT Gateway, model VG54, for
Heavy Duty Vehicles
HW-VG54-NAH
6 $0.00 0%$0.00 $0.00
Enhanced VG Series J1939 or J1708 (9-
pin)
CBL-VG-CJ1939
5 $0.00 0%$0.00 $0.00
VG54 Aux Cable
CBL-VG-CAUX 3 $0.00 0%$0.00 $0.00
Enhanced VG Series direct-wire non-
diagnostic power cable
CBL-VG-CPC
3 $0.00 0%$0.00 $0.00
Enhanced VG Series J1708 (6-pin)
CBL-VG-CJ1708 1 $0.00 0%$0.00 $0.00
Hardware Due $0.00
Licenses Quantity List Price Discount %Annual Unit
Price
Total Annual
Price
License for Basic Powered Asset Tracker
LIC-AG-PWR-BASIC 14 $186.00 34.194%$122.40 $1,713.60
Annual
License Due $1,713.60
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
samsara.com 3
Samsara Inc
1 De Haro Street
San Francisco, CA 94107
www.samsara.com
Bundles Quantity List Price Discount %Annual Unit
Price
Total Annual
Price
License for Vehicle Gateways - Public Sector
Only, No WiFi, No ELD
LIC-VG-PS
82 $312.00 24.808%$234.60 $19,237.20
Annual
License Due $19,237.20
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
samsara.com 4
Samsara Inc
1 De Haro Street
San Francisco, CA 94107
www.samsara.com
Thank you for considering Samsara for your fleet.
Samsara provides real-time visibility, business-relevant tools, and powerful
analytics that enable customers to increase the productivity of their fleets and
reduce operating costs. A solution for your fleet is proposed below.
What is included?
Samsara’s fleet tracking solution includes hardware accessories and a per-
gateway license. Gateway licenses provide all ongoing elements of the service,
including:
-Real-time location and vehicle telematics
-Dashboard access with unlimited administrator accounts
-Driver App for iOS and Android devices with unlimited driver accounts
-Over-the-air software feature upgrades
-API access as it relates to features for integration with 3rd party systems
-Maintenance and phone support
Samsara does not include hidden costs in its licenses. If you want access to
Samsara’s full set of fleet features--including but not limited to WiFi hotspot and
ELD capabilities--you will need to upgrade your license. Samsara reserves the right
to audit usage of features unrelated to the solution as well as remove them from
the Samsara Dashboard.
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
samsara.com 5
Samsara Inc
1 De Haro Street
San Francisco, CA 94107
www.samsara.com
Payment Terms
This order form includes a license fee for the Samsara Software associated with the Hardware to
be paid annually and, if applicable, a one-time Hardware cost to be paid upfront (Net-30). The
annual fees are payable by check or recurring wire transfer. All transfers are subject to a 3%
processing fee unless the wire transfer is initiated by Samsara via ACH, in which case the 3%
processing fee will be waived. Late payments are subject to a 1.5% per month late fee. If license
payments are delinquent by 60 days, Samsara may suspend the Service until late payments are
remitted.
License Term
The license term for the Samsara Software licenses purchased under this Order Form begins on
the day Samsara activates the applicable Samsara Software license by providing you a claim
number and access to the Hosted Software (“License Start Date”). If Hardware associated with
a
then-unactivated Samsara Software license will be shipped to you under this Order Form, such
Samsara Software license will be activated on the day the Samsara Hardware ships.
Notwithstanding the foregoing, if you are renewing the license term for a previously-activated
Samsara Software license under this Order Form, the License Start Date for the renewal license
term shall be the day that Samsara extends your access to the Hosted Software for the renewal
license term. Samsara Hardware requires a valid license to function.
Samsara may ship Hardware under this Order Form subject to a schedule as mutually agreed
between the Parties or as determined by Samsara. To the extent such Hardware is associated
with then-unactivated Samsara Software licenses, the Samsara Software license term for each
such Hardware device will start on the day that device ships regardless of the shipment schedule
for the other such Hardware devices. If all such Hardware is shipped in one shipment, the license
term for all such Hardware will be the full license term under this Order Form. If such Hardware is
shipped in multiple shipments, only the license term of such Hardware in the initial shipment will
be such full license term. The license term of the remaining such Hardware shipped after the initial
shipment will be set to match the then-remaining license term of the initial shipment, so that the
license term for all such Hardware under this Order Form expires on the same date. The total cost
of the licenses for such Hardware shipped after the initial shipment will be pro-rated based on their
actual license term, rounded up to the nearest month, as compared to the full license term under
this Order Form. Certain payment amounts under this Order Form assume that the entire order is
fulfilled at the same time and are subject to potential reduction based on the actual schedule of
order fulfillment.
Support and Warranty
Samsara stands behind its Products. Hardware Products that require a valid license to function
come with a warranty that lasts as long as you maintain a valid license for such Hardware. All
other Hardware Products, such as accessories, come with a one-year warranty, unless otherwise
specified on the relevant Samsara data sheet. During the warranty period, Hardware exhibiting
material defects will be replaced pursuant to our Hardware Warranty & RMA policy at
www.samsara.com/support/hardware-warranty. Additional support information can be found at
www.samsara.com/support.
Terms
Unless otherwise set forth herein, your use and access of the Hardware, Products, and
Services specified herein are governed by Samsara’s terms of service found at
https://www.samsara.com/legal/public-sector-customers-platform-terms-of-service, unless the
Parties have entered into a separate terms of service agreement and/or a separate terms of
service agreement is attached to this Order Form, in which case such separate terms of service
agreement shall govern (the “Terms of Service”). You agree to be bound by the Terms of Service,
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
samsara.com 6
Samsara Inc
1 De Haro Street
San Francisco, CA 94107
www.samsara.com
and any capitalized terms not defined herein shall have the meaning set forth in the Terms of
Service. You further agree that any other Order Forms you enter into for the purchase of Products
shall also be governed by the Terms of Service unless otherwise set forth in the applicable Order
Form. For clarity, unless otherwise agreed by the Parties or approved by Samsara, the pricing and
payment terms under this Order Form shall not apply to any such other Order Forms.
The continuation of this Order Form one (1) year after the license start date and annually
thereafter is contingent upon the appropriation of sufficient funds by Customer. If sufficient funds
fail to be appropriated by Customer to provide for the continuation of the Order Form for
Customer’s then-subsequent fiscal year, Customer may terminate this Order Form with prior
written notice effective as of the later of the date of the beginning of such subsequent fiscal year
and the end of the then-current annual license period. If Customer so terminates this Order Form,
Samsara shall be entitled to payment of and for: all amounts due as of the date of termination;
deliverables in progress; liabilities, fees, or costs caused by such termination including for
obligations that extend beyond the date of termination; and reasonable Order Form close-out
costs.
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
samsara.com 7
Samsara Inc
1 De Haro Street
San Francisco, CA 94107
www.samsara.com
Notification of Confidentiality
This Order Form is a legally binding agreement between you
(“Customer”) and Samsara Inc. (“Samsara”). IN WITNESS WHEREOF, Customer has caused
this Order Form to be executed by its duly authorized representative.
I confirm acceptance of this Order Form on behalf of the Customer identified herein and represent
and warrant that I have full and complete authority to bind the Customer to this Order Form,
including all terms and conditions herein." "Please confirm acceptance of this Order Form by
signing below:
Signature \s1\
Print Name:\n1\
Date:\d1\
Cristine Alilovich (May 17, 2024 11:48 PDT)
Cristine Alilovich
Cristine Alilovich
05/17/2024
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
CONTRACT ROUTING FORM
INSTRUCTIONS: Use this cover sheet to circulate all contracts for review and approval in the order shown below.
Step RESPONSIBLE
DEPARTMENT
DESCRIPTION COMPLETED
DATE
REVIEWER
Check/Initial
1 Project Manager
a. Email PINS Introductory Notice to Contractor
b. Email contract (in Word) and attachments to City
Attorney c/o Laraine.Gittens@cityofsanrafael.org
Click here to
enter a date.
4/29/2024
☐
☒SM
2 City Attorney
a. Review, revise, and comment on draft agreement
and return to Project Manager
b. Confirm insurance requirements, create Job on
PINS, send PINS insurance notice to contractor
5/14/2024
5/14/2024
☒ NT
☒ NT
3 Department Director Approval of final agreement form to send to
contractor
5/14/2024 ☒ AM
4 Project Manager
Forward three (3) originals of final agreement to
contractor for their signature
Click here to
enter a date.
☐
5 Project Manager When necessary, contractor-signed agreement
agendized for City Council approval *
*City Council approval required for Professional Services
Agreements and purchases of goods and services that exceed
$75,000; and for Public Works Contracts that exceed $175,000
Date of City Council approval
☒ N/A
Or
Click here to
enter a date.
☐
PRINT CONTINUE ROUTING PROCESS WITH HARD COPY
6 Project Manager Forward signed original agreements to City
Attorney with printed copy of this routing form
7 City Attorney Review and approve hard copy of signed
agreement
8 City Attorney Review and approve insurance in PINS , and bonds
(for Public Works Contracts)
9 City Manager / Mayor Agreement executed by City Council authorized
official
10 City Clerk Attest signatures, retains original agreement and
forwards copies to Project Manager
TO BE COMPLETED BY INITIATING DEPARTMENT PROJECT MANAGER:
Contracting Department: Public Works
Project Manager: Shannon Mackle (for Gerardo Paredes) Extension: 3353
Contractor Name: Samsara Inc
Contractor’s Contact: Richard Geck Contact’s Email: Richard.geck@samsara.com
☐ FPPC: Check if Contractor/Consultant must file Form 700
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
Samsara Inc - Fleet GPS Hardware agreement
Final Audit Report 2024-05-17
Created:2024-05-14
By:Shannon Mackle (shannon.mackle@cityofsanrafael.org)
Status:Signed
Transaction ID:CBJCHBCAABAA9t5BIxWGrEYDDjRS_RrHhENTGNuq2cyx
"Samsara Inc - Fleet GPS Hardware agreement" History
Document created by Shannon Mackle (shannon.mackle@cityofsanrafael.org)
2024-05-14 - 11:03:52 PM GMT
Document emailed to Laraine Gittens (laraine.gittens@cityofsanrafael.org) for approval
2024-05-14 - 11:05:00 PM GMT
Document shared with Jonathan Schellin (jonathans@cityofsanrafael.org) by Shannon Mackle
(shannon.mackle@cityofsanrafael.org)
2024-05-14 - 11:05:28 PM GMT
Email viewed by Laraine Gittens (laraine.gittens@cityofsanrafael.org)
2024-05-14 - 11:40:28 PM GMT
Document approved by Laraine Gittens (laraine.gittens@cityofsanrafael.org)
Approval Date: 2024-05-14 - 11:51:06 PM GMT - Time Source: server
Document emailed to Genevieve Coyle (genevieve.coyle@cityofsanrafael.org) for approval
2024-05-14 - 11:51:07 PM GMT
Email viewed by Genevieve Coyle (genevieve.coyle@cityofsanrafael.org)
2024-05-15 - 3:51:47 PM GMT
Document approved by Genevieve Coyle (genevieve.coyle@cityofsanrafael.org)
Approval Date: 2024-05-15 - 3:52:35 PM GMT - Time Source: server
Document emailed to city.clerk@cityofsanrafael.org for approval
2024-05-15 - 3:52:38 PM GMT
Email viewed by city.clerk@cityofsanrafael.org
2024-05-15 - 4:15:37 PM GMT
Signer city.clerk@cityofsanrafael.org entered name at signing as Lindsay Lara
2024-05-15 - 4:15:46 PM GMT
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
Document approved by Lindsay Lara (city.clerk@cityofsanrafael.org)
Approval Date: 2024-05-15 - 4:15:48 PM GMT - Time Source: server
Document emailed to cristine.alilovich@cityofsanrafael.org for signature
2024-05-15 - 4:15:49 PM GMT
Email viewed by cristine.alilovich@cityofsanrafael.org
2024-05-17 - 6:48:24 PM GMT
Signer cristine.alilovich@cityofsanrafael.org entered name at signing as Cristine Alilovich
2024-05-17 - 6:48:43 PM GMT
Document e-signed by Cristine Alilovich (cristine.alilovich@cityofsanrafael.org)
Signature Date: 2024-05-17 - 6:48:45 PM GMT - Time Source: server
Agreement completed.
2024-05-17 - 6:48:45 PM GMT
Docusign Envelope ID: 0C8B0449-A454-462B-9F1C-291928BA3AF0
Certificate Of Completion
Envelope Id: 0C8B0449-A454-462B-9F1C-291928BA3AF0 Status: Completed
Subject: DocuSign: Amendment with Samsara for Fleet GPS Hardware Services
Source Envelope:
Document Pages: 26 Signatures: 4 Envelope Originator:
Certificate Pages: 5 Initials: 4 Shannon Mackle
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
111 Morphew St
San Rafael, CA 94901
Shannon.Mackle@cityofsanrafael.org
IP Address: 199.88.113.8
Record Tracking
Status: Original
8/11/2025 1:14:57 PM
Holder: Shannon Mackle
Shannon.Mackle@cityofsanrafael.org
Location: DocuSign
Signer Events Signature Timestamp
April Miller
April.Miller@cityofsanrafael.org
Public Works Director
Security Level: Email, Account Authentication
(None)Signature Adoption: Uploaded Signature Image
Using IP Address: 199.88.89.34
Sent: 10/21/2025 12:50:52 PM
Resent: 10/22/2025 10:05:34 AM
Viewed: 10/22/2025 2:14:45 PM
Signed: 10/22/2025 2:14:52 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Nataly Torres
Nataly.Torres@cityofsanrafael.org
Legal Assistant
City of San Rafael
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address:
2600:1700:9750:3df0:44ff:d3c8:7d4d:1e73
Sent: 10/22/2025 2:14:54 PM
Viewed: 10/22/2025 3:33:53 PM
Signed: 10/22/2025 3:33:57 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Van Bach
vanb@cityofsanrafael.org
Signing Group: Finance
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 199.88.113.8
Sent: 10/22/2025 2:14:55 PM
Resent: 10/23/2025 9:48:24 AM
Viewed: 10/23/2025 9:48:57 AM
Signed: 10/23/2025 9:49:41 AM
Electronic Record and Signature Disclosure:
Accepted: 10/23/2025 9:48:57 AM
ID: 99edab8d-fe94-4a37-8524-1918fcd23ca2
Adam Eltoukhy
legalnotices@samsara.com
EVP, Chief Legal Officer
Samsara Inc.
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 104.129.205.31
Sent: 10/23/2025 9:49:44 AM
Viewed: 10/23/2025 12:53:15 PM
Signed: 10/23/2025 1:00:43 PM
Electronic Record and Signature Disclosure:
Accepted: 10/23/2025 12:53:15 PM
ID: 5d5e07ac-acdb-4cc0-840b-9fd99fd5c8de
Signer Events Signature Timestamp
Andrea Visveshwara
Andrea.Visveshwara@cityofsanrafael.org
Chief Assistant City Attorney
City of San Rafael
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 199.88.113.8
Sent: 10/23/2025 1:00:46 PM
Resent: 10/27/2025 1:26:40 PM
Viewed: 10/27/2025 4:21:33 PM
Signed: 10/27/2025 4:21:57 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Heather Davis
Heather.Davis@cityofsanrafael.org
Risk Manager
City of San Rafael
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 199.88.113.8
Sent: 10/23/2025 1:00:46 PM
Resent: 10/23/2025 1:44:53 PM
Resent: 10/27/2025 1:26:40 PM
Viewed: 10/28/2025 1:57:28 PM
Signed: 10/28/2025 1:57:59 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Cristine Alilovich
Cristine.Alilovich@cityofsanrafael.org
City Manager
City of San Rafael
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address:
2600:100c:b240:c1ae:f9ff:78a:75b2:719b
Signed using mobile
Sent: 10/28/2025 1:58:02 PM
Resent: 10/29/2025 1:09:52 PM
Viewed: 10/29/2025 1:53:00 PM
Signed: 10/29/2025 1:53:07 PM
Electronic Record and Signature Disclosure:
Accepted: 8/8/2025 5:50:59 PM
ID: 92734b64-c5dc-4308-af7f-b0f4b9ffd306
Lindsay Lara
Lindsay.Lara@cityofsanrafael.org
City Clerk
City of San Rafael
Signing Group: City Clerk
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 199.88.113.8
Sent: 10/29/2025 1:53:11 PM
Viewed: 10/29/2025 2:59:24 PM
Signed: 10/29/2025 3:00:19 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Nataly Torres
Nataly.Torres@cityofsanrafael.org
Legal Assistant
City of San Rafael
Security Level: Email, Account Authentication
(None)
Using IP Address:
2600:1700:9750:3df0:4d4a:95db:8d61:a624
Sent: 8/11/2025 3:50:09 PM
Viewed: 8/19/2025 6:57:26 PM
Completed: 10/21/2025 12:50:51 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Richard Geck
richard.geck@samsara.com
Security Level: Email, Account Authentication
(None)
Sent: 10/29/2025 3:00:21 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 8/11/2025 3:50:09 PM
Envelope Updated Security Checked 8/11/2025 3:51:49 PM
Envelope Updated Security Checked 8/21/2025 3:18:51 PM
Envelope Updated Security Checked 9/12/2025 11:57:30 AM
Envelope Updated Security Checked 9/12/2025 12:00:43 PM
Envelope Updated Security Checked 9/12/2025 12:00:43 PM
Envelope Updated Security Checked 9/12/2025 12:00:43 PM
Envelope Updated Security Checked 9/12/2025 12:38:19 PM
Envelope Updated Security Checked 9/12/2025 12:41:37 PM
Envelope Updated Security Checked 10/9/2025 2:50:57 PM
Envelope Updated Security Checked 10/16/2025 3:21:01 PM
Envelope Updated Security Checked 10/21/2025 10:42:32 AM
Envelope Updated Security Checked 10/21/2025 12:50:51 PM
Envelope Updated Security Checked 10/23/2025 1:44:52 PM
Envelope Updated Security Checked 10/23/2025 1:44:52 PM
Certified Delivered Security Checked 10/29/2025 2:59:24 PM
Signing Complete Security Checked 10/29/2025 3:00:19 PM
Completed Security Checked 10/29/2025 3:00:21 PM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, City of San Rafael (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
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 City of San Rafael:
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: city.clerk@cityofsanrafael.org
To advise City of San Rafael 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 city.clerk@cityofsanrafael.org and in the body of such request you must state: your
Electronic Record and Signature Disclosure created on: 5/22/2025 12:46:43 PM
Parties agreed to: Van Bach, Adam Eltoukhy, Cristine Alilovich
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 City of San Rafael
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 city.clerk@cityofsanrafael.org 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 City of San Rafael
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 city.clerk@cityofsanrafael.org 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 City of San Rafael 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 City of San Rafael during the course of your relationship with City of
San Rafael.