HomeMy WebLinkAboutCardConnect RecPro Credit Card Processing 05.19.21Merchant Processing Application and Agreement eardeonnect.
Please review the information below and sign if everything looks right. If you have any questions please contact your representative.
$1ET11P WORMATION
Sales Code REC4 Application Platform North f�
BUSINESS DETAILS
CtONTACT.I1:FORMA"M
First Name Richl a Last Name
Email _ sigdelr@pasco-wa.gov — Phone Number
NOTE: Failure to provide accurate information may result in a withholding of merchant funding per IRS reg
information.)
Business Legal Name City of Pasco 1 DBA Name
Tax Filing Name Cisco Tax Filing Methr
Tax ID (EIN) --
Type of Ownership
„ ® Government O Individual / Sole Proprietor O Limited Liability Company O Non-Profd Org O Part
I�O Tax Exempt
Stock Exchange (Only applicable for Public Corporations) Stock Ticker Sy
I O NYSE or NASDAQ ® Other/Not Applicable
Industry (MCC) 9399 - Government Services (Not Elsewhere Classified) Business Descr
Industry Options O Quasi Cash Business Start I
Website
Street 11dress 1
I Street Address 2
y State
)Country
https:/Awm.pasco-wa.gov/166/Parks-Recreation I Business Phom
52525 North 3rd Avenue T� Street Address
City Pasco StreetAddres:
Washington ZIP 99301 State
United States of America Country
OWNER INFORMATION
SigdeI
(509) 5453065
lotions. (See Part IV, Section AA of your Program Guide for further
City of Pasco, Parks & R.tien
d OEINOSSN
iership O Private Corporation O Public Corporation
nbol (NYSE or NASDAQ)
ption Parks & Rea
late
(509)5453456
t PO Box 293
2 City Pasco
Washington ZIP 99301
United States of America
Please provide the following information for each individual who owns, directly or indirectly, 25 % or moreof the equity interest of your business.
INFO
First Name Riche Last Name Sigdel Street Add.. t 525North 3rdAvenue
% Ownership 0 % Personal Guarantee Oyes Street Address 2 I City Pasco
SSN Date of Birth State Washington ZIP 99301
Mobile Phone Country Unted States of America
Email sigdelr@pasco-wa.gov
Page 1 of 5 CardConnect LLC is a registered ISO of Wells Fargo Bank, N.A., Concord, CA GenCP-WF-2403_MPA_02.01.21
First Name
Last Name
% Ownership
SSN
Date of Birth
Mobile Phone
First Name Last Name
% Ownership I SSN
Date of Birth i Mobile Phone
First Name
% Ownership
Date of Birth
�1 last Name
% SSN
Mobile Phone
ADGITIONAL BUSINESS OWNER III
iL Street Address 1
Lam' Street Address 2 City
�i State ZIP d
Country
Street Address 1
Street Address 2 Clry —J
I State i� ZIP
Country
Stree
�. $tree
State
0 city �I
ZIP 3
First Name last Name Street Address 1
% Ownership � % SSN C� Street Address 2 City
Date of Birth L J. Mobile Phone State ZIP
LL��JJ Country
BANKING AND PROCESSING
Bank Name US Bank Average Monthly Card Volume $ / month
Account Type ® Business Checking Q Savings Average Transaction Amount I $
Routing Number 125000r05 Account Number 153501454992 -
On average, Products I Services are delivered In
Days O 8-14 Days ® 15-30 Days O 30+ Days
In Person 20
Telephone 5
Online 75 % 1
Must total 100%
Page 2 of 5 CardConnect LLC is a registered ISO of Wells Fargo Bank, N.A., Concord, CA GenCP-WF-2403_MPA 02.01.21
EQUIPMENT
Product Name
Network Qty Price "
----��''
(CardPointeGateway (RapidConnectNorth)
;Frequency
,
I
$ I
---------------
Clover Menu Requested O ' Price does not include tax and shipping & handling.
Ship To Attention
Street Address 1
Ship To Email
Street Address 2
State
City
ZIP
Country
MERCHANT SERVICES
American Express Opt Blue Discover Full ACQ Mastercard Visa Discover Program ® Discover Full ACQ O Discover EASI
Discover EASI SE
AAIERICRN EXPRESS
Discover Industry Options
Amex Program ® Amex OptBlue O Amex ESA
Q Enable Incremental Authorizations
Amex ESA BE �� IATAIARC Number O Debt Repayment Program
l PRICING INFORMATION
Discount Frequency O Dues & Assessments
® Monthly Q Daily (See Agreement for definitions, warranty requirements, and any additional fees.) All
Funding Rollup other card association fees are passed I at cost - NABU, APF, connectivity, &
O Net Fees and Deposits ® Separate Fees and Deposits 0Individual Batches usage.
1wr"CHANGE PLUS
Pass Through Interchange — Includes Dues and Assessments. You will be charged the applicable interchange rate from MasterCard, Visa or Discover, plus a MasterCard
Assessment Fee of 0.13%, a Visa Assessment Fee of 0.14%, or a Discover Assessment Fee of 0.13%, plus any other fees indicated on this Service Fee Schedule. (MC
Assessment Fee when transaction is equal to $1,000 or more will be assessed an additional 0.01 % per transaction.) American Express Assessment Fee of 0.15 %
Passthrough Interchange Costs ® Gross Interchange Q Net Interchange
Discount Fees Credit I Non -PIN Debit
Visa Qualified 0.6
MasterCard Qualified i 0.6
Discover Qualified 0.6 %
Amex Qualified 0.6
Page 3 of 5 CardConnect LLC is a registered ISO of Wells Fargo Bank, N.A., Concord, CA GenCP-WF-2403 MPA_02.01.21
� 9 TTERED
I Discount Fees
Visa Qualified
Visa Mid -Qualified
I Visa Non -Qualified
I
1 Mastercard Qualified
Mastercard Mid -Qualified
Mastercard Non -Qualified
BILL BACK FLAT RATE
Non -Qualified Surcharge Fee (excluding interchange pass -through fees, see Discount Fees Credit / Non -PIN Debit
I Section 18.1) Applies to Non -qualified MC, Visa, Discover, American Express Credit Visa Qualified
and/or Non -PIN Debit Transactions.
Mastercard Qualified %
L
Discount Fees Credit Non -PIN Debit Discover Qualified %
k Visa Qualified % "�
Il Amex Qualified
Mastercard Qualified
Discover Qualified
j Amex Qualified �% J
L _ _ _
F AUTil4RL7ATH)N PIN DEBIT -
Authorization Fees (All Card Types) l $ 0.10 ! Discount Fee
ACH Batch Fee i $0.10 1 Each I Transaction Fee $ _ — !Each
Voice Authorization Fee $ 0.10 ! Each I i
Address Verification Fee (AVS) $ 0� 10 1 Each
Transaction Fees (All Card Types)- $ 0.00 I Each
"Transaction Fees (All Card Types) and Gateway Transaction Fee will be added
together and billed on your merchant statement as'Trans Fee"
EBT
FNS# - - — -- 7Authonzaflon $ / Each
i Transaction Fee $ /Each %
WRIGHT EXPRESS C
IDiscount Fee % Setup Fee $ 0.00 (One Time)
Transaction Fee $ / Each CardPointe Monthly Platform Fee $ 26.50 / Monthly
f+ Chargeback Fee $ / Each Gateway Monthly Fee $ 0.00 / Monthly
I Retrieval Fee $ / Each i Gateway Transaction Fee* ` $0.00 / Each
-
"Gateway Transaction Fee and Transaction Fees (All Card Types) will be added
together and billed on your merchant statement as "Trans Fee".
Credit Non -PIN Debit Debit
Discount Fees
I _ l�J
Discover Qualified
l % J Y-,
Discover Mid -Qualified
Discover Non -Qualified
-A i
Amex Qualified
Amex Mid -Qualified
E-7 _ %
Amex Non -Qualified
Credit Non -PIN Debit
i�
Clover !Tnye $ / Monlhly
TransArmor Token and Encrypt Fee $0.00 f Monthly Clover Go Service Fee, Per MID $0.00 / Monlhly J
Page 4 of 5 CardConnect LLC is a registered ISO of Wells Fargo Bank, N.A., Concord, CA GenCP-WF-2403 MPA_02.01.21
Application Fee $0.00
Minimum Processing Fee s0.00
NEOUSFEES
(One Time) Annual Membership Fee
/ Monthly Regulatory Product Fee
DDA Rejects f $0.00 1 Each
Statement Fee $ 0.00 / Monthly
Chargeback Fee $25.00 1 Each
Retrieval Fee $15.00 / Each
$ 0.00 / Annual
$3.50 /Monthly
PC[ Non -Compliance Fee
$ 29.95
/ Monthly
Wireless Fee
$ 0.00
/ Monthly
Wireless Activation Fee
$ 0.00
(One Time)
PCI Annual Fee
$ 0.00
/ Annual
CONFIRMATION
FEE — - —
The initial term of this Agreement is three years from the date of your approval by our Credit Department (the Initial Tenn). If you terminate this Agreement before the end of the
then current term or otherwise stop processing your transactions with us, you will be charged this Early Termination Fee. After the Initial Term, subject to Part IV, Section A.3,
this Agreement shall automatically extend for an additional period of one year each (each an Extended Term).
Early Termination Fee $ 0.00 T
Client Initials �s
PERSONAL SUARAHTEE
By signing below, signer(s) unconditionally guarantee(s) to the Processor and Its successors and assigns the full and prompt payment when due of all its obligations of every
kind and nature of Merchant arising directly or indirectly out of the Agreement and /or the TeleCheck / TRS Services Agreement or any document or agreement executed and
delivered by Merchant in accordance with the terms of the Agreement. The undersigned further agrees to pay to the Processor all expenses including attorney fees and court
costs) paid or incurred by the Processor in collecting such obligations and in enforcing this Guaranty.
Signature Data
1, At REEMENT APPRf7YAL
I Merchant Acceptance — Each person signing betow agrees to the terms and conditions stated in the front and back of this agreement and certifies that all information prmidLldin the application is true, correct and complete. Client acknowledges and agrees that we, our Affiliates and our third party subcontractors and/or agents may use automtelephone dialing systems to contact Client at the telephone numbers) Client has provided in this Merchant Processing Application and Agreement and/or may leave a
i voice message in the event that Client is unable to be reached, even if the number provided is a cellular or wireless number or if Client has previously registered on a Do Not
Call list or requested not to be contacted by Client for solicitation purposes. Client hereby consents to receiving commercial electronic mail messages from us, our Affiliates and
our third party subcontractors and/or agents from time to time. Each signer authorizes CardConnect LLC and/or the Member Bank or any agent of the Member Bank, to make
whatever inquiries CardConnect LLC and/or the Member Bank deem appropriate to investigate, verify, or research references, statements or data, including personal credit
reports for the purpose of this application. Merchant understands this agreement shall not take effect until Merchant has been approved by CardConnect LLC and/or the
I Member Bank and a merchant number is issued.
You further acknowledge and agree that you will not use your merchant account and/or the Services for illegal transactions, for example, those prohibited by the Unlawful
Internet Gambling Enforcement Act, 31 U.S.C. Section 5361 at seq, as may be amended from time to time, or processing and acceptance of transactions in certain jurisdictions
pursuant to 31 CFR Part 500 et seq. and other laws enforced by the Office of Foreign Assets Control (OFAC).
Client certifies, under penalties of perjury, that the federal taxpayer identification number and corresponding filing name provided herein are correct
i
Signature 7Application Approved By:
J ture r
Date s i5 ao2!
Date
IA:p:plication Approved By: Name
ature
Address
URL
CardConnect LLC
1000 Continental Drive, Suite 300, King of Prussia
PA, 19406
www.cardoonnect.com
Customer Service (Phone) 1-877-828-0720
Page 5 of 6 CardConnect LLC is a registered ISO of Wells Fargo Bank, N.A., Concord, CA GenCP-WF-2403—MPA-02.01.21
CONFIFtMATION PAGE
PROCESSOR Name: CardConnect, LLC
INFORMATION: Address: 1000 Continental Drive, Suite 300, King on Prussia, PA 19046
URL: www.cardconnect.com
Customer Service M 1-877-828-0720
Please read the Program Guide in its entirety. It describes the terms under which we will provide merchant processing Services to you.
From time to time you may have questions regarding the contents of your Agreement with Bank andlor Processor or the contents of your
Agreement with TeleCheck. The following information summarizes portions of your Agreement in order to assist you in answering some of
the questions we are most commonly asked.
1. Your Discount Rates are assessed on transactions that qualify for
certain reduced interchange rates imposed by MasterCard, Visa,
Discover and PayPal. Any transactions that fail to qualify for these
reduced rates will be charged an additional fee (see Section 25 of the
Program Guide).
2. We may debit your bank account (also referred to as your
Settlement Account) from time to time for amounts owed to us under the
Agreement.
3. There are many reasons why a Chargeback may occur. When
they occur we will debit your settlement funds or Settlement Account.
For a more detailed discussion regarding Chargebacks see Section 14 of
the Your Payments Acceptance Guide or see the applicable provisions
of the TeleCheck Solutions Agreement.
4. If you dispute any charge or funding, you must notify us within 60
days of the date of the statement where the charge or funding appears
for Card Processing or within 30 days of the date of a TeleCheck
transaction.
S. The Agreement limits our liability to you. For a detailed
description of the limitation of liability see Section 27, 37.3, and 39.10
of the Card General Terms; or Section 17 of the TeleCheck Solutions
Agreement.
6. We have assumed certain risks by agreeing to provide you with Card
processing or check services. Accordingly, we may take certain actions to
mitigate our risk, including termination of the Agreement, and/or hold
monies otherwise payable to you (see Card Processing General Terms in
Section 30, Term; Events of Default and Section 31, Reserve Account;
Security Interest), (see TeleCheck Solutions Agreement in Section 7), under
certain circumstances.
7. By executing this Agreement with us you are authorizing us and our
Affiliates to obtain financial and credit information regarding your business
and the signers and guarantors of the Agreement until all your obligations to
us and our Affiliates are satisfied.
8. The Agreement contains a provision that in the event you terminate the
Agreement prior to the expiration of your initial five (5) year term, you will
be responsible for the payment of an early termination fee as set forth in Part
1V, A.3 under "Additional Fee Information" and Section 16.2 of the
TeleCheck Solutions Agreement.
9. If you lease equipment from Processor, it is important that you review
Section 1 in Third Party Agreements. Bank is not a party to this Agreement.
THIS IS A NON -CANCELABLE LEASE FOR THE FULL TERM
INDICATED.
10. Card Organization Disclosure
Visa and MasterCard Member Bank Information: Wells Fargo Bank, N.A.
The Banks mailing address is P.O. Box 6079, Concord, CA 94524, and its phone number is 1-844-284-6843.
Important Member Bank Responsibilities:
Important Merchant Responsibilities:
a) The Bank is the only entity approved to extend acceptance of Visa
a) Ensure compliance with Cardholder data security and storage
and MasterCard products directly to a merchant.
requirements.
b) The Bank must be a principal (signer) to the Agreement.
b) Maintain fraud and Chargebacks below Card Organization thresholds.
c) The Bank is responsible for educating merchants on pertinent Visa
c) Review and understand the terms of the Merchant Agreement.
and MasterCard rules with which merchants must comply; but
d) Comply with Card Organization Rules and applicable law and regulations.
this information may be provided to you by Processor,
e) Retain a signed copy of this Disclosure Page.
d) The Bank is responsible for and must provide settlement funds to
f) You may download "Visa Regulations" from Visa's website at:
the merchant.
https://usa.visa.com/supl2orL m=rchant.html.
e) The Bank is responsible for all funds held in reserve that are
g) You may download "MasterCard Regulations" from MasterCard's website at:
derived from settlement.
httul/www.mastercard.corn/us/merchant/support/ruies.htmi.
i) The Bank is the ultimate authority should a merchant have any
h) You may download "American Express Merchant Operating Guide" from
problems with Visa or MasterCard products (however, Processor
American Express' website at: www.americanexpress.com/merchantopguide.
also will assist you with any such problems).
Print Client's Business Legal Name: City of Pasco
By its signature below, Client acknowledges that it has received the Merchant Processing Application, Program Terms and Conditions
[versionCardCoN2104J consisting of 50 pages [including this Confirmation Page and the applicable Third Party Agreement(s)], Interchange
Qualification Matrix, American Express Program Pricing, and Interchange Schedule.
Client further acknowledges reading and agreeing to all terms in the Program Terms and Conditions. Upon receipt of a signed facsimile or
original of this Confirmation Page by us, Client's Application will be processed.
NO ALTERATIONS OR STRIKE -OUTS TO THE PROGRAM TERMS AND CONDITIONS WILL BE ACCEPTED.
Client's Business Principal:
Signature (Please sign below):
X _
Cka, s� C,a�
Please Print Name of Slghgr
CardCoN2104
f fin5 15 w2I
Title Date