BANK CARD MERCHANT AGREEMENT
AND APPLICATION
MERCHANT INFORMATION
Federal Tax ID Number of Locations
Legal Name DBA Name (if applicable)
Type of Legal Entity Merchant Category Code
Physical Address Mailing Address
City Mailing City
State Zip Mailing State Zip
Website URL Merchant Descriptor/DBA
Time Zone *Will appear on Customer’s Statement next to charge amount* Cut Time Merchant Descriptor
Entity Established Customer Service Phone
Product Description Customer Service Email
Business Contact Information Invoice & Chargeback Contact Information Name Name
E-mail address E-mail address
Phone Phone
ADDITIONAL INFORMATION
Projected Volumes Estimate Projected Volumes Estimate
Chargeback Percentage Visa/MC/Discover Monthly Volume
Return/Refund Percentage AMEX Monthly Volume
Card Present Percentage Average Ticket Amount
Card Not Present Percentage High Ticket Amount
Have you had more than 25 chargebacks in the past 12 months? Yes No Has this entity, or any of its predecessors or affiliates, even been fined by Visa, MasterCard, Discover or American Express? Yes No If yes, please select: Visa MasterCard Discover American Express Warranty or Return Policy offered? Yes No
Is your business seasonal?
If yes, please select: Q1 Q2 Q3 Q4
Peak and/or payment deadline(s): 1: 2:
Yes No
Phone
E-mail address
Name
Phone
E-mail address
Name
Federal Tax ID
Physical Address Mailing Address
High Ticket Amount
Average Ticket Amount
AMEX Monthly Volume
Visa/MC/Discover Monthly Volume
Merchant Descriptor
Entity Established
Website URL
State Zip
City
Mailing State Zip
Mailing City
Legal Name DBA Name (if applicable)
EXHIBIT 2
CONFIGURATION SETTINGS
Accepted Payment Types FIS Channel Type Gateway Information & Settings American Express PayDirect Web Address Verification System (AVS) Discover PayDirect Virtual Terminal Card Verification Value (CVV) M sterCard IVR Partner Certified (if applicable) Yes No Visa Mail / Telephone Order Partner Name (if applicable) PIN Debit (card present only) API 4.X Duplicate Payment Protection PIN-less Debit (eCom, Web only) API 5.0 (WCF)
E-Check/ACH API 6.0 (REST) Duplicate Time Period:
Method of Payment Pricing Model Description
Credit Card
eCheck/ACH
Pricing for these options will be as agreed in the respective service agreement between Merchant and the authorized FIS affiliated partner Settlement Information
Routing Number Account Number
NOTE: The above account must accept incoming debits from FIS’s Company ID 1621868563 to recover ACH Returns and Chargebacks Separate Batch for ACH Returns Yes No
If yes, FIS will initiate a separate batch that contains only returns instead of ‘netting’ returns out of each nightly batch Billing Routing Billing Account Number
NOTE: The above account must accept incoming debits from FIS’s Company ID 9803595965 to facilitate monthly invoicing via direct debit.
Notes & Instructions
Routing Number Account Number
GENERAL TERMS AND CONDITIONS
This “Bank Card Merchant Agreement and Application” (herein collectively “Agreement”) consists of the following component parts all of which are incorporated by reference herein and constitute the entire agreement between the parties and supersede all prior agreements or representations between the parties whether written or oral with respect to the subject matter herein: (1) the Bank Card Merchant Agreement/Application, (2) the Bank Card Merchant Agreement, (3) Merchant Price Schedule and (4) any and all other applicable addenda, schedules, exhibits, attachments, or amendments thereto. Unless otherwise explicitly stated, all capitalized terms that are used but not defined in this paragraph have the meanings specified in the Agreement. Each person signing immediately below this paragraph (each, as “Signer”) certifies that (i) he or she is an officer, owner, principal, or other authorized representative of the Merchant identified on page 1 of the Agreement (the “Merchant”), AND (ii) all of the information contained herein is true, accurate, and complete, AND (iii) he or she has been provided a full and complete copy of this Agreement, AND (iv) that he or she has read, understands, and accepts all of the terms and conditions contained in this paragraph and elsewhere within the Bank Card Merchant Agreement/Application.
No modification, alterations, or manual changes (including lining out fees, unless otherwise pre-approved and/or pre-designated by Processor) made by Merchant to the Agreement shall have any force or effect unless and until such modifications or alterations are expressly consented to in writing by Processor. This Agreement may be executed in counterparts and a scanned, facsimile, or duplicate copy of this Agreement executed by the parties shall be treated as and/or constitute an original. Each undersigned below warrants and represents that he or she is a duly authorized representative of the legal entity on behalf of which he or she is executing this Agreement. By signing below, Signer(s), on behalf of the Merchant, (i) agrees to be bound by all of the provisions of the Agreement, including without limitation, the choice of law, jurisdiction, and venue provisions contained in the Terms and Conditions, and (ii) acknowledges Merchant is aware of and must comply with the Rules Summary, Operating Regulations and Merchant Operating Requirements.
Signer(s) further individually authorizes Processor or its representative to (i) investigate Merchant by utilizing a third-party credit reporting agency; (ii) share information provided in the Bank Card Merchant Agreement Application with third parties for fraud and risk purposes; and (iii) conduct an initial and ongoing comprehensive credit inquiry and/or investigation. In the event Merchant is not approved by Processor for the provision of services under the Agreement, Signers), on Merchant’s behalf, authorizes Processor to share all information provided herein with Processor’s strategic partner for the possible provision of substantially similar services.
Signer(s), on behalf of the Merchant, irrevocably authorizes Processor to initiate Automated Clearing House (“ACH”) debit and/or credit entries from and to the Designated Accounts for all fees, costs, and amounts due to Processor or payable to Merchant pursuant to this Agreement and ACH rules and regulations. In the event that a credit or debit entry is erroneously initiated, Signer(s), on behalf of the Merchant, authorizes Processor immediately to correct such error. This ACH Authorization shall remain in full force and effect until Processor has collected payment on all fees, costs, and amounts due or which may become due pursuant to this Agreement. The Designated Account(s) may not be changed or altered without thirty (30) days prior written notification to Processor and the execution of any forms or instruments deemed reasonably necessary by Processor.
BANK CARD MERCHANT AGREEMENT
Merchant acknowledges receipt of the Bank Card Merchant Agreement, located at http://info.worldpay.com/multipay, the application thereto, the Price Schedule, and any and all other applicable amendments, schedules, exhibits, and attachments, including without limitation, the documents listed below. Merchant has read, understands and agrees to be bound by the Agreement, as may be amended from time to time in accordance therewith. If Member Bank and/or Processor agree to provide services to Merchant, submission of any transactions or items to Member Bank, Processor, or its third party providers constitutes consent to the Agreement Terms And Conditions and the terms and conditions related to any other service Merchant has elected to receive. Merchant can request a copy of the Agreement at any time by contacting a Processor Customer Service Representative at (866) 453-7047 or Relationship Manager.
Addendum A – General Services Addendum
Transaction Risk Fee Schedules
Network Interchange Schedules (as applicable)
Rules Summary
Privacy Notice
VISA DISCLOSURES
VISA MEMBER BANK INFORMATION: Citizens Bank, N.A., 1 Citizens Plaza, Providence, Rhode Island, 02903 (877) 550-5933 IMPORTANT MEMBER BANK RESPONSIBILITIES:
(1) A Visa Member is the only entity approved to extend acceptance of Visa products directly to a Merchant. (2) A Visa Member must be a principal (signer) to the Merchant Agreement. (3) The Visa Member is responsible for educating Merchants on pertinent Visa Operating Regulations with which Merchants must comply. (4) The Visa Member is responsible for and must provide settlement funds to the Merchant. (5) The Visa Member is responsible for all funds held in reserve that are derived from settlement.
IMPORTANT MERCHANT RESPONSIBILITIES:
(1) Ensure compliance with cardholder data security and storage requirements. (2) Maintain fraud and chargeback below thresholds.
(3) Review and understand the terms of the Merchant Agreement. (4) Comply with Operating Regulations.
The responsibilities listed above do not supersede the terms of the Merchant Agreement and are provided to ensure the Merchant understands some important obligations of each party and that the Visa Member (Acquirer) is the ultimate authority should the Merchant have any problems.
The parties agree electronic signatures will have the same legal effect as an original (i.e. ink) signature and that an electronic, scanned, facsimile, or duplicate copy of such signatures may be used as evidence of execution. A scanned, facsimile, or duplicate copy of this Disclosures page executed by the Merchant shall also be treated as and/or constitute an original.
Merchant Signature Date
Printed Name Title
MEMBER BANK: CITIZENS BANK, N.A., ONE CITIZENS PLAZA, PROVIDENCE, RHODE ISLAND 02903 FISPDE-RS-8.2021 Title
Date
Printed Name
Merchant Signature
APPROVED
________________________ Alexander Trinidad
Executive Director of Finance and Management Services Agency
CITY OF SANTA ANA ATTEST
________________________ _______________________ Alvaro Nuñez Jennifer L. Hall City Manager City Clerk
APPROVED AS TO FORM WORLDPAY, LLC dba FIS. ________________________ ________________________ Jonathan Martinez
Assistant City Attorney