SPEEDPAY MASTER SERVICES AGREEMENT CONVENIENCE FEE
~~
~
~.
SPEEDPA Y MASTER SERVICES AGREEMENT
CONVENIENCE FEE
This Agreement is between Speedpay, Inc. ("SPI"), 199 Water Street, New York, New York 10038 and Client.
1. Le al Name of Client:
Cit of Clearwater, Florida
James K. Geary
2. Street Address:
C' :
Clearwater
Tele hone: 727-562-4556
Person si nin contractfTitle:
William B. Horne, III Cit
Contact TItle:
Director of Customer Service & Marketing
Floor/Suite:
Customer Service
State:
Zi Code:
FL
33756
Fax: 727-562-4577
By signing this Agreement, Client certifies that the information herein is complete and accurate, and agrees to the Terms and Conditions attached hereto.
This Agreement is not binding on SPI until signed by SPI ("Effective Date") and the service application set forth in Schedule B is approved by SPI.
CITY OF CLEARWATER, FLORIDA
---'-.-".
Camilo A. Soto
Assistant City Attorney
SPEEDPAY, INC.
(
BY:
NAME:
~~ ~lfO
(print name) 0
SJ\
/ oj,/o 1
TITLE:
DATE:
~/
By:
/).~i>.~-:IJ: ".~,,~,.
t/~mB.Horne, II _--". _
City Manager - .~ ___._~.-
.,.....
':"' .~.. 'w....
Attest:
..~..--
-
~...~
-:;~.. ,~..-
./ ' - ,; :
...- ........... ~
.~ -"
City of Clearwater CF 9.26.07
SPEEDPA Y MASTER SERVICES AGREEMENT TERMS AND CONDITIONS
CONVENIENCE FEE
1. Service. SPI will provide the Westem Union Speedpay payment service to
Client (the "Service") as described in Schedule A. The parties shall
perform and comply with their respective responsibilities set forth in
Schedule A.
2. Online Bankin!!. In addition to the Service described in Schedule A, SPI,
in coordination with its affiliates, will provide the online banking payment
service ("Online Banking Pavrnents") to Client to enable the delivery of
biII payments from or through online banking portals. Customer Payments
that are initiated through Online Banking Payments will be integrated into
your existing Service and processed, delivered, and settled by SPI in a
manner operationally consistent with the terms of Schedule A. SPI
will not charge Client or Client's customers ("Customers") a fee for
payments processed through the Online Banking Payments service.
Online Banking Payments may result in a charge to the Customer from
the Customer's bank.
3. Intellectual Pronertv. Each party is granted the nonexclusive right to use
the other party's intellectual property for the limited purpose of
advertising and promoting the services, subject in each case to the prior
written approval of the party whose intellectual property is being used.
Each party agrees that use of the other party's intellectual property shall
not confer any proprietary right thereto in any manner, and each party
agrees to cease all use of the other party's intellectual property
immediately upon termination of this Agreement.
4. Payments and Billin!!s. For the Service, SPI will charge Customers a fee
("Convenience Fee") as set forth in Schedule A. SPI reserves the right to
increase such fees upon thirty (30) days prior written notice at any time.
5. Disclaimer. SPI MAKES NO WARRANTY, EXPRESS OR IMPLIED,
WITH RESPECT TO THE SERVICE, WHETHER OF
MERCHANTABILITY, OR OF FITNESS FOR ANY PARTICULAR
PURPOSE, OR OF ANY OTHER TYPE OR KIND WHATSOEVER.
6. Indemnification.
A. Client agrees to indenmify SPI and its agents, employees, officers,
directors, affiliates, subsidiaries, successors and assigns and hold
them harmless from and against all third party claims except those
resulting solely from SPl's breach of this Agreement.
8. SPI agrees to indenmify and hold harmless Client and its agents,
employees, officers, directors, affiliates, subsidiaries, successors and
assigns from and against all third party claims resulting solely from
SPl's breach of this Agreement.
7. Comnliance with Laws. Client shall comply (and shall cause its
employees, agents, and subcontractors to comply) with all laws, orders,
rules and regulations applicable to Client's business and the payments to
be made by Client's customers as contemplated hereby, including but not
limited to: (a) the Fair Debt Collection Practices Act and any applicable
debt collection regulations or statutes set forth under state or local law, (b)
the Electronic Fund Transfer Act and its implementing rules and
regulations of the Federal Reserve Board and Regulation E, and (c)
privacy laws, orders, rules and regulations. Client shall also comply (and
shall cause its employees, agents, and subcontractors to comply) with the
rules and regulations established by NACHA, any card association and
any Network Rules, including those with respect to the use of On-line
PIN-less Debit. Provided Client shall comply with the foregoing, SPI
represents that its Services shall comply with all laws, orders rules and
regulations applicable to SPl's payment processing business. Client
represents and warrants that all information disclosed to SPI in connection
with this Agreement for Services, is true, accurate and complete. This
representation and warranty shall be deemed an ongoing representation
and warranty from Client.
8. Limitation of Liability. Under no circumstances will SPI and its affiliates
or any of its directors, officers, employees, agents or subcontractors be
liable under any theory of tort, contract, strict liability or other legal or
equitable theory for lost profits, indirect, incidental, special, consequential,
exemplary, incidental, or punitive damages, each of which is hereby
excluded by agreement of the parties regardless of whether such damages
were foreseeable or whether SPI or any entity has been advised of the
possibility of such damages. Notwithstanding anything in this Agreement
to the contrary, SPl's cumulative liability, including for claims, expenses,
damages or indenmity obligations arising out of this Agreement, shall not
exceed (a) except as provided in clause (b) below, the lesser of the
Client's direct actual damages or the most recent six (6) months' fees
received by SPI, or (b) in the case of a claim involving a customer of
Client, a refund of the service fee paid in connection with the affected
transaction. Client's maximum liability hereunder shall be subject to the
limitations set forth in Section 768.28 Florida Statutes.
9. Confidential Information. Each party agrees to treat as confidential all
information received from the other party regarding the Service. Neither
party shall disclose such information except to perform its obligations
under this Agreement or as required by law, and in the event such
disclosure is required by law, the disclosing party shall give the other
party prior notice of such disclosure except that a party need not provide
such notice where such party is prohibited by applicable law from
providing such notice.
10. Term and Termination. The term of this Agreement shall be for a period
of two years from the Effective Date and continuing until terminated as
hereinafter provided. Either party may terminate this Agreement (i) for
material breach if such breach is not cured upon thirty (30) days notice, or
(ii) for convenience upon ninety (90) days notice. Notwithstanding any
other provision of this Agreement to the contrary SPI may immediately
terminate this Agreement in the event that SPI determines, in its sole
discretion, that compliance with this Agreement would cause SPI or any
of its affiliates to violate or potentially violate any local, state or federal
law or regulation or any court order, or any compliance policy of SPI or
any of its affiliates. SPI may also terminate or suspend this agreement or
the Service without notice to Client if SPI determines that any information
provided by Client is false or misleading or that Client has breached or
defaulted under any term of this agreement.
11. Force Maieure. Neither party will be liable for any failure or delay in its
performance under this Agreement due to any cause beyond its reasonable
control, including but not limited to, acts of war or terrorism, acts of God,
acts of govemment, earthquakes, floods, embargoes, fires, natural
disasters, accidents, riots, sabotage, strikes, labor disputes or labor
shortages, shortages of materials or supplies, failures of transportation,
communication or digital transmission, Intemet failures or delays and
third party mechanical or other equipment breakdowns.
12. Goyernin!! Law. This Agreement shall be governed by and construed in
accordance with the laws of the State of Florida, without regard to the
conflicts oflaws principles thereof.
13. Notices. All notices required to be given under this Agreement shall be in
writing and shall be deemed given if sent and delivered by facsimile and
confirmed by ovemight courier addressed to the President of each party
and SPl's General Counselor to such other address or addresses as either
party may from time to time designate to the other by notice pursuant to this
Section. Notice sent to SPl's General Counsel should be sent to: General
Counsel, Speedpay, Inc., 12500 E. Belford Ave., Englewood, CO 80112 Fax:
720-332-{)515.
14. Assi!!nment. Client may not assign or otherwise transfer its rights and
obligations pursuant to this Agreement without SPl's prior written
consent.
15. Other. This is the entire Agreement between the parties, including any
attached addenda and the Service Application, with respect to its subject
matter, and any previous or contemporaneous understanding is merged
herein. Captions are included for convenience only and have no
substantive significance.
16. Survival. The provisions of Sections 2, 3, 4, 5, 7, 8, 11 and 15 of this
Agreement shall survive termination or expiration of this Agreement
City of Clearwater CF 9.26.07
....
Schedule A
CONVENIENCE FEE SERVICE
I. Service Descrintion. SPI will host the Service on its server (the "Sneednav Hosted Service").
A. Payment Accentance: Client may receive customer payments ("Customer Pavments") in U.S. funds (no foreign exchange provided) via the Service through:
181 Customers' credit/debit cards ("Sneedpav Credit Card Pavment"). Credit cards accepted are Visa and MasterCard.
181 Debits to Customers' bank accounts through transfers using Customer's on-line debit cards without personal identification number entry or verification
("On-line PIN-less Debit"). The parties acknowledge that the use and availability of On-line PIN-less Debit is subject to the rules and regulations of
applicable debit card networks (as in effect from time to time, the "Network Rules"), including, but not limited to, daily transaction limits.
181 Debits to Customers' bank accounts through an automated clearing house ("ACH") electronic transfer (a "Sneedoav ACH"). SPI will create and submit
file to the Originating Depository Financial Institution ("ODFI") for processing, prepare and send confirmation letters (where applicable) and will be
responsible for ODFI fees
B. Payment Entry: Client may receive Customer Payments for processing into a U.S. account using the Service through:
181 an Internet-based system operated by SPI and accessed directly by Customers via a website hosted and operated by SPI (the "SDeedDav Website"). The
Speedpay Website pages relating to Client shall be developed and displayed in accordance with the mutual agreement of the parties.
181 an Internet-based systern operated by SPI and accessed by Client employees on behalf of Customers via a secure website (the "SpeedDav Extranet
Service") for the purpose of inputting Customer Payment information when such Customer requests that a Customer Payment be made.
181 an interactive voice response ("IVR") system operated by SPI and accessible by Customers (the "SDeedDav IVR Service").
2. SPI ResDonsibilities.
A. Resources. SPI will provide, as applicable, the materials and services ("Resources") necessary to process Customer Payments through the Service, except for the
minimum requirements set forth in paragraph 3A of this Schedule which are Client's responsibility. SPI shall use commercially reasonable efforts to ensure that
the Resources will accurately and correctly perform the functions required to make Customer Payments using the Service.
B. IVR. For the Speedpay IVR Service, SPI will (i) make available a toll free (800 or similar) telephone number to access the Speedpay IVR Service, (ii) provide
IVR equipment and software, as necessary to allow Customers to input their account number, payment amount and credit card or checking account information
through the Speedpay IVR Service; and (iii) maintain the IVR unit.
C. Transit numbers. SPI shall maintain an updated national database of all ABAffransit numbers for banks and bank verification throughout the country as
necessary to provide the Service.
D. Card Association Charges. SPI shall submit all Speedpay Credit Card Payments and On-line PIN-less Debit to third party credit card networks and debit card
networks. SPI shall be responsible for paying all merchant processing costs and fees associated with Speedpay Credit Card Payments and On-line PIN-less
Debit payments.
E. Downtime. SPI reserves the period from 12:01 AM through 6:01 AM EST on Sundays for maintenance, repairs, inspections, modifications and improvements to
the Service, during which period the Service may not be available. Downtime is subject to change.
3. Client Responsibilities.
A. Hardware and Software Reauirements. Client's browser must be Internet Explorer 5.5, Service Pack 2 and above OR Netscape 4.7.2 or above. Microsoft VM
(Virtual Machine) for Java must be installed if using Internet Explorer (VM usually downloads automatically when IE is downloaded). SPI will not be
responsible if Client's systems do not meet these requirements.
B. System AccesslPosting Charges. All charges with respect to accessing or posting to Client's servicing system are Client's sole responsibility. Client is also
responsible for all credits, retums, disputes and the accuracy and authenticity of all data provided to SPI.
C. FraudulentlUnauthorized Transactions/Errors. Client shall not accept, deposit, enter into its computer terminal or database a Customer Payment that has not
been properly authorized by the Customer concerned, and shall be responsible for all losses and liabilities incurred by SPI or any Customer or other third party
that arise out of unauthorized or fraudulent Customer Payments. Client is responsible for errors made by Customers in entering credit card and/or bank account
numbers and other Customer Payment information and any resulting unauthorized debits or credits to Customer or other third party accounts.
D. Customer RelationshiD; Credits. Client is responsible for all relationships with all Customers, including without limitation, delivery of all communications and
disclosures to Customers, unless specifically provided by SPI as indicated herein. Client shall respond to and resolve Customer inquiries and complaints. Client
shall maintain complete and accurate records of inquires and complaints from Customers arising out of the Service, including the lnanner of disposition or
resolution thereof, and shall promptly notifY SPI in writing of such complaints and provide SPI with any information reasonably requested by SPI related to the
disposition or resolution of such complaints.
E. Password Protection. SPI may provide Client user name(s) and/or password(s) in order for Client's employees to access and use the Speedpay Extranet Service.
Client is solely responsible for maintaining the confidentiality of all such user names and passwords, and is fully responsible for all activities that occur under
Client's user names and passwords. Client may not disclose such user name(s) or passwords to any third party. Client agrees to immediately notify SPI of any
unauthorized use of Client's user names or passwords or any other breach of security. SPI is not responsible for any loss to Client that arises from such use or
action or from Client's failure to comply with these provisions.
F. Authorizations. Client is responsible for obtaining all required authorizations in form and manner from Customer, including the authorization for the
Convenience Fee payment made directly to SPI. Should Client obtain recurring authorizations from Customers, Client shall be responsible for complying with
Regulation E and at a minimum Client will: (I) obtain preauthorized electronic fund transfers from a consumer's account authorized only by a writing signed or
similarly authenticated by the Customer; (2) provide a copy of the authorization to the Customer; (3) provide information to Customer about their right to stop
payment by notifying Client orally or in writing at least three business days before the scheduled date of the transfer; (4)provide information to Customer about
their right to revoke their authorization; (5) provide Customer with written notice, unless waived by Customer, of the amount and date of a transfer amount that
will fall outside the range or differ by more than an agreed-upon amount at least ten (10) days before each scheduled date of transfer; (6) obtain authorization for
transfers varying in amount by giving the Customer the option of receiving notice only when a transfer falls outside a specified range of amounts or only when a
transfer differs from the most recent transfer by more than an agreed-upon amount.
G. Miscellaneous. Client represents and warrants that all sums owed by Customers must be bona fide, just and lawfully due and owing. Client has all necessary
licenses and authorities to conduct its business and lawfully collect the sums from the Customers.
4. A. Merchant Processor & ODFI Election. For Speedpay Credit Card Payments, the parties agree that the Client will use its own merchant processor. For
ACH and On-line PIN-less Debit payments, SPI will use its own relationships with the ODFI or debit processing networks to debit Customer's accounts for On-line PIN-
less Debit payments or ACH payments. ACH and On-line PIN-less Debit payment funds will be held temporarily in SPI, and where applicable (as determined from time
to time by SPI in its sole discretion) Western Union Financial Services, Inc. accounts, and then swept into the Client's designated bank account.
B. Process. SPI shall provide to Client a posting file and a separate reversal file each business day for all payments entered and scheduled for processing since
the last processing cycle (usually the same time the prior business day).
City of Clearwater CF 9.26.07
'f
.<
1. The "Posting File" contains information on that processing day's principal payment amounts and typically includes: (i) information on the Customer
receiving credit for the payment, (ii) the credit account number (the Client's account number); (iii) payment amount; (iv) effective date, and (v) any
additional information required to post the payment to the Client's accounts receivable system.
2. The "Reversal File" contains information on that day's principal payment amounts that have been returned for any reason, including NSF (insufficient
funds), charge back, account closed, etc, and includes information on the Customer who originally received credit for the payment, including: (i) the credit
account number (Client's account number); (ii) amount; (iii) effective date, and (iv) any additional information required to reverse the payment from the
Client's accounts receivable system.
The transactions in both of these files can either be:
o Segregated into multiple files based on "Payment Type" (Credit Card, ACH, Debit Cards); or
o Annotated to indicate the type of payment.
SPI will submit payments included in the Posting File to the merchant, or credit/debit processing network (as applicable) to request the debit of the Customer's
account in the amount of the principal amount plus any applicable Convenience Fee. The total dollar value of these charges/debits is referred to as the "Payment Total"
for the particular transaction type (i.e., payment total for credit cards). The "Payment Total" amount less the aggregate dollar amount of any Convenience Fees will be
the "Client Total'~
C. Settlement to Client.
1. ACH and On-line PIN-less Debit: SPI shall credit the "Client Total" using an ACH credit to the account designated by the Client for ACH and On-line PIN-less
Debit payments. This amount will equal the sum of the principal payment amounts included in the Posting file for the same processing day minus all chargeback/return
items identified since the last processing cycle.
2. Soeedoav Credit Card Pavrnents. The Client Total will settle directly to Client's designated account from the merchant processor minus all chargeback/return
items identified since the last processing cycle and the Convenience Fees for Speedpay Credit Card payments will settle to an account designated by SP\.
5. Customer Pavments and Fees. In consideration of the Service, SPI will charge Customers a Convenience Fee for use of the Service, which fee will be determined
by SPI in its sole discretion and collected from the Customer. Customer will be advised of this fee and the specific dollar amount and be given the option of accepting or
rejecting the Convenience Fee and the attendant Service. The initial Convenience Fee will be $3.95. No fee will be assessed to the Client for this Service unless Client opts
to waive the Convenience Fee paid by the Customer to SPI. In such case, Client shall pay SPI directly for the Convenience Fee. SPI shall determine the number of
Customer Payments that have been waived by Client during each calendar month and shall bill Client based upon the total waived Customer Payments multiplied by the
Convenience Fee. Client will pay SPI within thirty (30) days of invoice receipt.
City of Clearwater CF 9.26.07
;5624577
~OOI
# 2/ 3
_~~j02/07 TUE 14:25 FAX 314 241 6618
, 10- 2-07; 3:51PM,Customer Service
PBX
Schedule B
SERVICE APPUCATION
Legal Name of BusIness
Webslte Address
Prlndpal Business
SIreet Add~__.
Mailing Address
Telephone
city of Clearwater DBA or Trade Name
www.myclearwater.com Tax identification No. I j
~~~~ MyrUeAvenue _.~~.~.. aom.- "t --- ~ jr~p I 33765 - ...-
P.O. ~~~748 ______...._______ CIty _~earwa~_______ _~ _..~~.:. Zip 133758-47~___.1
727-562-4556 Fax 127-682-4577 ;:~ _Liim,ge&ry@mYClearwater.com I
'M--lclpaI-"Gov. -ent---'-'--- "COntact NsnHi and Ti1Ie'of .18m. K. G88iy. DinlclDr orciii'tOmer'.' ---,
un mm Buslness Contact ServIce I
[JlndMdual 0 Partl'ler$hlp In Ihe state of limited UablUty ComI*1Y In Corporation In the stite of !
PlOprlelDrshi the state of J
Annual Transactton VoIlmle I
(EstImated) . I
Type of Business
Trade References
Name of TraCie Referenc:e
Telephone NlI1lber of Trade Reference
I
-.,
I
------l
i
i
1.
2..
3.
Yes-ettach copy of gaming
J.. '~''''''1F _ll:r,Trj;\1 \;"Ti111 ,It"; , ~~"'j ~ " \' "1"'~-'9::11^tr"""T-...-n J.;.I"t~ r"" II' 1,1..) '{'I"^';"" 'j 1-/ " -~ r ,-... . II' I~ .--,- - - ~- r' III ,1-Wl~I'H'f' ~1-T'1 \I -Il'll~CI lr!j.i.'~I"'~lf: 111~'--;~I":O;~~ E!9a:;':'"-;f
~~~11kll'1~}[!i11i~~~I~)1. -\~~~\~, ..' 11. !;!!..'I"I ~J(rrl!t'.~'J:14'~1111"\1 I'l'. ,1~,I:llc.::l-= ~ I). " "-~)-"I':' .',~.'. "s. :~ '\ 'l~"\'IJJI~ I' ;>~:'..Jllf.~IL,(' )1-', ~l,,:!l~".fJh lll,~
'~T~.. rr. '!rr.;r:f~ri";~:r jil' I, ~ Yll'~l~ )~44f8lt~lll.Il!~ H .fJ~Jio!m 1Jl1;e-~{I\,r~rili\L'1 "'"";:1,1 ,1 J}r~'~ \Jl~, .. - ~""-, ~- -~ . ~f) .;TI~-"2'fr'7'n:i t~:-, ~ i - ~a't(lif"'~l' f~J ,; .t 't ~ Iftllt111 ~:;?t~~ll;~l.l" t~"!\~~ll':1 L~) q]
\~.~~ ~~~~ i tri~h r~~ ~ill"':~J l:~.~~',~~~.\:t'.~~~i ~;;::,.:tt.~-ltp~,t,(ll~idl~~li.J ~j ~. I r~' ~\, ,) ~, ~_ j ... !: -' - .. :- '~r 1/ J' ;.r' ~,l~ '__IJr J;-. = F'" t ~.:'1-.~ "\:~i:v~ ~~.? ",- t ~l~~lniJ~}-2li~;i>;~Jl]~~~;d~~~t-l:;t/~l.' ~tl'~I%1
l'1.,r;,_,\,,~E"I"'tl 1'\;<,:' I ';'\t"t'I41~~f,)-,~P"~I.l-;r,h~'; l~..[, ..' , "'~t 111""J1"F-.......~II',...ll! I~ ('''''I{,~I.r..l,;!~'nkj'',..,1;~,i\-;901'~,1,...l~
f.< '~'II ' >f.;<_----... ~.' \ b' ~') ..~\ 'U I .h..~. I .., r, "- ) ~ . L. t~ rr:;',_L_t."tt
',Q'cl-tm:" "e.c, -..' 1""-","'2.'" iti, '-'11' '1'" ",cll-1"'''j' . - " ."" '11-'" ""-" -,". '. b',- - ,-,. . "~,,;"R 11'-B"'-:UW'U"\' ~']e"'-[I
;'llt~".I'lttP~'j~,.f;r(--;--;.' , '~(,11!~~i' "I :"I'I~ ~~ ;'1[l;L>1~. '!'r:,' .~..'~ . = t _ ~ <.._I,'t',l1~;!'i.I:"",~!~~~~"t""' .~h!v.r'~'_t~:J-_I::,1/41::';Tld--='-lj2l\ '":.:i itf ~t"~} 1~ ;i-I
~~'"~"~"lli~.M"'~" I" - ..~ ,-""""illClr.'j..,jmI1'r)",'"1. r'I'..!:'-- -"', _iLo.' ,I., - " '~':"~"'::I ' ';-'~"~~I~'I' .,. - l'dl"fiJ;;~;'I~,j ,TI~! 'I "'7f.!?
,,\hr""'=-j""j'\-<--"~ Ml---.. 1;.f""'11i 'll':::;:llj~jl~:I-~ ,-j,.I; . _ I' ..J'", '11--< t,_ L; !;.l ~(T' 1 ..."c ;r"'II,lj,i1'i11Il;,\:Q.I'i(jlll tn~,
~h-.l.~''''['''~ll:r ~;-;;-~ " ..~~ l~-'-'[jr Il[j'~1),' ~ ~t..:-~... ..1--h -"/1_ ~Il -.!..1'l:I!'j;'-IJ.. 1:;I*"'~I"-:i\~t ,II,' ':/:d~~'1f.~~I"J.I'111~r11It'qSIJl_;'Lili~-;i
~~~~t:2~~-.:~~:-~{ ~lt:~: ~~.-'~~ ~~'I 'jlt~~~~~~: ; _~_~~ . ~ ~~l, ' ; '"-~ _ ~ - ;-,' I ~,~~ ~~~' \ \~' t M >'ir:.~i~~~ j' ,~-~=~- :.~ l~.~~..t:;"~:l ~~ ~;;! ~~. ~ 1~~: ~ ~i\~:~'f ~~~T i~~ ;:~~~~, l~~(:~t;~~i~ ~s:jf
AU sIIltcmcnls conlllincd in this appllcation aDd other documcula1fon 8lIbmiltId In suppon of d1is appHcaticJD are true and COI1'eOt. Penni88100 IIId authorization is hereby
gnmted to Watem Union Finam:ial Servicea, Inc. and l1s affiliates aDd represeollItives (collectively "WUFSl"). II well as to trade refereaces, Dun & Bradstreet, banIcs.
c:onsumer credit semc:cs. COIlIlUIl<< reporting agancies and state, federal, or fomgn goverJlll1mt rqwcsmtatiws, without reprd to whether they are listed herein, to
verify. receive, ezchaage, and obtain busin_ and/or persooal CIldit aod other. infunnatioD (iJdading without Iimilation cri1ninal background cbcc1a;). as part of this(application or lit any time themlfter in CODDeCtIon with the ongoins Appliamt evaluation process. review of activity and/or collection of any obligation arising from the
business Rllatiooship. including any rdated guaranties or any services offered by WUFSL The unds1ipcd t'urtMr ear= that neither WUFSI nor anyone who has
fumi&hcd WUFSIllIlY information conceming Applicant shall be rcsponsible for any loe8es ordamaps Applicaat may olaim as re81.Ihing from laid ventiOltion. receipt,
~change. or obtainina business aadIor persoual credit or other businolB and/or pCISOIIlll infonlllltion. WUFSr RlSCm:!I the rilht in its !!Ole and absolute di3cretion to
reject Applicant's 3flPlication and such ndeotion be without peoalty of lID)' type 01' Idad to WUFSI.
f~-~.l!Itl~l~lq,~RE:!I;-rf[~!~.M. ..~I.~~.9.f."~-~~~'~T~~L.-.-__." --.--T..-..-----T-..---..-.---.......---..... '-''''1
1_~~;".tf~~__6"~~~~~~:i~~j~Lf~.(G:j
7 Z.7-a~ V-7&Z~
City ofClelrwater CF 9.19.07.OOc
~nj02/07 TUE 14:25 FAX 314 241 6618
10-' 2~07; ~:::5iPt.,~;Customer' Ser\'I;:e
PBX
~J 001
; ~36':;;:4E;'/'i
'ii'
Schedule B
~f{VICE APPLlCATIO!\
i..!:':""l!',m,,:'"",,":,,"[ CI~ ~f CI",,-""~.__.""_.""___"_.__ DBA" "'d"N':~_~: ---- :=:"~. ---:. J
f~E~~~:'-=::: :~{~E#;~~::-=':=:li~~:r~:~:1:=.tI~~_i:::-=~,-.............'.',",H;Ji..~:.~~~~ i
[~~;~:~-= ::~J~~~~~::-'---_-1~~]:-'2;:';:;2:;;~--r~~~;;;I!m'""'Y~~':~'::,""--_:
: Type of Business I M Iclpal G t I Contact Name and Ti:le ,)f i James K Geary, Director of Customer
I-:;;P9 of Entity '"~ E1u~ndiv[~~:ver;:artnerShip In the s~t=~~nest::~~~~Clabil:tY'CO~P~~~~~--rrrtorpora'uonfnYtle staTe;;r"""j
l"-oate and Place----- propr7 ~- Annuall:r;';'~~cti-;-nv;;iu~~c:""""',,+--- .-....- - .,.... ""I
I Business Started (Esllmateo; 1
Trade References
Name of Trade Reference
Telephone 1\ umber of'i'rade Reference
i.
2..
3,
All statements conrni[ll:d in this application and other documentation submitted in suppon of this application arc tru~ and correct Permission and Iluthorization is hereby
granted ro Western Union Financial Services, Inc. and its affiliates and representatives (collectively "WUFSl"), as well as to trade rcH:rences, Dun & Brdd~treet, bunks,
consumer creilit servkes, consumer reporting agencies and state, federal, or foreign government n:pre.sclltativcs, without regard ((f whether Liley ale l.istoo herein, (0
verify, receive, exchange, and obtain business and/or pet1lonal credit and other. intiJrmation (including without iimitatiou criminal background chwy.E), as palt of this
application or lit any time thereafter in cOlmection with the ongoing Applicant evaluation process, revww at activity and/or collection of any ub'ligatklll arising Hom tlle
business relationship. including any related guaranties or any services offered by WUFSL Tile undersigned further agree that ne;:ther WUFSI nOI anyone who jlllS
furnished WUFSI any infonnation concerning Applicant shall be responsible for any losses or damage., Applicant may claIm a~ r,"\lUng from ~llid v(;dlivatkn, receipt,
exchange. or obtaining business and/or personal credit or other business andior personal infonnation. W U FSI reserves lite right in it'i sole amll.!bsolut<: di:;Cl~.tioll 10
rejlXt Applicant's application an.d slIch n;jection sl)l< be without penalty of any type or kind to WUFSL
I
,(AN AUTHORIZER REPRES:~NrA.TIY!= fy1~. .SIGN OF BEliAL" OF TI:iE .AP;:>L1CANT;, .. mm..........,.
i SIGNATURE l I / I .. : PRINTED: '. ' 6l. . DAn:
i ,~.b F u:> ~~ Lk;p;, 6n'~~ w
i A~~,~.~.~.~_,....i,./b~~:n~t.~~E CITYif1~n'n...:I:~::E
7],. 7 - z.z.1f-13Zl~
,
I /0' I"~ -'"I '7
! "".....~ "t) ,
. ..i....E1:I~:f,........l~~~...!
City ofO.ellfWajer (:F 9.. , \JJn,d")i.}