Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
WIRE TRANSFER SERVICES CUSTOMER SETUP FORM AND AGREEMENT
2016-08-22 12:18 Wells Fargo GIB 8132254450 >> P 1/5 WELLS VARG Wire Transfer Services Customer Setup Form and Agreement Pert I — Setup Information Treasury Management Customers Complete Part I and sign as provided In Part III. The Information In this setup form and your separate treasury management documents relating to wire transfers govern your use of Wells Fargo's wire transfer service. All Other Customers (including consumers and non-Treasury Management business customers) Complete Part I, review the Wire Transfer Services Agreement In Part II, and sign as provided in Part III. Type of Request: ® New 0 Update Existing Information 0 Delete Existing Information A. Account Numbers (list aCeounts to be debited for each wire transfer) For additional accounts attach a signed listing with notation of Customer's name and the additional account numbers, Check the appropriate box for each account number to Identify the account type. 1) 4053613063 2) 3) 4) (I DDA O G/L D ICDA ©G/L ❑ DDA ❑G/I. ❑ DDA ❑G/L S) 6) 7) 8) ❑DDA 0 G/L 0 ODA 0 G/L 0 DOA 0 G/L 0 DDA 0 G/L 9) 10) 11) 12) 0 ODA 0 G/L ❑ DDA 0 G/L 0 DDA 0 G/L 0 DDA 0 G/L B. Advice Xnformatlon(additional fees apply for these services) For Fax or Email Notification on Intraday wire activity use the Info>=ax setup form. Mall Advicelthlua_per based service Is no longer available to add)0 Delete Mail Advice C. Authorized Oaligra (people authorized to initiate wires) $1l.rmit_ Use"N"if unlimited. The limit applies to all functions unless noted otherwise. If no limit Is noted we will set the limit as unlimited. 1'nitlatlon Type = If no Initiation Type is noted, we will set the individual up for both Repetitive and Non-Repetitive Wire Initiation, Complete by checking appropriate box: R = Repetitive/13= Both Repetitive & Non-Repetitive. I Authorized Callers Phone Numbar Initiation first a lost R name, Caller $ Limit including area Code rpt0 Brian .L Ravins 0 Aoo 0 DELETE iS 5,000,000.00 1727-552-4538 0 IRI imonica D. Mitchell ; 0 AOD Q DELETE 1$ 5,000,000.00 1727-562-4533 0 21 LMary Beth Setter ! It1 APP D DELETE 4 5,000,000,00 . 727-562-4517 ; O 2 • !Clement Vericker E)ADD 0 DELETE ;# 5,000,000.00 i 727-562-4520 . : 0 IN _.... r-- ---. _.... .... ... ..._.............� 0 ADD 0 DELETE ;$ ; 0 0 I 40 2016 Wails Farge Bank.N.A.All rights reserved.Member FDIC. WTRE173 (Rev 06-05/16 FO) Page 1 of 5 no/o91-mIA l l . ')nAM !r`MT_AC . nn1 2016-08-22 12:18 Wells Fargo GIB 8132254450 >> P 2/5 O. OPTIONAL Verify Callback Service(does riot apply to repetitive wires) Selecting this fee-based service requires a minimum of two persons with wire transfer authority because the initiator of a wire cannot also approve me wire, If the form does not Indicate on Authorized Approver other than the initiator, the optional Verify Callback Service cannot be provided, Verify Orders exceeding: ; ��"��r- - - Authorized Approvers Phone number first&last name Approver $ Limit including area code Brian ]. RavIns 131App Q DELre $ 5,000,000,00 727-562.4538 `Monica D. Mitchell ffiI AOD DELVE $ 5,000,000.00 727-562-4533 ;ry Beth Setter { I1 ADD 0 Mem $5,000,000.00 727562-4517 Clement Vericker ADD J]DELA $ 5,000,000.00 727.562-4520 ©ADD❑DELETE $ Ci ADD© DELETE $ ❑A00❑DELETE !$ E. Alternate Account to be Charged for Wire Fees(Available to Business and Wealth Private Banking customers ONLY) List account only if wire fees arc to be assessed to this account for the accounts listed in Part I-A, o DDA £1 AU and G/L .. ..., . ...,... Part XI -Wire Transfer Services Agreement 1, Introduction. This Wire Transfer Services Agreement("Agreement"), along with the account agreement applicable to the account used In connection with the wire transfer services ("Account"), govern your use of Wells Fargo's wire service. With this service,the Wells Fargo customer Identified In this Agreement("you"or"your") can instruct Wells Fargo Bank,N.A. ("Wells Fargo")to transfer funds by wire.from the Account("Order"). 2. Security Procedure 2.3.. General. You agree to use the security procedure described in this Section ("Security Procedure")when you request an Order(except for an Order delivered to Wells Fargo In person by you or your authorized representative).The purpose of the Security Procedure Is to verify the authenticity of an Order delivered to us In your name and not to detect errors In the transmission or content of an Order. You agree the Security Procedure is commercially reasonable and, In view of your requirements, Is a satisfactory method of verifying the authenticity of Orders.You agree you are bound by any Order, whether or not authorized, Issued in your name and accepted by Wells Fargo in compliance with the Security Procedure. 2.2. Voice Initiated Orders.Wells Fargo's standard Security Procedure for a voice-initiated Order consists of confirming the personal Identification number("PIN")accompanying an Order corresponds with a valid PIN assigned to you, and confirming the voice print provided when placing an Order matches the print registered on file for that PIN holder. A PIN and voice print are required for all voice-initiated transfers. 2.3. PIN. Each person authorized to initiate and/or approve Orders for you will be issued a unique PIN, PINS are computer-generated and you cannot choose your own PIN. Wells Fargo employees do not have access to PINS. You agree to safeguard any PIN assigned to you, You must supply the PIN each time you initiate an Order. PINs are Issued via a two-part, Confidential mailer sent to you. If lost or forgotten, Wells Fargo cannot reconstruct PINs, For your protection, If you suspect a PIN has been compromised, or if an authorized person is no fonper authorized, immediately notify Was Fargo Wlrc Transfer Services at 888.384.8400. Wells Fargo, In its sOle discretion, may cancel or reissue any PIN It believes may have been Compromised, Including, without limitation, a PIN that has never been acknowledged as having been received and any PIN that has been used by anyone other than the intended authorized user. 2016 Wells Fargo Bonk,N.A.All rights reserved.Member FDIC. WTR8173 (Rev 06-05/16 FO) Page 2 of 5 ns�i��/ Alf 19 • 7nOM rr_MT_n .nnl 2016-08-22 12:18 Wells Fargo GIB 8132254450 >> P 3/5 2.4. Identify Authorized Persons. You will notify Welle Fargo in writing of the identity of each Individual authorized to receive information regarding the Security Procedure, You will promptly notify Wells Fargo in writing of any change In an authorized individual. Your notice will be binding on wells Fargo If It Is received In a time and manner that gives Wells Fargo a reasonable opportunity to act on It. Wells Fargo will be fully protected in relying on your notices. 2.5. OPTIONAL Verify Callback Service. If you select this optional fee-based service by providing the information requested in Section D of Part I, it wilt become part of your Security Procedure, Wells Fargo will make one attempt to telephone an individual authorized to approve wires other than the initiator(an "Authorized Approver") to verify the voice-initiated non-repetitive wire transfer order is authorized when the amount of the wire exceeds the wire transfer order limit designated In Section D of Part I.You may designate a limit up to which en Authorized Approver may authorize en order. A PIN is required to authenticate each Authorized Approver. If Wells Fargo Is unable to (a)contact and authenticate or(b)obtain approval from en Authorized Approver, the wire will not be processed. 3. Inconsistency of Name and Number. If an Order describes the person to receive the wire transfer ("Beneficiary") Inconsistently by name and account number, the wire transfer may be made on the basis of the account number even if the account number Identlfles a person different from the Beneficiary. If a wire transfer request describes a financial institution Inconsistently by name and identification number,the Identification number may be relied upon as the proper identification of the financial Institution. You further acknowledge the beneficiary account number or beneficiary bank identification rmmt,or(e.g, XO4ly, RTN,ar SWIFT BIC) you provide in connection with an Order will be complete and accurate, and you understand you could lose the transfer amount If the Information Is incorrect. 4. Responsibility of Wells Fargo. Wells Fargo may send an Order by wire, telegraph, telephone, cable, or whatever other transmission method Wells Fargo considers to be reasonable. Wells Fargo may transmit an Order directly to the Beneficiary's bank, or indirectly to the Beneficiary's bank through another bank,government agency, or other third party that Wells Fargo considers to be reasonable. Wells Fargo may utilize any reasonably selected funds transfer system or Intermediary bank,even if its selection differs from instructions in the request. 5. Additional Actions by Wells Fargo. Any action Wells Fargo takes to detect an erroneous Order,or any actlons Wells Fargo takes beyond those described above in an attempt to detect an unauthorized Order,will be taken at Wells Fargo's sole discretion. No matter how many times Wells Fargo takes this action, it will not become part of Wells Fargo's standard procedures for attempting to detect such erroneous or unauthorized Orders, and Wells Fargo will not In any situation be liable for failing to take or to correctly perform the action. 6. Liability. Wells Fargo is only responsible for making a good faith effort to execute your Orders and will only be responsible for performing the services specified In this Agreement. For Orders subject to Article 4A of the Uniform Commercial Code ("UCC 4A"), Wells Fargo will be liable to you only for damages required to be paid under UCC 4A. For Orders not subject to UCC 4A and for other obligations under this Agreement,Wells Fargo will only be liable for Its negligence or willful misconduct. Wells Fargo will not be liable for any third party's failure to or delay or error In processing an Order. Wells Fargo will not be liable for any delay in performing or failure to perform if the delay or failure results from any cause beyond Its reasonable control, In no event will Wells Fargo have any liability for con sequential,special,punitive or indirect loss or damage which you may Incur In connection with this Agreement. 7. Indemnification. You agree to Indemnify and hold Wells Fargo, its directors,officers, employees and agents harmless from all third party claims, demands,judgments, and expenses(including reasonable attorney's fees)arising out of or connected with the performance of any wire transfer service under this Agreement.This indemnification will survive the termination of this Agreement. 8. Cancellation,Amendment, ReverSal. An Order will be final and not subject to cancellation, amendment or reversal by you,except Wells Fargo may, at your request,make an effort to effect such cancellation, amendment or reversal without Incurring any liability for its failure or Inability to do so. 9. Your Duty to Notify wells Fargo of Unauthorized Activity. If you identify any discrepancies in your account setup (Including repetitive wire transfer templates),please Contact us Immediately at 1.888-384.8400. Wells Fargo will not be responsible far any delays in payment or additional fees caused by your failure to notify us promptly of any such discrepancy. You will exercise ordinary care to determine whether an Order accepted by Wells Fargo was either erroneous or not authorized and to notify Wells Fargo of the facts within a reasonable time not exceeding 14 days after you have received notification from Wells Fargo that the Order was accepted or that your Account was debited or credited with respect to the Order,whichever IS earlier. You will be precluded from asserting that Wells Fargo Is not entitled to retain payment for an Order unless you object within 14 days, 10. Fees and Taxes. You agree to pay Wells Fargo's current wire transfer service fees. A copy of Wells Fergo's current fee schedule Is available to you on request. You also agree to pay amounts equal to any applicable taxes on these wire transfer services(exclusive of taxes based on net Income of Wells Fargo). b 2015 Wells Fargo Bank,N.A.All rights reserved,Member hard. WTR8173(Rpv OG -OS/16 FO) Pace 3 or S 11 .onoM frMT_nI .nnl 2016-08-22 12:19 Wells Fargo GIB 8132254450 >> P 4/5 11. Currency. An Order expressed In U.S. Dollars will be sent in U.S. Dollars. You may request that prior to executing an Order, Wells Fargo convert the amount to be transferred from U.S. Dollars to the currency of a designated foreign government or intergovernmental organization("Foreign Currency")at Wells Fargo's selling rate kr exchange in effect on the date the order is executed by Wells Fargo. if the financial Institution designated to receive the funds does not pay the beneficiary specified in the Order and the Order is payable In Foreign Currency, Wells Fargo will not be liable far a sum In excess of the value of the Order after it has been converted from Foreign Currency to U.S. Dollars at Wells Fargo's buying rate for exchange at the time the cancellation of the Order is confirmed by Wells Fargo. 12, Term and Termination. This Agreement may be terminated by you or Wells Fargo with prior written notice, but will remain In effect with respect to any transaction occurring prior to Its termination. 13. Amendments to Agreement. Wells Fargo may, from time to time, notify you of a change to this Agreement or Its rules or procedures. By using the wire transfer service after the notice is sent or otherwise made available to you, you will be conclusively deemed to have agreed to the change. 14. Governing Law; Rules and Regulations. Our rights and obligations regarding Orders will be governed solely by this Agreement, your account agreement,and, to the extent applicable, federal law and the state laws governing your Account. All Orders will be subject to the rules and regulations of any funds transfer system used by Wells Fargo, as amended from time to time. 15. Notices; Receipt of Confirmations. If a notice Is sent to you, it will be effective II'it Is delivered in person or sent by first class mall to your last address as shown on Wells Fargo's records. If a notice Is sent to Wells Fargo, it will be effective if it is delivered by first class mail to the address shown In Wells Fargo's then current fee schedule(or to such other address as Wells Fargo may from time to time direct)and after Wells Fargo has had a reasonable opportunity to act on It.An optional confirmation or a bank statement showing a wire transaction, sent electronically or by mall, to your last address as shown in Wells Forgo's records and not returned,will be conclusively presumed to have been received by you.Wire Transfer mall confirmations are not available for addresses outside of the United States. 16. Miscellaneous. Wells Fargo's waiver of any term of this Agreement will not constitute a waiver of any other term or Impair any of its rights If you breach this Agreement. You agree not to assign your interest in this Agreement to anyone else. If any prevision of this Agreement Is determined by a court to be invalid, it will not affect the validity of any other provision, In interpreting this Agreement,the headings will not be considered a substantive part of this Agreement. Unless the context requires otherwise,terms not defined in this Agreement hove the meanings, If any, provided in UCC4A.This Agreement and any applicable account agreements constitute ow entire Agreement with respect to the matters they cover and supersede all prior oral or written communications between us regarding such matters. In the event of conflict between a provision of this Agreement and any other agreement you may have with Wells Fargo (including without limitation, any account agreement between us),the terms.of this Agreement will govern the subject matter of this Wire Transfer Agreement, 17, Additional Terms Governing Outgoing Consumer International Wires 17.1. General. This Section Contains additional terms applicable only to Orders initiated by a natural person In the United States to transfer funds to a Beneficiary in a foreign country for personal,family, or household purposes(each, an'Outgoing Consumer International Wire"). This Section does not apply to any Order sent to a Beneficiary in the United States, to any Order initiated by a non-consumer,ar to any Order initiated by a consumer for any non-personal, non-family,or non-household purposes. In the event of a conflict between a provision In this Section and a provision in the rest of this Agreement or in the agreement governing your Account,the provision in this Section will control. 17.2. Disclosures and Receipts. Prior to sending an Outgoing Consumer International Wire, Wells Fargo will disclose to you, by telephone, the amount that will be transferred to the Beneficiary, a description of any fees and taxes imposed by Wells Fargo, the total amount of the transaction, the exchange rate to be used,the amount to be transferred In the Foreign Currency, a description of any fees and taxes CO be applied by any other person to the extent known by wells Fargo, and the amount that will be received by the Beneficiary, Wells Fargo will mall a receipt for an Outgoing Consumer International Wire within 30 days after payment Is made for the Outgoing Consumer International Wire. 17.3. Liability. Wells Fargo Is liable only for damages required to be paid as provided under Regulation E, subpart B or, to the extent applicable, UCC4A(except as expressly modified by this Agreement). Except as required by Regulation E, subpart B, Wells Fargo will not be responsible for the acts or omissions of any other person or entity, including but not limited to any processor,any country's central bank, or any other financial institution, and no such person or entity will be deemed Wells Fargo's agent, to no event shall Wells Fargo have any liability for any indirect, incidental, consequential, punitive, or special damages, even If advised of the possibility of such damages, cb 2016 Wells Fargo Bank,N.A.All rights reserved.Member FO1C. • WTRB173(Rev 06 -05/16 FO) Page 4 of 5 nit/77/7A1g 11 . 7nAM rnmT-ns. •nn) 2016-08-22 12:20 Wells Fargo GIB 8132254450 >> P 5/5 17.4. Cancellation. You may cancel an Outgoing Consumer International Wire for a full refund within 30 minutes of completing a transaction.To cancel, call the cancellation phone number provided to you at the time of your request. 17.5. Error Resolution. In the event that you believe an error has occurred with respect to an Outgoing Consumer international Wire, you must notify Wells Fargo no later than 180 days after the"Availability Date" (the date when funds will be available to the Beneficiary)disclosed to you by contacting us at 1.868.384-8400 or by mailing Wells Fargo at the address shown in Wells Fargo's then current fee schedule or to such other address as Wells Fargo may from time to time direct. If you fail to notify us within this time period, Wells Fargo will not be liable for any error or loss of interest or any Interest equivalent relating to the erroneous transaction, When you contact us, please tell us: (a)your name, address,and telephone number where we can reach you during business hours; (b)the Beneficiary's name and, if known, his or her telephone number and address; (c) the date, dollar amount and transaction confirmation number of the Outgoing Consumer International Wire; and (d) the error or problem with the wire transfer, and why you believe It Is an error or problerfl, 17,6. Governing Law. An Outgoing Consumer International Wire is a "remittance transfer"as defined in Regulation E, Subpart B, and will be governed by the laws of the United States and, to the extent applicable, the laws of the state of New York, including New York's version of UCC4A, without regard to its conflict of laws principles. Part III -Agreement and Approval Customer Approval - Signatures as required by Certificate of Authority or Signature Card. Under the dispute resolution program in your account agreement, you agree our disputes may be decided before one or more neutral persons in an arbitration proceeding and not by a judge or Jury trial. Legal Name as it appears on your Account Customer's Primary Phone No. LCity of Clearwater, Florida 1727-562-4538 _,_ ,___ _•. Mailing address for PINS and mall advice including City,State,and zip code.(11 blank,items will be mailed to address an primary statement malting address.) • Printed Name of Authorized Signer Printed Name of Authorized Signer Brian ,). Ravius Signature Date Signature Date ff 7 Bank Approval - Forms submitted without Customer and Banker signatures or older than 90 days will be returned unprocessed. _ Customers' iD Type 10 Number issued by State/Country Expiration Date i"EY HMI Customers' ID Type ID Number •Issued by State/Country Expiration Date 2"10 I Banker/Officer's Phone b I Banker/Officer's Fax s Bank MAC Document Prepared by&phone a (in case of questions 813-225-4432 1813-225-4450 � about this setup)Lynn Sams 813-225-4429 Banker's Wells Fargo email address for notification.A reasonable attempt will be made to contact the banker at the Wells Fargo email provided up om Iction. tmotion w NOT be sent to any email address outside the Wells Fargo system. C14-1.• C�wi /fit 1SJ 'L4_t.JYri + a r d r h, L' I"Y13 G4ll sib d. carr) Banker/Officer's Printed Name Banker/Officer'. 'r•nature— Rep ired bat _Olaf 9IrkAlde x1441 r' adtto 4' �� I .Oat, Once the customer approves and signs the form,the Banker/Relationship Manager must approve and sign the form,then fax it to wire Implementation at 866-922-6202 from a valid Wells Fargo Fax. File copies in your ioeation'S record-retention file. 2016 Wells Fargo Bank,N.A.All rights reserved. Member FDIC. WTR8173(Rev 06- 05116 FO) Page 5 of 5 na/99i9111f 11 • 9nAM (GMT-05:00)