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RM <br />Uaign enveropa iu: r <br />AUTHORIZED ADMINISTRATOR FOR PURPOSES OF ACCOUNT BOARDING AND IMPLEMENTATION MEANS AN OWNER, PARTNER, OFFICER, EMPLOYEE OR OTHER AGENT <br />OF THE MERCHANT THAT HAS BEEN APPOINTED BY AN EXECUTIVE OF MERCHANT AND WHO IS DULLY AUTHORIZED TO PROVIDE INFORMATION AND EXECUTE <br />DOCUMENTATION ON BEHALF OF AND RELATED TO MERCHANT IN ORDER TO FACILITATE THE INITIAL SET UP OF MERCHANTS'SACCOUNT WITH CHASE PAYMENTECH, <br />PER CHASE PAYMENTECH POLICY, AUTHORIZED ADMINISTRATORS ARE NOT PERMITTED TO MODIFY THE MERCHANT'S ACCOUNT WITH CHASE PAYMENTECH AFTER <br />COMPLETION OF THE INITIAL SET UP OF MERCHANTS'S ACCOUNT. SUCH CHANGES MUST BE MADE, BY AN EXECUTIVE OR FINANCIAL CONTACT, AS APPLICABLE AND AS <br />THOSE ROLES ARE DEFINED BY MERCHANT. <br />NAME (please print) <br />Francisco Gutierrez TITLE [please print) <br />Finance Director <br />TELEPHONE NUMBER <br />714-647-5400 <br />EMAIL ADDRESS: <br />fgutierrez@santa-ana.org <br />SIGNATURE DATE: <br />F <br />1, the undersigned, being an officer/principal of_ represent and warrant that the statement made an this document are correct and factual. 1PMorgan Chase <br />Bank, N.A. ("Member') and Paymenterh, LLC ("Paymentedi" or "Chase Paymentech") are authorized to conduct any necessary Investigation, Including without <br />[Imitation, authorization for a bank to release standard banking information. <br />(Photocopy of signature below k valid for the release of Information and will remain valid until the terminauon or expiration of the Merchant Agreement <br />NAME (please print) <br />Francisco Gutierrez <br />TITLE (please print) <br />Finance Director <br />SIGNATURE <br />DATE <br />II SUBMITTER NAME Invoice Cloud, Inc, <br />*Note: Each Merchant is required to submit a W9 with this application, regardless if Paymentecit will be utilizing the Submitter's TIN for IRS <br />reporting purposes. <br />Rey D LS <br />Page 2 of 2 Paymentech Contract No. 063576 <br />25C-32 <br />