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)Invdce,("""Joud'M <br />Biller Order Form <br />• •• <br />Ownership Type:Government <br />Biller Contacts <br />Legal Name: <br />City of Santa Ana <br />• r <br />Minerva Mancha, Treasury Services Super <br />Address 1: <br />20 Civic Center Plaza <br />Phone Number: 714-647.5442 <br />Ext. <br />Address 2: <br />Email Address: mmancha@santa-ana,org <br />City: an Ana State: <br />Ca Zip: 92701 Hans Nialsen, Project Manager <br />Phone# 714.647.5400 Fax #: <br />7146475069 Phone Number; 714.647.5442 <br />Ext. <br />Website URL: <br />http://www.cl.santa-ane,ca,us/ Email Address: hnielsen@santa-ana.org <br />Business Open Date: 1886 <br />Pon Minerva Mancha <br />Federal Tax ID#: <br />Phone Number: 714-647.6442 <br />Ext. <br />Note: Federal Tax ID and Legal Name must match on all documents. Email Address: mmancha@santa-ana.org <br />- <br />Signatory Contact: Franoisco Gutierrez Title: Finance Director <br />Phone Number: 714-647-5400 <br />Ext, Email Address:i igu6errez@sono-ana.org <br />Paperwork Contact: Will Holt, Treasury & Customer Services Manager, (714) 647-5456, wholt@santa-ana.org <br />New Biller Implementation: $ 1,500 <br />Paperless Presentment: $ <br />0.11 Per Item <br />---- <br />-- - includes3 email notifications)-- <br />- <br />Biller Portal Access: $ <br />_ <br />100 <br />i Monthly <br />IC Payment - Credit Card: <br />$ <br />6.oa <br />Per Item <br />Additional User(s) $ <br />0,00 <br />Monthly Per User <br />IC Payment - EFT/ACH: <br />$ <br />0 00 <br />Per Item <br />Online Bank Direct Access: $ <br />0.00 <br />Choose an i'Cem. <br />Online Bank Direct: <br />$ <br />0.25 <br />Per Item <br />Go Mobile Gateway $ <br />0.00 <br />Choose an item. <br />Harris Go Mobile: <br />$ <br />0,00 <br />Perltem <br />Invoice Presentment: $000 <br />Monthly <br />EFT/ACH Reject: <br />$ <br />95,00 <br />Per item <br />Charge Back: $ <br />20,00 Per Item <br />BILLER BAN" (MU"J"CU" <br />V• JOED IMINESS, Cw�•Awul • <br />• <br />Name of Checking Account (Aspappears onchock atBankLener): City of Santa Ana <br />Bank J. P. Morgan <br />Address: 3 Park Plaza Fir 9 Irvine, CA 92614 Phone; <br />949-833-4061 <br />Name: <br />Depository Routing#; <br />Account#: <br />lions will be electronlcall da. <br />Fees Routing#: <br />_ <br />Account#: <br />nvoice an <br />gaymen races n" fees will be electronica0v deducted from this account <br />