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CHASE 6 i Merchant Services - 4 Northeastern Boulevard Salem. NH 03079-1952 - e,uw,v chasepaymenlechoom Phone 1603) 896-6000 - Fax: (603) 896-8715 - kierchant—SeN!ce%@CfiagePaymeritech.com SECTION 4: 1099K CONTACT INFORMATION (W-9 required if new US entity andloi, taxpayer ID, W-8 required for Canadian Transaction Division's Taxpayer ID #/No. 95-6000785 Same as Corporate Yes El No Z 1099K Contact Name Francisco Gutierrez 1099K Contact email address Division Name: City of Santa Ana -PREP fg.utierrez@santa-anaorg (up to 30 bytes - this will appear on your Financial Reports) Currency (list only I each per division): Presentment: US Settlement: ` If using our Cross Currency Product - please provide both the Presentment and the —Settlement Currencies us • The following field appears on the customer's statement and Identifies the merchant name for the consumer and credit card organizations To further aid consumer recognition, Visa has sanctioned the abbreviation of the merchant name It must be separated from product information by an asterisk ('), Which Must appear in the 4th, 8th or 131h position. The asterisk cannot be used for Retail Merchants. Internet service providers, e-commerce merchants may utilize a URL instead of Customer Service Phone if not processing any Mail-order transactions (URL must only be 13 bytes) Cardholder Descriptor (For all card types with the exception ofAmencan Express}' (22 bytes) bytes) bytes) bytes) Division Location Address: 20 Civic Center Plaza Country: USA (Must be a street address, Po Boxes not acceptable) City'. Santa Ana Statelprov; Zip Code (US): EqUiE7=1 (Fo(Rotail-City above must match City Location) Postal Code (Intl): E= Postal Code (Can): (6 bytes) (StatelProvaince and Paseil2la codes must match the address given above) Producti'Service Description (Enuirproduct i.0 dolling, books, membarshial K�� Publication Descriptor (Pleaseprovide only if required by your submitter): D= Avg. Trans. $ Amt: 80 Avg, # Trans.Nr: 850 Projected Refund % 10 BPS How do you market this product? (Check pirty those that apply to this division) D Catalog 0 Direct Mail 9 Internet 0 Space Ad [] TV [] Outbound Telemarketing E] Other How will consumers provide credit card information to you when they girder this product? (Select only one): 0 Retail El MaiiPhone(Minketing Material Required) [9 Internet(Pease provide your URL): http:// www.invoiceCIOLid.com/santa- an@ ff internet is selected and the website Isnot yet available to consumers please complete a Marketing Material Supplement form which you may obtain from Merchant Services oryour account executive. If Internet, please advise: Select one: E SSL [] SET 0 No encryption method Will the consumer be able to place their order and provide their credit card info (or electronic check info) through this website? 0 Yes E] No Is the web site secure, i.e , will the information that the consumer provides, such as their name and credit card number be encrypted so that it can't be read or intercepted by other people? ®Yes []No Maximum Sale Transaction Amount: $125k (Default $25.000 11S. dollars orestablished international currenryequrvalent per transaction) Maximum Refund Transaction Amount $125k (Default 526.000 U.S. dollars or established international currency equivalent per transaction) (Approval will be required for any himporan, or permanent increases to this ceding limit), Please check the consumes payment option for this division: (Select only one): FISingle payment ElInstallment payments ElDeferred payments [JRecurnrig (transactions managed byrinsitunarnisubmarer) isay1l/18J10 2 Nov,01visionsaluic/cbmi Customer Service Phone #.' Required for Mail Order or Recurring}r- City: (Required for Retail) IR L: amonal, if phonaff provided above) — (13 (13 (13 I 7 1 q 6 — 4 7 5 TFTF�J- 3 3 5 (22 bytes) bytes) bytes) bytes) Division Location Address: 20 Civic Center Plaza Country: USA (Must be a street address, Po Boxes not acceptable) City'. Santa Ana Statelprov; Zip Code (US): EqUiE7=1 (Fo(Rotail-City above must match City Location) Postal Code (Intl): E= Postal Code (Can): (6 bytes) (StatelProvaince and Paseil2la codes must match the address given above) Producti'Service Description (Enuirproduct i.0 dolling, books, membarshial K�� Publication Descriptor (Pleaseprovide only if required by your submitter): D= Avg. Trans. $ Amt: 80 Avg, # Trans.Nr: 850 Projected Refund % 10 BPS How do you market this product? (Check pirty those that apply to this division) D Catalog 0 Direct Mail 9 Internet 0 Space Ad [] TV [] Outbound Telemarketing E] Other How will consumers provide credit card information to you when they girder this product? (Select only one): 0 Retail El MaiiPhone(Minketing Material Required) [9 Internet(Pease provide your URL): http:// www.invoiceCIOLid.com/santa- an@ ff internet is selected and the website Isnot yet available to consumers please complete a Marketing Material Supplement form which you may obtain from Merchant Services oryour account executive. If Internet, please advise: Select one: E SSL [] SET 0 No encryption method Will the consumer be able to place their order and provide their credit card info (or electronic check info) through this website? 0 Yes E] No Is the web site secure, i.e , will the information that the consumer provides, such as their name and credit card number be encrypted so that it can't be read or intercepted by other people? ®Yes []No Maximum Sale Transaction Amount: $125k (Default $25.000 11S. dollars orestablished international currenryequrvalent per transaction) Maximum Refund Transaction Amount $125k (Default 526.000 U.S. dollars or established international currency equivalent per transaction) (Approval will be required for any himporan, or permanent increases to this ceding limit), Please check the consumes payment option for this division: (Select only one): FISingle payment ElInstallment payments ElDeferred payments [JRecurnrig (transactions managed byrinsitunarnisubmarer) isay1l/18J10 2 Nov,01visionsaluic/cbmi