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<br />Section 1: Assessment Information <br />Instructions for Submission <br />This Attestation of Compliance must be completed as a declaration of the results of the service provider’s <br />assessment with the Payment Card Industry Data Security Standard Requirements and Security <br />Assessment Procedures (PCI DSS). Complete all sections: The service provider is responsible for <br />ensuring that each section is completed by the relevant parties, as applicable. Contact the requesting <br />payment brand for reporting and submission procedures. <br />Part 1. Service Provider and Qualified Security Assessor Information <br />Part 1a. Service Provider Organization Information <br />Company Name:Bluefin Payment Systems <br />LLC <br />DBA (doing <br />business as): <br />Bluefin Payment Systems <br />Contact Name: <br />Telephone: <br />Brent Johnson <br />770.299.8533 <br />Title:CISO <br />E-mail: <br />City: <br />bjohnson@bluefin.com <br />AtlantaBusiness Address:8200 Roberts Drive, Suite <br />150 <br />State/Province: <br />URL: <br />GA Country: United States Zip: 30350 <br />https://www.bluefin.com <br />Part 1b. Qualified Security Assessor Company Information (if applicable) <br />Company Name: <br />Lead QSA Contact Name: <br />Telephone: <br />Foregenix Ltd <br />Shawn Shifflett Title:Managing Consultant <br />sshifflett@foregenix.com <br />Marlborough <br />+1 972.292.8039 <br />1st Floor, 8-9 High Street <br />E-mail: <br />City:Business Address: <br />State/Province: <br />URL: <br />Wiltshire Country: UK Zip: SN8 1AA <br />http://www.foregenix.com <br />PCI DSS v3.2.1 Attestation of Compliance for Onsite Assessments – Service Providers, Rev. 1.0 <br />© 2006-2018 PCI Security Standards Council, LLC. All Rights Reserved. <br />June 2018 <br />Page 1