FIRST NATIONAL BANK OF OMAHA/TSYS MERCHANT SOLUTIONS, LLC 1 -2013

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2012 10 Merchant Application SBS Pass Through CONFIDENTIAL AMERICAN E.XPRFSS ? Existing American Express ESA ESA SE Merchant CAP L1 New American Express OnePoint Discount % ? New American Express ESA Discount % EJ Monthly Flat (ESA)$ Merchant Name City of Santa Ana Annual American Express Charge Vol $ Avg Ticket $ Retail: + $0.10 Trans Fee Retail: 0.30% CNP downgrade ? D Daily Net Pay - ESA only ? Daily Gross Pay - ESA only Restaurant: + $0.05 Tran Fee Restaurant: 0.30% CNP downgrade ? ? Monthly Gross Pay (+.03% if $100K +) - ESA only 13213 & Services, Wholesale & All Other: + $0.15 Trans Fee ? Payment Timing - ESA Only: ? 3 Day ? 15 Day ? 30 Day Inbound Fee: 0.40% on Cross Border Transactions Prepaid Gift Card Discount All industries except supermarkets 1.95% Supermarkets: $0.20 per transaction By signing the Merchant Transaction Processing Agreement with BANK and TMS, I represent that I have read and am authorized to sign and submit this applica- tion agreeing to be bound by the American Express'" Card Acceptance Agreement ("American Express Agreement"), and that all information provided herein is true, complete, and accurate. I authorize TSYS Merchant Solutions, LLC. and its agents, assigns or affiliates (collectively "TMS") and American Express Travel Related Services Company, Inc. ("American Express") and American Express agents and Affiliates to verify the information in this application and receive and exchange information about me personally, including by requesting reports from consumer reporting agencies from time to time, and disclose such information to their agent, subcontractors, Affiliates and other parties for any purpose permitted by law. I authorize and direct TMS and American Express and American Ex- press agents and Affiliates to inform me directly, or inform MERCHANT, of reports about me that they have requested from consumer reporting agencies. Such information will include the name and address of the agency furnishing the report. I also authorize American Express to use the reports on me from consumer reporting agencies for marketing and administrative purposes. I am able to read and understand the English language. I understand that upon American Express's approval of the application, the MERCHANT agrees to abide by the American Express Agreement and will be sent materials welcoming it, either to American Express's program for TMS to perform services for American Express or in American Express's standard Card acceptance program which has different servicing terms (e.g. different speeds of pay). I understand that if MERCHANT does not qualify for TMS's servicing program, that the entity may be enrolled in American Express's standard Card acceptance program, and MERCHANT may terminate the American Express Agreement. By accepting the American Express Card for the purchase of goods and/or services, or otherwise indicating its intention to be bound, MERCHANT agrees to be bound by the American Express Agreement. I understand that TMS and BANK are not parties to the American Express Agreement. IT"RSONAL GUARANTY THIS general, absolute, and unconditional continuing Guaranty ("GUARANTY") by the undersigned (collectively "GUARANTOR" or "my" or "I" or "me"), is for the benefit of TSYS Merchant Solutions, LLC and/or First National Bank of Omaha ("Collectively TMS"). For value received, and in consideration of the mutual undertakings contained in the Merchant Transaction Processing Agreement and allied agreements ("AGREEMENT') between TMS and ("MERCHANT") as set forth below, I absolutely and unconditionally guarantee the full performance of all MERCHANT's obligations to TMS, together with all costs, expenses, and attorneys' fees incurred by TMS in connection with any actions, inactions, or defaults of MERCHANT. I waive any right to require TMS to proceed against other entities or MERCHANT. There are no conditions attached to the enforcement of this GUARANTY. I authorize TMS, its agents or assigns to make from time to time any personal credit or other inquiries and agree to provide, at TMS's request, financial statements and/or tax returns. I agree that this GUARANTY shall be governed and construed in accordance with the laws of the state of Nebraska, and that the courts of the state of Nebraska shall have and be vested with personal jurisdiction over me. This is a continuing GUARANTY and shall remain in effect until one hundred eighty (180) days after receipt by TMS of written notice by me terminating or modifying the same. The termination of the AGREEMENT or GUARANTY shall not release me from liability with re- spect to any obligations incurred before the effective date of termination. No termination of this GUARANTY shall be effected by any change in my legal status or any change in the relationship between MERCHANT and me. This GUARANTY shall bind and inure to the benefit of the personal representatives, heirs, administrators, successors and assigns of GUARANTOR and TMS. PERSONAL GUARANTOR: (Signature-No Titles) Print Name: (No Titles) MERCHANT: (Business Legal Name) City of Santa Ana Social Security Number: Home Address: Home Phone: Work Phone: (714) 647-544 AGRETMENT ACCEPTANCE By their execution below the undersigned parties agree to abide by the merchant transaction processing agreement (the "AGREEMENT"). The AGREEMENT consists of the Merchant Application and the Terms and Conditions (a separate attachment hereto), and MERCHANT acknowledges receipt of the terms and con- ditions at the time of signing. MERCHANT warrants that the information provided on the Merchant Application is complete and accurate. MERCHANT author- izes TMS and/or BANK to provide a copy of this Merchant Application to any third party for the services requested. MERCHANT, and its signing officer/owner/ partner, authorize TMS and/or BANK, or its agents or assigns, to make from time to time, any business and personal credit and other inquiries. If applicable, MERCHANT agrees by its signature below to the Equipment Agreement and/or the Card Compromise Assistance Plan Agreement. In witness whereof the parties hereto have caused this AGREEMENT to be executed by their duly authorized representatives effective on the date signed or approved by BANK. Principal's Name (Please Print): AP, MS R ; A-5 Title: kLI e?? Equity Ownership (%) Home Phone No Date of Birth: Principal's Soc Sec No'. 0 Principal's Home Address: City: State: Zip' MERCHANT (PRINCIPAL / OFFICER / OWNER) Name (Please Print): Title: Date: Signature x TSYS Merchant Solutions, LLC ("ThIS") Signature: Name: ry 4 Mora- ?u6?J_ ?^O Title?X D7t ?/-3 First National Bank of Omaha Name: Title Date: ("BANK") Signature G TSYS Merchant Solutions, LLC is a registered agent of First National Bank of Omaha, 1620 Dodge Street, Omaha, NE 68197 800-853-9586 3 of 4