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N- 2014 -074 <br />Principal /Bank: Associate /Group: 002000 Chain/Association: 002001 MIDtt: MCC Code: 7523 <br />MERCHANT TRANSACTION PROCESSING AGREEMENT — MERCHANT APPLICATION <br />201310 Merchant Application SBS Pass Through CONFIDENTTAL <br />BUSINESS <br />INFOPTVIATION <br />Business Legal Name (must match name on tax return); <br />Business DB /A: <br />( "MERCHANT) CITY OF SANTA ANA <br />City of Santa Ana <br />Location Street Address:(No P.O. Boxes) <br />City: <br />State: <br />Zip: <br />20 Civic Center Plaza M -13 <br />Santa Ana <br />CA <br />92701 <br />Contact Name: <br />Phone: <br />Fax; <br />Email: <br />Minerva <br />1 (714 ) 647 -5440 <br />MMancha @santa - ana.org <br />Mailing /Billing Address: (If different from Location) City: State: Zip; Phone: <br />20 Civic Center Plaza M -13 Santa Ana CA 92701 (714) 647 -5440 <br />ASSUMPTIONS BUSINESS PROFILE AND <br />4 of Locations; Fed. Tax ID: Annual Vise/MasterCard/Discover Location Volume ($): Business Open Date: <br />1 956000785 Volume ($): 86,400.00 86,400.00 <br />Average Ticket ($): <br />Highest Ticket (S): <br />Avg. monthly Vol. ($): <br />Length of Ownership: <br />Visa/MasterCard/Discover 101 as <br />1,00 <br />5.00 <br />7,200.00 <br />0 Yr 0 me <br />Currently Accepted? ❑No <br />N of Employees: <br />Ownership Type: <br />%of Goods /Services Cash and Carry: 100 <br />0 <br />Government <br />Business: <br />Pricing Method: Retail <br />TyppoGoods /Services sold:(Please include a copy of your retam/refund policy) <br />Rataof <br />R <br />parking <br />PIC' &s Processor: (Please Include copy ofstatements) <br />Business Website: www.santa- ana.org � <br />Card Present 100 %+ Card Not Present %= TOTAL: 100% <br />Sales to: Consumer -2952----Y. + Business 5 %= TOTAL: 100% <br />— <br />IfCNP Choose one: <br />Card Swipe 100 %+ Imprint 0 %= TOTAL Card Present % <br />Application Type: <br />Addl. Location LOC /Old MID: <br />Dun &Bradsbeetll: (Ifavailable) <br />Have you or your business ever declared <br />Additional Location <br />51542672 <br />-0 < 3 Z`-}' <br />bankruptcy? ❑ Yes ® No <br />Do you use any third party fulfillment houses? ❑ Yes m No <br />Do you work with any third parties or software vendors who have access to <br />If Yes, please provide a contact list of all third party fulfillment houses. <br />cardholder data? L I Yes [Z No <br />If yes, please provide a contact list of all third parties and software vendors who <br />have access to cardholder data. <br />When is cardholder billed for goods /services? ® On Order ❑ On Shipment Average number of days between order and shipment? 0 <br />Expected date of Srst hansaction? <br />Do you operate as a Seasonal Merchant? ❑Yes V1 No <br />If seasonal, indicate operating months: ❑Jan []Feb ❑Mar ❑Apr []May ❑Jun [:]Jul ❑Aug ❑Sep ❑Oct []Nov ❑Dec <br />RE <br />Bank Reference Name: Contact: <br />S <br />Phone: Account Number: <br />JP Morgan Chase Kathy Kobayashi <br />(949) 833 -4801 935309500 <br />Trade /Supplier I Name: Contact: <br />Phone: Account Number: <br />Trade /Supplier 2Name; <br />Contact Phone: <br />Account Number: <br />DISCLOSURE VISA <br />MEMBER BANK (ACQUIRER) <br />IMPORTANT MEMBER BANK (ACQUIRER) RESPONSIBILITIES) <br />IMPORTANT MERCHANT RESPONSIBILITIES <br />INFORMATION <br />1. A Visa Member is the only entity approved to extend acceptance of <br />1. Ensure compliance with cardholder data security and <br />First National Bank of Omaha <br />Visa products directly to a Merchant <br />storage requirements. <br />1620 Dodge Street <br />2. A Visa Member is responsible for educating Merchants on pertinent <br />2. Maintain fraud and chargebacks below thresholds. <br />Omaha, NE 68197 <br />Visa Operating Regulations with which Merchants must comply <br />3. Review and understand the terms of the Merchant <br />800- 853 -9586 <br />3. The Visa Member is responsible for and must provide settlement <br />Agreement. <br />funds to the Merchant <br />4. Comply with Visa Operating Regulations. <br />4. The Visa Member is responsible for all funds held in reserve that are <br />derived from settlement. <br />The responsibilities )fisted above do not supersede the terms of the Merchant Agreement and are provided to ensure the Merchant understands some important <br />obligations of each party and that the Visa Member (Acquirer) is the ultimate authority should the Merchant oblems. <br />Merchant Name: <br />Authorized Signature: <br />CITY OF SANTA ANA <br />X <br />Address: 20 Clvlc Center Plaza M -13 <br />print Name: �- <br />Santa Ann CA 92701 <br />TSYS Merchant Solutions, LLC is a registered agent of First National Bank of Omaha, 1620 Dodge Street, Omaha, NE 68197 800- 853 -9586 <br />1 of4 <br />t <br />