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r 1 volceClou ' <br />' • _ Business License ®• 1 1 /19/2015 <br />Invoicing Parameters sheet must be completed for each Invoice e. <br />a • • <br />' In-houseSiNon-Submitter <br />® • • ®Visa ® MasterCard ® Discover ❑Amex ®EFT/ACH <br />• • ❑EBPP ®Cloud Store ❑ Cloud Pay ❑ OBD ❑ IVR ❑Kiosk <br />Billing Frequency: Monthly Number of Bills: 200 <br />Number of Cycles: <br />nje Number of Installments: 1 <br />Average Invoice Amount: <br />$380 Highest Invoice Amount: <br />$ <br />30,000 <br />Billing Months (please select the applicable months below): <br />❑Jan ❑Feb ❑Mar ❑Apr ❑May ❑Jun ❑ Jul ❑ Aug ❑ Sept ❑Oct ❑ Nov ❑ Dec ® All <br />-. <br />• e• ❑1St. loth ❑ 11th -20th El 21st -31st <br />• • ❑ Biller ❑ Template ❑ Bill Print Vendor (please complete below) <br />Hardware: Choose an item. QTY Choose an item. Provided by: ❑Sales Rep ❑ Operations <br />Per Unit Price: $ Shipping Address: <br />-- <br />; <br />(if different than location address) <br />Total Due: $ <br />I Feet; <br />seteattrowthebelo iftho service &��"4bythe <br />Pale�or if Biller will absorb foe <br />Item I Paid by payer Item <br />Paid by Biller <br />❑ Credit Card: <br />® Credit Interchange, fees, dues assessments+ <br />-% with $''Minimum Card: Authorization S 020''...., + 50'. %BP <br />❑ EFT/ACH: $t <br />per item ® EFT/ACH: $ 0.50 per item <br />❑ Flex Pay ACH: $ per item ❑ Flex Pay ACH: $ per item <br />Item Paid b payer Item Paid by Biller <br />ElCredit Card: ElCredit Interchange, fees, dues assessments + <br />%_ with Minimum Card: <br />(Without Visa Acceptance) Authorization $ + T. BP <br />❑ EFT/ACH: $ Per item ❑ EFT/ACH: $ Per Item <br />❑ Credit Card Service Fee: $ Max Cap for Credit Cards: $ <br />❑ EFT/ACH: Service Fee: $ ❑ Paid by payer ❑ Paid by Biller <br />❑ Paid by payer Service Fee + $ ❑ Paid by Biller $ per item surcharge <br />- <br />Notes/Spectal Handling <br />Business License Cloud Store requires a custom lockbox file. City will provide the exact specifications for the file and format. Pricing for <br />development is listed on page 1 ofthis BOF. <br />_ -.•.0 12/14/2015 _._- _.. <br />Biller • -_.. • Live• s• Hans Nielsen <br />Please note the above requested date is not guaranteed. The implementation time frame is not guaranteed subject to change and delays to <br />workload, systems/data requirements, biller cooperation and other factors. <br />