Laserfiche WebLink
1 <br />V <br />1° <br />Principal /Bank: Assoclate/Oroup: 002000 Chain /Association: 002001 <br />N- 2014 -106 <br />MCC Code: 7523 <br />MERCHANT TRANSACTION PROCESSING AGREEMENT — MERCHANT APPLICATION <br />201405 Merchant Application SBS Pass Through CONFIDENTIAL <br />BUSINESS <br />Business Legal Name (must match name on tax return): <br />INFORN/INLION <br />Business D/B /A: <br />( "MERCHANT') CITY OF SANTA ANA <br />CITY OF SANTA ANA <br />Location Street Address: (No P.O. Boxes) <br />City: State: <br />Zip: T <br />20 CIVIC CENTER PLZ <br />Santa Ana CA <br />92701 <br />Contact Name: <br />Phone: <br />Pax: <br />Email: <br />Minerva <br />(714) 647 -5440 <br />MMancha @santa - ana.org <br />Mailing/Biiftig Address: (If different from Location) City: State: Zip: Phone: <br />20 CIVIC CENTER PLAZA SANTA ANA CA 92701 (714) 647 -5440 <br />PROFILE BUSINESS • ASSUMPTIONS <br />g of Locations: Fad. Tax ID: Annual Visa/MasterCard/Discover Location Volume ($): Business Open Date: <br />1 956000785 Volume($): 10,000.00 10,000.00 7/1/14 <br />Avenge Ticket ($): <br />Highest Ticket ($): <br />Avg. monthly Vol. ($): Length of Ownership: <br />ViswMasterCard/Discover Yes <br />1.00 <br />5.00 <br />833.33 0 Yr 1 Me <br />Currently Accepted? 10 No <br />4 of Employees: <br />Ownership Twe: %of Goods /Services Cash and Carry: 100 <br />0 <br />Government <br />Type of Business: <br />Pricing Method Type of Goods /Services sold: (Please include a copy ofyour return /refind policy) <br />Card Not Present CNP <br />MOTO <br />PARKING <br />ftous Processor: (Please Include copy of statements) <br />Business Website: W W W.SANTA- ANA.ORG <br />Card Present 0 % + Card Not Present 100 %= TOTAL: 100% <br />Sales to: Consumer 9° + Business 5 %= TOTAL: 100% <br />If CNP Choose one:_ CATMO <br />Card swipe ° +Imprint 0 %= TOTAL Card Present % <br />Application Type: <br />Addl. Location LOC /Old MID: <br />Dun & Bradstreet 0: (If available) <br />Have you or your business ever declared <br />Additional Location <br />84870052081880 <br />bankmptay? []Yes []No <br />Do you use any third party fulfillment houses? O Yes O No <br />Do you work with a rind parties or software vendors who have access to <br />rdes <br />If Yes, please provide a contact list of all third party fulfillment houses. <br />cardholder data? ®No <br />If yes, please provide a contact list of all third parties slid software vendors who <br />have access to cardholder data. <br />When is cardholder billed for goods /services? <br />On Order 0 On Shipment Average number of days between order and shipment? <br />Expected date of first transaction? <br />Do you operate as a Seasonal Merchant? 0 Yes 0 No <br />If seasonal, indicate operating months: E] Jan Feb L]Mar CApr [E:DIMay Jun E]Jul Aug DSep ®Oct oNov E] Dec <br />Bank Reference Name: Contact: Phone: Account Number: <br />JP MORGAN CHASE KATHY KOBAYASHI (949) 833 -48 935309500 <br />Trade /Supplier I Name: Contact: Phone: Account Number: <br />Trade /Suppl ier 2 Name: <br />Contact: Phone: <br />Account Number. <br />VISA DISCLOSURE <br />MEMBER BANK (ACQUIRER) <br />IMPORTANT MEMBER BANK (ACQUIRER) RESPONSIBILITIES <br />IMPORTANT MERCHANT RESPONSIBILITIES <br />INFORMATION <br />I. A Visa Member is the only entity approved to extend acceptance of <br />I. Ensure compliance with cardholder data security <br />First National Bank of Omaha <br />Visa products directly to a Merchant <br />and 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 finds held in reserve that are <br />derived from settlement. <br />The responsibilities listed 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 have any problems. <br />Merchant Name' - <br />CITY OF SANTA ANA <br />Authm ized Signature <br />�-._,. <br />C�fiWlp c�v - <br />AddS RQ CIVIC CENTER PLZ <br />Print Name: <br />Nna @_" A,, & CA 92701 <br />Aix" _ <br />r. s I LLL j v rued .ra a a W s vaex+a, <br />d' 1. "f S' Merchant Solutions, LLC is a registered agent of First National Bank of Omaha, 1620 Dodge Street, Omaha, NE 68197 <br />MARIA D. HUIZAR 1 of4 <br />CLERK OF THE C11.1NC9t.. <br />LISA E, STORCK <br />M919t6ht 0Ity Attorney <br />01 0 <br />