flexgift app(1)

8/3/2019 FlexGift App(1)

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LLooyyaa ll tt yy PPrroogg rraamm AApppp ll ii cc aa tt ii oonn255 Rt. 17 South Hackensack , NJ 07601Tel. 800-260-3388 Fax. 201-562-1486

New Loyalty Only Existing Merchant ID Date ____/____/___

BBuussiinneessss

IInnffoorrmmaattiioonn

Legal Name DBA Name

Address City State Zip Code

Business Phone Fax E-mail #of Locations

OOwwnneerr

IInnffoorrmmaattiioonn Owner Name SS # Home Phone #

Home Address City State Zip Code

EEqquuiippmmeenntt

IInnffoorrmmaattiioonn

Terminal Type

Nurit 2085 Nurit 8320 Nurit 3000 series

Omni 3740 Omni3730 FG1000 Other :

IP Transaction Server Supported Terminal Omni 3740/ Omni3750 Vx 570 Ethernet Nurit 8320 LAN

Bankcard Processor Global Paymentech Visanet Other :

SScchheedduulleeooffCChhaarrggeess

Single Location Multi Locations

(If choose Multi Locations, please fill out Corporation Merchant ID & DBA Name)

Corporation Merchant ID

Corporation DBA Name

IP Transaction Server* Yes No

IIPPTTrraannssaaccttiioonnSSeerrvveerr

BBuunnddlleePPllaann**

Monthly Rate FeePlan 1 Plan 2 Plan 3 Plan 4

$ .00

Monthly Fee

Corporation Monthly Web Access Fee**

Monthly Web Access Fee

Transaction Fee

Transaction Minimum FeeAnnual Fee

* UMS credit card processing merchants only**Multi Locations Only

$ .00

$ .00

$ .00

$ .00

$ 10 .00

$ .00

Monthly Web Access Fee

Annual Fee

$ .00

$ .00

.Plan 1 500 Transactions Per Month Plan 2 2000 Transactions Per M

Plan 3 5000 Transactions Per Month Plan 4 Unlimited

Additional Transaction $0.10 Per Transaction

The term of this Agreement shall commence for ONE year from the date UMSIs acceptance. There is a cancellation fee of $200.00. This fee applies solely to cancellation of the Loyalty Agreement. Other cancellation fees maapply as relates to bankcard processing or other additional services. Refer to terms and Conditi ons for further details.

Credit Card Payment

Visa Master Card American Express Discover

Expiration Date: __ __/ __ __ CVV#Card #

I agree to pay according to cardholders agreement Signature ________________________________________________

PleaseStaple

VOIDC

HECK

TTeerrmmss aanndd CCoonnddiittiioonnss

Merchant agrees to pay the fees set forth above. Merchant understands that participation in the Electronic Gift Card and Loyalty CardProgram is governed by the Merchant Processing Agreement and the terms and conditions set forth on the reverse side of this form.

________________________________________________________________ ________________________________________

Merchant Name Signature

______________________________________________ #_______________ _________________________________________

ISO Name Number Signature

UUMMSSII OOffffiicceerr

____________________________________________ ____________________________ ______________Approved By Name Date

Rev. 01

110 6

Top It Off - fantastically frozen yogurt

401 Broad St Ste 105 Chattanooga TN 37402

[email protected] 1

931-242-0964

Chattanooga TN 37406

4 2 3 2 5 2 0 0 0 0 0 4 9 0 0 6

Top It Off

Forrest and Smith Investments

423-475-5192

Zach Smith

4125 Safehaven Ct

05

20

43604 14


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United Merchant Services, Inc.

Electronic Gift Card / Loyalty ProgramTerms and Conditions

Merchant agrees to pay to UMSI the fees set forth on this Enrollment Form in the manner provided on this Enrollment Form.

Merchant acknowledges and agrees that its participation in the UMSA Electronic Gift card / Loyalty program (EGCL Program) aacceptance of electronic gift cards is governed by the Merchant Agreement between Merchant and UMSI. In the event of a conflict betwthe Merchant Agreement and these terms and conditions, these terms and conditions will control.

Merchant acknowledges that there are certain state and federal laws, rules and regulations applicable to the issuance, use and acceptance

gift cards and/or the operation of customer loyalty programs, specifically including, but not limited to, laws applicable to expiration daescheat. Merchant agrees that it has sole responsibility to comply with all such laws, rules, or regulations at all times. Merchant furthagrees to provide assistance to UMSI with respect to compliance with any such laws, rules and regulations as may be applicable to UMwith respect to the EGCL Program.

Merchant acknowledges and agrees that title to all customer data created through the EGCL Program will vest solely in UMSI. Uptermination of the relationship between UMSI and Merchant and/or the EGCL Program, Merchant shall have no rights whatsoever to adata created through the EGCL Program.

UMSI SHALL NOT BE LIABLE FOR INDIRECT, SPECIAL OR CONSEQUENTIAL DAMAGES INCLUDING LOSSES RESULTINFROM DESTRUCTION OR DAMAGE OF RECORDS, LOST DATA OR LOST PROFITS. THE LIMIT OF MONETARY DAMAGAGAINST UMSI UNDER ANY CIRCUMSTANCES SHALL BE THE AMOUNT PAID BY MERCHANT TO UMSI PURSUANT THE EGCL PROGRAM IN THE THIRTY (30) DAYS PRECEDING THE DATE ANY CLAIM AGAINST UMSI AROSE.

UMSI DOES NOT MAKE ANY REPRESENTATIONS OR WARRANTIES, EXPRESS OR IMPLIED, INCLUDING WITHOLIMITATION (A) ANY WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE WITH RESPETO THE EGCL PROGRAM OR ANY ELECTRONIC GIFT CARDS FURNISHED TO MERCHANT HEREUNDER OR (B) ANREPRESENTATION OR WARRANTY WITH RESPECT TO THE COMPLIANCE OF THE EGCL PROGRAM OR THE UISSUANCE OR ACCEPTANCE OF ANY ELECTRONIC GIFT CARDS WITH AND FEDERAL, STATE OR LOCAL LAWS, RULOR REGULATIONS.

UMSI shall not have any liability whatsoever for any lost or stolen electronic gift cards.

All disputes between Merchant and its consumers relating to any electronic gift card or loyalty program transactions shall be settbetween the Merchant and its consumer. Merchant shall indemnify, defend and hold UMSI harmless from and against any and all claimcosts and/or liabilities, including any reasonable attorneys fees and costs incurred by UMSI and arising out of the EGCL Program or tissuance, use or acceptance of electronic gift cards.

In the event Merchant has selected the Automated Clearing House payment option (ACH Option) in the Merchant Agreement, Merchhereby authorizes UMSI or its bank to debit the account identified by Merchant in connection with such ACH Option periodically for afees or other payments due from Merchant to UMSI hereunder.

UMSI will commence billing for the Monthly Web Access Fee and Statement Fee from the date UMSI provides written acceptance aapproval of this Agreement.

The EGCL Program and these Terms and Conditions shall not be subject to termination by Merchant prior to the one year anniversarythe date on which UMSI provided written acceptance and approval of Merchants EGCL account except upon payment of an eartermination fee of $200.00. In the event Merchant elected to receive 100 free gift cards at the time the application for the EGCL Progrwas submitted, any termination prior to the one year anniversary of the date on which such free gift cards were issued shall also be subjto an additional $100.00 early termination fee payable by Merchant to UMSI. UMSI shall have the right in its sole discretion to withholdset-off any termination fees here under from any funds of Merchant then held by UMSI or charge to any account (credit card or otherwi

that Merchant has authorized UMSI to charge fees against any such termination fees. UMSI reserves the right to terminate MerchanEGCL Program at any time for any reason.

These Terms and Conditions and the EGCL Program shall be governed by the laws of the State of New Jersey, without regard to aconflicts of laws principles. Any dispute arising out of or related to these Terms and Conditions and the EGCL Program shall be subjectthe exclusive jurisdiction of the state or federal courts located in the State of New Jersey and Merchant hereby consents to the excluspersonal jurisdiction of such courts over Merchant.

Merchant Initial_____________


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CUSTOMIZED CARD ORDER FORM

Card Design

Customized Selected design from a sample book: _______________________ *Please indicate the sample number

Use DBA company name indicated above on my gift cards Use my company logo on gift cards instead of DBA name

Copy of logo is attached Paper Logo 3.5 Floppy Disk Zip Disk CD Rom E-Mail

Printing Options

Full Color OneSpot Color Printing TwoSpot Color Printing

Card Order

Quantity # of Gift Cards :_________ # of Point Cards :__________

Price Per Card $ ____. ___ ____ 100 FREE Gift Cards* Offer valid for merchants using UMSIs bankcard processing services only.* Merchant agrees to accept all applicable gift card processing fees as stated at right.* If a merchant receives cards and cancelson or before one year from the date cards are issued,UMSI will charge an additional $100.00 cancellation fee.

* Spot color design only

* Customized gift/loyalty card orders must be paid in full before work orders are submitted for processing.* Money orders and credit card payments only. No personal checks accepted.* Logo Set Up Fee is non-refundable. This Agreement is subject to a $200 cancellation fee if termination within oneyear of the date this application is approved by UMSI. See Terms and Conditions on the below of this application.

Shipping & Handling $

Logo Set Up Fee $ 50.00

Total Fee*

Design Proof By

E-Mail : ________________@_____________ Mail Sample Cards actually printed ( The cost is $10.00 per 3 cards

Spot Color Printing Choices

Card Options Color for Lettering and Graphics

White Card Black Card

Silver Pearl Card Gold Pearl Card

White Black Teal Warm Red

Gold Burgundy Green Royal Blue

Silver Process Blue Red

Front

*Please place here what youd like the card to look like.

Back

Card Range # to #

Terms & Conditions

The EGCL(Electronic Gift card / Loyalty)Program and these Terms and Conditions shall not be subject to termination by Merchant prior to the one year anniversary of thedate on which UMSI provided written acceptance and approval of Merchants EGCL account except upon payment of an early-termination fee of $200.00, which UMSIshall have the right to withhold from any funds of Merchant then held by UMSI or charge to any account (credit card or otherwise) that Merchant has authorized UMSI tocharge fees against. In the event Merchant elected to receive 100 free gift cards at the time the application for the EGCL Program was submitted, any termination prior tothe one year anniversary of the date on which such free gift cards were issued shall also be subject to an additional $100.00 early termination fee payable by Merchant andsubject to being withheld by UMSI from any funds of Merchant on deposit with UMSI or charged to any account (credit card or otherwise) that Merchant has authorizedUMSI to charge fees against. UMSI reserves the right to terminate Merchants EGCL at any time.

The Logo Set Up Fee is non-refundable.

The approved design of the colored cards that sent by e-mail as previewed on the monitor screen may be slightly altered from the actual desired results when reproduced onthe print out. UMSI will not issue any refunds or exchanges for these discrepancies.

I agree to accept this Terms & Conditions Signature _____________________________________________________________

1000

0 50

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