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hvoicle-Clould" <br /> Biller Order Form <br /> Invoice Parameters <br /> 7/5/2016 <br /> Invoicing Parameters sheet must be completed for each invoice type. <br /> Advanced won-Submitter (Chose) <br /> ®Visa 0 MasterCard M Discover DAmex ZIEFT/ACH <br /> NEBPP E]Cloucl Store 0 Cloud Pay 0 08D 0 IVR OKiosk <br /> U_ <br /> Billing Frequency: Monthly Number of Bills: <br /> r 501-000 vu <br /> Number of Cycles: Number of Installments: <br /> Weekly N/A <br /> Average Invoice Amount: $58 Highest Invoice Amount—*. F, $125,000 <br /> Billing Months (please select the applicable months below): <br /> OJan OFeb DMar DApr DMay DJun 0 Jul 0 Aug 0 Sept 00ct 0 Nov ❑0 Dec CK All <br /> 7 <br /> Z I St 10th 0 11th-20th 0 21 St–31 It <br /> 0 Biller 0 Template 0 Bill Print Vendor (please complete below) <br /> L <br /> - .­j�!� 1 407.454.1633 <br /> ICATHEDRAL <br /> Lori Forester <br /> Card Readers: Ipad — QTY 7 Provided by: 0 Sales Rep 0 Operations <br /> Per Unit Price: 15 Shipping Address: <br /> Monthly (if different than location <br /> Total Due: 000 address) <br /> 71 <br /> • % <br /> ItemPaid by payer tr Item Paid by Biller(Non-Submitter) <br /> 0 Credit Card Credit Interchange,fees,dues assessments+ <br /> F [—Minimum -I..- — — <br /> %with$ Card: Authorization + F %BP <br /> ❑ EFT/ACH: per item 0 EFT/ACH: <br /> per item <br /> 0 Flex Pay ACH: per item 0 Flex Pay ACH: per item <br /> E <br /> Item Paidk" ZZ.f <br /> Item Mid hv Biller <br /> El Credit Card: 0 Credit Interchange,fees,dues assessments+ <br /> with$1 Minimum <br /> "iihOU'lViSo Acceptance) Card: Authorization F0.20 + 0.42 %BP <br /> ❑ EFT/ACH: Per item EFT/ACH: 6.35 Per Item <br /> F <br /> • Credit Card Service Fee: $ Max Cap for Credit Cards: <br /> • EFT/ACH: Service Fee: $ _Tff Paid by payer _70 Paid by Biller <br /> n_ <br /> REP RMS.-NERM-NUM <br /> El Paid by payer Service Fee + Paid by Biller 0.00 per item surcharge <br /> ' 74 <br /> IVR provided through existing provider, Invoice Cloud just acting as merchant processor <br /> 142 <br />