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Biller Order Form <br />Matt Braley <br />Cathedral <br />Advanced <br />• • _ _- ® EBPP ❑ Cloud Store ❑ Cloud Pay ® Pay by Text ® IVR ❑ OBD ❑ Kiosk <br />® Visa/MasterCard/Discover ❑American Express ® ACH/EFT <br />Ownership Type: <br />Utility -- - <br />Biller Contacts <br />Legal Name: <br />FCounty of Indian River BCC (spelled out) <br />• <br />FBethany Messersmith <br />Address 1: <br />1801 27th Steel _ <br />Phone Number: <br />772-226-1837 <br />Ext. <br />Address 2: 2: <br />-���- <br />Email Address: <br />bmessersmith@ircgov.com <br />City: <br />Vero Beach <br />State <br />Fl <br />Zip: <br />32960 <br />�i • .. • <br />Bethany Messersmith` <br />Phone# (772) <br />226-185 <br />Fax #: <br />772.770.5318 <br />Phone Number:^� <br />-� <br />Ext. <br />Website URL: <br />hV://www.ircublites.com/ � <br />Email Address: <br />Business Open Date: 1925 <br />mg=tl, <br />Cindy Corrente <br />Federal Tax ID#: <br />11 59-6000674 <br />Phone Number. <br />772.226.1832 <br />Ext. F— <br />Note: Federal Tax ID and Legal Name must match on all documents. <br />Email Address: <br />ccorrente@Ircgov.com <br />Signatory Contact; Bob Solari Title: <br />Board of County Commissioners <br />Phone Number: <br />r772.226-1440 Ext. <br />Email Address: <br />bsolari@ircgov.com <br />_ <br />New Biller Implementation: <br />$ <br />0.00 Paperless Presentment: <br />includes 3 email notifications <br />$ <br />0.00 <br />Per Item <br />Hiller Portal Access: <br />$ <br />6,00 <br />Monthly IC Payment - Credit Card: <br />$ <br />n/a <br />Per Item <br />Additional User(s): <br />$ <br />0,00'-- <br />6Q. <br />Monthly Per User IC Payment - EFT/ACH: <br />$ <br />n/a v <br />F <br />Per Item <br />Online Bank Direct Access: <br />$ <br />0.00 <br />Monthly Online Bank Direct: <br />$ <br />n/a <br />Per Item <br />Invoice Presentment: <br />$ <br />0,00 <br />Monthly EFT/ACH Reject: <br />$ <br />15.00 <br />Per Item <br />Encrypted Reader License <br />Fee: <br />$ <br />0.66 <br />Monthly Charge Back: <br />$ <br />15.66 <br />Per Item <br />r <br />Name of Checking Account {As It appears an check or Sank letter}: <br />Bank <br />Name:-__..__ <br />- �-. _.____.____ <br />Address: <br />— <br />Phone: <br />Depository <br />Routing#: <br />Account#: <br />Your Invoice o ment collections will be electronically de osited into this account. <br />Fees <br />Routing#: <br />Account#: <br />Invoice and poyMent processing fees will be electronicall deducted from this account. 14 <br />