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MERCHANT PROCESSING APPLICATION AND AGREEMENT (Page2of 3)
<br />DBA Name: Indian River County
<br />Loc. 1
<br />of
<br />TD2008ia
<br />(6) EQUIPMEN • ETAILS
<br />MICEIM5M
<br />Rental • Purchase
<br />Customer -Owned
<br />Lease*
<br />-
<br />QTY
<br />IPType
<br />Equipment T e
<br />Industry Type
<br />Model Code and Name
<br />Unit Price
<br />w/o Tax
<br />and S&H
<br />For Customer -Owned
<br />Equipment
<br />Track/Version/Serial #
<br />Debit Fees*
<br />❑
<br />%
<br />(Applies to Signature, PIN and PINIess Debit)
<br />Sales/Return Transaction Fee (124,125) $
<br />Unbundled Debit Transaction Fee (018) $ .15
<br />$
<br />*Plus applicable PIN Debit Network fees.
<br />Miscellaneous Fees* (If Applicable)
<br />D
<br />TransArmor Data Protection Tokenization & Encryption
<br />(per authorization) (12E,12G, 121) $ .01
<br />%
<br />%
<br />%
<br />PCI Non -Compliance Fee (42G) $ 20.00
<br />$
<br />Monthly Account Minimum Fee (954) $ 15.00
<br />Paper Statement Fee (240) $ 0
<br />(Default is free electronic statement)
<br />Chargeback Fee (205, 725, 20L) $ 25.00
<br />❑,
<br />Batch Settlement Fee. (227) $ 0.19
<br />Monthly Funding Advantage (158) 0.00
<br />AVS (405, 406, 407, 408, 07A, 078, 07C, 069, 079) $ 0.01
<br />$
<br />MasterCard/Visa/Discover Network Access Fee (505, 504, 526) $ 0.0195
<br />MasterCard License Volume Fee (818) 0.0075
<br />MasterCard Cross Border Fee (605, 606) 0.60
<br />0
<br />American Express Authorization Fee (IOP) $ .21
<br />EBT (18E, 181, 02X, 18H) $
<br />Other: $
<br />$
<br />*You must reimburse us for all obligations of any kind that a Card/Payments
<br />Organization imposes on us in connection with your acceptance of its Card types,
<br />In connection with the transactions processed under your MID, or as a result of
<br />your actions or failures to act, including but not limited to the fees and costs
<br />described in the Interchange Qualification Matrix and American Express OptBlue®
<br />Guide (both available at www.businesstrack.com). 34
<br />Shipping and Handling: Standard $ 20.00 Overnight $ 50.00 II Enable EMV
<br />*See Equipment Lease Agreement for the Terms and Conditions governing your leased equipment.
<br />(7) FEE SCHEDULE
<br />Product Subscriptions (Monthly)
<br />Clover Services (Per Device)*
<br />Clover Insights (Insightics Solution)
<br />(2CS) $
<br />(49M) $
<br />*Charges for Clover Services may appear on your monthly statement or may be
<br />billed through the Clover App Market, depending on the device.
<br />Mobile Payments Solution (Clover Go)
<br />Mobile Payments Monthly Fee (Per Terminal ID)
<br />(32Y) $
<br />eCommerce/Wireless Solutions
<br />Payeezy Monthly Fee (40A) $
<br />Payeezy Authorization Fee (OFC) $
<br />Clover Online Store (2D9) $
<br />Global ePricing MC/Visa Service Fee (897, 898)
<br />Third Party Internet Set -Up Fee (30R) $
<br />Third Party Internet Authorization Fee (03R, 04R, 061, 071, 435) $
<br />Third Party Internet Service Fee (394) $
<br />Wireless Access Fee (Per Device) (60J) $
<br />Petroleum Services
<br />Datawire Micronode ❑ Yes ❑ No Datawire Monthly Fee (354)
<br />Voyager
<br />WEX
<br />Authorization Fee (0D0, OD1, ODV) $
<br />Sales/Credit Discount (766, 767)
<br />Full Service Authorization Fee (004) $
<br />Sales/Credit Discount (840, 841, 842, 843)
<br />Chargeback Fee (29H) $
<br />Retrieval Fee (291) $
<br />Non -Full Service
<br />Authorization Fee (OBO, 0131, OBV) $
<br />Start -Up Fees
<br />Application Fee (Non -Refundable) (321) $ 82
<br />Reprogramming Fee (31A) $ 0
<br />Debit Set -Up Fee (31 B) $ 0
<br />Miscellaneous Fee (31J) $ 0
<br />*Equipment Purchase (ACH) $
<br />Other: ( ) $
<br />Total Amount $ w/o tax
<br />*Plus applicable State/City/Local sales tax.
<br />Debit Fees*
<br />Bundled Debit Discount Rate (120)
<br />%
<br />(Applies to Signature, PIN and PINIess Debit)
<br />Sales/Return Transaction Fee (124,125) $
<br />Unbundled Debit Transaction Fee (018) $ .15
<br />(Applies to PIN Debit Only)
<br />*Plus applicable PIN Debit Network fees.
<br />Miscellaneous Fees* (If Applicable)
<br />TransArmor Data Protection Tokenization & Encryption
<br />(per authorization) (12E,12G, 121) $ .01
<br />%
<br />%
<br />%
<br />PCI Non -Compliance Fee (42G) $ 20.00
<br />Monthly Service Charge (329) $ 11.00
<br />Monthly Account Minimum Fee (954) $ 15.00
<br />Paper Statement Fee (240) $ 0
<br />(Default is free electronic statement)
<br />Chargeback Fee (205, 725, 20L) $ 25.00
<br />ACH Reject Fee (401) $ 35.00
<br />Batch Settlement Fee. (227) $ 0.19
<br />Monthly Funding Advantage (158) 0.00
<br />AVS (405, 406, 407, 408, 07A, 078, 07C, 069, 079) $ 0.01
<br />Voice Authorization (10B, 10E, 10K, 100) $ 1.25
<br />MasterCard/Visa/Discover Network Access Fee (505, 504, 526) $ 0.0195
<br />MasterCard License Volume Fee (818) 0.0075
<br />MasterCard Cross Border Fee (605, 606) 0.60
<br />Visa Int'I Service Fee USD (22A) 0.80 % Non -USD (22Z) 1.57
<br />American Express Authorization Fee (IOP) $ .21
<br />EBT (18E, 181, 02X, 18H) $
<br />Other: $
<br />*You must reimburse us for all obligations of any kind that a Card/Payments
<br />Organization imposes on us in connection with your acceptance of its Card types,
<br />In connection with the transactions processed under your MID, or as a result of
<br />your actions or failures to act, including but not limited to the fees and costs
<br />described in the Interchange Qualification Matrix and American Express OptBlue®
<br />Guide (both available at www.businesstrack.com). 34
<br />May 2018 Manual MPA - CAP # 48360
<br />
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