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3_ Diversion $'RRng ofAcrrrurnsr <br />YES NO <br />a. ❑ 2i Central Wil/Central Pay of Charges (Diversion Billing/Central Pay of Annual <br />Card Fees. County shall be fully responsible ler all liability and p;i3ments on behalf <br />ofthe Accounts issued under the Diversion Bill including Annual Card Fecs. <br />C. PAVMIENT OPTIONS l C'btck the Uesiral C)plion hhdicnted Ilclorc): <br />1. Cenrraffy RfRerL"Q#versfnn R####rrg oJ.•l ccoernrs: <br />YES NO <br />a. ❑ ic1 County Payment by Automated Clearing (louse ("ACli") . On each <br />consolidated monthly Malenicrit a date shall he provided us the "Closing, Date," which is <br />the last day in the period covered by the conxnlidalcd monthly statement. County <br />shall pay all Charges on the consolidated mnntbh statements sent to County within <br />14 calendar days aver the Closing hale of e:Ich such statement +ria AC[ l transaction from <br />County's dcsignaled Demand Deposit Account. Cuunly authori/es FirS1 Unroll <br />to detail Counlys Demand Deposit Account or any other accianit with First Ihhinn <br />designaled below by County. for any payments due under this Account Agreement <br />or Service Schedule(s). Cbmriy further certilies that County holds legitimate <br />o;vnership ofthis account and pre -authorises this periodic dchit as part of its rights under <br />said owaership of the deposit account. <br />Demand deposit Account Number: <br />Name of Financial Institution: <br />fronsit and (touting Number: <br />YES NO <br />b. $1 O County Payment by Check. Cin cath consolidated monthly stLite rue nl a date shut <br />be provided ars Ibc "C'lusing Daty� ` %%high is the lash Jay in thr period covered by the <br />consolidated monthly srslealcnl, County shall pay 1111 (`barges on the consolidated <br />monthly sl:hlemenls sent to County within 15 calendar da)s Atcr ILC C'Imirlp Date of <br />cuelh such statement via check. <br />W DESIGNATED COUNTY PROGRAM MIANAGER: <br />Name: Jzwea E. Qlarxile—r <br />Title: C otmty AdAb intratoDr <br />Address: 1840 25th Street <br />City: Vero Reach State: FL Zip: 32960 <br />Telephone H: (561)567-8000 ext.4O8 Fax 11: <br />17. DELIVERY INSTRUCTIONS; <br />1. C".onsolfihued Monthly Statetaents shall he delivered to the personldcliortmem design awd heltm <br />Name: Arzclln Ilalfield <br />Title: Account,, Payable Stopervistar <br />Deportment: Accounting Department <br />Address: 1840 23"' %ircet <br />INDIAN <br />Veritas I I1(9199 <br />Last Rev. 516A)7 <br />