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CARD ACCEPTANCE(PLEASE CHECKEACH CA RI)YOU WISH TO ACCEPT.) 1 PRICING CATEGORY . <br /> ill ALL VISA/MASTERCARDIAMEX/UNIONPAY/DISCOVER N"ir ad IS 0 RETAIL INTERN <br /> ❑MO/TO/ ❑SUPERMARKET <br /> 0 VISA CREDITO VISA DEBIT 13 MASTERCARDCREOT❑MASTERCARD DEBIT❑DISCOVER 0 UNIONPAY 0 AMEX 0 LODGING 0 RESTAURANT ❑ARU <br /> PRICINGINFORMATION U FEES <br /> RATES ARE FOR ALL CARD ACCEPTANCE TYPES SELECTED. ALL CARD BRAND ASSESSMENTS WILL BE PASSED THROUGH ATCOST. APPLICATION FEE $ <br /> ❑TIERED VISA MASTERCARD DISCOVER' UNIONPAY AMERICAN EXPRESS INSTALLATION/TRAINING $ <br /> OR <br /> 0 ENHANCED IC RATE(%)+PER ITEM($) RATE(%)+PER ITEM($) RATE(%)+PER ITEM($) RATE(%)+PER ITEM($) RATE(%)+PER ITEM RETURN ITEM FEEINSF $25.08 <br /> PLUS (PER OCCUR) <br /> QUALIFIED -%+ $— _%+ $— _%+$- -%+ $__ -%+ $__ ACCOUNT MAINTENANCE $ <br /> MID QUALIFIED %+ $ -%+ $- -%+ $ %+ $ -%+ $ CHARGEBACK(PER OCCUR) $15.01 <br /> NON QUALIFIED %+ $ %+ $ %+ $ %+ $ %+ $ ANNUAL FEE <br /> START DATE $ <br /> OTHER TIER 0 CHECK CARD(T-opt/EJC-req) 0 SPRMQ(T-0piE)C-NA) 0 QPS/SMALL TKT(T-optiEIC-NA) <br /> MONTHLY MINIMJM $20 <br /> _%+ $- %+ $ %+ $ %+ $ -%+ $_ <br /> REWARDS TIERTani %+, $- %+ $ %+ $ %+ $ %+ $_ MONTHLY SERVCE FEE $ <br /> (T-opt/EIC-rev 10.0 <br /> COMMERCIAL OTHER: $ <br /> CARD TIER -%+ $- %+ $ %+ $ %+ $ -%+ $- <br /> (T-opt iEIC-req) OTHER: $ <br /> PASS THRU:1C Plus VISA MASTERCARD DISCOVER° UNIONPAY AMERICAN EXPRESS OTHER: • $ <br /> • IC PLus <br /> OR ❑ICDIFF RATE(%)+PER ITEM($) RATE(%)+PER ITEM($) RATE(%)+PER ITEM($) RATE(%)+PER ITEM($) RATE(%)+PER ITEM($) OTHER: SerVICeFee 6916 $9,95 <br /> MARKUP 0.000 %+ $ 0.000 %+ $ 0.000%+ $ 0.000%+ $ 0.350%+ $0.20 STATEMENT: PAPE❑ ELECTRRONIC OR <br /> ❑ <br /> VISA MASTERCARD DISCOVER° UNIONPAY AMERICAN EXPRESS PRICING PROGRAM <br /> CI DIFFERENTIAL MONETARY PROGRAM <br /> RATE(%)+pER ITEM($) RATE(%)+PER ITEM($) RATE(%)+PER ITEM($) RATE(%)+pER ITEM($) RATE(%)+PER ITEM($) <br /> QUALIFIED -%+ $ %+ $ %+ $ %+ $ %+ $ AUTH PROGRAM <br /> NON QUALIFIED %+ $ %+ $ %+ $ %+ $ %+ $ EOUIPLENT: 59999 <br /> 'Discover indudes JCB,DI,PAY PAL PAYMENTDEVICE MISCELLANEOUS: 59999 <br /> AUTHORIZATIONS (PER OCCURRENCE) , SAFE T SERVICES BUNDLE <br /> VISA $ .20 UNIONPAY $ 0.20 VOICE AUTH TOUCH TONE $ U.b I 0 ASSOC COMPLIANCE <br /> MASTERCARD $0.20 WEX $ VOICE-OPERATOR ASSISTED $ 0,60 0 SAFE TSILVER <br /> DISCOVER $0,20 DIAL COMMUNICATION $ VOICE-WITHAVS $ 0.60 ❑SAFE TGOLD $ <br /> AMEX $0.20 AVS: $ VOICE-BANK REFERRAL $ 0.60RPer D $ apply,sea mnnaas and°rrttyhe fees ' <br /> rapresentahonandaedlbeliono) . <br /> PIN DEBIT T <br /> MONETARY:0 PASSTHROUGH (ICD IF)❑PASSTHROUGH(ICPLS)0 SURCHARGE(FLAT RATE) AUTH:TJ PASSTHROUGH(INTERCHANGE PLUS MARKUP)-O FIXED(FLAT RATE) <br /> APPLY RATE TO ALL NETWORKS:RATE(%)+PER ITEM($) %+$ AUTH$ <br /> - <br /> IIIUMMIIMUIREGOILIMII MAESTRO- o+ •_AUTH-- UPDBT-%+ $_AUTH$_ ACCEL-°/a+$_ AUTH$ <br /> Tr L • NETS=.,+ AUTH <br /> i STAR %+$ AUTH$_ <br /> OTHER CARD TYPES EXISTING <br /> AMEX SE#(TODIGITS): PER AUTH: $ I EBT SE#(7D(GITS): PER AUTH: $ II 0 VAEX(ADDITIONAL PAPERWORKREQ) <br /> OTHER SE#: PERAUTH: $ I OTHER SE it: PERAUTH: $ 0 VOYAGER(ADDITIONAL PAPERWORKREQ) <br /> I POINTOF SALE(EQUIPMENTOR SOFTWARE) <br /> NETWOR 11 ELAVON O OTHER I #OFTIDs: I 0 A THIRD PARTY INTEGRATOR Ni LL BE USED FOR IMPLHMENTATDN: I COMMUNICATION METHOD(IP DEFAULT): 0 DIAL <br /> VAR SERVICE PROVIDER(HOSTED): VAR(DISTRIBUTED): VENDOR: PRODUCT: VERSION: <br /> QTY POS DESCRIPTION ITEM CODE PRICE PER UNIT MONTHLY FEE PER UNT ANNUAL FEE PER UNT PER AUTH PURCHASE EXISTING EXCHANGE <br /> $ $ $ $ 0 ❑ ❑ <br /> $ $ $ $ 0 0 0 <br /> $ $ $ $ 0 0 ❑ <br /> $ $ $ $ 0 0 ❑ <br /> $ $ $ $ 0 El 0 <br /> $ $ $ $ 0 0 0 <br /> ALL APPLICABLE STATE AND ICCALTAXES WLL BE APPLIED U SA TAX EXEMPT(ACDRIONAL DOCUMENTATION REQUIRED) <br /> U SATURDAY DELIVERY U NEXT DAY AIR U 7'"DAY AIR I ELAVON BILLS ONETIME FEES <br /> Eleven endMenterhava no msponsbiBy br,and steel ham no(abilyto Conpanyir mnredim wilt,enyhardtiam or software,rr anymisted sambas,Conpanymcaives under a died ageanant(im(rdngany me,wananlyorerd+rser(cense <br /> agreement)belweer Conpany arida third•, ,indrdiig my Vdre Added&evbe:men:Eleven mlbdsfees crnlhorarmuntsfrom Conpery with rasped to arch hardware,mtbvam or services. <br /> DESCRIPTION SETUP FEE ANNUAL FEE MONTHLY FEE PERAUTH FEE <br /> ADDITIONAL POS SERVICES: $ $ $ $ <br /> $ $ $ $ <br /> I TERMINAL PROGRAMNG INS1RUCSONS (DO NOT USE FOR CONVERGE-THIS INFORMATION IS COVERED DURING TRAINING) <br /> D RE-1:411_0U10 CLOSE DEFAULT) U QUICK CLOSE ❑ STORE AND FORWARD b NOSIGNATURE ❑ CONTACT LESS(+NO SIGNATURE) <br /> CI RESTAURANT(QUICK CLOSE DEFALL1) ❑ TIP FUNCTION CASHER ❑ FINE DINING 0 TAB FUNCTION <br /> 0 CARD NOTi $ENT(AU O CLOSE DEFAULT) ❑ QUICK CLOSE 1 0 LODGNG(QUICK CLOSE DEFAULT) ❑ QUICK STAY <br /> OUST PROMPTS: D Totuo.�L AuToCLosE(Rn,NC/TO)-Ton ZONE 0 CAS.BACK PN Dear(Rn.):S Ow) D Cusroc FOOTER:- <br /> ( NPn00rrn°DULDRERLTNL Dat 0 NOTr Esr 0 NO SERVE PRo.mr REX 0 CLERK PROMPT(RTL)13 REMovE SECURITY PROMPta <br /> ( MIPROW£RAtE$1 (R ) (REX) (FORM RmUa ED) TmFUNCTgN WMEA (RTL)0 TP FUNCTION Comes(RTL) <br /> ININ (DEF/CULT=NOTRAI NG): 0 TRAINING I PHONE INFORMATION: ACCESS N: CONTACT NAME: CONTACT PHONE/1: <br /> LOOki-Initials j 3 USA-MSP-ELV-0716 <br />