Reso 2021-3185 - Laserfiche WebLink

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FAX to: WEXPAY ENROLLMENT PACKET FAX #: 1. Complete parts A and B. 2. Be sure to sign the form and keep a copy for the Purchasing Entity's emrc5, 3. Fax completed form to: 1-800-516-7536. ACCOUNTA. •• • Account Name: Account Number: 04 Authorized Fleet Contact: Phone No.: Fleet Contact email: Fax No.: B. •' • Complete the below items: Number of Alternative Authorization Instruction cards needed. (WEX recommend at least one per driver usingWEXPay) $ How much spend does the Purchasing Entity anticipate? (Credit line may need to be reviewed) C. TERMS AND CONDITIONS These terms and conditions supplement the WEX' Business Charge Account Agreement (the "Agreement") between the Purchasing Entity and WEX Bank ("Issuer"). The following additional terms and conditions shall be applicable to theiraccount upon their completion and WEX's acceptance of this WEXPayTA° Request form. The Participating Entity's continued use of their account and the product referenced herein constitutes acceptance of these terms and conditions. All capitalized terms shall have the same meaning as in the Agreement, as amended from time to time. Issuer will provide single use virtual MasterCard® Cards for purchases made by the Purchasing Entity only at U.S. merchant locations that do not accept the WEX® Universal Fleet Card. A virtual card is one where there is no plastic issued, only card numbers. Single use virtual cards may be used for purchases one time only. MasterCard International's chargeback rules apply. The Purchasing Entity's MasterCard purchases will appear on their WEX® Universal Fleet invoices. The Purchasing Entity agrees to pay and/or perform, as the case may be, when due all indebtedness, obligations and liabilities of each MasterCard account established pursuant to this request of every kind, nature and character whatsoever, including, without limitation, (i) all amounts payable under each account, (ii) all obligations, covenants, and agreements contained herein. Purchases are due and payable in full by the Purchasing Entity upon billing in accordance with the terms of credit Agreement with Issuer. In the event the Purchasing Entity currently participates in any rebate or discount program offered by Issuerfor the WEX® Universal Fleet card purchases, their purchases made using WEXPaylm will apply to such rebate or discount provided they meet any conditions of such rebate or discount program. Issuer reserve the right to modify or terminate WEXPoylm at any time upon 15 days notice to the Purchasing Entity, Issuer will provide WEXPayTM Alternative Authorization Instruction card for the Purchasing Entity's distribution to their drivers. When their drivers present the Alternative Authorization Instruction card to a merchant, the merchant may, at the merchant's discretion and their own risk, either complete the work or contact Issuer to validate the Purchasing Entity's account. Issuer will not pre -authorize the transaction if the work has not been completed but WEX will provide the merchant with a reference number so that they may contact WEX upon completion of the work for payment authorization. In order to validate the Purchasing Entity's account WEX must preview their account information and this may affect their control limits, if the Purchasing Entity has set them on their account, including the number of transactions available per day and the total daily dollar limits. The Purchasing Entity should check their current controls (if any) to be certain that they have sufficient limits for these transactions. If they make any changes or set any control limits, the Purchasing Entity agrees that WEX is authorized to rely on such changes and WEX will not be responsible for any losses resulting from such changes. The Purchasing Entity will also agree that WEX will not be liable to the Purchasing Entity for any loss, liability or damages they suffer which arise from, are related to, or are in any way connected with any fraud control or purchase restrictions such as Authorization Controls which WEX implements from time to time. WEX is not liable on account of any merchant's refusal to honor the MasterCard or to participate in the WEXPayTm process, regardless of the reason. The person signing this Out -of -Network Authorization Process Request represents and warrants that he/she is authorized to execute this Request. X Authorized Fleet Contact Signature: Date: Print Name: Title: MASTER AGREEMENT No. 00819 — FLEET CARD SERVICES PAGE 66 OF 138