Merchant Agreement Renewal Application

MERCHANT AGREEMENT RENEWAL APPLICATION

Name of Business ______

Business Address (Include City and Zip Code)

Name of Store Manager

Business Phone Number Business FAX Number

Corporate Owner Name (The entity that owns the above business)

Corporate Owner Address Corporate Phone Number (Include City and Zip Code)

Name of State Type of Corporate Entity Where business was incorporated (Examples: Sub corp., C Corp.)

Name and Corporate Title of person signing legal agreement

Number of years in business Years business has been at this location

Type or Description of Business Alcohol sold on premises (Yes/No) (Examples: Fast Food, Convenience)

Reimbursement Address (Where you want checks mailed)

Return this form to: Allison Ayo Colonel Card Nicholls State University P. O. Box 2045 Thibodaux, LA 70310 COLONEL CARD AGREEMENT

This Agreement is hereby made between Nicholls State University, Thibodaux, LA, herein referred to as NSU and , having a principal place of business at , herein referred to as MERCHANT, hereto agree and covenant as follows:

PURPOSE

For the convenience of the students, faculty, and staff, NSU agrees to contract with a Merchant for the purpose of administering the Colonel Card program at Merchant’s place of business. The Colonel Card is offered to all NSU students, faculty, and staff.

IN STORE

Merchant will verify the customer’s ID and deduct the amount of the purchase from the customer’s account by scanning the patron’s Colonel Card through VX570 merchant terminal. Merchant will verify that the student, faculty, or staff member has their own ID card. All revenues due Merchant will be computed on the dollar amount scanned through the VX570 merchant terminal. Merchant will not allow ID card holders to receive cash back for any reason. All individuals requesting a refund for a purchase that was paid for with the Colonel Card, must have the entire amount refunded credited to the ID holder’s account. Any merchant who refunds cash to a card user will be removed from the Colonel Card program.

Merchant will verify by visual inspection that the person in the possession of the Colonel Card is the person pictured in the photo on that card prior to accepting a Colonel Card payment. Merchant acknowledges and agrees that NSU will not be liable for payment to Merchant for any Colonel Card transactions consummated by merchant on a lost or stolen Colonel Card, it being expressly acknowledged and agreed by merchant that merchant shall be solely responsible for verifying the validity of any Colonel Card presented to merchant in payment for merchant’s goods.

Merchant shall make a receipt available to the Colonel Card customer at the time the cardholder initiates a Colonel Card transaction with merchant.

Merchant must be in compliance with all state laws that apply to the sale of alcohol, tobacco, and obscene material. Merchant is responsible for verifying the age on any purchases made for alcohol, tobacco, or obscene material.

FINANCIAL

Merchant is provided ( ) VX570 merchant terminal and ( ) printer after payment is received from Merchant to lease equipment from university. Attached is the quote for the VX570 merchant terminal and printer. The Merchant agrees to pay the cost of the VX570 merchant terminal (s) and printer(s) as well as a onetime set up cost of $100.00. This fee must be paid before the terminal set-up date. During the first year of the contract NSU agrees to pay the merchant 95% of gross sales verified on the monthly computer generated printouts supplied to merchant by NSU. After year one of the contract has ended and Merchant enters into year two contract NSU agrees to pay the Merchant 94% of gross sales. After year two has ended NSU agrees to pay Merchant 93% of gross sales. Merchant agrees to remit all applicable sales tax to the State of Louisiana. Merchant also agrees to comply with all federal, state, and local codes. Merchant shall comply with all government health codes regarding services performed under this agreement. Merchant shall provide proof of possessing all state and local licenses and permits necessary to conduct business.

NSU will furnish merchant with monthly reports indicating net transaction totals and customer counts. NSU will remit to merchant on a monthly basis all monies due merchant. NSU will process payment no later than fifteen (15) University working days after month end. Notwithstanding, the foregoing, NSU shall not be responsible or obligated to pay merchant for any Colonel Card transactions which are prohibited hereunder, or which are processed by merchant on a stolen or invalid Colonel Card.

INDEMNIFICATION

Merchant shall indemnify and save and hold harmless, NSU, the State of Louisiana, Board of Supervisors, offers, agents, and employees, from and against any claims of loss, liability, injury, or damage to persons or property. Indemnification shall include expenses, including but not limited to reasonable attorney fees, for injury, death, loss or damage of whatever nature to any person, property or any other claims by merchant or officers, employees, agents, customers, licensees, invites, or any other person, form or corporation resulting from the use of and participation in the Colonel Card Program.

OFF LINE TRANSACTIONS

The equipment will not accept the Colonel Card when offline. If at any time, the Colonel Card equipment at merchant’s location indicates an off-line status, Merchant shall refer to the directions in the manual provided by ID Card Operations to bring the equipment on line. If merchant continues to accept Colonel Card payments while in an “off-line” mode the University shall not make payment for any transaction which is later denied by ID Card Operations due to insufficient funds or because the card was invalid. In no event shall NSU be liable for any losses, damages, claims, cost or expenses suffered or incurred by merchant due to failure of the Colonel Card equipment or verification system to operate properly. Notify ID Card Operations at (985) 448-4967 or email [email protected] for other equipment problems.

EQUIPMENT REQUIREMENTS

Merchant leases a VX570 merchant terminal and printer from NSU. Merchant is responsible for securing the VX570 merchant terminal and printer. Loss or damage to the VX570 merchant terminal ands or printer will result in the Merchant being charged to repair or replace the VX570 merchant terminal and or printer at the current quoted price, including shipping. All networking and internet service charges and installation fees will be at the expense of merchant. An Ethernet (broadband) internet connection and a dedicated IP address provided by the Merchants Internet service provider are required.

ADVERTISING

Merchant agrees that it shall not advertise any connection with NSU nor use NSU’s name, symbol or any other identifying marks or property nor make any representations, either expressed or implied, as to NSU’s promotion or endorsement of merchant or merchant’s business, unless it has received written permission from NSU. GOVERNING LAWS

This agreement shall be governed by and in accordance with the laws of the State of Louisiana. Any legal action arising pursuant to this agreement shall be brought in a court of competent jurisdiction in the State of Louisiana.

The terms of this contract shall be for a term no more than one year beginning on the effective date , and ending . Merchant shall be notified sixty (60) days prior to the end of the contract period of NSU’s intent to renew or terminate the contract. Failure by merchant to perform under this contract shall be cause for cancellation of the contract by NSU. Either party may cancel this contract at any time, and for any reason, with a sixty (60) days written notice. In the event either party of this agreement exercises its rights to terminate this agreement as herein provided, as of the date of termination, neither party shall have any further obligation or liability hereunder. The VX570 merchant terminal and printer must be returned to NSU if the contract is terminated. Failure to do so will result in payment of the value of the VX570 merchant terminal and printer at time of termination of contract.

I understand and agree to the terms of this contract.

Signature (Merchant) Signature (NSU)

Date ______Date ______

Title______Title______