8 months ago

Divvy Signup Application 3_30_2018 (2) 2

Divvy Signup Application 3_30_2018 (2)

! Payables Account Application (New Customers-WEX Credit) Please read the following information before completing this form. Company requests additional accounts on the WEX Bank (“Issuer”) MasterCard® Card program. By signing below, you acknowledge and certify that: 1) all of the information below is complete and accurate and you authorize Issuer to check with credit reporting agencies, credit references and other sources we deem appropriate in investigating the information given; 2) you agree that the terms of use of the account and/or card(s) shall be governed by the WEX Bank MasterCard® Card Program Terms and Conditions (the “Agreement”); 3) the person signing below is either a proprietor, general partner or officer of the company with authority to enter into the Agreement; 4) if requested, you shall provide financial statements for the last two (2) years; 5) Issuer may review the personal credit of the undersigned if this application is for a partnership or a proprietorship to make a credit decision and a consumer report of the undersigned may be obtained. Direct inquiries of employers and businesses where the undersigned maintains accounts may also be made; and 6) in the event you do not meet your obligations under the Agreement, Issuer may report your liability for and the status of the account to credit bureaus and others who may lawfully receive such information. In addition, Company understands that the Issuer may require a guarantee, letter of credit, surety bond, or other acceptable form of security in order for Company to receive credit. Company also understands that credit on this Account, once approved, will be extended by Issuer and there is no binding contract until the Issuer approves Company’s application for credit. Program Operator/Sponsor: Divvy Pay, Inc. Initial Term: This Agreement shall be effective for an Initial Term of 1 year. The Agreement is subject to automatic renewal as set forth below. Select the program services in which you are interested: Subject to the terms of your WEX Bank MasterCard® Card Program Terms and Conditions, and acceptance of your application by Issuer, Issuer shall arrange for issuance and the establishment of an account using our virtual card web based solution which allows you to request single use card numbers through our web services to use to pay your suppliers and vendors that accept MasterCard as payment. Select Service and Billing Terms: Billing and financial terms are subject to final credit approval by Issuer. All payments due upon receipt by the payment due date provided on your billing statement which is based on final credit approval by Issuer (subject to a five (5) day grace period for billing cycles of Weekly or longer). WEX ONE CARD (Purchasing, Travel and Fuel) Billing cycle: Expense Reporting: Interface to Divvy Payment Method: Debit ACH – enrollment in autopay program (requires credit approval) Credit ACH – Company will pre-pay funds Notes: (1) Company will remit all funds (in full) due to Issuer using the remittance method selected above and defined as follows: (a) “Debit ACH” refers to a debit initiated by Issuer (via Automated Clearing House or other electronic means) against an account designated by Company; (b) “Credit ACH” refers to a credit initiated by Company, at its own expense, (via Automated Clearing House or other electronic means) to an account designated by Issuer. (2) Company is required to send or transmit its Issuer Account Number with each payment. (3) Issuer shall apply all payments beginning with the oldest invoiced amounts through the most recently invoiced amounts. (4) If a payment is returned or rejected, Issuer, at its sole discretion, may reduce or cancel Company’s available credit limit, assess a return payment fee, and reserves the right to modify the remittance method and frequency. ACCOUNT INACTIVITY: If your account is inactive for a period of 180 days, Issuer may close your account and terminate this Agreement without further notice. INFORMATION SHARING DISCLOSURE: Issuer or its affiliates may, to the extent allowed by law, share information disclosed by or generated as a result of this application with each other, and with merchants accepting the card as well as MasterCard International. In addition, information regarding your transactions may be provided to accepting merchants or their service providers to facilitate discounts or other promotional campaigns of interest to you. Executive Sponsor /Authorized Representative: ____________________________ Title:_________________ Print Name: ____________ Phone:____________ _ Issuer complies with federal law which requires all financial institutions to obtain, verify, and record information that identifies each company or person who opens an account. What this means for you: when you open an account, we will ask for your name, address, date of birth, and other information that will allow us to identify Company and/or any authorized users. We may also ask to see documentation, including driver’s license(s) or identifying documents for Company. Additional terms, conditions, and summary of fees begin on page 4

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