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Contract 2282
2282 ~- - Netwnrkrw !f you have any problems or questions when filling out this form, please call us at 1.800.929.0228 ore-mail info@atmnetwork.net Customer ID 10749 gren Rd. E. Minnetonka, MN 55343 1-800-929-022$ Fax: 877.928.6638 ~ T PURCHSE, LEASE OR PRCCESS[NG a - ~ =--r .t ~ ~ ` ~ • Business type (check one} ^ Proprietorship ^ Carp. ^ 5-corp. ^ Partnership Business name ~` _! Principal #i Are you a U.5 citizen? ^ Yes ^ No ^ Nonprofit ~,„ Munici al Cor oration--No Private Ownershi Title Social Security # Ownership City of Columbia Heights _ ~;` _ DBA name ^ Check here if same as above ° Residence sfreet address ^ Rent ^ Own Date of birth _Top Valu I -_ - ~° __- Federal Tax tD # (9 dtt~rts) Incorporation data SIC coda n ~ City .State ZIP code ~~~~~~~i~~~~~r~ 3-14-1898 t `~ t ocation street address (cannot be a P.O. box} 4950 Central Avenue NE _ _ _ city State ZIP Dods __C~lt~ia 1-Teig hts _ _.MN __ 55421__. Phone Pax 763-706-3$19 _ 763-706-3821 Contact ___ Contact E-mail Larry SCOttC T c ++ . L~rl y~ ~.J I.L/Ll ~ ~ ~ t, t,+,. 1+1.1~V1Ullll~la'11et C~jltl,J.11111. L!J Mailing street address ^ Check here if same as above . 4950 Central A venue NE _ __ --`- C#Y State ZIP code CoPumbia Heigh ts ~ 55421 Phone _ Fax ---- -- _~ -~_ Principal #2 (if applicable} Are you a U S. citizen? ^ Yes ^ hJo Tine Social Security # Ownership Residence street address C7 Rent ^ Own Date at birth Gity Phone ~~ ~__..w,~.-®.y...~_.g__a _..~,._~ - ~ ~~ y_~.~. .a~?~ v.. _._n sue. h _ .:;S,i~. ~ ® m ~ Open Close MONDAY - ^ Closed ^ Open 24 hours ~ ~M ~ ~ TUESDAY ^ Closed ^ Open 24 hours ~ Al~/I 1 O ~~ WEDNESDAY ^ Glosed ^ Open 24 hours 9 A 1 ~ Pn THURSDAY ^ Closed ^ Cpen 24 hours 9 I ~ P~ FRIDAY ^ Closed ^ Ooen 24 hours 9 ~! 1 d P11 SATURDAY ^ Closed ^ Open 24 hours ~ 1 Q P~ SUNDAY ^ Closed ^ Open 24 hours Form PLA-Fi-V7 5 January 2010 ~. h' r„ N: _; ~j~~ Open Close MONDAY ^ Closed ^ Open 24 hours ~ ~~ P ®Py TUESDAY ^ Closed ^ Open 24 hours (~ AM 1 ~ P WEDNESDAY -^ Glosed ^ Open 24 hours } ISM 1 ~ P THURSDAY ^ Closed ^ 6pen 24 flours y AM IU P FRIDAY ^ Closed ^ Open 24 hours 9 AM I D P SATURDAY ^ Closed ^ Open 24 hours 9 1~ PN SUNDAY ^ Closed ^ Open 24 hours State Z1P code Fax y ~'~ ~ ;t ~ ~ ~ ..~. ~ ~ F I ,:; Terminallacation -`'_~ ~ Inside ^ Outside ~?(''_: Buildingtype -- '+ L~ Public ^ Private ~'~_ ^ Mobile ^ Government fi ;j Restriefed aocass? ^ Yes ~ No ]/~,~ - -- ' `~ Dedicated camera? F`;.Y -"-' ^ Yes ^ iJCi ~~ Expected monthly withdrawal amount IV~~ ~ - -- Expected no. of monthly transactions ~~~ 8 20'.0 ATM Network Inc All tights reserved 1 t 7 NetworkTM If you have any problems or questions when filling out this form, please call us at 1.800.929.0228 or e-mail infoC~atmnetwork.ne# Customer ID 10749 Bran Rd. E. Minnetonka, MN 55343 1-800-9~9-0228 Fax: 877.928.6638 AUTOMATED CLEARING HOUSE EACH} SETTLEMENT DATA Automated Clearing House (ACH) refers to the electronic transfer of funds behveen ATM Network and your designated bank account(s). This section provides ATM Network wish the information needed to deposft your money into the proper accounts, and gives you the option to use ACH to pay for receipt paper, service calls or parts. • . / + ~ . • i •. This section provides information about the This section provides information about the This section provides information about bank account you will use for daily ACH bank account where you will receive your the bank accourrt you will us® for ACH services. Each day, we'll deposit an amount surcharge income. Each month, we'll deposit withdrawals. It's the account we'll draw from equal to the amount of cash withdrawn the your surcharge revenue for the previous for specific authorized charges, such as day before. month. receipt paper or repairs, Besitles titling out this section, you MUST If you want to use the same account far PROVIDE a VOIDED CHECK or LETTER both daily and monthly deposits, just ctreck FROM YOUR BANK, as explained bedew the "Same as daily'° box above and leave this section blank. Corporate narne/DBA name _ CITY OF COLUMBIA HEIGHT~orparate name/DBA name Account type ^ Bustness checking ^ Savings Account type Personal checking ~ General Ledger ^ Business checking ^ Savings ^ Personal checking L7 General Ledger Nar"~'~4a4`lt~`t"COLUMBIA HEIGH3;J --~ Name on the acrourtt Routing transit number .__._ 091000132 Acccunt number Bank name Northeast Bank Bank phone 763-788-9351 ch a VOIDED check r a tatter from your bank stating the cu omer's name, routing! fransft number and account number. All surcharge income shall be ma Routing transit number to Top Valu I at 4950 Central Av Account number E Columbia .Heights, IVIN ~ 542 i an Bank name monthly basis. Bank phone Attach a VafDED check, or a tatter from year bank stating the customer's name, routing/ transit number and account number. N you warn to use the same account you use for either daily or monthly deposits, just check the appropriate box above, indicate the service(s) you authorize payment for, and leave the rest of this section blank, Payment authorized for (check ail that apply): ^ Paper ^ Parts and service Corporate namelDBA name ~~ Accountiype 1 O Business checking ^ Savings ^ Personal checking ^ General Ledger Name wr the account ~iClti tS nut authar2Zcd tar oily Routing transit number Char~eS ar eXpenSeS. Account number Bank name --_--~- Bank phone _ Attach a VOIDED cheek, or a letter from your bank stating the customer's name, routing! transit number and account number. 6d, WITHDRAWAL AUTHORIZATION (needed only if section 7c fitted a Customer authonzes ATM Network to inftiaze ACH transfer entries and to debtt and/or credit the account identified herein for all costs and applicable taxes associated with ATM Nehvork providing customer with the indicated services Customer agrees to keep account funded to the extent needed to reasonably support transaction ameunts posted by ATM Network In the event that an ACH is returned unpaid to ATM Network, Customer agrees to pay a returned ACH tee of $35 00 per returned item All shortages and adjustments are the full responsibility of the Customer. The undersigned represents and warrants to ATM Network that the person executing the Authorization is an authorized signatory on the Account referenced herein and ail information regarding the Account antl the Ac- count Hoicler is true and correct Signature (Printed name iltie ~ Date Form PLA-P2-Vt 5 January 2070 ~ I I ®2010 ATM Neltvork fnc Atl rights reserve 1Vetw©rkTw If you have any problems or questions 4vhen filling out this form, please call us at t.S0Q.929.D228 or e-mail info@atmnetwork.net Customer ID 10749 Bren Rd. E. Minnetonka, MN 55343 1-800-929-0228 Fax: 877.928.6638 AGREEMENT FCR ~T PURCHASE, LEASE 0R PROCESSfNG - P~~e 3 Manufacfurer M odel ,.w No. ordered This section gives information on cash handling, to help prevent fraud and so we know who to r` ~~,,,- ~ (_ ~ ~ ~ ~( - `s~ cali'rf there's a pro6iem with keeping the machine supplied with cash. Software Surcharge amoun~ _"-! If you're not sure which box to check, check "ATM operator." ~nn11C~-d~ $2.00 ~~ -- ------ ------- _ _ LCII ~ Revenue split (% or ~ r Funding method (who is responsible for keeping the machine loaded with cash?) 5. ~ I I ! ~l~ i,• ~~ ; y ' ^ ATM operator ^ ISO ®Merchant ^ BanWISO ^ B W ^ Thi rt d ---- Location: ;- .) an processor pa y r Lock ';-~ --- ---- --- er~ 31 to 't Other: p ~ ~ ! Name of person who is loading cash _ ... --~-A 1------ ` ~ CD ` : ~ Zarry Scott --- --- -- -- ~L ~ l 1 ll i a,~~ e ATM owner - TCP/IP ~: i ----.. - --- ~~ E- --- - i ATM owner contact pfione no. EPP fee -- °a~,, 763-706-3852 --- ----- --- ------ •+ nj Source of loads - - ~ ~ ~~v ~ ^ ATM operator I?5 Merchant ^ Armored car ~ r.~_ _ _ a.. ~'~...i~ ~.....~[_'- _._ ~'~ ^ ISO ^Third Party 1rI~~ s~1 ------- ------ ------- - n~~~~~f~Z~J'1°t4~•~ Expected frequency of toads st monthly payment ~ - ^ Daily ~ Weekly ^ Monthly First antl last nfh's '~ ~ Twice weekly ^ Every two weeks ---- - Payment, p tax ~ s , . ~ _. ,.~- _ - - - - wrFr:.<. -- - Lease buy price ~ .' ~ _ .: ~ _, ~~ ! ~; signing: below, each undersigned individual, who is eRhar a principal of tho applicant or a par- ___.e _ current tee Lease length (months] ~~ sonai guarantor of its obiigaiions, provides written instruction to Lender of its Assignee and cert~es ____ ~ that aA information provided is true and correct, and authorizes Lender or fts assignees} to verify g,~ ~ an credit information Pram whatever source it deems necessa and further authorizes Lender or ----- ---- TOTAL N PAYMENT -'~;~~.y Y ry Type of to `~ ~ its assignee{s} to investigate the references, statements or ether data rested or aecomparrying th[s ___-~ 'application.. The undersigned aLthorzes all parties contacted including but not limited to any credit _ _ ~ reporting agency to release credit and financial irrfonnation requested by telephone or facsimile, ~ ~ ~ ~t' < r Tho undersigned further understands that any information obtained now or from time to time tiviil be treated confldentia(ly and will only be used for securing financing ar for the purposes of updating, • 1 • ' ~ • renewing, or extension of such creditor additional credit and for reviewing or collecting the resulting Amount paid ---- account.. A Photostat or facsimile copy of this authorization shall be as valid as the original. By b check Purchase price signature below, I/we affirm my/our identity as the respective Individuals} identified in the above y application.. If credit card information is supplied, the signature below authorizes ATM Network, Inc.. $2, 02S . ~ $ _-_ ~ ~ f u ~ ~ _ to charge the ATM purchase to purchaser's credft card, or to charge any Monthly Access fee due to Amourrt paid Sales tax (if applicable) "~ ATM Network, Inc to the credit card specified above by credit card 6 $7S o ~ ,-~3-'°~-'~Q-- ~'~'' 7 - -~ = To help the government fight the funding of terrorism and money laundering activities, Federal law Other charges ~~ requires all financial institutions to obtain, verify and record information that identifies each person Card type ~ ~ who opens an account. What this means for you: When you open an account, we will ask for your ^ Vsa ^ Discover TOTAL PRICE name, address, date of birth, and other information that will w us to identify you. We may also ^ M/G ^ Amex _ _ ~ -- ask for a copy of +rour rev is licym or ~ ing cu grits Card number $2,025 28 ~ ,,~.^~ l ~ ,,i-~C~ ~u1~`t ~ EXeTll t $OTI7t ~OCaI OT tI"arlSlt taX _ ~~ Principal #1Ysigna re ate National Account Manager Date Expiration Charge date Cara address: X x--~~ ^ Business location -- ^ Business mailing f~ Principal #2 signature Date Dealerl050 llate Form PLA-P3-Vt 5 January 2010 ~ Principal #m residence 8 2070 ATM Network Inc Ali rights raserv~eU t l ] 1V~tworkr'~ If you have any problems or questions when filling out this form, please call us at '1,.800.929.0228 or e-mat info@atmnetwork,net Customer ID SITE L®CAT1~iV E T 10749 Bren Rd. E. Minnetonka, MN 55343 1-800-929-022$ Fax: 877.928.b638 This Agreement is effective on the 1St day of ApI11 20 10 between ATM Network, Imo , 10749 Bren Road East, Minnetonka, MN 55343 (the "Company"}, and Top Valu I located at_ 4950 Central Avenue ~ Columbia Heijjhts MN 55421 (tne "LACatlon'~. i. Equipment Location agrees to place its own AUTOMATED TELLER MACHINE("ATM"} on its Premises in an indoor location or locations as mutually agreed upon 2 Availability. Location agrees that the ATM shall at alt times remain available far use by Location customers during Location's normal business hours for the term of this Agree- ment. The previous sentence notwithstanding, Company reserves the right to schedule reasonable downtime to accomplish necessary matnienance or system improvements, not to exceed five percent (5%} of available time, per calendar month. 3, Transaction Processing and Surcharge Fees. Company shalt collect ail transaction revenue from the ATM and pay Location For each transaction made on the ATM A transac- tion, for purposes of computing revenue due to Location, will be defined as any assessable cash withdrawal made from a cardholder's account. Company will pay Location per transaction under eifhcr of the following Location selected options: Option 9 ~ Location receives i 00°% of surcharge revenue on assessable cash withdrawal transactions plus 13 months of free maintenance, parts and repairs on the ATM (available on new ATMs only}.` Merchant's Signatte .~° -_ Choose .~,` , either - ____ dp'~~n ~ Option 2 _, Location recefves 90% of surcharge reve~Yue on cash wRlidrawai transactions f~ plus free maintenance, parts and reoatrs on the ATM for the term of this Agreement.' ®r ~~~®~ ~ Merchant's Signature X 'Provided, however, that any damage fa an ATM caused by vandalism, other intensional acts or Acts of God shall not be covered by the provisions of either of the above-referenced service options. Location's share of transaction revenue will ba disbursed monthy by Company to Location on or before iha 20th day of each calendar month following the calendar month in which the applicable transactions occurred 4 tnstaifaiian 8 Training Company agrees to install the AiTA, train Location's staff, coordinate muting of telepfone lines as may be required (subject to pamgraph 9, belrnv}, coor- dinateshipment and delivery of the ATM and iniiia(suppiies to Location if LocaSon acquires the ATM through Gompany, all of these services are included in the ATM purchasing price. 5. MaintonancelRepair. Company agrees to provide alt maimonance, parts and repair of the ATN at the Locatlon To the extent not covered by Option 1, charges for such services shat! beat Company's standard rotas for maintenance, parts and repairs.. ' ocation shat( be responsible far paying arty charges by Compaery for such services in a Yimety manner. Location agrees that M such charges by Company to Location era not paid in a timely manner, Company may w(thhold such charges from any revenue doe to Location under this Agreement uati(the outstanding maintenance, parts or repair sarvtces charges are paid 1n full !n the event the ATM at Location's premises is vandalized, Company agrees to assist Location in the filing of any insur- ance rampant' claims, if sd requested by Location. Location agrees it shat! make nc attaratien or addiScn to rho AT M, and shall not permit anyone, other Than an authorized representative of Company, to perform any service or rapes work an the ATM, without Company's prior written approval 6. Processing Services. Gompany agrees to provide, and Lotion agrees to utCize axctus(veiy during the term of this Agreemenf, such data processing services as Company, in its Sete discretion, has selected, to process alt ATM transactions on any Location awned or leased ATM on Location's premises or on arryATM placed on Location's premises pursuant to a third party placement agreemariL, during the term of this Agreement. Company agrees That it will use [ts 6esL efforts to provide high quality data processing services from a service pmvitler with a national or regional roputation for reliability, accuracy and customer satisfactlan. Location agrees io accuratey complete, or has accurately completed, all of the necessary documentation as is reasonably required by Company to facilitate the implementation and delivery of such processing and other related services In the event surcharge fees or other fees become non-assessable, the transaction fee option selected In Paragraph 3 shall be subject to automatic adjustment by Company 7 Cash Requirements and Inventory. Location agrees to keep sufficient amounts of cash in its ATM during business hours Location also agrees to inventory an adequate supply of paper and ribbons at Location's promises, which are available for purchase from Company 8. Phone & ©ecirical Requirements. Location agrees, at its expense, to provide and maintain a dedicated business telephone line and one (1}operating electrical power outlet (116V} within 2 feat of the ATT.t silo Location shall pay for monthly charges incurred in conneotion with such telephone Tine and electrical power usage 9 Sole Provider. Location shalt neither permit the removal of the ATM from the Premises, nor allow the placement of any other ATMs on the Premises, nor subscnbe to any other data processing service for processing ATM transactions during the term of this Agreement, except as may be agreed upon by Company in writing or as otherwise required by any lessor of the ATM.. Location further agrees that Company shall have the exclusive right to advertise on the screen and the body of the ATM dudng the term of this Agreement. 10 Insurance Requirements. Location agrees to protect the ATM and its contents from damage, loss, theft, or destruction. Location shall provide and maintain property insurance against loss, theft, damage, or destruction of the ATM in an amount not less than the full replacement value of the ATM. Insurance shall include avraiver of art' subrogation rights and Location waives any rights of recovery against Company arising from such foss, theft, damage or destruction. Location agrees d Is solely responsible for providing securhy against theft at the Premises and Company shall have no liability Eo Lccation in the event of theft or damage. Aq cash kept in the ATM shad be the property of the Location and Locafion shall bear the risk of loss H any cash is stolen or otherwise bst or destroyed. 11 Tema. This Agreement shall be for a Perm of five (a~ years fmm the date of ATM installation, unless amended or terminated by mutual written agreement of both Company and Locafion orterminated by Company pursuant to paragraph 14, below Notwithstanding anything contained herein to the contrvy, this Agreement shall be autematicalfy extended for addftional periods of rve (5} years each unless either party provides to the other, at least thirty (30} days and not more than ninety {g0} days pdorto the and of the term of the agreement, written notice of its intention to terminate Form SIAWC90-P1-Vi 1 August 2C09 m?009 ATM Nehvark Ina All rights reserved l t 1 fVetwarkrM jt you have any prD6lems or questions when filling out this form, please call us at 1.800.929.0228 or a-mall Info@atmnetwork.net Customer ID SITE LOGATIt]N ~GREE~IENT ®P~ge 2 10749 Bren Rd. E. Minnetonka, MN 55343 1-800-929-0228 Fax: 877.928.6638 12 Property Ownership or Lease Terms.. Locadon represents and wanams that it is the owner of the Premises or that it holds a lease or option to renew the lease for said Prem- ises of equal or greater length than the initial five-year term of this Agreement. 13 Equipment Relocation. In the event Location transfers or moves its business from the Premises, Location shatl notify the Company not less than thirty (30) days pdor to any such event. In such event, this Agreement shall be automatically deemed amended to apply to Location's new Premises for the remaining term of this Agreement The ATM shall be placed in a mutnaliy agreed upon indoor location or locations 14. Cancellation. Company may terminate this Agreement at any time in the event Location engages in unlawful activity in connection whh the use or operation of the ATM, or in the event Location breaches a material provision of this Agreement 15. Liquidated Damages. Location agrees that in the event Location terminates, Fcr any reason, the agreement between Location and Company, prior to [he then current termina- tion date of the agreement, Location agrees to pay to Company, upon demand (or as a deduction from any amounts owed by Company to Location}, as liquidated damages, and not as a penalty, in satisfaction of the claims of Company, a sum of money equal to the average number of transactions per month on Location's ATM(s) times the revenue earned by Company par each cash withdrawal transaction times the number of months remaining in the agreement as of the date of termination by Location.. It is agreed that this provision for liquidated damages is fair and equi- tableand the afiount set forth above is reasonable under the circumstances. Nothing in this provision shall be Interpreted to preclude Comparry from pursuing any other Legal claim for money damages against Location 16. Notlces. AO notices hereunder shall be in writing and shall be by registered or certified mail, return receipt requested, addressed to Location, simply to whom d may concern, at its address as listed in the preamble of this Agreement Ail notices shall he deemed received three {3) weekdays altar the date of such mailing 77 Attorney Fees If suit or acNOn is instRuted to enforce or Interpret any of the terms of the Agreement, the prevailing party shall ba entitled to recover from the other Party, in ad- dition to casts, such sums as the court may adjudge reasonable for legal fees at trial and an any appeal therefrom. Location agrees to pay all costs of collection for sums due to Company under this Agreement, including attorney fees, whether or not suft or action is commenced. 16 Company Not Agent. Locatlor, understands and agrees that the Company is not an agent of any lessor of the ATM; that ft has no authority to act on behalf of or for any lesso, and that it is not authorized to waive or alfer any term or condition of any (ease for the ATM; and that it Is nni an agent of LncaNnn fir arty purpose whatsoever 1 g.. Dtsctaimer. FYCEPT AS SPEC1FiCALLY PROVIDED iN THIS AGREEt~RENT, LOCATION UNDERSTANDS AND AGREES TrIAT COMPANY MAKES NO WARRANTY, (7(PRESS, IM- PLIED, OR STATUTORY, AS TO ANY MATTER WHATSOEVER, INCLUDING THE CONDtT10N OFTHE ATM, [7-S MERCHANTA&L1TY OR FITNESS FOR ANY PARI-tCULAR PURPOSE COMPANY SHALL IN NO EVENT BE RESPONSIBLE FOR ANY LOST PROFITS OR DIRECT, INCIDENTAL, CONSEQUENTIAL, SPECIAL, OR INDIRECT DAMAGES THAT LOCATION MAY INCUR COM- PANY'SSOLE LIABILITY TO LOCATION HEREUNDER, EXCEPT AS OTHERWISE PROVIDED, SHALL BE TO REMEDY ANY BREACH OP THIS AGREEMENT IN A TIMELY MANNfft 211. Assignment. Location shall nat assign or in arty way dispose of all or any pad of ifs rights w ohligations under this Agreement without the prior written consem of the Company 21. Controlling Law and Campltance With t.aw. This Agreement shall he construed, interpreted, and enforced In accordance vdth the laws of the State of Minnesota. Location waives arty right ft ma`y have to challenge the jurisdction of the state and federal ceurts of Minnesota and irrevocably consents to their judsdictlon. Locaton agrees it vrtC compt,~ with all state laws and 2gulations governing operetlon of an ATM on its premises and further agrees to post all consumer notKications provided by Network to Location 22. Adjustments, In the event any cash withdrawal transaotien is disputed by the cardholder's {oustbmar's) financial institution and, as a result is charged back by That financial'sn- sLayrklon, Lacatiar. hereby author"Wes charging any such deputed amount {plus any assassod toes} directly to Location's clearing acacunY as Ider,Btisd in t;,s signed ACH farm Any other disputed amounts or charges for denied transact(ons, balance inquiries, transfers ru other costs associated whhnon-monetary transactions and any other network assessed fees, program fees or compii- ancacosts, may , at Company's discretion, be offset and deducted fmm any Transaction Processing Fees or Transaction Surcharge Fees due Location pursuant to Paragraph 3, above Monthly Access Fee. Location agrees to gay to Company,. during the term of this Agreement, a monthly tea for access to the systems ei network services providers such as Asa and to sterCard. Locafian agrees to pay either of the fallowing amounts as a Monthly Access Fee: Choose orre: ,~~ 94 carets per transacfion ~ {inifiaks} OR 95 per montft nitials) If access to the systems of network services providers, network Interchange rates or internal processing costs of Company change, the Monthly Access Fee may, at Company's sole discretion, be subjectto change upon 30 days pdor written notice to Location.. ae, waiver. A wanner by either party of z brsactr of any provision of this Agreement shalt not constitute a waiver of that party's rights to cthervrise demand strict compLance wR,h this Agreement and any and ail provisions hereof 25 Authariry. The undersigned are the duly authorized representatives of Location and Company and have all of the necessary authorty to execute and perform this Agreement 26 Entire Agreement. ibis Agreement constitutes the entire agreemerrt of the parties hereto. There are no other promises, representations, terms, conditions, or ohligations other than those contained herein. This Agreement supersedes all pdor communications, representations. or agreements, oral or written, between the parties and shall not be mod~ed except in wr3- ing signed by imth parties. Location hereby acknowledges that sales representatives or Dealers affidated w(th Company are not authorized to make or approve any additions to, deletions from or alterations of the pdnted provisions of this Agreement , or to terminate this Agreement, and that no such addition, deletion, alteration or termination shall be valid or binding on Company unless in writing and signed by an officer of Company Any purported amendment, modification or termination of this Agreement which is oral, or which is in writing but not signed by both Location and an officer of Company, shall be void and of no effect whatsoever. IN VJTRVES HEREOF, the undersigned duly authorized representatives of the parties have executed this Agreement as of the day and year last stated below.. CO , jai •~~ ~ LOCATION: - _ y /3 __ __ ATM Network president Date Principal #1 Da , Walter R. Fehst City Manager Print name Tdle Form SLA192190-P2-Vt 1 August 2009 "`~-- rc~?nag ATt~A Network In¢ Alt rights reserv~i VW +'.~ ~ --r-;- ;~ Networkr'° if you have any prcblems or questions when filling out this form, please call us at 1.860.929.0228 or e-mail info@atmnetwork.ne# Customer ID 10749 Bren Rd. E. Minnetonka, MN 55343 1-800-929-0228 Fax: 877 928.6638 ADDENDUM TD SITE I.DCATIQN AGREEMENT AS REQUIRED B~ DEBIT NETWORKS AND THE USA PATRIaT ACT THIS ADBENDUM shall amend and shall constitute a paz2 of, together tivith any exhibits or schedules attached hereto, that certain Site Location Agreement (the "Agreement"} made as of the day of __ , by and bettiveen _ ("AT1VI Operator") and ATiT Network, Inc , 10749 Bren Road East, lVfinnetonka, MN 55343 ("ISO"}., The terms hereo# will for all purposes be deemed incorporated in the Agreement In the event of any conflict between the terms of the <4greement and the terms of this Addendum, the terms of this Addendum shat! control All capitalized terms, unless otherwise indicated, shall have the meanings attributed to them in the Agreement The following provisions aze added to the Site Location Agreement Rdem6er Bank: The Member financia[ institution sponsoring the AIM transactions under this Agreement is RBS Citizens Bank, NA whose principal address is 1 Citizens Flaza, Providence, RI 02903 and which can be reached for customer service at (888) 486-4949 (hereinafter "Member Bank") Compliance with Rules and Flegulations: ATM Operator and ISO each acknowledge that sponsorship of .ATM Opezator and its activities under this Agreement may be terminated for failare to comply with the terms of this Agreement: if the applicable networks detezmine that the ATM Operator is not qualified to act as such; or if they :tie found to be in violation of the rules and regulations of [he applicable debit networks ATM Operator further acknowledges that the applicable debit networks ate the sole and exclasive owners of their respective Service Marks and agrees that it wiU not contest the ownership of the Service Mazks for any reason whatsoever The debit networks may at any time, immediately and without advance notice, prohibit the ATM Operator fiom using any of then respective Setvice Marks for any reason Finanolal Infotmafion: ATM Operator hereby acknowledges that it is required to provide requested financial Information to Member Bank under this Agreement since the transactions settled by Member Rank hereunder cnnsrihire "finanriZ tranear[nna' ,nd,r gede;a,~ r.~;., !.. ,. rre e p.,,.;,,~ '- ~...b , .,..... ......,. ACT) Member Bank is therefore required to obtain, verify, and record the regaired information A consumer credit report and criminal background investigation may also be required by Member Bank in connection with the sponsorship of AI'M Operator's activities under this Agreement ATM Operator hereby authorizes Member Bank or any of its agents to investigate informatien or data obtained fiom Operator ATM Operatot fnrthet represents that all information provided to Member Bank ^~ ' recr'---- --~ ---'1 Signed I- ____ ~ Date X Principal #1 Title ,,_;~ C ~ 'i~' ----- ~;,~ Social Security No. Signed I,J X _ < _,. - Name ' ~ '~,~ Date of Birth ~~ Phone Title Date 1 -~-_ ~~- (', <~ Home street address City 4 , ft U.S. Citizen? If no, Country of citizenship ^Yes ^No~ ~9oney Services Business ^ Yes l~No Financial institution? ^ Yes ~( No If Yes: ^ U S. Fl ^ Non-U.S FI Fi#/FDiCINCUk/ASL• _~~_ State ZIP code Politically Exposed Person? ^ Yes ~No 'A Money Services Business is generally defined as a person who engages in the business of accepting currency, or funds denominated in currency, and transmits the currency or funds, or the value of the currency or funds, by any means through a financial agency or institution, a Federal Reserve Bank or other facility or eiectronie funds transfer network or any other person engaged in the business of transferring funds. Specific definitions and limitations exist that may apply to your status as an MSB. Business name __r10 (3WTt8I' ~edera@ Tax III Date of incorporation Form PAA-Pt-Vt 1 July 2005 ~ 2009 ATk1 Netwaric !nc Ali rights reserv/ed/~\~ 1 C./ l ~~ - ~ - .. ~ " Network~^ [f you have any problems or questions when filling out this form, please call us at 1.800.929.0228 or e-mail infoCatmnetwork.net Customer ID l 0749 8ren Rd. E Minnetonka, MN 55343 1-800-929-0228 fax: 877.928.6638 ~ PURCH~SE, LEASE UR PROCESSING ,. :_ ,. , Business type (check one} `,~ Principal #1 Are you a U.S citizen? ^ Yes ^ No ^ Proprietorship ^ Corp. ^ S-Carp. ^ Partnership- ^ Nonprofit >_ y : `~ lr/IUR1CIpal CUrpUratlUri--NO Private OW11eTShlp Business name ; : ~ Title Socia( Security # Ownership >i City of C'alumbia Heights _____--__-_ __ _ DBA name ^ Check here if same as above ,'~ Residence street address ^ Rent ^ Own Date of birth Top Valu II _ _ _ -_ _ ?aa Federal Tax fD # ig digits} Incorporation date SIC coda Cib~ State Z{P code _ ~ 14-1898 t ~ ~ 4' _ __ _._ _._. Location streef address (cannot be a P.O.. box} -. 'Phone I Fax 2105 3 ?th gvenue NB _ _ i City State ZIP code '~' ', Principal #2 lif applicable} Are you a U.S. citizen? ^ Yes ^ Nc C'nlt3mbia-_H._~ights _ 1~LN 55421 ' '! -- - Phone Fax ~ --- - _ i s~ Title Social Security # Ownership ~ 763-706-3813._ ~706-3821 _ Contact Contact E-mail I,atTy SCOtt~Q _ _ .~ -- - Residence street address ^ Rent ^ Own Date of birth . Ldi 1~Y JGUL6 -,~ ~ la.l'iV1U111U1A-11Gi~'111A.t1111.UJJ ~-.'~~ Mailing street address ^ Check here if same as above -~ City State ZIP code ~ 4950 C entra( r"tvenue NE -~' _ _ __ _ Glty State ZIP code _ _ _ __ ~\}~ - {; •~ Phone Fax -- Col~lmbia f Ieights l~fN 55421 ~ ~ 1' ' _ _ _ .m - -~®. Open ,Close MONDAY _-^ Closed ^ Open 24 hours 9 ~ 1 ~ p TUESDAY ^ Closed ^ Open 24 hours 9 A1VI. 10 P WEDNESDAY ^ Closed ^ Open 24 hours 9 10 P THURSDAY _ ^ Closed u Open 24 haws 9 10 p FRIDAY ^ Closed ^ Open 24 hours 9 10 I' SATURDAY ^ Closed ^ Open 24 hours g 1 ~ p SUNDAY ^ Closed ^ Open 24 hours Form PtA-Pt-V7 5 January2010 Y 3 +_ ~( -~: a ~ ~ , :~ ~~ 1 4;-'- i _7 ~,f~? ~ii+4ii145a~ s `~ ' - Open Close MONDAY ^ Closed ^ Op-n 24 hours 9 I.M. 1 a I3~ TUESDAY ^ Closed -^ Open 24 hours g ~M 10 I' WEDNESDAY ^ Closed ^ Open 24 hours 9 f1yM 10 I' THURSDAY C7 Closed ^ Open 24 hours (~ ~/I 10 p FRIDAY ^ Closed ^ Open 24 hours 9 AM. 10 h SATURDAY ^ Closed ^ Open 24 hours 9 !~ 1 Q P SUNDAY ^ Closed ^ Open 24 hours ~ ~-~t~'1 t't ~i ' N l CU -` <S erminal~ocation '' f%Inside ^ Outside 6uliding type L~Public ^ Private ^ Mobile ^ Government 1~1 ~ ... _- -- I'}t, Restricted access? `' ~ ^ Yes [~ No '~ Dedicated camera? s .i ^ Yes ^ No N ..~y ~ _ ~^ Fucpected monthly withdrawal amount ~/ Expected no, of monthly transactions oT , 2010 ATM Network Inc M rights reservetl ! i 1 NetwarkrM if you have any problems or questions when tilling out this form, please call us at 7.800.929.0228 or a-mail info(~atmnetwork.net Customer 1D 10749 Bren Rd. E. Minnetonka, MN 55343 1-800-929-0228 Fax: 877.928.6638 AUTOMATED GLEARiNG HOUSE (AGH) SETTLEMENT DATA Automated Clearing House (ACHj refers to the electronic transfer of funds beriveen ATM Network and your designated bank account(s). This section provides ATM Network with the information needed to deposit your money into the proper accounts, and gives you the option to use ACH to pay for receipt paper, service calls or parts. .. / ~ ~ . • • ~ . j This section provides information about the This section provides information about the this section provides information about bank account you will use for daily ACH bank account where you will receive your the bank account you will us® for ACH services. Each day, we'll deposit an amount surcharge income. Each month, we'll deposit withdrawals. It's the account we'll draw from equal to the amount of cash withdrawn the your surcharge revenue for the previous for specific authorized charges, such as day before. month. receipt paper or repair;. Besides fitting out this section, you MUST if you want to use the same account for PROVIDE a VOIDED CHECK or LETTER both daily and monthly deposits, just check FROM YOUR BANK, as expiained below the "Same as daily" box above and leave this section blank. Corporate name/DBA name - CITY OF COLUMBIA HEIGHT~orporate nameR38A name Account type - „~ _ ^ Business checking ^ Savings Account type ^ Personal checking ^ General Ledger ^ Business checking ^ Savings Ii you want to use the same account you use fior either daily or monthly deposits, just check the appropriate box above, indicate the service(s) you authorize payment for, and Peeve the rest of this section blank. Payment auth d for (check all that apply); ^ Paper ^ Parts and service Corporate name/DBA name --- ^ Personal checking ^ General Ledger I _ Nametcxlt,~a~~un~,OLUMBIA HF,IGH`~---~ ~ Account type ----- Name on the account All surchar~~e income shall be mail d ° Business checking ° savings Routing transit number ^ Personal checking ^ r3eneral Ledger _ 0 910_0. 013 2 Routing transit number _ t0 TQ X2111 I at 495® Ce22tral t~tr8, Name on the account Account number p Bank name Northeast Bank Bank phone 763-78€~-935I ch a VOIDED check r a letter ur bank stating the`oustomer's name, routi,~9gf transft number and account number. ACL`otJnt numbeP Columbia Heights,l~3 55421 on Bank name monthly basis. Bank ptsone Attach a VOIDED check, or a letter from your bank stating the customer's name, routing/ transit number and account number. ~.CH is not authorized for at~y Routing transit number char~~es or expenses. Account number Bank name Bank phone Attach a VOIDED check, or a letter from your bank stating the customer's name, routing/ transit number and account number Sd, WITHDRAWAL AUTHORIZATION {needed only if section 7c filled a Customer authortzes ATM Network to initiate ACH transfer entries and to debit and/or credit the account identified herein for all costs and applicable taxes associated with A7M Nehvork providing customer with the indicated services Customer agrees to keep account funded to the extent needed to reasonably support transaction amounts posted by ATM Network in the event that an ACH is returned unpaid to ATM Network, Customer agrees to pay a returned ACH fee of $35 00 per returned item All shortages and adjustments are the full responsibility of the Customer. The undersigned represents and warrants to ATM Network that the person executing the Authorization is an authorized signatory on the Account referenced herein and all information regarding the Account and the Ac- count Holder is true and correct Signature ~ Printed name iitle I Date Fonn PIA-P2-Yl 5 January 2070 ~ ~ I 02010 ATM Network fnc Ail rights rese/rv~e~ r' J ) If you have any problems or questions when filling out this form, 10749 8ren Rd. E.. please call us at t.8Q0.929.022$ or e-mail info@atmnetwork.net Minnetonka, MN 55343 1-800-9z9-0228 IVe~workT"° customer ID Fax: 877.928.6638 ,AGREE@~ENT FCR ATE PURCHASE, LEASE OR PROCESSING ~--- Page 3 Manufacturer ~ Model No. ordered ~'~ This section Ives information on cash handlin to hei g g, p prevent fraud and so we know who to '~ .- call if there's a robiem with kee m the machine su Ired with cash. Software Surcharge amoun,~, ~, If You're not sure which box to check, check "ATM operator." ~nn~FC_ _$2.00 '~_~ - ------- --- -._-- LCD Revenue split (% or $} ~ Funding method (who is responsible for keeping the machine loaded with cash?) -t it `~- t7 ATM operator ^ ISO (ffi Merchant S. r ~~~- ~ 7 ~ ^ Bank/lSO ^ Bank/ rocessor ^ Third -- Location:~,~ ;.,.;~ P Patty Lack 1j -- -__.._.~-- -- -.._ i U Other: i Name of person who is loading cash -- .__ 1,,8IZ~ SG®tt CDU ,,~ --- - --- ~~ 1~ ~ fsI AT'M owner --- _ ~_!~ ~ ~--~ i , "-'': ATM owner contact phone no. -------,L-~-=- !cira EPPtee - '` 763706-3852 _-- ___-- ____-- _~' Source of loads ;;,~; . i ,~- r; ~, ~ , ~~r 1,. ^ ATM operator R5 Merchant ^ Armored car . _ _ _ _ . _ ~' 1 ^ ISO ^ Third Party ~ • ~ • ~ T ^" Expected frequency of loads '-_-- -~---~ _ -- `' *~ ^ Daily ~ Weekly ^ Monthly st. mortthiy payment "~ ~- C7 Twice weeks ^ cv two weeks -- ^~ Fast andiast rrth's y ~' ks payment, p tax 4 ~ .. - _, ~_ . ,s ..: ~ --,z .~. - .~......... ,_~ Lease buy price s..--~ ~` - __ . _ :, ' _. _ __ '. ': ---- `'~t si nin helnw, each undersi ned indivldrrai, who is either a ttnci al of the __.__._._....--------_.. cumenttee ~ ... -~ 9 9 - g P ~ p applicant or a per- Lease Pen '~"? sonal guarantor of its obligations, provides written instruction to Lender of its Assignee and certifies gth (months} _ that aH information provided is true and correct, and authorizes Lender or its assignees) to verify --- ----~ TOTAL N PAYMENT ~ any credit information from whatever source it deems necessary and further authorizes Lender or T}rpe of Pe ~ its assignee(s) to investigate the references, statements or outer data Bsted or accompanying this ~~_ ` appiieaticn. The undersigned authorizes elf parties contacted including but not limned to ary credit _ _ _ _ ~' ~`4 reporting agency to release credit and financial information requesfed by telephone or facsimile. is +fi E' _ ~ ~ ~~ a ~. t ': The undersigned further understands that any information obtained now or fmm time to time will be treated confidentially and will andy he used for securing financing or for the purposes of updating, " i • ' ~ • renewing, or extension of such creditor additional credit and for reviewing or collecting the resulting :. n, Amount paid --------- account. A Photostat or facsimile copy of this authorization shall be as valid as the original. By by check Purchase price signature below, Uwe affirm my/our identity as the respective individual(s) identified in the above ' ~ ~ ~- application. It credit card information is supplied, the signature below authorizes ATM Network, Ina _ -_ t ___ to charge the ATM purohase to purchaser's credit card, or to charge any Monthly Access fee due to Amount paid Sales tax (if applicable} ''"" ATM Network, Inc to the credit card specified above.. ~'' by credit card 6 875 ~0 = ~ ;-~e~i-~`-gyp--- F~'"? ;'~ To help the government fight the funding of tercorism and money laundering activities, Federal law 7 __ Other charges i'-'~, requires all financial institutions to obtain, verify and record information that identifies each person Carr! type ~• ~ ''~ who opens an account. What this means for you: When you open an account, we wit! ask for your ^ Use ^ Discover T03AI. PRICE name, address, date of birth, and other information that will w us to idenYrfy you. We may else ^ M!C ^ Amex _- ask for a copy o your driver's ' en or ther identifying cu ents Card number $2,025 28 ~ ,L ~ ___ ~ ~ (} a ~l - l t ~ EXeri1 t fi0TT1 IOGal Oi ti"3riSlt t8X Principal #7 signet r Date National Account Manager Date Expiration Charge date Card address: si X X ^ fusiness location ~~~~ -- - i ^ Business mailing Principal #2 signature Date DealerlOSO Uate Form PtA-P3-V7 5 January 20i 0 ~ Principal #t residence - ®2010 ATM Nerivork Inc NI fights jre/serv~~ed~~ t l i ~I~twarkrM If you have any problems or questions when filling out This form, please call us at 7,800.929.0228 or e-mail intot3atmnetwork.net Customer ID SITE L~CAT[QN E T 10749 Bren Rd. E. Minnetonka, MN 55343 1-800-929-0228 Fax: 877.928-6638 This Agreement is effective on the ~ St day of ApRl . 20 1 d between ATM Networf<, 3nc , i 0749 Bren Road East, Minnetonka, MN SS343 (the "Company"j, and Top Valu II located at 2105 37th Avenue'VE, Columbia Heights MN 55421 (the °Locatlon"). i.. Equipment Location agrees to place its own AUTOMATED TELLER MACHINE("ATM") on its Premises in an indoor location or locations as mutually agreed upon 2 Availability. Location agrees that the ATM shall at alt times remain available for use by Locatlon customers during Location's normal business hours for the term of this Agree- ment Tha previous sentence notwithstanding, Company reserves the right to schedule reasonable downtime to accomplish necessary maintenance or system improvements, hot to exceed five percent (5%) ai available time, per calendar month. 3. Transaction Processing and Surcharge Fees. Company shall coiled ail transaction revenue from the ATM and pay Location for each transaction made on the ATM A transac- tion, far purposes of computing revenue due to Location, will be defined as any assessable aash ~ndthdrawaf made from a cardholder's account Company will pay Location per transaction under cfther of the following t.acetion selected options: Option 1 ~ Location receives 100% of suroharge revenue on assessable cash wdhdrawai transactions plus 73 months of free maintenance, pads and repairs on the ATM (available on new ATMs only}.' Merchant'sSPg ut.. `' ~ ~ --- ~i1~QOS~' J' ~ either ------ __ _. Option 1 OPtion 2 __ Locatlon receives se% of surcharge revenue on cash withdrawal transactions plus free maintenance, parts and repairs on the ATM for'the teen of this Agreement.' ~r Option ~ Merchant's Signature 'Provided, however, that any damage to an ATM caused by vandalism, other intentional acts or Acts of God shall not be covered by the provisions of either of the above-referenced service options. Locafiods share of transaction revenue will be disbursed monthly by Company so Location on or before the 20th day of each calendar month folbwing the calendar month in which the applicable transaations occurred 4. Installation 8 Train6tg: Gompany ag2es to install the RTM, train Location's staff, anardinate routing of telephone linos as may be required {subject to paragraph 9, 6e(ow), coor- dinate shipment and delvery of The ATM and inRial supplies to Location. If Location acquires the ATM through Company, all of these services era included in the ATM purchasing price. S. MasnfenancefRepair. Company agrees to provide al! maintenance, parts and repair of the ATM at the Location To the e#ent not aoversd by Option t, charges far such services shalt be ai Company's standard rates tar maintenance, pares and repairs. Location shall be responsible for paying any cfrarges by Company for such services in a timely manner. Location agrees that if such charges by Company to Locaton are not paid in a timely manner, Comparry may withhold such charges from any revenue due to Location under this Agreement until the outstanding maintenance, parts or repair swvices charges are paid In fu(L En the everd the ATM ai Location's premises is vandalized, Gompany agrees to assist Locatlon in the H!ing of any insur- ance company claims, if so requested by Lpcatian, Location agrees if shat( make nu aftaration ar addition to the ATM, and strati not permit anyone, other Than an authorized representative of Company, to perform any service or repair work on the ATM, without Company's prior written approval 5 Processing ServEces. Company agrees to provide, and location agrees to utilize exclusively during the farm of this Agreement, such data processing services as Gompany, in its sole discretion, nos selected, to process all ATM hansaptfons an any Location awned or leased ATM on Locatton's pramisas or on anyATM placed on Locatton's premises pursuant to a third party placement agreement, during the term of this Agreement Company agrees that H will use its best efforts to provide htgh quality data processing services from a sarvtes provider with a national or regional reputation for reliability, accuracy and customer satisfaction. Locatlon agrees to aocuratety complete, or has accurately completed, all of the necessary documentation as is esasonabty required by Company to faciiRate the implementation and delivery of such processing and ether related services In the event surcharge fees or other fees become non-assessable, the transaction fee opfion selected in Paragraph 3 shall be subject to automatic adjustment by Company 7 Cash Requirements and Inventory. Location agrees to keep suffiaent amounts of cash in its ATM during business hours Location also agrees to inventory an adequate supply of paper and ribbons at Location's premises, which are available for purchase from Company 8. Phone ii Electrical Requirements. Locaticn agrees, at its expense, to provide and maintair, a dedicated business telephone Ilna and ono f1) oneratinp alectdcal power outlet (710V} within 2 feet of The ATM site Locatlon shall pay far monthty charges inwrred in connection with such telephone line and electrical power usage. 9 Sole Provider. Location shall neither permtt the removal of the ATM from the Premises, nor allow the placement of any other ATMs on the Premises, nor subscribe to any other data processing service for processing ATM Vansactions during the term of this Agreement, except as may be agreed upon by Company In wrft3ng or as otherwise required by arty lessor of the ATM. Location further agrees That Comparry shall have the exclusive right to advertise on the screen and the hody of the ATM dudng the term of this Agreement 10. Insurance Requirements. Location agrees to protect the ATM and its contents from damage, loss, theft, or destruction. Location shall provide and maintain property insurance against toss, theft, damage, or destructon of the ATM in an amount not Tess than the full replacement value of the ATM. Insurance shall include a waiver of arty subrogation rights and Location waives any rights of recovery against Comparry arising from such loss, theft, damage or destruction. Location agrees it is solely responsible for providing security against theft at the Premises and Company shall have no liability to Location in the event of theft or damage All cash kept in the ATM shall be the property otthe Location and Locatlon shall bear the risk of loss if any cash is stolen or otherwise (osf or destroyed. 17 Term. This Agreement shall be for a term of £ve (5} years from the date of ATM installation, unless amended or terminated by mutual written agreement of both Company and Location ortenninated by Company pursuant to paragraph 14, below Notwithstanding anything contained herein to the contrary, this Agreement shall be automaficatiy extended for additional periods ref five (5) years each unless either party provides to the other, of least Thirty (30) days and not morn than ninety {90) days priorto the end of the term of the agreement, wr3ten notice of its intention fo t..rminate Fortn SLAY0090-Pt-V71 August 2009 ~~2C-09 AThi Network lnc Nt right/s reLS~e_rv~~ed\) l 1 f Ne1~WOi'I~.M If you have any problems cr questions when filling out this form, glease call us at 1.800.829.0228 ore-mall Into@atmnetwork.net Customer Id 10749 Bren Rd. E. Minnetonka, MN 55343 1-800-929-022$ F'ax: 877.928.6638 SITE LGGATION ~~REEENT ~ Page Z 12 Property Ownership or Lease Terms. Location represents and warrants that it is the owner of the Premises or that it holds a lease or option to renew the (ease for said Prom- ises of equal or greater length than the initial five-year term of this Agreement. t 3. Equipment Relocation.. In the event Location transfers or moves its business from the Premises, Location shag notify the Company not less than thirty (3~ days prior to any such event In such event, this Agreement shall be autamatical(y deemed amended to apply to Location's new Premises for the remaining term of this Agreement The ATM shall be placed in a mutually agreed upon indoor location or towtions 74. CanceltaBon. Company may terminate this Agreement at any time In the event Location engages in uniavdul activity In connection with the use or operation of the ATM, or in the event Location breaches a material provision of this Agreement 75. Liquidated Damages. Location agrees that in the event Location terminates, for any reason, the agreement between Location and Gompang prior to the then carrEnt tefmina- tion date of the agreement, Location agrees to pay to Company, upon demand {or as a deduction from arty amounts owed by Company to Location}, as liquidated damages, and not as a penalty, in satisfaction of the claims of Company, a sum of money equal to the average number of transactions per month on Location's ATM(s) times the revenue earned by Company per each cash withdrawaf transaction times the number of months remaining in the agreement as of the date of tenninaibn by Location.. it is agreed that this provision for liquidated damages is Fair and equi- tableandthe amount set forth above is reasonable under the circumstances. Nothing in this provision shall be interpreted to preclude Company from pursuing any other legal claim for money damages against Location. 16. Notices.. All notices hereunder shall be in writing and shall be by registered or certified mail, return receipt requested, addressed to Location, simply to whom it may concern, at its address as listed in the preamble of this Agreement Ali notices shall de deemed received three (3) weekdays after the date of such mailing 17 Attorney Fees It suit or aM(on ks instituted to enforce or Interpret any of the terms of the Agreement, the prevaiFng party shall be entitled to recover from the other Party, in ad- dition to casts, such sums as the court may adjudge reasdnabla for legal fees at trial and om any appeal therefrom. incation agrees to pay elf costs of coiledion for sums due to Company under this Agreement, including attorney fees, whether or not suit or action is commenced. 16 Company Not Agent. Location understands and agrees that the Company is not an agent of any lessor of the ATM; that it has no authority to aai on behalf of or for any lessor, and that it is not autharizad to waive or alter any term or condition of any :ease for the ATM; and that it is not an agent of t. nratinn for any purpose whatsoever 19.. Disctaimer. EXCEPT AS SPECIRCAt1Y PROVIDED IN THIS AGREEMENT, LOCATION UNDERSTANDS APdD AGREES THAT COMPANY MAKES NO GAJARF>ANTY, EXPRESS, IM< PLIED, OR STATUTORY, A5 TO ANY MATTER WHATSOEVER, tNCl.t1DING THE CONDITION OF THE ATM, RS MERCHANTA81L.ftY OR FITNESS FOR ANY PARTICULAR PURPOSE. COMPANY SHALL IN NO EVENT BE RESPONSIBLE FOR ANY LOST PROFITS OR DIRECT, INCIDENTAL, CONSEQUENTIAL, SPECIAL, OR INDIRECT DAMAGES THAT LOCATION MAY INCUR. GOM- PANY'SSOLE L1A6(UTY TO LOCATION HEREUNDER, DCCEPT AS OTHERWISE PROVIDED. SHALL BE TO REMEDY ANY BREACH OF THIS AGREEMENT IN A TIMELY MANNER zti i+ssigrtment. Location shall not assign or in any way dispose of all or any par! of its rights or obligailons under this Agreement wdhout the pdor written consent of the Company 21 Controlling Law and Compliance With taw This Agreement shag be construed, interpreted, and enforced In accordance wkh the laws of the State of Minnesota. t_acatlon waives arty right it may have to chelisnge the jurisdiction of the state and federal tours of Minnesota and irrevocably consents to their jurisd&:fian, location agrees it will comply with all sta#e laws and regulations governing operation of an AlTA on its premises and further agrees to post all consumer notfications provided by Network to Location 22. Adjustments, to the event arty cash withdrawal transaction is disputed by the cardholder's {customer's) financial institution and, as a result is charged back by that financial in- stftutton, Location hereby authorizes charging any such dsputad amount (plus am assessed feast directly to Location's afearing account as Identified in the signed ACH form. any other dispG,}ed amounts or charges for dented transactions, balance inquiries, transfers or other costs associated with non-monetarytransactions and any other network assessed fees, program fear ar compli- ancecosts, may , at Company's discretion, be offset and dsduaked tram any Transaction Processing Faes or 7Fansachan Surcharge Fees due Location pursuant to Paragraph 3, above Monthly Access Fee. Location agrees to pay to Camoany, during the term of this Agreement, a monttrly tee for access to the systems of network services providers such as Uisa and M sterCard. Location agrees to pay either of the following amounts as a Monthly Access Fee: Choose axe: jyjp~-r 1 cents per transaction (initials} dR ~18 pee month , itlals) If access to the systems of network services providers, network Interchange rates or intemai processing costs of Company change, the Months Access Fea may, at Company's sole discretion, be subject to change upon 30 days prior written notice to Location 24. Watver. A waiver by either party of a breach of any provision of this Agreement shat! not constitute a waiver of that party's rights to otheralse demand strict compliance with this Agreement and any and all provisions hereof. 25. Authority. The undersigned are the duty authorized representatives of Location and Company and have alt of the necessary authority to execute and perform this Agreement 26 Entire Agreement This Agreement constitutes the entire agreement of the parties hereto. There are no other promises, representations, terms, conditions, or obiigatlons other Ehen those contained herein. This Agreement supersedes all prior communications, representations, or agreements, oral or written, between the parties and shall not be modified except in wrd- Ing signed by both parties. Location hereby acknowledges that sales representatives or Dealers affiliated with Company are not authorized to make or approve any additions to, deletions from or alterations of the prinked provisions of this Agreement , or to terminate this Agreement, and that no such addition, deletion, alteration or tannination shall be valid or binding on Company unless in writing and signed by an officer of Camparry Any purported amendment, modification or termination of this Agreement which is oral, or which is in carting but not signed by both Location and srr officer of Cornpuny, shaiE be void and of no effect whatsoever. IN VdITNESS WHEREOF, the undersigned duly authorized representatives of the parties have executed this Agreement as of the day and year last s',ated below. QY•it J ~ ,~-. ATM Network president Date Principal Yri Date Walter R. Fehst City onager Print name Title Form StA10090-P2-Vt 1 August 2009 Network Inc. All d4hts r /~ ~JW'~~~ ` yf Netw©rkT:, if you have any problems or questions when fjiiing out this form, please call us at 1.800.929.0228 ore-mail infoCsatmnetwork.net Customer ID 10749 Bren Rd. E. Minnetonka, MN 55343 1-800-929-0228 Fax: 877 928.6038 ADDENDUM T® SITE LOCATION AGREE ENT AS EDIRED R~ DEBIT NETWORKS AND THE USA PATRIOT ACT THIS ADDENDUM shall amend and shall constitute a part of, together Fvith any exhibits or schedules attached hereto, that certain Site Location Agreement {the '`Agreement") made as of the day of , by and between __ {"ATM Operator"} and ATM Network, Inc , 10749 Bten Road East, Minnetonka, MN 55343 ("ISO") The terms hereof will for all purposes be deemed incorporated in the Agreement In the event of any conflict between the terms of the Agreement and the terms of this Addendum, the terms of this Addendum shall control All capitalized terms, unless otherFVise indicated, shall have the meanings attributed to them in the Agreement. The following provisions are added to the Site Locafion Agreement: Member Bank: The Mcmber financial institution sponsoring the AIM transactions under this Agreement is RBS Citizens Bank, N A. whose principa3 address is 1 Citizens Plaza, Providence, RI 02903 and which can be reached for customer service at ($88) 4&b-4949 (hereinafter ";VSernber Bank") Compliance with Rules and Regulations: ATM Operator and ISO each acknowledge that sponsorship of ATM Operator and its activities under this Agreement may be terminated for failur's to comply with the terms of this Agreement if ±he applicable iterivorks determine that ttte AI'M Operator is not qualified to act as such; or if they are found to be in violation of the rules and reguIatians of the applicable debit nettvorks A'I'M Operator further acknawlectges that the applicable debit networks are the sole and exclusive owners of their respective Service Mmks and agrees that it will not contest the ownership of the Service Marks for any reason whatsoever The debit networks may at any time, immediately and without advance notice, prohibit the ATM Operator from using any of their respective Service Marks for any reason. Firrant:ial Information: ATM Operator hereby acknowledges that it is requited to provide requested financial Information to Member Bank under this Agreement since the aansactions settled by Member Bank hereunder constitute "financial transactions" under Federal Law to e.. USA Patriot AC"I'} Member Bank is therefore required to obtain, verify, and record the required information A consttmet credit report and criminal background investigation may also tie required by Member Bank in connecfion with the sponsorship of ATM Operator's activities under this Agreement ATM Operator hereby authorizes Member Bank or any of its agents to investigate information or data obtained fiam Operator ATM Operator further represents that all information provided to Member Bank -ar:Q-earracK--- ------~ ~-°-1 d ` ~ S Signed ~ ~~~ Name Kurt C~uhn Title General Manager _ Date _ :. Signed X ` Name l ills Dais ~ a A - t' e - - - I Signed E---- --1 X Principal #i ~LiIllCI~?E~ ~Of~?(7F i ;-:. --- Title it „:~ Date -' 1 ~; Social Security No. _s '~~E Date otBirth Phone :+ E'i _~ ~~ Home street address City U.S. Citizen? If no, Country of citizenship ^ Yes ^ No date of incorporation rYloney Services Business?' ^ Yes I~No Financial Institution? ^ Yes ~ No If Yes; ^ U.S. Ft ^ Non-U.S FI FI#/FCIC/tdCUf,/RSI:__ t~ ~k State ZIP code Politica,,lly/ Fxposed Person? ^ Yes (B No 'A Money Services Business is generally defined as a person who engages in the business of accepting currency, or funds denominated in currency, and transmits the currency or funds, or the value of the currency or funds, by any means through a financial agency or institution, a Federal Reserve Bank or other facility ar electronic funds transfer network or any other parson engaged in the business of transferring funds. Specific definitions and limitations exist that may apply to your status as an MSB. Business name 04~1TTeT~UFederal Tax t® Form PAA-Pr-V7 7 Jufy 2999 ®2069 AThi Network lnc All rights reserved i V f