Document Sample
					EQUIPMENT LOCATION AGREEMENT This Agreement is made this ___ day of ___________, 200__by and between Electronic Finance Transfer Corp. with principal place of business at 231 Quincy St., Rapid City, SD 57701 ("Provider") and ____________________________________, ("Merchant"), a (Corporation),(Partnership),(Sole Proprietor), doing business in the state of _____________________________________, located at _______________________________________________________________________________ with regard to the following facts: street address city st zip A. Merchant is the operator of a retail establishment described herein and incorporated herein by reference (the "Site"). (Additional locations will be listed on Exhibit “A”.) B. Provider is the owner of the Scrip ATM Machine and owns or has the right to utilize all software needed for the operation of said machine (the “ATM”). C. Provider desires to locate the ATM at the Site and Merchant is agreeable to said placement on the terms and conditions set forth. NOW, THEREFORE, it is agreed as per the pricing schedule below and the terms on the reverse side of this form: D. CUSTOMER SURCHARGE IS: $ 3.00 per transaction.


I. For value received the merchant hereby guarantees that 90 days after installation the equipment will produce a minimum income to the provider of $40.00 per month for a scrip machine. For the term of this contract, merchant authorizes provider to initiate debit or credit entries to the merchant's checking or savings account as indicated on the attached ACH Agreement. The difference between actual income and the minimum guarantee will be debited to your DDA account by ACH the last day of the month following the activity. J. OTHER:_____________________________________________________________________________________ IN WITNESS WHEREOF, the parties hereto have executed this Equipment Location Agreement on the date above. The reverse side is a part of this agreement. ELECTRONIC FINANCE TRANSFER CORP. X______________________________ H.J. Marlow President P.O. Box 3074 Rapid City, SD 57709 (605)341-6461 (5407 Fax)
OFFICE USE ONLY: EQUIPMENT______________________ SERIAL NUMBER__________________ PROCESSOR_______________________ INSTALLER________________________ _____________________________________________

MERCHANT X__________________________________ Signature ____________________________________ Print Name/Title (Officer, Partner or Sole Owner) ____________________________________ Social Security or Fed Tax ID Number ____________________________________ Home Address City State Zip

___________________________________ Sales Rep As Witness ___________________________________ Marketing Office Name

____________________________________ Business Phone Number FAX Number ____________________________________ Individual as Guarantor

Date: ___________________________

equipment location agreement 8-6-08


Placement of Equipment: Provider shall install the equipment in a mutually agreed upon area at the Site which is in plain view and readily accessible to the general public. The cost of moving the equipment within the store will be the merchant’s expense after the initial installation. Responsibility of Merchant: Merchant shall: a. Allow Provider or its designated agents access to the site for the purpose of installing, maintaining, servicing, repairing, and removing the equipment. b. Contract for and provide, at own expense, a dedicated data quality telephone line and a two outlet operating electrical power source (110V) within 2 feet of the equipment site. The cost of installation of said power source, telephone line, all necessary construction, and monthly utility bills shall be paid by merchant. c. Provide the necessary working cash for the operation of the equipment. d. Maintain the area around the equipment so that it is clean, safe, accessible and visible to the general public. e. Maintain appropriate liability insurance with Provider named as an additional insured protecting the parties from any injuries or damages claimed or sustained by any person using or attempting to use the equipment. f. Maintain physical damage insurance for the full replacement value including cash contents covering the equipment for damage due to fire, flood, vandalism and other general perils and naming Provider as the loss payee. The merchant may elect to have the Provider pay the insurance and bill the merchant on a monthly basis. g. Notify Provider within 24 hours of any operating problems with the equipment or Paragraph J. will be invoked and cannot be waived. Assist Provider in troubleshooting the equipment & clearing all non-technical error codes. h. Operate Merchant's current business at the Site during normal and customary hours of operation for the business of the type operated by Merchant. Merchant shall give Provider not less than thirty (30) days notice of any change in the nature of Merchant's normal business hours or any location transfers and moves. i. Not post or allow to be posted on the equipment any signs, plaques, advertising or other material except as may be authorized in writing by Provider. j. Not allow any like equipment to be installed at the Site without the prior written consent of Provider. k. Allow Equipment owner to place signage including a banner on the exterior of the building and list Equipment availability on all advertising. l. Merchant provides equipment cash; 1) perform weekly balancing functions at the equipment and maintain a balancing log in the format provided by Provider. The balancing log must show weekly detailed terminal totals; 2) print and store the equipment's transaction journal log as instructed by Provider for a period of three (3) consecutive years. m. Merchant provides equipment cash and if an equipment transaction is disputed by the cardholders (Customer's) financial institution and, as a result, charged back by that financial institution, Merchant hereby approves charging (debiting) the amount of any such dispute, plus any assessed fees, directly to Merchant's equipment cash clearing account. n. Merchant shall be responsible for payment of any sales, use or property taxes, which are levied against the equipment or premises during the term of this agreement. Responsibilities of Provider: Provider shall: a. Install the equipment on or before sixty (60) days from date of this contract. b. Maintain the equipment and repair same in a timely manner. c. Provide Merchant with appropriate instructions and training with regard to the operations of the equipment. d. If so indicated, provide the necessary working cash for the operation of the equipment. e. Provide Merchant with copies of the monthly reports received by Provider from its electronic funds service provider showing the services performed and the charges collected for the use by the public of the equipment. f. Cause to be transferred directly to Merchant's designated bank account the cash advanced by Merchant (if merchant supplies its own cash) through the equipment. Transfers with regard to cash advances shall be made on a daily basis, weekends, bank holidays excepted, unless otherwise agreed by Merchant. Transfers of Merchant's share of surcharge fees shall be made on a monthly basis. Payment will be by check or by automatic deposit. g. Inventory an adequate supply of paper and ribbons at Merchant's premises, which are available from Provider at no cost to Merchant. h. Provider will be exercising due diligence upon the execution and acceptance of this Equipment Location Agreement for the purposes of our placement program, the monthly minimum revenue must be met for all equipment placed under this Agreement. The Provider may raise the surcharge amount to meet the minimums. Provider exclusively reserves the right to impose a monthly minimum billing to the Merchant or relocate at its discretion any equipment which is not performing the prescribed minimum number of transactions after 90 days. Term: The term of this Agreement shall commence upon the date that the equipment has been installed and is operational and shall continue for a period as indicated. Thereafter, the Agreement shall be automatically renewed for successive three (3) year terms until one party gives the other not less than one hundred eighty (180) days written notice of its intent not to renew. Upon transfer of merchant business, it shall be merchant’s responsibility to obtain transfer of this agreement to new merchant with EFTC’s written consent. Notwithstanding the foregoing, a party may terminate this Agreement upon three (3) days written notice in the event of a breach by the other party of a material provision of this Agreement if same has not been cured within seven (7) days of written notice from the non-breaching party as to the specifics to the extent known, of the breach. Waiver: The failure of either party to enforce at any time a provision of this Agreement or to exercise any right herein provided shall not in any way be constructed to be a waiver of such provision or right and shall not in any way affect the validity of this agreement or any part hereof, or limit, prevent or impair the right of such party subsequently to enforce provision or exercise such right. Default: If you do not replenish cash in the equipment or if you break any of your promises to this Agreement, you will be in default. If you default, liquidated damages equal to the last twelve (12) months revenue produced by the equipment or $2500.00, whichever is greater will be assessed and you must return the equipment to us. We can also use any of the remedies available to us under the Uniform Commercial Code or any other law. If we refer this agreement for collection, you agree to pay our reasonable collection costs, including attorneys’ fees. Such collection charges include, but are not limited to, charges for collection letters, collection phone calls we make, and charges of collection agencies, courts, sheriffs, etc. If we have to take possession of the equipment, you agree to pay the cost of repossession. You agree that we will not be responsible to pay you any consequential or incidental damages for any default by us under this Lease. This Lease shall be interpreted under the laws of the State of South Dakota, and the parties agree that in any cause of action, the venue and jurisdiction will be vested solely in the Courts of the State of South Dakota, located in Pennington County, South Dakota. Entire Agreement: This Agreement, together with the exhibits hereto, represents the entire understanding between the parties with respect to the matters contained herein and may be amended only by instrument in writing signed by the parties hereto. There are no representations or warranties, express or implied, other than those contained herein. Notice: Any notice required or permitted hereunder shall be in writing and may be given by personal service or by depositing same in the United States Mail, first class postage prepaid, to the address of the party receiving the notice as appears on the signature page of this Agreement or as changed through written notice to the other party. Binding Effect: This Agreement is binding on the parties and their respective successors and assigns. Merchant must assign this Agreement as part of a sale of the business and request consent of the Provider, which will not be unreasonably withheld. Severability: If any provision of this Agreement, or the applicability of such provision to any person or circumstance, shall be determined to be invalid by any court of competent jurisdiction, then such determination shall not affect any other provision of this agreement, all of which provisions shall remain in effect and, if the provision is capable of being construed in two ways, one of which would render it valid, the provision shall have the meaning which renders it valid. Validity and Enforceability: Proprietor represents and warrants that the execution and delivery of this Agreement by it have been duly authorized by all actions required under the terms of the provisions of its governing instruments and creates a legal, valid and binding obligation on Merchant.











The merchant, by initialing here, acknowledges reading this page._________________________
Page 2 of Equipment location agreement 8/6/08

ACH SETTLEMENT INFORMATION Merchant Name: Authorized Signature: Who do we call if we have any questions? Name: Phone: Please attach a voided check from the DDA account that you would like us to credit and/or debit in the space provided.

Attach voided check here !

ACH settlement will remain in effect until we receive 30 days written notification of your request for change.





dba of Data Capture Systems, Inc.

MERCHANT: _____________________________________________________

___ Exterior Banner 72" x 24" "ATM Inside" (1furnished if allowed) Exterior Metal "ATM INSIDE" Sign with hanging bracket (can be substituted for Banner) Lawn Sign 24" x 18" "ATM Inside" (1 furnished if space available) Arrow Hanging Sign 16" x 24" "ATM" with Arrow (1 furnished) Lighted Window Sign 5" x 18" "ATM" (1 ea. furnished if window space) Cash Register Decal 5" x 3" "ATM Machine" (1 ea. furnished) Gas Pump Decal 5" x 3" "ATM Machine" (1 ea. fuel pump) Topper Decal 18" x 9" - Showing Cards Accepted (1 for ea. Triton topper if needed) Napkins "Need Cash - ATM"




___ ___













___ Total $ _____________


Return to MSI-SD indicating number of items required.

Corp: 231 Quincy St., Box 3074, Rapid City, SD 57701  Tel. 800-888-4457 Fax (605)341-5407