Merchant DBA:
1. Willyouprovidemewithlocal,face-to-faceservice? Yes No
a. If yes, how?
2. Areyou? W2Employee AnIndependentContractor RepforanISO
3. Willadedicatedrelationshipmanagerbeassignedtoservicemybusinesslocallyonanongoingbasis?YesNo
4. WhenIcallforcustomerortechnicalsupport,ismycallhandleddomesticallyorinternationally?
5. Arecustomerortechnicalsupportcallsansweredbyyourcompanyspecificallyorarethosecallsoutsourcedtotheprocessor?
6. Whatarethehoursforcustomerortechnicalsupportcalls?
7. WillIneedtoleaseorpurchaseequipmentfromyou? Lease Purchase Neither
a. IsthereawarrantyandwhowouldIcontactifmyequipmentfails?
8. WhattypeofpricingstructurewillIbeon?(Pleaseexplainindetail)
9. Supplyadefinitivefeeanddiscountperitemfor:
Enterprise Business Park | 400 Technology Way | Scarborough, Maine 04074 | 877-290-1975 | getnationwide.com
PIN-based Debit:
Signature Based Debit:
Qualified:
Rewards 1:
Rewards 2:
Mid-Qualified:
Non-Qualified:
Statement Fee:
Compliance Fee:
PCI/Security Fee:
Annual Fee:
Maintenance Fee:
Installation Fee:
Batch Fee:
Enterprise Business Park | 400 Technology Way | Scarborough, Maine 04074 | 877-290-1975 | getnationwide.com
10. Howlongaremyratesandfeesguaranteednottochange?
11. HowdoesyourcompanyhandlerateincreasesanddecreasesfromVisa,MasterCard,Discover?
12. AfterIsettlemybatch,howlongdoesittaketoreceivemyVisa,MasterCard,andDiscoverdeposits?
13. Howarethedepositsidentifiedonmybankstatement?
14. Whendoyoudebityourfees? Daily EndoftheMonth Both
15. Pleaseattachasamplecopyofamonthlystatement.
16. Pleaseattachalistoffivemerchantreferencesinmyimmediatearea–includingcontactinformationforeachaswellasyourbusinesscard.
17. CanyoudocumentmonthlysavingsIwillreceivebydoingbusinesswithyourcompany? Yes No
a. Ifyes,wherewillthesesavingsoccur?
18. Pleaseattachyourproposalaswellasthecompletetermsandconditionsofyourmerchantagreement.
19. IfIdecidetodobusinesswithyourcompany,willIbeinacontract?YesNo
a. Ifyes,whatisthelengthofthecontact?
20. Doesthecompanyyourepresenthaveanearlycancellationpolicy? Yes No
a. Ifyes,pleaseexplainthecancellationpolicyindetail.
21. Whatpenaltiesarethereforanearlycancellationofmyservicewithyou?
MysignaturebelowconfirmsIhavedisclosedall feesandguaranteethe accuracy ofthecompetitiveproposalIhavesubmittedonbehalfofmyorganization.
Merchant DBA:
Printed Name:
Signature: ______
Date:
Enterprise Business Park | 400 Technology Way | Scarborough, Maine 04074 | 877-290-1975 | getnationwide.com