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CM-08-01-004BLUE SHEET FORMAT DATE: January 9, 2008 SUBJECT: City Manager - January 11, 2008 ITEM: Consider having the City Manager sign authorization forms for Pitney Bowes in order to consolidate all postage accounts under a single account for the City of Round Rock. Department: Finance Staff Person: Cindy Demers, Finance Director Justification: This consolidated account will allow the City to better manage the flow of funds into the various postage meters and bulk permits in the various departments. This consolidation allows for online reporting by meter for administration purposes and gives quicker access to departments for meter refills. The City currently has five different meter accounts and 2 permit accounts which will be consolidated into a single administrative account. Funding: Cost: 0.00 Source of funds: N/A Background Information: N/A Public Comment: N/A Blue Sheet Format Updated 01/20/04 JL 1.11--tp PitneyBowes Engineering the flow of ` comm on rca do n Funds Transfer Authorization Form All Fields are required Requests with missing or illegible data cannot be processed Today's Date: 1 1- ILO -01 Postage By Phone® Account # q OS65 (p Company Name: C 1 k o� O v+ o C,k Contact Name: Tax Identification #: Contact Phone: (512) 218-5444 Contact Fax/Email: ewilson@round-rock.tx.us Elaine S. Wilson 746017485 I, as a duly authorized representative of the company named above, hereby request and authorize the transfer of the current balance held by the United States Postage Service in respect to the Pitney Bowes Postage by Phone® account identified above, to our Pitney Bowes Reserve Account. It is the company's intention to use the Pitney Bowes Reserve Account for the funding of postage. Authorized Signature: X Jame- R. Nuse, City Manager E -Mail your completed forms to Theresa Bodick@pb.com or Fax this completed to (203) 460-5583 Pitney Bowes use only: Approval 1: Approval 2: Processed by: Pitn Lit r eyBowes PHONE: 1-800-243-7800 • FAX: 1-203-546-2277 DEAR VALUED CUSTOMER: FEDERAL LAW UNDER THE USA PATRIOT ACT REQUIRES US TO OBTAIN A FEDERAL TAXPAYER IDENTIFICATION NUMBER (TIN) FROM EACH CUSTOMER OPENING A PITNEY BOWES BANK ACCOUNT. PITNEY BOWES BANK PRODUCTS INCLUDE THE PURCHASE POWER ACCOUNT AND RESERVE ACCOUNT. YOUR TAXPAYER IDENTIFICATION NUMBER (TIN) IS YOUR EMPLOYER IDENTIFICATION NUMBER (EIN) IF YOU ARE A PARTNERSHIP, CORPORATION, BANK, STATE OR GOVERNMENT AGENCY, OR NON-PROFIT ORGANIZATION, OR YOUR SS NUMBER IF YOU ARE A SOLE PROPRIETOR. ADDITIONALLY, THE INTERNAL REVENUE SERVICE (IRS) REQUIRES US TO OBTAIN TAXPAYER IDENTIFICATION NUMBERS (TIN) FROM CUSTOMERS IN ORDER TO REPORT THE FREE POSTAGE EARNED ON THE RESERVE ACCOUNT. PLEASE COMPLETE THE FORM BELOW AND RETURN BY FAX TO 1-203-460-5583. THANK YOU. INFORMATION REPLY FORM Tax Identification Number (TIN) 7 4 6 0 1 7 4 8 5 Certification. Under penalties of perjury, I certify that: (1) The number shown above is my correct taxpayer identification number (or I am waiting for a number to be issued to me); (2) I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and (3)1 am a U.S. person (including a U.S. Resident Alien). If you have been notified by the IRS that you are subject to backup withholding, cross out item 2 above. S ture of Principal James R. Nuse City Manager Please indicate if your company is one or more of the following: o Partnership o Sole Proprietor o Corporation o Other o Bank o State/GovtAgency o Non -Profit o Foreign Organization Name: C 0-P Bound hack Postage By Phone Acct #: 1-1q 6555--(0 (8 -digits) Lk- c Z Pitney Bowes Acct #: —1-1 I - - 2-0 - (11 -digits) Reserve Account Deposit Instructions: To ensure timely application of funds: 1. Make checks payable to "Reserve Account" 2. Your 8 digit Postage By Phone Account number (PBP#) should appear deposits pP on all Regular Mail: Reserve Account P.O. Box 856056 Louisville KY 40285-6056 Express Mail: Reserve Account 5101 Interchange Way Louisville KY 40229 Bank Wires: (Wires received prior to 1 PM EST will be applied that day) Destination Bank: Routing Number: City, State: FDN (Beneficiary): AC (Account Number): OBI (Other Information): ACH Credit: Remit to: Routing Number: Credit to Account Number: Company Name: National City Bank of Kentucky 08300005-6 Louisville KY Pitney Bowes Reserve Account 754401126 Account Name /PBP # Postage By Phone® 1240-8462-7 (PBP#) Customer Name Go to PostagebyPhone.com to obtain daily weekly and monthly Postage reports }uawpedaa eoHod env pep6e8 M LO£ COO - 8£OPZOL co v O cp. o • 00 m m O c E ° co al m m N cQ vco r) o v "CT O m CD X X X X X CD cD m CD CD D D cD sit v v iv-) uoReoo1 uiew COO - St06.1717L Jeuuedp Ja481 uopooi unq ZOO - 81"061 i L 6ui1eJ poses adegs w w w rn rn rn OD w w CA.) CO O -lmm-1—ccncnKoo OOOOOO0000v0)O(Q') tNv O Co N 0 0 CI) O O O O rs A N W -� W W O w 0 0 w v 0 CO K3 0) W uogeoo-j umA) X00 - Z981 -88Z uopoo1 u!eW 1-00 - 6Z81 -88Z pot' punoj Jo 40 r cr. N CD K o v m O O CO , -, 0 cn cn Fir ��vOajrn� CD 3 Fp, am o c CD 0 - • 3 rt w CO N con 00000-o-°0 a - o (7t000oiC(1)00 CD 0 47, 0 uiuiewa; Waal 0 a cD N0) N W N(0 -aOCb C71 CO C3tO 01 cp . O OW SO W W W O OW O 0) O c3)01c coIt T7 0 # lunooad dad Centralized Account Processing System (CAPS) Electronic Funds Transfer Authorization Agree... Page 1 of 2 UNITED STATES POSTdLSERYKEo Horne PS Form 6003 - Centralized Account Processing System (CAPS) Electronic Funds Transfer Authorization Agreement Centralized Account Processing System (CAPS) Electronic Funds Transfer Authorization Agreement This form is an authorization agreement for Automated Clearing House pre -authorized corporate payments. The undersigned hereby authorizes the U.S. Postal Service to originate debit and/or credit entries via the Automated Clearing House to the account indicated below at the Depository Financial Institution named below, to accept and to debit/credit the amount of such entries to the account. Bank Name: !Mellon Bank Contact Name:JConrad Tselepis, Sharon Freund Telephone No.:J412-234-9587, 412-234-4141 Address: City:State: IPA ZIP+4: 115262 Bank Account Number: 155700 Bank Transit ABA Number: 1043000261 This authorization will remain in effect until written notification of termination has been given by the customer and that notification has been received by the Manager, CAPS Service Center (for the U.S. Postal Service). In addition, the U.S. Postal Service, in its discretion, may terminate the customer's ability to participate in the Electronic Funds Transfer system. Any termination will take effect only after all entries originated by the U.S. Postal Service have been honored by the bank. Name: (As shown on bank account)) C 1 Jof _ e0 u aock..e0 Taxpayer ID Number:746017485 Address: ! a a i E City: 1 Found eoc _ State: J ZIP: J (CAP'-{ Authoriz-d SignatureJames R. Nuse Signature: Date: I -iI-ne Customer, bits signature above, and the U.S. Postal Service, by its initiation of a debit authorized, hereby agree to be bound by the National Automated Clearing House Association (NACHA) rules relating to Corporate Trade payment entries in the administration of these debit entries. Debit entries will be initiated only as authorized above. Any issues, objections, or discrepancies regarding the amounts debited will be reported in writing to: MANAGER CAPS SERVICE CTR 2700 CAMPUS DR SAN MATEO CA 94497-9442 no later than 90 days from the debit date. Failure to deliver such notice within the prescribed period http://caps.usps.gov/business/eftaa.asp 10/19/2004 Centralized Account Processing System (CAPS) Electronic Funds Transfer Authorization Agree... Page 2 of 2 will serve as an absolute waiver by the Customer of any and all remedies, causes of action, and other forms of relief arising out of or in connection with each such debit transaction. The U.S. Postal Service will then have 30 days in which to respond. This authorization is not governed by the provisions of Postal Service Publication Number 41, Procurement Manual, or the Contract Disputes Act. PS Form 6003, October 2001 PS Form 6001, CAPS Application. All applicants must complete and submit this form to apply for a CAPS account. PS Form 6002, Local Account Information. All applicants must complete and submit this form with information about current trust accounts. [ Overview I Services & Support I Q&A 1 Account Inquiry 1 Account Inquiry Help 1 Forms Copyright © 1999-2002 USPS. All Rights Reserved. Privacy Policy http://caps.usps.gov/business/eftaa.asp 10/19/2004 61 PitneyBowes Postage By Phone ® Reserve Account Permit Mail Enrollment Form Pitney Bowes enables you to pay for USPS permit postage through your Postage By Phone® Reserve Account at The Pitney Bowes Bank, Inc. You'll enjoy the convenience of one account for payments and tracking of your meter and permit postage. Now, your permit mail postage dollars will earn the same rewards - free postage - that you earn for your meter postage through Reserve Account. You can combine one or more permits for all your permit mailings through your Reserve Account. One account, one postage payment address, and one source for your all your postage - with more rewards! Please indicate below the information regarding each of the permits you want linked to your Postage By Phone® Reserve Account: Permit Location City/State Permit . Number Annual Permit Postage Dollars Annual Number of Permit Mailings Rocrnd eoce, Tx I `i Kochd to -k, TX 14 . > Please be aware that not all USPS locations have access to the Centralized Account Processing System (CAPS), which is required to take advantage of the program. You will be contacted if your USPS location does not qualify.. > Once your permit mail postage through USPS is linked to your Postage By Phone® Reserve Account, Pitney Bowes and the USPS will contact you via phone or email that your account is active and your prepaid account balance with Reserve Account will automatically fund all you future USPS permit mailings. > Please check here if you would like to receive combined statements for your Permit Reserve and Meter Reserve Account v" Yes No • Please provide the following information to acknowledge your enrollment in the program and acceptance of the attached Terms and Conditions. Business Name: C OT (O u ne f•.OGk. 4 Tax ID Number: 746017485 PBP# 07 t-1 q S6 S i0 CAN#: --1-1I(v-- 4C,u2- 2O-1 Address: D.0.1 e Ma In S+ City, State &ZIP 'RQk n d - enc, T)( -721 L_ Phone number: E-mail Address: ewilson@round-rock.tx.us Contact Name Elaine S. Wilson 'Authorized Signature: V -Th mes R. Nus-, City Manager Sales representative na, e - rt rti e FSD Name -1-11e r.esQ Date: i 1 1- Sales Representative# cd IC k- District 3 t\ Ar tr>n I d > Please fax the completed form to 203-922-4630 or e-mail to robert.avesato@pb.com or shelley.houser@pb.com. For questions or more information about the program, please call Rob Avesato at 203-922-4615 or Shelley Houser at 203-922-4296. Note: Please allow 30 days for us to link your permits to your Postage By Phone® Reserve Account. Postage By Phone® Reserve Account— Agreement and Disclosure Statement; Effective date: October 1, 2005 Important Information for Participants in the Postage By Phone® Reserve Account Program This Postage By Phone® Reserve Account Agreement and Disclosure Statement (this "Agreement") contains the terms and conditions goveming the Postage By Phone® Reserve Account Program (the "Program"). As used herein, the terms "Pitney Bowes" means Pitney Bowes Inc., "Bank" means The Pitney Bowes Bank, Inc., a Utah industrial loan corporation, and "we," "us" and "our' means Pitney Bowes and the Bank. "You" and 'your" mean the corporation, partnership, limited liability company, association, sole proprietorship, or other business entity in whose name your Account (as defined below) has been opened. 1. This Is Your Contract With Us: By participating in the Program in any manner, or by failing to cancel your participation in the Program in writing within 30 days after receiving this Agreement, you are confirming your agreement to be bound by the terms of this Agreement. You further agree to provide to Pitney Bowes an executed W-9 Form of the Internal Revenue Service or an appropriate alternative certification. 2. Business Customers Only: The Program is available only to corporations, partnerships, limited liability companies, associations, sole proprietorships and other business entities. You acknowledge that your participation in the Program is not for personal, family, or household purposes. 3. Description Of The Program a) Reserve Account. As a participant in the Program, a savings account (your "Account") has been established in your name at the Bank. Deposits to your Account may be made at any time by mailing a check a money order or by sending funds electronically to the Bank. When you use the Pitney Bowes Inc. Postage By Phone® service or the United States Postal Service® CAPS service, you authorize your Account to be debited electronically that day in an amount sufficient to cover the postage meter refill and/or permit mail postage purchase, and related fees and charges, if any. You agree that these are the only types of electronic transfers that you can make from your Account You may withdraw funds from your Account by sending a written request to the Bank requesting a withdrawal. In any event, no transfer or withdrawal may be made from your Account in an amount which is in excess of the balance in your Account less the aggregate amount of any debits to be made under Section 3(c) below. Subject to the terms of this Agreement, funds from your Account to pay for postage will be transferred to the United States Postal Service upon receipt of your instructions. Any funds that you have on deposit with the United States Postal Service will be used in full before any funds are transferred from your Account b) Limits on Withdrawals. You may not make more than six transfers or withdrawals from your Account in any statement period. You agree not to authorize any third party to debit or draw on your Account. The Bank has the right to require seven days prior written notice of withdrawal. c) Reserve Account Plus. In the event you exceed six transfers or withdrawals from your Account in each of any two statement periods within 12 months, you agree that in each subsequent statement period, in lieu of immediate debits to your Account for meter refills and permit mail postage purchases, your Account may be debited each Friday, and/or on the last business day of the month, for all meter refills and permit mail postage purchases made during that week. d) Overdrafts; Overdraft Fee. In the event that (i) there is an overdraft in your Account which arose as a result of a debit thereto made to effect a refill of your postage meter and either (x) you are not a Purchase Power® customer or (y) you are a Purchase Power® customer but your Purchase Power® line of credit is not available in the amount of such debit, (ii) there is an overdraft in your Account which arose as a result of a debit thereto made to pay for permit mail postage and either (x) you are not a Pitney Bowes EasyPermitPostage® Reserve customer or (y) you are a Pitney Bowes EasyPermitPostage® Reserve customer but your Pitney Bowes EasyPermitPostage® Reserve Zine of credit is not available in the amount of such debit, or (iii) there is an overdraft in your Account which arose other than as specified in clauses (i) and (ii) above, you agree to pay the amount of the overdraft to the Bank (which shall be reduced to the extent that the Purchase Power® line of credit or the Pitney Bowes EasyPermitPostage® Reserve line of credit, as the case may be, has been applied thereto), together with interest thereon, for each day from the day the overdraft arose until such amount is paid to the Bank, at the daily periodic rate of 0.0555% (corresponding Annual Percentage Rate 19.98%) on demand. In the event that an overdraft arises as to which you have an obligation to make a payment to the Bank under this Section 3(d), you agree to pay to the Bank an overdraft fee equal to .5% of the overdraft promptly after the overdraft is created. 4. Reserve Account Rewards: Pitney Bowes will pay you Reserve Account Rewards in an amount equal to 1.0% per annum (0.0833% per month) of your average daily Account balance ("Reserve Account Rewards"), provided, however, that you shall not receive such payment for any month as to which the amount calculated as aforesaid for such month shall be less than $4. Your Account balance is the net amount in your Account each day after accounting for all transactions in your Account that day and Tess any debits to be made under Section 3(c) above. The average daily Account balance is calculated by adding your Account balance for each day of the period and dividing that figure by the number of days in the period. Reserve Account Rewards are credited monthly. You are responsible for any federal, state and/or local tax liability that arises as a result of your receipt of Reserve Account Rewards. If you close your Account before any Reserve Account Reward is credited, you will not receive the amount of any accrued Reserve Account Reward which has not been redeemed for postage. 5. Authorization: You authorize Pitney Bowes to debit your Account electronically for the purposes specified in Section 3(a) above. 6. Termination Of Authorization: Your authorization contained in Section 5 above is required for your participation in the Program, and shall remain in full force and effect until written notice of modification or termination of authorization from you has been received by us at Postage By Phone® Reserve Account, P.O. Box 5135, Shelton, CT 06484-7135, and we have had a reasonable period of time to act thereon. 7. Purchase Power® Account; EasyPermitPostage® Reserve Account: Subject to Section 3(c) above, if you are a Purchase Power® customer, postage meter refills and other related fees and charges which exceed your Account balance will be paid for by debiting the full amount in your Account, and the remaining balance of such refills and related fees and charges will be charged to your Purchase Power® line of credit, to the extent such credit is available. Subject to Section 3(c) above, if you are a Pitney Bowes EasyPermitPostage® Reserve customer, permit mail postage purchases and other related fees and charges which exceed your Account balance will be paid for by debiting the full amount in your Account, and the remaining balance of such purchases and related fees and charges will be charged to your Pitney Bowes EasyPermitPostage® Reserve line of credit, to the extent such credit is available. Purchase Power® transactions are subject to the provisions of your Purchase Power® Terms and Conditions, and Pitney Bowes EasyPermitPostage® Reserve transactions are subject to your Pitney Bowes EasyPermitPostage® Reserve Service Agreement. 8. Statements: We will mail or make available to you a Postage By Phone® statement showing your transactions under the Program, including deposits, debits for postage meter refills, permit mail postage purchases and any related fees and charges, and credits for Reserve Account Awards. Your Postage By Phone® statement will be sent to you at the current address shown in our files, unless you request in writing that we send statements to a different address. 9. Address And Telephone Number. If you have any questions regarding the Program or your Account, call 1-800-243-7800 during regular business hours, or write to us at Postage By Phone® Reserve Account, P.O. Box 5135, Shelton, CT 06484-7135. 10. Business Days: Our business days are Monday through Friday. Saturdays, Sundays, and national holidays are not business days. 11. Account Charges: If a check that you deposited with the Bank is returned unpaid by the financial institution on which it is drawn, the amount of the returned check will be charged against your Account The Bank will charge a fee for all deposited items retumed unpaid, which fee currently is $50 or 1% of such deposited item, whichever is greater. If your Account has had no transaction activity for a year or longer, you agree to pay a maintenance fee of $50; provided, however, that such maintenance fee shall not be assessed more than once in any 12 -month period. 12. Disclosure Of Account Information To Third Parties: Neither Pitney Bowes nor the Bank will disclose information to third parties about your Account or the transactions you make except a) Where necessary for completing transactions; b) To comply with applicable laws, govemmental regulations, or legal process (such as a court order or subpoena); c) To our affiliates (persons that control, or are controlled by, or under common control with, the Bank or Pitney Bowes); or d) If you give us your written permission. 13. Incomplete Payments Or Transfers: We reserve the right to cancel and not make certain transfers for various reasons, including but not limited to: a) The payment or transfer would exceed the amount of money you have in your Account; b) The funds in your Account are subject to legal process or other encumbrances restricting payments and transfers, or your Account has been re -titled, closed or blocked for security purposes; or c) Circumstances beyond our control (such as, but not limited to, fire, flood or interference from an outside force) prevent the proper execution of the transaction and we have taken reasonable precautions to avoid those circumstances. 14. In Case Of Error Or Questions About Your Electronic Transfers: Telephone or write us using the address and telephone number provided in Section 9 above as soon as you can, if you think your Reserve Account Statement is wrong or if you need more information about a transfer or item listed on the statement. We must hear from you no Tater than 30 days after we sent you the FIRST statement in which the problem or error appeared. a) Tell us your name and Account number. b) Describe the error or the transfer you are unsure about, and explain as clearly as you can why you believe it is an error or why you need more information. c) Tell us the dollar amount of the suspected error. if you tell us orally, we may require that you send us your complaint or question in writing within 10 business days. We will tell you the results of our investigation within 10 business days after we hear from you and will correct any error promptly. If we need more time, however, we may take up to 45 days to investigate your complaint or questions. If we decide to do this, we will recredit your Account within 10 business days for the amount you think is in error. If we ask you to put your complaint or question in writing and we do not receive it within 10 business days, we may not recredit your Account 15. Other Terms And Conditions: a) Assignment/setoff. We may assign this Agreement, and the Bank may assign your Account, without obtaining your consent. You may not assign or transfer your Account or this Agreement without our prior written consent. You also agree that, subject to applicable law, we have a lien and security interest and right of setoff in your Account. This means that if you owe us money for any reason, we may take the funds owed to us from your Account to the extent allowed by law, even without giving you prior notice. b) What law applies. This agreement is governed by the laws of the state of Utah and applicable Federal laws. c) Provisions severability. If any provision of this Agreement is held to be invalid or unenforceable, the rest of this Agreement will not be affected. d) Legal action. If we initiate any legal action to collect money owed to us under this Agreement, you agree to pay all our costs for such action, including any reasonable attomeys' fees. e) Federal deposit insurance. Funds deposited in your Account are insured by the Federal Deposit Insurance Corporation (FDIC), up to a maximum of $100,000. f) USA PATRIOT Act. To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account Accordingly, in order to activate your Account, the Bank asks that you provide identifying information, including your address and taxpayer identification number. The Bank may also ask for additional identifying information, where appropriate, including asking that your representative who is opening your Account to provide his/her name, address, date of birth, driver's license and/or other documents and information that will allow the Bank to identify him/her. You agree to provide all such requested identifying information. Information About Your Current Trust Accounts UNITED STATES POSTAL SERVICE. Home PS Form 6002 - Accounts and Services to be Paid Through CAPS Accounts and Services to be Paid Through CAPS Company C P Y Name:0-1` Round_ e,0_Gh.._ CAPS Account Number (For linking additional permits): I Provide the following information for permits to be linked to your CAPS account: AEC Payment 0 Please check if applicable. Account Type BRM = Business Reply Mail P= Periodicals Page 1 of 2 PD = Postage Due PI = Permit Imprint EM = Express Mail Corporate Account Permit Number " Type City, State & ZIP Code Date to Lir► a ( See above) (Where permitis held) , `(Aflow7 'i da rs) I44 5 M pt eaunot eoct, TV Zouhd Rock, TX Use additional page if necessary. Please print the name of the Primary Contact: !Elaine S . Wilson Signature of Primary Contact (For linking additional permits): littp://caps.usps.gov/business/ctas.asp 10/19/2004 Information About Your Current Trust Accounts Signature: l.._......... Date: PS Form 6002, October 2001 Page 2 of 2 PS Form 6001, CAPS Application. All applicants must complete and submit this form to apply for a CAPS account. PS Form 6003, EFT Authorization Agreement. Only applicants who wish to establish a CAPS debit account complete and submit this form. When linking to a CAPS trust account, funds in the local permit account at time of linking (except EMCA) will be transferred to the CAPS trust account unless otherwise specified. [ Overview' Services & Support 1 Q&A 1 Account Inquiry 1 Account Inquiry Help 1 Forms ] Copyright © 1999-2002 USPS. All Rights Reserved. Privacy Policy http://caps.usps.gov/business/ctas.asp 10/19/2004