CM-12-05-094ADDENDUM HE FUEL CARD SERVICES AGREc)ENT BETWEEN
WRIGHT EXPRESS FINANCIAL SERVICES CORPORATION ("WEX FSC")
AND THE NATIONAL JOINT POWERS ALLIANCE (NJPA)
CREDIT INFORMATION
Participating Entity has requested a credit account pursuant to the Vendor Agreement #062411-WEF (Agreement), ("Agreement") entered into between the National Joint
Powers Alliance ("NJPA") and Wright Express Financial Services Corporation ("WEX FSC"). By enrolling in this Program, the Participating Entity named below agrees that in
the event their account is not paid as agreed, WEX FSC may report the undersigned's liability for and the status of the account to credit bureaus and others who may lawfully
receive such information.
Participating Entity
City of Round Rock Texas
Phone #
5122185400
Fax#
5122185442
Headquarters Name and Physical Address (Do not include PO Box)
City of Round Rock Texas 221 East Main Street Round Rock, Texas 78664
NJPA Member ID Number
6969
Applicants Taxpayer ID # (TIN, FEIN or SSN)
74-6017485
In Business Since
Write Participating
R®CIlld
(yyyy)
Entity
name
R®ck1
Year of Incorporation
as you wish
(yyyy)
it to appear
t!:®pS
on
cards.
Number
900
ACCOUNT
Limit
of
of Vehicles
20 characters
SETUP INFORMATION
& spaces.
Avg Monthly Fuel Expenditures
$160000
Unless specified, no company
Avg Monthly Service Expenditures
$0
name will appear on cards.
Billing Contact
Sherri Crone
Billing Address
221 East Main Street
City
Round Rock
State
TX
Zip+4
78664
Designate the Fleet Contact authorized to receive all charge cards, reports, and other such information we provide from time to time and to take ac ions with respect to your
account and account access. This is also the person designated by your company to provide all fleet vehicles, driver and other information we may request.
Authorized Fleet Contact Name
Chad McDowell
Title
GSD
Phone #
512-341-3191
Fax #
Mailing Address (if different from billing address)
2008 Enterprise Drive
City
Round Rock
State
TX
Zip+4
78664
Email address (required to take advantage of product type card controls)
cmcdowell@roundrocktexas.com
Card Controls: To help estimate your credit needs, indicate the types of cards you
anticipate using.
If you provide a valid email address above, you can select from these product type options
0 All Products ® Fuel & Service 0 Mix of card types
0 Fuel & Fluids w/Roadside Assistance 0 Fuel w/Roadside Assistance
ID Check here if business is exempt from motor fuels tax
TERMS
1. This Addendum is to allow the Participating Entity to participate under the Agreement between WEX FSC and NJPA. It does not modify, amend or change
the Agreement in any way.
2. Participating Entity hereby requests the services of WEX FSC described in the Agreement and agrees to perform all duties required under the Agreement,
including, without limitation, timely payment of all charges (including any additional fees) on its account(s) . Participating Entity agrees to be bound by the
terms and conditions of the Agreement, including, without limitation, rules for authorized and unauthorized use of cards, disputes of charges, reporting lost
and stolen cards, and all other rules and provisions relating to use of Participating Entity's account.
3. Participating Entity acknowledges that its failure to make timely payment in accordance with the terms of the Agreement may result in suspension or
cancellation of the account(s).
INFORMATION SHARING DISCLOSURE: Information regarding your transactions may be provided to NJPA accepting merchants or their service
providers.
DISCLAIMER: THIS IS AN APPLICATION FOR SERVICES AND SHALL NOT BE BINDING UPON WEX FSC UNTIL FINAL CREDIT APPROVAL HAS BEEN
GRANTED BY WEX FSC.
PARTICIPATING ENTITYAUTHORIZED SIGNATURE REQUIRED
Any person signing on beha •f the Participatin• Entity has been duly authorized by all necessary action of Applicant's governing body, and that the undersigned is
authorized to make tr„� i•n and a - • he terms referen : herein on behalf of the Participating Entity.
Signature: � / �J / Printed Name: S'/C(/2 /L/O C'
_
Title:C./7?-7"74),,,Ge!, -p y Date: c.---// — %7"
Complete and sign addendum. Fax to 207-791-1606
FOR OFFICE
USE ONLY
Oppty Number
04 ADDEND.CRDAPP
Sales Code
10900072
Plastic Type
NJPA
Coupon Code
NJA
Account Number
04