MERCHANT AGREEMENT RENEWAL APPLICATION
Name of Business _______________________________________________________
Business Address (Include City and Zip Code)
Name of Store Manager
Business Phone Number
Business FAX Number
Corporate Owner Name (The entity that owns the above business)
Corporate Owner Address
(Include City and Zip Code)
Corporate Phone Number
Name of State
Where business was incorporated
Type of Corporate Entity
(Examples: Sub corp., C Corp.)
Name and Corporate Title of person signing legal agreement
Number of years in business
Years business has been at this location
Type or Description of Business
(Examples: Fast Food, Convenience)
Alcohol sold on premises (Yes/No)
Reimbursement Address (Where you want checks mailed)
Return this form to:
Allison Ayo
Colonel Card
Nicholls State University
P. O. Box 2045
Thibodaux, LA 70310
COLONEL CARD AGREEMENT
This Agreement is hereby made between Nicholls State University, Thibodaux,
LA, herein referred to as NSU and
, having a principal place of
business at
, herein referred to as MERCHANT, hereto
agree and covenant as follows:
PURPOSE
For the convenience of the students, faculty, and staff, NSU agrees to contract
with a Merchant for the purpose of administering the Colonel Card program at
Merchant’s place of business. The Colonel Card is offered to all NSU students, faculty,
and staff.
IN STORE
Merchant will verify the customer’s ID and deduct the amount of the purchase
from the customer’s account by scanning the patron’s Colonel Card through VX570
merchant terminal. Merchant will verify that the student, faculty, or staff member has
their own ID card. All revenues due Merchant will be computed on the dollar amount
scanned through the VX570 merchant terminal. Merchant will not allow ID card holders
to receive cash back for any reason. All individuals requesting a refund for a purchase
that was paid for with the Colonel Card, must have the entire amount refunded credited
to the ID holder’s account. Any merchant who refunds cash to a card user will be
removed from the Colonel Card program.
Merchant will verify by visual inspection that the person in the possession of the
Colonel Card is the person pictured in the photo on that card prior to accepting a Colonel
Card payment. Merchant acknowledges and agrees that NSU will not be liable for
payment to Merchant for any Colonel Card transactions consummated by merchant on a
lost or stolen Colonel Card, it being expressly acknowledged and agreed by merchant
that merchant shall be solely responsible for verifying the validity of any Colonel Card
presented to merchant in payment for merchant’s goods.
Merchant shall make a receipt available to the Colonel Card customer at the time
the cardholder initiates a Colonel Card transaction with merchant.
Merchant must be in compliance with all state laws that apply to the sale of
alcohol, tobacco, and obscene material. Merchant is responsible for verifying the age on
any purchases made for alcohol, tobacco, or obscene material.
FINANCIAL
Merchant is provided ( ) VX570 merchant terminal and ( ) printer after payment
is received from Merchant to lease equipment from university. Attached is the quote for
the VX570 merchant terminal and printer. The Merchant agrees to pay the cost of the
VX570 merchant terminal (s) and printer(s) as well as a onetime set up cost of $100.00.
This fee must be paid before the terminal set-up date. During the first year of the
contract NSU agrees to pay the merchant 95% of gross sales verified on the monthly
computer generated printouts supplied to merchant by NSU. After year one of the
contract has ended and Merchant enters into year two contract NSU agrees to pay the
Merchant 94% of gross sales. After year two has ended NSU agrees to pay Merchant
93% of gross sales. Merchant agrees to remit all applicable sales tax to the State of
Louisiana. Merchant also agrees to comply with all federal, state, and local codes.
Merchant shall comply with all government health codes regarding services
performed under this agreement. Merchant shall provide proof of possessing all state
and local licenses and permits necessary to conduct business.
NSU will furnish merchant with monthly reports indicating net transaction totals
and customer counts. NSU will remit to merchant on a monthly basis all monies due
merchant. NSU will process payment no later than fifteen (15) University working days
after month end. Notwithstanding, the foregoing, NSU shall not be responsible or
obligated to pay merchant for any Colonel Card transactions which are prohibited
hereunder, or which are processed by merchant on a stolen or invalid Colonel Card.
INDEMNIFICATION
Merchant shall indemnify and save and hold harmless, NSU, the State of
Louisiana, Board of Supervisors, offers, agents, and employees, from and against any
claims of loss, liability, injury, or damage to persons or property. Indemnification shall
include expenses, including but not limited to reasonable attorney fees, for injury, death,
loss or damage of whatever nature to any person, property or any other claims by
merchant or officers, employees, agents, customers, licensees, invites, or any other
person, form or corporation resulting from the use of and participation in the Colonel
Card Program.
OFF LINE TRANSACTIONS
The equipment will not accept the Colonel Card when offline. If at any time, the
Colonel Card equipment at merchant’s location indicates an off-line status, Merchant
shall refer to the directions in the manual provided by ID Card Operations to bring the
equipment on line. If merchant continues to accept Colonel Card payments while in an
“off-line” mode the University shall not make payment for any transaction which is later
denied by ID Card Operations due to insufficient funds or because the card was invalid.
In no event shall NSU be liable for any losses, damages, claims, cost or expenses
suffered or incurred by merchant due to failure of the Colonel Card equipment or
verification system to operate properly. Notify ID Card Operations at (985) 448-4967 or
email joe.bernard@nicholls.edu for other equipment problems.
EQUIPMENT REQUIREMENTS
Merchant leases a VX570 merchant terminal and printer from NSU. Merchant is
responsible for securing the VX570 merchant terminal and printer. Loss or damage to
the VX570 merchant terminal ands or printer will result in the Merchant being charged to
repair or replace the VX570 merchant terminal and or printer at the current quoted price,
including shipping. All networking and internet service charges and installation fees will
be at the expense of merchant. An Ethernet (broadband) internet connection and a
dedicated IP address provided by the Merchants Internet service provider are required.
ADVERTISING
Merchant agrees that it shall not advertise any connection with NSU nor use
NSU’s name, symbol or any other identifying marks or property nor make any
representations, either expressed or implied, as to NSU’s promotion or endorsement of
merchant or merchant’s business, unless it has received written permission from NSU.
GOVERNING LAWS
This agreement shall be governed by and in accordance with the laws of the
State of Louisiana. Any legal action arising pursuant to this agreement shall be brought
in a court of competent jurisdiction in the State of Louisiana.
TERMS
The terms of this contract shall be for a term no more than one year beginning on
the effective date
, and ending
. Merchant shall be notified sixty (60) days prior to the end
of the contract period of NSU’s intent to renew or terminate the contract. Failure by
merchant to perform under this contract shall be cause for cancellation of the contract by
NSU. Either party may cancel this contract at any time, and for any reason, with a sixty
(60) days written notice. In the event either party of this agreement exercises its rights to
terminate this agreement as herein provided, as of the date of termination, neither party
shall have any further obligation or liability hereunder. The VX570 merchant terminal and
printer must be returned to NSU if the contract is terminated. Failure to do so will result
in payment of the value of the VX570 merchant terminal and printer at time of
termination of contract.
I understand and agree to the terms of this contract.
Signature (Merchant)
Signature (NSU)
Date ______________
Date _____________
Title_______________________
Title_____________________