7697 - Informal Amendment 2 Executed
Procurement
901 B Texas St., Denton, TX 76209 (940) 349-7100
OUR CORE VALUES
Inclusion Collaboration Quality Service Strategic Focus Fiscal Responsibility
June 26, 2024
Invoice Cloud, Inc.
30 Braintree Hill Office Park
Suite 303
Braintree, MA 02184
Ref: 7697 Integrated Utility Payment Solutions (the “Contract”)
The City of Denton (COD) has reviewed and accepts the addition of the following new item to the
“Products and Services” being purchased under the Contract with your firm:
PRODUCTS AND SERVICES
Products and Services [Cloud Store]
Such Products and Services are being purchased at the following Transactional Pricing:
Payment
Source
Description
Payment Method Price
All Payment
Sources Credit/Debit/PayPal $0.65
All Payment
Sources ACH/EFT $0.50
The City of Denton reserves the right to re-evaluate pricing as the market conditions change and can
ask your firm to provide updated proposed pricing, including, but not limited to, a decrease in
pricing, as a result of any such change.
All terms and conditions of the Contract shall apply. If your firm is in agreement, please sign and
return this letter to my attention. Signatures transmitted electronically shall have the same effect as
the delivery of original signatures.
We look forward to future business with your firm.
Regards,
___________________________ ___________________________
Christina Dormady, Buyer
Procurement Invoice Cloud, Inc.
DocuSign Envelope ID: EC7652DE-1A40-47ED-ABD5-98904B0A7E10
CEOBuyer
Add-On to the Biller Order Form
SALES INFORMATION
IC Sales Rep Gretchen Schmitt Vertical Utility
Order Date 6/24/2024 Sales Partner Software Partner None
PRODUCTS AND SERVICES
Products [Cloud Store]
PAYMENT METHODS ACCEPTED
Payment Types [VISA/Mastercard/Discover] [PayPal] [ACH/EFT]gschmitt@invoicecloud.com
BILLER INFORMATION
Ownership Type Government Phone (940) 349-8200 Fax
Legal Name City of Denton Website URL cityofdenton.com
Address 1 215 E McKinney St Bus. Open Date 1866
Address 2 Federal Tax ID
City Denton *Federal Tax ID and Legal Name must match on all documents
State TX ZIP 76201 Array
BILLER CONTACT
Primary Contact Name Christa Foster
Phone 940-349-7412
Email Address christa.foster@cityofdenton.com
SIGNING AUTHORITY
Name Christina Dormady Title Buyer
Phone (940) 349-8006 Fax Email Address christina.dormady@cityofdenton.com
BILLER PRICING
Description Interval Cost Type Cost
HARDWARE
Card Reader Type Quantity Cost per Reader
Card Reader Billing Interval
Shipping Addr.
(if different than
location address)
Kiosk Type Device Quantity Per Device Txn Min Note: Biller will be charged for the minimum number of transactions listed to left each
Standard/In-Door 750 month per kiosk unity. In addition, if the Biller's order includes kiosks then the terms
Thru-Wall 800 and conditions of Kiosk Managed Standard SOW (and applicable schedules) are hereby
Outdoor Model 850 agreed and incorporated by reference
BILLER BANK INFO
Note: Must include voided business check or bank letter for each unique account
Billing Method Monthly Invoice
Name on Account Bank Name
Bank Address Phone
Routing # Last 4 Acct #
DATA RETENTION
DocuSign Envelope ID: EC7652DE-1A40-47ED-ABD5-98904B0A7E10
Months to Keep 24 *Additional Fees apply if greater than 24 months
NOTES/SPECIAL HANDLING
CERTIFICATION AND AGREEMENT
A. By signing below, the Biller hereby ratifies its authorization for Invoice Cloud, Inc. ("Invoice Cloud") to execute debit/credit entries to its checking/deposit account(s)
indicated above at the depository financial institution(s) named above and to debit/credit the same such account(s). The Biller acknowledges that the origination of
ACH transactions to its account(s) must comply with the provisions of U.S. law. This authority is to remain in full force and effect until (i) Invoice Cloud has received
written notification (by electronic or U.S. mail) from the Biller of its revocation in such time and manner as to allow Invoice Cloud a reasonable opportunity to act on
it, but not less than 10 business days notice; and (ii) all obligations of the Biller to Invoice Cloud that have arisen under this Agreement and all other agreements have
been paid in full. The Biller must also notify Invoice Cloud, in writing, (by electronic or U.S. mail) when a change in account number(s) or bank has occurred at which
time this authorization shall apply to such new/changed account. This notification must be received within 10 business days of change. A fee will be charged for any
returned ACH debits.
B. By signing below, the Biller named: (1) has read, agreed to, ratifies the Biller Agreement, Biller T+C and other Order Forms previously executed by the Biller, and (2)
certifies to Invoice Cloud that he/she is authorized to sign this Add on to the Biller Order Form; (3) certifies that all information and documents submitted in
connection with this Order Form are true and complete; (4) authorizes Invoice Cloud or its agent to verify any of the information given, including credit references,
and to obtain credit reports (including a spouse if in a community property state); (5) agrees to pay the Monthly Access Fee through the last day of the month
following the effective date of termination as provided in the Billing Agreement; (6) agrees that Biller and each transaction submitted will continue to be bound by
the Order Form and the Biller Agreement in its entirety and any new agreement forms executed herewith; (7) If the Biller's order includes kiosks, then the terms and
conditions of Kiosk Managed Services Standard SOW (and applicable schedules) are hereby agreed and incorporated by reference.(8) agrees that Biller will submit
transactions only in accordance with the information in this Add on to the Biller Order Form and Biller Agreement and will immediately inform Invoice Cloud, by email
(contracts@invoicecloud.com) if any information in this Order Form changes, and (9) the Biller agrees and understands that outstanding sums due and owing to
Invoice Cloud., will be charged daily or monthly and debited from its current depository account. Non-sufficient funds for these debits are grounds for a change in
fees or termination of this Agreement. In the event of non-payment of any sums due, Invoice Cloud reserves the right to withdraw such sums from the current
depository account at any time to ensure payment of the same.
C. Pay by Text: Standard data rates and text messaging rates may apply based on the payer's plan with their mobile phone carrier. Payer can opt out of text messaging
at any time with Invoice Cloud. Partial payment or overpayment is not supported. Service fees may apply based on the biller set up with Invoice Cloud. Biller may not
use the service for activities that violate any law, statute, ordinance or regulation.
D. By signing below, the Biller hereby gives permission to Invoice Cloud to access his / her credit history via Trans Union, Equifax, or other credit-reporting agency.
E. This Add on to the Order Form will become effective only when counter-signed by Invoice Cloud and upon execution by the Biller of such third party agreement
required by Invoice Cloud to permit use of the payment function of the Service.
F. If the Biller's order includes kiosks, then the terms and conditions of Kiosk Managed Services Standard SOW (and applicable schedules) are hereby agreed and
incorporated by reference.
DocuSign Envelope ID: EC7652DE-1A40-47ED-ABD5-98904B0A7E10
In WITNESS WHEREOF, the parties have executed this Agreement as of this day
Accepted by Biller: Accepted by Invoice Cloud, Inc.:
X X
Corporate Officer Corporate Officer
Christina Dormady Kevin W. O'Brien
Printed Name Printed Name
Buyer
CEO
Title Title
DocuSign Envelope ID: EC7652DE-1A40-47ED-ABD5-98904B0A7E10
7/10/2024
Biller Order Form
BILLER ORDER FORM
INVOICE TYPE PARAMETER SHEET
Invoice Type Parameters must be completed for each invoice type
Invoice Type Powerful Connections Pricing Model Non-Submitter
Gretchen Schmittgschmitt@invoicecloud.comBiller Pays Network Fees Yes
CURRENT BILLING DETAILS
Please indicate how many bills are sent monthly by placing the bill count for each month below:
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
1 1 1 1 1 1 1 1 1 1 1 1
Avg CC
Transaction $ 1.00 Max Invoice $ 10,000.00 Bill Frequency Monthly Avg. Bills Per
Month 1
PRODUCTS AND SERVICES
Products and Services [Cloud Store]
TRANSACTIONAL PRICING (Paid by Biller)
Payment Source Description Payment Method Fee Rate % Fee Amount $ Additional Fee $
All Payment Sources Credit/Debit/PayPal $0.65
All Payment Sources ACH/EFT $0.50
TRANSACTIONAL PRICING EXCEPTIONS
SERVICE FEES (Paid by Payer)
Payment Source Description Payment Method Fee Amount Calculation
Type Min. Fee ($) per Transaction
SERVICE FEE EXCEPTIONS
MAX PAYMENT CAP
Card and PayPal Max ($) 125,000 ACH Max ($) 125,000
BILLER BANK ACCOUNT (FOR DEPOSITS AND CHARGEBACKS)
Note: must include voided business check or bank letter for each unique account
Routing # 121000248 Last 4 Acct # 1529 Last 4 Acct # for OBD
NOTES / SPECIAL HANDLING
DocuSign Envelope ID: EC7652DE-1A40-47ED-ABD5-98904B0A7E10
Certificate Of Completion
Envelope Id: EC7652DE1A4047EDABD598904B0A7E10 Status: Completed
Subject: Complete with DocuSign: 7697 Integrated Utility Payment Solutions - Informal Amendment
Source Envelope:
Document Pages: 5 Signatures: 3 Envelope Originator:
Certificate Pages: 5 Initials: 0 Christina Dormady
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-06:00) Central Time (US & Canada)
901B Texas Street
Denton, TX 76209
christina.dormady@cityofdenton.com
IP Address: 198.49.140.10
Record Tracking
Status: Original
7/9/2024 4:28:36 PM
Holder: Christina Dormady
christina.dormady@cityofdenton.com
Location: DocuSign
Signer Events Signature Timestamp
Kevin O'Brien
Kobrien@invoicecloud.com
CEO
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 156.70.203.154
Sent: 7/9/2024 4:34:31 PM
Viewed: 7/9/2024 4:40:03 PM
Signed: 7/9/2024 4:49:54 PM
Electronic Record and Signature Disclosure:
Accepted: 7/9/2024 4:40:03 PM
ID: cc6bb96d-0d08-4093-9c74-f84e3dc2907b
Christina Dormady
christina.dormady@cityofdenton.com
Buyer
City of Denton
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.10
Sent: 7/9/2024 4:49:55 PM
Viewed: 7/10/2024 7:30:10 AM
Signed: 7/10/2024 7:30:19 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Christa Foster
Christa.foster@cityofdenton.com
Customer Service Manager
Security Level: Email, Account Authentication
(None)
Sent: 7/10/2024 7:30:21 AM
Electronic Record and Signature Disclosure:
Accepted: 5/7/2024 8:29:02 AM
ID: 3caa203e-3142-4db6-bd30-9b2560e2b0fd
Carbon Copy Events Status Timestamp
Cheyenne Defee
Cheyenne.defee@cityofdenton.com
Procurement Administration Supervisor
City of Denton
Security Level: Email, Account Authentication
(None)
Sent: 7/10/2024 7:30:21 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 7/9/2024 4:34:31 PM
Envelope Updated Security Checked 7/9/2024 4:37:25 PM
Certified Delivered Security Checked 7/10/2024 7:30:10 AM
Signing Complete Security Checked 7/10/2024 7:30:19 AM
Completed Security Checked 7/10/2024 7:30:21 AM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
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Electronic Record and Signature Disclosure created on: 7/21/2017 3:59:03 PM
Parties agreed to: Kevin O'Brien, Christa Foster
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