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APPENDIX "A" <br />PARTICIPATIONAGREEMENT <br />Tins Participation Agreemem ("Agreement")îs by and between <br />Parecipant Name: <br />Address: <br />City,Smte,Zip: <br />Main Voice Phone: <br />Web Address: <br />refbrred to herein as "Participant"and Government Payment Service.Inc.(dibía GovPayNeti,a Delaware <br />corporation having a principal place of business at 7102 Lakeview Parkway West Drive,Indianapolis,Indiana <br />46268 'GPSS. <br />WHEPJAAS,GPS has assembled and supports the "GovPayNet Payment Networld'consisting of govemmental <br />emities hat have each comracted with GPS to accept payments on their behalf made by cardholders through GPS;and <br />WHEREAS,GPS accepts credit cards and debit cards carryin-g the American Express*,Discover",MasterCard*and <br />Visa*brands û·om cardbokiers and,in accordance with the rules and requirements of such credit and debit card <br />cömpäriles exëeutes baÿtfients madibythisé caidhdiders to participants III die GovPayNet PayttlantNetworkrand <br />MTŒREAS,in order to improve Participam services and enhance administration,Participant desires to join the <br />GovPayNet Paymcat Network and accept payments tiom GPS,with such support services as GPS provides; <br />NOW,THEREFORE,in consideration of the mutual provïsions contained herein and other good and valuable <br />consideratica,de receipt and adequacy of which are hereby achowledged,Participant and GPS agree as follows: <br />L Recitals. <br />The above recitais are by this reference incorporated into and made a part of this Agreement. <br />GPS Agreement No.ST-PARTlCIP:UTENANK 20YYMMDD Page 1 of 6 <br />GPS R÷ Dovernmental,208 YOV26)