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.APPEi'1D .X ...
<br />PARTlCIP.-\'f10'i AGRE.EMENT
<br />'l'his Participalica Agreem~ni ("A&rruemeo1") i..-i :iy ;md ':,erwt!t.T.
<br />Participant Name:
<br />Address:
<br />City, Stu,e, Zip:
<br />Main Voice Phone:
<br />W;!b Address:
<br />n::fc r.(:d to her;iin a.'i ·''Participant'' and Governmcnc ?.a1rn~m S<or'°1ice , fo,c. (d.lb(!I GovPayNc~"}. a Dt:law11ro
<br />~oi:por.itic,n llavwg a prlncipa plac,~ of bu.'1Ul~ nt 7i02 la.ke1Jiew Pnkway W~t Dri-.c.-,, l:,dianapolis, Indiana
<br />46268 ("GPS'').
<br />WHEREAS , OPS ha$ af~le<.l and 3Upports the ''O vPayNci ?a!,>menJ Nctwor'.;;/' cprmi:iling oc govemrntJital
<br />,mtitfe Quit htL'Ve .ach ancracted with CPS ro accop l pa:11necms on thdr behalf r.nade by ~&dholde(!l hro ugh GP ; MO
<br />WREREAS, GPS accept,; credit carda and debit -:urJa r.a:rr-Jing the A:ro.erl.can fap~", Discover~, Master~ and
<br />V'i5lt 1,ran.da-&om ca.'l!hoWcrs aud, tn accordtulce with the ·ru1es Md req_uinmlen~ cf ,mch credit onrl debi t card
<br />1:firoparue&.· e-xecuteS-pdym<)tUS ~·b1 ·t11c.:ie caftlhol~ ro paru¢i~\:tts In~ aovPayN~ ?a.yn\1!-nt I etwru-!<; and
<br />Wl[ER.li',· , in rrler lO hnprov Part:ieLpant ..,ervic~ iJ enhllnca ddmloistrntion, Participant d.:sires to join the
<br />OovPayN~l t' ymrsnc Network IIJJ.11 accept pay;tn.cnts froin OPS, .with ruuh Stlllpcrt se.vices as OPS provides;
<br />NOW, Ta:ERi ORE in coru.idei·auon of the muural provisia.os conl3.ined hcr~n and other ~ood ~ntl valuable
<br />:;o!lllidcratio:i. d.te rec~ipt and .1dequncy of Which are hereby acl owll)dged, Participant and GPS agree as toll<>w :
<br />1. Redt.tb,
<br />r11e ,ibov-s! recitals are by this r~for<!nce inco:rporated :imo md made a part of mis Agreement.
<br />~-~-A.-,..~ro<!Rl saa~~~o--.:,JHho-e-.it--is-fullv e.~~~t111ieR
<br />md-eem.fuue-:fer-fil'1e-y..:e,a ~..,oJ.~y--~.ea~~~~8¼7~~~4Htales!He?W~rea
<br />00rh<!~~&heroi&.
<br />,:,;..1 ~~lru:!Ee El~.s ,·.\~~fc<lf) · , !'~W-!'i-l.1en-!le\313 ~e--~t!oi!:1 ~irnt!t'B
<br />~P•~O Ea)~ -.~1me:a-nr.!!%~..PiSifJaru,-fittls-~iey-·•N$--@S-~a,~,hiA!.1 fur
<br />µe.,-jo!:p~~ IP-i:h&--Oo ~f-?$,'ma.a~~-H..-e Ee,)--if?.m1ldlm1Hy-,J?F · -1 :ai~~~
<br />~~ .. ~irus-Agl'<lemtlHh
<br />GPS A.gr«'tlment 1'10. ::; f-P.·\RTlC1P ilJ'ffl'iAME, lOYY;i;[MDD
<br />'GP';.P,l• ,._,·;o.,,eYnm~nwl, '21il iNOV?6)
<br />P·:ll_;e 1 of 6
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