Wright Express - Non Acquiring - Memphis
Wright Express - Non Acquiring - Memphis
Wright Express - Non Acquiring - Memphis
Please read the following before completing this form: 1) The undersigned merchant (“Merchant”) represents that the information given in this application is complete
and accurate and authorizes Wright Express Corporation and Wright Express Financial Services Corporation (hereinafter collectively referred to as “Wright Express”)
to check with credit reporting agencies, credit references, and other sources to confirm information given; 2) Merchant agrees to provide additional financial
information to Wright Express upon request; 3) Merchant requests approval of this Wright Express Merchant Charge Card Agreement Application (“Application”); 4)
Merchant agrees to the terms and conditions set forth in the Wright Express Merchant Charge Card Agreement (“Agreement”) provided with this Application and
incorporated herein by reference; 5) If this application is for a general partnership or a proprietorship, Wright Express may obtain and use personal credit information
(including consumer reports from consumer reporting agencies) about the individual partners or owners of the Merchant in making a credit decision, and in the
administration of this program, to the extent permitted by law; 6) Merchant agrees that in the event the Merchant does not meet its obligations pursuant to the
Agreement, Wright Express may report the Merchant’s liability (as well as any general partner or proprietor's) liability for and the status of the account to credit
bureaus and others who may lawfully receive such information.
Site Name (DBA or AKA) Please use location form for additional sites Station Manager/Contact
Physical Site Address for site directory (number and street) City State Zip+4
Mailing Address if different than physical address (for settlement & Reporting) City State Zip+4
Email address
SECTION 2 – PROCESSING
Bank Card Processor Phone
Credit Card Network (check one): ADS Bank of America Buypass EFS First Data Corp GPI
At the dispenser POS Equipment (example, Omni 3200, Tranz 380, etc.) Terminal ID #
DO YOU SELL FUEL? Yes No If you sell fuel, please complete section 4. If you do not sell fuel, please complete section 3.
SECTION 3 - NON-PETROLEUM MERCHANTS
BRANDS (Check all that apply)
Aamco Chrysler GM Les Schwab Napa Quaker St/Pennzoil
ACCC D-Triumph GL Goodyear Maaco Nissan Tire Centers, Inc.
AC Delco Econolube Grease Monkey Mazda Novus Toyota
American Lubefast Firestone Harmon Glass Meineke Oil Changer Volvo
BF Goodrich Ford Honda Midas Parts Plus Wash Depot
Big O Tires Glass America Jiffy Lube Mitsubishi Pep Boys Winston Tire
BRAND PROGRAMS (Check one if applicable) Precision Tune Other
ACCC GE Dealer Direct Jiffy Lube
Dodge Business Link Grease Monkey Parts Plus Dealer/Location Code (if applicable):
PRIMARY SERVICE (Check one)
Auto Body Dealership Mechanical Parts Tires
Car Wash Glass Oil Change/Lube Road Service
SECTION 4 - FUEL MERCHANT ONLY SITE INFORMATION
Please check all features and fuel types that apply to your station:
Fuel available 24 hours Pin Pad Alcohol Unleaded Plus CNG
Car Wash CRINDs (Pay-at-the-pump) Unleaded Diesel LPG
Service Bays Tractor Trailer Accessible Premium Methanol
MERCHANT: The undersigned represents and warrants to Wright Express that all of the terms and conditions of this Wright Express Merchant Charge Card
Agreement Application consisting of this entire document in addition to any other document or addendum including the Wright Express Merchant Charge Card
Agreement have been reviewed in their entirety, are true and correct, and set forth the agreement between Wright Express and Merchant. Additionally, the
undersigned represents and warrants that he or she has authority to sign and to bind Merchant to the terms of this Application. Also, the undersigned represents that
the undersigned has the authority to provide information and execute this Application on behalf of the Merchant. The Agreement shall only become effective upon
Wright Express’ acceptance of the Agreement and the Application at its headquarters following approval, and the assignment to Merchant of a merchant processing
identification number. The Merchant further affirms that they are establishing a credit card processing relationship with the processor indicated on the attached
Wright Express merchant application. Once we begin processing credit cards through this processor, our company does not intend to process any transactions
through a processing agreement with a branded petroleum marketer.
X
Title Date
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EXHIBIT A
WRIGHT EXPRESS CARD SALE PROCEDURES
1.1 METHOD OF TRANSMISSION OF CARD SALES TO WEX records shall be provided to WEX within thirty (30) calendar days of WEX’s
A. MERCHANT shall have the necessary equipment to permit the electronic request. Failure to provide the requested record will result in a charge back of the
acceptance of the Card at its Distribution Sites including but not limited to their Card Sale to MERCHANT.
point of sale equipment and networking services. 1.4 DATA INPUT AND TRANSMISSION
B. MERCHANT shall collect and transmit the Card Sale data in accordance with the A. Merchant is responsible for the data entry of Card Sale information by its
WEX Technical Specification. Merchant shall obtain from Wright Express the personnel, or representatives. All data shall meet the WEX Technical Specification
necessary acceptance certification for its network and equipment that will be used and shall be in good and usable condition.
for processing sales transaction. B. If information pertaining to any Card Sale is garbled in transmission such that
1.2 MANUAL CARD SALE PROCEDURES part or all of the record is likely to vary from what MERCHANT transmitted, WEX
A. If MERCHANT is unable to obtain an authorization for a Card Sale due to the may advise MERCHANT of the suspected inaccuracy and request retransmission of
communication facilities for WEX are not operable, MERCHANT must capture the the record or other appropriate confirmation. WEX may, with notice to MERCHANT,
sales transaction through the use of a suitable imprinter to legibly imprint the Cards withhold payment for such Card Sales until the record is retransmitted or
on the sales slip and requiring the cardholder to sign the sales receipt (“Manual Card MERCHANT provides other appropriate confirmation.
Sale”). C. If MERCHANT has not provided WEX with required information or that WEX
B. MERCHANT shall obtain all information required in Section 1.3.A below. needs to interpret, verify, or validate a Card Sale, WEX may, withhold payment for
MERCHANT shall take all commercially reasonable efforts to protect Manual Card such Card Sale until MERCHANT sends WEX the necessary information. WEX may
Sale data from fraud or misuse. make appropriate adjustments in its settlements with MERCHANT to reflect the
C. MERCHANT shall not submit paper Manual Card Sales directly to WEX for receipt or correction of any such Card Sale information. WEX shall provide notice to
processing unless prior approval is first obtained. In the event that WEX has agreed MERCHANT of any Card Sales that it is not able to process due to errors or missing
to accept such Manual Card Sales, WEX reserves the right to assess the Manual information through its daily settlement reports.
Transaction Fee set forth in Exhibit B. D. MERCHANT shall submit all Card Sales to WEX for processing within thirty (30)
D. In the event that MERCHANT allows a Manual Card Sale without first obtaining days of the transaction date. WEX may accept transactions up to one hundred and
an authorization from WEX, the Merchant may still accept the Card for payment, twenty (120) days from the date of the transaction for processing and billing to the
however shall contact WEX as soon as communication with the WEX authorization fleet, however, reserves the right to chargeback any such transaction that is
facilities can be re‐established. disputed by a fleet customer.
E. When submitting a Manual Card Sale for processing, MERCHANT shall include E. MERCHANT authorizes WEX to refer to a default price per gallon table, which
the authorization or other approval code it received from WEX when submitting the may be used when the calculated price per gallon for the transaction falls outside of
completed Card Sale to WEX for processing. WEX’s acceptable range of pricing which is updated from time to time by WEX based
F. WEX limits its liability for Manual Card Sales made in accordance with Section upon market conditions. The table is based upon average price per gallon data
D above to $50.00 per transaction and $500 per day per Distribution Site. WEX collected from all merchants who accept WEX Cards.
reserves the right to change these limits from time to time. Manual Card Sales that F. MERCHANT authorizes WEX to refer to the authorization log to obtain
exceed these limits shall be at the credit risk of MERCHANT. information to complete the processing of transactions in the event that errors are
1.3 MINIMUM CARD SALE PROCESSING REQUIRMENTS detected by WEX during processing. It is understood by the parties that the
A. Card Sale data sent to WEX shall include: account number, vehicle number, driver information contained in the authorization log is the “actual, real‐time” information
identification number, sales date, sales time, site identification number, received by WEX from the MERCHANT at the time the use of the charge card was
authorization number, product code(s), quantity, total sales amount (in dollars), authorized. If sufficient information is not available in the authorization log to
odometer, ticket number and any other information as WEX and MERCHANT may correct any errors in the transaction file received by WEX from MERCHANT, then
mutually agree upon. these transactions will be returned back to MERCHANT for correction.
B. All Card Sales require an authorization or approval from WEX. MERCHANT shall G. Use of the defaults in Section 1.4.E and 1.4.F above does not affect the total
request such authorization from WEX for the total Card Sale amount prior to transaction value submitted for settlement and is only used to facilitate reporting to
sending the Card Sale to WEX for processing. fleet customers. It does not relieve MERCHANT of its requirements to provide
C. WEX does not provide pre‐authorizations, nor does it place available credit on accurate and complete data as set forth in 1.3.A for Card Sales.
“hold”. If MERCHANT calls prior to completion of the services being provided to the 1.5 CHARGEBACKS
cardholder, MERCHANT still needs to obtain an authorization number upon A. Chargebacks shall be made for Card Sales that are disputed and (i) the required
completion of the services or Card Sale to obtain payment from WEX. authorization was not obtained, (ii) were for unauthorized Products, (iii) were
D. An authorization or other approval code is not a guarantee that MERCHANT will fraudulently made by an employee of MERCHANT or (iv) the WEX Card Sale
receive payment. WEX does not provide payment to merchants based upon receipt Procedures were not followed. MERCHANT shall remain liable for all outstanding
of information during the authorization process. MERCHANT is still required to Chargebacks.
submit the completed Card Sale, including the authorization or other approval code, B. Any obligation to pay a Chargeback pursuant to this Agreement shall be
to WEX. Obtaining an authorization without submitting the completed Card Sale to unconditional and shall be waived, released or affected by any settlement,
WEX may result in non‐payment by WEX for such Card Sale. extension, compromise of forbearance or other agreement made or granted by WEX
E. MERCHANT shall not accept payment through use of an expired Card or when with or to any cardholder or obligor. Failure to issue a Chargeback with knowledge
advised upon authorization inquiry, that the Card is not to be honored. of a breach of warranty or other defect shall not be deemed a waiver of any of WEX’s
F. MERCHANT shall never make a Card Sale when MERCHANT believes or has rights with respect to such a Card Sale. WEX will expend normal business efforts to
reason to believe that the Card may be counterfeit or stolen or the Card Sale is in remedy against cardholders and shall not be required to exhaust its remedies
any way fraudulent or otherwise suspicious. against cardholders or others as a condition precedent to requiring performance by
G. Merchant shall maintain a record of all information required in Section 1.3.A MERCHANT of their obligations hereunder.
above.
H. Upon request, MERCHANT shall provide the cardholder with a copy of the
transaction receipt documenting the Card Sale. Such receipt shall not include the
full account number or driver identification number printed on the receipt.
I. If the Card Sale is not an island card reader transaction (“pay‐at‐the‐pump”),
MERCHANT shall require the cardholder to sign the transaction receipt unless the
total for the Card Sale is less than $25.
J. Any Card Sale data received by WEX from MERCHANT by 5:00 p.m. Eastern Time
(“ET”) shall be treated as having been received on the next business day.
K. MERCHANT shall not divide the price of goods and services purchased in a single
transaction among two (2) or more transaction receipts for billing to WEX.
L. Merchant must not submit Card Sales until Products are delivered.
M. A Card must be present at the time of purchase. In the event that MERCHANT
processes a Card Sale when the Card is not presented, MERCHANT bears the risk of
the sale being charged back.
N. MERCHANT shall maintain a record of the Card Sale, including all sales data
required for a period of one (1) year. Upon the reasonable request of WEX, such
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To Wright Express:
_____________________________________ ______________________
Signature Date