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HomeMy WebLinkAbout165-16 RESOLUTION113 West Mountain Street
Fayetteville, AR 72701
(479) 575-8323
Resolution: 165-16
File Number: 2016-0416
WEX BANK:
A RESOLUTION TO APPROVE A CONTRACT WITH WEX BANK, PURSUANT TO A NATIONAL
JOINT POWERS ALLIANCE COOPERATIVE PURCHASING AGREEMENT, TO ENABLE THE CITY
TO PARTICIPATE IN A FUEL CARD PROGRAM.
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE,
ARKANSAS:
Section 1: That the City Council of the City of Fayetteville, Arkansas hereby approya contract
itii1el�rt 1
with WEX Bank, pursuant to a National Joint Powers Alliance cooperative purchasing•`t rhe} y nable
the City to participate in a fuel card program ••` �,. ■' " ■'`�sf�r
r
= � ,•'Cry Y [] ■,G �:
PASSED and APPROVED on 9/20/2016' FAYETTEW ll l -E
Attest: �1;�i its O 10%% ���•`
Sondra E. Smith, City Cler Tre safer
Page 1 Printed on 9/21/16
City of Fayetteville, Arkansas 113 West Mountain Street
Fayetteville, AR 72701
— ■1 (479) 575-8323
Text File
-- File Number: 2016-0416
Agenda Date: 9/20/2016 Version: 1 Status: Passed
In Control: City Council Meeting File Type: Resolution
Agenda Number: A. 4
WEX BANK:
A RESOLUTION TO APPROVE A CONTRACT WITH WEX BANK, PURSUANT TO A
NATIONAL JOINT POWERS ALLIANCE COOPERATIVE PURCHASING AGREEMENT, TO
ENABLE THE CITY TO PARTICIPATE IN A FUEL CARD PROGRAM
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE,
ARKANSAS:
Section 1: That the City Council of the City of Fayetteville, Arkansas hereby approves a contract with
WEX Bank, pursuant to a National Joint Powers Alliance cooperative purchasing agreement, to enable
the City to participate in a fuel card program
City of Fayetteville, Arkansas Page 1 Printed on 9/21/2016
Andrea Rennie
Submitted By
City of Fayetteville Staff Review Form
2016-0416
Legistar File ID
9/20/2016
City Council Meeting Date - Agenda Item Only
N/A for Non -Agenda Item
9/2/2016 Purchasing /
Finance & Internal Services Department
Submitted Date Division / Department
Action Recommendation:
Staff recommends the signing of an addendum to the fuel card services agreement between WEX Bank and
National Joint Powers Alliance (NJPA), enabling the City to receive fuel card services off of NJPA Contract# 042016-
WEX. Signing this addendum will enable the City to utilize the fuel card contract, as renewed by NJPA through July
20, 2021.
Various
Account Number
Various
Project Number
Budgeted Item? NA
Budget Impact:
Current Budget
Funds Obligated
Current Balance
Does item have a cost? NA Item Cost
Budget Adjustment Attached? NA Budget Adjustment
Remaining Budget
Previous Ordinance or Resolution #
Original Contract Number:
Comments:
Various
Fund
Various
Project Title
Approval Date:
V2014071
CITY OF
'0 r
. � 4 1 le CITY COUNCIL AGENDA MEMO
ARKANSAS
MEETING OF SEPTEMBER 20, 2016
TO: Mayor Lioneld Jordan and Fayetteville City Council
THRU: Paul A. Becker, Chief Financial Officer
FROM: Andrea Rennie, Purchasing Manager
DATE: Friday, September 02, 2016
SUBJECT: Approval of contract with WEX Bank for fuel card services
RECOMMENDATION:
Staff recommends the signing of an addendum to the fuel card services agreement between WEX
Bank and National Joint Powers Alliance (NJPA), enabling the City to receive fuel card services
off of NJPA Contract# 042016-WEX. Signing this addendum will enable the City to utilize the fuel
card contract, as renewed by NJPA through July 20, 2021.
BACKGROUND:
The WEX contract is recognized and utilized by the State of Arkansas and was competitively
solicited through NJPA. WEX offers no set up fees or card fees and is an Arkansas Office of
State Procurement statewide contract. The City will be able to obtain valuable monthly rebates
on fuel and maintenance transactions, some of which are being tracked manually.
This contract also features an online tool including a profile manager, expense management tools
and fuel price mapping. The profile manager allows the City to set rules for how the card can be
used, how often and when, giving the City flexible control limits. The expense management tools
enable the City to manage the fuel card spend in a centralized location. Fuel price mapping
combines fuel transaction data with Google Maps to help drivers find current best prices by city,
state, zip, fuel type, price per gallon, or brand.
WEX fuel cards are accepted by the vast majority of fueling stations and provides access to one
of the largest proprietary fleet card networks.
DISCUSSION:
Currently, three City departments and divisions have the opportunity to utilize a consolidated fuel
card program. Transitioning the Fleet Division, Police Department, and Fire Department to the
new fuel card program will consolidate fuel purchases and save the City resources currently being
used to manually receive tax rebates. The cards have the capability to be customized by each
department and division to meet varying needs.
Mailing Address:
113 W. Mountain Street www fayetteville-at:gov
Fayetteville, AR 72701
BUDGET/STAFF IMPACT:
Budgeted funds will be utilized primarily by Fleet, Fayetteville Police Department and the
Fayetteville Fire Department based on their fuel card needs. Fuel is a budgeted expense.
Attachments:
Contract Acceptance and Award from NJPA, Contract#; 042016-WEX
Fuel Card Services Addendum between WEX Bank and NJPA
WEX General Information
Andrea Rennie
Submitted By
City of Fayetteville Staff Review Form
Legistar File ID
City Council Meeting Date - Agenda Item Only
N/A for Non -Agenda Item
3/2/2017 Purchasing /
_ Finance & Internal Services Department
Submitted Date Division / Department
Action Recommendation:
Staff recommends the signing of an addendum to the fuel card services agreement between WEX Bank and
National Joint Powers Alliance (NJPA), enabling the City to open a second fuel card account off of NJPA Contract#
042016-WEX. Signing this addendum will enable the City to open a second account with WEX for use by the Drug
Task Force as renewed by NJPA through July 20, 2021.
Budget Impact:
Various_ Various
Account Number
Various
Project Number
Budgeted Item? NA
Does item have a cost? NA
Budget Adjustment Attached? NA
Current Budget
Funds Obligated
Current Balance
Item Cost
Budget Adjustment
Fund
Various
Project Title
Remaining Budget ra
V20140710
Previous Ordinance or Resolution # 165-16
Original Contract Number:
Comments:
Approval Date: J— q — Ir7
CITY OF
a t1i
�
ARKANSAS
TO: Mayor Lioneld Jordan
THRU: Paul A. Becker, Chief Financial Officer
FROM: Andrea Rennie, Purchasing Manager
DATE: - Thursday, March 2, 2017
STAFF MEMO}
SUBJECT: Completion of addendum to open second fuel card account with WEX Bank
RECOMMENDATION:
Staff recommends the signing of an addendum to the fuel card services agreement between
WEX Bank and National Joint Powers Alliance (NJPA), enabling the City to open a second fuel
card account off of NJPA Contract# 042016-WEX. Signing this addendum will enable the City
to open a second account with WEX which is needed to maintain daily operations for the
Fayetteville Police Department.
BACKGROUND:
On September 20, 2016 via Resolution 165-16, the Fayetteville City Council authorized the City
to enter into a contract with WEX Bank for the City to participate in a fuel card program. _
DISCUSSION:
Due to needs of the Fayetteville Police Department, a second account is necessary to maintain
fuel card operations. WEX Bank requires the City to complete a new signed addendum in order
to open a second account under the NJPA master agreement.
BUDGET/STAFF IMPACT:
Fuel purchased under the new account is a budgeted expense.
Attachments:
WEX NJPA Addendum
Resolution 165-16
Mailing Address:
113 W. Mountain Street www.fayetteville-ar.gov
Fayetteville, AR 72701
ADDENDUM TO THE FUEL CARD SERVICES AGREEMENT BETWEEN
WEX BANK, FORMERLY WRIGHT EXPRESS FINANCIAL SERVICES CORPORATION ("WEX")
AND THE NATIONAL JOINT POWERS ALLIANCE (NJPA)
• - I . • ,
Participating Entity has requested a credit account pursuant to the Vendor Agreement #042016-WEX (Agreement), ("Agreement") entered into between the National Joint
Powers Alliance ("NJPA") and WEX Bank, formerly Wright Express Financial Services Corporation ("WEX"). By enrolling in this Program, the Participating Entity named below
agrees that in the event their account is not paid as agreed, WEX may report the undersigned's liability for and the status of the account to credit bureaus and others who may
lawfully receive such information.
Participating Entity
Phone #
Fax#
City Of Fayetteville
479-575-8220
Headquarters Name and Physical Address (Do not include PO Box)
113 W Mountain Fayetteville, AR 72701
NJPA Member ID Number Applicant's Taxpayer ID # (TIN, FEIN or SSN)
31413
In Business Since (yyyy) Year of Incorporation (yyyy) Number of Vehicles Avg MonthlyFuel Expenditures Avg Monthly Service Expenditures
11/3/1836 1836 <10 $1000.00 $0.00
ACCOUNT SETUP INFORMATION
W❑rite❑Paicipat❑ing Ent❑ityFnam❑e a❑s you❑wis�t t❑o appe❑ar o❑n0rd❑s Limit of 20 characters &spaces. Unless specified, no company name will appear on cards.
❑
Billing Contact
Billing Address
City
State
Zip+4
Andrea Rennie
113 W Mountain
Fayetteville
AR
72701
Designate the Fleet Contact authorized to receive all charge cards, reports, and other such information we provide from time to time and to take actions with respect to your
account and account access. This is also the person designated by your company to provide all fleet vehicles, driver and other information we may request.
Authorized Fleet Contact Name
Title
Phone #
Fax #
Andrea Rennie
Purchasin Mana er
479-575-8289
Mailing Address (if different from billing address)
City
State
Zip+4
Fayetteville
AR
72701
Email address (required to take advantage of product type card controls)
aforen@fayefteville-ar.gov
❑ Check here if business is exempt from motor fuels tax
1. This Addendum is to allow the Participating Entity to participate under the Agreement between WEX and NJPA. It does not modify, amend or change the Agreement in
any way.
2. Participating Entity hereby requests the services of WEX described in the Agreement and agrees to perform all duties required under the Agreement; including, without
limitation, timely payment of all charges (including any additional fees) on its account(s). Participating Entity agrees to be bound by the terms and conditions of the
Agreement, including, without limitation, rules for authorized and unauthorized use of cards, disputes of charges, reporting lost and stolen cards, and all other rules and
provisions relating to use of Participating Entity's account. Additional terms that govern this Participation Addendum between Company and Issuer are set forth in
Schedules A and B attached hereto and incorporated by reference.
3. Participating Entity acknowledges that its failure to make timely payment in accordance with the terms of the Agreement, or for government entities subject to Prompt
a
Payment Act, may result in suspension or cancellation of the account(s).
4. INFORMATION SHARING DISCLOSURE: Information regarding your transactions may be provided to NJPA accepting merchants or their service
providers.
5. Compliance with Federal Law:'Our bank complies .with federal law which requires all financial institutions to obtain, verify, and record information that identifies each
company.orpersott who opens, an account. What thismeans for you: when you open an account, we will askfor your name; address, date of birth, and other information
that will allow us to identify you. We may also ask to see your driver's license or other identifying documents for your business.
6. DISCLAIMER: THIS IS AN APPLICATION FOR SERVICES AND SHALL NOT BE BINDING UPON WEX UNTIL FINAL CREDIT APPROVAL HAS BEEN GRANTED
BY WEX.
7. This Addendum shall become effective July 20, 2016.
PARTICIPATING ENTITYAUTHORIZED SIGNATURE REQUIRED
Any person signing on beh of the P i ting E ity has en duly authorized by all necessary action of Applicant's governing body, and that the undersigned is authorized
to make this applicati accep t r refer nced h ein on behalf of the Participating Entity. 11
Signature: - Print Name: J0ruf�
Title: Date: -
Complete and sign addendum. Fax to 1-866-527-8873.
• -H-61
• iml Oppty Number Sales Code Plastic Type Coupon Code Account Number
• NJPA NJA 04
04.ADDEND.CRDAPP (1/12)
•
113 West Mountain Street
Fayetteville, AR 72701
(479) 575-8323
Resolution: 165-16
File Number: 2016-0416
WEX BANK:
A RESOLUTION TO APPROVE A CONTRACT WITH WEX BANK, PURSUANT TO A NATIONAL
JOINT POWERS ALLIANCE COOPERATIVE PURCHASING AGREEMENT, TO ENABLE THE CITY
TO PARTICIPATE IN A FUEL CARD PROGRAM.
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY - OF FAYETTEVILLE,
ARKANSAS:
Section 1: That the City Council of the City of Fayetteville, Arkansas hereby appioi�eitra contact
with WEX Bank, pursuant to a National Joint Powers Alliance cooperative purchasing'° ' a;eFv{,`I i nable
the City to participate in a fuel card programq.
+. ,,xI .`
C: •
L.
X7
PASSED and APPROVED on 9/20/2016
U �
Attest:
94"ti lv �s °°°-
fv.
Sondra E. Smith, City Cler Tre surer;
Page 1 Printed on 9121116
3
City of Fayetteville, Arkansas 113 West Mountain Street
Fayetteville, AR 72701
1 (479) 575-8323
m Text File
File Number: 2016-0416
Agenda Date: 9/20/2016 Version: 1 Status: Passed
In Control: City Council Meeting File Type: Resolution
Agenda Number: A. 4
WEX BANK:
A RESOLUTION TO APPROVE A CONTRACT WITH WEX BANK, PURSUANT TO A
NATIONAL JOINT POWERS ALLIANCE COOPERATIVE PURCHASING AGREEMENT, TO
ENABLE THE CITY TO PARTICIPATE IN A FUEL CARD PROGRAM
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE,
.ARKANSAS:
Section 1: That the City Council of the City of Fayetteville, Arkansas hereby approves a contract with
WEX Bank, pursuant to a National Joint Powers Alliance cooperative purchasing agreement, to enable
the City to participate in a fuel card program
City of Fayetteville, Arkansas Page 1 Printed on 9/21/2016
City of Fayetteville Staff Review Form
2016-0416
Legistar File ID
9/20/2016
City Council Meeting Date - Agenda Item Only
N/A for Non -Agenda Item
Purchasing / '
Andrea Rennie 9/2/2016 Finance & Internal Services Department
Submitted By Submitted Date Division / Department
Action Recommendation:
Staff recommends the signing of an addendum to the fuel card services agreement between WEX Bank and
National Joint Powers Alliance (NJPA), enabling the City to receive fuel card services off of NJPA Contract# 042016-
WEX. Signing this addendum will enable the City to utilize the fuel card contract, as renewed by NJPA through July
20, 2021.
Original Contract Number: Approval Dater
Comments:
Budget Impact:
Various
Various
Account Number
Fund
Various
Various
Project Number
Project Title
Budgeted Item? NA
Current Budget
$
Funds Obligated
$
Current Balance
Does item have a cost? NA
Item Cost
.... ...... .. _ ..
Budget Adjustment Attached? NA
Budget Adjustment
Remaining Budget
V20140710
Previous Ordinance or Resolution #I
Original Contract Number: Approval Dater
Comments:
CITY OF
s
Fa � � � le CITY COUNCIL AGENDA MEMO
ARKANSAS
MEETING OF SEPTEMBER 20, 2016
TO: Mayor Lioneld Jordan and Fayetteville City Council
THRU: Paul A. Becker, Chief Financial Officer
FROM: Andrea Rennie, Purchasing Manager
DATE: Friday, September 02, 2016
SUBJECT: Approval of contract with WEX Bank for fuel card services
RECOMMENDATION:.
Staff recommends the signing of an addendum to the fuel card services agreement between WEX
Bank and National Joint Powers Alliance (NJPA), enabling the City to receive fuel card services
off of NJPA Contract# 042016-WEX. Signing this addendum will enable the City to utilize.the fuel
card contract, as renewed by NJPA through July 20, 2021 _
BACKGROUND:
The WEX contract is recognized and utilized by the State of Arkansas and was competitively
solicited through NJPA. WEX offers no set up fees or card fees and is an Arkansas Office of
State Procurement statewide contract. The City will be able to obtain valuable monthly rebates
on fuel and maintenance transactions, some of which are being tracked manually.
This contract also features an online tool including a profile manager, expense management tools
and fuel price mapping. The profile manager allows the City to set rules for how the card can be
used, how often and when, giving the City flexible control limits. The expense management tools
enable the City to manage the fuel -card spend in a centralized location. Fuel price mapping
combines fuel transaction data with Google Maps to help drivers find current best prices by city,
state, zip, fuel type, price per gallon, or brand.
WEX fuel cards are accepted by the vast majority of fueling stations and provides access to one
of the largest proprietary fleet card networks.
DISCUSSION:
Currently, three City departments and divisions have the opportunity to utilize a consolidated fuel
card program. Transitioning the Fleet Division, Police Department, and Fire Department to the
new fuel card program will consolidate fuel purchases and save the City resources currently being
used to manually receive tax rebates. The cards have the capability to be customized by each
department and division to meet varying needs.
Mailing Address:
113 W. Mountain Street www,fayetteville-ar.gov
Fayetteville, AR 72701
4
BUDGETISTAFF IMPACT:
Budgeted funds will be utilized primarily by Fleet, Fayetteville Police Department and the
Fayetteville Fire Department based on their fuel card needs. Fuel is a budgeted expense.
Attachments:
Contract Acceptance and Award from NJPA, Contract#; 042016-WEX
Fuel Card Services Addendum between WEX Bank and NJPA
WEX General Information
2
4
FORM E
CONTRACT ACCEPTANCE AND AWARD
(Top portion of this form will be completed by NJPA it the vendor is awarded a contract. The vendor should
complete the vendor authorized signatures as part of the RFP response.)
NJPA Contract #:042016-WEX
Proposer's full legal name: WEX Bonk
Based on NJPA's evaluation of your proposal, you have been awarded a contract. As an awarded vendor, you
agree to provide the products and services contained In your proposal and to meet all of the terms and
condillons set forth In this RFP, In any amendments to this RFP, and In any exceptions that are accepted by NJPA.
The effective dote of the Contract will be July 20, 2016 and will expire on July 20, 2020 (no later than the later of
four years from the expiration date of the currently awarded contract or four years from the date that the NJPA
Chief Procurement Officer awards the Contract). This Contract may be extended for a fifth year at NJPA's
discretion.
Awarded on May 26. 2016
Vendor Authorized Signatures:
ere: S 1111YICT'7
,Chad coquette
1, PA Ci rltrr7Gl U 042016 -WEE
The Vendor hereby accepts this Contract oward. including oil occupied exceptions and amendments.
Vendor Name WEX Bank
Authorised Signatory's Title President/CEO
Kirk 3, Weiler
�;+''....._...,:i NJPA Contract tt 042016 WGX
A. S'RitOVED
4
ADDENDUM TO THE FUEL CARD SERVICES AGREEMENT BETWEEN WEX BANK
AND THE NATIONAL JOINT POWERS ALLIANCE (NJPA) FOR THE STATE OF ARKANSAS
CREDIT+ .. +
Participating Entity has requested a credit account pursuant to the Vendor Agreement #062411-WEF (Agreement), ("Agreement") entered Into between the National Joint
Powers Alliance ("NJPA") and WEX BANK. By enrolling in this Program, the Participating Entity named below agrees that in
the event their account is not paid as agreed, WEX BANK may report the undersigned's liability for and the status of the account to credit bureaus and others who may lawfully
receive such information,
Participating Entity
Phone #
Fax#
City of Fayetteville, Arkansas
479-575-8289
479-575-8289
Headquarters Name and Physical Address (Do not include PO Box)
113 W. Mountain
NJPA Member to Number Applicant's Taxpayer ID # (TIN, FEIN or SSN)
34143 71-6018462
In Business Since (yyyy) Year of Incorporation (yyyy) Number of Vehicles Avg Monthly Fuel Expenditures Avg Monthly Service Expenditures
11/3/1836 11836 70 $21,142.45 $Various
ACCOUNT.-
Write Participating Entity name as you wish it to appear on cards,. Limit of 20 characters & spaces, Unless specified, no company name will appear on cards.
oa000000000000a000FL] [fl
Billing Contact
Billing Address
City
State
Zip+4
Andrea Rennie
113 W. Mountain
Fayetteville
AR
72701
Designate the Fleet Contact authorized to receive all charge cards, reports, and other such information we provide from time to time and to take actions with respect to your
account and account access; This is also the person designated by your company to provide all fleet vehicles, driver and other information we may request.
Authorized Fleet Contact Name
Title
I Phone #
Fax #
Andrea Rennie I
I Purchasing Agent
479-575-8289
479-575-8257
Mailing Address (if different from billing address)
City -
Slate
Zip+4
113 W. Mountain I
Fayetteville
AR
72701
Email address (required to take advantage of product type card controls)
aforen@fayetteville-ar.gov
El Check here if business is exempt from motor fuels tax *Exempt from federal not state of Arkansas
1. This Addendum is to allow the State of Arkansas to participate under the Agreement between WEX BANK and NJPA (AR contract # 4600027573). It does
not
modify, amend or change the Agreement in any way,
2. Participating Entity hereby requests the services of WEX BANK described in the Agreement and agrees to perform all duties required under the Agreement,
including, without limitation, timely payment of all charges (including any additional fees) on its account(s). Participating Entity agrees to be bound by the
terms and conditions of the Agreement, including, without limitation, rules for authorized and unauthorized use of cards, disputes of charges, reporting lost
and stolen cards, and all other rules and provisions relating to use of Participating Entity's account,
3 Participating Entity acknowledges that its failure to make timely payment in accordance with the terms of the Agreement may result in suspension or
cancellation of the account(s).
INFORMATION SHARING DISCLOSURE: Information regarding your transactions may be provided to NJPA accepting merchants or their service
providers:
Compliance with Federal Law Our bank complies with federal law which requires all financial institutions to obtain, verify, and record information that
identifies each company or person who opens an account. What this means for you: when you -open an account, we will ask for your name, address, date
of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents for your
business.
DISCLAIMER: THIS IS AN APPLICATION FOR SERVICES AND SHALL NOT BE BINDING UPON WEX BANK UNTIL FINAL CREDIT APPROVAL HAS BEEN
GRANTED BY WEX BANK.
4. Issuer shall pay financial incentives to Company in accordance with the terms and conditions set forth in the Agreement between WEX BANK and NJPA (AR
contract # 4600027573).
Ji
Any person signing on beh the Partici g E tity has be duly authorized by all necessary action of Applicant's governing body, and that the undersigned is
authorized to make is %a£roon and pt the nms refe rtced herein on behalf of the Participatind Entity.
Signature: , Wil. �+.r Print Name:
�L
Title N Date: 4 Lp
Complete and sign addendum. Fax to 1-866-527-8873.
• • Oppty Number Sales Code Plastic Type I Coupon Code I Account Number
' I NJPA NJA 04
04,ADDEND,CRDAPP (08/12)
FUEL
Global
-
ACGEPTC0 IN CANAOA M
of wa ALO ANIPRIDE .fid
Grow Mark
Petro Stop
&t
!ialleys
illi
<h�iurt
—ii�llltli
Handy Andy's
Pure
�oncca -,.CROWN' �� _ � fTN� EJKOt�
� ►y„x.
Oik N EZ
::'PFEUC3.i r
goexxar^ tauti H£55E
Quality Oil
g/ g LR 8LMobil- 8'
Ideal
n,euamm
Certified
3wwr
-. ��.;-•
Robinson Oil
City Garage
Johnson & Dixon Rotten Robbie
U�t�
Jr, Food Stores
do Itil
X
Kenyon
®�' 'i£SORU
Cumberland
King Soopets
Rymes 24
Sr:Y co
Koch
SC Fuels
D & D Oil
�At�sa
Smokers Express
Dairy Mart
Krause
'$print
SERVICE
_ f �¢ �... l nunt y � ssa,� •rYrSd'
iiffvlube t"��,<,
Pa#QP2..,ttsseNtVdD Qfmoinrrka f' Y
AC & T
Global
Petro King
Aviation
Grow Mark
Petro Stop
Bell Gas
!ialleys
PRIDE
Bigfoot
Handy Andy's
Pure
Break Time
Nuck's
Oik N EZ
Capital CityIGo
Quality Oil
Carousel
Ideal
Quik Mart
Certified
Inter City
Robinson Oil
City Garage
Johnson & Dixon Rotten Robbie
Cages
Jr, Food Stores
Royal Farms
Crystal Flash
Kenyon
Rutter-,
Cumberland
King Soopets
Rymes 24
Farms
Koch
SC Fuels
D & D Oil
Krarne:
Smokers Express
Dairy Mart
Krause
'$print
Depot
Kroger
Stevarts Shops
Drivers Traveler
Kum & GO
T':y'or Foods
Dynamic Mart
Kwik pantry
P'CI
Economy
Ll Champ
Thornton Oil
Eddins Walcher
Bucky atop
TOTAL
Enmark
M & H
-ownRCountry
ETNA
Macs Stores
`rade Mart
Express Step
McClure Oil
Trade Oil
Family Express
MFA Oil
Tnpar Gii .
Farmland
Minit Mart
us Oil
Farstad
M, Cut Rate
USCO
Fast Stop
Multi Sety
Valley Dairy
Fauser Oil
Murphy Express Weigel Store
FFP
,NAPA
Wasco
Flash Foods
Nevus
Williams Trove!
Food Chief
NU -Way
Xtra Fuels
Fuel Mart
Oasis
Youngs
Gas America
O'Connor
Zip Mart
Giant
OK Petroleum
Git-n-Go
Pantry
Ameticin Lub.Fast
Nelcost Auto Glass
Big O Tires
Tire Centers Inc
Daimfer/Chrysler
Wash
Depot
Diamor:d/iriumph
...and
many regional
Auto Glass
and independent
[)edge Businessi.ink-
locations nationwide.
(limited participation)
GM Goodwreach
!limited participation)
I lannon Glass
For more inforn�lation, visit
www.WEXinc.com
800-395-0812
•
i
WEX On►ine'offers a suite of reporting capabilities, Our specialized fleet
management reports give you the power to save money, cut administrative
time, comply with tax reguiations, and more,
STANDARD AND CUSTOM REPORTS
WEX Online offers both standard and custom reports, so you get the type of
inforr nation you need.
EXAMPLES:
Purchase Activity Report (PAR) — compile information on all fueling
and maintenance purchases made with the WEX Universal Fleet card -- for
hundreds of vehicles orjust a few,
Premium Custom Reports —select your criteria to generate ad hoc, real -
gime reports: Exception, Transaction Summary, and Transaction Detail reports.
[_xport these reports directly into your own spreadsheet, to easily analyze and
share your data.
Summary Reports -- use our Financial Surnmary, Site Summary and
Exception Summary reports to manage _your vehicle -related expenses and -
plan your fleet budget.
Tax Exemption Reports — for qualified tax-exempt fleets, monthly report
packages provide tax infon7lation at bot -11 the transaction and summary iPVe,
and will include all tax exemptions that can be applied to your account under our
program,
Minority and Women -Owned Businesses Report (MWOBE) — a quarterly
report, summarizing by fleet account and rronth, transactions, gallonsand
dollars spent at INIVV013E fuel and service locations.
www.WEXinc.com
500-395-0812
�P;U,f�CHASE'iCOMROLS�'
the `•:'VEX fleet card offers a suite of control and alert tools that let you know
where, when, what and how much is being spent. Managed through our
i'.dustry leading WEX Online" account management tool, these powerful
:Dols provide actionable: purchase po ley enforcement capabilities.
When the card is swiped, merchant product code's autornatically connPare
tiles purchase against pre-set card profile lii7tits. if the product types are
allowed and the set limits ha•,e not been exceeded, we authorize the
transaction, anti the rnercnani cornpletes the sale, If thc, card is beyond the
lim`t , it wil; be declined.
You can set overall lirruts for all purchases for a specific time period —
daily. ;vee kly, twice., rnorthly, or snortthly; and your fleet's total purchases
for that o nod transactions per period, dollars per period and gallons/
units .ger per':.oc.
PUMP SHUT-OFF FEATURE
W;','X r:.o•.: offers a powerful pump shut-off feature" tto asrilsil youi vvith _
en`orcerncnt of policies,. i^Vtten a driver exceeds your pre set limits, the f untfj
Will s:gut off. Thi, feature s avada ,le at most ma or retail fuel brands.
REAL TIME ALERTS
control generates an alert dela linri a
,: eJil:hu:e.-hat is beYonc' your pre Set alai
Text: citta r"i ;tee quick dec'slonc on 1'E:ai;a' lift :it
io deal V';ith ? e `.SltUal:i 3n at handi.
+�y $yhoursu(day
krY
800-395-0812
By days of the week
Do irsperdayiweek
'+ ti0118di�tlranSdttlOtt
producttategory
14
WEX Online' is a cutting-edge web -based tool that provides you access to
views and manage (-,very detail of your fleet card proorarn.VVe created The site
to put information at your fingertips 24/7 so you can take action as needed,
PROFILE MANAGER
The profile manager allows you to establish purchase control profiles for
individuals, groups of drivers, vehicles and rnore. Set ruses for ho+,,.(the card
can be used, how often, and when. Add spend limits for fuel, service, parts,
arid general nlerchanclise,Youi fules will be embedded in the respective
cards -- if a transaction exceeds your iirrits, The system wi I I decline the
purchase. YOU set the co nt,u: limits, tits, "Ale enforce. oi ce i hem,
To
EXPENSE MANAGEMENT f OLS
WEXOnline makes it easyto, [nanage your feet spend in one central place.,
Set jD profiles, billing, and re.portir ig functions, Nmi:s, and restrictions. Add
custom fit -Ids and assign -odes, Such as (:eneral Ledger L), Run 0. L J e., r e s on
purchase transac-lions, :vehicles and dri-Vers.
FUEL PRICE MAPPING
Our Fuel Site Locator cornbmer fIje. transaction data v,,,,'th Google Maps" tv
e,
help drivers find current best prices r- c:[:y, ..,tate, zip, fu�,., typPrOG,or Nand.
Find the lowest cos' fuel sm.inn: vvith our fuel c';rice snapping techrolo-ay,
which up(,: tes prices hourly.'0W Octane mobile version is free, and gives
drivers access on t! ,0 road.
6
AL
A IN IE
IfIMN
www.WEXinc.com
800-395-0812
WEX Bank Fuel Account
City of Fayetteville Staff Review Form
2017-0220
Legistar File ID
N/A
City Council Meeting Date - Agenda Item Only
N/A for Non -Agenda Item
Andrea Rennie 4/17/2017
Purchasing /
Finance & Internal Services Department
Submitted By Submitted Date Division / Department
Action Recommendation:
Mayor's signature for the completion of forms required by WEX Bank for tax exemption for the purchase of fuel.
Budget Impact:
Account Number Fund
Project Number Project Title
Budgeted Item? NA Current Budget $ -
Funds Obligated $ -
Current Balance $ -
Does item have a cost? NA Item .Cost
Budget Adjustment Attached? NA Budget Adjustment
Remaining Budget $ -
V20140710
Previous Ordinance or Resolution # 165-16
Original Contract Number: Approval Date: ��—�(�—I t7
Comments:
CITY OF
aegleARNSAS
TO: Mayor Lioneld Jordan
THRU: Paul A. Becker, Chief Financial Officer
FROM: Andrea Rennie, Purchasing Manager
DATE: Monday, April 17, 2017
STAFF MEMO
SUBJECT: Completion of forms required by WEX Bank for tax exemption for the
purchase of fuel
RECOMMENDATION:
Staff recommends the completion of two WEX Bank packets for tax exemption purposes for the
purchase of fuel through WEX Bank. The City has two WEX Bank accounts and each requires a
separate completed packet. Each packet contains (1) Certificate of Buyer form and (2) Tax
Exemption & Reporting Enrollment Form.
BACKGROUND:
On September 20, 2016 via Resolution 165-16, the Fayetteville City Council authorized the City
to enter into a contract with WEX Bank for the City to participate in a fuel card program.
DISCUSSION:
Completion of these packets is critical and necessary to make the City exempt, as allowed by
local governments, from certain taxes on fuel.
BUDGET/STAFF IMPACT:
Fuel purchased under the new account is a budgeted expense.
Attachments:
Resolution 165-16
Tax Packet 1 of 2 (City's main WEX Bank fuel account)
Tax Packet 2 of 2 (City's Drug Task Force — DTF account)
Mailing Address:
113 W. Mountain Street www.fayetteville-ar.gov
Fayetteville, AR 72701
r `orf
113 West Mountain Street
Fayetteville, AR 72701
(479) 575-8323
Resolution: 165-16
File Number: 2016-0416
WEX BANK:
A RESOLUTION TO APPROVE A CONTRACT WITH WEX BANK, PURSUANT TO A NATIONAL
JOINT POWERS ALLIANCE COOPERATIVE PURCHASING AGREEMENT, TO ENABLE THE CITY
TO PARTICIPATE IN A FUEL CARD PROGRAM.
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE,
ARKANSAS:
Section 1: That the City Council of the City of .Fayetteville, Arkansas hereby n
approv�tS a contract
with WEX Bank, pursuant to a National Joint Powers Alliance cooperative purchasing �NN�`",iiae;»inable
the City to participate in a fuel card program ��� �', ' •� ` rs'%
PASSED ard APPROVED on 9/20/2016
Attest: ''/ G -r0 i�� � %````*
kux M,
Sondra E. Smith, City Clerl Trelsiirer C
Page 1 Printed on 9/21116
0
City of Fayetteville, Arkansas 113 West Mountain Street
Fayetteville, AR 72701
(479) 575-8323
Text File
File Number: 2016-0416
Agenda Date: 9/20/2016 Version: 1 Status: Passed
In Control: City Council Meeting File Type: Resolution
Agenda Number: A. 4
WEX BANK:
A RESOLUTION TO APPROVE A CONTRACT WITH WEX BANK, PURSUANT TO A
NATIONAL JOINT POWERS ALLIANCE COOPERATIVE PURCHASING AGREEMENT, TO
ENABLE THE CITY TO PARTICIPATE IN A FUEL CARD PROGRAM
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE,
ARKANSAS:
Section 1: That the City Council of the City of Fayetteville, Arkansas hereby approves a contract with
WEX Bank, pursuant to a National Joint Powers Alliance cooperative purchasing agreement, to enable
the City to participate in a fuel card program
City of Fayetteville, Arkansas Page 1 Printed on 9/21/2016
E
City of Fayetteville Staff Review Form
2016-0416
Legistar File ID
9/20/2016
City Council Meeting Date - Agenda Item Only
N/A for Non -Agenda Item
Purchasing /
Andrea Rennie 9/2/2016 Finance & Internal Services Department
Submitted By Submitted Date Division / Department
Action Recommendation:
Staff recommends the signing of an addendum to the fuel card services agreement between WEX Bank and
National Joint Powers Alliance (NJPA), enabling the City to receive fuel card services off of NJPA Contract# 042016-
WEX. Signing this addendum will enable the City to utilize the fuel card contract, as renewed by NJPA through July
20, 2021.
Budget Impact:
Various Various
Account Number Fund
Various Various
Project Number
Budgeted Item? NA
Does item have a cost? NA
Budget Adjustment Attached? NA
Current Budget
Funds Obligated
Current Balance
Item Cost
Budget Adjustment
Project Title .
5
5
Remaining Budget
X120140710
Previous Ordinance or Resolution #
Original Contract Number: Approval Date:
Comments:
CITY OF
Taypp T�11s
1.- � l � CITY COUNCIL AGENDA MEMO
ARKANSAS`
MEETING OF SEPTEMBER 20, 2016
TO: Mayor Lioneld Jordan and Fayetteville City Council
THRU: Paul A. Becker, Chief Financial Officer
FROM: ' Andrea Rennie, Purchasing Manager
DATE: Friday, September 02, 2016
SUBJECT: Approval of contract with WEX Bank for fuel card services
RECOMMENDATION:
Staff recommends the signing of an addendum to the fuel card services agreement between WEX
Bank and National Joint Powers Alliance (NJPA), enabling the City to receive fuel card services
off of NJPA Contract# 042016-WEX. Signing this addendum will enable the City to utilize the fuel
- card contract, as renewed by NJPA through July 20, 2021.
BACKGROUND:
The WEX contract is recognized and utilized by the State of Arkansas and was competitively
solicited through NJPA. WEX offers no set up fees or card fees and is an Arkansas Office of
State Procurement statewide contract. The City will be able to obtain valuable monthly rebates
on fuel and maintenance transactions, some of which are being tracked manually.
This contract also features an online tool including a profile manager, expense management tools
_ and fuel price mapping. The profile manager allows the City to set rules for how the card can be
used, how often and when, giving the City'flexible control limits. The expense management tools
enable the City to manage the fuel card spend in a centralized location. Fuel price mapping
combines fuel transaction data with Google Maps to help drivers find current best prices by city,
state, zip, fuel type, price per gallon, or brand.
WEX fuel cards are accepted by the vast majority of fueling stations and provides access to one
of the largest proprietary fleet card networks.
DISCUSSION:
Currently, three City departments and divisions have the opportunity to utilize a consolidated fuel
card program. Transitioning the Fleet Division, Police Department, and Fire Department to the
new fuel card program will consolidate fuel purchases and save the City resources currently being
used to manually receive tax rebates. The cards have the capability to be customized by each
department and division to meet varying needs.
Mailing Address:
113 W. Mountain Street www.fayetteville-ar.gov
Fayelleville, AR 72701
BUDGET/STAFF IMPACT:
Budgeted funds will be utilized primarily by Fleet, Fayetteville Police Department and the
Fayetteville Fire Department based on their fuel card needs. Fuel is a budgeted expense.
Attachments:
Contract Acceptance and Award from NJPA, Contract#; 042016-WEX
Fuel Card Services Addendum between WEX Bank and NJPA
WEX General Information
FORM E
CONTRACT ACCEPTANCE AND AWARD
0
(Top portion of this form will be completed by NJPA if the vendor is awarded a contract. The vendor should
complete the vendor authorized signatures as part of the RFP response.)
NJPA Contract ft: 042016-WEX
Proposer's full legal name: WEX Bank
Based on NJPA's evaluation of your proposal, you have been awarded a contract. As an awarded vendor, you
agree to provide the products and services contained In your proposal and to meet all of the terms and
conditions set forth In this RFP, In any amendments to this RFP, and In any exceptions that are accepted by NJPA.
The effective dote of the Contract will be July 20. 2016 and will expire on July 20, 2020 (no later than the later of
four years from the expiration dote of the currently -awarded contract or four years from the dole that the NJPA
Chief Procurement Officer awards the Contract). This Contract may be extended for a fifth year at NJPA's
discretion.
NJPA Authorized Signatures:
'.:tv+i:
C) ^or... tkPr :�3✓,•� ire:_.
Awarded on May 26. 2016
Vendor Authorized Signatures:
Jeremy Schwartz
had Coauelie
NUF'a Contracf # 042016-44EX
The Vendor hereby accepts this Contract award, including all accepled exceptions and amendrnenis.
Vendor Name _._ WEX Bank
Authorized Signatory's Title President/CEO
;;fit; <Uri :,,a?F%t jt::;'•,.:r
FxecVteCian
Ma 27 7.0._16
APPROVED
DyAGonran a 0:07 ", Eby Zi :010:
Kirk S. Weiler
NJPA Contract ff 042016-WEX
ADDENDUM TO THE FUEL CARD SERVICES AGREEMENT BETWEEN WEX BANK
AND THE NATIONAL JOINT POWERS ALLIANCE (NJPA) FOR THE STATE OF ARKANSAS
CREDIT
Participating Entity has requested a credit account pursuant to the Vendor Agreement #062411-WEF (Agreement), ('Agreement') entered into between the National Joint
Powers Alliance ("NJPA') and WEX BANK. By enrolling in this Program, the Participating Entity named below agrees that in
the event their account is not paid as agreed, WEX BANK may report the undersigned's liability for and the status of the account to credit bureaus and others who may lawfully
receive such information.
Participating Entity
Phone #
Fax#
City of Fayetteville, Arkansas
1479-575-8289
479-575-8289
Headquarters Name and Physical Address (Do not include PO Box)
113 W. Mountain
NJPA Member ID Number
Applicant's Taxpayer ID # (TIN, FEIN or SSN)
34143
71-6018462
In Business Since (yyyy) Year of Incorporation (yyyy) Number of Vehicles Avg Monthly Fuel Expenditures Avg Monthly Service Expenditures
11/3/1836 1836 70 $ 21,142.45 .,$Various
I
ACCOUNT
SETUP INFORMATION
Write Participating Entity name as you wish it to appear on cards. Limit of 20 characters & spaces, Unless specified, no company name will appear on cards,
000a11oo1110oa000aooaoo
Billing Contact
Billing Address
City
State
Zip+4
Andrea Rennie
113 W. Mountain
Fayetteville
AR
172701
Designate the Fleet Contact authorized to receive all charge cards, reports, and other such information we provide from time to time and to take actions with respect to your
account and account access. This is also the person designated by your company to provide all fleet vehicles, driver and other information we may request,
Authorized Fleet Contact Name
Title
Phone #
Fax #
Andrea Rennie
I Purchasing Agent
479-575-8289
479-575-8257
Mailing Address (if different from billing address)
City
State
Zip+4
113 W. Mountain -
Fayetteville
AR 172701
-
Email address (required to take advantage of product type card controls)
aforen@fayetteville-ar.gov
17 Check here if business is exempt from motor fuels lax 'Exem t from federal not state of Arkansas
TERMS
I, This Addendum is to allow the State of Arkansas to participate under the Agreement between WEX BANK and NJPA (AR contract # 4600027573). It does not
modify, amend or change the Agreement in any way.
2, Participating Entity hereby requests the services of WEX BANK described in the Agreement and agrees to perform all duties required under the Agreement,
including, without limitation, timely payment of all charges (including any additional fees) on its account(s). Participating Entity agrees to be bound by the
terms and conditions of the Agreement, including, without limitation. rules for authorized and unauthorized use of cards, disputes of charges, reporting lost
and stolen cards, and all other rules and provisions relating to use of Participating Entity's account,
3 Participating Entity acknowledges that its failure to make timely payment in accordance with the terms of the Agreement may result in suspension or
cancellation of the account(s).
INFORMATION SHARING DISCLOSURE: Information regarding your transactions may be provided to NJPA accepting merchants or their service
providers.
Compliance with Federal Law. Our bank complies with federal law which requires all financial institutions to obtain, verify, and record information that
identifies each company or person who opens an account. What this means for you: when you open an account, we will ask for your name, address, date
of birth, and other information that will allow us.to identify you. We may also ask to see your driver's license or other identifying documents for your
business.
DISCLAIMER: THIS IS AN APPLICATION FOR SERVICES AND SHALL NOT BE BINDING UPON WEX BANK UNTIL FINAL CREDIT APPROVAL HAS BEEN
GRANTED BY WEX BANK.
4. Issuer shall pay financial incentives to Company in accordance with the terms and conditions set forth in the Agreement between WEX BANK and NJPA (AR
contract # 4600027573).
PARTICIPATING rSIGNA"RE REQUIRED'
1
Any person signing on beh the Partici t g E tity has 6e duly authorized by all necessary action of Applicant's governing body, and that the undersigned is
authorized to make is (cation and pl the ercns rete aced herein on behalf of the Participating Entity,
Signature: L �.�`, Print Name: E'
Titlev Keftv pAv Date: -I
Complete and sign addendum. Fax to 1-866-527-8873.
• • Opply Number Sales Code Plastic Type Coupon Code I Account Number
Kma�NJ I NJA 04
04,ADDEND.CRDAPP (08/12)
a
ACCEPT i4rNCE-WHEREY4UU,NEE
•- }'31t..b.y{.i:rir'�i�. r^ �..1. 4�,aJ.�U r �.�t f'f l L, �• �i
Access one of th_e largest proprietary fled etworks
_ `
.J
FUEL
_•A- ACCEFFEO iN Cn NADA :,f SAC
S17 fS50 a -i11.1 AtON.A A AL3 AMPRibE
8't
Aviation
Global
Grow Marts.
Petro King
Petro Stop
.„.
Bell Gas
Halley's
PRIDE
Bigloot
Handy Andy's
Pure
t'P
<krgron
© f
Break Time
Capital City
HUCK's
ICO
Dix N EZ
Duality Oil
crtno
Carousel
Ideal
Ouik Mart
COf101t:O
�•�
�j(y 7
f �r Lwl �ONI q
�iiovirll !�`„' LLwwwll fl� r=J 1 •+�
Certitiad
City Garage
Coq os
Inter City Robinson Oil
Johnson 8 Dixon Rotten Robbie
Jr. Food Stores Royal Farms
Crystal Flash
Kenyon
Rollers
1 I
r'"411111111/ FPEEDCF 1 �t GOGAS f
f1 ►lam l_I 0. 1
t= -r; � •�-. �GATEr 1
Cumberland
Farms
0 E coil
King Soopers
Koch
Rymes 24
SC Fuels
11
1
Oairy Man
frame:
{rause
Smokers Express
Sprint
© gonr ar: '.G ul►
HESS
Depot
Drivers Traveler
Krognr
Kum R Go
Slowans Shoes
Tayaar Foods
Dynamic Merl
KwiK Pantry
'TCI
r-- r7UT-3
KwiR ASvix
LUK*IL O ���� �
Economy
Eddins Walcher
Tal Champ
Lucky Slop
Thornton Oil
TOTAL
I I
Enmark
M 8 H
Town&Coumry
jl
metjer '1T” AtU�COfA'
USA*.
C?"+ __r� Mobil �Murunt
ETNA
Ewss Stop
x P P
Macs Stores
McClure Oil
Trade Mad
Trade
Fomily Expr¢ss
MFA pit
7nhar Oil
'�
Farmland
Farstad
mi,;[ Mart
Mr. Cul Rate
us Oil
LISCO
-
PEivui N -u+ nfcy
Fast Stop
Multi Swv
Valley Dairy
�>;�s93 .'%.
�•'' J/ -
Fauser pit
FFP
'durpby Express Weigel Sore
NAPA wasco
i
Finsh r. ds
%c us
WJliams Trovc!
- r
Food Chiel
'vJ-Way
Xlra Fuels
'rE50Ro
Fuel Mart
Cia^, Aa:¢nca
Oasis
O'Connor
Youngs
Zip Man
..taco -
Gfanl
OK Petroleum
—Q'— j9T.A„IIIA.
—M— ,z+-
r _
'RO
Wawa �'..J•+`"3
Gi!-n•Go
Pantry
...-�..
vnt¢no 1�,._...., W
,ucl ncr.:p:an<r.: suhircii:, ;n:f,;,,•nd••nr c•:r[errr.;•^ret;vi,.nis:y:n!:•,r,::•::f:,�iyr.; to rt,any<::•i!I;u:+l nnr!•� -
SERVICE
American LubeFnst Neteost Auto Glass
Big O Tires
tire.
CenLers Inc
t
.!*'•M`i ,a„ ” . r
Oaimond/T rysler
D.amcrd(Gwmph
Wash Depot
many
many regional
Auto Glass
...and
and independent
r,
�Jl tasrxw�e msmeke < ice+?. FF. PttlJ:'s;
Dodge Business! nk-
Ilim�l¢d panicipahon]
locahon., oatmr wide,
)Iftylube ��•--• -_..__
GM Goe.,6 h
I
(limitedrl partiripabon)
'y'
srs SA fe7ife
I
Sears ; Tri ILS � tZ� ��7ICSSlU�C
I Ian,= Glass
A;;rnGiasa
-�
%OFormore information, visit
www.WEXinc.com
800-395-0812
3KiPJ-.i; 120:
"RFROP
,11 1
WEX Online offers a suite of reporting capabilities, Otjrsl-)eciAli7ecin(ef.-.t
management reports give you the power to save money, cut administrative
time, comply with tax regulations, and more.
STANDARD AND CUSTOM REPORTS
WEX Online'offers both standard and Custom reports, so you get the type of
information you need.
EXAMPLES:
Purchase Activity Report (PAR) — compile information on air fueling
and maintenance purchases made with the WEX Universal Fleet card — for
hundreds of'vehicles or just a few.
Premium Custom -Reports — select your criteria to generate ad hoc, real-
time reports: Exception, Transaction Surnmary, and Transaction Detail reports.
r`xnoit these reports directly into your own spreadsheet, to easily analy2e and
share Your data,
Summary Reports use out Financial-Surnmary, Site Summary and
Exception Summary reports to rnanaf
,)eyot,rvc,lii.cle-ielatedexpensc,saiid
plan your fleet budget.
Tax Exemption Reports — for qualified tax-exempt fleets, monthlyrepoit
packages provide tax information at both the transaction and surn-mary level,
ind will include all tax exernptions that can be applied to Your account under Our
program.
Minority and Women -Owned Businesses Report (MWOBE) — a quarterly
report, summarizing by sleet account and rnonth, transactions, gallons and
dollars spent ail IViVVOBE fuel and service locations.
www.WEXinc.com
800-395-0812
n
I he WV.X fleet card offers i suite of control and alert tools that let you know
where, when, what, and how much is being spent. Managed through our
industry leading WEX Online' account management tool, these powerul
tools provide actionable purchase policy enforcement eapabilirie:s.
i
PRODUCT TYPE CONTROLS
i
vVher? the card is swiped, merchant product codes autoli?atically compare
the purchdse arlainst pre -ser card profile limits. If the product types are
allowed )nd the set limits have nor, been exceeded, we authorize the ;
transaction, and the merchant completes the sale. If the card is beyond the t
limits, it will be declined.
You can set overall limits for all purchases 'for a specific time perirJd —
daily, vfeekly, bAic:e rnonthiy, or monthly; and your fleet.'s total purchases .r - = ,> • �
for that Jerrod -- transactions per period, dollars per eri t �M
f f' P p_ od and gallons.
units Per period.
i
PUMP SHUT-OFF FEATURE
!!�
t
YR FX offe!s a pow.-Irful purnpshut-off feature* to assist you r✓ith
cnfo,cernent of pollc.ua. Whcn a driver exceeds your pre set limits, tf?c purf?Ia
will shat off Thi; 1`2atur;) is a;JaiIa ,le i,t rnOsf major r;rtad fuel brands
By hours of day
t By (lays of the .414.
e DuHars ptuf ddy/sceek
Dokus per naasaclion
Product category
0of molt � i; jr jr l r?dt i;Jrr, V;51:
www.WEXinc.com
800-395-0812
REAL TIME ALERTS
[his, control generates an alert detain a
purchase that is bevond your pre-set alert
valt_c,. Choose to iie by
�.,,,. •. q;c- notified el'lall of
;, .,, •r ,,,,. ;e> t. and mage c;u,ck decisions on h vi bf:st
::,.:. J •„ to dea"I with the situation at Wild
`.'J-.
4.: :.:•`*:.all
"V:i:=�+•-a....�In(....:;Ct::Tr:tl�::tnf+(.�I IIt: C(dtif:fl .!tTn:f
1
By hours of day
t By (lays of the .414.
e DuHars ptuf ddy/sceek
Dokus per naasaclion
Product category
0of molt � i; jr jr l r?dt i;Jrr, V;51:
www.WEXinc.com
800-395-0812
C
WEX - Online' is a'cuttirig-cclge web -based tool that provides you access to
view and manage every detail ofyour fleet card program. We created the site
to Put infOrrnation at your fingertips 24/7 so you can lake action as needed,
PROFILE MANAGER
The profile manager allows you to establish PUrCrIaSe control profiles for
individuals, groups of drivers, vehicles and more. Set rules for how the card
can be used, hovel often, and when. Add spend limits for fuel, service, parts,
and general merchandise. Your rules will be embedded in the res!:)e.c! ive
cards if a transaction exceeds your limits, the system will decline the
purchase. You set the control limits. We enforce them.
EXPENSE MANAGEMENT TOOLS
WEX Online" makes it easy to manage your nc.-et speri(j in one central p a: e
Set up pr6files, billing, and reporting functions, limits: and restric-liOns, Add
custom fields and as -sign codes, such. as General (..edger (c,ID, Rrin `Uefi(:t 01:
puichase transactions, vehicles and drivers..
FUEL PRICE MAPPING
.
Our Fuel Site Locator cornbincs fuel tranc:action data with Google ;Vlans"t0
help drivers find current best prices by city, (;late, zip, fuel type, PK3,ni Mand.
Find the lowest cost fuel slalion!, With Our fuel price rnapping Ledir.olocly,
which updates prices hourly. Out Octane mobile version is free, and gives.
drivers access on the road.
6
C, TALI IN En
www.WEXinc.com
800-395-0812
0
WEX Fuel Card:,
Main City Fuel Account
. Tax Package 1 of 2
Packet total: 6 Pages
We see corporate payments diHerentiy.
Thank you for your interest in our
Tax Exemption and Reporting Program
The WEX Tax Exemption and Reporting Program can significantly reduce accounting and administrative time for
qualified fleets exempt from motor fuel excise taxes or certain sales taxes — at Federal, state, county or local levels.
Benefits include:
-Net billing of federal excise tax on applicable fuel purchases at any location.
-Net billing of state, local, county and special tax on applicable fuel purchases at participating merchant brands
based on local tax laws.
-Detailed reporting of the purchase data and tax exemption.
Exemptions are dependent upon several factors, such as your tax-exempt status for fuel purchases, the taxing
jurisdiction's laws, regulations and requirements, and for most state, county and local taxes, merchant participation. In
the event that a transaction cannot be billed "net of tax", you will receive detailed reporting showing the full purchase
price and the tax paid.
Before we can start billing you net of applicable taxes on fuel transactions based upon your eligibility, you will
need to complete the following required documentation:
Tax Exemption and Reporting Program Enrollment form (enclosed)
Certificate of Buyer of Taxable Fuel form for federal exemptions (enclosed)
Any required State forms – obtain these from the appropriate state governing body.
Please review the enclosed Frequently Asked Questions sheet for helpful information on the program.
IMPORTANT: You must fill out all forms completely and accurately in order to avoid delays in your
program enrollment, so please follow the instructions on the enrollment form carefully..
IRS regulations require that WEX Inc obtain from you, your certification that you are eligible to receive exemptions from
federal excise taxes. For all other taxing jurisdictions (state, county, local) you may need to submit similar certifications as
required by the different taxing jurisdictions. The state certifications may, in most cases, be obtained from the appropriate
state's tax department. WEX must have all applicable documents on file prior to providing you with exemptions. It is
the customer's responsibility to make sure WEX has all of the necessary current forms properly filled out in order to be
billed "net of tax". -
If you have any questions about the program or the enclosed materials, please call us at 1-866-841-3542.
Thank you for your business, and we look forward to providing you with the benefits of this comprehensive
Tax Exemption and Reporting Program.
Sincerely,
WEX Inc. Tax Exempt Department
WWI.
see corporate payments differently.
Q: If my fleet begins fueling before I have provided
all necessary tax exemption paperwork, what
will occur?
We will not be able to bill you net of taxes or report tax
exemptions until we have received all necessary
forms and completed the qualification and setup process.
Q: When will taxes begin to be exempted?
Once we receive all the properly completed
forms, we will complete the tax exemption setup
in approximately 3 business days. We will then begin
calculating applicable exemptions. It is your
responsibility to notify us of any errors or omissions that
you feel may have occurred. If you notice any problems,
contact the tax department at 1-866-841-3542.
Q: How can I determine my fleet's tax-exempt status
for fuel, as well as what type of forms I need?
Contact your local Department of Revenue for free help
and answers regarding your tax-exempt status for fuel and
necessary forms. They can best assist you with
questions of this nature.
Q: Will my fleet be exempted from federal fuels
excise taxes?
Yes if you are a qualified entity. Federal law effective
January I; 2006 allows a card issuer to invoice qualified
fleets net of federal gasoline and federal diesel excise tax
for transactions that occur wherever cards are accepted in
all 50 states. In order to be exempted fi-om federal fuels
excise taxes; you will need to complete a Certificate of
Buyer of Taxable Fuel in the name of the card issuer.
Q: Does my tax-exempt status apply in all states and
localities?
The local Department of Revenue, in each state that your
fleet will be fueling, will be able to help you determine
exemption eligibility for each state and locality
respectively.
/Q: Will I receive state and local exemptions
anywhere I can fuel with the card?
Not necessarily. Merchant brand participation in our tax
program is optional in states. Merchant participation
is not necessary in the following states:. Maine, Georgia,
Michigan, North Carolina, Alabama, New York and New
Jersey.
Q: What do I do if my tax-exempt status changes?
You should immediately notify us by calling the WEX Inc
Tax Exempt Department at 1-866-841-3542.
Tax Exemption & Reporting Program
Frequently Asked Questions
Q: Do any of these forms expire and if so will I be
notified prior to the expiration?
Yes. Federal forms expire every 24 months and certain state
forms expire as well. Starting at 120 days prior to the
expiration of your tax exemption form(s), we will send you
three monthly reminders that renewed forms are required. If
we have not received renewed tax exemption forms by the
expiration date, the tax exemption process will cease
until we receive the necessary paperwork and no credits will
be given.
Q: Will my fleet be exempted from taxes on non -fuel
products?
The Tax Exemption Program provides applicable tax
exemption and reporting for motor fuel taxes only;
however, merchants may provide us with non -fuel
transaction data net of tax on a fleet -by -fleet basis at their
discretion. The fleet will need to supply the mercharit with
proper documentation of their tax-exempt status at the
point of sale for this to occur. .
Q: What if my deet is entitled to a refund for
motor fuel taxes that cannot be exempted up
front through the WEX program?
In these instances, the "non -exemptible" tax is reported
(not exempted) on your fleet report, These reported taxes
appear at the transaction level and at a summary level,
providing you with supporting documentation; which can
help you when filing for a refund of the non -exempted
taxes.
Q: What types of tax information reporting will I
receive?
At the transaction level, your fleet report will provide
Gross Cost, Exempted Amount, Net Cost and Reported
Taxes (for non -applicable taxes). Additionally, a Tax
Exemption Summary will provide a detailed list of all
taxes exempted, sorted by state and by tax type. Finally,
a Tax Reported Summary will provide a detailed list of
all taxes reported, sorted by state and by tax type.
Q: How do I know how many forms to send in?
If you qualify for Federal exemptions, you need to send
in one form per account or one form with a letter certifying
all accounts belonging to the same FEIN. If a new account
is added in the future, a new form or amended certification
letter will need to be sent. For state exemptions, each state
is different and will be addressed on an individual basis.
CERTIFICATE of BUYER of TAXABLE FUEL FOR USE BY A STATE OR
NONPROFIT EDUCATIONAL ORGANIZATION
(To support credit card issuer's claim for a credit, refund, or payment under § 6416(a)(4)(B) or § 6427(I)(6)(D) of the Internal Revenue Code.)
WEX Account Number (if known):
Federal Tax Identification Number:
Certification:
The undersigned hereby certifies under penalties of perjury
that I am the (Title of Officer):
Of (Certifying Entity):
Entity Physical Address:
Entity Phone Number:
And that I am authorized to execute this certificate and that all
purchases, are, or will be, purchased using a credit card
issued by (Credit Card Issuer):
Credit Card Issuer Address:
Regular Account: 0496002905602
71-6018462
Mayor
City of Fayetteville, Arkansas
113 W. Mountain St.
479-575-8330
WEX BANK
3995 South 700 East, Suite 450
Salt Lake City, LIT 84107
Buyer will use the taxable fuel to which this certificate relates for the exclusive use of: (check one)
❑ State government El American Red Cross or Blood Collection Center
® Local government ❑ Indian Tribe
❑ Public nonprofit educational organization ❑ Volunteer Fire/Rescue
❑ Private nonprofit educational organization ❑ Foreign Diplomat (you must provide a copy of your PLD Card)
and it applies to all exempt purchases of gasoline and diesel fuel, if eligible, using charge cards issued by the
Credit Card Issuer named above. Information including the nature and quantity of each purchase of gasoline and
diesel fuel (the subject of this Certificate) are evidenced by periodic reports provided by WEX BANK, the above-
named Credit Card Issuer.
Certification will be valid for twenty-four consecutive calendar months commencing upon completion and
remittance of this Certificate. WEX Inc. may extend the certificate period upon its discretion for an additional
period not to exceed four months.
I understand that by signing this certificate, I, as an authorized representative of the entity named above, give up
our right to claim a credit or payment for the taxable fuel purchased with the credit card to which this Certificate
relates. I understand that the exemption from tax, in this case of sales of articles under the exemption Certificate,
is limited to the sale of articles purchased for our exclusive use. I understand that the fraudulent use of this
Certificate for the purpose of securing this exemption will subject us, and all parties making such fraudulent use
of this Certificate, to fines or imprisonment, or both, together with the costs of prosecution.
The parties ree that a signed transmission shall be considered valid for purposes of this certification and that
the parties reby wai any claim that a transmission does not satisfy the requirements of a signature or writing
under ap able la
crAla n
Aut riz d Signa a Printed Signature
Mayor, City o Fay teville, Arkansas a0' ��f
Title Date
Email or FAX completed forms to TaxExemptForms@WEXINC.Com or 1-207-523-7104
INTERNAL USE ONLY Sales Representative: Philip Kent
WWe see corporate payments differently.
Tax Exemption & Reporting
Enrollment Form
Instructions:
1. Complete part A and sign form at the bottom.
2. Attach FEDERAL Certificate of Buyer and STATE forms (see details below).
3. For questions on signing up for tax exemption and reporting, please call 1-866-841-3542 or email
GovTaxServicesoWEXlnc.com.
4. E mail completed forms to TaxExemptForms(&WEXlnc.com , fax to 1-207-523-7104, or mai I to
Fleet Services, Tax Exempt Department, P.O. Box 639, Portland, ME 04104.
5. Retain the terms on page 2 for your records.
ACCOUNTA. •- •
Fleet Name:
WEX Account Number (if known):
City of Fayetteville, AR (Regular Account)
-.0496002905602
Authorized Fleet Contact:
Phone No.:
Lioneld Jordan
479-575-8330
Fleet Contact email:
Fax No.:
mayor@fayetteville-ar.gov
479-575-8257
Federal Taxpayer ID Number: 7 1-6 01 8462
IMPORTANT: Eligibility maybe limited based on applicable federal, state and local laws.
You must fill out these forms completely and accurately in order to avoid delays in your program
enrollment, so please follow the instructions carefully.
B. MOTOR FUEL TAX
• Tax regulations require us to maintain current copies of the following applicable forms. based on your.eligibility:
1. Federal —A Certificate of Buyer of Taxable Fuel in the name of. WEX BANK (Included with this form.)
2. State — Applicable state forms. (Obtain these from the appropriate state governing body.)
• Once we receive all of your properly completed documentation we will complete the tax exemption set up on
your account within approximately three business days and start billing you net of the applicable taxes.
I he parties agree that a signed transmission
that a transmission does not satisfy the requi
X Authorized Fleet Signature
USER (INTERNAL USE ONLY):
n er valid for purposes of this enrollment form and that the parties hereby waive any claim
a igpatur or writing underppplicable law.
Date:
The information contained in this message is intended only fortf% use of the individual or entity named above and may contain confidential
information. If the recipient of this message is not the intended recipient, or the employee or agent responsible for delivering the message to the
intended recipient, you are hereby notified that any dissemination, distribution, or copying of this communication is strictly prohibited. If you have
received this communication in error, please notify us immediately at 1-800-492-0669 and return the original message to the attention of the sender at
97 Darling Avenue, South Portland, ME 04106.
J�
PAGE 1 of 2
t^n,wTax Exemption & Reporting
We see corporate paymems differently.
Enrollment Form
C. TERMS AND CONDITIONS
This Tax Exemption and Reporting Enrollment Form modifies your charge card agreement based on your participation in the Tax Exemption and
Reporting Program ("Program"). Your signature on this form and your continued use of your account constitutes acceptance of these terms and
conditions. All capitalized terms contained herein shall have the same meaning as in your charge card agreement with us unless otherwise expressly
provided herein. Except as amended hereby, the charge card agreement governing your account remains in full force and effect.
TAX EXEMPTION AND REPORTING PROGRAM
a. The Tax Exemption and Reporting Program (the "Program") permits qualified tax-exempt fleets to be billed net of certain "Applicable
Taxes" (as defined herein). By completing this enrollment form you are electing to participate in the Program. We will enroll you in the
Program upon receipt by us of all of your enrollment materials, including all required certificates, and validation of your tax-exempt status.
Upon completion of your enrollment, your invoices will reflect the net amount due with a line item indicating total "Applicable Taxes" (as
defined herein). Your reporting will provide a specific breakdown of Applicable Taxes deducted for each taxing authority or jurisdiction.
Applicable Taxes are those federal, state, county and/or local taxes levied on the purchase of gasoline or diesel fuel for which you have
provided the proper documentation to us showing your exempt status, and for which such documentation has been accepted,by us and
for which the Program provides exemption'.
b. As your credit card issuer we have elected to provide you with net billing of Federal excise taxes on fuel based upon the participation
requirements in section (a) above. We will file a claim for refund with the Internal Revenue Service for these taxes. You agree that you
may not file a claim for refund of any federal excise tax exempted by us and not billed to you by us.
C. For state, county, special and local taxes, merchants have the option of electing to participate or not to participate in our Program based
on their own preferences and ability to obtain refunds from state/local taxing authorities. Transactions that occur at merchant locations
not participating in our Program will be billed to you with the tax included regardless of your exempt status. In these instances your
reporting will contain a detailed listing of your transactions and the taxes charged to you. This information may assist you in filing your
own claims for refunds if you so desire. You agree that you may not file a claim for refund of any state, county, special or local taxes
exempted by a participating merchant and not billed to you by us.
d. The tax certificates and other pertinent documentation on which your exemption is based must be received by us from you in order for us
to. provide you with net billing of any Applicable Taxes. These documents are required to be completed prior to any net billing of
Applicable Taxes in order for us or a participating merchant to recover such exempted taxes from the applicable taxing jurisdiction. We
shall have no responsibility to verify the correctness of the certificate supplied by you and shall be entitled to rely thereon in preparing the
reports and tax exemptions until such time as we are notified by you in writing of a change in any such data. We reserve the right to
terminate your participation in the Program, provided, however, that such termination shall not terminate the underlying Agreement
between you and us.
e. We shall calculate tax exemptions based on Internal Revenue Service or other applicable taxing authority guidelines for transactions
made by you. For state, county and local taxes, only those transactions agreed upon by the participating merchant shall be treated as
tax exempt'. If we are obligated to reimburse a participating merchant for any actual loss incurred or rebill you for any taxes previously
exempted (including refunds denied and assessments of previously made refunds and penalties) attributable to the provision of a tax
exemption to you, you hereby agree to reimburse us for said losses incurred.
f. For non -fuel transactions, merchants may provide transaction data to us net of tax at their sole discretion. You would need to supply the
merchant with proper documentation of your tax-exempt status at the point of sale. The merchant will send the transaction to us and we
will bill you net of tax for those transactions. You will not receive reporting of taxes levied or exempted for non -fuel purchases. '
g. We shall comply with reasonable requests for information retrieval made by you. A fee may be charged by us for such requests, which
relate to information which was presented to you more than ninety (90) days ago.
h. We cannot apply exemptions to transactions that occurred prior to our receipt and acceptance of your completed certificates.
i. We shall use reasonable efforts to correctly calculate the amount of tax included in each account arising from a tax exempt sale. We
shall recalculate taxes only in cases where we miscalculated the original taxable transaction.
j. We disclaim all warranties in connection with tax-exempt reporting and invoicing and shall not be responsible for the accuracy or
completeness of such reports. In no event shall we be liable to any person for loss, liability or damages, including consequential or
special damages, arising as a result of any inaccurate or incomplete report. You hereby agree to hold us harmless and defend us from
and against all liabilities, damages, costs and expenses, including taxes, penalties, interest and attorneys' fees, which you may suffer or
incur in connection with or arising out of the tax-exempt reporting/invoicing service offered hereunder.
' Subject to the appropriate taxing jurisdiction's laws, regulations and requirements.
PAGE 2 of 2
i
WEX Fuel Card:
DTF Account
Tax Package 2 of 2
Packet total: 6 Pages
OW,
see corporate payments differently.
Thank you for your interest in our
Tax Exemption and Reporting Program
The WEX Tax Exemption and Reporting Program can significantly reduce accounting and administrative time for
qualified fleets exempt from motor fuel excise taxes or certain sales taxes — at Federal, state, county or local levels.
Benefits include:
-Net billing of federal excise tax on applicable fuel purchases at any location.
-Net billing of state, local, county and special tax on applicable fuel purchases at participating merchant brands
based on local tax laws.
-Detailed reporting of the purchase data and tax exemption.
Exemptions are dependent upon several factors, such as your tax-exempt status for fuel purchases, the taxing
jurisdiction's laws, regulations and requirements, and for most state, county and local taxes, merchant participation. In
the event that a transaction cannot be billed "net of tax", you will receive detailed reporting showing the full purchase
price and the tax paid.
Before we can start billing you -net of applicable taxes on fuel transactions based upon your'eligibility, you will
need to complete the following required documentation:
Tax Exemption and Reporting Program Enrollment form (enclosed)
Certificate of Buyer of Taxable Fuel form for federal exemptions (enclosed)
Any required State forms — obtain these from the appropriate state governing body._ _
Please review the enclosed Frequently Asked Questions sheet for helpful information on the program.
IMPORTANT: You must fill out all forms completely and accurately in order to avoid delays in your
program enrollment, so please follow the instructions on the enrollment form carefully.
IRS regulations require that WEX Inc obtain from you, your certification that you are eligible to receive exemptions from
federal excise taxes. For all other taxing jurisdictions (state, county, local) you may need to submit similar certifications as
required by the different taxing jurisdictions. The state certifications may, in most cases, be obtained from the appropriate
state's tax department. WEX must have all applicable documents on file prior to providing you with exemptions. It is
the customer's responsibility to make sure WEX has all of the necessary current forms properly filled out in order to be
billed "net of tax".
If you have any questions about the program or the enclosed materials, please call us at 1-866-841-3542.
Thank you for your business, and we look forward to providing you with the benefits of this comprehensive
Tax Exemption and Reporting Program.
Sincerely,
WEX Inc. Tax Exempt Department
Owe
see corporate payments differently.
Q: If my fleet begins fueling before I have provided
all necessary tax exemption paperwork, what
will occur?
We will not be able to bill you net of taxes or report tax
exemptions until we have received all necessary
forms and completed the qualification and setup process.
Q: When will taxes begin to be exempted?
Once we receive all the properly completed
forms, we will complete the tax exemption setup
in approximately 3 business days. We will then begin
calculating applicable exemptions. It is your
responsibility to notify us of any errors or omissions that
you feel may have occurred. If you notice any problems,
contact the tax department at 1-866-841-3542.
Q: How can I determine my fleet's tax-exempt status
for fuel, as well as what type of forms I need?
Contact your local Department of Revenue for free help
and answers regarding your tax-exempt status for fuel and
necessary forms. They can best assist you with
questions of this nature.
Q: Will my fleet be exempted from federal fuels
excise taxes?
Yes if you are a qualified entity. Federal law effective
January l; 2006 allows a card issuer to invoice qualified
fleets net of federal gasoline and federal diesel excise tax
for transactions that occur wherever cards are accepted in
all 50 states. In order to be exempted from federal fuels
excise taxes, you will need to complete a Certificate of
Buyer of Taxable Fuel in the name of the card issuer.
Q: Does my tax-exempt status apply in all states and
localities?
The local Department of Revenue, in each state that your
fleet will be fueling, will be able to help you determine
exemption eligibility for each state and locality
respectively.
Q: Will I receive state and local exemptions
anywhere I can fuel with the card?
Not necessarily. Merchant brand participation in our tax
program is optional in most states. Merchant participation
is not necessary in the following states: Maine; Georgia;
Michigan, North Carolina, Alabama, New York and New
Jersey.
Q: What do I do if my tax-exempt status changes?
You should immediately notify us by calling the WEX Inc
Tax Exempt Department at 1-866-841-3542.
Tax Exemption & Reporting Program
Frequently Asked Questions
Q: Do any of these forms expire and if so will I be
notified prior to the expiration?
Yes. Federal forms expire every 24 months and certain state
forms expire as well. Starting at 120 days prior to the
expiration of your tax exemption form(s), we will send you
three monthly reminders that renewed forms are required. If
we have not received renewed tax exemption forms by the
expiration date, the tax exemption. process will cease
until we receive the necessary paperwork and no credits will
be given.
Q: Will my fleet be exempted from taxes on non -fuel
products?
The Tax Exemption Program provides applicable tax
exemption and reporting for motor fuel taxes only;
however, merchants may provide us with non -fuel
transaction data net of tax on a fleet -by -fleet basis at their
discretion. The fleet will need to supply the merchant with
proper documentation of their tax-exempt status at the
point of sale for this to occur.
Q: What if my fleet is entitled to a refund for
motor fuel taxes that cannot be exempted up
front through the WEX program?
In these instances, the "non-exemptable" tax is reported
(not exempted) on your fleet report. These reported taxes
appear at the transaction level and at a summary level,
providing you with supporting documentation, which can
help you when tiling for a refund of the non -exempted
taxes.
Q: What types of tax information reporting will I
receive?
At the transaction level, your fleet report will provide
Gross Cost; Exempted Amount, Net Cost and Reported
Taxes (for non -applicable taxes). Additionally, a Tax
Exemption Summary will provide a detailed list of all
taxes exempted, sorted by state and by tax type. Finally,
a Tax Reported Summary will provide a detailed list of
all taxes reported, sorted by state and by tax type.
Q: How do I know how many forms to send in?
If you qualify for Federal exemptions, you need to send
in one form per account or one form with a letter certifying
all accounts belonging to the same FEIN. If a new account
is added in the future, a new form or amended certification
letter will need to be sent. For state exemptions, each state
is different and will be addressed on an individual basis.
t:
CERTIFICATE of BUYER of TAXABLE FUEL FOR USE BY A STATE OR
NONPROFIT EDUCATIONAL ORGANIZATION
(To support credit card issuer's claim for a credit, refund, or payment under § 6416(a)(4)(6) or § 6427(I)(6)(D) of the Internal Revenue Code.)
WEX Account Number (if known):
Federal Tax Identification Number:
Certification:
The undersigned hereby certifies under penalties of perjury
that I am the (Title of Officer):
Of (Certifying Entity):
Entity Physical Address:
Entity Phone Number:
And that I am authorized to execute this certificate and that all
purchases, are, or will be, purchased using a credit card
issued by (Credit Card Issuer):
Credit Card Issuer Address:
UC Account: 0496003003589
71-6018462
Mayor
City of Fayetteville, Arkansas
113 W. Mountain St.
479-575-8330
WEX BANK
3995 South 700 East, Suite 450
Salt Lake City, UT 84107
Buyer will use the taxable fuel to which this certificate relates for the exclusive use of: (check one)
❑ State government ❑ American Red Cross or Blood Collection Center
® Local government ❑ Indian Tribe
❑ Public nonprofit educational organization ❑ volunteer. Fire/Rescue
❑ Private nonprofit educational organization ❑ Foreign Diplomat (you must provide a copy of your PID Card)
and it applies to all exempt purchases of gasoline and diesel fuel, if eligible, using charge cards issued by the
Credit Card Issuer named above. Information including the nature and quantity of each purchase of gasoline and
diesel fuel (the subject of this Certificate) are evidenced by periodic reports provided by WEX BANK, the above-
named Credit Card Issuer.
Certification will be valid for twenty-four consecutive calendar months commencing upon completion and
remittance of this Certificate. WEX Inc. may extend the certificate period upon its discretion for an additional
period not to exceed four months.
I understand that by signing this certificate, I, as an authorized representative of the entity named above, give up
our right to claim a credit or payment for the taxable fuel purchased with the credit card to which this Certificate
relates. I understand that the exemption from tax, in this case of sales of articles under the exemption Certificate,
is limited to the sale of articles purchased for our exclusive use. I understand that the fraudulent use of this
Certificate for the purpose of securing this exemption will subject us, and all parties making such fraudulent use
of this Certificate, to fines or imprisonment, or both, together with the costs of prosecution,t
The parties ag ee that a signed transmission shall be considered valid for purposes of this certification and that
the parties hVebypaweany claim that a transmission does not satisfy the requirements'of a signature or writing
under appl' le 1To —�_ 1 _IOYIPII.1 r&,
Au riz d gnature ' Printed Signature
Mayor, C eville, Arkansas ��Q - Iri
Title Date
Email or FAX completed forms to TaxExemptForms@WEXINC.Com or 1-207-523-7104
INTERNAL USE ONLY Sales Representative: Philip Kent
Tax Exemption & Reporting
Owe
� corporate payments differently. Enrollment Form
Instructions:
1. Complete part A and sign form at the bottom.
2. Attach FEDERAL Certificate of Buyer and STATE forms (see details below).
3. For questions on signing up for tax exemption and reporting, please call 1-866-841-3542 or email
GovTaxServices(cDWEXlnc.com.
4. E mail completed forms to TaxExemptFormsta"�.WEXlnc.com , fax to 1-207-523-7104, or mail to
Fleet Services, Tax Exempt Department, P.O. Box 639, Portland, ME 04104.
5. Retain the terms on page 2 for your records.
ACCOUNTA. •- •
Fleet Name:
WEX Account Number (if known):
City of Fayetteville, AR (Drug Task Force Account)
0496003003589
Authorized Fleet Contact:
Phone No.:
Lioneld Jordan
479-575-8330
Fleet Contact email:
Fax No.:
mayor@fayetteville-ar.gov
479-575-8257
Federal Taxpayer ID Number: 7 1-601 8462
IMPORTANT: Eligibility maybe limited based on applicable federal, state and local laws.
You must fill out these forms completely and accurately in order to avoid delays in. your program
enrollment, so please follow the instructions carefully.
B. MOTOR
Tax regulations require us to maintain current copies of the following -applicable forms. based on your eligibility:
1. Federal —A Certificate of Buyer of Taxable Fuel in the name of WEX BANK (Included with this form.)
2. State — Applicable state forms. (Obtain these from the appropriate state governing body.)
• Once we receive all of your properly completed documentation we will complete the tax exemption set up on
.your account within approximately three business days and start billing you net of the applicable taxes.
I he parties agree that a signed transmission shaIA91conS1dereg_majd for purposes of this enrollment form and that the parties hereby waive any claim
that a transmission does not satisfy the requiregid
Asofa §kjfiature or icing under apAicable law.
X Authorized Fleet Signature . / fj,4�/��/ Date:
USER (INTERNAL USE ONLY): V
The information contained in this message is int nded for the use of the individual or entity named above and may contain confidential
information. If the recipient of this message is not a intended recipient, or the employee or agent responsible for delivering the message to the
intended recipient, you are hereby notified that any dissemination, distribution, or copying of this communication is strictly prohibited. If you have
received this communication in error, please notify us immediately at 1-800-492-0669 and return the original message to the attention of the sender at
97 Darling Avenue, South Portland, ME 04106.
PAGE 1 of 2
0
Tax Exemption & Reporting
Owe
see corporate payments differently.
Enrollment Form
C. TERMS AND CONDITIONS
This Tax Exemption and Reporting Enrollment Form modifies your charge card agreement based on your participation in the Tax Exemption and
Reporting Program ("Program"). Your signature on this form and your continued use of your account constitutes acceptance of these terms and
conditions. All capitalized terms contained herein shall have the same meaning as in your charge card agreement with us unless otherwise expressly
provided herein. Except as amended hereby, the charge card agreement governing your account remains in full force and effect.
TAX EXEMPTION AND REPORTING PROGRAM
a. The Tax Exemption and Reporting Program (the "Program") permits qualified tax-exempt fleets to be billed net of certain "Applicable
Taxes" (as defined herein). By completing this enrollment form you are electing to participate in the Program. We will enroll you in the
Program upon receipt by us of all of your enrollment materials, including all required certificates, and validation of your tax-exempt status.
Upon completion of your enrollment, your invoices will reflect the net amount due with a line item indicating total "Applicable Taxes" (as
defined herein). Your reporting will provide a specific breakdown of Applicable Taxes deducted for each taxing authority or jurisdiction.
Applicable Taxes are those federal, state, county and/or local taxes levied on the purchase of gasoline or diesel fuel for which you have
provided the proper documentation to us showing your exempt status, and for which such documentation has been accepted by us and
for which the Program provides exemption'.
b. As your credit card issuer we have elected to provide you with net billing of Federal excise taxes on fuel based upon the participation
requirements in section (a) above. We will file a claim for refund with the Internal Revenue Service for these taxes. You agree that you
may not file a claim for refund of any federal excise tax exempted by us and not billed to you by us.
C. For state, county, special and local taxes, merchants have the option of electing to participate or not to participate in our Program based
on their own preferences and ability to obtain refunds from state/local taxing authorities. Transactions that occur at merchant locations
not participating in our Program will be billed to you with the tax included regardless of your exempt status. In these instances your
reporting will contain a detailed listing of your transactions and the taxes charged to you. This information may assist you in filing your
own claims for refunds if you so desire. You agree that you may not file a claim for refund of any state, county, special or local taxes
exempted by a participating merchant and not billed to you by us.
d. The tax certificates and other pertinent documentation on which your exemption is based must be received by us from you in order for us
to. provide you with net billing of any Applicable Taxes. These documents are required to be completed prior to any net billing of
Applicable Taxes in order for us or a participating merchant to recover such exempted taxes from the applicable taxing jurisdiction. We
shall have no responsibility to verify the correctness of the certificate supplied by you and shall be entitled to rely thereon in preparing the
reports and tax exemptions until such time as we are notified by you in writing of a change in any such data. We reserve the right to
terminate your participation in the Program, provided, however, that such termination shall not terminate the underlying Agreement
between you and us.
e. We shall calculate tax exemptions based on Internal Revenue Service or other applicable taxing authority guidelines for transactions
made by you. For state, county and local taxes, only those transactions agreed upon by the participating merchant shall be treated as
tax exempt'. If we are obligated to reimburse a participating merchant for any actual loss incurred or rebill you for any taxes previously
exempted (including refunds denied and assessments of previously made refunds and penalties) attributable to the provision of a tax
exemption to you, you hereby agree to reimburse us for said losses incurred.
f. For non -fuel transactions, merchants may provide transaction data to us net of tax at their sole discretion. You would need to supply the
merchant with proper documentation of your tax-exempt status at the point of sale. The merchant will send the transaction to us and we
will bill you net of tax for those transactions. You will not receive reporting of taxes levied or exempted for non -fuel purchases.
g. We shall comply with reasonable requests for information retrieval made by you. A fee may be charged by us for such requests, which
relate to information which was presented to you more than ninety (90) days ago.
h. We cannot apply exemptions to transactions that occurred prior to our receipt and acceptance of your completed certificates.
i. We shall use reasonable efforts to correctly calculate the amount of tax included in each account arising from a tax exempt sale. We
shall recalculate taxes only in cases where we miscalculated the original taxable transaction.
j. We disclaim all warranties in connection with tax-exempt reporting and invoicing and shall not be responsible for the accuracy or
completeness of such reports. In no event shall we be liable to any person for loss, liability or damages, including consequential or
special damages, arising as a result of any inaccurate or incomplete report. You hereby agree to hold us harmless and defend us from
and against all liabilities, damages, costs and expenses, including taxes, penalties, interest and attorneys' fees, which you may suffer or
incur in connection with or arising out of the tax-exempt reporting/invoicing service offered hereunder.
' Subject to the appropriate taxing jurisdiction's laws, regulations and requirements.
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