Common Contracts
7 similar Smartpass Agreement contracts
Submit completed form and all supporting documents to smartpass@ibigroup.com.Smartpass Agreement • October 4th, 2022 • California
Institution Name (Provide DBA or prior Institution name, if applicable) Billing Address (Street, City, State, ZIP Code) Federal Tax Identification Number (If your organization has federal tax-exempt status, provide your tax ID number and any supporting documents. For more information on acceptable documents, visit www.irs.gov/charities-non-profits/exempt-organizations-affirmation-letters). Coordinator Contact Information (Full Name, Title, Email Address, Phone Number) Primary Coordinator: Back-up Coordinator: Miscellaneous Do you require a Purchase Order to process payments?If yes, please include the PO number here: □ Yes □ No FOR VTA USE ONLY(To be completed by VTA staff) May VTA identify you as a member of the SmartPass Program in promotional material? □ Yes □ No SmartPass Category Are you required by a local city ordinance to enroll in a transit program such as the SmartPass Program? □ Yes □ No Address of Each Participating Facility Headcount perFacility† Service Level Annua
Submit completed form and all supporting documents to smartpass@ibigroup.com.Smartpass Agreement • January 25th, 2022 • California
Institution Name (Provide DBA or prior institution name, if applicable) Billing Address (Street, City, State, ZIP Code) Federal Tax Identification Number (If your organization has federal tax-exempt status, provide your tax ID number and any supporting documents. For more information on acceptable documents, visit www.irs.gov/charities-non-profits/exempt-organizations-affirmation-letters). Coordinator Contact Information (Name, Title, Email Address, Phone Number) Primary Coordinator: Back-up Coordinator: Miscellaneous Do you require a Purchase Order to process payments?If yes, please include the PO number here: FOR VTA USE ONLY(To be completed by VTA staff) May VTA identify you as a member of the SmartPass Program in promotional material? SmartPass Category Are you required by a local city ordinance to enroll in a transit program such as the SmartPass Program? Address of Each Participating Facility Headcountper Faciliy† Service Level Annual Rateper Person Amount a. b.
Submit completed form and all supporting documents to smartpass@ibigroup.com.Smartpass Agreement • November 2nd, 2021 • California
Institution Name (Provide DBA or prior institution name, if applicable) Billing Address (Street, City, State, ZIP Code) Federal Tax Identification Number (If your organization has federal tax-exempt status, provide your tax ID number and any supporting documents. For more information on acceptable documents, visit www.irs.gov/charities-non-profits/exempt-organizations-affirmation-letters). Coordinator Contact Information (Name, Title, Email Address, Phone Number) Primary Coordinator: Back-up Coordinator: Miscellaneous Do you require a Purchase Order to process payments?If yes, please include the PO number here: □ Yes □ No FOR VTA USE ONLY(To be completed by VTA staff) May VTA identify you as a member of the SmartPass Program in promotional material? □ Yes □ No SmartPass Category Are you required by a local city ordinance to enroll in a transit program such as the SmartPass Program? □ Yes □ No Address of Each Participating Facility Headcount per Faciliy† Service Level Annual Rat
Submit completed form and all supporting documents to SmartPass@vta.org.Smartpass Agreement • January 15th, 2021 • California
Institution Name (Provide DBA or prior institution name, if applicable) Billing Address (Street, City, State, ZIP Code) Federal Tax Identification Number (If your organization has federal tax‐exempt status, provide your tax ID number and any supporting documents. For more information on acceptable documents, visit www.irs.gov/charities‐non‐profits/exempt‐organizations‐affirmation‐letters). Coordinator Contact Information (Name, Title, Email, Phone) Primary Coordinator: Back‐up Coordinator: Miscellaneous Do you require a Purchase Order to process payments? □ Yes □ No FOR VTA USE ONLY May VTA identify your Institution as a member of the SmartPass Program in promotional material? □ Yes □ No SmartPass Category: Is your Institution required by a local city ordinance to enroll in a transit program such as the SmartPass Program? □ Yes □ No Location Address Headcount per Location† Service Level Annual Rate per Person Amount a. b. c. Agreement Period Quantity
Submit completed form and all supporting documents to SmartPass@vta.org.Smartpass Agreement • October 16th, 2019 • California
Institution Name (Provide DBA or prior institution name, if applicable) Billing Address (Street, City, State, ZIP Code) Federal Tax Identification Number (If your organization has federal tax-exempt status, provide your tax ID number and any supporting documents. For more information on acceptable documents, visit www.irs.gov/charities-non-profits/exempt-organizations-affirmation-letters). Coordinator Contact Information (Name, Title, Email, Phone) Primary Coordinator: Back-up Coordinator: Miscellaneous Do you require a Purchase Order to process payments? □ Yes □ No FOR VTA USE ONLY May VTA identify your Institution as a member of the SmartPass Program inpromotional material? □ Yes □ No SmartPass Category: Is your Institution required by a local city ordinance to enroll in a transit program such as the SmartPass Program? □ Yes □ No Location Address Headcountper Location† Service Level Annual Rateper Person Amount a. b. c. Agreement Period Quantity
Submit completed form and all supporting documents to SmartPass@vta.org.Smartpass Agreement • October 16th, 2019 • California
Institution Name (Provide DBA or prior institution name, if applicable) Billing Address (Street, City, State, ZIP Code) Federal Tax Identification Number (If your organization has federal tax-exempt status, provide your tax ID number and any supporting documents. For more information on acceptable documents, visit www.irs.gov/charities-non-profits/exempt-organizations-affirmation-letters). Coordinator Contact Information (Name, Title, Email, Phone) Primary Coordinator: Back-up Coordinator: Miscellaneous Do you require a Purchase Order to process payments? □ Yes □ No FOR VTA USE ONLY May VTA identify your Institution as a member of the SmartPass Program inpromotional material? □ Yes □ No SmartPass Category: Is your Institution required by a local city ordinance to enroll in a transit program such as the SmartPass Program? □ Yes □ No Location Address Headcountper Location† Service Level Annual Rateper Person Amount a. b. c. Agreement Period Quantity
Submit completed form and all supporting documents to SmartPass@vta.org.Smartpass Agreement • October 31st, 2018 • California
Institution Name (Provide DBA or prior Institution name, if applicable) Billing Address (Street, City, State, ZIP Code) If your organization has a federal tax-exempt status, provide your tax ID number and/or any supporting documents (e.g., an affirmation letter from the IRS, which may be obtained atwww.irs.gov/charities-non-profits/exempt-organizations-affirmation-letters). Tax ID # (please do not enter your Social Security Number): FOR VTA USE ONLY Location Address Headcountper Location † Standard orExpress Pass Service Level Annual RatePer Person Amount a. b. c. d. Agreement Period Blank Clipper® Card Quantity(if needed) Clipper® Per Card Fee Order Total Start Date End Date $3.00 Total Amount Due
