HT Account Setup Form - United Bank Card

POS SETUP FORM
Please submit all three pages of
this form along with the Merchant
Application and all supporting
documentation by email to
apps@harbortouch.com
or via fax to 908-730-7437
OFFICE ID:
SALES REP NAME:
M.S.B. AMOUNT: $
CERTIFIED HARBORTOUCH RESELLER ACCOUNT
FOR INTERNAL USE ONLY MID:
NEW ACCOUNT
EXISTING ACCOUNT EXISTING MID:
EQUIPMENT RELOCATION FEE OF $250.00 AND MENU/DATABASE REBUILD FEE OF $400.00 WILL BE CHARGED IF APPLICABLE
OWNERSHIP CHANGE OLD MID:
MERCHANT INFORMATION
NAME OF BUSINESS (DOING BUSINESS AS)
EXACT LEGAL NAME
DBA ADDRESS (IF DIFFERENT FROM LEGAL)
LEGAL ADDRESS
CITY STATE ZIP
CITY STATE ZIP
DBA TELEPHONE (WILL BE PRINTED ON RECEIPTS)
CONTACT INFORMATION
The primary and secondary contacts will be consulted for the online presentation of the menu design. Please make sure these contacts are decision makers such as business owner or partner.
PRIMARY CONTACT
SECONDARY CONTACT
CONTACT NAME:
POSITION WITH COMPANY:
TELEPHONE #:
CELL PHONE #:
E-MAIL ADDRESS:
ALTERNATE PHONE NUMBER OR ALTERNATE E-MAIL ADDRESS:
CONTACT NAME:
POSITION WITH COMPANY:
TELEPHONE #:
CELL PHONE #:
E-MAIL ADDRESS:
ALTERNATE PHONE NUMBER OR ALTERNATE E-MAIL ADDRESS:
Please supply the following information about your business so that we can accurately set up your POS system and ensure that it meets all of your needs.
1. SELECT SOFTWARE TYPE
Harbortouch Hospitality Harbortouch Retail Harbortouch QSR & Delivery
2. CONFIRM THE MENU/INVENTORY INFORMATION YOU ARE PROVIDING
It is vital that we receive all menu information, pricing, and modifications that you would like included in your POS.
Hospitality/QSR & Delivery
Number of menu/supporting pages submitted with paperwork:
Please check the documents/information that have been provided:
Alcohol Takeout Catering Kids menu Dessert menu Delivery fees Happy hour prices and times/days Discounts/coupons Modifiers
Table Layout Void reasons Job list Employee list
Retail
Please include your inventory using the method selected in section 3. Please note that inventory must be entered in order to ship your system. Harbortouch does not ship blank POS
systems without any inventory programmed.
3. INVENTORY ENTRY METHOD (RETAIL ONLY)
How will you be entering your product inventory
Completed inventory will be supplied in approved Harbortouch Inventory Import Template File
Inventory will be compiled using the Harbortouch Inventory iOS application.
You will use a Harbortouch supplied handheld barcode scanner to compile your inventory ($11.00 for shipping)
4. WILL THE EQUIPMENT BE SHIPPING TO THE BUSINESS ADDRESS
YES N0
We always prefer that the order ships to the business location. We understand that there are times when a location has not yet opened and no one will be there to receive the equipment,
so we can ship to an alternative location if there is no other option.
If we are shipping the equipment to another location, the merchant will be responsible for transporting the equipment to the site of installation and should not open the boxes. The
installer should be the first person to open the boxes to verify that all equipment is present and intact.
If NO, please provide name and shipping address:
5. WILL A SPANISH SPEAKING REPRESENTATIVE BE REQUIRED YES N0
HT2020_10082014
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6. WILL THIS BE YOUR FIRST HARBORTOUCH SYSTEM YES N0
If NO:
MID of existing location:
Will you be using the same prices and menu items Yes No
7. WHAT ARE YOUR BUSINESS HOURS
This information will allow us to set appropriate times for daily backups and reporting. For payroll settings, please circle the day your pay week begins.
OPENING TIME
CLOSING TIME
SUNDAY
MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY
8. BUSINESS MODEL INFORMATION
Describe your business model (i.e., restaurant, bar, pizza delivery, clothing store, convenience store, etc.)
Indicate the percentage of each transaction type that is handled in your business (if retail, enter 100% counter service):
Number of full-service tables (if retail, enter zero):
How many of each type of staff do you have per shift
Counter service:
Dine-in:
Call-in/pick-up:
Delivery:
Bar:
Cashiers:
Servers:
Bartenders:
Drivers:
Hosts:
%
%
%
%
%
Do you serve alcohol
How many total retail items do you sell
How many of these retail items are barcoded
Yes
No
Are you using manufacturer barcodes or printing your own
Manufacturer
Custom
Will you require a barcode scanner
A barcode scanner can be used for recalling tickets, scanning membership cards, or assigning tickets to servers or drivers.
9. ARE YOU CURRENTLY OPEN FOR BUSINESS
If NO:
What is your projected opening date
Yes
YES
No
N0
Is the building construction complete
Are countertops installed
Do you have all required permits and licenses
Yes No If no, ETA:
Yes No If no, ETA:
Yes No If no, ETA:
If you answered no to any of the above questions, we will be unable to complete the shipment and installation of your system. You may e-mail the team assigned to your account when your
business is ready for installation.
10. WILL YOU BE USING HARBORTOUCH-SUPPLIED GIFT CARDS
YES
If YES, continue to question 10
If you intend on using a third-party gift card provider, we will require the following:
Gift card conversion form (available from your sales representative or by emailing giftcards@harbortouch.com)
A physical card so we can test compatibility.
Please send your sample card and conversion form to Harbortouch, Attn: Gift Cards, 2202 N. Irving St., Allentown, PA 18109. E-mail giftcards@harbortouch.com with questions.
11. DO YOU CURRENTLY HAVE HIGH-SPEED INTERNET ACCESS
Satellite and dial-up are not approved Internet types for the Harbortouch POS system. If you will be using a wireless Internet option (3G/4G) you must provide 3 speed tests to verify that it
meets required connection speeds and sign a wireless waiver (provided by your factory team).
If YES, what type of connection
Who is your Internet Service Provider (ISP) (i.e., Verizon, Comcast)
YES
N0
N0
DSL Cable Fiber Optic 3G/4G
If NO, when will you have Internet installed
ETA:
Are you part of a larger network (mall, university, etc.)
Do you have additional devices on the network such as security cameras or a jukebox
Yes
Yes
No
No
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12. DO YOU HAVE THE REQUIRED POWER OUTLETS
We require the following power outlets in order to install and use the system:
2 power outlets within 4 feet of each terminal
1 power outlet within 4 feet of each remote printer (if applicable)
2 power outlets required for each Kitchen Video System (if applicable)
A power strip can be used to ensure the number of outlets are available. A surge protector is recommended.
YES
N0
13 . CABLE REQUIREMENTS
Each networked device (POS systems, kitchen printers, KVS and Caller ID) will require a CAT 5 Ethernet cable run from the router to each piece of equipment. An existing Ethernet jack within
10 feet of the equipment is also acceptable as Harbortouch will supply a 10' patch cable.
Please select the appropriate option below in regards to your CAT 5 cabling:
CAT 5 cabling is already installed
CAT 5 cabling will be installed by merchant ETA:
Harbortouch to install CAT 5 cable runs ($249 one-time fee or $8/month fee applies per cable run as selected on Exhibit A. If neither option is selected on Exhibit A, $249 will
automatically be billed retroactively per cable run.)
Number of cable runs required:
14. WILL YOU BE USING A HARBORTOUCH-SUPPLIED CALLER ID UNIT
If using a Harbortouch-supplied caller ID unit (must be included on service agreement), please provide every available phone number that will be associated with it:
YES
N0
Who provides your phone service (i.e., Verizon, AT&T)
Service Type: Standard Phone Line Advanced Phone System (VOIP, Modem, PBX, etc.)
15. SALES TAX INFORMATION
What is your primary state sales tax rate
Tax rate:
Added Included Applies to:
It is common for alcohol and other items to have a separate sales tax. If your business includes any additional taxes, please supply them below:
Name of tax:
Tax rate:
Added Included Applies to:
Name of tax:
Tax rate:
Added Included Applies to:
Name of tax:
Tax rate:
Added Included Applies to:
16. 30 DAY FREE TRIAL! HARBORTOUCH ONLINE ORDERING (HOSPITALITY MERCHANTS ONLY)
YES, PLEASE ENROLL ME IN HARBORTOUCH ONLINE ORDERING
SETUP FEE: $99.00 MONTHLY FEE (INCLUDES 50 TRANSACTIONS): $
TRANSACTION FEE (FOR EACH TRANSACTION OVER 50): $
By choosing this option, Merchant will be enrolled in a thirty (30) day Harbortouch Online Ordering Trial Program ("Trial Program"). Merchant will be able to set up their online menu and accept orders through this menu during this period. Normal
processing fees apply. Unless Merchant opts out prior to the expiration of the Trial Program, the program will automatically convert to the paid Harbortouch Online Ordering program and the Merchant will be charged the monthly fee listed above for use
of the online ordering service. Fifty (50) online order transactions per month will be included in this monthly fee. For any transactions over these 50, the transaction fee listed will also apply per order placed online through this service.
17. 60 DAY FREE TRIAL! TABBEDOUT MOBILE SOLUTION (HOSPITALITY MERCHANTS ONLY)
YES, PLEASE ENROLL ME IN THE INTEGRATED TABBEDOUT MOBILE MARKETING SOLUTION PROGRAM
By choosing this option MERCHANT will be enrolled in the sixty (60) day Harbortouch-Tabbedout Trial Program ("Trial Program"). Merchant will have free access to the Tabbedout software on its Harbortouch POS System during this period. Normal
processing fees apply. Merchant will be entitled to two (2) complimentary Tabbedout Periscope Campaigns during Trial Program ($9.99 for each additional Periscope Campaign) but Conversion Fees of 25% of the discount a Patron redeems during the
Campaign will apply. Unless MERCHANT opts out prior to the expiration of the Trial Program, the program will automatically convert to the paid Tabbedout Enrollment Program and MERCHANT will be charged $12.50/month for the use of
the software. See Tabbedout Program License Agreement in the Addendum to the Terms and Conditions for complete details. Tabbedout is a third-party service.
18. FREE TRIAL! PAY-AT-THE-TABLE POWERED BY PERKWAVE AND APPLE PAY
YES, PLEASE ALLOW MY BUSINESS TO ACCEPT PAY-AT-THE-TABLE TRANSACTIONS
By choosing this option, customers will be able to pay their bill using the Perkwave mobile application powered by Apple Pay. Merchant will also be able to offer reward and loyalty programs to their customers through the Perkwave application.
19. PREMIUM INSTALLATION
YES, I WILL REQUIRE PREMIUM INSTALLATION
Premium installation includes a software expert from Harbortouch headquarters to travel on-site for all day installation, software customization, and training. Cost will be billed after installation and will include any and all travel-related expenses plus
$150 fee for premium service.
20. NOTES AND/OR MISCELLANEOUS COMMENTS:
Apple is a trademark of Apple Inc., registered in the U.S. and other countries. Apple Pay is a trademark of Apple Inc.
© 2014 Harbortouch Payments, LLC. All rights reserved.
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