Please fax your completed order form to VPS at (305)670-9586 or email to subwayecardorders@ipcoop.

com
Purchaser Information Order Date Name Company Name Address Address City Phone ( ) State Email ZIP /

SUBWAY Card
Volume Sales Order Form
Shipping Information Same as Customer Information Name Company Address City Phone ( ) State Email ZIP
Cards cannot be shipped to PO Boxes.

New Client Reorder

/ PO #

Federal Tax ID / BN # (Required) Referring SUBWAY Store Number Ordering Information

Min. Order: 10 Cards Min. Total Order: $250 Min. Card Load: $5 Max. Card Load $100

Payment Information Credit Card Payment* * (Limit $2,500. For orders over this amount,

please submit payment using another method.)

BULK ORDER DISCOUNT Save 2% on any order of $5,000 or more When ordering multiple currencies, please submit separate order
forms for each currency. Cards will be loaded with either US or Canadian Dollars. However, cards can be used in either country. The Point-of-Sale system will automatically convert currency at time of transaction based on established exchange rates. Bilingual Cards are intended for use in Quebec province. SPECIFY FUNDS

VISA
Name on Card Street City Phone ( Card # Expiration: Signature / )

MasterCard

AMEX

Discover

to be loaded:

State Email /

ZIP

**

$ US $ CAN
LINE TOTAL

QTY

ITEM
SUBWAY Cards SUBWAY Cards SUBWAY Cards SUBWAY Cards

CARD LOAD DENOMINATION

CARD TYPE**

ENG BILINGUAL ENG BILINGUAL ENG BILINGUAL ENG BILINGUAL

$8.00 USD/pack

I agree to pay total amount according to card agreement.|

ACH/Wire Transfer (Fax to 305-670-9586) ABA #

Account # Name on Account Authorized Signature

Optional Card Carrier Envelope

(100/Pack)

SELECT SHIPPING OPTION BELOW Ground Delivery (1-6 Days) Next Business Day*
*Orders must be received by 11AM Eastern for same day processing. FREE FREE

I hereby authorize VPS LLC to initiate a debit transaction for the order total amount from the account specied above.

(250 cards or less)

Please call for rates on orders of more than 250 cards

$25.00

Company Check or Money Order Make Checks Payable to: Value Pay Services LLC Please mail order form with payment to: SUBWAY Card Program Value Pay Services LLC 9200 S. Dadeland Blvd. Suite 705 Miami, FL 33156 Attention: Corporate Sales
All orders are NOT processed until payment is conrmed. All bulk order Card sales are nal. No return and no refunds. Cards are shipped inactive as a safeguard against unauthorized use in the event cards are lost or stolen. Buyer is required to submit an activation request form to VPS to conrm delivery of order so that cards can be activated prior to use. Card activation takes 24-48 business hours from VPS receipt of your activation form. Card balances do not expire or decline with non-use nor are there any fees or service charges associated with dormancy.

Allow 2-3 days for order Shipping Information processing prior to shipAllow 2-3 days for order ping. Shipping is to shipprocessing prior available to Shipping is available ping.one address only.
to one address only.

CARD TOTAL
2% discount on any order greater than $5,000)

LESS DISCOUNT ORDER TOTAL

Orders are not processed until payment is conrmed. *Overnight orders must be received no later than 11AM Eastern for orders to be processed for delivery.

Authorized Signature
Signature Title

Company

Date

By signing the above you agree to purchase the cards specied in this order. SUBWAY Cards are issued by Value Pay Services LLC and may only be used for purchases at participating SUBWAY restaurants. Unless the Card is registered online at www.mysubwaycard.com, remaining balances on lost, stolen or damaged Cards cannot be replaced or refunded.

Terms & Conditions:

SUBWAY Cards can be used in the US, Canada, Puerto Rico, Guam and Saipan at this time.

Questions? Please contact Value Pay Services (VPS) at 786-270-1273.

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