Advertising Agreement Form – Dupont Values Website

Company Name *

Billing Name *

Contact Name *

Billing Email *

Contact Email *

Billing Address *

Address Line 1

City

State

Zip Code

Contact Phone *

Billing Phone *

INSERTION ORDER

Any changes to this section will not be considered if not received by the 15th of the month preceding the next issue.

Scroll down to select the appropriate value to each box below.

Ad Size *

First Month *

Last Month *

Monthly Price

As per your desired size and term on the current rate card provided.

TERMS

• Providing your credit card through our secure server authorizes us to charge your card for your advertising expenses according to the terms of this contract or otherwise agreed in email correspondence between both parties.

• All charges to your credit card will be made when the flyer is sent to the printer each month, typically in the week of the 18-25th of each month. The invoice will be marked paid and emailed to the email address you have provided within this agreement. You may view your ad online at www.dupontvalues.com

• Graphic design services are billed at $30 per hour. Changes are billed at minimum 1/2 hour increments. On ads created by DuPont Values, a proof will be provided, and once approved by the client, DuPont Values assumes no liability for errors, or for errors in ads directly supplied by advertiser.

• Changes to ad sizes or designs can not be guaranteed after the 15th of the month for the next month’s issue.

• Absence of communication or advisement to otherwise is authorization to continue the same ad from the previous month in the next month’s flyer, unless previously agreed by this signed agreement or in email correspondence to dupontvalues@gmail.com. • Ad content is subject to publisher’s approval. Position requests are not guaranteed. • Advertiser assumes full liability for their ad content including authorized use of photos and images, and agrees to indemnify and hold harmless Lat 30 Communications & Design, DuPont Values and it’s associates.

• If advertiser defaults on the agreed upon term, they will be billed for the difference in discounts between the agreed term and the ending term.

AGREEMENT

By submitting this form, the company representative named above agrees to the terms contained within, as well as any additional terms later agreed in writing/email between representatives for both parties regarding insertion size, frequency, design or payment. To complete this insertion order, click the submit button below to email this form to us. You will then be directed to our secure server site to input your credit card information so that we may charge your card each month that your ad is scheduled to run. We will email you a paid statement to the email address provided on the payment form.