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AGREEMENT FOR MEDIA PLACEMENT SERVICES

To sign up online please complete the form below. If you prefer, you may download a PDF document to print, sign and return via fax: 908.439.3268, or mail to: PayPerClipPR, 37 Hollow Brook Road, Califon, NJ 07830.

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* Denotes Required Action
* This is an agreement between PayPerClip (PPC) and (your company name).

*1. Term. This Agreement shall begin , 2007 and shall continue until terminated according to paragraph 5.

2. Services and Fees. PPC will provide media placement services as follows. You will be billed for PPC-generated placements and, for a period of 6 months after the initial appearance, for any additional placements with the same media outlet.

Check all that apply:

Radio - local: Where?
Radio - national
TV - local: Where?
TV - national
Print - local and regional newspapers
Print - national dailies
Print - national business publications
Print - trade magazines: What industry?
Print - consumer magazines
Print - newsletters: What industry?
Internet Media

3. Rates. PPC rates are defined on the PPC Rate Sheet dated 1/1/2007 and is a part of this agreement. Rates are effective until December 31, 2007.  Additional services requested from PPC (other than media placements) will be billed at an hourly rate of $165.

4. Billing. Payment for PPC services will be by:

Credit Card, at the time you accept a media opportunity
Deposit of $ (minimum $10,000). When billings reach 75% of the deposit amount the account will be replenished.

5. Termination. This agreement can be cancelled by either party at any time by giving written notice to the other party. You will be billed for any PPC-generated placements that appear after termination.

6. Agreement Disclosure. We may include your name in our client roster for the purpose of further business development efforts.

7. Guarantee. Any fees paid when an interview is secured will be refunded if a placement does not result within six months. If you are not satisfied with our results for any reason, we will refund the entire placement fee. Refund requests must be made within 72 hours of placement.

8. General Terms. This agreement shall be construed and interpreted in accordance with the laws of New Jersey, and the forum for resolution of any disputes shall be in the state of New Jersey.

* I am an authorized representative of (company name).

* Today's date

 

 

* First Name
* Last Name
* E-mail
Your City
Your State or Country
Phone Number

* I have read and understand the PPC Rate Sheet and accept these agreement terms.