I agree to the terms stated above
Please fill out the below form, then contact
Steven Barnes at 503-328-8520 to complete
your order.
Company Name:
Address:
City:
State:
(DE, MD, NJ,etc...)
Zip Code:
Phone Number:
(555-555-5555)
Contact Person:
Fax (if any):
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Preferred Restaurant(s):
Payment Method:
Credit Card over phone
By Check over phone
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Terms and Conditions: Subject to terms and conditions stated below. Net 15 day accounts are available as payment terms for this publication after application approval. All balances which remain unpaid after 15 days from the date of this agreement are subject to a FINANCE CHARGE at 11/2% per month on the unpaid balance (ANNUAL PERCENTAGE RATE 18%) until paid in full, but in no event shall said finance charge be in excess of the applicable legal maximum rate of interest.By clicking on the "I agree" button below or submitting this form, you agree to pay the total cost of all contracts (with any applicable discounts) at the time of this online forms submission. Before an advertisement can be designed, payment in full is required as designated through calling NPCSI at 503-328-8520 after submission of this form. Should NPCSI incur difficulties with payment such as a credit card charge back or returned check, the ADVERTISER agrees to pay for all expenses we may incur to enforce collection of any amount due under this agreement and ADVERTISER agrees to pay for all collection costs, reasonable attorney's fees, court costs and private investigation costs incurred in such collection.This agreement is non-cancelable by ADVERTISER and ADVERTISER acknowledges full and complete understanding of the terms contained herein. ADVERTISER agrees that the liability of NPCSI, if any, for any omissions, mistakes, errors, and/or defects in said advertisement shall in no event exceed the amount of advertising fees actually paid by ADVERTISER. NPCSI in no event shall be required to reprint any advertising material because of incorrect advertisement copy after proof copy is signed. Changes to the proof must be made within the time allotted to guarantee proof changes. ADVERTISER further acknowledges by execution of this agreement that it has not relied upon any promise, statement, or representation other than as contained herein, and hereby acknowledges that printing this form may be used as their receipt of this agreement or that they can contact NPCSI for a copy of this agreement at any time. |
