Company Name				Contact Name
Billing Address				City, State, Zip
E-Mail Address				Fax #
Phone #				Invoice sent via (circle one)		Email           Fax           Mail
Herein called the “customer” and Stanley’s Advertising and Distribution herein called the “carrier”, the customer and carrier unconditionally agree to the following terms, conditions and descriptions:
Materials to be distributed (flyer, newsletter, etc)			Quantity to be Distributed		Projected Distribution Date(s)		Repeat Dates
Distribution Area (Boundaries/Attach Map)					Distribution Method (circle one) Toss         Hand         Plastic       Bags         Other
Materials to Carrier (circle one)                                 Pickup from Customer Pickup from Printer Delivered to Warehouse					Print Shop Name & Address
Special Instructions:
Distribution Price Agreement
Zip Code/City	Quantity			Rate Per 1000		Subtotal
						$
Other Charges:
Plastic Bags	Quantity			$10 Per 1000		$
Material Pickup Charge				$25.00		$
Material Return Charge				$25.00		$
Other Charges						$
Total Cost						$

1.   The carrier agrees to schedule for delivery the customer’s items upon receiving a deposit equal to 100% of the quoted rate.  Balance due upon completion. Payment not received within 5 days will be subject to 1 ½% monthly charge to the balance owing.

2.   The carrier assumes NO liability for the content of any advertising item or the response received from any advertising item of any delivery for the customer.  Delivery items that are in the care, custody, and control of the carrier will be handled with reasonable care and delivered in good condition with the following exceptions:

The customer will hold harmless the carrier for damage to items delivered that are damaged by perils or acts outside of the carrier’s control. These perils or acts include, but are not limited to, rain, snow, slush, wind, fire, and theft. The carrier will take all reasonable actions to protect the items of the customer from damage.

3.   The carrier agrees to deliver items within a reasonable time specified by the customer and will verify the delivery of these items. Excess materials not picked up within 30 days of distribution will be destroyed.

4.   The customer acknowledges that the carrier is not an agent, affiliate, or associate of the customer and vice versa.

The customer and carrier agree this ________ day of ____________, ________to the foresaid.

 

Customer Signature	Printed Name
Stanley’s Rep. Signature	Printed Name