| Name__________________________________________ Phone # ( )_______-_______ |
| Company_____________________________________________ |
| Address____________________________ City___________ State______ Zip_______ |
| |
| Video |
| (8mm, Hi8, Digital8, Mini DV, VHS-C, and VHS) |
| |
| Original Format |
|
Output Format |
|
| Count_____________ |
X |
Count_____________ |
|
| |
| Movie Reels |
| (8MM, Super8MM & 16MM) |
| Prices are based on a per foot basis* |
| |
| Original Format |
|
Output Format |
|
| Feet_____________ |
X |
Number of Copy’s_____________ |
|
| |
| Slides, Negatives, Photos |
| |
| Number of Slides, Negatives, or Photos______________________ |
| |
| Audio |
| |
| Original Format |
|
Output Format |
|
| Count_____________ |
X |
Count_____________ |
|
| |
| |
| |
| |
By submitting the order form, customer requests processing services described herein and agrees to pay the standard charges hereto.
Customer agrees that the liability of our company, its agents and employees, for any losses or damages of any kind or nature to the customer’s videotape, storage device or other material, is limited to the cost of replacing such videotapes, storage device or other material with blank videotape, unused storage device or other material. Customer also agrees that our company, its agents, and employees, shall not be otherwise liable to the customer for any loss and damage of any kind or nature, whether direct, incidental, consequential or otherwise. Customer declares that all materials submitted to our company for transfer or other reproduction are not in violation of such laws. The materials submitted were either created by customer or customer has permission of the copyright owner to duplicate them. All copyrighted material must be accompanied by written release. |
| |
| Customer’s Signature |
Date |
| _____________________________________________ |
_____________________ |
| |
| |
Refer ID # |
|
_____________________ |
|
| |
|
| |
