Proximity Advertising Order Form
Contact Information

 

 

Name:

Title (optional):

Address:

City:

State:

Zip:

Phone:

Fax:

Email:

 

 

Cost

 

 

Ad runs are $45 per week per location. (Choose a quantity below.)

Quantity:

1 location 2 locations

$_________

Quantity:

3 locations 4 locations

SC Sales Tax 7% $_________

Quantity:

5 locations

Customization/ Design

 

Add your store’s phone number, address and text you’d like in the ad.

Ad Text:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Customized Design $_________

 

 

Use Existing Art $__45_____

Payment

 

NOTE: ORDER MUST BE PRE-PAID.
Check or Credit Card information must be received before ad is run.

SUBTOTAL $_________

If paying by check, make payable to: Zarvo
Mail your check to: Zarvo, 24 Glen Drive, Lugoff, SC29078.

A 3% Surcharge for AMEX credit card payments.
Please fill in credit card information below.

CREDIT SURCHARGE $_________
(only for AMEX) Subtotal x .03

Credit Card:

 

VISA MasterCard AMEX Check

Card Number:

 

Name on card:

 

Exp. Date:

 

FINAL COST $_________

TERMS: All sales are final. Signatory certifies that he/she is authorized to place order and agrees to all fees associated with the collection of debt. By signing, you agree that this estimate is now an order and is non-cancellable. Your signature on this quote constitutes acceptance of the terms of same. Unpaid balances are subject to a 1.5% per month charge based upon the time differential value of funds. In the event it is necessary for Zarvo to institute legal action to collect these sums, you agree that both venue and jurisdiction will be in Kershaw County, South Carolina, and that you will be responsible for the costs of collection including attorney fees.

I agree to the terms:

YES

 

Initials: