Recipient ____________________________________________ Date ___________________
Address_______________________________________________ Delivery Memo No. ___________________
______________________________________________________ Purchase Order No. ___________________
Per Request of ______________________________________________ Telephone ___________________
Photo Return Due __________________________________ Extension Granted ________________________________
Purpose of Delivery ________________________________________________________________________
Value* Quantity Format/ Original Description/File Number BW/Color
Size or Dupe
* Value is in case of loss, theft, or damage.
Total Color__________________ Total Black and White___________________
Please count all photographs and confirm that the count is accurate by returning one signed copy of this form. If objection is not immediately made by return mail, the Recipient shall be considered to accept the count shown on this form as accurate and that the photographs are of a quality suitable for reproduction.
Acknowledged and Accepted _____________________________________________________ Date__________________
Authorized Signatory, Title
Subject to All Terms and Conditions Above and on Reverse Side
Terms and Conditions
1. Purpose. Photographer hereby agrees to entrust the photographs listed on the front of this form to the Recipient for the purpose specified. "Photographs" are defined to include transparencies, prints, negatives, digitized encodations, and any other form in which the images can be stored, incorporated, represented, projected, or perceived, including forms and processes not presently in existence but which may come into being in the future.
2. Acceptance. Recipient accepts the listing and values as accurate if not objected to in writing by return mail immediately after receipt of the photographs. If Recipient has not signed this form, any terms on this form not objected to in writing within 10 days shall be deemed accepted.
3. Ownership and Copyright. Copyright and all reproduction rights in the photographs, as well as the ownership of the physical photographs themselves, are the property of and reserved to the Photographer. Recipient acknowledges that the photographs shall be held in confidence and agrees not to display, copy, or modify directly or indirectly any of the photographs submitted, nor will Recipient permit any third party to do any of the foregoing. Reproduction, display, sale, or rental shall be allowed only upon Photographer’s written permission specifying usage and fees.
4. Loss, Theft, or Damage. Recipient agrees to assume full responsibility and be strictly liable for loss, theft, or damage to the photographs from the time of [ ] shipment by the Photographer [ ] receipt by the Recipient until the time of [ ] shipment by the Recipient [ ] receipt by the Photographer. Recipient further agrees to return all of the photographs at its own expense by the following method of transportation: ______________________________. Reimbursement for loss, theft, or damage to a photograph shall be in the amount of the value entered for that photograph. Both Recipient and Photographer agree that the specified values represent the value of the photographs. If no value is entered for an original transparency, the parties agree that a fair and reasonable value is $1,500 (Fifteen Hundred Dollars).
5. Insurance. Recipient [ ] does [ ] does not agree to insure the photographs for all risks from the time of shipment from the Photographer until the time of delivery to the Photographer for the values shown on the front of this form.
6. Holding Fees. The photographs are to be returned to the Photographer within _____ days after delivery to the Recipient. Each photograph held beyond _____ days from delivery shall incur the following weekly holding fee: $_______which shall be paid to the Photographer when billed.
7. Arbitration. Recipient and Photographer agree to submit all disputes hereunder in excess of $_____________ to arbitration before ______________ at the following location __________________ under the rules of the American Arbitration Association. The arbitrator’s award shall be final and judgment may be entered on it in any court having jurisdiction thereof.
8. Miscellany. This Agreement contains the full understanding between the parties hereto and may only be modified by a written instrument signed by both parties. It shall be governed by the laws of the State of_________.
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