HomeMy WebLinkAbout20101417.tiff c( SWANK
MOTION PI
TIM SWUM,
`""""°" Exhibition Request Form
Not valid unless all sections on this form are completed and faxed to: (314) 909-0879 Attention:
MARY WARNICK(this form requires a signature so you are also welcome to scan and email).
❑ Confirming order
Seeking price quote(your film will not be ordered until you make further confirmation)
*If you are STATE SALES tax exempt, please be sure to fax a copy of your STATE exemption certificate
(just the number is not sufficient)with this form.DO NOT SEND YOUR FEDERAL IRS FORM. We must
have this on file to remove the tax from your account.If you do not provide it then your local state sales tax
will be added to your total.Your sales tax form must be signed and dated to be valid. If it is not signed and
dated you will be charged tax.* ' , f II // //�
Organization/College/University Name: VV tli W u'ai `�I DVS✓ VYlt°M*
Department: Yilu'Vllt�(1%j�LS`o' lore a JJJ
Contact Person: Sk--C4.0 �Dct'v#ert — #1"'[ ,,1e -,, �^
Staff or Student(if applicable)—Circle one Job title: V\�QAI4A.¢SS 1oD vtli_AP-1-W--
Phone Number: (CO )% 1220 Fax Number: (310 35.,i- q D lei
Email: 5-Preti@ CO. we td . CD . LAS
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Mailing Address(please include City,Statd&Zip Code)
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Billing Address(please include City,State&Zip Code)
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Shipping Address(if not same as mailing address—WE MUST SHIP A COPY TO YOU EVEN FOR MOVIES
READILY AVAILABLE COMMERCIALLY unless otherwise specified by your account executive)THIS MUST BE A
PHYSICAL STREET ADDRESS FOR UPS DELIVERY-UPS CANNOT DELIVER TO A P.O.BOX
Movie Title Requested: 7V\I �k -ee, N,p\I f_, Date
Date of Screening: IA� I3 2lO
(you can list multiple titles and dates on this/skeet��^or attack an addendum) )
Name of Event or Reason for Screening:/`�^ l -I t 1)P j'Yteaf_et_I C((At c o
Name of Screening Location: h)t1A J 4—t4 13A Ott , J Indoors or Outdoors: (Vtc{DOvA2
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If you are screening a film outdoors,what size screen are you using?/p G What time is your
screening?
Address of Screening Location: 4ai N , t S A t G, re t l (IL Rotc 31
Contact person at screening location(if different from main f contact): ] e I )i >PGI`
Format(DVD,VHS,35mm or 16mm) 1"Choice: DVD 2'd Choice V HE
Are you charging admission for the film screening? N 0 If so,how much? -"er-- (if you are
charging admission please read paragraph 2 in the policies section for your obligations))((
Capacity of venue(#of seats—please approximate if using an outdoor venue): `-op
Anticipated Audience Size[MANDATORY FIELD—We will not process your order unless this field is completed.A
range of audience size is fine] �nr)-3OO
Credit card information(We accept VISA,Mastercard and American Express.Please include number,expiration date
and name as it appears on the card)—You can call with this information if preferred: aari Da-Ft ri.- Fre
U Please check if you would like us to keep this credit card on file for future orders. J-
LL c N R 2010-1417
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How did you hear about us?
❑ Website
❑ Convention(please provide name):
❑ Magazine Ad(please provide name of magazine):
❑ Studio referral(please provide studio name):
g Referral from a current customer(please provide name): Jason vevt5cni L'ij c(-etre-€141
❑ Referral from an equipment provider(please provide name):
❑ Other,please specify
Once you place an order for movies with Swank Motion Pictures,we will give you an immediate verbal confirmation of your order,if
possible. Additionally,Swank Motion Pictures will mail or email you a written confirmation once the movie is booked. REVIEW YOUR
CONFIRMATION. You must call Swank Motion Pictures at 1-800-876-5577 if your written confirmation is not correct. Please note that
your movie is not confirmed until you receive a printed confirmation from Swank Motion Pictures and you are not permitted to begin
promoting your screening until such confirmation is obtained.Swank Motion Pictures is not responsible for any expenses incurred if a
film that is promoted prior to confirmation must be changed or cancelled. 35mm prints are not confirmed until we have official
confirmation from the studio.We are not allowed to confirm it to you to begin promoting until we have received written confirmation.
Promotional materials can be provided where available and when requested however Swank Motion Pictures is not required to provide
promotional materials of any kind and is never responsible for any promotion expenses of any kind on your part.
Movie prices are for one day's rental. Additional fees will apply to multiple day shows. If you charge admission,your movie rental rate
is the quoted rental price OR 50%of your gate receipts,whichever is greater. This policy is applicable regardless of non-profit status.
You can log on to your online account to submit your audience. Audience reports must be completed within 24 hours of your screening.
Failure to return the audience report could delay the shipment of future orders.If the admission price of your event includes something
other than the movie itself(i.e.food,a band,an art show,etc.)you will fill out the audience report with only the amount of admission
designated for the movie itself. Even if you consider the film"free"to the customer(as a part of a ticket to another event)you must still
assign some measure of the admission to the film and report a percentage of your admission fee.Please fill out your audience report
carefully as you are obligated to the overage amount once it is processed with no exceptions.
Once you have made pre-payment arrangements(required for your first three shipments),we will ship your movies so they arrive at
least two days before your show date.Shipping and handling fees are in addition to the rental fee. Shipping fees may be quoted at the
time of your rental quote but you are obligated to the shipping fees whether they are verbally quoted or not.The first three films that you
do with Swank Motion Pictures must be pre-paid. If your print has not arrived,you must call Swank Motion Pictures at 1-800-876-5577.
Payment of your full rental fee is required if there is no notification to Swank Motion Pictures one(1)business day prior to show date.
Movies are delivered to you at least two business days prior to your show so that you can preview the ENTIRE movie in the actual
equipment that will be used for your screening;previewing movies in your home equipment will not suffice. If you find that the movie is
damaged or your player and movie are incompatible,contact your Swank Account Executive immediately. At that time all efforts will be
made to resolve the problem. No adjustments or refunds will be given if we are not alerted at least one business day prior to your
screening date regarding damaged/incompatible movies.
The movie is to be returned the next business day after your show.Late fees will apply for delayed returns. If a film is misplaced
completely,a lost fee will be assessed.If the print is found at a later date and returned to Swank,a portion of the lost fee can be refunded
but will be a factor of how long the print has been missing.The full lost fee may still apply if the print is out for an extended period of
time.
Disney films cannot be shown at any venue that serves alcohol.Other limitations will apply for outdoor shows.Please consult your
account executive for more details.
Pricing is based on your average crowd size throughout the year.It is your obligation to inform your account executive if your crowd size
changes significantly(up or down)over the course of the year.Your account executive may make pricing adjustments based on this
information.Pricing is strictly confidential.Sharing pricing outside your organization can result in termination of your contract.
Any film may be canceled without obligation provided that Swank Motion Pictures receives written notification fourteen(14)days before
the film is shipped,or the full rental and handling charges must be paid. All show date changes must be made in writing and received by
Swank Motion Pictures ten(10)days before the film is shipped,or the full rental and handling charges must be paid. If your screening is
canceled after the movie has already shipped to you(rainout,projector malfunction,etc.),we will allow you to reschedule the same movie
within one year of the original show date;you must pay the original invoice and you must pay the cost of shipping for us to send it back
out to you. You may not substitute another title for this free show.You have the option to book a newer film at a discounted rate but this
forfeits your free reschedule of the film that was rained out.This unforeseen circumstance policy does not include the issue of attendance.
Promotion of the event and level of attendance is strictly the responsibility of the licensor.If you have no attendance or if the attendance
does not meet your anticipated level,this does not result in a reduction of price or refund of any kind.
These motion pictures are specifically licensed for non-theatrical showings only. We encourage you to inform your organization's
members and patrons via on-premise bulletin boards,emails and private mailings. Paid advertising through media such as radio,
television or newspaper is discouraged;however you may list your event in the calendar of events section of your local newspaper. If this
policy is violated,or becomes openly competitive with a commercial theater,all shows will be canceled WITHOUT notice.
The obligation of Swank Motion Pictures, Inc.to furnish films is subject to the continued location approval by the producer and
to the availability of prints.
I have read the preview instructions and understand that it is my responsibility to preview the DVD or VHS copy
prior to the show.If I choose not to preview the product prior to my show I understand that Swank Motion
Pictures is not responsible for incompatibility issues that arise during the show and further understand that no
pricing adjustment will be made. Qp
Authorized SignatureT(2"D2/aEs� ✓rl�cfritaf'� JUN 3 0 2010
Please Print Name: Douglas Rademac er, Chairman Date: 06/24/2010
$o/a—/4/7
POLITICAL SUBDIVISION SALES TAX EXEMPTION CERTIFICATE
(For use by States, Territories, or Political
Subdivision thereof, or the District of Columbia)
The undersigned hereby certifies that she is the Controller of Weld County Government and that she is
authorized to execute this Certificate and that all taxable articles/services purchased from
are for the exclusive use of Weld County Government, State of Colorado.
It is understood that the exemption from tax in the case of sales of articles under this Exemption
Certificate to the State, Territory, or Political Subdivision or District of Columbia is limited to the sale of
articles purchased for their exclusive use, and it is agreed that if articles purchased tax-free under this
Exemption Certificate are used otherwise or are sold to employees or others, such fact must be reported
to the manufacturer of the articles covered by this Certificate. It is also understood that the fraudulent use
of this Certificate to secure exemption will subject the undersigned and all parties making use of this
Certificate to all applicable criminal penalties under the Internal Revenue Code.
COLORADO SALES TAX CERTIFICATION OF EXEMPTION NUMBER -98-03551-0000
FEDERAL TAX EXEMPTION NUMBER-84-6000813
STATE TAX IDENTIFICATION NUMBER - 14-02101
Contro Ier
Colorado statute exempts from state and state-collected sales tax all sales to the United States government and the State of
Colorado,its departments and institutions,and its political subdivisions(county and local governments,school districts and special
districts)in their governmental capacities only.[C.R.S.39-26-114)1)(a)(l)J.
Some governmental entities have a Colorado-issued tax-exemption number,although they are not required to have one. Following
is a copy of Weld County Government's most recent Colorado-issued Certificate of Exemption for Sales and Use Tax Only,
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.,0OtCR.D0 DEPARTMENT OF IIEVENUE - - r r
°EWER Coffrp6-OQ13 CERTIFICATE OF EXEMPTION:FOR COQ bliQ.;mR NLY
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USE ACCOUNT NUMBER LIABILITY INFOR ?" s
THIS UCENSE IS for all references
NOT TRANSFERABLE t };
98-03551-0000 03 057 z � ._z00
920 9TH ST 202 GREELEY "c;.-'
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COUNTY OF WELD
WELD COUNTY OF ``
PO EE 758
GREELEY 4‘14,1/4,
CO 60632-0158
• Executive Director
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