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TELETERIA **** Please print out this form and fax ****
Teleteria Custom Casino Web Site Billing & Contact information: Customer name:________________________________________________ Company:_________________________________________________ Tax ID(or Social Security #):_____________________________________ Address:________________________________________________________ City_______________________________State:_________________________ Postal/Zip code:___________________ Country:____________________ Telephone:___________ work:___________fax:___________cell:______________ Current Email:________________________________________ Checks payable to:____________________________________________
Teleteria Services: Custom Casino Turn-Key Site:- Creation of account with billing company in YOUR name
Site information: http://www._______________________________________ http://www._______________________________________ http://www._______________________________________ Web Site Hosting: $100.00/per month billed quarterly. Unlimited bandwith. Payments:
(payable by credit card, check, or money order) All payments are made payable to Teleteria. Customer is expected to pay full invoice charges no later than 7 days after invoice date. Failure to make appropriate payments 7 days after date of invoice will result in interruption of service. Limitations of Liability for Teleteria, Inc.: Customer agrees to hold harmless Teleteria, Inc. , its employees, officers, agents, and directors from any and all fines, penalties, losses, claims, or other liabilities resulting from or in connection with this Service Agreement. Teleteria, Inc. assumes no liability of the customer for failure to follow this Service Agreement and any results caused by the acts or omissions them, including, but not limited to, claims of third parties arising out of or resulting from or in connection with the customer’s products or services, messages, programs, caller contracts, promotions, advertising infringement or any claim for libel or slander. Teleteria is limited to, vandalism, theft, telecommunication services outages, extreme or severe weather conditions. Please note the definition of our guarantee. We require a 50% deposit on all site design. Once the site is done, the customer reviews it. At that time the customer has the opportunity to accept it, request changes that we will make within 24 hours, or if the customer is dissatisfied the customer can request a full refund of the deposit. Once the customer accepts the site and pays the balance a refund is no longer an option. Customers paying in monthly installments are not subject to a refund at any time. Customer agrees to pay all quarterly charges and any and all charges within 7 days of the due date or Customer will pay a 25.00 late fee. Cancellation of hosting services must be provided 30 days in writing prior to cancellation to avoid additional charges. By signing below, I declare that I have read, understand, and agree to the terms and conditions in the above service agreement. Name:_______________________________________ Date: ____________________Company:___________________________________________ Approved agreementBy:_________________________________________Date:____________________ Jay Servidio, President, Teleteria, Inc. Teleteria is available for service and support 24 hours a day.
Credit Card Authorization Form: It is understood that the charge from Teleteria, Inc. for any and all of our services by credit card are all non-refundable fees outside of the Teleteria guarentee. This covers the design, hosting, content packages, etc. If you add any of the options they are non-refundable fee as well as. We have to pay the designers, programmers, tech support and for the services that you will be using in advance. We are not allowed any refunds so we can not provide any refunds. The charge will appear on your credit card statement as Teleteria, Inc. I (print your name) __________________________________________ understand and accept all of the above in making this purchase. I faxing a photo copy of the front of the credit card being used along with a photo ID that has the same name on the credit card. I am authorized to make the charge of $____________ on the credit card that I am using to make this purchase. I understand that this charge is non-refundable. Credit card number :_______________________________Expire:__________________ Credit card billing address below. Address:_____________________________________ Country:____________________ City: __________________________ State:__________ Zip/Postal Code:_____________ (Signature)________________________________________ (Date)_________________
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