Docusign Envelope ID: E152479E-C128-8CA0-82FF-97BD9F6B37C5
Advertising Agreement Mailbox Publishings, Inc. 2081 SE Ocean Blvd. • Suite 4 • Stuart, FL 34996 Phone 772.334.2121 • Fax 772.334.2221
Company Name _______________________________________________________ Date _____________________ Contact Name ________________________________________ Specific Business ___________________________ Address_________________________________________ City_________________ State _______ Zip __________ Phone __________________ Cell __________________ Email _________________________________________ WINDOW GENIE OF VERO BEACH -PSL 4-22-2026 BRIAN PEARL WINDOW CLEANING /TINT 701 8TH STREET VEROBEACH FL 32962 772-999-6992 772-882-5159 BRIAN.PEARL @WINDOWGENIE.COM
FIRST PAYMENT DUE WITH INSERTION AGREEMENT Please fill in the information below to authorize payment.
PAYABLE TO MY LIVING MEDIA
ACH – DIGITAL CHECK
Bank Name:_______________________________________________ Bank Address: ________________________________________________________
Routing Number: ________________________________ Account Number: _____________________________ Amount: $________________________
❏ Check here to authorize automatic payments for each issue.
Authorized Signature:
________________________________________________
– CREDIT CARD –
3% CONVENIENCE FEE
4246 3154 7126 1097
02/31
687
Account Number:
_________________________________________________________ Exp Date: _______________ CVV Code:
__________
964.00
Authorized Signature:
_____________________________________________________________________ Amount: $______________
32968
❏ I hereby authorize automatic payments for each issue
Billing Zip Code: _____________________________
ADVERTISING PROGRAM
Vol. #
In Home
Size
Zone (s) / Section (s)
Investment*
ALL SLCOUNTY AND IRCOUNTY ALL SLCOUNTY AND IRCOUNTY ALL SLCOUNTY AND IRCOUNTY ALL SLCOUNTY AND IRCOUNTY ALL SLCOUNTY AND IRCOUNTY ALL SLCOUNTY AND IRCOUNTY ALL SLCOUNTY AND IRCOUNTY ALL SLCOUNTY AND IRCOUNTY ALL SLCOUNTY AND IRCOUNTY ALL SLCOUNTY AND IRCOUNTY ALL SLCOUNTY AND IRCOUNTY ALL SLCOUNTY AND IRCOUNTY ALL SLCOUNTY AND IRCOUNTY
644-5/6/26 645-5/20/26 646-6/3/26 647-6/17/26 648-7/1/26 649-7/15/26 650-7/29/26 651-8/12/26 652-8/26/26 653-9/9/26 654-9/23/26 655-10/7/26 656-10/21/26
1/4V 1/4V 1/4V 1/4V 1/4V 1/4V 1/4V 1/4V 1/4V 1/4V 1/4V 1/4V 1/4V
964.00 964.00 964.00 964.00 964.00 964.00 964.00 964.00 964.00 964.00 964.00 964.00 964.00
964.00
Instructions:________________________________________________________________________________
BRIAN PEARL
Sales Representative TRACY PADOVA GLEN FETZNER
Print Name/Title Authorized Advertiser
Authorized Signature of Advertiser
Sales Manager
The undersigned states that he/she is authorized by the above business to sign this Agreement and agrees to be personally liable, jointly, and severally, under this contract regardless of wether or not he/she has any ownership interest in above business; and agrees to abide by all terms of this contract. This agreement is not in effect until accepted and approved by Mailbox Publishing management.
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