As the legal representative of my organization, I certify that the following film print will be borrowed from the American Genre Film Archive (AGFA) under the following conditions:
1. AGFA has no obligation to borrower until contract is signed and processing fee is paid.
2. Film will be shipped both from and to AGFA via Federal Express 3-day Express Saver with insurance coverage valued at $3000 per film; all shipping will be paid for by borrower.
3. Film will be returned to AGFA in the shipping container in which it was sent.
4. Film will be returned to AGFA within five business days of screening date.
5. Film will be returned to AGFA in the condition in which it arrived; The borrower is responsible for inspecting prints after delivery and notifying AGFA of any damage discovered before projection. Otherwise, condition will be based on the observations of AGFA personnel upon its departure from AGFA facilities and borrower will be billed for any damages discovered upon examination upon return to AGFA at stated insured value.
6. Film will be screened unspliced on reel to reel projector, not on platter system, unless specific permission is granted herein.
7. NO SCREENING RIGHTS ARE GIVEN OR IMPLIED WITH THIS TRANSACTION. This arrangement covers the physical materials only. Any and all liabilities for screening rights are the responsibility of the borrower. The print shall NEVER be given up to any entity other than AGFA under any circumstances or legal intimidation.
8. There is no agreement without signed contract; AGFA is not liable for promotional errors.
9. AGFA will be recognized at screenings and in promotional material for screenings of AGFA-owned prints. Copies of promotional materials, especially those naming AGFA, will be submitted with return of the film.
10. The undersigned is AGFA’s primary contact at the borrowing organization.
Signed: _______________________________ Signed: ________________________________
Printed: ______________________________ Printed: _______________________________
For:________ _________________________ For: American Genre Film Archive
Date: ________________________________ Date: __________________________________
Projectionist signature: ______________________________________________________________
Film: ____________________________________________________________________________
Produced date/Country: _____________________________________________________________
Directed by: ______________________________________________________________________
If not English, Language/Subtitled:_____________________________________________________
Screening purpose/occasion:_________________________________________________________
Screening date(s)/time(s): ___________________________________________________________
Screening location: _________________________________________________________________
To leave AGFA on date: _____________________________________________________________
To return to AGFA on date: __________________________________________________________
Insured value: ____________________________________________________________________
Processing fee, to be paid with contract submission: ______________________________________
Fee will be paid via PayPal or check.
Borrower Fed Ex Account number: ____________________________________________________
Borrower shipping address: __________________________________________________________
Address 2: _______________________________________________________________________
City, State, Zip/Postal code: __________________________________________________________
Country: _________________________________________________________________________
Contact phone: ___________________________________________________________________
Contact cell phone: ________________________________________________________________
Contact fax: ______________________________________________________________________
Contact email: ____________________________________________________________________