Jorge Visions Video and D.J. Productions

721 Five Mile Drive, apt. #2, Ithaca, NY 14850
(607) 256 - 4106        Jorge@htva.net
www.JorgeVisions.com

This is a contract of obligation between Jorge T. Cuevas, on behalf of Jorge Visions
Video & D.J. Productions and:
(please print your name(s), address, & phone #s, & e-mail below)
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

to do business as stated in this agreement.

Date                 Time range                    Location (Directions, maps, & contact phone#)
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________

Type of services provided _____________________________________________

Other special arrangements ____________________________________________
____________________________________________________________

Cost plus tax $_________________________________________________

Deposit $ ___________________________________________________________

(Non-refundable, but applied towards total cost)

Balance due $ ___________________________________________________

Your signature(s):_________________________________________________

Service provider:__________________________________________________