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INSERTION ORDER

VELISMEDIA information: AFFILIATE information:
Company Name VelisMedia Ltd. Company Name __________
Primary Contact __________ Primary Contact

Billing Contact

__________

__________

Email __________ Email __________
Address Jabotinsky 7, Ramat Gan, Israel Address __________
Phone +972-__________ Phone __________
Fax +972-__________ Fax __________
Date issued _________________ Effective Date _________________
service description:
Subject to the execution of this Insertion Order and to affiliate’s full compliance with the General Terms and Conditions for affiliates (the “Terms”), VelisMedia will promote the Advertiser’s Creative via affiliate’s Publishers network (as such terms are defined under the Terms). These Terms shall govern all future and any future mutually agreed campaigns, unless otherwise agreed by the Parties in writing.
Campaign description:
Velis’ Advertiser Pricing Type Payout Other characteristics Payment Terms
        Net 30
         
By executing this Insertion Order, you acknowledge, represent, warrant and agree that:

(i) You and the Affiliate’s Primary Contact indicated above are each a duly authorized representative of the Affiliate, each eligible and authorized to represent the Affiliate and to commit it to enter into this Insertion Order and to be bound by the Terms, and hereby make all representations and warranties herein on both your and Affiliate’s behalf.

(ii) You have read and understood the Terms, you acknowledge that this Insertion Order and the Terms constitute a binding and enforceable legal contract between VelisMedia and Affiliate, and you agree to be bound by them and to comply with all applicable laws and regulations regarding Affiliate’s use of VelisMedia’s services.

(iii) This Insertion Order and the Terms shall govern any and all future mutually agreed campaigns, unless as agreed otherwise by VelisMedia and Affiliate in writing (including by email exchange between VelisMedia’s and Affiliate’s Primary Contacts), or otherwise as set forth under the Terms.

Authorization:
VelisMedia Ltd.

By: ________________________________

Signature: __________________________

Date: ______________________________

[Affiliate]

By: ________________________________

Signature: __________________________

Date: ______________________________