Coupons

1. I [We] hereby request that the North Dakota Grocers Association act as my [our] agent in collecting money due me for any and all coupons I submit to the association for redemption. Redemption is defined as stated in Section 8 of contractual agreement, between International Outsourcing Services and the North Dakota Grocers Association. I certify to you that all coupons submitted to you herewith, or in the future, have been or will be redeemed by us strictly in accordance with the written provisions on the face of each coupon so submitted.

2. I [We] understand that coupons submitted to NDGA need to be separated (pads of coupons not separated may be rejected by coupon processors). Coupon Totals are recommended and will be used by NDGA to work with third party processors to assure adequate coupon reimbursement. Such requests will result in assessment of an annual processing fee, which will be assessed against retailer and/or processor.

3. I understand that I will receive an advance payment upon receiving the coupon valuation from the processor. The redemption center may retain a portion of coupon shipment if there’s a problem with expired coupons or chargebacks.

4. I further agree that all coupons submitted remain my property until redeemed and to hold the association and its officers harmless from any and all claims or judgments resulting from failure on my part to redeem coupons in accordance with the requirements of the manufacturer issuing the same, including attorney’s fees and court costs.

5. I AM REQUIRED TO NOTIFY THE NORTH DAKOTA GROCERS UPON SALE OR TERMINATION OF MY BUSINESS. This can be done with a letter in the bag or box of your last shipment of coupons.

Types of Stores

Food Stores

I hereby certify that all information provided in this questionnaire is correct