218 Little Falls Road, Unit #3 Cedar Grove, New Jersey (973) (973) (fax)

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1 Welcome to Visual Alchemy, LLC. If you are already familiar with our facility, you know that we have been offering our services to the Film and Television Industry since That s more than twenty years of experience! We are the leading television and 24 frame playback Rental House on the East Coast. Our friendly and knowledgeable staff will work with your crew to provide you with all the vintage and modern televisions, monitors and servers. If there is anything more we can do for you, just ask us! The attached paperwork is designed to allow a efficient process. Please complete the forms and fax back to or to ali.visualalchemy@gmail.com. All productions must have a current Certificate of Insurance on file with Visual Alchemy, LLC in order to check out any equipment. Please see the attached form for details. We accept checks and all major credit cards for rentals. 218 Little Falls Road, Unit #3 Cedar Grove, New Jersey (973) (973) (fax) Cedar Grove Hours: 8:00-4:00pm Monday-Friday Or by appointment visit our website at:

2 Client Information Sheet DATE PRODUCTION COMPANY BILLING ADDRESS JOB NAME/SHOW MAIN PHONE FAX RENTAL CONTACT INFORMATION Television Commercial Gallery Feature Film Other ACCTS PAYABLE/ BILLING CONTACT: UPM: SET DECORATOR/ASSIST: PROP MASTER: ART DIRECTOR/ASSIST: SHOPPER: PHONE/CELL OTHER: METHOD OF PAYMENT CHECK CREDITCARD Is a purchase order required for this production: Yes PO# No

3 Standard Insurance Requirements For Rentees/Lessees of Equipment Visual Alchemy, LLC requires a Certificate of Insurance from all outside parties renting equipment or property. The Certificate should reflect the following insurance coverage: Commercial General Liability $1,000,000 per occurrence $1,000,000 aggregate All Risk Property Insurance on Miscellaneous Equipment, Props and/or any other property rented/ leased by Rentee/Lessee. Rentee s/lessee s Policy must cover and state that coverage is written on a replacement cost value for the equipment. Visual Alchemy, LLC, shall be included as an additional insured on liability and loss payee on property insurance. Rentee s/lessee s insurance is primary and any insurance maintained by Visual Alchemy, LLC is non-contributing to any of the insurance of the Rentee s/lessee s. ALL OF THE ABOVE REQUIREMENTS MUST BE ON THE CERTIFICATE OF INSURANCE IN ORDER TO BE APPROVED CERTIFICATE HOLDER: Visual Alchemy, LLC 218 Little Falls Road, Unit #3 Cedar Grove, NJ Please Send Certificate to: Ali Lanfrank at address above, fax or ali.visualalchemy@gmail.com Fax:

4 TERMS AND CONDITIONS Lessee and Visual Alchemy, LLC hereby agree as follows: 1. Visual Alchemy, LLC rents to Lessee the equipment listed on the rental work order, as therein specified, (hereafter referred to as the Equipment ). 2. Lessee agrees to use the Equipment only for the purpose for which it is designed and in a careful and prudent manner such as will not cause any injury or damage to the Equipment, other than reasonable wear and tear, or to any person or property. 3. Upon the expiration of the rental period specified above hereof, Lessee shall return the Equipment to Visual Alchemy, LLC in the same condition, reasonable wear and tear excepted, as it was in when received by Lessee from Visual Alchemy, LLC. 4. Lessee acknowledges that it has inspected the Equipment, that the same is now in good repair, mechanical condition and working order, and that Visual Alchemy, LLC makes no warranty whatsoever in connection therewith. Lessee agrees that if the Equipment shall be returned to Visual Alchemy, LLC in need of repair, Lessee shall pay to Visual Alchemy, LLC the cost of such repair. Should Equipment be damaged beyond reasonable repair, lost by whatever means, or destroyed, Lessee shall promptly pay and indemnify Visual Alchemy, LLC in the full amount of the sum(s) set forth in this agreement under the columnar heading Replacement Price without allowance for depreciation or obsolescence. 5. We shall indemnify and hold Visual Alchemy,LLC harmless from any loss and damage which it may suffer, incur or which results from and by reason of Lessee s use of the Equipment, including but not limited to, the loss thereof of any damage thereto. In connection therewith Lessee agrees to obtain and furnish, Visual Alchemy, LLC, if it shall request the same, satisfactory evidence of such insurance as Visual Alchemy, LLC may reasonably require. If any legal action is necessary to enforce the terms of this agreement, the prevailing party shall been titled to reasonable attorney s fees in addition to any relief to which it may be entitled. 6. Rental price set forth in this agreement is based on Lessee s initial estimate of the equipment required to service its needs. It is agreed and understood by Lessee that should its requirements subsequently increase beyond those originally estimated, additional rental charges will be paid by Lessee. Such additional rental charges will also be based on the fair value of the property rented and the time period for which such equipment is needed. Authorized Representative: Print Name: Production Company:

5 CREDIT AUTHORIZATION FORM DATE: JOB NAME: COMPANY NAME: CONTACT PERSON: CONTACT VISUAL ALCHEMY INVOICE # AMOUNT $ VISA MASTER CARD AMERICAN EXPRESS CARD # CVV EXP CARDHOLDER NAME: CARD BILLING ADDRESS: I the undersigned authorize Visual Alchemy, LLC to charge the above Credit Card for services provided and/or rented articles including a credit card fee of 3.5% SIGNATURE OF CARDHOLDER: PRINT NAME: DATE:

6 CREDIT DEPARTMENT Exact Legal Name of Business: Date: D/B/A: Street Address: City: State: Zip Code: Phone: Federal ID#: SSN: (if sole proprietor) Accounts Payable Contact: Phone #: COMPANY PROFILE Check one: Corporation Proprietorship Partnership LLC Other BANK INFORMATION Name: Branch: Address: Account #: Contact: CREDIT REFERENCES Name: Name: Name: Address: Address: Address: Note: Please send your ST-121, Exempt Use Certificate (If applicable)

7 Directions to Visual Alchemy 218 Little Falls Road Unit 3 Cedar Grove, NJ Office Mike s Cell (M-F 8a-4p or by appointment), video & computer services for film production From the Lincoln Tunnel Take the RT-3 WEST ramp (sign reads: Meadowlands Sports Complex/Garden State Parkway/Secaucus ) - go 11.1 mi Take Rte. 3 West until it merges with Rte. 46. Then exit at Great Notch/Cedar Grove - (the exit is after the Exxon station & the Great Notch Inn, the first one you will come to after the Rte 3/46 merge) At stop sign at end of exit, Turn left on Rifle Camp Rd - go 319 ft back over the hwy Turn right at Notch Rd - (which will bend to the left, & then to the right) go to the traffic light (Church on right, Train station on left) Turn left at the light, bear right at fork (.14mi) in the road, go.4mi to another light at Francisco Ave. Turn right on Francisco Ave, go.7 mi to Cedar Grove Rd. (this is the turn right BEFORE a small bridge, also note a rail crossing at.37 mi...the sign says 15MPH & they mean it!...potential Streets of San Francisco stunts here!) Turn left at Cedar Grove Rd, which changes names (you ARE in NJ) to Little Falls Rd. Continue on Little Falls Rd - go 0.8 mi (watch for NARROW train bridge!) Pass Commerce Rd, the recycling dump, some tennis courts & basketball courts, cross another small bridge and make an immediate right into the industrial park. We re in the building in the back. Units 3 & 4, loading dock in the rear

8 Form W-9 (Rev. December 2014) Department of the Treasury Internal Revenue Service Print or type See Specific Instructions on page 2. Request for Taxpayer Identification Number and Certification 1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank. Visual Alchemy, LLC 2 Business name/disregarded entity name, if different from above 3 Check appropriate box for federal tax classification; check only one of the following seven boxes: Individual/sole proprietor or single-member LLC C Corporation S Corporation Partnership Trust/estate Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) Note. For a single-member LLC that is disregarded, do not check LLC; check the appropriate box in the line above for the tax classification of the single-member owner. Other (see instructions) 5 Address (number, street, and apt. or suite no.) 22 Woodland Avenue 6 City, state, and ZIP code Verona, New Jersey List account number(s) here (optional) Give Form to the requester. Do not send to the IRS. 4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3): Exempt payee code (if any) Exemption from FATCA reporting code (if any) (Applies to accounts maintained outside the U.S.) Requester s name and address (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Note. If the account is in more than one name, see the instructions for line 1 and the chart on page 4 for guidelines on whose number to enter. Part II Certification Under penalties of perjury, I certify that: Social security number or Employer identification number The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and 3. I am a U.S. citizen or other U.S. person (defined below); and 4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct. Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions on page 3. Sign Here Signature of U.S. person General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Future developments. Information about developments affecting Form W-9 (such as legislation enacted after we release it) is at Purpose of Form An individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following: Form 1099-INT (interest earned or paid) Form 1099-DIV (dividends, including those from stocks or mutual funds) Form 1099-MISC (various types of income, prizes, awards, or gross proceeds) Form 1099-B (stock or mutual fund sales and certain other transactions by brokers) Form 1099-S (proceeds from real estate transactions) Form 1099-K (merchant card and third party network transactions) Date Form 1098 (home mortgage interest), 1098-E (student loan interest), 1098-T (tuition) Form 1099-C (canceled debt) Form 1099-A (acquisition or abandonment of secured property) Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN. If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding? on page 2. By signing the filled-out form, you: Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners' share of effectively connected income, and 4. Certify that FATCA code(s) entered on this form (if any) indicating that you are exempt from the FATCA reporting, is correct. See What is FATCA reporting? on page 2 for further information. Cat. No X Form W-9 (Rev )