| Supermarket Advertisement Contract Preparation Form | We require this information to prepare your agreement accurately. Please provide the necessary details to proceed. |
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Privacy Assurance We value your privacy. Your information will only be used for the purpose of providing the requested service and will never be sold, shared, or used for any other purposes. |
| Your Name | Samira zargari |
| Business Name | Samsamfitness |
| Your title | Owner |
| Your Address | 120 monroe Irvine, California 92620 United States Map It |
| Your Phone | (424) 440-9187 |
| Your Email Address | Email hidden; Javascript is required. |
| Type of Ad | Business, Service, Product Ad |
| SuperMarket | 18040 Culver Dr, Irvine, CA 92612 |
| Start Date | 10/20/2025 |
| End Date | 01/20/2026 |
| Prices Listed Are for Information Only | No Payment Required via This Form |
| Display Ads Standard Monthly Rate | Display Ads Standard Monthly Rate, Price: $250.00 |
| Total | $830.00 |
