1. I/we herewith request permission to publish, exhibit, or broadcast the following item(s) owned by the library:
2. Description of intended use of above item(s):
3. I/we understand that this contract grants permission for one time, non-exclusive use of the material, and that any different or subsequent use must be applied for in writing. A $50.00 per image use fee is charged for each commercial or for-profit use of photographic, audio-visual or any other graphic materials or images from the Northeastern University Libraries, Archives and Special Collections Department, including all of its associated divisions.
4. I/we understand that materials used for exhibition, publication, or broadcast must be credited to Northeastern University Libraries, Archives and Special Collections Department.
5. I/we agree to supply the Northeastern University Libraries, Archives and Special Collections Department with two copies of the book, periodical, film, audiotape, videotape, or any other work in which materials owned by the library are used.
6. I/we understand that the library does not claim to control the copyright for all materials in the collection. The publishing, exhibiting, or broadcasting party assumes all responsibility for clearing reproduction rights and for any infringement of United States copyright law. The library has no readily available information concerning the existence and/or whereabouts of copyright holders.
7. I/we understand that the library reserves the right to refuse permission for the use or reproduction of materials when such restrictions have been specified by a donor.
8. I/we agree to defend, indemnify, and save and hold harmless the Northeastern University Libraries, Archives and Special Collections Department and their employees or designates from any and all costs, expense, damage and liability arising because of any claim whatsoever which may be presented by anyone for loss or damage or other relief occasioned or caused by the release of said items to the undersigned and their use in any manner, including their inspection, publication, reproduction, duplication or printing by anyone for any purpose whatever.
Your signature below indicates that you have read and will comply with this contract.
Name (please print):_________________________________
Subject to all conditions stated above, permission to publish, exhibit, or broadcast is herewith granted.
For the library:______________________________________________
Archives and Special Collections Department
92 Snell Library
Boston MA 02115