Form BLS 1810E BLS 1810E PPI Product Checklist

Producer Price Index Survey

BLS-1810E

Producer Price Index Survey - Initiation Private Sector

OMB: 1220-0008

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Bureau of Labor Statistics
PPI Product Checklist

U.S. Department of Labor

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O.M.B. No. 1220-0008

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SU ID:

Item Num:

NAICS 541810 – ADVERTISING AGENCIES
PAGES 2 - 3
PAGES 4 - 7
PAGES 8 - 11
PAGES 12 - 15
PAGES 16 - 18
PAGES 19 - 20
PAGES 21 - 22

AD CREATION SERVICES ONLY
AD PLACEMENT: PRINT MEDIA
TELEVISION AD PLACEMENT
RADIO AD PLACEMENT
INTERNET AD PLACEMENT
SALES PROMOTION & OTHER ADVERTISING SERVICES
DEFINITIONS

INDUSTRY DEFINITION
This industry comprises establishments primarily engaged in creating advertising campaigns and placing such advertising
in periodicals, newspapers, radio and television, or other media. These establishments are organized to provide a full
range of services (i.e., through in-house capabilities or subcontracting), including advice, creative services, account
management, production of advertising material, media planning, and buying (i.e., placing advertising).
Note that establishments which provide ad creative services, but do not place advertising in different forms of media, are
still considered primary to NAICS 541810 as long as the plurality of revenue is derived from ad creative services.
Establishments that provide ad placement services only are classified in NAICS 541830. However, establishments that
derive the plurality of their revenue from ad placement, but also provide ad creative services, are classified in NAICS
541810.
EXCLUDED FROM THIS INDUSTRY ARE THE FOLLOWING:

NAICS

Title

Services

541830

Media Buying Agencies

Purchasing advertising space from media outlets and reselling it
directly to advertising agencies or individual companies

541430

Graphic Design Services

Conceptualizing and producing artwork or graphic designs without
providing other advertising agency services

541860

Direct Mail Advertising

Creating direct mail advertising campaigns

541613

Marketing Consulting Services

Providing marketing consulting services

541840

Media Representatives

Selling media time or space for media owners as independent
representatives

541820

Public Relations Agencies

Designing and implementing public relations campaigns

___________________________________________________________________________________________________________
BLS 1810E (Revised 10/2020)

Page 1

124

CHECKLIST CODE: D541810A

CHECKLIST TITLE: AD CREATION SERVICES ONLY

01 TYPE OF SERVICE
001
002
003
004
005
006

Price Basis
019 Price basis: Entire project
020 Price basis: Portion of project

Television ad creation services
Radio ad creation services
Periodical ad creation services
Newspaper ad creation services
Internet ad creation services
Other ad creation services:

04 TYPE OF PRICE

________________________________________

02 SERVICE IDENTIFICATION

001 Current month price reported
002 Price reported on one month lag
003 Price reported for other lag period:
________________________________________

001 Client name:

05 OTHER FEATURES (255 character limit)

________________________________________
002 Project ID:

001 ________________________________________
____________________________________________

________________________________________
003 Total media budget:

____________________________________________

________________________________________
004 Other identification:

____________________________________________
____________________________________________

________________________________________

____________________________________________

03 SERVICE CHARACTERISTICS
001
002
003
004
005
006
007

Type of Professional
Type of professional: Account Executive
Type of professional: Art Director
Type of professional: Producer
Type of professional: Traffic Manager
Type of professional: Writer
Type of professional: Copy Designer
Other type of professional:

____________________________________________

COMMENTS
____________________________________________
____________________________________________

_______________________________________

____________________________________________

Client relationship
008 New client
009 Repeat client

____________________________________________

010 Length of contract:

____________________________________________

____________________________________________

________________________________________

____________________________________________

Number of ads
011 Single ad created
012 Multiple ads created
013 Other number of ads created:

____________________________________________

_______________________________________
014
015
016
017
018

Outside Services Hired
Outside talent services hired
Outside production crew services hired
Outside director services hired
Outside artist’s services hired
Other outside services hired:
_______________________________________
Page 2

CHECKLIST CODE: D541810A

CHECKLIST TITLE: AD CREATION SERVICES ONLY

06 AVERAGE BILLING RATE PER HOUR
a. Total billings for specified professional

$

b. Total number of hours billed

hours

c. Average price per hour (a / b)

$

07 TRANSACTION PRICE - Project/labor-based
RATE PER HOUR
a. Level of Professional:

Subtotal (sum of a):

$
$
$
$
$
$
$
$
$

# OF HOURS

PRICE
$
$
$
$
$
$
$
$
$
$

b. Additional Fees:
Fax Fees
Copying Fees
Mail Expenses
Travel Expenses
Telephone Expenses

$
$
$
$
$
$
$
$
$
$
$

Subtotal (sum of b):
c. Outside Services:

Subtotal of Outside Services (sum of c):

$
$
$
$
$

d. Commission Rate/Percentage Mark-up
e. Dollar Amount retained by Agency

%
(c x d)

f. Grand Total (sum of a + b + e)

$
$

Page 3

CHECKLIST CODE: D541810B

CHECKLIST TITLE: AD PLACEMENT: PRINT MEDIA

06 PERIODICAL PLACEMENTS: ALL PRICES

Price Basis
014 Price basis: entire project
015 Price basis: portion of project

001
002
003
004

Type of ad
Display ads
Insert ads
Classified ads
Other type of ad:

005
006
007
008
009
010
011

_______________________________________
Size of Ad
1/6 page ads
1/3 page ads
1/2 page ads
2/3 page ads
Full page ads excluding covers
Full page cover ads
Other ad size:

012
013
014
015

________________________________________
Frequency of Issue
Weekly issue
Monthly issue
Quarterly issue
Other frequency of issue:

08 TYPE OF PRICE

_______________________________________

07 PERIODICAL PLACEMENTS: TRANSACTION
PRICE
001
002
003
004
005

Ad Placement
Front inside cover placement
Back inside cover placement
Back cover placement
Placement: Run of magazine
Other placement:

________________________________________

09 OTHER FEATURES (255 character limit)
001 ________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________

COMMENTS

____________________________________________
____________________________________________
____________________________________________

_______________________________________
Insertion Frequency
006 Single insertion
007 Multiple insertions (specify number of issues):

008
009
010
011

001 Current month price reported
002 Price reported on one month lag
003 Price reported for other lag period:

_______________________________________
Ad Color
Black ink only
Two ink colors
Four ink colors
Other number of ink colors:

_______________________________________
Graphics
012 Graphics included
013 Text only

Page 5

____________________________________________
____________________________________________
____________________________________________

CHECKLIST CODE: D541810B
10

CHECKLIST TITLE: AD PLACEMENT: PRINT MEDIA

AVERAGE COMMISSION PER AD PLACEMENT
a. Total commissions for ad placement services

$

b. Total number of ads placed
c. Average commission per ad placement (a / b)

$

11 AVERAGE COMMISSION RATE
a. Price of ad placement

$

b. Average commission rate

%

c. Average commission (a x b)

$

12 AVERAGE BILLING RATE PER HOUR
a. Total billings for specified professional

$

b. Total number of hours billed

hours

c. Average price per hour (a / b)
13

$

AVERAGE PRICE PER EMPLOYEE HOUR
a. Total fees for ad placement services

$

b. Total number of employee hours placing advertising
c. Average price per employee hour (a / b)

hours
$

14 TRANSACTION PRICE - Commission-based
a. Price of ad placement

$

b. Commission rate

%

c. Commission amount (a x b)

$

Page 6

CHECKLIST CODE: D541810B

CHECKLIST TITLE: AD PLACEMENT: PRINT MEDIA

15 TRANSACTION PRICE - Project/labor-based
RATE PER HOUR
a. Level of Professional:

Subtotal (sum of a):

$
$
$
$
$
$
$
$
$

# OF HOURS

PRICE
$
$
$
$
$
$
$
$
$
$

b. Additional Fees:
Fax Fees
Copying Fees
Mail Expenses
Travel Expenses
Telephone Expenses

$
$
$
$
$
$
$
$
$
$
$

Subtotal (sum of b):
c. Outside Services:

Subtotal of Outside Services (sum of c):

$
$
$
$
$

d. Commission Rate/Percentage Mark-up
e. Dollar Amount retained by Agency

%
(c x d)

f. Grand Total (sum of a + b + e)

$
$

Page 7

CHECKLIST CODE: D541810C

CHECKLIST TITLE: TELEVISION AD PLACEMENT

05 SERVICE DESCRIPTION: TRANSACTION
PRICE

07 OTHER FEATURES (255 character limit)
001 ________________________________________

Type of sale
001 Package plan (specify name, if applicable):

_______________________________________
002 Non-package plan

____________________________________________
____________________________________________

Preemption status
003 Advertising preemptible
004 Advertising guaranteed

____________________________________________

Transaction Details
005 Purchase lead time:

____________________________________________

____________________________________________

________________________________________
006 Number of weeks run:
________________________________________
007 Number of advertisements per week:
________________________________________

____________________________________________

COMMENTS

____________________________________________
____________________________________________
____________________________________________

Price Basis
008 Price basis: Entire project
009 Price basis: Portion of project

____________________________________________
____________________________________________

06 TYPE OF PRICE

001 Current month price reported
002 Price reported on one month lag
003 Price reported for other lag period:
________________________________________

Page 9

CHECKLIST CODE: D541810C
08

CHECKLIST TITLE: TELEVISION AD PLACEMENT

AVERAGE COMMISSION PER AD PLACEMENT
a. Total commissions for ad placement services

$

b. Total number of ads placed
c. Average commission per ad placement (a / b)

$

09 AVERAGE COMMISSION RATE
a. Price of ad placement

$

b. Average commission rate

%

c. Average commission (a x b)

$

10 AVERAGE BILLING RATE PER HOUR
a. Total billings for specified professional

$

b. Total number of hours billed

hours

c. Average price per hour (a / b)
11

$

AVERAGE PRICE PER EMPLOYEE HOUR
a. Total fees for ad placement services

$

b. Total number of employee hours placing advertising
c. Average price per employee hour (a / b)

hours
$

12 TRANSACTION PRICE - Commission-based
a. Price of ad placement

$

b. Commission rate

%

c. Commission amount (a x b)

$

Page 10

CHECKLIST CODE: D541810C

CHECKLIST TITLE: TELEVISION AD PLACEMENT

13 TRANSACTION PRICE - Project/labor-based
RATE PER HOUR
a. Level of Professional:

Subtotal (sum of a):

$
$
$
$
$
$
$
$
$

# OF HOURS

PRICE
$
$
$
$
$
$
$
$
$
$

b. Additional Fees:
Fax Fees
Copying Fees
Mail Expenses
Travel Expenses
Telephone Expenses

$
$
$
$
$
$
$
$
$
$
$

Subtotal (sum of b):
c. Outside Services:

Subtotal of Outside Services (sum of c):

$
$
$
$
$

d. Commission Rate/Percentage Mark-up
e. Dollar Amount retained by Agency

%
(c x d)

f. Grand Total (sum of a + b + e)

$
$

Page 11

CHECKLIST CODE: D541810D
01 TYPE OF SERVICE

CHECKLIST TITLE: RADIO AD PLACEMENT
018 Channels aired (Satellite radio only):

001 Placement of advertising on network radio
002 Placement of advertising on local radio
003 Other type of radio advertising placement:

________________________________________
019 Daypart rating:
________________________________________
020 Average CPP (cost per point):

__________________________________

02 SERVICE IDENTIFICATION

________________________________________
021 Number of listeners for daypart:

001 Client name:

_________________________________________
002 Project ID:

________________________________________
022 Average CPM (cost per thousand):

_________________________________________
003 Total media budget:
_________________________________________
004 Other identification:
________________________________________

03

SCOPE OF SERVICE

001 Ad placement only
002 Ad placement and ad creation
003 Ad placement and other advertising services:
_______________________________________
Type of professional
001 Type of Professional: Media Buyer
002 Type of Professional: Media Planner
003 Other type of Professional:

001
002
003
004
005
006
007
008

Type of sale
AAA sale
AA sale
TAP sale (Total audience plan)
BTA sale (Best times available)
ROS sale (Run of schedule)
Unspecified sale
Non-package plan sale
Other type of sale:

011 Purchase lead time:

_______________________________________
Length of advertisement
15-second spot
30-second spot
60-second spot
Other length of advertisement:

______________________________________
Day of week
008 Weekday
009 Weekend
010 Specific day of the week:

011
012
013
014
015
016

05 SERVICE DESCRIPTION: TRANSACTION
PRICE

______________________________________
Preemption status
009 Advertising preemptible
010 Advertising guaranteed

04 SERVICE DESCRIPTION: ALL PRICES

004
005
006
007

________________________________________

________________________________________
Daypart
Daypart: Morning drive
Daypart: Midday
Daypart: Afternoon drive
Daypart: Evening
Daypart: Overnight
Other daypart:
_______________________________________

017 Type of programming:
________________________________________
Page 12

_______________________________________
012 Number of weeks run:
_______________________________________
013 Number of spots run per week:
________________________________________
014 DMA (designated market area):
________________________________________

CHECKLIST CODE: D541810D

CHECKLIST TITLE: RADIO AD PLACEMENT

Spot placement
015 Spot run during regular programming
016 Fixed placement spot
017 Spot tied to a specific program (news, sports,
etc.):
_______________________________________
018 Spot tied to specific event (concert, football game,
etc.):
_______________________________________
019 Other spot placement:
_______________________________________
Price Basis
020 Price basis: Entire project
021 Price basis: Portion of project

COMMENTS

____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________

06 TYPE OF PRICE

001 Current month price reported
002 Price reported on one month lag
003 Price reported for other lag period:
________________________________________

07 OTHER FEATURES (255 character limit)
001 ________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________

Page 13

CHECKLIST CODE: D541810D
08

CHECKLIST TITLE: RADIO AD PLACEMENT

AVERAGE COMMISSION PER AD PLACEMENT
a. Total commissions for ad placement services

$

b. Total number of ads placed
c. Average commission per ad placement (a / b)

$

09 AVERAGE COMMISSION RATE
a. Price of ad placement

$

b. Average commission rate

%

c. Average commission (a x b)

$

10 AVERAGE BILLING RATE PER HOUR
a. Total billings for specified professional

$

b. Total number of hours billed

hours

c. Average price per hour (a / b)
11

$

AVERAGE PRICE PER EMPLOYEE HOUR
a. Total fees for ad placement services

$

b. Total number of employee hours placing advertising
c. Average price per employee hour (a / b)

hours
$

12 TRANSACTION PRICE - Commission-based
a. Price of ad placement

$

b. Commission rate

%

c. Commission amount (a x b)

$

Page 14

CHECKLIST CODE: D541810D

CHECKLIST TITLE: RADIO AD PLACEMENT

13 TRANSACTION PRICE - Project/labor-based
RATE PER HOUR
a. Level of Professional:

Subtotal (sum of a):

$
$
$
$
$
$
$
$
$

# OF HOURS

PRICE
$
$
$
$
$
$
$
$
$
$

b. Additional Fees:
Fax Fees
Copying Fees
Mail Expenses
Travel Expenses
Telephone Expenses

$
$
$
$
$
$
$
$
$
$
$

Subtotal (sum of b):
c. Outside Services:

Subtotal of Outside Services (sum of c):

$
$
$
$
$

d. Commission Rate/Percentage Mark-up
e. Dollar Amount retained by Agency

%
(c x d)

f. Grand Total (sum of a + b + e)

$
$

Page 15

CHECKLIST CODE: D541810E

CHECKLIST TITLE: INTERNET AD PLACEMENT

COMMENTS
___________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________

08

AVERAGE COMMISSION PER AD PLACEMENT
a. Total commissions for ad placement services

$

b. Total number of ads placed
c. Average commission per ad placement (a / b)

$

09 AVERAGE BILLING RATE PER HOUR
a. Total billings for specified professional

$

b. Total number of hours billed

hours

c. Average price per hour (a / b)
10

$

AVERAGE PRICE PER EMPLOYEE HOUR
a. Total fees for ad placement services

$

b. Total number of employee hours placing advertising
c. Average price per employee hour (a / b)

hours
$

11 TRANSACTION PRICE - Commission-based
a. Price of ad placement

$

b. Commission rate

%

c. Commission amount (a x b)

$

Page 17

CHECKLIST CODE: D541810E

CHECKLIST TITLE: INTERNET AD PLACEMENT

12 TRANSACTION PRICE - Project/labor-based
RATE PER HOUR
a. Level of Professional:

Subtotal (sum of a):

$
$
$
$
$
$
$
$
$

# OF HOURS

PRICE
$
$
$
$
$
$
$
$
$
$

b. Additional Fees:
Fax Fees
Copying Fees
Mail Expenses
Travel Expenses
Telephone Expenses

$
$
$
$
$
$
$
$
$
$
$

Subtotal (sum of b):
c. Outside Services:

Subtotal of Outside Services (sum of c):

$
$
$
$
$

d. Commission Rate/Percentage Mark-up
e. Dollar Amount retained by Agency

%
(c x d)

f. Grand Total (sum of a + b + e)

$
$

Page 18

CHECKLIST CODE: D541810F

CHECKLIST TITLE: SALES PROMOTION & OTHER
ADVERTISING SERVICES
05 OTHER FEATURES (255 character limit)

01 TYPE OF SERVICE
001
002
003
004
005

Sales promotion
Account management
Media advertising verification
Competitive advertising reports
Other advertising service:

001 ________________________________________
____________________________________________
____________________________________________

________________________________________

____________________________________________

02 SERVICE IDENTIFICATION
001 Client name

____________________________________________

________________________________________
002 Total media budget:

____________________________________________
____________________________________________

________________________________________
003 Other identification

COMMENTS

________________________________________

____________________________________________

03 SERVICE CHARACTERISTICS

____________________________________________

001
002
003
004
005

____________________________________________

Type of professional
Type of Professional: Account Executive
Type of Professional: Art Director
Type of Professional: Producer
Type of Professional: Traffic Manager
Other Type of Professional:

____________________________________________
____________________________________________
____________________________________________

________________________________________
Client relationship
006 New client
007 Repeat client
008 Length of contract:

009
010
011
012

_______________________________________
Outside services hired
Outside talent services hired
Outside production crew services hired
Outside director services hired
Outside artist’s services hired

________________________________________
013 Other outside services hired
________________________________________
Price Basis
014 Price basis: Entire project
015 Price basis: Portion of project

04 TYPE OF PRICE

001 Current month price reported
002 Price reported on one month lag
003 Price reported for other lag period:
________________________________________

Page 19

CHECKLIST CODE: D541810F

CHECKLIST TITLE: SALES PROMOTION & OTHER
ADVERTISING SERVICES

06 AVERAGE BILLING RATE PER HOUR
a. Total billings for specified professional

$

b. Total number of hours billed

hours

c. Average price per hour (a / b)

$

07 TRANSACTION PRICE - Project/labor-based
RATE PER HOUR
a. Level of Professional:

Subtotal (sum of a):

$
$
$
$
$
$
$
$
$

# OF HOURS

PRICE
$
$
$
$
$
$
$
$
$
$

b. Additional Fees:
Fax Fees
Copying Fees
Mail Expenses
Travel Expenses
Telephone Expenses

$
$
$
$
$
$
$
$
$
$
$

Subtotal (sum of b):
c. Outside Services:

Subtotal of Outside Services (sum of c):

$
$
$
$
$

d. Commission Rate/Percentage Mark-up
e. Dollar Amount retained by Agency

%
(c x d)

f. Grand Total (sum of a + b + e)

$
$

Page 20

CHECKLIST CODE: D541810

CHECKLIST TITLE: ADVERTISING AGENCIES

DEFINITIONS
AAA – Commercials are aired in the station’s best dayparts.
AA – Some of the commercials purchased are aired on the station’s best dayparts and the remaining are aired
on the station’s second best dayparts.
Affiliate listings – Listings presented in the directory of a Web search portal that are sold by an affiliated third
party, and not directly by the portal.
Banner advertisement - A graphical Web advertising unit, typically measuring 468 pixels wide and 60 pixels
tall.
Best Times Available (BTA) – the station is given discretion to broadcast the commercials at the “best times
available”.
CPM (Cost-Per-Thousand) - The advertising cost to reach 1000 households or viewers. For example, if the
cost of the commercial time is $50,000 and the audience delivery is 4,606,000, then the CPM equals $10.86.
The formula:

CPM =

Media cost
Audience delivery

x 1000

CPP (Cost-Per-Point) - The advertising cost to reach one rating point of the target audience. For example, if
the cost of the commercial time is $50,000 and the number of rating points delivered is 10, then the CPP
equals $5,000.00. The formula:

CPP =

Media cost
Ratings delivery

Daypart - A specific segment of a broadcast schedule, e.g., morning, daytime, early fringe, primetime, late
night.
Directory Listings – Listings provided by a Web search portal which have been reviewed by human editors,
and for which a short written description is prepared and presented on the site.
DMA (Designated Market Area) – Represents an exclusive geographic area of counties in which the home
market stations are estimated to have the largest quarter hour share (as defined by Nielsen).
Floating advertisement – An advertisement that appears when a user goes to a Web page, and then "floats"
or "flies" over the page for anywhere from 5 to 30 seconds.
Guaranteed placement – Placement of an advertisement at a specified location in the newspaper. This
positioning is requested by the advertiser and agreed to by the newspaper. Guaranteed placement usually
costs more than run-of-paper placements.
Impressions – The number of times that an Internet advertisement appears on the screen of an Internet user.
Index listings – Listings provided by search engines for which no human editorial review has been provided.
These listings are not presented with a written description.

Page 21

CHECKLIST CODE: D541810

CHECKLIST TITLE: ADVERTISING AGENCIES

Interstitial advertisement – An advertisement that loads between two content pages. This typically takes the
form of a full-page advertisement that appears when a user clicks on a specific content link, forcing exposure
to the advertisement before the user can view the content that has been requested.
Pop-up advertisement - An advertisement that "pops up" in its own window when a user goes to a Web page,
obscuring the content that the user was attempting to view.
Pop-under advertisement – An advertisement that appears in its own window when a user goes to a Web
page. As opposed to a pop-up advertisement, this advertisement window appears under the content the user
is attempting to view and does not obscure it.
Pre-emption - A station will bump one advertiser's commercial if another is willing to pay more for that
position.
Purchase lead time – The amount of time between the purchase date of media space and the time at which
the advertising is actually run.
Run of Station (ROS) – The station is given discretion to broadcast the commercials at the “best times
available”.
Run of Paper (ROP) - Positioning of an ad at the discretion of the newspaper layout editor rather than in a
location requested by the advertiser.
Superstitial advertisement – An interstitial advertisement that uses animation technology to create a videolike commercial.
Surround session advertisement – An advertising sequence in which a Web page visitor receives ads from
one advertiser throughout an entire site visit.
Text advertisement – A Web advertisement that uses text-based hyperlinks.
Total Audience Plan (TAP) – Commercials are aired during different times of the day in an attempt to capture
the full spectrum of listeners. The TAP usually sells for less per commercial because the station can fill some
of its less desirable time slots.
Vertical banner advertisement - A graphical Web advertising unit that is taller than it is wide. These ads
typically measure 120 pixels wide and 240 pixels tall.

Page 22

CHECKLIST CODE: D541810

CHECKLIST TITLE: ADVERTISING AGENCIES

TRANSACTION INFORMATION
ITEM PRICE

MARKET/INTRA-COMPANY TRANSACTION

__________________________________________________

Market sale
Intra-company transfer
Same price to both

TYPE OF PRICE

Average commission
Average price
Retainer fee
Actual transaction price
Estimated transaction price
List

DOMESTIC/FOREIGN BUYER
Domestic buyer
Foreign buyer
Same price to both

TYPE OF BUYER

Other ______________________________________

Agricultural user
Mining
Construction
Manufacturing
Transportation
Communications
Public utility
Wholesale organization
Retail organization
Service provider
Government
Household
Exporter
Same price to all buyers

NOTE: For average prices, enter basis of average in
Comments.

UNIT OF MEASURE
Ad placement
Ad creation
Hour
Employee
Project
Month
Quarter

Other _______________________________________

Other ______________________________________
Type of Buyer Code _____________

BLS CONTRACT:

YES

NO

CONTRACT TERMS

Contract
No contract
Purchase order
Other ______________________________________

REPRICING CYCLE
Jan
Feb
Mar
Apr
May
Jun

M
M
M
M
M
M

O
O
O
O
O
O

S
S
S
S
S
S

Jul
Aug
Sep
Oct
Nov
Dec

M
M
M
M
M
M

O
O
O
O
O
O

S
S
S
S
S
S

COMMENTS
____________________________________________
____________________________________________
____________________________________________
____________________________________________
____________________________________________

Page 23

CHECKLIST CODE: D541810

CHECKLIST TITLE: ADVERTISING AGENCIES

ADJUSTMENTS TO PRICE WORKSHEET
CASH DISCOUNT

TRADE DISCOUNT

_____________________________________________
Complete cash discount structure
_____________________________________________

_____________________________________________
Amount
_______________________________________
Offered to

CASH SURCHARGE

_____________________________________________

Respondent name for discount

Respondent name for discount

Respondent name for surcharge
_____________________________________________
Complete cash surcharge structure
_____________________________________________

COMPETITIVE DISCOUNT
Not currently in effect
Respondent name for discount

_____________________________________________
Standard discount
Amount
______________________________________
Price reductions vary with market conditions
Average amount
______________________________
Reported price reflects market condition reductions

SEASONAL DISCOUNT

Respondent name for discount

QUANTITY DISCOUNT

Respondent name for discount
_____________________________________________
Amount
_______________________________________
Required size
_____________________________________________
Discount on shipments
Discount on orders
Discount on both shipments and orders

OTHER DISCOUNT
Type of discount

_____________________________________________
Amount
_______________________________________
Terms
_____________________________________________

_____________________________________________
Discount on shipments
Discount on orders
Complete seasonal discount structure

OTHER DISCOUNT
Type of discount

_____________________________________________

_____________________________________________
Amount
_______________________________________
Terms

Adjustment factor, by month, where applicable

_____________________________________________

_____________________________________________

Jan
Feb
Mar
Apr
May
Jun

____________
____________
____________
____________
____________
____________

Jul
Aug
Sep
Oct
Nov
Dec

____________
____________
____________
____________
____________
____________

OTHER SURCHARGE
Type of surcharge

_____________________________________________
Amount
_______________________________________
Terms
_____________________________________________

Page 24

CHECKLIST CODE: D541810

CHECKLIST TITLE: ADVERTISING AGENCIES

ADJUSTMENTS TO PRICE
Adj Type

___ Adj None (No adjustments to price)

Adj Amount Terms

Adj
Category
D

Cash discount

Adj Rep Adj Order
Applied
Applied

Adj
Sign

Adj
Seas Flag

Y

N

* + -- %

Adj Factor

Y N

Cash surcharge

S

Y

N

* + -- %

Y N

Competitive

D

Y

N

* + -- %

Y N

Seasonal

D

Y

N

* + -- %

Y N

Trade

D

Y

N

* + -- %

Y N

Quantity

D

Y

N

* + -- %

Y N

D S

Y

N

* + -- %

Y N

D S

Y

N

* + -- %

Y N

D S

Y

N

* + -- %

Y N

D S

Y

N

* + -- %

Y N

D S

Y

N

* + -- %

Y N

REPORTER ADDRESS INFORMATION
Reporter Name _________________________________________________________

Reporter Phone _________________________________

Reporter Title __________________________________________________________

Reporter Fax ___________________________________

Reporter Company ______________________________________________________

Primary Email _____________________________________

Reporter Address Street __________________________________________________

Secondary Email ___________________________________

Reporter Address City ________________________________

Reporter Address State _______

Overlap Reporter Code ___________________

Repricing Method ____________

Page 25

Reporter Address Zip _______________


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