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We decided the way forward was to lose the old business model of a large upfront "creation design and setup" fee and then charging separately for hosting, email services and each and every update and content change, and move to a "website as a service" model.
We rolled all the various fees and charges, including the "creation design and setup" fee, in to one flat rate annual fee which is calculated based on how many hours we anticipate we will work on your website, but averaged over several years.
It cuts out the worry we have heard people tell me of, that they don't know from edit to edit, how much their website designer might charge. We also find that as we pro-actively contact clients about their website, they often mention news or promotions that they had meant to pass to us for the website, but which had slipped their minds.