Exhibitor Equipment Order Form
Exhibitor Equipment Order Form
Exhibitor Equipment Order Form
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COMPUTER & DISPLAY RENTAL ORDER FORM<br />
*** NOTE: ALL PRICING IS PER DAY FOR ENTIRE LENGTH OF SHOW ***<br />
QTY EQUIPMENT<br />
DAILY RATE TOTAL<br />
FLAT PANEL DISPLAYS<br />
50" Flat Panel Display (16:9) with Dual Post Stand<br />
42" Flat Panel Display (16:9) with Dual Post Stand<br />
37" Flat Panel Display (16:9) with Tabletop Stand<br />
20" Flat Panel Display (16:9) with Tabletop Stand & Built-In DVD Player<br />
19" Flat Panel Display (4:3) with Tabletop Stand<br />
$645<br />
$495<br />
$425<br />
$350<br />
$300<br />
QTY EQUIPMENT<br />
DAILY RATE TOTAL<br />
COMPUTERS<br />
Desktop Computer, 19" Flat Panel Display, Win XP, MS Office 2003<br />
Laptop Computer, Win XP, MS Office 2003<br />
$450<br />
$375<br />
QTY EQUIPMENT<br />
DAILY RATE TOTAL<br />
PRINTERS & FAX MACHINES<br />
HP B/W LaserJet Printer<br />
HP Color LaserJet Printer<br />
Fax Machine<br />
$275<br />
$425<br />
$150<br />
QTY EQUIPMENT<br />
DAILY RATE TOTAL<br />
PRESENTATION EQUIPMENT<br />
DVD Player<br />
VHS Player<br />
8" TV/VHS Combo Player<br />
2000 Lumen LCD Projection Unit<br />
3000 Lumen LCD Projection Unit<br />
6' Tripod Screen with Skirt<br />
8' Tripod Screen with Skirt<br />
$150<br />
$150<br />
$185<br />
$395<br />
$450<br />
$50<br />
$70<br />
UHF Wireless Lavaliere Microphone<br />
UHF Wireless Handheld Microphone<br />
UHF Wireless Headset Microphone<br />
Wired Handheld Microphone<br />
4 Channel Audio Mixer Unit<br />
10" JBL Powered Speaker with Stand<br />
15" JBL Powered Speaker with Stand<br />
$150<br />
$150<br />
$200<br />
$100<br />
$100<br />
$150<br />
$200<br />
PAYMENT: The JW Marriott Las Vegas Audio Visual Department requires payment in full at<br />
the time your order is placed. Payment includes but is not limited to <strong>Equipment</strong> Rental,<br />
Service Fees and Nevada State Tax.<br />
SUBTOTAL<br />
CREDIT CARD: For your convenience, we will use this authorization to charge your credit<br />
card for your advance orders and any additional fees incurred as a result of on-site orders by<br />
your representatives. These fees include any services provided by the JW Marriott Las<br />
Vegas Audio Visual Department or charges we incur on your behalf.<br />
20%<br />
SERVICE<br />
FEE<br />
CANCELLATIONS: Written cancellation of ordered equipment and services must be<br />
received 24 hours prior to delivery. Failure to do so will result in a 100% charge to your<br />
account.<br />
RESPONSIBILITY: Customer is responsible for all loss and damage to equipment. All orders<br />
are subject to the JW Marriott Las Vegas Audio Visual Department standard terms and<br />
conditions.<br />
8.1%<br />
NEVADA<br />
STATE<br />
TAX<br />
INVOICE<br />
TOTAL<br />
RETURN TO: ASGE Conference Manager, Michelle Thomas, via fax at 630-963-8332 or email mthomas@asge.org<br />
by July 12, 2013
Company Name<br />
Billing Address<br />
City<br />
State<br />
Email Address<br />
Credit Card Number<br />
Expiration Date<br />
Phone Number<br />
Fax Number<br />
Print Name<br />
Authorized Signature<br />
PAYMENT INFORMATION<br />
Zip Code<br />
CVV2 Code<br />
Strike Date9/21/13<br />
EXHIBITION INFORMATION<br />
Trade Show Name: EndoFest<br />
Room for Trade Show: Valencia Ballroom<br />
Booth # / Location:<br />
Booth Contact<br />
Booth Contact Cell Number<br />
Set-Up Date: 9/19/13<br />
Set-Up Time 11AM - 7:00PM<br />
Strike Time 6:15PM<br />
/Valencia Ballroom<br />
CREDIT CARD TYPE<br />
** A COPY OF THE FRONT AND BACK OF CARD MUST<br />
ACCOMPANY THIS ORDER **<br />
ORDER COMMENTS / SPECIAL INSTRUCTIONS
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