42nd Conference Audio Visual Order Form

Event Production Resources Audio Visual Equipment Rental Order Form
Show: NHSA
Venue: WALTER E. WASHINGTON CC
Phone: 800.381.9868
Fax: 401.781.9977
Equipment
Audio Equipment
Tapered Gooseneck Table or Podium Microphone
Wired Handheld Microphone
Wireless Handheld Microphone
Wireless Lavalier Microphone
Microphone Boom Stand
Laptop Ipad Audio Interface
6 plus 2 (8 Channel) Audio Mixer
Self Powered Speaker on stand
25' XLR Microphone Cable
Projectors & Screens
LCD Data/Video Projector (3000) Lumens
LCD Data/Video Projector (5000) Lumens
Tripod Screen with Skirt (Specify 6, 8, 10 Foot)
Fast Fold Projection Screen w Dress Kit
Video Equipment
DVD Player
Computer Equipment
Ipad
Notebook PC
Macbook Pro
Color Laser Printer
Black Laser Printer (20 PPM)
24" HD LCD Data/Video Display Monitor
32" HD Plasma Data/Video Display Monitor
42" HD Plasma Data/Video Display Monitor
50" HD Plasma Data/Video Display Monitor
61" HD Plasma Data/Video Display Monitor
Floor Stand for Plasma Monitor
Miscellaneous
PC Wireless Remote with laser pointer (rental)
PC Wireless Remote with laser pointer (purchase)
Flip Chart Stand with Pad & Markers
Flip Chart Pad
mac lightning adapter (rental)
mac lightning adapter (purchase)
Email form to: [email protected]
#
Date
Daily
Quantity Days Total Added
35.00
35.00
90.00
90.00
10.00
35.00
75.00
110.00
5.00
200.00
325.00
45.00
190.00
50.00
75.00
125.00
150.00
150.00
75.00
135.00
195.00
375.00
475.00
625.00
95.00
20.00
40.00
45.00
35.00
30.00
45.00
mac thunderbolt ms surface video (rental)
mac thunderbolt ms surface video (purchase)
hdmi to vga adapter rental
hdmi to vga adapter purchase
Internet access
Single User Presenter Laptop Internet Connection
Wireless Internet Router Hotspot 20 user
Labor Service Charges 15% of total order
*Does NOT include Union Fees When Applicable
30.00
45.00
30.00
45.00
75.00
200.00
Total to be Charged
Order Contact Name:
Phone / Email:
Billing Contact info:
Name card
email address:
Phone:
credit card number
exp Date;
Card Billing Address
Zip Code:
Card Holder Signature:
cv security #
On Site Contact Info:
email address:
On Site Contact
Phone:
Room Name
Set up Date
Booth #
Setup Time (no later than)
Pick up Date
Pick Up Time