N o R EA L13 NOR THSTA TE PREHOSPITAL SPRfNQ” CONFERENCE WIN-RIVER RESORT AND CASINO EVENT CENTER SATURDAY-MAY 16, 2015 — SPONSOR / VENDOR APPLICATION Company Name: Contact Representative: Address: City, State, Zip: Telephone and Fax Numbers: Email Address: Yes, I would like to be a Sponsor Vendor Meals are compilmentary for one. Additional attendees will be asked to purchase meals at $30.00 per person. Note: Our insurance carrier has requested all Sponsors/Vendors provide Nor-Cal EMS with a Certificate ofInsurance. Please include Nor-Cal EMS as an “additional insured” on your copy. • Name• Name: Add’l) ATTENDANCE: Our 2014 SPRING and FALL events were attended by over 200 committed and dedicated First Responders, EMTs, Paramedics and Nurses (paid and volunteer). • PREVIOUS SPEAKERS: Doctors, Nurses, CHP Officers, EMS Instructors, Paramedics, Flight Nurses, Disaster and Terrorism Training Instructors and SWAT Team Doctors. • PREVIOUS SUPPORTERS: American Medical Response Enloe Medical Center Medtronic Mercy Medical Center Nor-Cal EMS PHI Air Medical Shasta Regional Medical Center St. Elizabeth Community Hospital Life Assist Bound Tree Medical Progressive Medical Int’l American Heart Association Cardiac Science Corporation Disaster Management Systems Enerspect Medical Solutions Enloe FlightCare Butte Community College Emergency Nurses Association Phillips Healthcare Physio Control Life Assist Medical Reserve Corps Minto Research and Development Pacific Bio Medical REACH Air Medical Services Stryker EMS Equipment Zoll Medical Institute of Technology National College of Technical Instruction ReddiNet DataTechOll Braun Northwest - - - - - - - - - - - - - - — - — - - - - - - - - - — - - - SPONSOR LEVEL: • • • • $1100 Sponsor fee ($100 will be used to purchase a gift certificate in the Sponsor’s name for our Raffle) Corporate logo advertised on the Nor-Cal EMS website (Sponsor Level Only) Corporate logo recognition on registration material and conference handouts Two six-foot tables for display material VENDOR LEVEL: • • • $550 Vendor Fee ($50 will be used to purchase a gift certificate in the Vendor’s name for our Raffle) Corporate logo recognition on registration material and conference handouts One six-foot table for display material PLEASE COMPLETEAND RETURN VIA FAX To: KATHY VANDONGEATNOR-CAL EMS 1890 PARK MA NINA DRIVE, SuITE 200, REDDING, CA 96001 530.229.3979 (OFFIcE) 530.229.3984 (FAx) NOR-CALE3 NOR THSTA TE PREHOSPITAL SPR/iVQ” CONFERENCE SPONSOR EVENTAPPLICA TION WIN-RIVER RESORT AND CASINO EVENT CENTER SATURDAY MAY 16, 2015 - Nor-Cal EMS, mc, henceforth known as “Company,” and henceforth known as “Sponsor”, enter into this agreement freely and willingly on the 2015. day of The covenants of this agreement are as follows: The Event Sponsor agrees to provide sponsorship (details below) for the Northstate Prehospital “Spring” Conference, henceforth known as “Event.” The Sponsorship Sponsor agrees to provide Company with $1,100.00 for Event. Credit In exchange for this sponsorship, Company agrees to provide Sponsor with free advertising on the Nor-Cal EMS website until the date of the conference (May 16, 2015). A gift card of $100.00 will be purchased from a local vendor as a give-away and Sponsor’s name will be recognized for the gift card. Sponsor’s corporate logo recognition on registration material and conference handouts and two six-foot tables for display material. Meals Complimentary meals are provided for one (1) attendee at Sponsor booth. Sponsor agrees that for each additional attendee at Sponsor’s booth, Sponsor will purchase the meals at $30.00 for each attendee. Certificate of Insurance Sponsor agrees to provide a copy of their Certificate of Insurance to Nor-Cal EMS 30-days prior to event. Note: Please include Nor-Cal EMS as an “additional insured” on your copy. Relationship This agreement represents the only relationship between Company and Sponsor. No other relationship between the two entities exists, implied or otherwise. Nor-Cal EMS Authorized Signature Sponsor Signature Company Representative Name Company Representative Name Date Date 1 NORTHSTATE PREHOSPITAL ‘SPR/M6’CONFERENCE WANT FREE ADVERTISING? ==-:= / IT’S EASY.. ..JOIN US AS A SPONSOR FOR THE NORTHSTATE PREHOSPITAL”SpR1H’ CONFERENCE WHEN: SATURDAY, MAY i6, 2015 WHERE: WIN-RIVER RESORTAND CASINO EVENT CENTER COMPLETE AND RETURN THE APPLICATION (ATFACHED) TODAY AND YOUR CORPORATE LOGO WILL “ROTATE” ON THE FRONT PAGE OF THE NOR-CAL EMS WEBSITE AT WWW.NORCALEMS.ORG UNTIL THE DAY OF THE CONFERENCE (MAY i6, 2015) IT’STHAT EASY....SO HURRY.....SEND IN YOUR APPLICATION SOON TO MAXIMIZE THIS FREE OFFER! SPONSORS ONlY
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