The Tenth Annual - Healthcare Design Magazine
The Tenth Annual - Healthcare Design Magazine
The Tenth Annual - Healthcare Design Magazine
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Audio Visual Request Form<br />
ORDERING: To order audio visual equipment for your booth, fill out the necessary information and return to Southwest Audiovisual, 1734 N. 22nd Ave, Phoenix, AZ 85009.<br />
You will receive notification confirming your order within two business days. If you do not receive notification of receipt, please call our office.<br />
PRICING:<br />
PAYMENT:<br />
Orders must be received 14 days in advance of show date to insure availability.<br />
Prices are based on a "per day" usage with a 2 day maximum charge up to 5 days. Setup days with NO equipment usage will NOT be charged!<br />
<strong>The</strong>re is a $90.00 service fee which includes the delivery and pick-up of equipment. Any additional labor required must be specified in advance and will be quoted accordingly.<br />
All orders must have 100% of estimated charges plus sales tax remitted with order. We accept checks, Visa, Mastercard, or American Express for payment.<br />
CANCELLATIONS:<br />
Cancellation of equipment ordered must be received 48 hours prior to delivery date to avoid charges. If services have already been provided at the time of<br />
cancellation, 50% of original charges will be applied with a minimum charge of one full day.<br />
Name Phone Show Name<br />
CO Fax Show Site<br />
<strong>Healthcare</strong> <strong>Design</strong> Conference,<br />
<strong>The</strong> <strong>Tenth</strong> <strong>Annual</strong><br />
Phoenix Convention Center North<br />
Building Halls A-E<br />
Address<br />
Show Dates<br />
November 3-6, 2012<br />
City State Zip On Site Contact<br />
Email Booth # Contact's Cell #<br />
VIDEO MONITORS ( IF MOUNTING, PLEASE CALL WITH SPECS FOR PRICING! )<br />
20" LCD (for computer use only!) $55.00<br />
32" LCD $195.00<br />
42" PLASMA ON FEET W/COBRA STAND (check one) $395.00<br />
50" PLASMA ON FEET W/COBRA STAND (check one) $495.00<br />
VIDEO PLAYERS<br />
STANDARD DVD $25.00<br />
BLU-RAY DVD $95.00<br />
DATA PROJECTORS<br />
1000 LUMENS $125.00<br />
2300 LUMENS $250.00<br />
SCREENS & ACCESSORIES<br />
6 FT. TRIPOD W/SKIRT $25.00<br />
8 FT. TRIPOD W/SKIRT $35.00<br />
CART W/SKIRT 34" 44" 54" (check one) $30.00<br />
AUDIO<br />
P.A. SYSTEM (1 SPEAKER) W/WIRED MIC. Lavalier Hand Held (check one) $55.00<br />
P.A. SYSTEM (2 SPEAKER) W/WIRED MIC. Lavalier Hand Held (check one) $95.00<br />
WIRELESS MIC. (USE W/SYSTEMS ABOVE) Lavalier Hand Held (check one) $95.00<br />
CD PLAYER (USE W/SYSTEMS ABOVE) $25.00<br />
Price Quantity Total Cost<br />
PLEASE NOTE: This form is only a partial list of equipment featuring commonly requested items. We stock a full<br />
line of audio and video equipment. For items not found above, please inquire about availability and prices.<br />
Sub Total $<br />
Visa MasterCard American Express # Show Days (2 Day Max) x<br />
Credit Card Number<br />
Card Address (if different then above)<br />
Card Code<br />
Equipment Total =$<br />
9.3% Sales Tax +$<br />
Delivery/PU + $90.00<br />
Additional Labor +$<br />
X TOTAL AMOUNT DUE $<br />
Signature<br />
By purchasing services from Southwest Audio Visual, Inc., customer agrees to all<br />
Terms and Conditions of Service Agreement. (See reverse side)<br />
Expiration<br />
www.swav.net - Office (602) 258-4911 - Toll-Free (800) 266-SWAV - Fax (602) 254-4226<br />
1734 N. 22nd Avenue Phoenix, AZ 85009 BREDE 0109