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PLASMAS – FLAT PANELS COMPUTER EQUIPMENT ORDER FORM Order Deadline Date: January 28, 2012 Company Name: Event Name: 2012 NCBA Trade Show Address: Location:Nashville, TN Booth No: Ordered by: Onsite Contact: Phone: Delivery Date & Time: E-Mail: Pickup Date & Time: ITEM/SPECS EVENT PRICE QUANTITY TOTAL $149.00 _______________ _____________ $199.00 $279.00 ________________ ________________ _____________ _____________ DESKTOPS (Includes 17” Monitor & WIN XP PRO) Pentium 4, 1GB RAM, 40GB HD, CD-ROM LAPTOPS (Includes WIN XP PRO) Pentium 4, Core Duo 1.66, 512 RAM, 80GB HD MACBook Pro, 2.2 Core Duo, 2GB RAM, 160GB HD DISPLAY MONITORS & PLASMAS (Connection Type: VGA, HDMI, RGB, Composite, Component) 50” HD Plasma (table stand or wall mount) 42” HD LCD Monitor (table stand or wall mount) 32” HD LCD Monitor (table stand or wall mount) 24” HD LCD Monitor 20” LCD Monitor 17” LCD Monitor 6’ Dual Post Floor Stand $649.00 $549.00 $349.00 $225.00 $175.00 $ 99.00 $49.00 ________________ ________________ ________________ _________________ ________________ ________________ ________________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ $159.00 $325/$.25 pp $ 85.00 ________________ ________________ ________________ ______________ ______________ ______________ $ $ $ $ $ ________________ ________________ ________________ ________________ ________________ ______________ ______________ ______________ ______________ ______________ PRINTERS/FAX MACHINES LaserJet Printer, HP 4200 Series Color LaserJet Printer LaserJet Fax Machine MISCELLANEOUS Software - MS Office XP or 2007 Speaker Set with Sub-Woofer DVD Player AV Cart with Black Skirt Plasma Shelf for dual post stands 25.00 25.00 59.00 49.00 30.00 *All prices cover the duration of your event. If you need an item not listed here, please call us and we will do our best to locate it for you Payment Information  Company Check Visa MC AMX Discover Sub Total 10% Discount by 1-20-12 Sales Tax 9.25% Total Due $ __________ $ __________ $ __________ $ __________ Card No._____________________________________ Exp.___________ Cardholder’s Name (Print)______________________________________ Signature____________________________________________________ Terms & Conditions Exhibitor is responsible for any/all loss or damage to equipment. Exhibitor must be present at time of delivery. All payments must be made in advance in US Funds. A 50% fee will apply for orders cancelled less than 72 hours prior to delivery. Cancellations after services render will be charged at 100%. 7035 South Fulton Street Centennial, Colorado 80112 Toll Free: 866-522-7000 Tel: 303-768-8555 Fax: 303-768-8118 orders@ccrent.com