Equipment Rental Order - Hill AudioVisual

Bill To
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Fax
P.O. Number
Event Start Date*
Event End Date*
Ordered By
First Last
Email*
Delivery To
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Customer Name
Room
On-site Contact Name
First Last
Site Production Phone
Setup Time

: HH

MM
Meeting Start Time

: HH

MM
Meeting End Time

: HH

MM
Event End Date
Video
LCD Projector
Price: $200.00 Quantity:
DVD Player
Price: $50.00 Quantity:
DVD Recorder
Price: $75.00 Quantity:
Camcorder
Price: $100.00 Quantity:
34" Video Cart
Price: $10.00 Quantity:
54" Video Cart
Price: $20.00 Quantity:
Safe Lock Stand
Price: $10.00 Quantity:
Camcorder Tripod
Price: $30.00 Quantity:
42" Monitor
Price: $200.00 Quantity:
50" Monitor
Price: $250.00 Quantity:
65" Monitor
Price: $350.00 Quantity:
Computer
Laptop
Price: $100.00 Quantity:
Wireless Remote w/Laser Pointer
Price: $30.00 Quantity:
VGA Splitter/Amplifer
Price: $50.00 Quantity:
HD Splitter/Amplifier
Price: $50.00 Quantity:
VGA Cable
Price: $30.00 Quantity:
Switcher/Scaler
Price: $100.00 Quantity:
Audio
Portable Powered Speaker
Price: $100.00 Quantity:
2 Speaker Sound System
Price: $200.00 Quantity:
4 Speaker Sound System
Price: $300.00 Quantity:
4 Channel Mixer
Price: $20.00 Quantity:
8 Channel Mixer
Price: $40.00 Quantity:
12 Channel Mixer
Price: $60.00 Quantity:
24 Channel Mixer
Price: $100.00 Quantity:
Wired Handheld Microphone
Price: $20.00 Quantity:
Wireless Handheld Microphone
Price: $80.00 Quantity:
Wireless Lavaliere Microphone
Price: $80.00 Quantity:
CD Player
Price: $50.00 Quantity:
Wood Podium
Price: $75.00 Quantity:
Floor Microphone Stand
Price: $5.00 Quantity:
Table Microphne Stand
Price: $5.00 Quantity:
Acrylic Podium
Price: $150.00 Quantity:
Audio Recorder
Price: $50.00 Quantity:
Audio Patch Fee
Price: $25.00 Quantity:
Screens
6' Tripod Screen
Price: $20.00 Quantity:
8' Tripod Screen
Price: $30.00 Quantity:
7' 6" by 10' Fast-fold Screen
Price: $100.00 Quantity:
Dress Kit for Fast-fold Screen
Price: $75.00 Quantity:
9' x 12' Fast-fold Screen
Price: $150.00 Quantity:
Flip Chart / Dry Erase
Flip Chart Easel, Pad and Markers
Price: $25.00 Quantity:
3' x 4' Dry Erase Board
Price: $30.00 Quantity:
4' x 6' Dry Erase Board
Price: $50.00 Quantity:
Poster Easel
Price: $15.00 Quantity:
Common Items
Power Strip
Price: $5.00 Quantity:
Extension Cord
Price: $5.00 Quantity:
Power Strip & Extension Cord
Price: $10.00 Quantity:
Other
Please list other items you require
Labor
Labor - 4 Hour Minimum
Price: $50.00 Quantity:
Holiday Labor - 4 Hour Minimum
Price: $100.00 Quantity:
Delivery
Delivery Charge
Price: $25.00
Emergency Delivery (less the 24 hrs) will incur an additional fee
Estimated Total
Estimated Total
$0.00

Bill To

Delivery To

Video

Computer

Audio

Screens

Flip Chart / Dry Erase

Common Items

Other

Labor

Delivery

Estimated Total