Equipment Rental Order Bill ToName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*FaxP.O. Number Event Start Date* MM slash DD slash YYYY Event End Date* MM slash DD slash YYYY Ordered By First Last Email* Delivery ToAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Customer Name Room On-site Contact Name First Last Site Production PhoneSetup Time : Hours Minutes AM PM AM/PM Meeting Start Time : Hours Minutes AM PM AM/PM Meeting End Time : Hours Minutes AM PM AM/PM Event End Date MM slash DD slash YYYY VideoLCD Projector HD Quantity Price: $200.00 Quantity DVD Player Quantity Price: $50.00 Quantity DVD Recorder Quantity Price: $75.00 Quantity Camcorder Quantity Price: $100.00 Quantity 34" Video Cart Quantity Price: $10.00 Quantity 54" Video Cart Quantity Price: $20.00 Quantity Safe Lock Stand Quantity Price: $10.00 Quantity Camcorder Tripod Quantity Price: $30.00 Quantity 42" Monitor Quantity Price: $200.00 Quantity 50" Monitor Quantity Price: $250.00 Quantity 65" Monitor Quantity Price: $350.00 Quantity ComputerLaptop Quantity Price: $100.00 Quantity Wireless Remote w/Laser Pointer Quantity Price: $30.00 Quantity VGA Splitter/Amplifer Quantity Price: $50.00 Quantity HD Splitter/Amplifier Quantity Price: $50.00 Quantity VGA Cable Quantity Price: $30.00 Quantity Switcher/Scaler Quantity Price: $100.00 Quantity AudioPortable Powered Speaker Quantity Price: $100.00 Quantity 2 Speaker Sound System Quantity Price: $200.00 Quantity 4 Speaker Sound System Quantity Price: $300.00 Quantity 4 Channel Mixer Quantity Price: $20.00 Quantity 8 Channel Mixer Quantity Price: $40.00 Quantity 12 Channel Mixer Quantity Price: $60.00 Quantity 24 Channel Mixer Quantity Price: $100.00 Quantity Wired Handheld Microphone Quantity Price: $20.00 Quantity Wireless Handheld Microphone Quantity Price: $80.00 Quantity Wireless Lavaliere Microphone Quantity Price: $80.00 Quantity CD Player Quantity Price: $50.00 Quantity Wood Podium Quantity Price: $75.00 Quantity Floor Microphone Stand Quantity Price: $5.00 Quantity Table Microphne Stand Quantity Price: $5.00 Quantity Acrylic Podium Quantity Price: $150.00 Quantity Audio Recorder Quantity Price: $50.00 Quantity Audio Patch Fee Quantity Price: $25.00 Quantity Screens6' Tripod Screen Quantity Price: $20.00 Quantity 8' Tripod Screen Quantity Price: $30.00 Quantity 7' 6" by 10' Fast-fold Screen Quantity Price: $100.00 Quantity Dress Kit for Fast-fold Screen Quantity Price: $75.00 Quantity 9' x 12' Fast-fold Screen Quantity Price: $150.00 Quantity Flip Chart / Dry EraseFlip Chart Easel, Pad and Markers Quantity Price: $25.00 Quantity 3' x 4' Dry Erase Board Quantity Price: $30.00 Quantity 4' x 6' Dry Erase Board Quantity Price: $50.00 Quantity Poster Easel Quantity Price: $15.00 Quantity Common ItemsPower Strip Quantity Price: $5.00 Quantity Extension Cord Quantity Price: $5.00 Quantity Power Strip & Extension Cord Quantity Price: $10.00 Quantity OtherPlease list other items you requireLaborLabor - 4 Hour Minimum Quantity Price: $50.00 Quantity Holiday Labor - 4 Hour Minimum Quantity Price: $100.00 Quantity DeliveryDelivery Charge Price: Emergency Delivery (less the 24 hrs) will incur an additional feeEstimated TotalEstimated Total $0.00
