PEORIA CIVIC CENTER
Name of Event
Booth / Meeting Room #
Firm Name
Phone
Address
Fax
City
State
Zip
Authorized By
Date
Title
EQUIPMENT AVAILABLE
Advance Fee*/ Day
Floor Order Fee** / Day
Qty.
# of days
Total
1. Slide projector w/zoom lens, tray, remote control, spare lamp
$ 50.00
$ 65.00
2. Flip Chart (includes pad of paper and markers)
$ 20.00
$ 35.00
3. A/V Cart (2 or 3 tier)
$ 17.50
$ 32.50
4. Overhead projector w/spare lamp
$ 50.00
$ 65.00
5. Screen - tripod 5' x 6'
$ 25.00
$ 40.00
6. Screen - tripod 8' x8'
$ 50.00
$ 65.00
7. 7.5' x 10' fastfold screen (front or rear fabric)
$ 75.00
$ 90.00
8. 10.5' x 14' fastfold screen (front projection)
$ 110.00
$ 120.00
9. 16' x 21' fastfold screen (front or rear projection)
$ 200.00
$ 225.00
10. Wired microphone
$ 15.00
$ 25.00
11. Wireless microphone (lav. or hand held)
$ 75.00
$ 90.00
12. JBL Eon 12" Powered Speaker
$ 75.00
$ 90.00
13. Video Cassette Recorder-VHS Player
$ 55.00
$ 70.00
14. 27" video monitor & DVD combo
$ 75.00
$ 90.00
15. Video cassette recorder / DVD player
$55.00
$70.00
16. Cassette Deck
$ 45.00
$ 60.00
17. CD Player
$ 55.00
$ 70.00
18. Easels
$ 8.00
$ 13.00
19. Easels (with white board surface and markers)
$ 20.00
$ 35.00
20. Projector-Sanyo Multiverse LCD Projector w/3200 ANSI Lumens
$ 150.00
$ 165.00
21. Projector-Panasonic DLP Projector w/5500 Lumens
$ 450.00
$ 485.00
* Up to fourteen (14) days before event
** Within thirteen (13) days before event or on the day of the event
Grand Total
Remit payment to:
Peoria Civic Center - Accounting Dept., 201 SW Jefferson, Peoria, IL 61602
Phone (309) 673-8900 Fax (309) 680-3585
METHODS OF PAYMENT CHECK / MONEY ORDER / CREDIT CARD (check one)
MasterCard
AmericanExpress
Discover
Visa
Credit Card Number
Expiration Date
Name as it appears on card
Due to a requirement by federal law, the exact name of the credit card holder and the address in which the bill for the credit card arrives at need to be used. If the information at the top of the form does not correspond with these requirements, please fill out the following:
Address Bill Arrives At:
City, ST, ZIP:
DELIVERY/PICK UP CHARGE IS $10.00 IF APPLICABLE
* OTHER EQUIPMENT IS AVAILABLE UPON REQUEST
The parties agree that the implied warranties of merchantahility and fitness for particular purpose and all other warranties express or implied, are excluded from this agreement. Peoria Civic Center Authority does not assume any liability for damages of any type whatsoever or loss of anticipatory profits resulting from the use of equipment or services or delivery or installation, or damage of any sort whatsoever to user's goods or equipment arising from any cause whatsoever. For additional copies please contact the Peoria Civic Center or refer to our web site at www.PeoriaCivicCenter.com
*ALL PRICES SUBJECT TO CHANGE WITHOUT NOTICE
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