EXHIBITOR REQUEST FORM
Fax or Email to:
Carol Franzone
Grand Hyatt Tampa Bay
2900 Bayport Drive
Tampa, Fl 33607
Phone: 813.207.6626
Fax: 813.207.6627
cfranzone@avt.com
Section A
Group/Organization:
On Site Contact:
Requested By:
Client Information
Address:
Phone:
Fax:
Email:
Web Site:
Section B
Service Request
Function Space:
ROOM 1
ROOM 2
ROOM 3
ROOM 4
ROOM 5
Start Time:
Start Date:
End Time:
End Date:
High Speed Lines
Section C
Service Type
Services Price
Cost Per Day
Quantity
Day(s)
Total
T1 High Speed Internet Access
$350.00
x
x
=
First computer
IP Address (Cost per IP)
Each additional computer connections
$50.00
x
x
=
Powered 12” speaker on stand
$90.00
x
x
=
42” Plasma Monitor
$525.00
x
x
=
DVD/VCR
$80.00
x
x
=
19” Flatscreen LCD Monitor
$100.00
x
x
=
PC Speakers
$50.00
x
x
=
Flipchart or White Board
$50.00
x
x
=
Skirted 54” cart
Laptop Rental/Windows ’07 $250.00
*Call for additional items
$25.00
$250.00
x
x
x
x
=
Note:
Custom instillations or dedicated internet service beyond the scope of existing
facilities will be individually quoted upon request.
Subtotal:
22% Service Charge:
7% Fl Sales Tax:
Grand Total:
Rev. 7/02
$
$ Waived per
cf
$
$
EXHIBITOR REQUEST FORM
Fax or Email to:
Carol Franzone
Grand Hyatt Tampa Bay
2900 Bayport Drive
Tampa, Fl 33607
Phone: 813.207.6626
Fax: 813.207.6627
cfranzone@avt.com
Section D
1 - Master Account #:
2 - Room #:
3 - Credit Card #:
Method of Payment (CHOOSE ONE)
Authorized Signer’s Name:
Name on Reservation:
x_________________________________
Customer Signature
Confirmation #:
Type:
Exp:
x_________________________________
Print Name (as it appears on credit card)
Section E
____________________
Date
Terms and Conditions
Internet Agreement
It is understood that AVT does not own or control the telecommunications facilities used to access the Internet and that the Internet is a
non-regulated public domain.
The total order cost will be billed to the form of payment specified in section D.
Cancellation charges will be incurred at 100% for cancellations within 24 hours of your event.
You are responsible for bringing your own NIC (Network Interface Card).
All materials and equipment furnished by AVT for this service order shall remain the property of AVT and shall be removed only by AVT
at the close of the meeting.
All request for services after your arrival are subject to the availability of the equipment and the services of our technicians.
Emergency service is an additional 40% of the listed prices on section C.
Under no circumstances shall anyone attempt to gain unauthorized access to or tamper with any part of the network.
You agree to remain entirely liable for all activities conducted through the network connections.
The Network may only be used for lawful purposes and in accordance with these terms and conditions. Transition of any materials in
violation of any local, state, federal, or international regulation(s) is prohibited. This includes but not limited to, copyrighted materials
legally judged to be threatening or obscene, or material protected by trade secrets.
These terms and conditions supersede all previous representations, understanding, or agreements and shall prevail notwithstanding any
variance with terms and conditions of any order submitted. These terms and conditions may be modified by AVT at any time.
No service will be provided without a signed copy of this form. This form must be received no later than one (1) week prior to the
meeting.
You or your IT professional will be responsible for appropriate computer configuration for the service provided. AVT personnel
can not be responsible for making configuration changes to your personal computer.
If you are uncertain of your requirements or for any changes you must notify Carol Franzone, Director of Audiovisual Services.
MY SIGNATURE INDICATES THAT I HAVE RECEIVED THIS EXHIBITOR REQUEST FORM AND SERVES AS
AGREEMENT OF MY ORDER AND ITS TERMS AND CONDITIONS.
__________________________________________________________
Customer Signature
__________________________
Date
__________________________________________________________
Title
__________________________________________________________
Carol Franzone
Manager of Event Production
Rev. 7/02
__________________________
Date