MEDIA SERVICES EQUIPMENT RENTAL AND SERVICE AGREEMENT
Department Contact Information (If your group is a Student Union group, please type in STUDENT UNION- and then your group name in the Department field)
Department:
Department designated Rental Coordinator's name:
Department designated Rental Coordinator's address
Department designated Rental Coordinator's phone
Department designated Rental Coordinator's email
Department designated Rental Coordinator's Student ID
Item
Quantity
Cost
Large projection screen (9x12) with masking and A/V Kit (NOTE:must hire tech set-up and tear-down if event is outside the DUC): $500
$500 x
0
1
2
3
4
5
$
Portable Stage (NOTE:For use in the DUC only): $200
$200 x
0
1
2
3
4
5
$
Small LCD projector (Dell or Epson): $50
$50 x
0
1
2
3
4
5
$
Portable projection screen: $15
$15 x
0
1
2
3
4
5
$
Self contained P.A. system: $30
$30 x
0
1
2
3
4
5
$
Fender P.A. system with Cart: $50
$50 x
0
1
2
3
4
5
$
Behringer 8 channel audio mixer: $20
$20 x
0
1
2
3
4
5
$
Wired hand-held microphone: $20
$20 x
0
1
2
3
4
5
$
Wireless hand-held microphone: $30
$30 x
0
1
2
3
4
5
$
Wireless clip-on lavalier microphone: $40
$40 x
0
1
2
3
4
5
$
Laser Pointer/Wireless Mouse: $15
$15 x
0
1
2
3
4
5
$
Powered Computer Speakers: $10
$10 x
0
1
2
3
4
5
$
30" TV/VCR combo: $30
$30 x
0
1
2
3
4
5
$
20" TV/VCR/DVD combo: $30
$30 x
0
1
2
3
4
5
$
Portable DVD Player: $15
$15 x
0
1
2
3
4
5
$
Pro model Canon GL2 digital video camera: $50
$50 x
0
1
2
3
4
5
$
Consumer model Canon ZR45MC digital video camera: $30
$30 x
0
1
2
3
4
5
$
Canon G-2 digital still camera: $20
$20 x
0
1
2
3
4
5
$
Dell laptop computer with Microsoft Office software bundle: $50
$50 x
0
1
2
3
4
5
$
Rental Packages
Projection package:
includes rental of the small LCD projector, portable screen, and the Dell laptop computer: $100
$100 x
0
1
$
Audio package:
includes rental of the Fender Public Address system and two (2) microphones: $70
$70 x
0
1
$
Movie package:
Includes DVD player, LCD projector, Fender PA system, portable projection screen: $100
$100 x
0
1
$
Estimated Total
Your estimated total is:
$
Rental Date
Please enter the date you would like to rent the above equipment:
/
/
(mm/dd/yyyy)
Please enter the time of the event:
Event location:
Method of payment:
Select...
Cash
Check
IDO
Department billing number: