CPExpo 2014 - Genova Porto Antico Conference Center December 9-11 2014 Applicant Company name: Address: Postal code: Country: VAT number: Tel: Email: Booth N.: City: Contact person: Fiscal code: Fax: Booth location: The undersigned company requests the following services and agrees to the terms and conditions herein specified. Description Qnty ___ ___ ___ ___ ___ ___ ___ ___ ___ Laptop Monitor LCD 19" (PC) Monitor LCD 30" (Video/PC) Monitor plasma 42" Monitor plasma 50” Plasma stand with wheels Video projector LCD XGA 2500 ansi l. Self-standing screen 180x180 Professional DVD PLAYER Rate per item € 100,00 € 80,00 € 120,00 € 200,00 € 350,00 € 35,00 € 200,00 € 35,00 € 85,00 Days x ___ x ___ x ___ x ___ x ___ x ___ x ___ x ___ x ___ Total cost VAT 22% TOTAL DUE The order form and payment must be sent no later than November 20 th 2014, to: [email protected]; [email protected]; fax +39 010 2758929 Order cancellation within 3 days prior to the event will entail full payment. Payment Bank transfer: Porto Antico di Genova S.p.A. Banca BNL S.p.A. Agenzia 5 – Via San Luca – Genova IBAN: IT53Y0100501405000000008773 SWIFT BIC: BNLIITRR Date Stamp & Signature Please return to PORTO ANTICO DI GENOVA SPA Calata Molo Vecchio, 15 – Magazzini del Cotone Modulo 5 – 16128 Genova Ref. Joanne Modica [email protected] Ref. Cecilia Pastorino [email protected] ph. + 39 010 2485620 fax + 39 010 2758929 Total cost € _______ € _______ € _______ € _______ € _______ € _______ € _______ € _______ € _______ € _______ € _______ € _______