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 Rate per item Total Fern, dieffenbachia, spathiphyllum ___ € 15,00 € _______ Bowl of flowered plants diameter cm. 20 ___ € 20,00 € _______ Bowl of flowered plants diameter cm. 30 ___ € 25,00 € _______ Tall green plant – height 100 cm (kentia, ficus) ___ € 20,00 € _______ Tall green plant – height 200 cm (kentia, ficus) ___ € 30,00 € _______ Total IVA 22% TOTAL € _______ € _______ € _______ The order form and payment must be sent no later than November 20th 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