Group Technology Service Order Form

GROUP TECHNOLOGY SERVICES

ORDER FORM

NAME OF CONVENTION OR GROUP: ______

ROOM LOCATION: ______

EXHIBITOR: ______BOOTH: ______

ADDRESS: ______

CITY: ______STATE: ______ZIP: ______

TELEPHONE: ______FAX: ______

EMAIL: ______

INSTALLATION DATE/TIME: ______STRIKE DATE/TIME: ______

GROUP ON-SITE CONTACT: ______

(TO BE USED FOR “POP-UP” ORDERS AS WELL)

PHONE EXTENSION: ______

WORKED PERFORMED: ______

*THISE FORM MUST BE RECEIVED BY THE RESORT 30 DAYS PRIOR TO ARRIVAL DATE OF CONFERENCE. ORDERS NOT RECEIVED PRIOR TO THIS DATE OR RECEIVED WITHOUT PAYMENT ARE SUBJECT TO AN ADDITIONAL $50 “SAME DAY SET-UP” FEE.

**PLEASE NOTE: NO EXTERNAL/PROPRIETARY EQUIPMENT ALLOWED IN THE MEETING SPACE OR ATTACHED TO THE NETWORK WITHOUT GROUP TECHNOLOGY MANAGEMENT’S PRIOR APPROVAL!

ANY QUESTIONS OR FOR CUSTOMS QUOTES/PACKAGES, PLEASE CALL GROUP TECHNOLOGY SERVICES DEPARTMENT/JON CARRES AT (561) 447-3433, OR FAX TO (561) 447-5970.

Boca Raton Resort, A Waldorf Astoria Resort

Credit Card Payment Authorization Form

Please complete all areas below. Incomplete requests may be rejected. This form must be received at least 5 business days prior to the Check-In, or by specified date in Event Contract, to ensure acceptance of the credit card to be charged.

Group Name:

Arrival Date:

Departure Date:

Contact: Phone:

Cardholder Name as it Appears on Credit Card:

Cardholder Billing Address:

City: State: Zip:

Daytime /Business Telephone:Evening Telephone:

Credit Card Number: Expiration Date:

Credit Card Type: (Circle one) Visa/MasterCard American Express Discover JCB Diners Club

Final Balance Billed to Credit Card (hotel use only): $______

By signing below, you authorize the hotel to charge your credit card immediately for the amount indicated above up to the “Maximum Amount” indicated above. You further acknowledge that if “all charges” has been selected, then all guest/group related charges (less Deposit) will be charged to the above card number at the time of check-out or event conclusion.

Cardholder Signature:Date:

HOTEL USE ONLY:

Authorized Amount:Approval Code: Date:

TELECOMMUNICATIONS

Direct Inward Dial

(DID) Line with Instrument (Includes Local/800) $150 One Time______

Direct Inward Dial

(DID) Line Without Instrument (Same Above) $150 One Time______

Digital Instrument $30 Daily______

Deluxe Speaker Phone (Plus DID Line Cost) $125 Daily______

Restricted House Phone $75 One Time______

Video Conferencing Service Installation Upon Request______

Nextel Radio $75 Weekly______

Nextel Set-Up/Configuration $100 One Time______

DATA SERVICES

High Speed Wireless Internet*

Up to 25 Connections$500 Daily______

26 – 100 Connections$1,000 Daily______

101 to 300 Connections$1,500 Daily______

301 to 600 Connections$2,000 Daily______

601 and above$2,500 Daily______

High Speed Wired Internet (includes 1st device)*$325 Per Room/Day______

Additional Devices**$125 One Time Fee______

Reserved Public IP, Static (for devices or networked printers)$125 One Time Fee______

Exhibitor Pass (per booth, per show, up to 4 devices)$800 per event______

VLAN Configuration Upon Request______

Live Webcasting & Video ArchivingUpon Request______

Audience Response SystemUpon Request______

Dedicated BandwidthUpon Request______

Wiring/Configuring $75 Hour______

* Internet Access For Each Device Requires A Pass Code. The 1st Device/Pass Code Is Included In The Basic High Speed Internet Pricing. Service Is Shared Over ( 2 ) 100MB Metro Ethernet Circuits.

* * An Additional Device Is Defined As An Additional Individual Computer, Printer, Public IP Etc., Logged Into The Network. Shared Lines Will Still Require Additional Pass Codes For Each Individual Computer.

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Telecom Order Form.doc