| Exhibit System Rental Agreement/Faxable Rental Form |
| Ocean Color LLC | 850 Aquidneck Ave., Middletown, RI 02842 | DATE:________________________ |
| (401) 847-2020 | (800) 219-8700 | FAX: (401) 847-0393 | |
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Credit Card Billing Address
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| Contact Person | |||
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| Fax | |||
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Method of Payment:
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Visa | [ ] | AmEx | [ ] | MasterCard | [ ] | Credit Card Security Code # | |
| Credit Card # | Exp Date | ||
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| Name On Credit Card (Please Print) | Signature | Date |
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Rental Equipment Description
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Ship To Address
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| Event | Rental Rate | ||
| Event Location | Rental Fee | ||
| Event Dates | Sales Tax | ||
| Set Up Date | Outbound Ship (est) | ||
| Outbound Ship Date | Total Charge | ||
| Return Ship Date | Replacement Value |
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- Rental term covers dates of event, additional days for arrival at the event location and set up, and ample time for outbound and return shipping by ground. An additional consecutive event would be a second term.
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Authorized Customer Signature
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Name (Please Print)
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Date
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