***PLEASE READ FIRST***In order to Save & Return Ensure to setup your account first. You will then be able to save your work and return to complete it at a later time. (optional)

New Users / Returning Users CLICK HERE to setup or return to your account for this form. Creating an account enables you to return to this form and your submitted results. An account will also enable you to partially complete this form and return later to finish. The account you establish is only for this form.

ADD HOSPITAL LED PRE-LITS

Today's Date * +

Agreement Reference # * 🛈

Production Company * 🛈

Producer * 🛈

Phone Number *

Email Address *

Start Date * 🛈 +

End Date * 🛈 +

SELECT HOSPITAL LED PRE-LIT PACKAGE OR SINGLE UNIT RENTAL

SILVER DREAM FACTORY DOES NOT SUPPLY EXPENDABLES. LICENSEE IS RESPONSIBLE FOR ALL BURN OUT LIGHT BULBS.

Add Hospital Pre-Lit Package 21 LED Bi-Color 1'x4' Dimmable Light Fixtures. 🛈

	$400 per day - 24 Pre-lit Hospital Package (LED BI-COLOR) ON-SITE ONLY
	$45 per day - Single Unit Pre-lit Hospital (LED BI-COLOR) ON-SITE ONLY

Select 'Calculate' to see your estimated total: 🛈

$0.00

Licensee agrees that adjustments to the estimate and/or invoice may be made that may not be reflected herein. * 🛈

Additional Charges/Costs: Licensee agrees that adjustments to the estimate and/or invoice may be made that may not be reflected herin.

ADDITIONAL TERMS & CONDITIONS

By selecting "I Agree" you are adding the additional equipment selected above is an addendum to the original agreement terms signed by Licensee. I understand that if my request to add said equipment is submitted less than 21 days in advance of the booking, I will be held responsible for payment based on the rental and cancellation terms stated on the original agreement submitted. * 🛈

Signature *

clear

Type your full name here *

Today's Date +

In order to ensure this is a real person please enter the word in the image *
captcha