PARTNERSHIP PROSPECTUS - 10th INTERNATIONAL SURGICAL SLEEP SOCIETY MEETING MAY 10-11, 2019 | NEW YORK, NEW YORK Program Chairs Ofer Jacobowitz ...
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PARTNERSHIP PROSPECTUS 10th INTERNATIONAL SURGICAL SLEEP 2019 SOCIETY MEETING MAY 10-11, 2019 | NEW YORK, NEW YORK Program Chairs Ofer Jacobowitz, MD, PhD, FAASM Maria V. Suurna, MD, FACS Otolaryngology www.sleepsurgery2019.com Head & Neck Surgery
Invitation for partnership Dear Industry Colleagues, On behalf of the Program Chairs, Ofer Jacobowitz, MD, PhD and Maria Suurna, MD, FACS, I invite you to join renowned national and international sleep disorder experts for the 10th International Surgical Sleep Society Meeting. This program will be held at the New York Marriott Marquis in New York City, New York on May 10-11, 2019. The ISSS was founded in 2006 and is the world’s preeminent organization dedicated to the surgical evaluation and treatment of patients with sleep disorders. The ISSS holds international scientific meetings like this one, that enable surgeons from around the world to discuss advances in sleep surgery and to share their research findings. These meetings have provided the foundation for ongoing ISSS research initiatives that will help patients with snoring or obstructive sleep apnea and the surgeons who will care for them. This comprehensive 2-day continuing medical education program offers industry sponsors an opportunity to reach clinicians with the latest sleep disorder techniques and products. The focused meeting environment is ideal for industry dedicated to delivering products and services that support these conditions. This forum will undoubtably allow you to interact with clinicians eager to learn about new technologies and innovations that aim to improve patient care. Upon completion of this course, participants should be able to: a. Describe the pathophysiology of OSA, become familiar with current research on mechanisms of sleep apnea. b. Recognize the common causes of CPAP intolerance and understand the role of adjunctive or alternative therapies in the treatment of OSA. c. Discuss the most current OSA medical and surgical evaluation and treatment options. d. Organize and implement a successful multidisciplinary approach to treat patients with OSA. For more information or to partner with ISSS, please visit www.sleepsurgery2019.com or contact Denise Castetter at 973.769.1020 or via email at denise@veritasmeetingsolutions.com. See you in the Big Apple! Denise Castetter Industry Relations Veritas Meeting Solutions 1061 E. Main St. Suite 300 East Dundee, Illinois 60118 (973) 769-1020 Otolaryngology denise@veritasmeetingsolutions.com Head & Neck Surgery 2
AGENDA FRIDAY, MAY 10 7:00 am – 5:00 pm Registration/Information Desk Open 7:00 am – 8:00 am Breakfast with Exhibitors WELCOME & INTRODUCTION 8:00 am – 8:30 am Introduction Ofer Jacobowitz, MD, PhD & Maria Suurna, MD Comments from ISSS President Stacey Ishman, MD Introduction of Sleep Surgery Fellowship Programs TBD PERSONALIZED TREATMENT OF OSA MODERATORS: Tucker Woodson, MD, Guillermo Plaza Mayor, MD 8:30 am – 8:45 am Physiologic Typing for OSA Andrew Wellman, MD 8:45 am – 9:00 am How Sleep Studies Can Direct Therapy Alan Schwartz, MD 9:00 am - 9:15 am How Anatomy Directs Treatment Tucker Woodson, MD 9:15 am – 9:30 am Outcomes for OSA Therapies Olivier Vanderveken, MD 9:30 am – 10:00 am Case Presentations & Discussion 10:00 am – 10:15 am Coffee Break with Exhibitors KEYNOTE LECTURE I 10:15 am – 10:50 am Sleep in Women Meir Kryger, MD 10:50 am – 11:00 am Discussion LIVING (OR NOT) WITH SNORING? MODERATORS: Lee Shangold, MD, Ahmed Baghat, MD 11:00 am – 11:10 am How to Evaluate a Snoring Patient Oleg Froymovich, MD 11:10 am – 11:20 am Why Treat Snoring? Kathleen Yaremchuk, MD 11:20 am – 11:30 am Procedures for Snoring Claudio Vicini, MD 11:30 am – 11:40 am Medical Devices for Snoring Treatment Itsuo Nakajima, MD 11:40 am – 12:30 pm Case Presentations & Discussion 12:30 pm – 1:30 pm Lunch with Exhibitors 3 ISSS
AGENDA FRIDAY, MAY 10 continued CONCURRENT SESSION 1A CONCURRENT SESSION 1B BURDEN OF OSA: THE GOALS OF TREATMENT PEDIATRIC SLEEP APNEA MODERATORS: Alan Kominsky, MD, Mustafa Gerek, MD MODERATORS: Evan Propst, MD, Megan Durr, MD 1:30 pm – 1:40 pm Treating Risk? Which Parameters Matter? 1:30 pm – 1:40 pm Anatomy vs. Neuromuscular Tone Edilson Zancanella, MD Stacey Ishman, MD 1:40 pm – 1:50 pm CV Outcomes of OSA 1:40 pm – 1:50 pm Cardiovascular Changes with Pediatric OSA Daniel Gottlieb, MD Wei-Chung Hsu, MD 1:50 pm – 2:00 pm Surgical Outcomes for OSA 1:50 pm – 2:00 pm Tonsillectomy vs. Tonsillotomy Edward Weaver, MD Pia Nerfeldt, MD 2:00 pm – 2:10 pm Functional Outcomes- Treating Sleepiness 2:00 pm – 2:10 pm Nasal Obstruction in Pediatric OSA Danielle Friberg, MD Cristina Baldassari, MD 2:10 pm – 2:30 pm Discussion 2:10 pm – 2:30 pm Discussion CONCURRENT SESSION 2A CONCURRENT SESSION 2B INDIVIDUALIZED OSA CARE - SPECIAL ADVANCED PEDIATRIC TREATMENTS POPULATIONS MODERATORS: Norman Friedman, MD, MODERATORS: Martin Hopp, MD, David Kent, MD Ron Mitchell, MD 2:30 pm – 2:40 pm Military Population 2:30 pm – 2:40 pm Pediatric Tongue Base Surgery Peter O’Connor, MD Sally Shott, MD 2:40 pm – 2:50 pm Overlap Syndrome 2:40 pm – 2:50 pm Maxillary Expansion/Midfacial Surgery Ana Krieger, MD Jay Neugarten, MD 2:50 pm – 3:00 pm Pregnancy 2:50 pm – 3:00 pm Treatment of OSA in Complex Pediatric Patients Grace Pien, MD Derek Lam, MD 3:00 pm – 3:10 pm Sexual Dysfunction and Sleep Apnea 3:00 pm – 3:10 pm Hypoglossal Neurostimulation in Pediatric Natan Bar-Chama, MD Patients Christopher Hartnick, MD 3:10 pm – 3:30 pm Discussion 3:10 pm – 3:30 pm Discussion 3:30 pm – 3:45 pm Coffee Break with Exhibitors 3:30 pm – 3:45 pm Coffee Break with Exhibitors 4 ISSS
AGENDA FRIDAY, MAY 10 continued CONCURRENT SESSION 3A CONCURRENT SESSION 3B PALATOPHARYNGOPLASTY FOR THE 21ST THE YEAR IN SLEEP APNEA - BEST PAPERS CENTURY MODERATORS: Peter Baptista, MD, MODERATORS: Marina Carrasco-Llatos, MD, Michael Friedman, MD Nico DeVries, MD 3:45 pm – 3:55 pm Surgery as Primary Treatment 3:45 pm – 4:35 pm TBD Stuart Mackay, MD 3:55 pm – 4:05 pm Choice of Palatopharyngoplasty Technique Rodolfo Lugo Saldana, MD 4:05 pm – 4:15 pm What’s Next After Unsuccessful Surgery? Victor Certal MD, PhD 4:15 pm – 4:25 pm Complications of Palatopharyngeal Surgery Kenny Pang, MD 4:25 pm – 4:35 pm Less Pain, More Gain Andrew Goldberg, MD 4:35 pm – 5:00 pm Discussion 4:35 pm – 5:00 pm Discussion 7:00 PM - SOCIAL EVENT SATURDAY, MAY 11 7:00 am – 5:30 pm Registration/Information Desk Open 7:00 am – 8:00 am Breakfast with Exhibitors DISE PANEL: PRO AND CON MODERATORS: Evert Hamans, MD, Katherine Green, MD 8:00 am – 9:30 am Panel Mark Blumen, MD, Vik Veer, MD, Winfried Hohenhorst, MD, An Boudewyns, MD, & Eric Thuler, MD KEYNOTE LECTURE II 9:30 am- 10:00 am Perioperative Care of OSA Frances Chung, MD 10:00 am – 10:15 am Discussion 10:15 am – 10:30 am Coffee Break with Exhibitors NEUROSTIMULATION FOR SLEEP APNEA: TODAY AND TOMORROW MODERATORS: Clemens Heiser, Maria Suurna, MD 10:30 am – 10:40 am Neurostimulation: Evolving Standard of Care for Sleep Apnea Joachim Maurer, MD 10:40 am – 10:50 am Bilateral Neurostimulation Richard Lewis, MD 10:50 am – 11:00 am Phrenic Nerve Stimulation for Central Sleep Apnea Shahrokh Javaheri, MD 11:00 am – 11:15 am Targeted Hypoglossal Neurostimulation Ofer Jacobowitz, MD, PhD ISSS 11:15 am – 11:30 am Improving Outcomes of Selective Neurostimulation Maurits Boon, MD 11:30 am – 12:00 pm Case Presentations and Discussion 12:00 pm – 1:00 pm Lunch with Exhibitors 5
AGENDA SATURDAY, MAY 11 continued CONCURRENT SESSION 4A CONCURRENT SESSION 4B FIRST IN LINE: THE NOSE OPTIMIZING TREATMENT FOR TOMORROW MODERATORS: Colin Huntley, MD, Fabio Lorenzetti, MD MODERATORS: Carlos Torre MD, Madeline Ravesloot, MD 1:00 pm – 1:10 pm Nasal Breathing and OSA 1:00 pm – 1:10 pm Losing Weight, Without Surgery Diagnosis/Treatment Shintaro Chiba Katherine Saunders MD 1:10 pm – 1:20 pm The Value of Nasal Surgery for OSA 1:10 pm – 1:20 pm Sleep Home of Tomorrow Michael Stewart, MD Rayleigh Chiang, MD 1:20 pm – 1:30 pm Plasticity of Route of Breathing 1:20 pm – 1:30 pm Diagnostic Applications for Home Monitoring Raj Dedhia, MD Robson Capasso, MD 1:30 pm – 1:40 pm UARS – A Distinct Disorder? 1:30 pm – 1:40 pm Positional Therapy Ryan Soose, MD Ulrich Sommer, MD 1:40 pm – 1:50 pm Allergies and OSA 1:40 pm – 1:50 pm PAP Technology Noah Siegel MD David Rapoport, MD 1:50 pm – 2:15 pm Discussion 1:50 pm – 2:15 pm Discussion CONCURRENT SESSION 5A CONCURRENT SESSION 5B GETTING TO THE BOTTOM…OF THE TONGUE ADVANCES IN ORAL APPLIANCES & SKELETAL MODERATORS: Erika Thaler, MD, Mark D’Agostino, MD SURGERY MODERATORS: Samuel Mickelson, MD, Jose Barrera MD 2:15 pm – 2:25 pm Tongue Base Reduction - 2:15 pm – 2:25 pm Improving Outcome Techniques That Work with OAT Vikas Agarwal, MD Michael Goldberg, DMD 2:25 pm – 2:35 pm Hyoid Suspension 2019 2:25 pm – 2:35 pm Complication Management in Oral Appliance Boyd Gillespie, MD Therapy David Binder, DDS 2:35 pm – 2:45 pm Genioglossus Advancement 2:35 pm – 2:45 pm MMA, Long Term Outcomes Sung Won Kim, MD Tod Huntley, MD 2:45 pm – 2:55 pm Do You Need Surgery in Era of 2:45 pm – 2:55 pm MMA With Adjunctive Procedures Neurostimulation? Paul Hoff, MD When and Why? Stanley Liu, MD, PhD 2:55 pm – 3:05 pm Robot-Assisted 2:55 pm – 3:05 pm Advanced and Future Oral Devices Surgery Outcome (Invicta, OnA, Belfour, Oventus) Filippo Montevecchi, MD David Schwartz, DDS 3:05 pm – 3:30 pm Discussion 3:05 pm – 3:30 pm Discussion 3:30 pm – 3:45 pm Coffee Break with Exhibitors 3:30 pm – 3:45 pm Coffee Break with Exhibitors 6 ISSS
AGENDA SATURDAY, MAY 11 continued CONCURRENT SESSION 6A CONCURRENT SESSION 6B MULTILEVEL SURGERY TODAY RESEARCH PRESENTATION TBD MODERATORS: Frederic Chabolle, MD, MODERATORS: Boris Chernobilsky, MD Clemens Heiser, MD Thomas Verse, MD 3:45 pm – 3:55 pm When to Perform Multilevel Surgery 3:45 pm – 3:55 pm TBD Hseuh-Yu Li, MD 3:55 pm – 4:05 pm Why Not Perform Multilevel Surgery 3:55 pm – 4:05 pm TBD Michel Cahali, MD 4:05 pm – 4:15 pm Neurostimulation in Multilevel Surgery Armin Steffen, MD 4:15 pm – 4:25 pm Multilevel Radiofrequency Bhik Kotecha, MD 4:25 pm – 4:35 pm Epiglottic Collapse – How to Manage It Julia Crawford, MD 4:35 pm – 4:45 pm Avoiding Complications Hsin-Ching Lin, MD 4:45 pm – 5:15 pm Case presentation and Discussion 4:45 pm – 515 pm Q&A 5:15 pm – 5:30 pm Closing Remarks 5:15 pm – 5:30 pm Closing Remarks SPEAKERS Vikas Agarwal, MD Mark D’Agostino, MD Wei-Chung Hsu, MD Samuel Mickelson, MD Ulrich Sommer, MD Ahmed Baghat, MD Raj Dedhia, MD Tod Huntley, MD Ron Mitchell, MD Ryan Soose, MD Cristina Baldassari, MD Nico DeVries, MD Colin Huntley, MD Filippo Montevecchi, MD Armin Steffen, MD Peter Baptista, MD Megan Durr, MD Stacey Ishman, MD Itsuo Nakajima, MD Michael Stewart, MD Natan Bar-Chama, MD Danielle Friberg, MD Ofer Jacobowitz, MD, PhD Pia Nerfeldt, MD Maria Suurna, MD Jose Barrera, MD Michael Friedman, MD Shahrokh Javaheri, MD Jay Neugarten, DDS, MD Erika Thaler, MD David Binder, DDS Norman Friedman, MD David Kent, MD Peter O’Connor, MD Eric Thuler, MD Mark Blumen, MD Oleg Froymovich, MD Sung Wan Kim, MD Kenny Pang, MD Carlos Torre, MD Maurits Boon, MD Mustafa Gerek, MD Alan Kominsky, MD Grace Pien, MD Olivier Vanderveken, MD An Boudewyns, MD Boyd Gillespie, MD Bhik Kotecha, MD Guillermo Plaza Mayor, MD Vik Veer, MD Michel Cahali, MD Andrew Goldberg, MD Ana Krieger, MD Evan Propst, MD Thomas Verse, MD Robson Capasso, MD Michael Goldberg, DMD Meir Kryger, MD David Rapoport, MD Claudio Vicini, MD Marina Carrasco-Llatos, MD Daniel Gottlieb, MD Derek Lam, MD Madeline Ravesloot, MD Edward Weaver, MD Victor Certal, MD PhD Katherine Green, MD Richard Lewis, MD Rodolfo Lugo Saldana, MD Andrew Wellman, MD Frederic Chabolle, MD Evert Hamans, MD Hseuh-Yu Li, MD Katherine Saunders, MD Tucker Woodson, MD Boris Chernobilsky, MD Christopher Hartnick, MD Hsin-Ching Lin, MD Alan Schwartz, MD Kathleen Yaremchuk, MD ISSS Rayleigh Chiang, MD Clemens Heiser, MD Stanley Liu, MD, DDS David Schwartz, DDS Edilson Zancanella, MD Shintaro Chiba, MD Paul Hoff, MD Fabio Lorenzetti, MD Lee Shangold, MD Frances Chung, MD Winfried Hohenhorst, MD Stuart Mackay, MD Sally Shott, MD Julia Crawford, MD Martin Hopp, MD Joachim Maurer, MD Noah Siegel, MD 7
HOTEL ACCOMMODATIONS New York Marriott Marquis 1535 Broadway | New York, New York 10036 212-398-1900 | www.nymarriottmarquis.com Set in the Heart of Times Square on West 46th Street and Broadway, the New York Marriott Marquis lets you experience all the magic of New York from the moment you arrive. Feel the energy all around you, both within the hotel and as soon as you step outside. Inside the towering hotel, you’ll find some of New York City’s largest hotel rooms and suites, multiple restaurants - including the only revolving restaurant in the city and our new outdoor lounge - 100,000 square feet of meeting and event space and a knowledgeable staff to help you navigate this expansive and ever-changing city. Reservations: 877-303-0104 Direct Booking Link: 2019 ISSS Meeting Room Rate: $299.00 Double/Double or King excluding taxes Hotel Deadline: On or before Tuesday, April 16, 2019 PARKING: Overnight Parking - Registered Guests 24 Hours Maximum Cars - $65.00 SUV (Explorers, Mini-Vans, etc.) - $75.00 Oversize (F150’s, Yukons, Suburbans, etc.) - $90.00 TRANSIT PARKING (HOURLY) 12 Hours Maximum 0-3 hours: Cars = $40 Oversized = $50 Supersized = $60 3-12 hours: Cars = $53 Oversized = $63 Supersized = $78 In & Out privileges are an additional $10 *No vans, limousines or motorcyces *All transients over 12 hours fall under overnight rates *18.375% NYC parking tax included 8 ISSS
PARTNERSHIP OPPORTUNITIES MAXIMIZE YOU IMPACT THROUGH PARTNERSHIP. This meeting offers industry sponsors an opportunity to reach surgeons from around the world who have come together to discuss advances in sleep surgery and share their research findings. Corporate functions may not be held concurrent with official International Surgical Sleep Society Meeting didactic or social functions. Any function, regardless of size and location, must be approved by the International Surgical Sleep Society course industry relations department. DIAMOND | $30,000 PRODUCT THEATER LUNCHEON A non-competing timeslot allowing you to increase your visibility with all attendees. Sponsorship signage will be provided at lunch. • Food, beverage, event marketing • 6 tickets to Social Event • Recognition in conference program • Premium exhibit assignment • Full page advertisement in program • Recognition on mass marketing emails • Draped table with chairs • Recognition signage at entrance of social event • Pre-meeting attendee list • 6 exhibitor badges • Logo recognition on conference website PLATINUM | $25,000 SOCIAL EVENT SPONSOR Allow your company to be recognized during the largest networking opportunity of the conference. CONFERENCE INTERNET ACCESS CODE Your company name will become the code that all attendees must use to access WIFI in the conference area. CONFERENCE PADFOLIO Alow your company to make a lasting impression by sponsoring a padfolio with your product informational brochure inside, given to every attendee upon arrival. • Food, beverage, event marketing • 5 tickets to Social Event • Recognition on mass marketing emails • Premium exhibit assignment • 1/2 page advertisement in program • Pre-meeting attendee list • Draped table with chairs • Logo recognition on conference website • Sponsorship signage will be provided • 5 exhibitor badges • Recognition in conference program GOLD | $15,000 EXHIBIT AREA BREAKFAST Sponsor breakfast for all attendees to enjoy prior to the educational sessions while they visit the exhibit hall. EXHIBIT AREA BREAK Sponsor a day of coffee breaks for all attendees may enjoy while taking a break while they visit the exhibit hall. • Food, beverage, event marketing • 4 tickets to Social Event • Recognition on mass marketing emails • Premium exhibit assignment • 1/4 page advertisement in program • Pre-meeting attendee list • Draped table with chairs • Logo recognition on conference website • Sponsorship signage will be provided • 4 exhibitor badges • Recognition in conference program SILVER | $10,000 • Draped table with chairs • 3 tickets to Social Event • Recognition on mass marketing emails • Standing display and equipment is allowed • Logo recognition on conference website • Pre-meeting attendee list • 3 exhibitor badges • Recognition in conference program BRONZE | $5,000 • Draped table with chairs • 2 exhibitor badges • Recognition in conference program • TABLE TOP DISPLAY ONLY and • 2 tickets to Social Event • Recognition on mass marketing emails NO EQUIPMENT allowed • Logo recognition on conference website • Attendee list given on-site ISSS PROGRAM BOOK ADVERTISEMENT | Full Page $1000 Half Page $750 The Program Book is put into the hands of every attendee, exhibitor and member of the press who come to the course. Let your company stand out with a full or half page ad. To keep the printed program cost reasonable, we can only offer 4-full pages of ads to industry. Secure your ad today! 9
EXHIBIT SCHEDULE EXHIBIT MOVE-IN THURSDAY - MAY 9, 2019 FRIDAY - MAY 10, 2019 9:00 PM 6:00 AM EXHIBIT HOURS FRIDAY - MAY 10, 2019 SATURDAY - MAY 11, 2019 7:00 AM - 3:45 PM 7:00 AM - 3:45 PM Breakfast 7:00 am-8:00 am Breakfast 7:00 am-8:00 am Break 10:00 am-10:15 am Break 10:15 am-10:30 am Lunch 12:30 pm-1:30 pm Lunch 12:00 pm-1:00 pm Break 3:30 pm-3:45 pm Break 3:30 pm-3:45 pm EXHIBIT TEAR-DOWN SATURDAY - MAY 11, 2019 3:45 PM - 6:00 PM PARTNERSHIP PAYMENT & RESERVATION FORM Exhibits provide an educational service to participants and provide useful information about developments, products and services related to their interests and responsibilities. Products or services displayed must further the purpose of the meeting and provide an atmosphere conducive to exchanging information relevant to the clinical content of the conference. Industry wishing to exhibit must submit a completed exhibitor form with method of payment indicated on the form. If paying by credit card, please include the credit card information on the exhibitor form and sent to Denise Castetter at Veritas Meeting Solutions. MAKE CHECKS PAYABLE TO: Weill Cornell Medicine EIN #13-1623978 SEND PAYMENT AND COMPLETED Veritas Meeting Solutions EXHIBITOR FORM TO: 1061 E. Main Street, Suite 300 East Dundee, IL 60118 10
International Surgical Sleep Society 10th Annual Meeting New York Marriott Marquis ● New York City, New York May 10 – 11, 2019 Company Name (As it should appear on printed material) Contact Person (Individual to whom all exhibitor information will be forwarded) Title Street Address City State Zip Telephone Fax Email Product *If you need electricity or have questions about shipping and receiving at the hotel , please refer to the appropriate forms on the next 2 pages. BADGES (please look at partnership opportunity descriptions to determine your badge allotment) Representative Name (First, Last) Title Email Address Phone INDICATE PARTNERSHIP LEVEL q DIAMOND $30,000 q Product Theater Luncheon Check one: q Friday or q Saturday q PLATINUM $25,000 q Social Event or q Internet Code or q Conference Padfolio q GOLD $15,000 q Breakfast Check one: q Friday or q Saturday q Breaks Check one: q Friday AM/PM or q Saturday AM/ PM q SILVER $10,000 q Floor Display and Equipment Allowed q BRONZE $5,000 q Table Display/No Equipment PAYMENT OPTIONS Method of Payment: Check Credit Card: Visa MC AMEX Make check payable to: Weill Cornell Medicine EIN #13-1623978 Card Number: _______________________________________Expiration Date: ____________CCV Code:___________ Name on Card: ________________________________________________________________ Total $___________ Credit Card Billing Address:__________________________________________________________________________ Please process payment as indicated above: Signature___________________________________________________ Return this completed exhibit reservation form and payment to Denise Castetter. Mail: Veritas Meeting Solutions, 1061 E. Main St. Suite 300 East Dundee, IL 60118 W: 973-769-1020 | F: 224-888-2661 | denise@veritasmeetingsolutions.com
NEW YORK MARRIOTT MARQUIS ELECTRICAL DEPARTMENT 1535 BROADWAY NEW YORK, NY 10036 TEL: (212)704-8799 FAX (212)704-8896 TRADESHOWS@AmpriteNYC.com Services Price QTY Total • ELECTRICAL ORDERS WITH VALID PAYMENT MUST BE SUBMITTED 10 DAYS WATTAGE (LOW POWER - 120 VOLT SERVICE) PRIOR TO THE EVENT OR A LATE CHARGE WILL AUTOMATICALLY BE APPLIED. SMALL OFFICE EQUIPMENT • WALL OUTLETS ARE FOR HOTEL USE ONLY, NOT FOR AV/GUEST EQUIPMENT. • EXHIBITORS AND A/V PROVIDERS MUST SUBMIT A SEPARATE ORDER FOR 0 -500 WATTS $150.00 EACH EVENT. 501-1000 WATTS $170.00 • IT IS NOT PERMITTED FOR ANYONE OTHER THEN NYMM ELECTRICAL DEPT. TO PROVIDE OR INSTALL POWER DISTRIBUTIONS. 1001- 1500 WATTS $185.00 • RENTAL RATES QUOTED ARE PER EVENT AND COVER A 5 DAY PERIOD. • ORDERED CIRCUITS WILL ONLY BE PLACED IN ONE LOCATION AND CANNOT 1501 - 2000 WATTS $250.00 BE SHARED OR SPLIT. 120 VOLT (Exclusive Circuit) • ADDITIONAL CHARGES WILL APPLY TO: EVENTS OVER 5 DAYS, ROOM Meeting & Large Office Equipment RELOCATIONS, AND RESETTING ANY ELECTRICAL. 20 AMPS $250.00 • NO REFUNDS AFTER THE START OF THE EVENT. EXTENSION CORDS Event Name: Power Not Included. Must order at least one circuit from above (Only 2 power strips or quad boxes per circuit) Company: QUAD BOX $40.00 POWER STRIP $40.00 Address: 208 VOLT (SINGLE PHASE) Specialty Equipment City: State: Zip: 20 AMPS $350.00 30 AMPS $450.00 Phone: Fax: FEEDER SERVICE (CAN NOT BE USED FOR DISTRIBUTION) Mobile: E-Mail: 60 AMPS - 3 PHASE $1,200.00 Representative Name: 100 AMPS - 3 PHASE $1,900.00 200 AMPS - 3 PHASE $3,700.00 Room Name: Booth: Cable Runs (Please call for pricing) Setup Date: Time: Fiber Cable Run Start Date: Time: COAX Cable Run Cat 5/6 Cable Run Removal Date: Time: LATE CHARGE $50.00 FOR PAYMENT BY CHECK PLEASE MAIL COMPLETED FORM WITH CHECK TO: SUBTOTAL ELECTRICAL DEPARTMENT * NEW YORK MARRIOTT MARQUIS 8.875% TAX 1535 BROADWAY * NEW YORK, NY 10036 GRAND TOTAL PAYMENT BY CREDIT CARD SPECIAL NOTES PLEASE SEND COMPLETED FORM TO: 1 (212) 704 - 8896 TRADESHOWS@AmpriteNYC.com NYC CODE REQUIRES THAT NO ELECTRICAL EQUIPMENT OR APPARATUS CAN BE CONNECTED UNLESS IT CONFORMS TO ITS CREDIT CARD NUMBER: ELECTRICAL CODE. UPON REQUEST, THE HOTEL WILL SUPPLY A COPY OF THE NYC ELECTRICAL CODE. THE HOTEL WILL SUPPLY QUALIFIED ELECTRICIANS TO CORRECT ANY INFRACTIONS AT PREVAILING COSTS. EXP DATE: WIRING REGULATIONS BASED ON THE NYC ELECTRICAL CODE ALL TYPE: ELECTRICAL APPARATUS AND SPLICES MUST BE INSTALLED IN A METAL ENCLOSURE TO PREVENT EMISSION OF SPARKS. ALL METAL RACEWAYS. METAL LIGHTING FIXTURES. AND METAL HOUSINGS OF CARDHOLDER'S NAME: ELECTRICALLY POWERED EQUIPMENT SHALL BE GROUNDED. ALL EXTENSION CABLES SHALL BE 3 WIRE SJ CORD OR OTHER APPROVED TYPE AND NOT MORE THAN 10 FEET LONG. THE GREEN COLORED WIRE 15 SIGNATURE: TO BE USED AS THE GROUND. THE CABLE MUST BE LARGE ENOUGH FOR THE LOAD AND HAVE A GROUND MALE PLUG. FLEXIBLE CORDS AND CABLES Receipt? LESS THAN #14 GUAGE WIRE SHALL NOT BE PERMIITED. PLUG IN STRIPS SHALL BE MOUNTED NOT LESS THAN 2FT. 61N ABOVE THE FLOOR AND SHALL BE SECURLEY FASTENED. NY MARRIOITT MARQUIS WILL NOT BE RESPONSIBLE FOR ANY VOLTAGE FLUCTUATIONS OR POWER FAILURES BEYOND OUR CONTROL Signature: Date: I approve the above electrical charges from the Marriott Marquis New York HOTEL USE ONLY PMS#/ Effective 01/01/2018 EVENTS/SALES/AV MANAGER & EXTENSION Folio#
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