The 2004 CMIA Medical Equipment Technology Vendor Fair

August 21, 2004

9AM to 3 PM

at the

Doubletree Hotel

2001 Point West Way, Sacramento, Ca.

Vendor Application;

Company Name: ________________________________________________________

Contact Name: ___________________________________________________________

Contact Phone Number: _______________________ Fax Number: _________________

Booth Information;

Standard Booth Configuration includes 8 x 10 ft. space, piping and drapes, table, chairs, company name sign and 5 amp power source. (40 spaces available)

Premium Booth Configuration includes standard configuration items plus 50 minute presentation opportunity, special advertising before and during the vendor fair. (6 spaces available)

Additional Expo configurations are available through Expo Services at www. expo.com

Selections;

Standard Booth [ ] $300.00

Premium Booth [ ] $500.00

Please check all items required for your booth;

[ ] Table [ ] 2 Chairs [ ] 5 amp power [ ] company name sign [ ] Additional Expo config.

Please complete the above information and email to Alan Koreneff at korenea@sutterhealth.org

For questions please contact Alan Koreneff at 916-733-8400 ext 60909. Reservations are confirmed when payment is received. Mail check or money order payments to;

CMIA Capitol Region Chapter

607 Elmira Rd. PMB 235

Vacaville, Ca 95687