Third Party Authorization Form

Third Party Authorization Form

This form should be returned when a third party (any party other than the exhibiting company) should be billed for services. In order for the request to be accepted, both parties MUST sign this form to indicate their acceptance. If the form is not signed, the request will be denied.
Suppose an exhibiting company plans to hire an exhibitor-appointed contractor (EAC) for booth building, supervision, design, delivery, or technical support. In that case, they need to be approved by Ortiz & Co. and must complete the following items: EACs are independent contractors and can include independent display companies or technicians. If an Exhibitor plans to hire a subcontractor, both the exhibiting company and the subcontractor company must provide their own Certificate of Insurance (COI).

By signing this form, both parties agree and understand that the exhibiting firm is responsible for all charges. If the named third party does not make payment by the end of the show, Ortiz & Co. will demand payment from the exhibiting firm on site. The invoice at the show site may or may not include charges for outbound services, such as material handling, rigging,andr shipping.
Event Name*
Exhibiting Company Name*
Booth #*
Exhibiting Company Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Exhibiting Company Phone Number*
Please enter a valid phone number.
Exhibiting Company Authorizer Email*
example@example.com
Exhibiting Company Authorizer Name*

First NameLast Name
Third-Party company will pay for the following (check all that apply):*

All ServicesBooth CleaningMaterial HandlingCarpetFurnitureExhibit RentalsRigging/LaborInstallation/Dismantle LaborLogistics/TransportationOther
Third-Party Company Name*
Third-Party Company Name Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Third-Party Company Phone Number*
Please enter a valid phone number.
Third-Party Company Email*
example@example.com
Third-Party Company Authorizer Name*

First NameLast Name
Third-Party Company Signature*

Clear
Accounting Contact Name*
AccountingPhone Number
Please enter a valid phone number.
Credit Card Information

American Express, Visa, MasterCard and Discover
Credit Card #*
Expiration Date*

MonthDayYear
Date
Security Code*
Name on Card*

First NameLast Name
Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Signature*

Clear
By signing the above, I acknowledge and understand that this credit card will be billed for ALL services rendered, including material handling, labor, and logistics.

For final payment, you can pay by credit card, company check (payable to Ortiz Events & Company, LLC), or via a bank wire transfer - please note that we still require the credit card authorization on file before processing any service orders. For your convenience, Ortiz&Co will use the authorization form to charge your credit card account for any additional amounts incurred due to any orders placed by your representative while on the show site. This includes material handling, labor, logistic charges for shipments received on your company’s behalf, and any unpaid balance due to Ortiz&Co.

Payments made via a credit card will incur a 3.5% processing fee.
Should be Empty:

Third Party Authorization Form

Credit Card Information