Pick Up Date *

MM

DD

YYYY

Producer (Primary Authorized Contact) *

First Name

Last Name

Producer (Primary) Phone *

(###)

###

####

Producer (Secondary) / If Applicable, Otherwise Skip To Billing

Please list a second producer if applicable (ex: assistant coordinator or anyone authorized to make approvals)

First Name

Last Name

Producer (Secondary) Phone

(###)

###

####

Final Invoice

Please send a copy of the final invoice to the selected

Producer (Primary Authorized Contact), above

Producer (Secondary Authorized Contact), above

Company's Main Billing Contact (on account paperwork)

Other Billing Contact - listed below:

Payment Method *

All accounts are COD unless Credit Terms are established. To setup Credit Terms, please fill out our Credit Terms Application form on the website.

ACH Bank Transfer (pay at invoice through DC secure portal)

Check (I will deliver prior to or on our pick up date. If additions are added at prep, the check will be delivered no later than the rental return date)

Chase Quickpay (sending to accounting@daufenbachcamera.com prior to or on the pick up date)

Credit Card with 3% convenience fee added to the rental total (charged at pickup)

We have Credit Terms with Daufenbach Camera and will pay accordingly (ex: Net 10, Net 20)

I am unsure how this company is set up and would like to use their preferred method of payment

Director of Photography

First Name

Last Name

1st AC

This contact is usually the primary assistant that will be prepping the rental. If prepping, our Operations team will usually coordinate the prep time with this contact unless specified in the other notes section below.

First Name

Last Name