Exhibitor Fact Sheet
Innovations in Cardiovascular Care Symposium 2014
www.tenetheart.com
Course Director: Eric Lieberman, MD
Sponsored by: Delray Medical Center
Date: Friday, October 10, 2014 – Saturday, October 11, 2014
Location:
Boca Beach Club, a Waldorf Astoria Resort
900 S Ocean Boulevard
Boca Raton, Florida 33432
Exhibition Area and Booths:
The exhibition hall is located in Surfside rooms A, B, and C, across from the meeting room, the Dunes
Ballroom. The hall is 2370 square feet.
The exhibit fee includes one 6-foot draped table and two side chairs.
Exhibitor Rate Schedule:
Name
Exhibitor
Platinum Exhibitor
Description
Represent your organization in the symposium’s exhibit hall. 6’
display table will be provided. Includes 2 representatives.
Represent your organization in the symposium’s exhibit hall. 6’
display table will be provided. Includes: Includes 4 representatives,
higher level name recognition, and ability to provide give-away/brochure along with program materials.
Pricing
$2,500
$4,000
Special Features



Exhibitors will be provided a 6’ display table in the exhibit hall, inclusion in pre-show and post-event
emails to registrants, and inclusion in the event’s program.
Name badges for representatives.
Opportunity to interact with attendees:
o Dedicated break times Saturday morning and afternoon for attendees to visit the exhibit
area
o Dedicated lunch break Saturday afternoon
Services


Exhibitor materials can be shipped prior to the symposium. Materials will be shipped to the Boca
Beach Club. Please see below for detailed instructions.
Wi-Fi is not included in your sponsorship but is available. The order form for data services is
attached.
Exhibitor Set Up
4:00-6:00pm on Friday, October 10th.
Exhibitor Hours
7:00am–5:00pm Saturday, October 11th.
Contacts
Alexandra Posada
(c) 954-235-6246
[email protected]
Tenet Healthcare, Symposium Coordinator
Laurie McCurdy
(t) 561-447-3457
Boca Raton Resort & Club, Shipping Services
Jon Carres
(t) 561-447-3433
(c) 561-447-5970
(f) 561-447-5970
[email protected]
Boca Raton Resort & Club, Event Technology Services
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Exhibitor Registration Form
I. Please check the exhibitor level of your choice:

Name
Exhibitor
Platinum
Exhibitor
Description
Represent your organization in the symposium’s exhibit hall.
6’ display table will be provided. Includes 2 representatives.
Represent your organization in the symposium’s exhibit hall.
6’ display table will be provided. Includes: Includes 4
representatives, higher level name recognition, and ability to
provide give-a-way/brochure along with program materials.
Pricing
$2,500
$4,000
II. Name and title of company representative - for all correspondence:
Name: _____________________________________________________________________
Title: ______________________________________________________________________
Organization/Affiliation: ______________________________________________________
Address: ___________________________________________________________________
City, State, Zip: ______________________________________________________________
Telephone: _________________________________________________________________
Fax: _______________________________________________________________________
Email: _____________________________________________________________________
III. Official company name as it is to appear in all references to this exhibit:
III. Exhibitors
Please print the names of representatives exhibiting at the symposium.
Name
Name
Name
Name
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
IV. Delivery of Exhibitor Materials
Please ship your materials to the following address. Please ensure that the materials arrive on or before
Thursday, October 9. Properly marked boxes will be delivered to your booth by 4:00pm on Friday,
October 10.
Hotel will accept shipments no earlier than five (5) days prior to the arrival day of the convention. Please
address all shipments to:
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Attention: Innovations in Cardiovascular Care Symposium
Arriving: (Your arrival date)
Laurie McCurdy
Boca Beach Club
900 South Ocean Blvd.
Boca Raton, FL 33432
Shipment handling charges will apply.
Hours of Operation: Mon-Fri 7:00 a.m. - 5:00 p.m.; Sat-Sun, 7:00 a.m.-3:00 p.m.
Exhibit Guidelines:
The commercial interest and Tenet Florida, Inc. agree to abide by all requirements of the Accreditation
Council for Continuing Medical Education (ACCME) Standards for Commercial Support of Continuing
Medical Education.
The ACCME defines a commercial interest as any proprietary entity producing health care goods or
services, with the exemption of non-profit or government organizations and non-health care related
companies.

Exhibitor agrees to abide by all requirements of the ACCME’s Accreditation Criteria, the ACCME
Standards for Commercial Support.
Specifically:
 Arrangements for commercial exhibits or advertisements cannot influence planning or interfere
with the presentation, nor can they be a condition of the provision of commercial support. Tenet
Florida, Inc. will be responsible for the identification, determination, and selection of needs,
objectives, content, faculty, educational methods, evaluation, and audience and will ensure that the
decisions are made free of the control of the exhibitor.
 All exhibitors must be in a room or area separate from the education; the exhibits must not interfere
or in any way compete with the learning experience prior to, during, or immediately after the
activity.
 Representatives of the company exhibiting may attend CME activities at the discretion of Tenet
Florida, Inc. for the direct purpose of the representatives’ own education; however, they may not
engage in sales or marketing activities while in the space or place of the educational activity.
 Information on the identity of learners at CME activities is considered to be the confidential
property of Tenet Florida, Inc.
 Exhibit space at this CME activity has not and will not be given as a condition of commercial support.
An exhibit fee is for rental of space and shall be paid to the sponsoring organization, department or
division.
 Tenet Florida, Inc. reserves the right to decline or prohibit any exhibit or part of exhibit booth
activity which, in its opinion, is unsuitable.
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Liability:
 Removal of any merchandise from the exhibit space will not be permitted except during the
dismantling period.
 The exhibitor assumes the entire responsibility and liability for losses, damages, and claims
arising out of injury or damage to exhibitor's displays and other property brought upon the
premises of the hotel, and shall indemnify and hold harmless Tenet Florida, Inc., and any
authorized representative, agent, or employee of the foregoing for any and all losses, damages
and claims.
 Each exhibitor is responsible for damages to floors, walls, and other hotel property. Nails, hooks,
thumbtacks, and scotch tape are not permitted on walls or ceilings.
1. Compliance Obligations. Group and Physicians each represents that it/he/she read,
understands, and shall abide by Tenet’s Standards of Conduct. The parties to this Agreement shall
comply with Tenet’s Compliance Program and Tenet’s policies and procedures related to the Deficit
Reduction Act of 2005, Anti-Kickback Statute and the Stark Law. Tenet’s Standards of Conduct,
summary of Compliance Program, and policies and procedures, including a summary of the Federal False
Claims Act and applicable state false claims laws (collectively “False Claims Laws”) with descriptions of
penalties and whistleblower protections pertaining to such laws, are available at:
http://www.tenethealth.com/about/pages/ethicscompliance.aspx. Group shall require any employees
providing services to Hospital to read the Standards of Conduct and information concerning Tenet’s
Compliance Program and abide by same. Further, the parties to this Agreement certify that they shall
not violate the Anti-Kickback Statute and Stark Law, and shall abide by the Deficit Reduction Act of 2005,
as applicable, in providing services to Hospital. Hardcopies of any information shall be made available
upon request. Group, Physicians, and any employees, if applicable, shall complete any training required
under Tenet’s Compliance Program.
2. Exclusion Lists Screening. Group shall screen all of its current and prospective owners, legal
entities, officers, directors, employees, contractors, and agents (“Screened Persons”) against (a) the
United States Department of Health and Human Services/Office of Inspector General List of Excluded
Individuals/Entities (available through the Internet at http://www.oig.hhs.gov), (b) the General Services
Administration’s System for Award Management (available through the Internet at
http://www.sam.gov), and (c) any applicable state healthcare exclusion list (collectively, the “Exclusion
Lists”) to ensure that none of the Screened Persons are currently excluded, debarred, suspended, or
otherwise ineligible to participate in Federal healthcare programs or in Federal procurement or
nonprocurement programs, or have been convicted of a criminal offense that falls within the ambit of
42 U.S.C. § 1320a-7(a), but have not yet been excluded, debarred, suspended, or otherwise declared
ineligible (each, an “Ineligible Person”). If, at any time during the term of this Agreement any Screened
Person becomes an Ineligible Person or proposed to be an Ineligible Person, Group shall immediately
notify Hospital of the same. Screened Persons shall not include any employee, contractor or agent who
is not providing services under this Agreement.
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REQUESTED BY: _______________________________________________________________
Print –Name of Authorized Company Representative
Company: ___________________________________________________________________
Address:
_______________________________________________________________
City, State:
_______________________________________________________________
Zip Code:
_______________________________________________________________
Country:
_______________________________________________________________
Telephone:
_______________________________________________________________
Fax:
______________________________________________________________________
Email: ______________________________________________________________________
By providing my signature below, I acknowledge that I have read and agree to abide by the Exhibit
Guidelines and the ACCME’s Standards for Commercial Support provided in this exhibit packet.
Tenet Florida, Inc.
d/b/a Tenet Florida, Inc.
Sincerely,
By: _______________________
Name: ____________________
Title: _____________________
Date: _____________________
Accepted and agreed
By: _______________________
Name: ____________________
Title: _____________________
Date: _____________________
A limited number of booth spaces are available for this conference.
In order to ensure your space, complete the exhibitor registration and CAM Stark II forms and email to
[email protected].
Please mail a copy of these forms with your check, payable to:
Tenet Florida, Inc. (write Cardiovascular Symposium in the memo area)
Mail to:
Tenet Florida, Inc.
Attention: Sandy Fabian, Cardiovascular Symposium
5810 Coral Ridge Drive, Ste. 300
Coral Springs, FL 33076
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STARK II
ACTION REQUIRED
STARK II
ACTION REQUIRED
Vendor Name:
Vendor Number:
Dear Vendor:
In order to ensure that Tenet Healthcare Corporation (“Tenet”) and its subsidiaries and affiliates, including Conifer Health Solutions, LLC (“Conifer”), and
all facilities owned and operated by Tenet (“Tenet Facility”) comply with federal law concerning financial arrangements between physicians and entities
that provide certain health care services, we require all vendors provide us with the following information.
For purposes of answering these questions, the following definitions apply:
“Immediate family member” means the following individuals: husband or wife; birth or adoptive parent, child, or sibling; stepparent, stepchild,
stepbrother, or stepsister; father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in-law, or sister-in-law; grandparent or grandchild; and
spouse of a grandparent or grandchild.
“Physician” means a doctor of medicine or osteopathy, a doctor of dental surgery or dental medicine, a doctor of podiatric medicine, a doctor of
optometry or a chiropractor.
1.
2.
3.
Is your company owned in whole or part, directly or indirectly, by a physician who refers patients to or treats patients at any
Tenet Facility or an immediate family member of a physician who refers patients to or treats patients at any Tenet Facility?
NO
YES
Is your company owned in whole or part, directly or indirectly, by any person (other than a physician or an immediate
family member of a physician) who refers patients to any Tenet Facility?
NO
YES
NO
YES
NO
YES
(ii) Does the compensation paid to the physician or the immediate family member of such a physician exceed fair
market value for the service provided by such physician or immediate family members of such physician?
NO
YES
If you are entering into an arrangement as a vendor with Tenet, Conifer or any Tenet Facility as an individual, are you a
physician who refers patients to or treats patients at any Tenet Facility or an immediate family member of a physician who
refers patients to or treats patients at any Tenet Facility?
NO
YES
Does your company employ or contract with a physician who refers patients to or treats patients at any Tenet Facility or
an immediate family member of a physician who refers patients to or treats patients at any Tenet Facility? If “YES”,
please answer the following:
(i)
4.
Does the employed or contracted physician, or immediate family member of the physician, receive
compensation from your company that is based on the volume/value of referrals to a Tenet Facility?
If you answered “Yes” to any of the questions (1-4) above, please indicate whether the physician/person is:
contractor of the company and complete the following:
(a) Name of Physician or other person who refers to the Tenet facility:
(b)
The name(s) of any Tenet Facility to which the physician or other person refers:
(c)
If applicable, the name of the physician’s immediate family member(s) who have
ownership in the company:
an owner,
an employee, or
Thank you for your anticipated cooperation in providing this information.
Sincerely,
I represent that the answers provided herein are truthful and accurate as of the date of my signature below. I agree to immediately notify
of any changes in the above-disclosed information.
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VENDOR Officer Signature
Date
Print Name
Title
BOCA RATON RESORT & CLUB
Event Technology Services
501 East Camino Real
Boca Raton, Florida 33432-6127
Telephone (561) 447-3433
Fax (561) 447-5970
Cell (561) 445-3498
Email [email protected]
ORDER FORM
NAME OF CONVENTION OR GROUP:_________________________________________________________
ROOM LOCATION: _____________________ ___________________________________________________
EXHIBITOR: ______________________________________________________ BOOTH: ________
ADDRESS: _________________________________ _____________________________________
CITY: ______________________ STATE: ___________ZIP:_________________
TELEPHONE: ______________________FAX: __________________________
EMAIL: _________________________________________________________________
INSTALLATION DATE/TIME: __________________
STRIKE DATE/TIME: __________________
GROUP ON-SITE CONTACT: _______________________________________________________
PAYMENT INFORMATION
_____________VISA
___________MASTERCARD
____ ____AMERICAN EXPRESS
CARD NUMBER: __________________________EXPIRATION DATE: ___________
CARD HOLDER NAME: _____________________________________________________________
(PLEASE PRINT)
AUTHORIZED SIGNATURE: _________________________________________________________
DATA SERVICES
Exhibitor Pass (per booth, per show, up to 4 devices included)
$800 per event
_______
No. of Conn. Wired
No. of Conn. Wireless
TELECOMMUNICATIONS
Direct Inward Dial (DID) line with instrument (includes local/800) $150 one time
Direct Inward Dial (DID) line without instrument (same above)
$150 one time
Deluxe Speaker Phone (plus DID line cost)
$125 daily
Restricted House Phone
$ 75 one time
_______
_______
____________
____________
____________
____________
PLEASE NOTE:
A SERVICE CHARGE OF 23% IS ADDED TO ALL ORDERS. A SALES TAX OF 6% WILL BE ADDED ON
TELECOMMUNICATIONS AND SERVICE CHARGES.
*INTERNET ACCESS FOR EACH DEVICE REQUIRES A PASSCODE, AND THE 1ST DEVICE/PASSCODE IS INCLUDED IN THE
BASIC HIGH SPEED INTERNET PRICING. SAME DAY ORDERS ARE SUBJECT TO AN ADDITIONAL $75 “SAME DAY SETUP FEE.
**AN ADDITIONAL DEVICE IS DEFINED AS AN ADDITIONAL INDIVIDUAL COMPUTER, PRINTER, PUBLIC IP, ETC.,
LOGGED INTO THE NETWORK. SHARED LINES WILL STILL REQUIRE ADDITIONAL PASSCODES FOR EACH
INDIVIDUAL COMPUTER!
**PLEASE NOTE: NO EXTERNAL/PROPRIETARY EQUIPMENT ALLOWED IN THE MEETING SPACE OR ATTACHED TO
THE NETWORK WITHOUT GROUP TECNOLOGY MANAGEMENT’S PRIOR APPROVAL!
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