Chrysler Imperial Eight Limousine
Service Agreement
CONTACT INFORMATION
Name(s): _________________________________________________________________________________________
Street Address: ___________________________________________
Home Telephone Number: ____________________________
City/State: _____________________________
Cell Phone Number: ____________________________
Email Address: _____________________________________________________________________________________
Person Responsible for Advance Payment: _______________________________________________________________
(Advanced payment is required for every reservation. Payment is accepted as cash, check, Visa, MasterCard and
Discover credit cards. An 18% gratuity will be added to your balance due and paid in advance. Any additional gratuity is at
your discretion and can be given to your driver the day/night of your reservation.)
Person Responsible for Overtime Payment: ______________________________________________________________
(Overtime payment and an additional 18% gratuity are due at the end of service at the final drop off location for any
overtime hours accrued. Payment is accepted as cash only and is tendered to the driver. Receipts are available upon request.)
RESERVATION INFORMATION
Date(s) Requested: _____________________________
Occasion: ____________________________________
Pick-Up Time: _________________________________
Length of Reservation: _______hours _______ minutes
Pick--Up Location: ______________________________
Final Drop-Off Location: _________________________
Number of Stops (Approx.): _______________________
Number of Passengers: _________________________
Names of Passengers: _______________________________________________________________________________
_________________________________________________________________________________________________
Package Name and Details (if applicable): _______________________________________________________________
_________________________________________________________________________________________________
Other Details: ______________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
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Chrysler Imperial Eight Limousine
RESERVATION TERMS AND CONDITIONS
The Chrysler Imperial Eight Limousine is scheduled for ______hours _______ minutes on __________________________.
(A two-hour minimum is required with all reservations)
The hourly rate for the vehicle reservation is as outlined below:
____________ for the 1st hour; ______________ for 2nd hour and _____________ per 1/2 hour.
(Rates may vary based on days of the week and selected “high demand” days of the year.)
The overtime rate for the vehicle reservation is as outlined below:
____________ for the 1st hour; ______________ for 2nd hour and _____________ per 1/2 hour.
(Rates may vary based on days of the week and selected “high demand” days of the year.)
I acknowledge that a non-refundable security deposit of $200.00 is due in full at the time the reservation is made. ________
I acknowledge that payment is required (2) weeks in advance from my reservation date or I forfeit my reservation. ________
I acknowledge that an 18% gratuity is added to my final balance due in advance. ___________
I acknowledge and agree that in the event of “overtime” (i.e. minutes and/or hours exceeding the initial reservation), that full
payment plus an additional 18% gratuity are due at the end of the service. ___________
I have read and understand the information pertaining to cancellations, weather/mechanical delays, policies and refunds. _______
I acknowledge that the lowest Air Conditioned temperature setting for the vintage limousine is 72 degrees. __________
PAYMENT INFORMATION
Payment Type (Circle One):
Cash
Credit Card (Visa, MasterCard, Discover)
Check (Check #_______)
**Please note: If payment is tendered with a credit card, a Credit Card Authorization form must be completed and signed**
Hourly Rate Total for Service
____________
18% Gratuity
____________
AMOUNT DUE:
____________
Security Deposit Due (____/____/____)
____________
AMOUNT DUE (14) DAYS PRIOR
TO RESERVATION: (____/____/____)
_____________
I, _________________________________, agree to and authorize the payment as listed above.
_____________________________________________
Client Signature
________________________
Date
_____________________________________________
Company Representative Signature
________________________
Date
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