Credit Card Authorization

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Credit Card Authorization Form
Client Information
First Name
Last Name
AddressStreet Address
AddressStreet Address Line 2
City
Stateor Province
Postal /Zip Code
Phone #(555) 555-5555
Cell #(555) 555-5555
Reservation Information
Passenger Name
First Name
Last Name
Passenger Phone #(555) 555-5555
Which Vehicle You're Reserving?
Date Needed
date_range
Time Needed?
access_time
Number of Passengers?
Location of Pickup (PU)
Where is the limo going after pickup?
Additional Stops? If so, please enter address(es) here...
Location of Drop Off - End of the Night (DO)
Any special requests?
0 /
Payment Information
Name on Card
Card Holder's Birthday
date_range
Billing Address
City
State
Zip
Credit Card Number
Expiration Date
Totals
Amount Total
Gratuity
Tolls
Deposit To Hold Limousine(s): $100
Client Authorizes the charge of the amount to the right by using the credit card stated above.
Amount Total(This Amount Should Equal The Trip Charge Above)
Who helped you with your reservation?
The Fine Print

Please Read - Terms of Agreement


COMPLIMENTARY SOFT DRINKS, ICE & WATERS **RENTAL AGREEMENT: FAILURE TO COMPLY WILL RESULT IN TERMINATION OF THE RUN WITHOUT A REFUND!

**Absolutely No Smoking or eating in the vehicle, no illegal activities (possession of illegal drugs & no alcohol by anyone under 21, Blackhorse Limo, LLC is not responsible for items left in the vehicle, please be sure to check for all personal belongings before vehicle is released. Vehicle and color request are subject to availability and are not guaranteed. Chartering party is responsible for any damage to the interior of the vehicle or any charges resulting from vehicle requiring more than routine cleaning. Cleaning fee subject to $500.If ANY illegal activity, disorderly conduct, or verbal/physical abuse is suspected or occurs during service, Blackhorse Limo, LLC reserves the right to terminate service immediately. Blackhorse Limo, LLC reserves the right to terminate service regardless of location without return to point of origin. Upon termination of service the client remains liable for the entire balance of service total and Blackhorse Limo, LLC of liability at the time of termination. There are no refunds/discounts for releasing the vehicle early & reserving party liable for all additional hours.

* Cancellations - A (14) fourteen day notice of cancellation is required for all other scheduled, hourly reservations. A full rate minimum charge will be applied for late cancellations. No-Shows or cancellations on day of scheduled reservation shall result in a charge of the total amount of the scheduled reservation, including the chauffeur's gratuity. Please inquire with any questions you may have at the time of reservation. All deposit are non-refundable! The balance will be charged to said credit card after completion of service, unless other payment arrangements were made.

When Payment is Due • Payment in full is before the trip starts. • All deposits are non refundable within 14 days of the trip. If the trip is cancelled before 14 days, a $99.00 administrative fee will be incurred. • On Fridays & Saturdays, there is a 5-hour minimum required to book. On Sundays thru Thursdays, there is a 4-hour minimum required to book, except airport. • If this is a promo trip, trip is restricted to follow itinerary exactly as stated on confirmation. • Promo trips not to exceed schedule, or 6 hour max, whichever is less. Additional Hourly Charges • When an hourly charter has been arranged, and vehicle usage exceeds the arranged time by 15 minutes or more, an additional charge equal to the hourly rate shall be made. • The additional time incurred will be billed to the account on file. Hourly rate plus 20% gratuity will be applied. • Other applicable fees and charges: + Tolls/parking will be billed at actual cost + Additional hours will be billed hourly plus gratuity* and any applicable fees listed above + Final charges will be based on actual ride time + All Terms & Conditions apply

• IF YOU FEEL THE DRIVER PROVIDED SUPERIOR SERVICE, YOU ARE WELCOME TO PROVIDE A CASH TIP AT YOUR DISCRETION!! Also, please advise if there is a gate code our driver need be aware of. Cancellation

• $50.00 cancellation fee for airport transfer reservations, pick-up & drop offs Limousine Service Confirmation

• We invite you to mail, e-mail, or fax us a detailed summary of your itinerary and directions with landmarks. You may email the details to Contact@LSLimos.com

• The more details you can provide us regarding your pickup point and destination, the more efficient and enjoyable your trip can be. Blackhorse Limo, LLC Damage Disclaimer

************ LIMOUSINE DAMAGE POLICY ************

The guarantor of this reservation will be held financially responsible for any physical damage or breakage or loss, switches, burn marks, stains etc. Escape Hatches are not to be confused with sunroofs and must remain closed at all times unless it is an emergency exit. Blackhorse Limo, LLC reserves the right to terminate service with no refund to client if clients renting service act in disorderly and violent manner. Blackhorse Limo, LLC reserves the right to initiate collection proceedings for all services or damage fees that are not paid within 14 days after date of service. Blackhorse Limo, LLC will collect any and all attorneys' fees, collection expenses and court costs incurred in its effort to collect the outstanding balance owed.

************ SMOKING/ALCOHOL POLICY ************

All vehicles are non smoking. There is a $ 500.00 additional charge per occurrence. If needed, your driver will pull over to allow passengers to smoke outside Limousine. Illegal use of drugs is prohibited in our limousines and can terminate ride at no refund to the paying parties. There is a minimum $500.00 clean up charge for any stains resulting from illness inside limousine. I certify that I have read, understand, and agree to the terms set forth in this policy. Blackhorse Limo, LLC Strives To Ensure Every Customer a Pleasant Experience

Service Guidelines

NO SMOKING ~ In order to maintain a pleasant experience for all of our customers, we maintain a fleet of smoke-free vehicles. CAR SEAT ~ When traveling with children, we encourage you to bring along your child's car seat to ensure the best accommodation for all. If necessary, the car seat can remain with the vehicle for round trip service. We'll ask you to reconfirm your seat needs for the return trip.

YOU CAN ALWAYS CONTACT US ~ Chauffeurs of Blackhorse Limo, LLC remain with the limousine and within reasonable proximity of the passengers throughout the service.

NO FOOD ALLOWED IN THE LIMOS

Client Responsibility Toward Your Safety & Ours While limousines, vans, and other chartered vehicles are often a "rolling party" for many customers, Blackhorse Limo, LLC does expect customers and their guests to exhibit responsible behavior toward the vehicles and service

PASSENGER DISCOMFORT ~ Should a passenger become ill at any time within the vehicle during the period of hire, they should immediately alert the driver. We regret that we must levy a cleanup fee if necessary.

PLEASE DON'T "HANG OUT THE LIMO" ~ Passengers may not extend their head or any other body part through the vehicle moon roof, if so equipped, while the vehicle is in motion. Such actions will result in immediate cancellation of service with no refund. Blackhorse Limo, LLC will not be held responsible for any injuries caused by such actions.

CUSTOMER CONDUCT ~ Customers deemed to be intoxicated to excess by the driver may be discharged in accordance with Department of Transportation regulations.

Blackhorse Limo, LLC reserves the right to cancel service in the event damages occur to the vehicle. Accordingly, the customer will be held financially liable for any damage to any vehicle caused by themselves or their party, including full cost of the service. No refunds will be made. This is a statement of responsibility including, but not limited to, the vehicle interior/exterior and any items contained within.

In the event any property damage occurs, Blackhorse Limo, LLC requires payment to be made on the same date it occurs. In the event the company is unable to ascertain the exact cost or extent of damage at that time, a deposit of up to $350 will be collected. When the actual costs are determined, you will receive the difference due, if any, with a copy of the bill for repairs.

Blackhorse Limo, LLC assumes no responsibility for any illegal acts of any customer or their party.

Blackhorse Limo, LLC will make every effort to provide the ride you desire but regrets we can make no guarantees on limousine color.

Blackhorse Limo, LLC strictly enforces Zero Tolerance on alcohol and drugs for all prom services.

A copy of this policy is available upon your request.

I agree to the terms & conditions
Please Authorize
Please Type "I agree" Into the following box if you agree to the terms above:
Please Type, "I authorize" if you authorize Lifestyle Limos, DBA of Blackhorse Limo, LLC to bill your credit card for the amount you stated above:
Please input your initials and press submit:
Please Authorize
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