RIDELINE CAR AND LIMO SERVICE

Corporate Account Application

 

Official Corporate Name_____________________________________________________ Please type or print official name of company Doing Business As __________________ ____________________________________________________ Please type or print name of D/B/A Billing Address: ____________________________________________________ City: _________________ State: ________ Zip: _________ Bill attention to: ___________ Telephone: ____________________________ Fax: _______________ Email address: ______________________________________ Fed ID#: _______________________ Type of Business: Corporation ______ Partnership _______ LLC ______ Sole Proprietor ______ State of Incorporation: ____________________ Date of Incorporation: ________________

CREDIT CARD AUTHORIZATION :

Credit Card Information Visa □ AMEX □ MasterCard □ Cardholder Name:_____________________________________________________________________ Credit Card Number:_________________________________________________________ Expiration Date:____________ Billing Address:__________________________________ __________________________________________________________________________ (Address where monthly credit card statements are received. Also provide copy of front & back of cc plus photo id.)

Phone Number(s):__________________________________________________________ (Associated with credit card) By signing this form below, the Company acknowledges and agrees to pay for any and all charges invoiced to the company by Rideline. The authorizer hereby warrants and represents he/she has the authority to legally bind the Company as set forth herein. Being the cardholder or Corporate Officer, by signing below I understand and agree to the terms set forth in this agreement, agree to pay, and specifically authorize Rideline Car and Limo  Service (“Rideline”) to charge my credit card, for the transportation services provided. Rideline will provide me with an itemized statement detailing all of my charges. I further agree that in the event my credit card becomes invalid, I will provide Rideline with a new valid credit card upon request, to be charged for the payment of any outstanding balances owed to Rideline. If the Company listed above fails to pay, I personally guarantee payment of all obligations the Company may owe to Rideline printed.

 

Name:__________________________________ Signature:______________________________________ Date:___________________

Official Corporate Title: __________________________

Toll Free: 844-855-7433, Local: 631-451-7433, Fax: 631-458-4166, email: info@limorideline.com