512-677-5957
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limousineservicetx@gmail.com
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Reservations
limoadmin
2016-05-25T16:30:11+00:00
1
Customer Information
2
Trip Information
3
Credit Card Information
4
Reservation Review
Name
*
First
Last
Phone
*
Email
*
Enter Email
Confirm Email
Total Number of Passengers
*
Please enter a value greater than or equal to
1
.
Choose Vehicle
*
if you have any questions regarding your vehicle selection please feel free to call…
Range Rover SUV (Max 4-Passenger)
Lincoln Towncar Sedan (Max 4-Passenger)
Cadillac Escalade SUV (Max 6-Passenger)
Stretch Lincoln Town Car Limousine (Max 10-Passenger)
Black Hummer (Max 20-Passenger)
White Hummer (Max 20-Passenger)
PICK-UP
Location Name (optional)
Date
*
Pick-up Time
*
:
HH
MM
AM
PM
Pick-up Address
Address, City*, State or Zip
Destinations
To Be Determined
First Stop
Location Name (optional)
Address
Address, City*, State or Zip
Date
SECOND STOP
Location Name (optional)
Date
Address
Address, City*, State or Zip
THIRD STOP
Location Name (optional)
Date
Address
Address, City*, State or Zip
Add more Stops?
Number of Stops
1
2
3
DROP-OFF
Location Name (optional)
Date
Pick-up Time
:
HH
MM
AM
PM
Drop-OFF Address
Street Address, City
Notes
Use this field for flight information, gate codes, etc.
Reservation or Quote?
Reservation
Quote
CREDIT CARD INFORMATION
In order to hold your reservation, we require a $150.00 deposit.
Card Number
*
Expiration Date
*
3 or 4 Digit Security Code
*
Billing Zip Code
*
I authorize company Limousine, to charge the above referenced credit card for transportation and related services. I understand that if a trip is not cancelled within the 24 hours time frame or if the passenger does not show up for the confirmed reservation, I will be billed the full amount of the service.
*
I authorize to charge the above referenced credit card a security deposit of $150.00 immediately upon sumbitting this form which is nonrefundable.
Signature
{all_fields}
Email
This field is for validation purposes and should be left unchanged.