East Coast Executive Car & Limousine 

Corporate Credit Application

NOTE: Please print and return completed application via fax to (212) 255-44442. You will receive a reply within the same business day.

If you have any questions, please call (917) 606-1978 Ext. 109. To return to the previous page, click on BACK button.

 

Print Business Name (The Company)	Phone #                                     Ext. Fax #:
Business Address:	Floor #:                            Room#:
City: State:	Zip:
Monthly Limousine Usage:	Number of Employees:
Type of Business
Main Phone Number:	Fax:
Account Contact:                                                                       e-mail Fax #:	Phone #                                        Ext.
Accounts Payable Contact                                                      e-mail Fax #:	Phone #                                        Ext.
How did your company find out about our service: Salesperson:                                                Another Contact:                                                     Other:
Business Reference: Address:	Phone #                                           Ext:
Business Reference: Address:	Phone #                                          Ext:
Bank Contact Name: Name :	Phone #                                          Ext:
Bank Address: City State Zip	Account# Account#

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Terms and Conditions: The Company and the undersigned accept the Rates and Service Terms presented and agrees to be responsible 

for all charges, orders and rides taken on the account. This includes no-show charges as well as all missing, stolen or lost vouchers. 

In order to close the account we must be notified in writing. All check payments must have the account number, invoice number and 

be paid to the order of EXECTRANSPORT, INC. All invoices are payable upon receipt. Payments received after 30 days of the invoice 

date may incur a 1.5% per month or 18% per year finance charge.  A $4.00 service charge is added to each job on the invoice. 

All non-contracted rates are subject to change. Applicants who will use $250.00 or less in car service per week are required to include 

credit card information.

Please Check One:   ____20% Gratuity   ____15% Gratuity   ____10% Gratuity   ____Other   ____Will determine in car

I HEREBY AUTHORIZE EAST COAST EXECUTIVE LIMOUSINE TO OBTAIN A CREDIT REPORT FOR THE PURPOSE OF

PROCESSING THIS APPLICATION FOR A VOUCHER ACCOUNT.

Authorized Signature:________________________________________ Print Name :______________________________

Title:______________________________________Date:_______________

 Client Information

Please provide us with any special billing requirements that your company may require:

(i.e. departmental summary, itemized invoice, email, diskette billing , etc.) Please specify and attach hard copy and diskette.

 

Please list your credit card information if you do not have a D&B listing or your D&B rating does not meet our accounting department’s

risk criteria: Credit Card information will be kept confidential. It will only be used if payment is delinquent. The client below permits

 EXECTRANSPORT, INC. to submit unsigned credit card vouchers stating that clients signature is on file to execute payment on behalf

 of the clients delinquent or non-payment of invoices.

Type of Credit Card
Card Number
Card Holder
Expiration Date
Print Name
Signature

 

Authorized User List

These are people who are allowed to place reservations under this account. For additional users please attach list.

Name	Title	Area Code Phone # Extension

Any other specific requirements:

Sales#__________________ Chauffeur#_____________