APPLICATION FOR DIRECT BILL ACCOUNT
Print out this form and fax to Fax: (818) 788-5468
 
Firm Name:__________________________________________________________________
 
Address:____________________________________________________________________
 
City:_________________________________ State:______________ Zip:________________
 
Business Telephone Number:_____________________ Contact:_______________________
 
Fax#____________________ E-mail___________________ Website:___________________
 
Nature of Business:_______________________________ Year Established:_____________
 
Federal Tax I.D. Number:___________________________TCP#_______________________
 
Corporation________ Partnership________ Sole Prprietorship____________ Other:_______
 
Principals:
 
1) Name:_________________________ Title:______________ Phone:__________________
 
2) Name_________________________ Title:_______________ Phone:__________________
 
3) Name_________________________ Title________________ Phone:_________________
 
Bank References:
 
Bank Name:________________________ Account Number:__________________________
 
Bank Address:_______________________________________________________________
 
City:_______________________ State____________________ ZIP Code:_______________
 
Telephone Number:____________________ Contact Person:__________________________
 
Trade References:
 
1) Name:____________________________ Telephone Number:_______________________
 
   Address:__________________________________________ Contact:_________________
 
2) Name:____________________________ Telephone Number:_______________________
 
    Address:_________________________________________ Contact:_________________
 
3) Name:____________________________ Telephone Number:_______________________
 
    Address:_________________________________________ Contact:_________________
 
Major Credit Card:
Credit card will be used only if a charge is delinquent more than 30 days(Thirty)
days.
Credit Card Number: __________________________________________________________
 
Cardholder’s Name:_______________________________ Expiration Date:______________
 
Card Identification Number (the last 3 or 4 digits of the number printed on the back of the card)   __________
 
Credit Card Billing Address:_____________________________________________________
AUTHORIZATION:
I certify that the fact contained in this application are true and complete to the best of my knowledge.
I further agree to submit payments to Hardrock International Limousines on a regular scheduled bases as required by
the governing laws of the Public Utilities Commission. In the event of a delinquency on my account
I authorize Hardrock  International Limousines to charge my credit card account listed above.
 
Terms & Conditions
Rates and Cancellation / No-Show Policy
 
CANCELATION POLICY: In the continental USA Hardrock International Limousines requires a minimum
Three (3) hours notice prior to the scheduled pickup time (based on the local
time zone of the pickup location) for Airport Sedan service and 24 hour notice for all
other services to avoid late cancellation or no-show charges. Cancellation number should
always be given and noted. It is the client’s responsibility to ask for the cancellation numbers.
 
NO SHOW CHARGE: If you not able to locate the chauffeur, please call our 24-hour
Customer Service at 877-427-1777 immediately. One of our customer service representatives
will be an able to locate your  chauffeur right away. No Show charge will be applied if a passenger fails to call
 Hardrock International Limousines before leaving the scheduled pickup location.
A No Show charge will also be applied if the client fails to inform of the cancellation.
 
CANCELLATION FEE: Late cancellations and No-Show will be charged at a full trip charge.
AIRPORT TRANSFER RATES: The Airport Transfer rates are based on pickup and
drop-off without any delay or waiting time for Domestic flights. Your reserved vehicle is
dispatched according to the flight estimated arrival time provided by the airline automated
system. All rates included 30 minutes airport grace waiting period.
Hardrock International Limousines is not responsible for delays caused by: Delay or loss of
luggage, inaccurate ETA or wrong gate/terminal information, or any unforeseen circumstance. All prices quoted by
 Hardrock International Limousines are for the specific services requested. Any deviation from the requested service by
 any passenger will result in appropriate additional charges.Hardrock International Limousines reserves the rights
 to assess a minimum fee of $150.00 for any necessary cleaning and/or damage to the vehicle beyond normal wear and tear.
Hardrock International Limousines is not liable for delays/service interruptions or damages caused by
acts of God, strikes, riots, authorities of law, public enemies, hazards or dangers caused by a state of quarantine, perils of navigation,
inclement weather, hazardous road conditions, accident or breakdowns or any other condition beyond its control.
The undersigned acknowledges and agrees that all rates quoted for services provided by
Hardrock International Limousines are estimates only. Final charges assessed upon service
completion will be based on the actual service provided. The undersigned acknowledges and agrees that
Hardrock International Limousines is not responsible for personal property left in the vehicles.
I confirms that I have read this document and agree to the terms and conditions contained therein.
 
 
Authorized Signature on Account:__________________________Date:_________________
 
 
Print Name:___________________________________________ Title:__________________
 
IT IS NECESSARY TO ACCOMPANY A CLEAR AND LEGIBLE PHOTOCOPY
OF THE FRONT AND BACK OF THE CREDIT CARD and PICTURE I.D.
 
Please print out this form and fax to: (818) 788-5468 - 24/7/365
 
FOR OFFICE USE ONLY
 
 
APPROVED BY:_______________________________________ DATE:________________