Credit Card Authorization Form

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Company Name

Cardholder

Authorized Person(If Different from the Cardholder)

Credit Card Number

Expiration Date

CVV

Billing Address

Postal Code

ID/Passport - file upload (*required field)

Upload

Credit Card - file upload (*required field)side with the numbers only

Upload

Reservation Date

Reservation Confirmation #

Phone

I hereby authorize B&W Limo Inc. to charge the above credit card account number for all ground transportation booked through B&W Limo Inc. This will include all NO-SHOW charges as well as late cancellations. All additional charges such as waiting time, additional time, extra stops, parking and tolls may also be charged. Additional time will be calculated in increments of 60 minutes. This amount will be billed to the CLIENT and the CLIENT’s credit card above will be charged. B&W Limo Inc. will honor all agreed upon rates previously contracted with our company. Any discrepancies with an individual charge should be addressed with B&W Limo Inc. directly. Adjustments will be at the discretion of a B&W Limo Inc. management representative. By signing the above authorization to process charges to the above referenced credit card which has been provided via e-mail. Cardholder and company mentioned above agree that payment will be made for this purchase and indemnify and hold B&W Limo Inc. and related companies harmless against any liability pursuant to this authorization. Understanding that failing to provide B&W Limo Inc. and related companies valid credit card information will result in cancelation of the reservation.

If this is a Credit Card Payment, I also authorize this payment to be charged to my/our credit card account given. I agree to pay the total amount shown above in compliance with the cardholder agreement and that this is a special customer order, non-refundable or rendered cancelled. As part of this agreement, we, the customer stipulate we will not generate chargebacks/stop payments through our bank institution and a facsimile signature is to be considered as an original.

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