(303) 421-4300
Fax (303) 424-3444
MAIL OR FAX: PLEASE PRINT THIS FORM TO SEND VIA THE POSTMASTER
Send your check or credit card information with completed form to:
A Advantage Limousine
6260 W 52nd Ave. #123
Denver Co. 80002
Name ______________________ Pick up Name ______________________
Address ______________________ Address ______________________
City state_____________zip______ City state_____________zip_______
email address__________________ email address___________________
Date of the run_________________ start_________ finish__________
Non- refundable deposit required
$0 to $200.00 = $50.00
$201.00 to $400.00 = $75.00
$401.00 to $600.00 = $100.00
$601.00 to $1000.00 = $150.00
$1001.00 to $1500.00 = $300.00
$1501.00 to $2500.00 = $400.00
$2501.00 to $4000.00 = $500.00
Total enclosed __________
Credit card type _____ #___________________________ ex-date_________ code on back of card (last 3 Digits)_______
Sign _______________________________________________
please include any other special instructions___________________________________________________
_________________________________________________________________________________________
Payment by: [ ] Check [ ] Money order [ ] Credit Card
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Thank you for booking your limo with A Advantage We appreciate your business and we'll give you top-quality service.