Executive Limousine Services
Home
Reservation Request Form
662-513-4311
MrLimoOxford@gmail.com
By Appointment Only
Executive Limousine Services
Home
Reservation Request Form
Home
Reservation Request Form
Home
/
Reservation Request Form
Thank you for completing our Reservation Request Form to speed up the reservation processing.
Reservation Request
If you are human, leave this field blank.
Client Name
*
Company Name
Mailing Address
*
Mailing Address
Mailing Address
Mailing Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Email Address
*
Home or Business Phone Number
Cell Phone Number
Pickup Address
*
Pickup Address
Pickup Address
Pickup Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Pickup Time
*
12
1
2
3
4
5
6
7
8
9
10
11
:
00
30
AM
PM
Pickup Date
*
Number of Pickup Locations
*
One
Two
Three
2nd Pickup Address
2nd Pickup Address
2nd Pickup Address
2nd Pickup Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
3rd Pickup Address
3rd Pickup Address
3rd Pickup Address
3rd Pickup Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Number of Destinations
*
One
Two
Three
Four
Destination Address
*
Destination Address
Destination Address
Destination Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
2nd Destination Address
2nd Destination Address
2nd Destination Address
2nd Destination Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
3rd Destination Address
3rd Destination Address
3rd Destination Address
3rd Destination Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
4th Destination Address
4th Destination Address
4th Destination Address
4th Destination Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Number of Final Drop Off Locations
One
Two
Three
One-way Trip
Drop Off Time
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
:
00
30
Drop Off Date
*
Drop Off Address
*
Drop Off Address
Drop Off Address
Drop Off Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
2nd Drop Off Address
2nd Drop Off Address
2nd Drop Off Address
2nd Drop Off Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
3rd Drop Off Address
3rd Drop Off Address
3rd Drop Off Address
3rd Drop Off Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Special Instructions
Your limousine booking is guaranteed upon receipt of the required deposit. Executive Limousine Services reserves the right to terminate any booking for the following reasons: (1) If any client or passenger possess or uses any illegal drug while in the limousine, (2) if anyone under the legal drinking age of the state is caught possessing or consuming alcoholic beverage, (3) If anyone smokes in the limousine, or (4) If any client or passenger should vomit in or on the limousine, any of the above actions shall immediately terminate the booking, without any refund. There is also a $300 fine for smoking and a $1,000 fine for vomiting or produces bodily fluids in or on the limousine, paid immediately. Client shall be liable for all expenses {including Executive Limousine Services legal cost(s) and/or damages (including consequential) caused by any passengers actions or client's failure to pay for service (e.g.credit card chargebacks, returned checks, or unpaid balances). Executive Limousine Services shall not assume any other liabilities or make any warranty, express or implied, whatsoever. Full payment of initial estimated services shall be paid in full prior to departure. Subsequent charges will be charged after service has ended.
I have read and agree to the terms and conditions.
*
Agree
