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“The Best Costs No More”
U.S.A LIMOUSINE SERVICE
 
SERVING THE GREATER WASHINGTON D.C. METROPOLITAN
SEDANE – LIMOS – BUSES
 
D.C. # 202-232-4440
 
703-979-4444
 
 

Online Form
 
ORDER
        
RECEIVED BY: 
 
TAG NO: 
     
DATE: 
     
P/U DATE: 
     
# CARS: 
 
PICK UP
    
 
Name
  
Street:
 
City:
 
Phone #:
 
     
 
Airline
  
Flight No
  
Arrival time
 
 
 
 
Destinations:
    
1.
  
2.
    
3.
    
4.
    
5.
    
 
 
 DON’T CALL  - IT’S A SURPRISE!
TELEPHONE: Local Calls $1.50 per min.
 
Start
End
Total
   min
 
 
 
D.C
AMX
VISA
MC
DISC
  
 
 
AMOUNT APPROVED:
  $
Card No.
   
Exp Date:
    
App. Code
   
Billing Name:
   
Billing Address:
   
State
    
Zip
    
 
 
 
S
M
T
W
T
F
S
 
PICK UP TIME:
   AM:
PM:
 
 
  SUPER STRETCH     SEDANVAL
  STRETCH     VAN
  ULTRA       BUSES
     
NUMBER OF PASSENGERS
 
 
 
Color of Car
  No show:
 
 
MILEAGE
Start
    
End
    
Total
  
 
 
DRIVE TIME
Start
     End     Total  
 
 
WAITING TIME
Start
     End     Total  
 
 
MINIMUM HOURS:
Hrs:
   
X
    
=
   $   
 
 
Tips $ 
 +   Sevr $   $ 
 
Extra Charges
Transfer  $ 
 
Addit. Passenger(s)_: $ 
 
Pone Charge Total: $ 
 
Damages/Cleaning Fee: $ 
 
Sub Total: $ 
 
Grand Total: $ 
 

DEPOSIT IS NON-REFUNDABLE
NO PERSONAL CHECKS
 
Not responsible for items left in vehicles. Passengers responsible for any
damage to vehicles due to negligence. VOMITING IN THE CAR
CHARGE 250.00
 
Driver’s Name: 
 
 
Fax 703-769-7866
Post Office Box 4621 Arlington VA 22204
 
 
 
 

 


USA Limousine Service Inc.
Copyright © 2008 . All Rights Reserved.