All Rights Reserved Bargain Limos                         Contact | Terms                                                              By: GraphixImage
Contact Information
Full Name: *
Phone Number: *
Email: *
Email (Confirm): *
Transportation Service Information
Type of Service: *
Please Select Your Vehicle Type: *
Total Hours: *
Pick Up Info
Address: *
City: *
State: *
Number Of Passengers:*
Date: *  
Time: *
Destination
Address: *
City: *
State: *
Date: *  
Time: *
Drop-Off Instructions:
Payment Information
Credit Card: *
Credit Card #: *
Expiration Date: * MM/YY
Card Security Code: *
Name Of Cardholder: *
Billing Address: *
Comments:
HOWDID YOU
LEARN ABOUT
OUR WEBSITE:
Other  
Yahoo
Google
MSN
AOL
Business Associate
Family / Friend
 
I have read and agree to the terms and conditions.

I understand that deposits are not refundable due to client cancellation, and authorize "manhattanpromlimo.com" to process charges to my credit card for rental service, overtime & any damages that might be incurred to the limousine by my guests or myself. I the customer take full responsibility and hereby waive any and all claims against "manhattanpromlimo.com".