Please complete the following form to submit your request (   * fields are required):
REQUEST TYPE:	Quotation Reservation      *
Transportation Services Required:
TYPE OF SERVICE:	General Transportation - One Way General Transportation - Round Trip General Transportation - Hourly Service General Transportation - Other Airport Transportation - Pick Up Airport Transportation - Drop Off    *
TYPE OF VEHICLE:	Luxury Sedan 6 Passenger Limousine 8 Passenger Limousine 10 Passenger Limousine 12 Passenger Limousine 14 Passenger Limousine 14 Passenger Minivan Luxury Minivan Limobus Minibus Coach (bus)    *
Contact Information:
FIRST NAME:	*
LAST NAME:	*
ADDRESS:	*
CITY:	*
STATE:	--- Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Iowa Illinois Indiana Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northwest Territory Nova Scotia Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon Territory    *
ZIPCODE:	*
TELEPHONE:	*
CELL PHONE (optional):
EMAIL:	*
EMAIL (confirm):	*
Pickup Location Details:
PICKUP LOCATION:	Office Residence Airport Other    *
ADDRESS:	*
CITY:	*
STATE:	--- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Iowa Illinois Indiana Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming    *
NO OF PASSENGERS:	*
PASSENGER NAME(S):	*
DATE:	--- Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec --- 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 --- 2008 2009    *
TIME:	--- 1 2 3 4 5 6 7 8 9 10 11 12 --- 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 --- AM PM    *
PICKUP INSTRUCTIONS:
Dropoff Location Details:
DROPOFF LOCATION:	Office Residence Airport Other    *
ADDRESS:	*
CITY:	*
STATE:	--- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Iowa Illinois Indiana Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming    *
NO. OF PASSENGERS:	*
PASSENGER NAME(S):	*
DATE:	--- Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec --- 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 --- 2008 2009    *
TIME:	--- 1 2 3 4 5 6 7 8 9 10 11 12 --- 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 --- AM PM    *
DROPOFF INSTRUCTIONS:
I have read and agree to the terms and conditions.   * I hereby Authorize LA-Limos Transportation & Tours to debit my credit card for transportation services listed herein above. I understand that all cancellations must be made as follows:   * HOURLY SERVICES: 7 DAYS NOTICE: For full refund LESS THAN 7 DAYS: 50% is charged LESS THAN 48 HOURS NOTICE: 100% of the contract price will be charged AIRPORT SERVICES: LESS THAN 24 HOURS NOTICE: 50% of the contract price will be charged.