Credit Card Information. (All transient customers must provide credit card info – even if intending to pay with cash) _ Visa _ MasterCard _ American Express _ Discover Card (Number) (Expiration) (CVV) (Name as it appears on Credit Card) (Credit card billing address if different from Page 1) (City) (State/Province) (Zip code) I do hereby authorize Everglades National Park Flamingo Marina (“Marina”) to charge my credit card for transient dockage, utilities, and other related expenses, fees, invoices, and debts as they become due and payable as outlined above for the duration of this agreement or until this authorization is revoked in writing. I hereby affirm and decree that this account is and shall remain viable and have sufficient credit available for purposes of all charges anticipated hereunder and shall remain so for the duration of this agreement. In the event a charge is denied or rejected, I hereby agree to pay the charge by certified funds directly and immediately to the Marina. I also grant the Marina the right to charge me a $25.00 processing fee for each denied charge. I understand that failure to pay a denied charge or fee shall be considered an event of default and will subject the vessel to any Marina actions deemed necessary to secure their common law or maritime lien(s). (Authorizing Signature for Credit Card) (Date) (Printed Name) BY SIGNING THIS LICENSE AGREEMENT, THE BOAT OWNER (INCLUDING ANY
Credit Card Information. Please ensure that the credit card belongs to the Subscription owner | | | | | | | | | | | | | | | | | / Credit Card Number Expiration Type CVV (3 numbers on back) Subscriber’s Personal Information: | | | _| | | | | | | _ Full Name ID Number/Private Company Cellular Phone Number Email Address of Contact I confirm everything contained within this contract and acknowledge that I have read the “User’s Guide” which is on the website. Cardholder’s Signature: Date:
Credit Card Information. In order of preference, list up to 2 credit cards you wish to use to pay for your Hertz #1 Club Gold rentals. The billing address for the cards must be one of the adresses you list above. At least one card must be entered in order to enrol. Only Hertz Charge Card/MasterCard/VISA/Diners Club and American Express will be accepted. CARD NUMBER: TYPE OF CARD: EXPIRY DATE: / MO. YR. / MO. YR. Hertz Europe Ltd, Hertz House, 00 Xxxx Xxxxxx, Xxxxxxxx, Xxxxxxxxx, XX0 0XX, XX 2833/EZ/EA/0406 RENTALS IN THE U.S. AND CANADA PLEASE SELECT THE OPTIONAL HERTZ CUSTOMER SERVICES YOU WISH TO PURCHASE AND THE CLASS OF CAR YOU WISH TO RENT WHEN USING HERTZ #1 CLUB GOLD. If you do not accept or decline an optional service, you will be deemed to have declined. U.S. U.S. OPTIONAL SERVICES (see paragraphs #9 through #16 of the Enrolment Terms): CANADA CANADA OPTIONAL SERVICES: LDW Loss Damage Waiver Accept PAI/PEC Personal Accident Insurance and Personal Effects Coverage Accept LIS Liability Insurance Supplement (Rentals commencing Accept in all states including California) LIS* Liability Insurance Supplement Accept (Rentals commencing in California only) ✔ (tick) Decline (tick) Decline ✔ (tick) Decline ✔ (tick) Decline (tick) ✔ (tick) (tick) (tick) LDW Loss Damage Waiver Accept PAI/PEC Personal Accident Insurance and Personal Effects Coverage Accept THE CAR CLASS YOU WISH TO DRIVE: (Tick one) ✔ Compact, 4-Door Mid-Size ✔ (tick) Decline (tick) Decline Sporty, 2-Door (tick) ✔ (tick) *If you accept LIS rentals commencing in all states, you must also accept LIS for California rentals. THE CAR CLASS YOU WISH TO DRIVE: (tick one) ✔ Compact, 4-Door Mid-Size Sporty, 2-Door Full-Size, 4-Door Premium Luxury SUV, 4-Wheel Drive Full-Size, 4-Door SUV, 4-Wheel Drive Premium Luxury
Credit Card Information. Your credit card information is transmitted using secure methods and, other than for transactional history purposes, is not stored by OINC. Change in Policies OINC has the right to modify any of its policies, at any time, without advance notice.
Credit Card Information. If your credit card account number changes or your credit card expiration date changes, we may acquire that information from our financial services partner and update your Account.
Credit Card Information. This authority is to remain in full force and effect until Xxxxx has received written notification from me (or either of us) of it’s termination in such time and in such manner as to afford Orion Healthcare Technology and Depository a reasonable opportunity to act on it. Type of Credit Card Name that appears on card Credit Card # Expiration Date 3 Digit CSV # (Security Code)
Credit Card Information. If you do not notify us of updates to your payment method, to avoid interruption of your service, we may participate in programs supported by your card provider to try to update your payment information, and you authorize us to continue billing your account with the updated information that we obtain.
Credit Card Information. Rental requires a valid credit card on file per the terms of this contract agreed to on page 1. Card information is kept confidential and shredded upon successful termination of contract (event ended, all fees paid, etc.).
Credit Card Information. 7.01 To the degree that the Client provides credit card information for the purpose of payment to the Company, the Company will be authorized to charge the Client’s credit card for any unpaid charges for the Course(s) on the dates agreed to by the Client and the Company, without seeking further authorization from the Client.
Credit Card Information. 7.1 Xxxxxxx Air will:
