My Chauffeur Transportation & Tour Co.

Portland, Oregon

Reservation Form -

Downtown Portland Service

(non-PDX service)

(Secure Form-SSL Encryption. The information is protected using the industry standard SSL )

Submit this reservation request by filling out the secure form below and clicking on the "I Authorize & Agree" button at the bottom. Please follow the instructions below. A representative will contact you within 24 hours to confirm the availability of your reservation and process your request.

If your reservation is within the next 48 hours, please do not use this form. Call 503-969-4370 to speak with a reservation agent.

a Instructions `

Past Customers:

If you have made a reservation with us at any time in the past, either over the phone or on-line, fill in section 1, section 3, & section 4 only, then hit the "I Authorize and Agree" button at the bottom of the page. To edit any personal information, see below.

New Customers:

If you have never made a reservation with us before, skip section 1, and fill in section 2, section 3 & section 4, and hit "I Authorize and Agree" at the bottom of the page.

Edit or update your contact information Edit or update your billing information

Subject:

Order Placed By: (past customers only)

First Name:
Last Name:
E-mail:
Phone #:

Go to Section 3

Fields printed in BLUE are REQUIRED

Order Placed By: (New customers only)

Past Customer -- Edited

Full Name
Organization
Home or Business Street Address
City
State/ Province
Zip/ Postal Code
Country
Contact Phone # 1	Work Home Cell
Contact Phone # 2	Work Home Cell
Contact Phone # 3	Work Home Cell
FAX
E-mail

How would you like us to contact you to confirm?

We will re-confirm with you one (1) day before the reservation date by phone.

(Multiple choices may be selected by holding down the 'Ctrl' Key).

Go To Section 3

Billing Information: *see PRICING TERMS/CONDITIONS below

This secure page uses a 120 bit SSL encryption for your protection.

(Billing Information is Required to Secure your Reservation Date. Only the Primary Cardholder responsible for this account may utilize this Account Online feature. Review our Cancellation /Liability Agreements. Review our Privacy Policy.

I authorize My Chauffeur to charge my credit card.

Below is my personal & credit card information.

Past Customer -- Edited CC Info.

Use my credit card account on file with My Chauffeur

If checked, you are stating that you have set up a credit card account with My Chauffeur; and authorizing the use of this credit card account with My Chauffeur. Do not fill in below.
Go To Section 4 Past Customer -- Edited CC Info.

Credit or Debit Card:

Credit Card Number: é
(no spaces)

Expiration Date:
save this credit card & billing info. on-file **

Name on Card:
same as name above

Billing Address:
same as home or business address above

Street or P.O. Box:

City:

State:

Zip Code:

Country:

Phone #:
same as above

Alt. Phone #:

Email Address:
same as above

** A credit card imprint and signature of your credit card will be required on your reservation date unless you have a My Chauffeur credit card account on-file. You may use any credit card for the final payment. **

** Unless requested, we do not hold your credit card information on-file for future reservations. For an on-file request, you will receive a confirmation and you may then use your cc account for future reservations.

By checking the box above, I hereby authorize placing this credit card on file with My Chauffeur to be used on any future My Chauffeur reservations. And I understand that my card information will be on file with My Chauffeur and I may initiate payments to My Chauffeur using this card. I understand that My Chauffeur will charge my card at the termination of each reservation contract, or at “rides end”. I understand that if I should become past due on my My Chauffeur fees or my account suspended, My Chauffeur may charge my fees owed to this card. This authorization to perform charges to my card will remain in full force and effect until one of the following events: (i) the termination of my account with My Chauffeur, (ii) the expiration of my card, or (iii) the termination of this authorization, notified from me to My Chauffeur via the terminate account page on our website.

é By selecting, "I AUTHORIZE AND AGREE" below, I hereby authorize My Chauffeur to initiate a one-time authorization on this credit card for the tours net dollar total or its equivalent to validate the card is in good standing, and to secure the tour. For my debit card, I authorize My Chauffeur to initiate a one-time authorization on this debit card for the tours net dollar total plus a $300.00 refundable deposit or its equivalent to validate the card is in good standing, and to secure the tour. This authorization will not be charged against my credit or debit card or credited to my My Chauffeur account. By placing this card on file I understand that my card information will be on file with My Chauffeur and I may initiate payments to My Chauffeur using this card. I understand that if I should become past due on my My Chauffeur fees or my account suspended, My Chauffeur may charge my fees owed to this card. This authorization to perform charges to my card will remain in full force and effect until one of the following events: (i) the termination of my account with My Chauffeur, (ii) the expiration of my card, (iii) the termination of this authorization, notified from me to My Chauffeur, or (iv) the termination of the requested services ordered herein (on this contract) and a reasonable time thereafter to perform and finalize the transaction.

Go To Section 4

(Downtown Transfer Reservations)

Res. #1 is RED only.
Res. #2 is Blue/Grey. Do not fill in Blue/Grey sections if you are not making 2 reservations. We suggest completing all of Res. #1; then complete Res. #2.

Each time we pick you up is a new reservation; for round-trips, please fill in Res. #1 & Res. #2.

Passenger Name:

Res. #1 same as name above (section 2 or section 1)

phone # (optional)

Res. #2 same as Res. #1

phone # (optional)

Reservation Date:

Res. #1

Res. #2

(for additional dates, see "additional pickups" below)

Pick-Up Address & Time:

P/U Address - Res.#1

Res. #1

P/U Time:

P/U Address same as address above (section 2) or "on-file" home address.

Street:

City:

Zip Code:

P/U Address - Res.#2 ONLY (if applicable)

Res. #2

P/U Time:

P/U Address same as address above (section 2) or "on-file" home address.

Street:

City:

Zip Code:

Drop-Off Address:

Res. #1 D/O address same as address above (section 2) or "on-file" home address.

Street:

City:

Zip Code:

Stops en-route or off-route: *

Res. #2 D/O Address same as address above (section 2) or "on-file" home address.

Street:

City:

Zip Code:

Stops en-route or off-route: *

STOPS EN-ROUTE: Town Car $5-$15 per stop (hourly reservations excluded); base charge is based on the furthest stop. STOPS OFF-ROUTE: Reverts to the vehicle hourly rate.

Number of Passengers:

(The credit card holder may be responsible for up to 100% of the people # indicated; please contact us for your specific liability. For groups of 9 or more, a limo bus supplemental, to be initialed by all guests on the tour date, will be required.)

Res. #1 approximate

Res. #2 approximate

Vehicle Requested:

The Credit Card Holder Is Responsible For the Minimum Charges of each Vehicle when choosing below. Multiple vehicles may be selected by holding down the 'Ctrl' Key. This is a request for a vehicle; your requested vehicle is the scheduled vehicle, but vehicles are not guaranteed. The vehicle is guaranteed to accommodate up to the # of persons in your reservation. For groups of 4-5 persons, if extra comfort is desired, we recommend requesting the 2-8 passenger stretch limo. For groups of 7-8 persons, if extra comfort is desired, we recommend requesting the 14 passenger limo bus. If no vehicle is chosen, we will send the minimum required based on the passenger # noted above.

For pickups from the airport, only the town car and Denali may be reserved. For groups larger than 6, multiple vehicles may be chosen. For pickups to the airport, any vehicle may be chosen.

View Vehicle Descriptions for vehicle descriptions and person capacities;

** If you are ordering the SUV Denali, please review the Denali seating capacity. **

Multiple vehicles may be selected by holding down the 'Ctrl' Key.

Vehicle Rates

Res. #1

Res. #2 same as Res. #1.

Payment Instructions:

(Options: please choose one):

The Passenger will pay with his/her credit card or cash. A completed section 3 above is required; If using a credit card; a credit card holder signature is required, and the receipt given to the passenger.

Please use my credit card information in section 3 above. Signifies Payee is not present at reservation time; no-signature account; 20% chauffeur gratuity applies.

Please use my Credit Card Account /Corporate Account information already on file with My Chauffeur. No-signature account; 20% chauffeur gratuity applies.

If the Payee is not the Passenger, please: (more than 1 option may be selected)

Give passenger the receipt

or;

e-mail receipt to: same as email address above (section 2) or "on-file" email address.

or;

U.S. postal mail receipt to: same as billing same as address above

Comments or Special Instructions:

Are 3 or more P/U Dates Requested?

(if yes, enter in additional pick-ups below)

Yes No

Additional Pickups:

Other:

Discount Coupon? Code:

Gift Certificate Reservation # (if applicable):

How did you hear about us?

Final Confirmation of your reservation date and vehicle will be sent to you by email or fax within 24 hours after we receive this reservation request. It is your responsibility to ensure that this communication is successful for each contract or renewed contact (if applicable), and to contact us if you do not receive the confirmation. Please contact us if you do not receive confirmation. My Chauffeur holds no liability and will issue no refunds due to lost communications.

TERMS & CONDITIONS:

CANCELLATION POLICY: ALL TRIPS RESERVED AT LEAST 48 HOURS IN ADVANCE OF THE RESERVATION MAY BE CANCELLED BY CUSTOMER WITHIN 24 HOURS OF RESERVATION CONFIRMATION WITH NO PENALTY. FOR POINT TO POINT AND HOURLY RESERVATIONS, IF A CANCELLATION OR CHANGE IN RESERVATION PICK-UP TIME OCCURS LESS THAN TWO HOURS BEFORE A SCHEDULED PICK-UP TIME, FULL CHARGE EQUAL TO THE COST OF THE TRIP PLUS THE 20% SERVICE FEE, IS CHARGED TO THE CUSTOMER’S CREDIT CARD. YOUR CANCELLATION MUST BE IN WRITING, AND WE MUST RECEIVE AND CONFIRM YOUR CANCELLATION NO LATER THAN 2 HOURS PRIOR TO YOUR SCHEDULED PICK-UP TIME. THE FINAL DECISION WITH CANCELLATION CHARGES LIES WITH MY CHAUFFEUR.

* PRICING TERMS/CONDITIONS: EARLY/LATE HOUR CHG: For early morning reservations occurring between 3:00 a.m. and 3:59 a.m., there is an additional $10.00 charge. For all late night reservations occurring between 11:01 p.m. and 2:59 a.m. (time is determined from when the passenger is in the vehicle), or all flights scheduled to land between 11:00 p.m. and 4:00 a.m., there is an additional $15.00 charge. COMMUTE CHG: 20-25% commute hours surcharge may apply M-F, 6:00 am-10:00 am & 3:00 pm-7:00 pm (removed if complete commute is deemed “easy” by the chauffeur). STOPS EN-ROUTE: Town Car $5-$15 per stop (hourly reservations excluded); base charge is based on the furthest stop. For no-signature accounts (if applicable); we will send the credit card receipt via e-mail the day after the final reservation date. VEHICLE REQUEST: to guarantee a special vehicle request, additional charges apply. COUPON: Coupon presentation at p/u loc. required to be valid. WAIT TIME CHARGES AFTER 10 MINUTES ARE THE VEHICLES HOURLY RATE, OR $1.00 PER MINUTE FOR TOWN CAR SEDANS.

LIABILITY AGREEMENT: THE CREDIT CARD HOLDER IS RESPONSIBLE FOR ALL CHARGES ORDERED IN THIS AGREEMENT: INCLUDING, BUT NOT LIMITED TO, TRIP COSTS, CHAUFFEURS GRATUITY, COSTS NOTED UNDER PRICING TERMS/CONDITIONS, PICKUP DATES, TIMES AND LOCATIONS AND OTHER ORDERED COSTS NOT SPECIFICALLY MENTIONED HEREIN: AND INCLUDING CHARGES AGREED UPON IN WRITING AFTER THIS CONTRACT IS SENT, AND UP TO AND DURING THE TIME OF THE CONTRACTED SERVICE. A CREDIT CARD IMPRINT AND SIGNATURE OF THE RESERVATION CREDIT CARD IS REQUIRED AT THE PICK-UP DATE AND TIME. THE CREDIT CARD HOLDER IS RESPONSIBLE FOR ANY AND ALL EXTRA-ACCRUED TIME ON THE SERVICE DATE. THE CREDIT CARD HOLDER ACCEPTS FULL RESPONSIBILITY FOR CUSTOMER CAUSED VEHICLE DAMAGE OR SPECIAL CLEANING, AND AUTHORIZES COMPANY TO CHARGE FOR THE EXPENSES REGARDLESS AND IN ADDITION TO ANY PRIOR UNDERSTANDING AND AGREEMENTS. THE CREDIT CARD HOLDER AGREES THAT ANY OF HIS / HER GUESTS ACTIVITIES OR BEHAVIOR DEEMED BY THE CHAUFFEUR TO BE ILLEGAL OR PERILOUS WILL RESULT IN IMMEDIATE TERMINATION OF THE JOB WITH NO REFUND. THE COMPANY’S DECISION IS FINAL. MY CHAUFFEUR IS NOT RESPONSIBLE FOR LOST OR STOLEN PERSONAL ITEMS LEFT ON THE VEHICLE EITHER DURING OR AFTER THE RENTAL PERIOD. IF APPLICABLE, DUE TO THE NATURE OF THE 14 PASSENGER LIMO BUS, AND THAT IT IS A BUS, DESIGNED TO ALLOW STANDING, ALL PASSENGERS ARE AWARE AND DECLARE THAT THEY ARE TO REMAIN SEATED AT ANY TIME THE VEHICLE IS IN MOTION. FURTHERMORE, DUE TO THE NATURE OF THE 14 PASSENGER BUS, AND THAT IT IS A BUS, THAT ALLOWS STANDING, AND THAT ALCOHOLIC BEVERAGES ARE ALLOWED ON BOARD, THAT EACH PASSENGER “RIDES AT THEIR OWN RISK”. MY CHAUFFEUR WILL NOT BE RESPONSIBLE FOR ANY PASSENGER THAT INJURES HIS OR HERSELF IN ANY WAY WHILE ABOARD THE VEHICLE OR DURING THE RENTAL PERIOD. MY CHAUFFEUR WILL NOT BE RESPONSIBLE FOR INJURIES SUSTAINED TO ANY PASSENGER, INFLICTED BY ANOTHER PASSENGER EITHER ACCIDENTALLY OR PURPOSEFULLY.

THE PURCHASER AND GUESTS RELEASES AND FOREVER DISCHARGES MY CHAUFFEUR COMPANY, AFFILIATES AND ADMINISTRATORS AND ASSIGNS FROM ALL MANNER OF ACTIONS, CAUSES OF ACTIONS, DEBTS, ACCOUNTS, BONDS, CONTRACTS, CLAIMS AND DEMANDS FOR OR BY REASON OF ANY DAMAGE, LOSS OR INJURY TO PERSON AND PROPERTY WHICH HAS BEEN OR MAY BE SUSTAINED AS A CONSEQUENCE OF THE FOLLOWING:

THE CLAIM OR DISPUTE AROSE AS A RESULT OF DAMAGES OR INJURIES CAUSED AS A RESULT OF ALCOHOL CONSUMPTION IN MY CHAUFFEUR TRANSPORTATION COMPANY AND AFFILIATES VEHICLES.
THE CLAIM OR DISPUTE AROSE AS A RESULT OF INJURIES OR ILLNESS CAUSED AS A RESULT OF THE USE OF PICNIC LUNCHES & SUPPLIES, WINE BOTTLE OPENERS, BROKEN GLASSWARE, BEVERAGE SERVICE AND ANY AND ALL OTHER INJURIES OR ILLNESS DURING THE RENTAL PERIOD SUPPLIED BY MY CHAUFFEUR TRANSPORTATION COMPANY AND AFFILIATES.

IN THE EVENT THAT ANY PART OF THIS CONTRACT/ RENTAL AGREEMENT IS DECLARED UNENFORCEABLE, THE REMAINING PROVISIONS SHALL REMAIN IN FULL FORCE AND EFFECT.

DAMAGES TO THE FOLLOWING WILL BE PAID FOR IMMEDIATELY BY CHARGING THE FOLLOWING AMOUNTS TO THE CUSTOMER’S RENTAL AGREEMENT:

SICKNESS IN CAR	$250.00 EACH	BROKEN GLASSWARE	$5.00 EACH
MAJOR SPILLS	$100.00 EACH	MISSING READERS/ PUBLICATIONS	$5/15.00 EACH
GUM	up to $200.00 EACH	DAMAGED CD/ DVD PLAYER/ TV	$350.00 EACH
SMOKING IN CAR	$100.00 EACH	TEAR, CUT OR BURN TO COUCH	$300.00 EACH
BROKEN WINDOW	up to $1000.00 EACH
ANYTHING ELSE WILL BE ESTIMATED BY A PROFESSIONAL PERSON

BY AUTHORIZING AND AGREEING BELOW, I CERTIFY I HAVE READ AND UNDERSTAND THIS CONTRACT, I AM AUTHORIZING THIS TRANSACTION, AND AGREEING TO THESE POLICIES. ADDITIONALLY, I AFFIRM THAT I AM 18 YEARS OF AGE OR OLDER. I AM AUTHORIZING TO BE CHARGED FOR THE ITEMS ORDERED WITHIN THIS CONTRACT, AS DESCRIBED IN THE LIABILITY AGREEMENT, AND AM AGREEING TO MY CHAUFFEUR'S TERMS & CONDITIONS.

Your request will be processed immediately. A representative will contact with you within 24 hours to confirm the availability of your reservation request. Final confirmation is issued at that time. Please contact us if you do not receive this confirmation within 24 hours (excluding Sunday).

Submitting this form is a request for a reservation. To complete your reservation request, select the Authorize & Agree button below.

Thank you for your order.

Do not click the submit button more than once or it may result in duplicate submissions.
The transaction is not final until you click the 'I Authorize and Agree to the Terms & Conditions' button below and the Confirmation Page appears.

Security Notice: This form features secure SSL technology.

TEL: 503-969-4370

Toll-Free: 1-877-692-4283