Direct Billing Application

To establish an account with Avant-Garde Global Transportation, the following in formation must be completed and returned within (15) days prior to commencing services. Approval is contingent upon full completion of this document. All invoices are payable upon receipt. Should the information be incomplete, unconfirmed or insufficient, full payment or partial deposit may be required prior to rendering service.

Note: We will be contacting you by phone to obtain your credit card and bank reference information.

Name of Organization, Association or Company
Contact Name*
First Last
Email*
Company Name*
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Fax
Invoice Mailing Address
Mail to:
Address*
Street Address Address Line 2 City State ZIP Code
Amount of credit requested (estimated monthly transportation):*
Credit References
Business Name*
Business Name*
City & State*
City & State*
Phone*
Phone*
Email*
Email*
Account Date*
Account Date*
Authorized Direct Bill accounts are subject to immediate payment upon receipt of invoice. Unpaid balances outstanding (15) days after original billing date are subject to late payment fees of 1.5% (annual rate of 18%), or maximum charges allowable by law. Further, all costs of collection required, including attorney fees, will be added to the account. A credit card is required to guarantee all Direct Bill accounts. This card may be charged on the 16th day of non-payment for any invoice. It is agreed, in the event of questions related to your unpaid account, that it is your responsibility to contact Avant Garde Global Transportation’s Receivables department to clarify any and all questions concerning your balance. It is also agreed that all other undisputed charges will be paid according to the terms described here, while Avant Garde Global Transportation remains in the process of resolving your question. Your signature below authorizes Avant Garde Global Transportation, LLC, to verify the above information and signifies your agreement to all terms and conditions related to our Direct Billing policy.
To be filled out by individual(s) authorized to approve direct billing or incur charges on behalf of Organization, Association or Company:*
- I have read and agree to the terms outlined above
Name*
Title*
Name
Title

Name of Organization, Association or Company

Invoice Mailing Address

Credit References

Limo service in:

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