My Chauffeur Airporter

Corporate/Private Rate Plan Account

On-line Submittal form

FAX submittal form

You may set up a private or corporate account Rate Plan at any time.  The My Chauffeur Rate Plan Account saves you time each time you arrange transportation, adds convenience and limits the exchange of sensitive information.  Our on-line submittal system is secure. We will contact you within 48 hours to confirm.  You may review our Privacy Policy, Rate Plan Terms & Conditions and our PCI DSS Compliance certificate.

Toll-Free 1-877-692-4283;       Local 503-969-4370;      Fax 503-261-0816

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

Today's Date        

PERSONAL        

CORPORATE   Company Name:

PERSON(S) AUTHORIZED TO ORDER THE 'TRIPS':

Additional go below, special instructions.

PERSON(S) AUTHORIZED TO USE THIS ACCOUNT AS PASSENGERS **:

Do not limit company passengers who may use this account.

1.

2.

3.

4.

Additional go below, special instructions.

** List passengers who may use this account.  Add additional passengers over 4 under Special Instructions below. 

CONTACT PERSON:

OFFICE STREET ADDRESS (Corporate Account): 

CITY: STATE: ZIP CODE:

OFFICE PHONE:   FAX:

HOME STREET ADDRESS (Personal Account):

CITY: STATE: ZIP CODE:

PHONE:

ALT. PHONE:

RATE PLAN: Choose your plan on the left column, then whether you would like the plan to include METRO.PDX or METRO.METRO. Choose between yearly or monthly, and select from only 1 row.

 

Portland Metro*

PDX

Portland Metro*
1-10 rides

$480/year $570/year
1-20 rides $970/year $1150/year
1-5 rides $240/month $270/month
1-10 rides $480/month $550/month

AUTOMATICALLY UPDATE  (Rate plan may be cancelled at any time.  All account financial balances must be at zero for the termination to be processed.)


Your credit card information is secure.  To view our PCI DSS Compliance certificate, click here.

Credit Card Info:

Contact us at 503-969-4370 or toll-free 877-692-4283) to give us your credit card info.  Or you may leave your phone # here (phone # same as above) and we will contact you.  After we contact you and receive this info, we will then confirm your reservation.  Please continue with sections below.

You may choose to save your CC info on-file and/or fill in the CC billing info below, if desired.

Save Credit Card # on file:

save this credit card & billing info. on-file **  If box is checked, after we receive your CC info, for convenience, we will save it on-file to be used for future reservations.

Enter your Credit Card Billing Info:    Billing address is the same as info above, section 2.
Name on Card:

Street or P.O. Box:

City:

State:

Zip Code:

Country U.S.A.    
I will be paying final bill by: Credit Card Debit Card Cash Undecided
 
** *** Billing Terms & Conditions

PERMISSION TO CHARGE CREDIT CARD:

AGREED AND ACCEPTED BY:

                                

TYPED NAME

(A typed name is contractually and legally binding.)

COMPANY TITLE (IF APPLICABLE):

SPECIAL INSTRUCTIONS:        

 

* By AUTHORIZING AND AGREEING below, 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 commencement of each Rate Plan contract, or at “rides start”.  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.  Corporate/Private Rate Plan (if applicable) is non-refundable and may be cancelled by either party with no notice at any time.  Checking the box 'automatically update' is a request for an automatic update and granted or not granted upon review of your account.

Submitting this form is a request for a My Chauffeur CC account.

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

Please confirm also by phone: Yes   No

Thank You for your Order

Security Notice: This form features secure SSL technology.

 

 

503-969-4370  |  1-877-692-4283

(intnl: +1 503 969 4370)

My Chauffeur Office Hours

DAILY ~ 7am - 6pm (Pacific Time) ~

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