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PERSON AUTHORIZED TO APPROVE WORK/CHARGES OR RECEIVING SERVICE


VEHICLE SERVICED DESCRIPTION TO BE PAID FOR BY CARDHOLDER

I certify that the information above is accurate and complete and hereby authorize the collection of payment via the above credit card for the services performed. I understand and agree to the following: Estimated charges may vary depending upon the actual conditions encountered. Should additional work be required that exceeds the estimate above, Milne Towing Services (Company) will obtain authorization from either the cardholder or the person indicated above listed as "PERSON AUTHORIZED TO APPROVE WORK/CHARGES" prior to completing additional chargeable work. The later may indicate their approval via their signature on the Company’s invoice. If the "Estimated Charges" field is left blank, I agree to pay the actual charges invoiced by the Company. I understand the Company is entitled to compensation for work performed and equipment utilized. I authorize the Company to charge for travel and work actually performed if the service cannot be completed due to materially inaccurate or incomplete information being provided to the Company. Hourly charges begin accruing when operator(s) depart base. Cancellation of service later than 15 minutes past operator departure will result in charges for their actual port to port travel time (time spent traveling from base and back). In the event of a default or dispute and referral to a collection agency or attorney for any collection or legal proceedings, the State of Nevada will be the State of jurisdiction and the customer will be responsible for all costs incurred.
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FAX COMPLETED FORM TO 775-359-0155 or EMAIL TO DISPATCH@MILNETOWING.COM
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