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C Breeze Shuttle &  Limo Service LLC                                                                                                              Booking Date: ____________

38016 Fenwick Shoals Blvd                                                                                                                                                     Vehicle #: ____________

Selbyville, De. 19975



                   Name: ___________________________                                    Phone: ____________________________

    Trip Origin: ___________________________                     Destination: ____________________________

P/U Address: ___________________________                 Credit Card # :____________________________

       City /State: ___________________________                           Exp. Date: _____________ Auth #: _________

        Tour Date: ___________________________           Billing Address: ____________________________

         P/U Time: ___________________________          # of Passengers: ____________________________

                  Notes: _______________________________________________________________________



            Miles In: _________            Miles Out: ___________                 Time Out: ________         Time In: _______


Contract Terms

I understand that the down payment used to make this reservation is Non Refundable. We refuse to carry anyone possessing, or using drugs, minors under 21 possessing, or consuming alcoholic beverages. (Run will be immediately terminated without refund.) We will not be civilly or criminally responsible for any use of prohibited substances. We are not responsible for lost or stolen items left in vehicles.


Damage to Equipment

Vehicles offered for charter are carefully inspected prior to each run. Any damages due to the direct result of the actions of the passengers shall be the responsibility of the chartering party, and any costs for repair or extensive clean up will be charged, and paid for by chartering party. (Additional charges for cleaning and disinfecting of bodily fluids.)


Destination/Arrival Time

C Breeze Shuttle & Limo Service LLC endeavors to maintain the arrival and departure time as planned

for a trip, but does not guarantee arrival at or departure from any point at a specific time. We shall not be held liable for claims of any kind resulting directly or indirectly from any delays caused by accidents, breakdowns, traffic and road conditions, storms or any other conditions or circumstances beyond our control. We allow 15 minutes each way driving time





Clients / Chartering Party’s Signature Chauffeur’s Signature




Credit Card Holders Signature

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