Local Family Owned & Operated – Serving Since 2007 Congratulations on taking the next step to provide the finest taxi transportation service for your customers. Please complete this form to begin your VIP Taxi Corporate Advantage experience.VIP Taxi 2710 E. Washington St. Phoenix, AZ 85034 3740 E. 43rd Place, Tucson, AZ 85713 Business Name:(Required) Division: Business Address:(Required) City, State, Zip:(Required) City State / Province / Region ZIP / Postal Code Your Name:(Required) Your Phone/Extension:(Required)Accounts Payable Contact:(Required) Accounts Payable Phone/Extension:(Required) Fax Number:(Required) E-Mail Address:(Required) Type of Business:(Required) Years in Business:(Required) Interested In:(Required) Tear-Off Vouchers Online Services Direct Billing I certify that the above information is true. This information is to be used only for opening an account. The Customer agrees to pay all invoices within 30 days from date of invoice, and to pay 2% per month on all overdue balances. Net accounts are subject to a 5% monthly service charge for invoice processing and handling. Signature(Required)Title:(Required) Date:(Required) MM slash DD slash YYYY After completion, please send to d.burr@viptaxi.com or fax to (520) 300-8369 Retain this copy for your records Your VIP Taxi Representative Derik Burr Director of Business Development Direct (602) 369-2759 (520)982-8636 Email d.burr@viptaxi.com Δ
