Application for Credit Voucher Charge

19 UTOG 2 WAY RADIO INC. #84 APPLICATION FOR CREDIT VOUCHER CHARGE Company Name:______

Address:______FL______Zip Code: ______

Contact Name:______Telephone: (_____)______Email: ______

Billing Contact:______Telephone: (_____)______Email: ______

Does hereby apply for credit voucher charge with UTOG 2-WAY RADIO, INC.

Local Bank & address :______Acct No.______Tel#______Fax: Acct. Officer______Credit Reference ______Tel# ______The above firm assumes all reasonable financial obligations with regard to any legal fees assumed by UTOG in collecting any unpaid invoices. The above firm assumes all financial obligations with regard to charges authorized by this agreement. UTOG 2-WAY RADIO, INC. reserves the right to refuse service to firms who are in arrears. Flat-Rates: Local 5 Boro – RE: Zone & Zip code Guide Flat-Rates: Out of Town – RE: Out of Town Rate Guide $42.00 per hour waiting time or part thereof. Manhattan $10.00 each stop in the same or touching zones en route. Others are full. Brooklyn, Queens, Bronx and Staten Island $10.00 each stop - same zone only. Others are half price. No Show Charge - $15.00 Man, Bklyn, Qns, Bx, SI Out of town – Flat Rate (See Price Guide) LGA A/P - Manhattan Only - $48.00 JFK $ 58.00; NWK Airport $65.00 (From Manhattan Only) Package service - all Boroughs -- Book Price plus $10.00 $4.00 Administrative Service Charge Per Voucher-2% Worker’s Comp.-Sales Tax -Fuel Charge. AIRPORT PICK-UPS: You can make a reservation or call us when you arrive at the Airport. You should be able to get a car within 15 minutes. We recommend that you meet our car at the designated pick-up area. There is no extra charge for this service. If, however, the driver is required to meet you inside the terminal after parking the car there will be a $20.00 charge plus parking. 30 minute free wait time included. (Authorization given to UTOG 2-WAY RADIO, INC. to obtain credit information and verify above data) Our terms: Net 10 days

______(PRINT NAME AND TITLE)

______

1 (Date) (AUTHORIZATION SIGNATURE) Gratuity ______(15__18 ___ 20 ___)

Please select one:

___ No Voucher / No Rides ______(UTOG REPRESNTATIVE) ___Driver Voucher OK* *NOTE: YOUR COMPANY ASSUMES ALL RESPONSIBILITY FOR VOUCHER VERIFICATION* Please fax or email back to : 718-361-1099 or [email protected]