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INVOICE-MONTHLY
RENTAL AGREEMENT / CREDIT CARD AUTHORIZATION AGREEMENT
Please
fill out, sign and fax to Roots Travel at +331- 42 74 01 01. After
we process your payment we will send you a receipt.
Name: ________________________________________ E-mail: ________________________________
Tel: ___________________________________________ Fax: __________________________________
Independent apartment Reference (type and address of apt.): ____________________________________
_______________________________________ Period: From ________________To
_________________
Number of persons: __________________________ Number of months: ___________________________
Arrival time in Paris: ___________________________ Departure time*:
___________________________
* to arrange an appointment with our agent at the apartment for inspection
before your departure.
Total monthly rent including utilities in euro: _____________________________
euro to be debited from my
credit card on file at the beginning of each month for the duration
of my stay as specified above.
One month rental deposit: ________________ euro
Additional services:
- Taxi service: Taxi with chauffeur and keys of your rental apartment:
YES
NO
Airport-Apartment One Way: 70 euro
YES
Round Trip: 140 euro
YES
Rail Station-Apartment One Way: 44 euro
YES Round Trip: 88
euro
YES
Keys will be picked up at the office of the agency during opening
hours:
YES
(85, rue
de la Verrerie 75004 Paris, from Mon. to Sat. 10am-1pm and 2-7 pm, Mon.
closes at 6pm, Sat. opens at 11am)
- Cleaning service
during your stay can be arranged, 2 hours/session: 40 euro
YES
NO
This is to certify that I, _________________________________________________________,
hereby authorize ROOTS TRAVEL to debit my Visa / Master Card
Credit Card Number: ________________________________________________________________
Card Identification Number (The last 3 digits of the number printed
on the back of the card): _________
Card billing address _________________________________________________________________
Expiring on ___________________________________ for the amount of ___________________
euro
(please include in the amount any optional services you selected above,
if any)
as payment of one month rental deposit for my accommodation at (specify
type and address of apt.):
________________________________________________________________________________.
In addition, I authorize ROOTS TRAVEL to debit my credit card at the
beginning of each month for the amount
of ________________ euro as payment of monthly rent for the period of
months of my stay as specified above.
I represent that the premises will be occupied only by myself and my
______________________ guest(s)
arriving on ___________________________ and departing on ___________________________.
I agree that my credit card may also be used as a guarantee against
any additional charges (see
"conditions"/ "security deposit")
that I, or my guests, may incur as a result of our occupancy of the
above captioned premises including, missing or damaged property (beyond
normal wear and tear).
"Conditions"
read and approved.
Signature ___________________________________ Date______________________
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