Florida Department of Management Services - DMS



Avis Budget

Car Commercial Billing Account - Complete fields, review and initial Exhibit A

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|AGENCY INFORMATION – Complete all fields |

|AGENCY NAME |NO. OF YEARS IN BUSINESS |NO. OF EMPLOYEES |

|      |NA |NA |

|PHYSICAL ADDRESS (P.O. BOXES NOT ACCEPTED) |NATURE OF BUSINESS |

|      |NA |

|ADDRESS 2 OR BILLING ADDRESS |PRIMARY CONTACT NAME |

|      |      |

|CITY |STATE |ZIP CODE |TELEPHONE NO. (NO CELL PHONES) |

|      |   |      |    -     -      |

|PREVIOUS BUSINESS ADDRESS (IF AT PRESENT ADDRESS LESS THAN 2 YEARS) |DUN & BRADSTREET NO. |

|      |  |

|      |      |

|ADDRESS |CITY |STATE |ZIP CODE |E-MAIL ADDRESS |

|      |      |   |      |      |

|APPLICANT IS: |TELEPHONE NO. (NO CELL PHONES) |

| Corporation Sole Proprietorship Partnership LLC NA |    -     -      |

|PURCHASE ORDER # OR COST CONTROL INDICATOR (CCI) REQUIRED? |TAX EXEMPT? YES NO |

| Yes No # of digits?    (min of 2 max of 15) |If yes, please provide a copy of your tax exemption certificate(s). |

| | |

|CAR COMMERCIAL BILLING APPLICANTS ONLY |

|NAME OF AGENCY AS IT SHOULD |

|APPEAR ON CARDS (MAXIMUM 22 |

|CHARACTERS INCLUDING SPACES) |

|LAST |FIRST |BRAND |LAST |FIRST |BRAND |

| | |AVIS |BUDGET | | |AVIS |BUDGET |

|      |      | | |      |      | | |

|      |      | | |      |      | | |

|      |      | | |      |      | | |

|      |      | | |      |      | | |

|      |      | | |      |      | | |

|      |      | | |      |      | | |

|      |      | | |      |      | | |

|      |      | | |      |      | | |

|AUTHORIZED REP CARDS | |Avis Global Electronic Billing (GEB) |Budget Applicant Billing Program |

|(Limit 5) | | | |

|AVIS    BUDGET    | | | YES NO | YES NO |

|SIGNATURE AREA |

|The undersigned has read the guidelines on page 2 and agree thereto on behalf of the Agency indicated in the Agency Name field above. The undersigned certifies the |

|completed information provided in this Global Commercial Billing Application to be correct and that he/she is authorized to commit the Agency to the financial obligation |

|of the billing account according to the guidelines of this application. The undersigned authorizes the release of any information required by the Avis Budget Group |

|company(ies) that are parties to this application. |

|Avis Budget Group: | | |Agency: | |

|Salesperson Name|      | |Agency Name |      | |

|(print) | | | | | |

|STC/Account |      | |Authorized Signature | | |

|Manager Code | | |Manager or above | | |

|E-Mail |      | |Print Name |      | |

|Address | | | | | |

|Office |    -     -      | |Title |      | |

|phone | | | | | |

|Cell phone |    -     -      | |Date |   -    -      | |

| |

Exhibit A – Avis/Budget Car Commercial Billing Application guidelines

Agency[1] payments made pursuant to this agreement shall be made in accordance with Florida law, including Chapters 215 and 218, Florida Statutes and the rules made thereunder. Avis/Budget Commercial Billing charge cards and/or Avis Global Electronic Billing (GEB)/Budget Applicant Program charge instruments will be issued upon confirmation of eligibility from the State of Florida Department of Management Services. The following guidelines shall apply:

1. The Commercial Billing account may be terminated by either party, in its sole discretion, upon thirty (30) days prior written notice provided however if Agency breaches these conditions, ABG may terminate immediately on notice to Agency. The subscribing Agency assumes full responsibility for all contractual charges incurred through the use of ABG issued charge instruments to the subscribing Agency or its employees, agents or representatives. The charge instruments issued to the subscribing Agency are not credit cards. All charges, fees and expenses, including, but not limited to, payment for parking tickets, tolls, etc. will be made in accordance with Chapters 215 and 218, Florida Statutes and the rules made thereunder. The subscribing Agency is responsible for maintaining the integrity and security of all charge instruments to avoid any potential abuse or misuse by unauthorized users.

2. The subscribing Agency is responsible for accessing the online monthly invoices and issuing payments upon receipt of the invoice. Such invoices must be accessed via online for Avis at and for Budget at as no paper statements will be mailed. ABG may send out monthly email reminders to the email address provided by the subscribing Agency on the application form. It is the sole responsibility of the subscribing Agency to notify ABG if there are any changes to the billing notice contact email address on file.

3. ABG Commercial Billing charge instruments are not transferable and may be invalidated or canceled or the terms thereof modified by ABG at any time without prior notice. Possession of an ABG Commercial Billing charge instrument does not automatically entitle the subscribing Agency’s employee to rent a vehicle from ABG.

4. The subscribing Agency understands their responsibility to report any change in the statement billing address, the subscribing Agency’s authorized officer, charge or financial contact. The subscribing Agency further understands their responsibility to promptly report any addition; revision or cancellation of the employees authorized to use ABG Commercial Billing charge instruments and has the responsibility to cancel any obsolete charge instruments. Lost or stolen charge instruments must be reported immediately by email to Charge.Card@ or by mail to ABG at: 300 Centre Pointe Drive, Virginia Beach, VA 23462, Attention: Charge Card Department. The subscribing Agency will be responsible for all charges incurred through use of such Commercial Billing charge instruments prior to receipt of notice by ABG.

5. Agency understands their responsibility to maintain records reasonably necessary for ABG to verify Agency’s compliance with these guidelines.

6. This application is not intended to conflict with or contravene the Rental Vehicles Contract between Florida Department of Management Services and Avis Budget Group, Inc., Contract No. 78111808-20-1, and shall be governed by the terms and conditions therein.

Agency Name:

|      | |

| |      |   -    -      |

|Initial to confirm your understanding of the guidelines. |Print name and Title (Manager or above) |Date |

| |

|FOR ABG USE ONLY- DO NOT WRITE IN THIS SPACE |

Central Billing |AWD |  |  |  |  |  |  |  |Acct # | | | | | | | | | | | | | 

  |DIV IND Y N | | |BCD |  |  |  |  |  |  |  |Acct # | | | | | | | | | | | | |  Credit approval

  |DIV IND Y N | |

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[1] As used in this Application, an Agency includes entities defined in §287.012(1), Florida Statutes, and Eligible Users defined in Rule 60A-1.001(2), Florida Administrative Code.

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Global Commercial Billing Application

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