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Manchester Super 8 Hotel & Conference Center
20 Taylor Street, Manchester CT 06040
(860) 643-1864, Fax (860) 643-1897
http://www.awardhotel.com/ |
Manchester Super 8 Hotel & Conference Center
Direct Bill Request Form
Today’s Date_________________
Company_______________________________________ Address ______________________________________
City: _______________________________________ State ________________ Zip Code______________
Telephone Number ______________________________ Contact ______________________________________
Subsidiary/Division of_______________________________________________________________________________
Billing Address ____________________________________________________________________________________
Company Credit Card # _________________________ Type ________________ ExpirationDate ________
Cardholder’s Name ________________________________ Relation to Business ___________________
Previous date your company has done business with Manchester Super 8 Hotel & Conference Center ___________________
Bank Name _____________________________________ (Super 8 Motel use only)
Address ________________________________________ Opening Date: _____________________
City ___________________________________________ Average Balance: _____________________
State ___________ Zip____________________________ Rating with hotel: _____________________
Phone Number __________________________________ Account #: _____________________
Checking Account Number______________________________________ Routing # ___________________________
Hospitality Trade-(preferably other local hotel properties) Date account opened ______________ By whom ___________
Reference: ______________________________________ High Amount______________________________________
Address: _______________________________________ Terms____________________________________________
Telephone: _____________________________________ Balance__________________________________________
Checkout Date: __________________________________ Date of Balance____________________________________
Hospitality Trade (preferably other local hotel properties) Date account opened _______________ By whom _________
Reference_______________________________________ High Amount ______________________________________
Address________________________________________ Terms ____________________________________________
Telephone______________________________________ Balance ___________________________________________
Checkout Date___________________________________ Date of Balance _____________________________________
Arrival Date_____________________________________ Departure Date _____________________________________
Estimated Amount $_______________________ Room Tax $___________Incidentals $_____________________
As an authorized agent of your company, your signature below will provide acknowledgment that your
company will pay all charges reflected on all invoices upon receipt.
Signature, Name & Title:__________________________________________________ Date: _______________________
GM approval: __________________________________________________ Date: _______________________
Please print, complete this form and then fax to (860) 643-1897
with your company information. Thank You. |
