Original of this form is your authorization to charge
Allow up to 10 business days for processing in Accounts Payable
(additional insurance at time of rental will be employee's responsibility)
Car Rental Agencies
that accept this form.
"I am in possession of a valid California driver's license. I certify that I have not been issued more than three moving violations or have been responsible for more than three accidents (or any combination of more than three thereof) during the last twelve-month period."
Signature of Applicant Date
UNIGLOBE Air Travel (BTA-Bus. Travel Account)
(justification required for first-class service)
that accept this form
VENDOR CONTACT NAME:
STATE & ZIP:
Signature of Applicant / Requestor
Dept. Head (Print Name)
Dept. Head Signature
SEND INVOICE TO:
California State University, Bakersfield
ADM 35 - Attention: Accounts Payable (x 6209)
9001 Stockdale Highway
Bakersfield, CA 93311-1022
Original to be retained in Accounts Payable for processing
NOTE: Make sure values on form are correct as
VALUES ARE CLEARED BEFORE PRINTING AND FORM IS REFRESHED!