AUTHORIZATION TO CHARGE CREDIT CARD
Name On Card:
Credit Card Number:
I authorize Blue Reef Consulting, Inc. to debit my credit card as a monthly
recurring charge for their services rendered at agreed published prices. Should
I dispute a charge through my credit provider this will constitute a breach of
contract and will result in immediate deactivation of my virtual server.
I have included a photocopy of the credit card both front and back and
have signed the photocopy.
Signature ______________________________________ Date ________________
Please print, sign, date, and fax to Blue Reef Consulting, Inc. (305-274-9593).
Mail original to Blue Reef Consulting, Inc. at address included below.
Blue Reef Consulting, Inc.
7785 SW 86 Street - Suite 417
Miami, FL 33143