LAX Van Rentals 11 12 15 Passenger Van Rental Los Angeles Airport

Auto Insurance Company's Name : [?]

Policy Number :

Expiration Date: :

Your reservation


Pick-up location:		Pick-up date
		Jan 1, 1970 at

Drop-off location:		Drop-off date
		Jan 1, 1970 at

<< Change locations / dates

Your vehicle

Passengers

Suitcase

Airbags

GPS

Wifi

ABS

Audio input

Coverage and extra

		How many vans do you need? [?]		*We hold your vans but the final price is based on one vehicle
		Additional driver(s) [?]		$ per day each
		Child, booster seat(s) [?]		$ per day
		Collision Damage Waiver [?]		$0
		GPS navigation system [?]		$9.99
		WiFi Internet [?]		$14.99
		Road Side Assistance [?]		$ per day
		Toll Rd Pass [?]		$
		Upfront Fuel [?]		$

Your quote details

	0 Day(s) rental	$0
	Discount	- $
	Additional driver(s)	$
	Child, booster seat(s)	$
	Personal Accident Coverage	$0
	Collision Damage Waiver	$0
	GPS navigation system	$0
	WiFi Internet	$0
	Road Side Assistance	$0
	Toll Rd Pass	$0
	Upfront Fuel	$0
	Insurance Coverage	$0

	Service Fee	$0
	Total	$0

Billing Information

	First name :		Last name :

	Address :		City :

	State :		Zip Code :


	Country :		Phone

Driver License

	Number :		Expiration :

	Date of Birth (Driver must be 25 years of age or older) :

Credit Card

Type :

Number :

Exp (MMYY) :

CCV :

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When your reservation is confirmed, there will be $300-$500 security deposit prior to your rental and it will be released after return.

Insurance - Flight Info (Optional)

	If you are flying into an airport, please provide us your flight information:

	Air Line: :Flight No. :



	Coupon Code :

Comments

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