Funeral Escort & Limousine Request form " Burial / Memorial Service"

SERVICE REQUEST FORM COMPLETED BY:

FUNERAL HOME:

DAY OF WEEK

DATE OF SERVICE

START TIME OF SERVICE:

ESCORT SPOT TIME: - (30 min from departure)

NAME OF DECEASED:

EMAIL ADDRESS:

CONTACT NUMBER:

PROCESSION START ADDRESS: *

PROCESSION DESTINATION: (include address & Description)

FORT LOGAN SERVICE TIME:

ADDITIONAL ESCORT SERVICE DETAILS:

REQUESTING A LIMOUSINE FOR THIS SERVICE? Required

YES

NOTE: IF THE LIMOUSINE VEHICLE TYPE IS UNAVAILABLE FOR THIS SERVICE DO YOU AUTHORIZE US TO PROVIDE SERVICE IN A SIMILAR TYPE VEHICLE?

LIMOUSINE VEHICLE TYPE SUBSTITUTE OK? Required

YES

PRIMARY PERSON RIDING IN LIMO (name & phone #)

LIMOUSINE SERVICE DETAILS/SPECIAL REQUESTS:

CLICK THE "SEND REQUEST" BUTTON TO SUBMIT THIS FORM.

Contact Information

City-Wide Protection, Inc.

Phone: 303-557-8454

Luxury Limousine LL-03939

PLEASE NOTE

Our staff might be working a service and will return messages as soon as possible

Hours of operation:

Mon-Fri: 8-5pm

Sat: on-call

Sun: on-call

Serving the Denver Metro Area

Honor - Professionalism - Dedication

(8) Passenger Cadillac Stretch Limousine

(8) Passenger Cadillac Stretch Interior

(6) Passenger Cadillac Limousine

(6) Passenger Cadillac Interior

(8) Passenger Lincoln Stretch Limousine

Honor - Professionalism - Dedication