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Untitled Document

Carshare Alexandria! Employer Reimbursement Request

Page One

The City of Alexandria provides a monetary incentive to encourage City of Alexandria businesses to use carsharing services available in the City. The “Carshare Alexandria!” incentive will reimburse businesses up to $100 towards their first year’s membership fee and pay half of their expenses for each employee’s application fee. Usage fees and security deposits are not eligible for reimbursement.

1. Applicant First and Last Name: *This question is required.

2. Applicant E-mail Address: *This question is required.

3. Applicant Phone Number: *This question is required.

4. Company/Organization: *This question is required.

5. Company/Organization Street Address: *This question is required.

6. Company/Organization Zip Code: *This question is required.

7. Carsharing service (e.g. Zipcar, Hertz On Demand) that your company/organization is joining?

8. Number of employees at this location? *This question is required. This question requires a valid number format.

9. Annual Membership Fee paid?

10. Application Fee paid?

In order to receive reimbursement for the above fees a copy of your organization's membership receipt/payment confirmation (Zipcar Members) or usage invoice (Hertz On Demand Members) must be sent to -

EMAIL: geralyn.taylor@alexandriava.gov, or
FAX: 703-746-3298, or
MAIL: Local Motion, ATTN: Geralyn Taylor, 421 King Street, suite 300, Alexandria, VA 22314

12. Please indicate how you will be sending a copy of your Company's membership reciept/payment confirmation (Zipcar Members) or usage invoice (Hertz On Demand Members): *This question is required.