Your Name*

Your Phone Number*

Your Email Address*

Company name or “Individual”*

Detail Location*

Detail Date*

Detail Start Time*

: HH

MM

Detail End Time*

: HH

MM

Number of Officers Requested*

Police Cruiser?*

Yes
No

What will the officers be doing during the detail?*

Are you a recurring customer? Please select if either apply.

Yes, my business/organization or I have scheduled an officer detail within the last 90 days.
Yes, I am requesting Extra Duty officers on a daily, weekly, or monthly recurring basis.

Comments regarding your detail or to pass along to the officers:

Check to copy name, phone, email from above

Billing/Accounts Payable Contact Person*

Billing/Accounts Payable Phone Number*

Billing/Accounts Payable Email Address*

Billing/Accounts Payable Address*

Terms

Rates:

$103.79 per officer hour

There is a 3 hour minimum per assigned officer and a 4 hour cancellation policy. Details must be scheduled for no less than 3 hours. Not canceling with at least 4 hour notice will result in the 3 hour minimum charge per assigned officer.

I have read and understand the Terms of Agreement. I agree to abide by Vineland rules, regulations and ordinances should my application be approved. Additionally, I will fulfill the requirements placed upon this application as expressed in the Terms of Agreement.

Signature Image url

Agree to Terms*

Check here to agree to the above terms

Payment Method*

Option 1: Please charge my credit card** for the amount of the estimated-invoice.
Option 2: I wish to prepay for this or a series of details. I understand my check, credit card**, ACH or wire payment must be received at least 3 days prior to the start of the detail (or first detail if a series.)
Option 3: Please send me an invoice. Upon receipt of the invoice, I will pay with a check, credit card**, ACH or wire. To guarantee this payment, I am providing a valid credit card. If I do not pay the invoice by day 30, I agree that Extra Duty Solutions can charge my credit card for the invoice amount plus a 5% late fee (late fee will replace the +3%.)
Option 4: Please send me an invoice as we are a publicly traded company. This option is only available for public companies traded on a stock exchange or in an over-the-counter market. Ticker or stock symbol is required.

Please select your preferred method of payment. If you select option 1 or 2, please proceed to billing and enter your credit card details. If you select option 3 or 4, please proceed to billing, select "check/ACH/wire" and follow the ensuing instructions.

Option 1

Option 1: Please charge my credit card** for the amount of the estimated-invoice.

Option 2

Option 2: I wish to prepay for this or a series of details. I understand my check, credit card**, ACH or wire payment must be received at least 3 days prior to the start of the detail (or first detail if a series.)

Option 3

Option 3: Please send me an invoice. Upon receipt of the invoice, I will pay with a check, credit card**, ACH or wire. To guarantee this payment, I am providing a valid credit card. If I do not pay the invoice by day 30, I agree that Extra Duty Solutions can charge my credit card for the invoice amount plus a 5% late fee (late fee will replace the +3%.)

Option 4

Option 4: Please send me an invoice as we are a publicly traded company. This option is only available for public companies traded on a stock exchange or in an over-the-counter market. Ticker or stock symbol is required.

Product Name

** Credit card charges are + 3%.

Vineland Extra Duty Detail Application

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