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12, 11.(0 <br /> i'l1Y OF rI(ifNt PUS _� <br /> 1828 R(ili;EVELI BLVt( <br /> LUGEIC O . 9i4O2.41S1 <br /> 54.1-68'!-4'112 MY OF un.chi i'ui •} <br /> 1M2u k(N SE.•ci i N.i+U <br /> CIFY OF EUEI I PUS <br /> d8,2:i.•Ib 22'.62.02 !:UfiFHt. OR Y74U2-4157 1'520 ROUSEVEI.T BLVD <br /> •`"41-6e 4512 LUGENi. OR. 9i4B2-4159 <br /> TOTALS REPORT R 'm INT >--4:: 5;1 412 <br /> REPRIIT ! <br /> Elavon . <br /> shone order -. af;'.:•14':!,:".1.,:71;4.,;:7:','(''.(..,. � <br /> d 1 nt Sale Promo ,, Pone edge ; <br /> IP- ,.�;gyp 44,6 , <br /> 67.75 0.00 67.46 iineK(z.1OXx� M 7^ . <br /> Ili. 1 4u.uU 0.00 4O.W 'iiCA El.i:1 'thod: I ual ,..1xxxxxx xxxx72IL <br /> Selz !Deal: $ 1e7.4t. VISA Entry Method: Manual <br /> low: $ 187.45 Total: $ 15.00 [, <br /> 08:23716 16:02:15 Total: $ 37.45 <br /> Inv it: 000000003 Apar Code; 017556 08/23/16 718:56:05 <br /> APPrvd: Online Inv q: 000000001 Aver Code: 013265 <br /> ,1 [Y AVS Code: ZIP MATCH Z APPrvd: Online <br /> j, ,': uI low Ilk PUS <br /> : 1.37.1 mou3LV21 f Il,vo CVV. Code: MATCH M AVS Code: <br /> 6.0611NE. OR. 9/482.41ba <br /> 541482 4812 CVV2 Code: NOT PROCESSED P <br /> I agree to Wr above total amount <br /> according to cord ismuer agreement <br /> 117.;.';•16 2..:..,.: (Merchant agreement if credit voucheri I agree to Pay above total amount <br /> SEITLEII:Ii 9E1according to card issuer agreement <br /> (Merchant agreement if credit vomcher•) <br /> 7 <br /> Mat:.h N,.,. 194 ^----�����^ "' -'G/VJ9_1.m <br /> Most home: Fla, ., X---; <br /> 1 <br /> Mer.ha»(.. ( R_.: .G c�� -•`_'_�Se�_"T 1 � <br /> Me,dwut. coo, lir/4 <br /> "Lt1 <br /> __� _ __ ___r. f <br /> gailall5"artgatiERMIA It:% IliAIm xrAn tiercla„t Loin • <br /> total 4 i to 4.: <br /> WANK YOU! <br /> Settlesent SuL;_t'7`.irui <br /> .6F. 181U:Y 4t t i? <br /> I <br /> 1852 4ti Q. CITY OF Out NE HOS <br /> �n� 1820 000`.i'vi.O.r B1'VD •i I'} td 10777.11E PO,. <br /> 11 C/ 15.00 + :Gall(:• OR yr012 41b8 .•._u wxx.€Viif BLVD <br /> 541-682 4812 <br /> t,r,:*Ni OR 9002- <br /> 411.9 <br /> 15.00 + S41 68?-4812 <br /> 002.....000,„... <br /> 30.00 Phot i - -; ^aRINT - <br /> ala <br /> e� • �` ate ; <br /> O• * xxz;Txxxxxxxx111.9 <br /> (`A.‘31. <br /> • VISA Entry Method: Manua! xxxxxxxxxxtx3119 <br /> 40.00 + MASlERM Entry Method; Mar(Lt31. <br /> OW Tott;l: $ 15.00 <br /> 40.00 08/23/1b 15:39:21 Total: $ 40.00 <br /> Inv II: WOONO02 Aver Code: 488093 /7116 16:23:51 <br /> 0• * Avvrvd: Online Inv ii: ;;i,>;;;, Aaar Code: 02386B <br /> t.�`'0 AVS Code: ZIP MATCH Z Append: Wine <br /> \27191 37.45 + 0112 Code: MATCH M AVS Code: <br /> 001,0•30000,1 • >20 <br /> CVV2 Code: MATCH M <br /> 37.45 vC 1 agree to Pa.,- abo.•t total amamt <br /> according to card issuer agreement I agree to NW JAN., total amount <br /> (Merchant agreement if credit voucher) according to card issuer agreement <br /> ,�,¢ ,, �� ��//� (Merchant agreement if credit va,cher) <br /> 0• �1 V•Vl _ V w- • <br /> O T I1 h0ot Coo ( 0, 1 G ho i. 40. 00 TI If4Y YIN!! Pei ch6,�1. c:A,G <br /> 37.45 + THAM6 YOU! <br /> ;•..003.•• . <br /> fV f .'mar <br />