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13058
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13058
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Last modified
1/3/2018 10:33:02 AM
Creation date
1/3/2018 10:33:01 AM
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PW_Operating
PW_Document_Type_ Operating
MTO
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:1k: 719-1/K (;1:!) <br /> Of EUGENE POS CITY OF EUGENE POS <br /> ao.+ROOSEVELT BLVD 1820 ROOSEVELT BLVD <br /> EUGENE. OR. 97402-4155 EUGENE. OR. 97402-4159 <br /> 541-682-4812 541-682-4812 <br /> REP' NT REPRINT <br /> Phone Order <br /> xxxxxxxxxxxx9l52 xxxxxxxxxxxx4719 <br /> VISA Entry Method: Manual MASRERCARO Entry Method: Manual <br /> Total: $ 165.00 Total: $ 90.00 <br /> 0118 12:06:48 014248 13:28:23 <br /> =2' APor Code: 856161 <br /> Inv q, ,,.,,,,,1 tor Code, ���, , Inv q, ,,,,,, <br /> Aoorvd: Online Aoorvd: Online <br /> AVS Code: AVS Code: <br /> CVV2 Code: CCM M <br /> I agree to oar above total amount <br /> accord)aro to card issuer agreement <br /> I agree to oar above total amount (Merchant agreement if credit voucher) <br /> according to card issuer agreement <br /> (Merchant agreement if credit voucher) <br /> z____ _M____2111/ <br /> L 4/28/ <br /> Merchant COPY <br /> Merchant Coot THAN( YOU! <br /> THAN( YOU! <br />
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