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( I ( S <br /> • <br /> CITY OF t14ttt P89 <br /> CITY Cr EVELTC P'� <br /> El1GEtE ALT BLVD 41§9 <br /> 1821 . OR. 974 2tw 541-882-4812 <br /> p(ft 541-6824812 <br /> 94412.4158 <br /> REPRINT <br /> REPRINT <br /> Phone Order <br /> Phone Order <br /> mab000noom21 ri6IEVEEntry Method: Manal <br /> ICISIERCK Entry Method; Maui 100.00 <br /> 60.00 Total: $ <br /> Total: $ 15;32:51 <br /> 83/2248 14;46:58 19 18;s,ss;; Pour Code: 7122�I <br /> Inv t s:;t:s;sc Noor Code: 612262 ppolvd; Online <br /> Noorvd: Online AVS Code: <br /> MS Code: CW2 Code: Mp1CM M <br /> CV Code: MICA <br /> I an. to oar above total amount <br /> I gree to above total amount accordamtcrd ifissue <br /> entt <br /> according to card Issuer aareamat (Merchant according creditvoucher) <br /> (ryercbnt arereent IF credit eoocherl I <br /> (OA 1,511Nen bent Caw <br /> ben bent Copy >wwl Yal <br />