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25357
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25357
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Last modified
10/26/2018 1:38:51 PM
Creation date
10/26/2018 1:38:50 PM
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PW_Document_Type_ Operating
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• <br /> I D . 25. 6/m60-Lads- <br /> CITY a WOE* POS <br /> CITY OF EISA POS 192d ROOSEVELT&VD <br /> 1828 ROOSEVELT IR VD EOCE. R.9i 2-9159 <br /> watt.l R 48 <br /> 912-4159 <br /> 2 <br /> 'EP' 1 REPRINT <br /> Phone ar•er Phone Order <br /> xinaxeccoN48 uuxx ana8S76 <br /> VISA Entry Method: Maul VISA Entry I1et}od: Manual <br /> Total: $ 100.00 Total: $ 100.00 <br /> 10/19/18 14:19:19 1O/25'18 14:20213 <br /> Inv t ;;+;";; Awe Code; <br /> IN I: s;;;:;;17 floor Code: 862829 <br /> toorvd: Online Awad: Online <br /> AVS Code; AVS Code: <br /> CVV2 Code: MAICH M CVV2 Cede MICH M <br /> I agree to Pay above total amount <br /> I .area to oar above total amount scow-dine to card mistier ea eeamnt <br /> accorduK to card tower aarerarnt (Merchant avree.rnt if credit voucher/ <br /> vr <br /> (Merchant aeenent mf credit voucher) <br /> , 64-- MA- 61 , � i� /} 22 <br /> Merchant Coon <br /> Ike chant COPY IiaP VOW <br />
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