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• <br /> 1 /-7116A # ai- agi <br /> CITY W ROAN( INS <br /> 1W u 19tH AVE sit 41.(1 1 <br /> WM. W 97401 <br /> 1541) bet S6(? <br /> ut,07,19 11-.9T06 <br /> MC RfPORI <br /> YID <br /> Caid 1.1 Sal. lot al <br /> VS 2 65.90 65.611 CHI 9l LOOM HIS <br /> Sal. Iota!: $ 6S.W 100 II 10111 AV,. SII. 4W <br /> Total: I 6S.00 (WIRE. OR 97401 1.111fuf Mitt POS <br /> 15411 b02.6677 WO If 111111 ARE Slt 400 <br /> WU6t. W 91401 <br /> 154)1 1u2•5617 <br /> REP•INT <br /> Bank ID: 1310 ' I° NT <br /> Bacchant ID: 1251 <br /> lore ID: out Dai. IL. 1.103 <br /> Lily Le WA* POS f .ID. ID: 2t1 <br /> 1W k 10114 AVT. Sit 41.11$ Phone Order <br /> 111111E. OR 91401 `ryy yyyt peIy1 a n• <br /> (5911 692 5677 L�tMv1INN 01802 �� <br /> Ira Ill: W1 VISA tnUx Iktthod: Manual MOX r <br /> 91.01,1, Total: $ 105.00 VISA ntrr Method: howl <br /> SET1WEt1NU REPORT Total: $ 40.00 <br /> Oath 16.. (WI 0147i19 15:11:41 <br /> Host <br /> Nome: <br /> I"'° Inv II: 906002 fear Code: 071411 0141(19 14:03:29 <br /> s.: 1 1 lwW f. crsd: Online Oatchn: Wail Inv II: 000091 kr Code: 65641 <br /> ,alai : ) 1 m CW2 Ca: hmioN M *Tedd: Online aatchp: 93lxf1 <br /> Reg coral 11.1 m. 919Lat ll ke4'1e.41 R.t a S91WW1 <br /> Settlerrnt Successful <br /> I awn to aar above total arkad I awe. to Pat aa.ft total aaamt <br /> serardam, to card :nom erector atcordina to cad mow evice..wnt <br /> (Merchant aveeaent if credit vouchn-I (Merchant areea.nt if credit veto:loci <br /> X ws-a • <br /> 1k..b.“1 iwr 11,..1..“1 I..o. <br /> i. <br /> P 105• + <br /> vJ1 tie:WWII0 Ik1115q'll(M LItkY1911. iN'MS0. WYI <br /> 5•3n <br /> P°, 14J J <br /> 0.•00 <br />