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...............x:....................: <br />i <br />..: ti: ; . ,..:R <br />... <br />'x <br />.,:" <br />~. ... .....y,. <br />Ted ~541~ 3459085 X111 Prairie Rd., ~~~~~e, QR 914Q~ ~~~~ <br />i'ax X541) 461-747 www.ianefiorest.com <br />h ~~ <br />~ ~ ~~or~e <br />~.,. <br />Denver to ~~, ~~' <br />~~ <br />~~~~ <br />~~~ ~ ~ ~ <br />Contact <br />~~ ~ <br /><. <br />~` Deliv <br />B~tl to ~, ~~ ~ ~~ <br />Date <br />dip MTW~~~.~~~ <br />w <br />, <br />.~:; <br />~.l <br />x~, ~p~y~~p x.~:I _ <br />..i.i.t.~ .~...>..: ti... <br />_.. ~~ ~ ~,.~'.:~~~~~~.:~:.:.:~=:~:::~;;~:,:..~.~:. ~ ~..;~: _-_~::~F~:: Tim <br />Driv Clerk ~ PQ# ~~ l~N4P~D SL~1NN <br />Q~ta~itity Descri~tian ~ri~e Amount <br /> <br /> ~ <br />~~ ~, <br /> ~~ ~~ ~ ` <br /> :~ ~ JV r ~L./ Y~~~~ <br /> <br />` ~~} ~L.~ ' + ~ ~ !i~ ~ ~ <br />4 ~+ ~ A~ f F <br />r <br />~~ r ~ <br />~~ <br />i <br />~ ~ ~ . <br />} <br />"° <br />} ff ~I~e~~~ <br />f ~ rw ~ ti ~~ s ~ ~ i ~. <br />~~C ~ ~~ ~ ~ <br />^ c~~~ <br />~t , ~~'~,- ~'~. ^ Cheque <br />~ ~ t ~ ~ } ~.. Credit Cara <br />' ~ ~ ~ Account <br />S~~ CI~~TQ~I~R QN 51T~ ~ST~ME~ VIIILL NOT ~~ ON SITS ~ Stan Grit <br />DUI~~ IN D~iv~ INAY B~O~I~R CLAN ~iP? ^ Gift Card <br />left Ry~f~t Midd[e Yes No <br />. ~ ~~~ ~ ~ <br />~. Thank you <br />and accepted ~y <br />~.~ <br />Far mQterfa[ terms ~rrd <br />cor~ditfar~s, see reverse side. <br />