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Platte River Implementation Funds Request no. 421
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Platte River Implementation Funds Request no. 421
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Last modified
10/8/2014 3:10:25 PM
Creation date
10/8/2014 9:48:47 AM
Metadata
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Template:
Water Supply Protection
File Number
421
Description
Request for Disbursement of Contributuion no. 421 Agreement no. R12AC60020
State
CO
Basin
North Platte
Author
Platte River Implementation Funds
Water Supply Pro - Doc Type
Correspondence
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a Inn <br /> „:,.,„:,,f,-01 <br /> : - 4.{' ess <br /> 4 Y eIv .ftes <br /> 9 07-22-14 <br /> Sara Townson Folio No. Room No. : 203 <br /> 1576 yosimity dr 7 A/R Number . Arrival : 07-21-14 <br /> Los Angeles CA 90041 Group Code Departure : 07-22-14 <br /> United States Company Conf. No. : 64501137 <br /> Membership No. : Rate Code : IMGOV <br /> Invoice No. • Page No. : 1 of 1 <br /> Date ` Description I Charges ( Credits <br /> 07-21-14 *Accommodation 83.00 <br /> :;: : : S:::;ax L 2.49 <br /> 07-21-14 Occupancy Tax -x 1.66 <br /> r!: <br /> 07-22-14 Visa 92.96 <br /> yt; <br /> I Total 92.96 92.96 <br /> Balance 0.00 <br /> Guest Signature: <br /> I have received the goods and/or services in the amount shown heron.I agree that my liablity for this bill is not waived and agree to be held <br /> personally liable in the event that the indicated person,company,or associate fails to pay for any part or the full amount of these charges.If <br /> a credit card charge,I further agree to perform the obligations set forth in the cardholder's agreement with the issuer. <br /> h(J,y G <br /> t ii . <br /> eEfl G <br /> W � <br /> sr <br /> Holiday Inn Express Lexington <br /> 2605 Plum Creek Parkway <br /> Lexington, NE 68850 <br /> Telephone: (308)324-9900 Fax: (308)324-7000 <br />
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