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I� ; tC,VZ <br /> COUnTRY <br /> 'NHS R SUITES <br /> Jeff Barna <br /> Room No. : 300 <br /> 1020 SW Taylor St. Arrival : 08-06-14 1/ <br /> Suite 530 Departure : 08-07-14 <br /> Portland OR 97205 Page No. : 1 of 1 <br /> Folio No. <br /> INFORMATION INVOICE Conf. No. : 79894735 <br /> Membership No. : Cashier No. : 3644 <br /> A/R Number <br /> Group Code <br /> Company Name 08-07-14 03:05:44 AM EST <br /> Date Text Charges Credits <br /> 08-06-14 Room 84.00 <br /> 08-06-14 State Tax 7% 5.88 <br /> 08-06-14 City Tax 5% 4.20 <br /> 08-07-14 VISA 94.08 <br /> Total 94.08 94.08 <br /> Balance 0.00 <br /> Club Carlson: A faster way to a free night stay at over 1000 Carlson hotels worldwide. <br /> Enroll and learn more at the front desk or at clubcarlson.com <br /> Thank You For Staying With Us <br /> I agree that my liability for this bill is not waived and agree to be held personally responsible in the event that the indicated person,company or <br /> association fails to pay for any portion or the full amount of these charges. <br /> Guest Signature <br /> Country Inn& Suites Omaha Airport <br /> 2210 Abbott Drive <br /> Carter Lake, IA 51510 <br /> Telephone: (712)347-5600 Fax: (712)347-5656 <br /> Email: cx_cart @countryinns.com <br />