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Innnn Iuu: WC vnLUC TUu! urinlui <br /> 001(e'(1 <br /> y C , crit, HMSHOST VValmart I'' <br /> LA B R E A BAKERY Save money.Live better. <br /> an 4 1W01 LAX INTERNATIONAL AIRPORT <br /> C 308 3 324 - 7-' <br /> r er, -7 ,Le-T 453 ' Jorge MANAGER FRONTINA STTEDT <br /> i,vfin, `ti!S..Ylq C H K 438 G S T 1 ST# 0637 OP#LEXINGTO <br /> 0. TE#68850 TR# 02893 <br /> BGL CHP P/G 0. :52304103 F 3.97 0 <br /> J b 21 ' 14 7 :4 3 A M GV TRAIL MIX .07874209522 F 4.98 N <br /> GVGF VN C 007874203917 F 2.68 0 <br /> NP GF B "IE 005844989039 F 4.56 0 <br /> 1 COFFEE M 2 6 9 SUBTOTAL 15.19 <br /> 1 PARFAIT 5 .99 VISA TOTAL TEND 16,19 <br /> SUBTOTAL ACCOUNT # **** **** **** 2832 S <br /> : .6 8 APPROVAL # 08125D <br /> TAX O. 8 REF # 1042000314 <br /> AMOUNT PAID 9 TRANS ID - 084203099637775 <br /> VALIDATION - 8H6Z <br /> XXXXXXXXXXXX2832 PAYMENT SERVICE — E <br /> VISA 9 : . TERMINAL # 17002771 <br /> ---4532 Closed JUL21 07: , .AM---- 07/21/14. 21:46:03 <br /> THANK YOU FOR YOUR :USINESS! CHANGE DUE 0,00 <br /> TELL US ABOUT YIAR EXPERIENCE ITEMS SOLD <br /> TC#,,•I. 4 1204 3306 9251 9088 ` + <br /> t 1 VICT:' KRISSMAN 11. fill I 1E111111 [11N 1 LI1f 1111 <br /> =_, p ` . 10-646-3470 <br /> �� <br /> 0' . RISSMAN @HMSHOST.COM Our Guarani-•d Low Prices <br /> Are Unbeatable th Ad Match' <br /> 07/21/14 '46:04 <br /> RA 5161536 ;i I 0 <br /> Renta 21-JUL-2014 ':49 PM <br /> OMAHA TT _ <br /> Return 27••.JL-201, 01:25 PM <br /> ONANA 'TT <br /> 'rlt;:l.i;:XlJtl: RUNZA RESTAURAIs <br /> SARA Tr • NO TO K 1-,C�I,� .5 56 ' 21 49 M c D E R M O T - <br /> Vehicle I # ' 110004,• -I di-I-I i f:31 <br /> r, 1 i -i L• VISTA NE 68 28 <br /> Class Drive • '• Class Charged FFAR 7 ti., Mitl IO I IV I".1 A.i'A <br /> License# 'K State/Province MO :1A,fii-IA NE 176 Ambe L <br /> MIKms Driven i ii 5 I 14' <br /> M/Kms Out 0 <br /> In .. <br /> M(Kms n � 0 I ; 'i_ 4"; 1271 1 q 10:41 Chk 4121'1,9769 -- 04:06P Gst 0 <br /> TETRA T e NATI' ' ACCOUNT H , f,''`11" 1 ' f i Gl.lil-All <br /> Billing ' f 158 •'7 OM'. 19.735 Dr i ye Th r t <br /> Charges No it Price Amount" ' L.Af1. ii h •20�f 1 BBQ Grill <br /> T&M 1 •-k 522.00 522,00* .. CAI,+I•t E 3e 65. 1 1 5,19 <br /> FREE M M 1400 MI s 0.00" I;1KCUi.01T '4P:t43i-1 S 2.00 1 SOUthwsL 5.19 <br /> COKE•.•ION RECOUP 51.99* 1 ,:k1I /.':l l P 4 ,). .I S.50 Grilled <br /> 1 . . OCCIJPATICN TA` 8.00 <br /> NE r',1a RECEIPTS a, 26,46 „.b..r,l. {'At-E S 73.67 1 LG Drink (i0 <br /> TAX 27,000 X 41.16 I.;It Wit :o: Sierra Mi- <br /> if.t,I. i:lii i all 7 'DAYS 1 LG Drink <br /> •tai Charges USD 655.61 1.00 <br /> Other <br /> Deposit Visa 2832 i, l ,h Ac c:it : 11815 1 MED FRY 1.89 <br /> Mount Due USD 655.61 A 0 t,- 782711 XXXXXXX XXX2832 <br /> ` ., • rl. t, secs 040 Visa 15.59 <br /> " Taxable Items I;HI'f,:>Y.LE. : 1()3404 <br /> Subject to Audit III .fri I`e1;r32341 <br /> Frequent Flyer """"" Credit to$ Sul Otal 14.57 <br /> For Reservatons: 1 800 PENT A CAR ),I;11 i El'?/, : 10 1 1 1 B 39 T. .02 <br /> If "in ID: 21 Yment ]' 59 <br /> riIR ' f-I1IE.i CikS? -----i76 Check Closed <br /> i EI:j]::clT EF1 1 ) 'dl•IV AT ---Ju121' 4 04:08PM <br /> 1tr,,\i C��A,S1/7:�1:T.i:: 1V1 •-- - --- <br /> t - eEy?A0'') <br />