EFTA00520902.pdf

IIIIIIII . Page 001/001 Sales Order 105169/55 08/180018 II Address. 17651 BISCAYNE BLVD artefac II Iim t°II Phone Number PriCto Is valid wog Ow WI on of the current month. Customer JSC INTERIOR LLC 1.0. 11193/55 in Conlea Phone Phone Number Home na Cel na Order Code READY-TO-ORDER $ales Consultants MANNY Mailing Address /-53 -6 LIC. Dist/Ci Citystounly Stale Zip Transport Delivery Incluse 0044 ROSSO CARRO Phone Number. Delivery Adress IBA D&ICi City/County AVENTURA Stale FL Zip 33160 Transport: Code Item O1. Description Delivery Dale UnIt Price Discount Sub Total 00119616 100 6.00 CALIFORNIA ARMLESS CHAIR (CTX8351NO) • V037 ASAP 385.00 2,310.00 WHITE TEXTURE 241( 19736'11• A.S. Otis.. cc RESERVA LOCAL REMOTO READY TO ORDER » Obs. Furniture Obs. Fabric Payment Conditions FULL PAYMENT Sub Total 2,310.00 Comeetal Dose. -231.00 DownPaymenl Date 08/18/2018 IM. D. Furniture 403.95 Oownpayment Amount 2.218.97 - CREDIT CARD Ship. & Handling 98.75 Sales Tax 7.00 % 145.17 Total 2.218.97 • Typing on oan8/2016 Printed by E2E0thEL in 03/20/2018 (i6:03) O ld ,110-4 1 EFTA00520902  artefacto Credit Card Holder's Authorization August 23. 20i 8 I, Te-WON GP5ien hereby authorize artefacto to charge my credit card as follows: • Visa • Number # : • Expiration Date: • Security code: • In the amount of: $ • For Sales Order #: ° S76 9 /..c.s IMPORTANT NOTE: PLEASE ATTACH A COPY OF YOUR DRIVER'S LICENSE. By signing below, I acknowledge the charges described here on. Payment in full to be made when billed or in extended payment in accordance with standard policy of issuing cord Company. Name as it Appears on Card: jer: Fr- ALE- y cst s 71-ti.v Billing Address: g&NY City: /Ve.e-c.) Vagd State: / 1-1 /Go O a ( Zip: 0 872 3 // Date 19915 Bisco ne Blvd. Aventura. FL 33180 Phone: Fax: EFTA00520903