KIMPTON®

KIMPTON® hotels & restaurants CREDIT CARD AUTHORIZATION I. Antti Ruohonen . hereby authorize the Surfcomber, a Kimpton Ho tel to process the following credit card: Group Name: ABB Meeting Contact Nome: Antti Ruohonen Nome on Credit Cord (if different from above): Credit Cord Number: Expiration Date: Billing Address: City/State/Zip: Daytime Phone Number: Email Address: Authorized Signature: Please Indicate Billing Instructions: (Check all that apply) [(Room and Tax Only El Daily Resort Fee of $24 (including tox) DAdvance Deposit of $ OBanquets DAudio Visual Only I:Incidentals Only DOther (please specify): "Please note that if a different form of valid payment is not received at time of check-in, all charges will be applied to the above credit card." Please complete this form and fax to the Surfcomber Front Desk at 305-532-7280. Please Include a copy of the cardholder's ID. EFTA00305400