IIIIIIII II .

IIIIIIII II . Address. 17651 BISCAYNE BLVD artefact° II I im II II Phone Number Customer Phone Number Order Code $ales Consultants Mailing Address Citystounly Transport Delivery Incluse ROSSO CARRO Phone Number. Delivery Adress City/County JSC INTERIOR LLC 1.0. 11193/55 in Conlea Home na Cel na READY-TO-ORDER MANNY /-53 -6 LIC. 00 44 IBA AVENTURA Transport: Phone Dist/Ci Stale Zip D&ICi Stale FL Zip 33160 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 • O ld ,110-4 1 Typing on oan8/2016 Sales Order 105169/55 Page 001/001 08/180018 PriCto Is valid wog Ow WI on of the current month. Printed by E2E0thEL in 03/20/2018 (i6:03) EFTA00520902 artefacto Credit Card Holder's Authorization August 23. 20i 8 I, Te-WON GP5ien card as follows: • Visa • Number # : • Expiration Date: • Security code: • In the amount of: $ • For Sales Order #: ° S76 9 /..c.s hereby authorize artefacto to charge my credit 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. Billing Address: City: /Ve.e-c.) Vagd State: / 1-1 Zip: /Go O a ( Name as it Appears on Card: jer: Fr- ALE- y cst s 7 1-ti.v g &NY 0 872 3 // Date 19915 Bisco ne Blvd. Aventura. FL 33180 Phone: Fax: EFTA00520903