SHOWTURF

SHOWTURF CREDIT CARD AUTHORIZATION FORM Company name: L— Sir Nombre de copania Address: Direccion Phone number: ( ri-o) (6:43,-(3S-69" Telefono Fax number: (W)9 -1 -5 2--52S Telefono de fax Col co Scro i-tor saTi Credit card: VA-MEX VISA MASTERCARD Tarjeta de credito Credit card number: Numero de tarjeta Expiration date: Dia de expiracion Security code: Codigo de segurida Billing address: E_ R-I 'SF ThTisa tT Direccion donde reciben los pagos N Lir/pi-2a authorize Showturf to Charge $ 373.OO to my credit card account. Print name of card holder: LA) Nombre en la tarjeta oi pc -7009 Signature of card holder: firma 0 ti thcZ. Please send signed and completed forms to 561-732-9972 or [email protected] EFTA01221281 ; ShowTurf a 0 a Hideout GC GCM 2830 Brantley Blvd Naples, FL 34117 MISCELLANEOUS QUOTE EXPIRY DATE: 06/19/2015 1365 Neptune Drive Boynton Beach, FL 33426 Phone: 561-732-8905 Fax: 561-732-8949 371-A Commercial Blvd Naples, FL 34104 Phone: 888-746-8873 Fax: 877-811-9949 www.showturf.com Blanch 01 • SHOWTUPF Date 05/22/2015 lime 8:44:54 (0) Page 1 Account No. 9999 Phone No. 000 000000 Esametaislo. 005861 SWp Via Purchase Order ANN RODRIGUEZ SaWspenwn CR PARTS ESTIMATE - NOT AN INVOICE SPECIAL ORDER PARTS ARE SUBJECT TO A 25% RESTOCKING FEE. **ALL QUOTES/ESTIMATES ARE ALSO SUBJECT TO SHIPPING CHARGES.** part# TCA17271 Authorization: Description HYDRAULIC PUMP Otv 1 Price Amount 370.75 370.75 Subtotal: 370.75 Tax: 22.25 TOTAL: 393.00 This is not an invoice. Do not pay from this parts estimate. EFTA01221282