========== TRANSACTION RECORD ==========
GERMED LTD

NEW HYDE PARK, NY
United States
WWW.GERVETUSA.COM

TYPE: Purchase

ACCT: Visa                   $ 96.74 USD

CARDHOLDER NAME : Andrea Rodriguez
CARD NUMBER     : ############1405
DATE/TIME       : 21 Jan 21 20:10:54
REFERENCE #     : 003 0684237 M
AUTHOR. #       : 588881
TRANS. REF.     : GV-1611277854

    Approved - Thank You 100


Please retain this copy for your records.

Cardholder will pay above amount to
card issuer pursuant to cardholder
agreement.
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