AC-2011-00178_0002.tif 7° CITY LAI
HNVONCE
218 S 16TH ST Invoice Number: 1853
BLAIR, NE 68008
Invoice Date: 11/4/11
r ° m/se of a Page: 1
Voice: 402/426 -4191
Fax: 402/426 -4195
Bill To: DELORES PETERS
1171 MAPLE ST j
BLAIR, NE 68008
Customer ID: PETERS DELORES
Customer PO Payment Terms, Sales Rep ID Due Date
11/25/11
Description Amount
BUILDING PERMIT AC-2011-00178 400.00
I
i
Subtotal 400.00
Sales Tax
Total Invoice Amount 400.00
Check /Credit Memo No: Payment /Credit Applied
TOTAL' 400.00: