2012-2013 Q4 expense report for Randall
Transcription
2012-2013 Q4 expense report for Randall
Randall Ellsworth (VP, North, Central & Eastern Regions) - 2012/13 4th Quarter Expense Report January 1, 2013 to March 31, 2013 Date 17-Jan-13 5-Feb-13 to 13-Feb-13 Purpose Cost Booked flight for trip to Thunder Bay to attend NAN (Nishnawbe Aski Nation) Quarterly Meeting Jan 30th $0.00 Accommodation $0.00 Hospitality $0.00 Meals $207.92 Transportation $0.00 Other Total $207.92 Trip to Kingston to attend meeting with Rural Legal Services (RLS) and Lanark, Leeds, and Grenville (LAN) Clinics Accommodation $0.00 $0.00 Hospitality $0.00 Meals $152.60 Transportation $0.00 Other Total $152.60 Summary of Expenses Accommodation Hospitality $0.00 $0.00 $0.00 $360.52 $0.00 $360.52 Meals Transportation Other Total Expenses (Q4 - 2012/13) Signature: Date: al A i d O n t anroi Form Reconciliation Mastercard Name --> RANDALLELLSWORTH- VP, North,CentralAnd EasternResiong Forthe month of Januarv2013 Transaction Description of charqe Date Account Cocling PorterAirlines- Flightto ThunderBay on Jan 30. NANQuartelymeetingin ThunderBav Jan17 Amount s207.92 61100-863000 rotal I $?ql-€? Note:this should equal ,nu utoilLnJ--..............- CertifiedCorrect:Dated earsas "Newaccountbalance",(as of statementdate)on the rightof the MC Signatu Claimant's ementunder"Y,curaccountat a glance". Mgr'sSignature aseattach all original receiptsin order heirappearanceon this form. g 6t(oo- f,63o.,o t1"'+o l(S)o { |{.5X BIf4o E FinanciatGroup Page1 of2 Your GorporateMastercarrdStaterment RANDALL ELLSWORTH date: + Stmt. IOIITARIO N.EGALAID Feb.3,2013+Acct.balance: Details of your transactions $207.92+ Pymt. dueby: Feb.10,2013 + Min.paymenr: your account at a glance $20I.9i1 Amounr Previous balance, Dec.3 - thankyou Payments rxedits Other TRANSACTToNS FORACCOUNT NUfltBE 1 z 3 Jan17 Jan.17PoBTEBAI ToRoNTo oN 207.92 Feb.3 Feb.3 TNTEREST ADVANCES To03FEB @1s.40000% 0.00 Feb.s Feb.3 |[email protected]%TO03FEB 0.00 PLEASE PAYYOUR SCHEDULED PAYMENT AMOUNT I3YTHEPAYMENT DUEDATE, I]RE.AUTHOBIZED DEBIT INEFFECT AS I]EQUESTED FROM YOUB DESIGNATED PAYMENT ACCOUNT. Purcn: ; + + + + + + $o.oo -$o.ori-$0.00 ' Casherdvances/Cheques Interest Fees Otherrharges Newaccounl balance, Feb.3 90.00 $0.00 $0.00 $0.0c} $207.92 bv FJ[:TE,iE#'.ntdue $207.e2 you're Amount payrng ($) + Yourcreditlimit Creditavalable.Feb.3 Repil anyitemswhichdonot itgreewitt yourrecords wilhin30 daysof staremefidare- Helpl'ulinformation - ^ Tlansaclions listed inthisstatement : - | i - Airlines $ 207.92 Y Hotel - 0 I Restaurants $o.oo $o.oo $o.oo Retail $ 0.00 Carrental Interestchargesand ratos CashadvanceslOheques $o.oo Itsm Interest charges onthisstatement (g) Annual interest ratesnextp,eriod (%) Dailyinterest ralesnextperiod(%) Other $ 0.00 conracrus Locarcals l:ll*r&tii i'n*t'"1',r,ug, Enquirisr:1 800263-2269 1 S0026&226Ar MastgGard TelephonoDevicesfortreDearf NIA 18669592089 | p.O.BoxS00StationM Loslorstolen cards:416232-8020 1 900961-9361 | Toronto, 0N M6S4)(2 @ @, @ PO BOX 187 STATIONF TORON-TOON M4Y 2L!' Begjstered kademafk of Bankot Montreal. Registefed hademark of Mastercard Intermtioml lmrporaterl. BMo G) FinancialGroup Account number: Accounl balance: paymenl Minimum due: F ; due R A N D A L LE L L S | l J O R T H L E G A LA I D O N T A R I O A T R I U NO N B A Y ' { [ D U N D A S T T O R O N TO ON 1 1 5 6e H l r r E Se 0 0 $ ?.07.92 $ 202.92 Feb,.t0.2013 you?epaying{g): IMI'ORTANT PAYMETITINFORMATION: lf youarepayingbymail,pleasemakeyourcheque or monev orderpayable to BMOBankol Montreai. Mailvourpavment io: Master0ard Payment-Cenlre, P.O.Box6044Sin.C'enire-Ville, Montreal, Quebec H3C3X2 -6lt- Itinerary - Porter Airlines Page1 of 4 -' Booking Information Youwillneedto providethisinformation withproofof identification foraccesstr:rtlre itemson youritinerary. Status: Cgnfirmed Confirmation number: Booking d ate: H2RZXI Thursday,January17,2013 FlightDetails DepartingFlight Toronto(YTZ) to ThunderBay (YQT) January-30-13FlightPD631 Bombardier Q400 DepartfromToronto(YTZ)a t 8:00r\l\/l Arrivein Thunder BavffQT) at 10:ll0AM ReturningFlight ThunderBay(YQT) to Toronto(YTZ) January-30-13FlightP D638 Bombardier Q400 Depa(fromThunder Bayffaf at4:00PM Arrivein TorontoffTZ at 5:50PM Auto Check-in No needto check-in; AutoCheck-inwilldo it for you! Porterw ill issuea printfriendlyversionandan electronic versionof yourboardingpass.lt willbe Priorto departure, attachedto the FlightRenrinder sentto the emailaddresson file.Beforearrivingat the airport,pleaseprinta paper versionof the boardingpasson your copyof yourboardingpa€ i s or verifythatyouareableto viewthe elecironic internetenabledmobiledevice. are eligiblefor Auto Check-in;pleasevisitAutoCheck-i1forfurtherdetails. Not all reservations Seat Selection There is no will be charged$15 CAD/USDplustax, perflight,p er seat,for seatselection. Firmfarereservations chargefor Flexibleor Freedomfare. additional PremiumSeats Flexible will be charged$30 CAD/USDplustax, perflight,p er seat,for PremiumSeatselection. Firmfarereservations andFreedomfareswillbercharged$15 CAD/USDplustax, perflight,p erseat.Seatselectionfees are non-refundable. and a a seatmorethan24 hoursbeforea flight.Alteryou havebeenAuto Checked-in t o pre-s;elect VisitMv Bookinqs seathas beenassigned,visitWeb Check-into changeseats. (aisleor windowand the areaof the plane)throughyourVlPortera ccount.We Youcan selectyourseatpreferences your preferences seats. assigning whenautomatically willattemptto accommodate For operationalreasons,Porterreservesthe rightto changeseatsat any tinne,. ?culture:en-CA https://www.flyporter.com/Flight/Itinerary r710u2013 T ' Itinerury- PorferAirlines Page 2 of 4 Contact Information Address MT. RANDALL ELLSWORTH 40 DundasStreetWest,{iuite200 Toronto, ONMsG2H1 Canada Phonenumber(s) Emailaddress(es) [email protected] Pa3senger Details Passenger Details 1. RANDALL ELLSWORTH #: 631/NA Flight#/Seat 638/NA Adult Payment Summary Charge Details BaseFare $ 298.00 NAVandSurcharges $ 46.00 AirTraveller SecurityCharge $ 14.24 Fee Airportlmprovement $ 20.00 Harmonized SalesTax $ 49.18 $ 427.42CAD TotalFarePrice PaymentDetails Charge Details ,l,i]f / CreditCard - MC (Declined) https://www. flyporter. com/Fli ght/Itinerary ?culture:en- CA crtatur v'w"t $ 207.92 r7/0r/2013 al Aid Ontario o MastercardReconciliation Form Name -----+ RANDALLELLSWORTH- VP. North. GentralAnd EasternReqions For the month of Februarv2013 Transaction Date Description of charoe Feb5 Feb6 F e b1 1 Febb13 - Gas lor rentalcar. lno Hetrocanaoa to Kingston.Meetingwith RLSand LANClinics. Discountcar rental- Car rentalfor lheclinicsmeetinq. Holidaylnn Kingston.Parkingfeesin Kinqston Queen'sPay and Displqps.Parking leesat the Queensuniversity. Vleetinqwith RLSand LANclinics. Account Codino Amount 61100-863000 5.00 61100-863000 $6.00 61100-863000 $8.0c Total ||'Note:this shouldequalthe amountthat appearsas "Newaccountbalance",(as of ant'sSignatu 133.60 61100-863000 the statementdate) on the right of the MC statementunder "Your accountat a glance". Signature Pleaseattachall originalreceiptsin order of their appearanceon this form. $152. At BMOFinancialGrourp, seekwaysto makeyourBMOCorporat€, Masrcrcardmoresecure. we continually Herearesomesimple,yet effective, stepsyoucantaketo helpprotectyourBMOCorporate MasterCard: . Alwayskeepyourcardin a safelocation . Onlyprovideyourcardinformation to reputable companies . Alwayspayattention to yoursurroundings whenusingyourcardor PIN . Reviewyourmonthlystatement andreportanydiscrepancies immediately Contactus immediately if yourcardis lost,stolenor if yoususpectyourcardhasbeencompromised; Canada& U.S.: Worldwide(callcollect): BMo 4I @ 1-800-361-3361 416-232-8020 tir,uncialGroup Page1 of 2 rporateMastercarrd Statement iiij'.i::il:ti1ti*1Yi6.${,1p RANDALL ELLSWORTI{ LEGALAIDONTARIO Mar.3, i1013t Acct. balance: ,,Details.of your transractions dats + Stmt. lbm no, itil Trans date 10,2013 { Min.payment: dueby: lllilar. $152.60+ Pymt. Your account at a glance Postino date Descrintion Preliousbalance, Feb.3 - thankyou Payments Othercredits TRANSACTIONS FORCARDNUMBE :.;:,' i:t. 1 + + Feb.11Feb.11AUTOMATIC 207.92cR PAYMENTRECEIVED-THANKYOU T TRANSACTIONS FORCARDNUMBE z a n 5 o 7 + + 5.00 133.60 + 6.00 -:)8.!0 0,00 0.00 + Feb.5 Feb.6 PETROCAN WHITBY ON Feb.6 Feb,6 DISCOUNTCAR&TRUCKRTORONTO ON Feb.11 Feb.11 Holiday Innl(ngslonI{NGSTONON .-Feb.13 Feb.t4- oUEEN€PAY-& ONDTSPLQPSKINGSTON.Ma.3 Mar.3 TNTEREST ADVANCES T003MAR @18.40000% Mar.3 Mar.3 INTEFiEST TO03MAB PURCHASES@ 18,40000% o CashadvanceslCheques Interest Fees Othercharges balance, Mar,3 Newaccount paying ($) Amountyou?e Hokrl 1.: t r : : Carrental Beprt any itemswhichdonotagreewithyourrecordswithin30daysof statenenldate. Resllaurants :i:, = a:a:. Retail eques Casln advanceslCh lnterestchargesand rates Item ; Conlactus L.ocalcalls $ $ 0.00 $ 6.00 $ 133.60 $ o.oo $ 13.00 $ 0.00 $ 0.00 Other $o.oo I 18.40000% I $o.oo {i152.60 1rT52.60 Airlines ($) onthisstatement Inlereslcharges interest ratesnextperiod(%) Annual ratesnextpetiod(%) Dailyinterest $0.00 $0.00 $0.00 Transactions inthisstalemenl : lisled ; = .:.:. ':,. ,,i. Purcffii152$o Hellpfulinformation DEBITINEFFECT AS PRE.AUTHORIZED REOUESTED FROMYOURDESIGNATED PAYMENT ACCOUNT. - {i207.92 {i207.92CR $0.00 Yourcreditlimit Cretllt avalable, Mar.3 AMOUNT PLEAI}EPAYYOURSCHEDULED PAYMENT BYTFIEPAYMENT DUEDATE. Q 9 o o $1s2.60 $o,oo 18.40000% 0.05041% | 0.05041% address aw Toll-freecalls Please 6: Canada & IJSA writlenenquiries i.i 1 S0026$22fi1 MasterCard Enquities: 1 800263-2263 M 300Station 1 86685+2@ P.0.Box fortheDeaf ltl/A Telephona Deviees Toronto, 0N M6S4X2 416232-8f201 800361-3361 Lostorsblencards; PO BOX 187 STATIONF TORONTOON M4Y 215 @ @* Rsistefed tradmarko{ Bank of Monkeal. Reiistefed kademarkot Mastecafd Iniematioml lmorF ated. @nEE BMo E FinanciarGro Account number: Account balance: payment due: lUlinimum duebv: N o 5 ELLShIORTH RANDALL L E 6 A LA I D O N T A R I O S T I d E SE O E A T R I U | ' lO N B A Y I i I ] D U N D A S T O N O N TO ON 1 1 5 Ga H l , 70 152,60 $ 152.50 Mat.10,2013 youtepaying($)r : IiJIPORANTPAYMENTINFORMATION makeyourchqueormoney bymail,please lf vouarepaying t0: toBMOBankof Montreal. Mailyoulpayment orderpayable Paymen-t Cenlre, P.O.Box6044Stn.']entrd-Ville; MasterCard H3C3X2 Montreal, Quebec ffi dffiffi P.O.NUMBER AGENTOUT Discount Car And Truck Rentals Ltd DISCOUNTNEW HORIZONS- ONTARIO 2440 DUNDASST W TORONTO Ontario For Customer Assistane (416)533-9227 For ReseruationsCall 310-CARS(2277) ANDREW16 RENTALAGREEMENT R.A. 2370029244 GST# 887892537RT1 FAX# (416)533-2548 2012 VEHICLE/VEHICULE TOYOTAYARISsDR NAME-NOM ELLSWORTH RANDALL BNAK362 cP000114 JTDKTUD36CD5O4562 02/05/201308:58 02106DO1308:58 45430 4t8 OUT/DEPART DUE IN / PREVUEDE RETOUT KM OUT / DEPART GAS/ ESSENCEOUT / DEPART KM INCLUDED I INCLUS ADDN'L DRIVER/ CONDUCTEURADDITIONNEL REMARKS.REMARQUES HIGHPARK EXPECTEDLOCATIONIN 2440 DUNDASSTW (4161s33-9227 3000KMPACK CAR @ VUAC FEE @ cDW @ 300 3000 / DAY ALLOWEDKI\,4S KM FOR AGREEMENT MAXTMUM CHARGES/ FRAIS KM CHARGED/ FRAIS HOURS/ HEURES DAYS/ JOURS / JOUR / DAY/ SUPLEMENTAIRE EXTENSION @13.00 @ 3B.9e @ 38.99 GST/HST @ 13.0./. PST/TVQ GAS / ESSENCEPER LITRE CONVSURDAILY/ JOUR @2.50 CHARGES/ FRAIS 5.00/Daily 1.15lDaily '19.99/Oaily Rentor is responsiblofor the Full Valu€ of Lost. Stolon or Damaged GPS unit(s). L6 Cliont ost t€nu r€sponsabledo tous dommages.psrtosou vols d'une ou des unito(s) do Eystsmedo navigation(GPS) loueo(s).XRonter is rosporciblo for any upgrado charg6(s) Lo@taireost resrcnsablo pour tow fiais de surola$emenl x- (1) NO OTHER DRIVERS ALLOWED / AUCUN AUTRE CONDUCTEURAUTORISE X(2) CLIENT OECLINE/ REFUSE X' ' CLIENT ACCEPTS / ACCEPTE XP.A.P./ DDC AT THE DAILYRATESHOWN/ R.P.S,/ DDC AU TARIFJOURNALIERINDIOUE' (3) RENTER ACCEPTS RESPONSIBILITYFOR ALL TOLL ROAO CHARGES PLUS ADMINISTRATIONFEES. CLIENT ASSUME TOUTE RESPONSABILITECONCERNANT LES COUTS ET FRAIS D'ADMINISTRATION RELIES A UUTILISATIONDE ROUTES A PEAGE. X(4)C.D.W.-R.C.D.CUSTOMER',S L|ABlLlry FOR DAMAGETO THE RENTEDVEHICLElS UP TO PER OCCURRENCE,REGARDLESSOF FAULT,EXCLUDINGTHEFT OF VEHICLE. THIS IS IN CONSIDERATIONOF PAYI\'IENT OF $ 19.99 PER DAY,LA SIGNATURE DU CLIENT LIMITE LA RESPOSABILITEDU LOCATAIRE POUR LES DOMMAGES DU VEHICLE LOUE JUSQU'AUAU MONTANT ,PAR EVENENMENT '19.99PAR JOUR, INDEPENDANTMENTDE LA RESPONSABILTE,EXCLUANTLE VOL DU VEHICULE, CECI, I.4OYENNANTLE PAIEMENTDE $ colLsroN DAMAGE WATVER(C.D.W.)COLLSIONDAMAGE wAlvER (q.D.w.) C,D.W. DOES NOT INCLUDE COVERAG CONCERNANTLES RENONCTATTON DoMMAGEs EN cAs DE coLlrsroN (R.c.D.) REOUESTFOR DRIVERUNDER21 YEARS OF AGE POUR CONDUCTEURDE MOINSDE 21 ANS DEI\,,IANDE are 1)rorrowinsi2) iranyorthetemsorconditio-ns-6srns.asrement *"onionsstipures 3YI,3;3;tXl*","T,t"1j'"t" fiffiY,illrS DISCOUNT REPRESENTATIVEMUST APPROVE tothovehicle isc?::"d!.11"--.. viorated: 3)ifross ordamage ",porte ou pasrespeots; 3)sira uiip"""niioniruil" DE DISCOUNT APPROBATION OBLIGATOIREDU REPRESENTANT undercariage, orabove the windshisld, by a @llision withany "oiont Cu rjenicutebu audesus du parei*i"..."".""t obj€6lbocauseofinsufficientolo-aran@{heig,ht91yil,lllla"* Uri""*iq""""p"ru*oilisionavectoutobjotacausedu ""-aessdus orDamageisnotrgporledtoOISCOUNTandnoarestPolic€ -. il"**""ii""rm"ant(hauteuroularq€ur)i4)sitapedoou Dopartmontat ih6 lim6 of lo$ within 24 hou6 of ih€ rimo oi Io$; 5) t.";;;;;s;;;;i ;; piJ"t" iing"r, i O|6COUNT ot au posr€ de AUTHORIZEDBY DiSCOUNTEMPLCYE! quisuivint s}sit€vehicureAUTHORISE PAR L'EMPLOYEDE DISCOUNT--..-levenoment; tmewiilb€rho. orosins $i"5ls'#i:Bi:i"lTafter rl*,*xJ:lieuies responsibilityofthoRonteruntilohock€dinby"gyY?q!:I5g _ i""u"f,iiuf""iui"""suprost6sheurosd6fermoture,seronila Dis@untAgentth6nextbusinessdayRent€dvo}lidesdrcp.podofi i"pi""if,f,t"i"t"""ijirojusqu,al,ouvorturedenosbur€auxle aff6r closins tim€ wiil be tho responsibilityorth: ;ii;;; t;i, eie irispoa* par un asent d€ Dis6unt. i;il;;i; - l:"]:f .rll!1,_ checked in by a duly aulhorized Discount Ag€nl lh€ n€xl business day. j'ai@mpris la politiqu€d€ confidentialitoa€ Dis@unt et jo J'ai lu 6t priwl und€rsrand DrscouN's Ihave road and ADDITIONALINFORMATION INFORMATION ADDITIONNELLE AIRBAGS CAN CAUSE DEATH OR INJURY IF MANUFACTURER'S :':'"Tff'S,x*niY:fet::i: RECOMIlIENDATIONSARE NOT FOLLOWED n5il""j€:5,iffJ[:,3X1:::?1, !:gl "l! personal lhelgEI anddisclosur€-of cli6nt's @ns6ntto [email protected]€ *f itior" O! -nna"niiutitede Dis@unt. Privacy Policy. withDISCOUNT'S information in ac@rdanc€ I agree to pay and I authorize DISCOUNT to process any applicable credit voucher for advance deposites ani all chirg-es incurred including parking violations.traffic violations.toll charges.damages to and theft ofthe vehicle. I agree to be bound by the terms and conditions in the contract folder that I have received with this rental agreement. Je m'engage a payer etj'authorise DISCOUNT de kaiter tout bordereau de carte de credit applicable pour depots ou avance et pour tous frais encourus incluant dommages ou vol du vehicule el incluant les contraventions de stationnemnent el poste de peage. Je consens a me conformer aux conditions enumerees sur i'enveloppe du contract de location dont j'accuse reception. SIGNATURE PERMISSIONGRANTED FOR VEHICLE TO LEAVE THE PROVINCE DONNEEAU VEHICULEDE OUITTERLA PROVINCE AUTHORISATION YES/OU|_ NO/NON_ PROVINCES/ PROVCTNES _ / AUTHORISEFAR L'EMPLOYE AUTHORIZEDBY DISCOUNTEI\4PLOYEE DE DISCOUNT L- DiS00|llfl CAR-i ilUti( RriltAL$ 24400UNIAS ST lJ ilz 'o*?fl3;uBf-U,.,', t:_ TERI1 ID: A4319445 Itlvll rlLfit{u ! EATCHII:292 SHIFT|:063 PETR{I-CRHfiST FD 3F1 T}IICI{SOH t'IHI TBV O H T f i R I OL 1 J 5 Y 9 I 0 5 4 3 6 7 16 8 Fre-Auth 6el80aq6S6 t'nu' """U6iHrti TotalrCAD$ 980.00 F - t l S T s : 8 6 6 2 9 8 4 4 10 P c0 8 38 3 2I l : 4 9 9 9 50 1 ^, , , ":""3vED@6s@q@' -li ub-teb 0g:04:00 .""tfiiilFfiu coFV 2613-0?-65 16:38 FUI'lP REGULRF L LI TBES F BI E E / L $ F U E LS H L E S $ CI1 3.906 1"27s 5.08* $ 5.08 T0TfiL 0tlED T O T R LP R I U C R E D I TC f i n D$ s"ff6 * F _ H S TI H C L $ 5 . 2 2 X P-HSTIHCI$ 0.35 S I l ' l U 0 IC E 5 7 5 2 C I 1 1 6 30 f , S fiuTll FURGHf,SE s 0 0 1[ 0 1 0 0 10 0 0 0 2 7 INH HOLTDRT IIH-HCTEBFRO}IT HTNGST BHIHG H O I E t .G U E S I SP L E R S E [[ fiPFROUEO TltRl.llt Y0u FoB DESH iicirr rn FItoHT P E BH t G H r 9 1 4 B B uiiioottrN 14:31 Paid 0n:2U13/0?/85 I l ' I P O R T R N -TR E T R I HT H I S C O P Y F O R Y O U NR E E O B O S -- 12:55 Entered:281il/02105 tt Ticket*: S836624s7 D u r. : 9 5 : ' 1 4 6' B B paid:$ 6-BB nriqinat ree:$ D u r. : 9 5 : 1 4 o'BB csr:$ B -s s [hange:$ credit Card:HRSTERIf,HD 5587-2858 0-BB s[:$ - -fione 0qain Thank-You T r a n 5 a c t i o n :P u r c h a s e Rooroued rilt"ntnt ID: BBBBS0BB T r a n s a c t i o nr e c o F d 2S13/S2/85 14:31:BL Batch 179 RBC7667 -dD$r p0IHTS i* oNDA'HFA.EuP o* ooa, ,o"t uP PLA.E PLACE ON DASH FACE UP P PLACEONDASHFACEUP Tindall Lot DueensUqiversitY l'indall l-lot EXPIRES 13 FEB 13 14:01 PAID lrT'FEB,. ,al rIl - r-fl,l ll lr|!-11t I PAID g 8.00c " $ 8.ooc rilrfv-rrmrEtr FEB131o:48 J J,'43'SiT.'5Jf9li$i' i''tB'sir"ioTffLf$l' ;,'43's%T'5#Fh''$i" ;4{#$3#Frl, r"1nfifi4df;'t?11 lnvoice DiscountGar& TruckRentalso/b New HorizonsCar& TruckRentalsLtd 720ArrowRoad NorthYork,OntarioMgM2M1 Canada BillTo MNDALL 1 l-2370012459 0210612013 0210612013 2370029244 DriverInformation H VINNumber Unit No. Vehicle Tvpe JTDKIUD36CD5O4562 cP0001'14 2012TOYOTAYARIS5DR Total Days Number: Date: DueDate: AgreementNo.: PONo.: Vehicle Plate BNAK362 Out Km In Km 45430 45975 1 STATEMENT OF CHARGES Rental Insurances $ 38.99 c 1000 InsuranceCode CDW $ 19.99 CDW Extras $6.15 ExtraCode KM 3OOOKMPACK CAR Price $ 5.00 ExtraCode VL VUACFEE Price $ 1.15 Fuel Sub Total GST/HST Total Paid BalanceDue $ 53.10 $ 118.23 $ 15.37 $ 133.60 $ 133.60 $ 0.00 RentalLocationAddress HIGHPARK 2440DUNDASST W TORONTOOntarioM6PlW9 CANADA PhoneNo.:(416)533-9227 FaxNo.(416)533-2548 HST/GST# DateRented DateReturned 02/05/2013 08:5t 02106/2013 08:0( PaymentTerms and Conditions Dueuponreceipt 887892537RT1 Page 1 of 1
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