Maintaining accsA : Canadian Roads ¢ a ON Since 1988 CERTIFIED VIC CORPORATE OFFICE: ERVICES ING: astf2! Miran Map, Mert BK 189 Phone: 250-378-4176 Fax; 250-378-4105 CREDIT CARD AUTHORIZATION HOTEL NAME ADitmenn + Pax or email_ Cesc Rion ran hp-es, HOTEL LOCATION: Raga Praie CARDHOLDER NAME: DARLENE A WEREMEY EMCON SERVICES INC CARD # 4084 5400 0101 8262 VISA __Exp Date: 09/23 Cv code 818 Card number NOT to be kept on file 1 give authorizations to charge the following ROOM & TAX. only: Guest Names: Done Wend a eee Con Ff SF 92 Number of Single Rooms: _| Number of Double Rooms: Cheek In Date: Su\y 24].2| cheek out Date: Th Aq 2/2) Authorization Sinature:___ AJA fersmeg FINAL RECEIPTS MUST BE FMAILED TO: hotels.emeon@gmail.com OR FAX: 780-632-5060 PHONE 780-632-4085 FOR ALL INQUIRES. Emeon Services Inc. Additional Information if required: Alberta Roads Division PO Box 40 4 Vegreville, AB Wyre haw ‘TOC IRI SS i agikLYBs