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158 W Fremont'' Rigby, lD 93442(208)745-s111exr. 19
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Jut, D, 2012 2:l3pM ilr sicru p0cATELL0z0B_23 3-1332 No.5i92 P. l
Blaz,e Sign and Graphic Design, lna
525 WEST I1IAPLE STREET
POCATELLO, ID 83201
lNcoMrNG LINE 208-232-77(is
FAX
EMAIL
208-233-7332
graphlcs@blazesign.com
sales@btazesign.com
DATE:
NUMBER OF PAGES:
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DESCRIPTION
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CLAIMANT OR HIS AGENT SIGN HERE
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Transaction Debits
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PZ SIGN DEPOSIT
Billing Information
tony golsary
,83201
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_Transaction Number: 1 64725ggpTurs_cover - XXXX-XXXX-XXXX_21 43Status: Refunded - Refunded
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J TTANSACI.ON NOTES: REFUND SIGN DEPOSIT 12OO311RIGBY PIZZA HUT SIGN1
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Transaction taken by; marianna
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O Copy{]gh\2AAZ - 2{12 Xptelrs niu ?ay LLC
https ://www.xpressbillpay. com/common/trans_details.phpftrans id=MTgOMTI2OTe%3D 8/13/2012
Xpress Bill Pay - Payment Processing
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|--- ^ -- -Billg$9:lv:gg-Provided Bv W'Ip:39gM!P,9r9o**
i___*"___._ .-_---_- -9opyright @ Xpress Biil pay 2012 _ AI Rights Reserved
City of Rexburg
35 Northlst East
Rexburg, lD 83440
208-359-3020
s165.AA
Transaction taken by: marianna
Page 1 ofl
l Transaction detail for payment to City of Rexburg.Date: 07/09/2012 - 3:49:25 PM
Transaction Number: 1 6022522PT
Discover - XXXX-XXXX-XXXX-21 43
Status: Successful
Description Reference #Amt per ltem f ltems Total Amt
ELECTRICAL PERMIT $65.00 1 s65.AA
Notes; 12 0031 1
PZ SIGN DEPOSIT $100.00 1 s1AA.0A
Notes: 12 0031 1
Billing Information
tony golsarry
, 83201
Total Paid:
https : //www.xpressbillpay. com/common/payment-process. php 719/20t2
Receipt Number:
35 North 1st East / Rexburg, tD. S3440Phone (208) 359-3020 / Fax (208) 3Sg-3022
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