Folio Number : 08912

Name : Taufik Afdal, Mr

Contact : 085765648325
Address : Jl. Sultan
Mahmud t. 01
!. 04 "#. 20
Tan$un%&inan%
City/State : '"A
Pax : 2
Payment : (S
Room Number : )4123
Room Rate : &. 550,000
Arrival Date : 28*"#+*2013
Departure Date : 29*"#+*2013
,-.r '/
:0AT'0A
/at. Tran-a1ti#n /.-1ri&ti#n (har%.-
(r.dit-
28*"#+ ##m (har%. ##m (har%. 28 2 29 "#+ ##m )4123 2 2 " 1,100,000.00
S.r+i1. (har%. ##m S.r+i1. (har%. ##m ##m )4123
Ta3 ##m Ta3 ##m )4123
29*"#+ /.&#-it (a-h /4ST )4123 2 2 " 1,300,000.00
1,100,000.00
4a%. 1 #f 1 5alan1. 6 200,000,00 7
I AGREE THAT MY LIABILITY FOR THIS BILL IS NOT
WAIVED AND AGREED TO BE HELD PERSONALLY LIABLE
IN THE EVENT THAT THE INDICATED PERSON, COMPANY
OR ASSOCIATION FAILS TO PAY ANY PART OR THE FULL
AMOUNT OF THESE CHARGES
SIGNATURE :
Jalan Industri Raya No. 8 Gunung Sahari Jakarta 10720, Tel: !2"21# !2$1 7788 %unting#, &a': !2"21# !2$1 77((
)e*site: +++.or,hadshotel.,o-