Monarch 09.10.12
Content
Your 4 Night Cruise Includes: $25 Per Stateroom Shipboard Credit Customary Gratuities All Meals and Entertainment onboard All Port Fees and Taxes Roundtrip Transfer to Port Canaveral Baggage Handling for One Bag per person Pre-Departure Meeting
Based on group minimum
The Sea is calling ...
Answer it Royally onboard...
Ports of Call: Nassau, Bahamas Coco Cay, Bahamas
Monarch Of The Seas
Wickham P Senior Center ark 4 Night Bahamas Cruise September 10 - 14, 2012 Monday - Friday
Harbor City Tours
CRUISE RATES: Current rates as of February 2012 and subject to change at any time.
CATEGORY N M L K H G F3 F2 TYPE Interior Interior Interior Interior Oceanview Oceanview Oceanview Oceanview PRICE $429.00 $439.00 $449.00 $459.00 $469.00 $479.00 $489.00 $499.00
All rates are per person, based on double occupancy, with 2 lower beds. 3rd and 4th in the same cabin, single and suite rates are available upon request and subject to availability. Cabins assigned with your $225.00 per person deposit. Availability in each category is limited - Reserve early for the best selection! Port charges and government taxes of $162.45 are INCLUDED, but subject to government change. As of December 2008, the fuel charge supplement imposed by the cruise line has been discontinued, but is subject to be reinstated at anytime.
Deposit & Payments: $225.00 per person required with reservation Final payment is due by June 20, 2012
Ship Highlights: Clients can enjoy live Latin music at our Boleros Lounge. The Circuit Lounge rocks nightly whether the DJ is spinning ‘70s tunes or Top 40 dance music. A few of the other amenities offered are Rock-climbing wall Jade sushi bar and Asian-fusion restaurant, Latté-tudesSM coffee house featuring Seattle's Best Coffee®, Ben & Jerry's® ice cream, Casino RoyaleSM Themed bars and lounges, two outdoor pools, two whirlpools, Adventure Ocean® youth facilities, including teen-only areas, Fuel and Living Room Day Spa and Fitness Center Open-air basketball court. Ship Facts: Maiden Voyage: November 17, 1991 Refurbished: 2003 Passenger Capacity: 2,744 Godmother: Lauren Bacall Gross Tonnage: 73,941 Length: 880' Beam: 106' Draft: 25' Cruising Speed: 19 knots Activities: From sunrise to sunset and around every corner, there's something exciting for you to do on a Royal Caribbean International cruise vacation. Onboard, try the rock-climbing wall, or work out with one of our fitness trainers. How about a swim or a relaxing massage? Better yet, try your luck at Caribbean Stud Poker, attend an art auction, or turn it out dancing in a nightclub. There are even supervised activities for kids. And on land, we offer Shore & Land Excursions for everything from city tours to swimming with dolphins in the Bahamas. Best of all, every experience is delivered with our unique Gold Anchor Service.
ITINERARY
Dates Monday, September 10, 2012 Tuesday, September 11, 2012 Wednesday, September 12, 2012 Thursday, September 13, 2012 Friday, September 14, 2012
Port Port Canaveral, Florida Coco Cay, Bahamas Nassau, Bahamas Cruising Port Canaveral, Florida
Arrive
Depart 4:30 PM
8:00 AM 7:00 AM
5:00 PM 11:59 PM
7:00 AM
PORTS OF CALL
For a city now known for its warming sun and balmy breezes, Nassau has a tumultuous past. First settled by the English, the area was contested by England, France and Spain. For many years, Nassau was a home base for notorious pirates, and it was burned to the ground by the Spanish three different times. Since 1740, however, visitors from all over the world in search of both relaxation and adventure have made Nassau their favorite destination. Located in the middle of the Caribbean's bright blue water lies the secluded island of CocoCay. With its white-sand beaches and spectacular surroundings, CocoCay is a wonderland of adventure. Reserved exclusively for Royal Caribbean guests, this tropical paradise has recently been updated with new aquatic facilities, nature trails and a ton of great places to just sit back, relax and enjoy a tropical drink.
Wickham Park Senior Center Cruise - Terms & Conditions
Cost: Per cabin selected. CREDIT CARDS: Credit cards are accepted for Final Payment. Deposit is by cash or check only. DOCUMENTS: Passports are strongly recommended. However, you may use a certified birth certificate and government issued photo I.D. Some restrictions apply. CANCELLATION, CHANGES AND REFUNDS: Cancellations after deposit will be charged $50.00 per person, 59 43 will be charged $225.00 per person, 42-29 days will be charged 50%, 28 – 15 days will be charged 75%, 14 days or less 100% of the total paid. Should you fail to complete the cruise for any reason there are no refunds for unused features. Additional charge may apply for any alteration or revision you make to your reservation after deposit and/or final payment date. C AN C E L L AT I O N , M E D I C AL & CARRIER DEFAULT INSURANCE: To protect yourself against cancellation charges & medical emergencies before & during your trip & loss of money due to supplier bankruptcy, carrier default, carrier default coverage varies please see actual policy, we offer travel insurance described below. Coverage includes trip cancellation up to the amount purchased, $25,000 emergency medical & dental, $500,000 emergency medical transportation, $1,000 baggage, $300 baggage delay, $800 travel delay, $800 missed connection, 24 hour medical & travel assistance. A doctors statement will be required for cancellation coverage. The program WILL cover pre-existing conditions as long as the insurance is purchased at the time of your first deposit & you are medically stable at the time of purchase & have not filed a claim for trip cancellation due to a pre-existing illness within 120 days of the effective date of this reservation. Should you choose to purchase insurance at the time of your first deposit, & the group is cancelled due to the group minimum not being met, the insurance payment cannot be refunded. All medical benefits are defined to be in excess of any other group or government insurance you maintain. Policy is provided by Access America. All terms & conditions are explained in their policy and it is YOUR RESPONSIBILITY to read & understand the coverage you are purchasing. Other coverage desired can be purchased on an individual basis. Payment is nonrefundable & nontransferable.
Trip Cost
Age 31 - 59 60 - 70 71 - 75 76 - 79 80 +
Up to $500
$37
$44
$57
$69
$110
NOT INCLUDED: Accommodations and meals not stated in the itinerary, passport fees, beverages, laundry and all other items of a personal nature. Gratuities to escort & guides. Increases due to abnormal cost fluctuations and/ or circumstances beyond supplier control. CHANGES TO ITINERARY: We reserve the right to vary itineraries, suppliers, vendors and substitute the best alternate features available. In the event of cancellation or alteration of itineraries, Harbor City Travel & Tours does not assume responsibility. The supplier (s) contract shall constitute the sole contract between provider (s) and purchaser (s) . NOT A GUARANTEED GROUP: This is a group offer however we cannot guarantee the number of passengers that compose the group. DISABILITIES: The cruise/tour company must be notified of any health disability requiring special attention. SMOKING: Is not allowed on motor -coaches or during group functions. LIMITATION OF LIABILITY: You acknowledge and agree that the liability of Cobb Management, Inc., a Florida corporation, d/b/a Harbor City Tours and Harbor City Travel, 305 W. Hibiscus Blvd.., Melbourne, FL 32901, 321-727-0946 and/or its agents or co-operative co-sponsors of its tours is strictly limited to that as described herein. Cobb Management, Inc., d/b/a Harbor City Travel & Tours shall not be liable for any act, error, omission, accident, damage, injury or loss resulting from any cause related to acts of third parties, including but not limited to any extra costs or losses resulting from any damage, expense or inconvenience caused by delayed or cancelled transportation services, changes of schedule, strikes or other conditions beyond the control of Harbor City Travel & Tours. All suppliers of services are independent and Harbor City Travel & Tours neither owns nor operates any of the suppliers of
services. If any tour/cruise must be withdrawn by Harbor City Travel & Tours prior to beginning travel date, Harbor City Travel & Tours liability is limited to a refund of monies received by us, exclusive of insurance. If any tour/cruise must be withdrawn due to carrier default, Harbor City Travel & Tours liability is limited to a refund of monies, if any, that has not yet been sent to the defaulting supplier. Harbor City Travel & Tours reserves the right not to accept or retain as a tour passenger any person whose condition or general deportment impedes the operation of the tour or affects the rights, welfare or enjoyment of other passengers. ADVANCE GUEST REGISTRATION FORM: In compliance with the U.S. Government Border Security Act effective January 1, 2003, all cruise lines are now required to submit passenger registration forms to the government in advance of your cruise. These forms request key personal information, including your social security number and must be filled out by each passenger. The advance collection of this information will enable the government to take as many precautions as possible to ensure that passengers and ships are safe. As this is a mandatory form required by the US. Government, failure to return the form will result in guests being denied boarding. PREGNANCY: Refer to the cruise line website for denied boarding policy regarding pregnancy.
Harbor City Tours A Travel Management Company
305 W. Hibiscus Blvd. Melbourne, FL 32901-2720 (321) 727-0946
Date of Revision: February 2012
HARBOR CITY TOURS ~ RESERVATION FORM
Complete Following Form, Enclose Your Deposit and Mail To: Harbor City Travel & Tours, 305 W. Hibiscus Blvd., Melbourne, FL 32901-2720 (321) 727-0946 / (800) 397-2113 / (321) 676-3907 Fax
Wickham Park Senior Center Cruise Monarch of the Seas ~ September 10 - 14, 2012
PERSONAL INFORMATION:
**** Name MUST BE exactly as it appears on your Passport. *****
Name:_______________________________________________Telephone:(_____)________________ Spouse or Roommates Name:___________________________ Cell Phone:(_____)_______________ Address: ____________________________________________________________________________ City:________________________State:______Zip:__________ Summer Address:_____________________________________Telephone:(_____)________________ City:________________________State:______Zip:__________ Expected Date of Arrival Back in Florida:____________ Email: _______________________________
Passports: (Required for cruise registration)
(Please send copy with registration)
Name _______________________ # _______________ Issue Date __________ Expire Date __________ Name _______________________ # _______________ Issue Date __________ Expire Date __________ What name would you like on your Name Badge(s):__________________________________________ Physical Health/Disabilities: (You must state if you need any type of assistance, or N/A) ______________________________________________________________________________________ Celebrations: Please state occasion & date if you are having an anniversary or birthday: _____________________________________________________________________________________
CRUISE INFORMATION: Alumni Membership #/s:___________________ Cabin Category Request: 1st Choice_______2nd Choice_______ Occupancy: (Circle One) Double Triple Quad Single
____________________
Bedding: 1 Bed
2 Beds
Dining Requests: Early Dining is requested for the group. Check here if you prefer Late Dining _______ Table Size: 2 - 4 - 6 - 8 Dining Companions:_________________________________
Continued on reverse
PAYMENT INFORMATION: Deposit of $225.00 per person due with reservation. Reservation confirmation/invoice will be mailed after first deposit is received. Emergency Contact Name: ____________________________________________ Relationship: __________________________Phone: (______)________________ NON-REFUNDABLE CANCELLATION COVERAGE (Circle One) Accept Decline Should you wish to cover any pre-existing conditions & carrier default, insurance is due with your first deposit. Otherwise, insurance can be purchased any time up to the date of final payment without the aforementioned coverage. The following information is required in order to process your insurance policy:
Trip Cost Age 31 - 59 60 - 70 71 - 75 76 - 79 80 + Up to $500 $37 $44 $57 $69 $110
Name: ______________________ Birth Date: ____________ State of Residency: ______________ Name: ______________________ Birth Date: ____________ State of Residency: ______________ Please sign below, showing that you have read the Terms & Conditions. Reservation cannot be processed without your signature. If no selection is circled regarding the insurance we will consider this as acceptance of the insurance and add it to your final payment. Signature:_______________________________________________DATE:______________________
CRUISE DEPOSIT: $_________INSURANCE PAYMENT:$_________TOTAL DEPOSIT:$____________
In Lieu of my Credit Card imprint, I, __________________________, hereby authorize HARBOR CITY TRAVEL to charge my credit card, number ______________________________, expiring on ________, credit card security code number: ___________, in the amount of _____________. Signature as it appears on the card: __________________________________________________
"I/We, the undersigned, do hereby release, absolve, indemnify, and agree to hold harmless Wickham Park Senior Center in Brevard County, Florida, its agents and employees, as well as the organizers and sponsors of the above described activity, for any and all damages and injuries caused or incurred as a result of our participation in the above described activity." Date: __________ Signature(s): ____________________________________________________
Harbor City Tours A Travel Management Company
305 W. Hibiscus Blvd. Melbourne, FL 32901-2720 (321) 727-0946 [email protected]
Office Use Only Cat: ____ Cabin #: ________ Booking #: ___________________ Rate: _______x_____=_________ Ins.: ______x____ = _______ Total: _________ Deposit: ___________ by CK: _____ CC____ Balance: __________ Final due by: ________________
Based on group minimum
The Sea is calling ...
Answer it Royally onboard...
Ports of Call: Nassau, Bahamas Coco Cay, Bahamas
Monarch Of The Seas
Wickham P Senior Center ark 4 Night Bahamas Cruise September 10 - 14, 2012 Monday - Friday
Harbor City Tours
CRUISE RATES: Current rates as of February 2012 and subject to change at any time.
CATEGORY N M L K H G F3 F2 TYPE Interior Interior Interior Interior Oceanview Oceanview Oceanview Oceanview PRICE $429.00 $439.00 $449.00 $459.00 $469.00 $479.00 $489.00 $499.00
All rates are per person, based on double occupancy, with 2 lower beds. 3rd and 4th in the same cabin, single and suite rates are available upon request and subject to availability. Cabins assigned with your $225.00 per person deposit. Availability in each category is limited - Reserve early for the best selection! Port charges and government taxes of $162.45 are INCLUDED, but subject to government change. As of December 2008, the fuel charge supplement imposed by the cruise line has been discontinued, but is subject to be reinstated at anytime.
Deposit & Payments: $225.00 per person required with reservation Final payment is due by June 20, 2012
Ship Highlights: Clients can enjoy live Latin music at our Boleros Lounge. The Circuit Lounge rocks nightly whether the DJ is spinning ‘70s tunes or Top 40 dance music. A few of the other amenities offered are Rock-climbing wall Jade sushi bar and Asian-fusion restaurant, Latté-tudesSM coffee house featuring Seattle's Best Coffee®, Ben & Jerry's® ice cream, Casino RoyaleSM Themed bars and lounges, two outdoor pools, two whirlpools, Adventure Ocean® youth facilities, including teen-only areas, Fuel and Living Room Day Spa and Fitness Center Open-air basketball court. Ship Facts: Maiden Voyage: November 17, 1991 Refurbished: 2003 Passenger Capacity: 2,744 Godmother: Lauren Bacall Gross Tonnage: 73,941 Length: 880' Beam: 106' Draft: 25' Cruising Speed: 19 knots Activities: From sunrise to sunset and around every corner, there's something exciting for you to do on a Royal Caribbean International cruise vacation. Onboard, try the rock-climbing wall, or work out with one of our fitness trainers. How about a swim or a relaxing massage? Better yet, try your luck at Caribbean Stud Poker, attend an art auction, or turn it out dancing in a nightclub. There are even supervised activities for kids. And on land, we offer Shore & Land Excursions for everything from city tours to swimming with dolphins in the Bahamas. Best of all, every experience is delivered with our unique Gold Anchor Service.
ITINERARY
Dates Monday, September 10, 2012 Tuesday, September 11, 2012 Wednesday, September 12, 2012 Thursday, September 13, 2012 Friday, September 14, 2012
Port Port Canaveral, Florida Coco Cay, Bahamas Nassau, Bahamas Cruising Port Canaveral, Florida
Arrive
Depart 4:30 PM
8:00 AM 7:00 AM
5:00 PM 11:59 PM
7:00 AM
PORTS OF CALL
For a city now known for its warming sun and balmy breezes, Nassau has a tumultuous past. First settled by the English, the area was contested by England, France and Spain. For many years, Nassau was a home base for notorious pirates, and it was burned to the ground by the Spanish three different times. Since 1740, however, visitors from all over the world in search of both relaxation and adventure have made Nassau their favorite destination. Located in the middle of the Caribbean's bright blue water lies the secluded island of CocoCay. With its white-sand beaches and spectacular surroundings, CocoCay is a wonderland of adventure. Reserved exclusively for Royal Caribbean guests, this tropical paradise has recently been updated with new aquatic facilities, nature trails and a ton of great places to just sit back, relax and enjoy a tropical drink.
Wickham Park Senior Center Cruise - Terms & Conditions
Cost: Per cabin selected. CREDIT CARDS: Credit cards are accepted for Final Payment. Deposit is by cash or check only. DOCUMENTS: Passports are strongly recommended. However, you may use a certified birth certificate and government issued photo I.D. Some restrictions apply. CANCELLATION, CHANGES AND REFUNDS: Cancellations after deposit will be charged $50.00 per person, 59 43 will be charged $225.00 per person, 42-29 days will be charged 50%, 28 – 15 days will be charged 75%, 14 days or less 100% of the total paid. Should you fail to complete the cruise for any reason there are no refunds for unused features. Additional charge may apply for any alteration or revision you make to your reservation after deposit and/or final payment date. C AN C E L L AT I O N , M E D I C AL & CARRIER DEFAULT INSURANCE: To protect yourself against cancellation charges & medical emergencies before & during your trip & loss of money due to supplier bankruptcy, carrier default, carrier default coverage varies please see actual policy, we offer travel insurance described below. Coverage includes trip cancellation up to the amount purchased, $25,000 emergency medical & dental, $500,000 emergency medical transportation, $1,000 baggage, $300 baggage delay, $800 travel delay, $800 missed connection, 24 hour medical & travel assistance. A doctors statement will be required for cancellation coverage. The program WILL cover pre-existing conditions as long as the insurance is purchased at the time of your first deposit & you are medically stable at the time of purchase & have not filed a claim for trip cancellation due to a pre-existing illness within 120 days of the effective date of this reservation. Should you choose to purchase insurance at the time of your first deposit, & the group is cancelled due to the group minimum not being met, the insurance payment cannot be refunded. All medical benefits are defined to be in excess of any other group or government insurance you maintain. Policy is provided by Access America. All terms & conditions are explained in their policy and it is YOUR RESPONSIBILITY to read & understand the coverage you are purchasing. Other coverage desired can be purchased on an individual basis. Payment is nonrefundable & nontransferable.
Trip Cost
Age 31 - 59 60 - 70 71 - 75 76 - 79 80 +
Up to $500
$37
$44
$57
$69
$110
NOT INCLUDED: Accommodations and meals not stated in the itinerary, passport fees, beverages, laundry and all other items of a personal nature. Gratuities to escort & guides. Increases due to abnormal cost fluctuations and/ or circumstances beyond supplier control. CHANGES TO ITINERARY: We reserve the right to vary itineraries, suppliers, vendors and substitute the best alternate features available. In the event of cancellation or alteration of itineraries, Harbor City Travel & Tours does not assume responsibility. The supplier (s) contract shall constitute the sole contract between provider (s) and purchaser (s) . NOT A GUARANTEED GROUP: This is a group offer however we cannot guarantee the number of passengers that compose the group. DISABILITIES: The cruise/tour company must be notified of any health disability requiring special attention. SMOKING: Is not allowed on motor -coaches or during group functions. LIMITATION OF LIABILITY: You acknowledge and agree that the liability of Cobb Management, Inc., a Florida corporation, d/b/a Harbor City Tours and Harbor City Travel, 305 W. Hibiscus Blvd.., Melbourne, FL 32901, 321-727-0946 and/or its agents or co-operative co-sponsors of its tours is strictly limited to that as described herein. Cobb Management, Inc., d/b/a Harbor City Travel & Tours shall not be liable for any act, error, omission, accident, damage, injury or loss resulting from any cause related to acts of third parties, including but not limited to any extra costs or losses resulting from any damage, expense or inconvenience caused by delayed or cancelled transportation services, changes of schedule, strikes or other conditions beyond the control of Harbor City Travel & Tours. All suppliers of services are independent and Harbor City Travel & Tours neither owns nor operates any of the suppliers of
services. If any tour/cruise must be withdrawn by Harbor City Travel & Tours prior to beginning travel date, Harbor City Travel & Tours liability is limited to a refund of monies received by us, exclusive of insurance. If any tour/cruise must be withdrawn due to carrier default, Harbor City Travel & Tours liability is limited to a refund of monies, if any, that has not yet been sent to the defaulting supplier. Harbor City Travel & Tours reserves the right not to accept or retain as a tour passenger any person whose condition or general deportment impedes the operation of the tour or affects the rights, welfare or enjoyment of other passengers. ADVANCE GUEST REGISTRATION FORM: In compliance with the U.S. Government Border Security Act effective January 1, 2003, all cruise lines are now required to submit passenger registration forms to the government in advance of your cruise. These forms request key personal information, including your social security number and must be filled out by each passenger. The advance collection of this information will enable the government to take as many precautions as possible to ensure that passengers and ships are safe. As this is a mandatory form required by the US. Government, failure to return the form will result in guests being denied boarding. PREGNANCY: Refer to the cruise line website for denied boarding policy regarding pregnancy.
Harbor City Tours A Travel Management Company
305 W. Hibiscus Blvd. Melbourne, FL 32901-2720 (321) 727-0946
Date of Revision: February 2012
HARBOR CITY TOURS ~ RESERVATION FORM
Complete Following Form, Enclose Your Deposit and Mail To: Harbor City Travel & Tours, 305 W. Hibiscus Blvd., Melbourne, FL 32901-2720 (321) 727-0946 / (800) 397-2113 / (321) 676-3907 Fax
Wickham Park Senior Center Cruise Monarch of the Seas ~ September 10 - 14, 2012
PERSONAL INFORMATION:
**** Name MUST BE exactly as it appears on your Passport. *****
Name:_______________________________________________Telephone:(_____)________________ Spouse or Roommates Name:___________________________ Cell Phone:(_____)_______________ Address: ____________________________________________________________________________ City:________________________State:______Zip:__________ Summer Address:_____________________________________Telephone:(_____)________________ City:________________________State:______Zip:__________ Expected Date of Arrival Back in Florida:____________ Email: _______________________________
Passports: (Required for cruise registration)
(Please send copy with registration)
Name _______________________ # _______________ Issue Date __________ Expire Date __________ Name _______________________ # _______________ Issue Date __________ Expire Date __________ What name would you like on your Name Badge(s):__________________________________________ Physical Health/Disabilities: (You must state if you need any type of assistance, or N/A) ______________________________________________________________________________________ Celebrations: Please state occasion & date if you are having an anniversary or birthday: _____________________________________________________________________________________
CRUISE INFORMATION: Alumni Membership #/s:___________________ Cabin Category Request: 1st Choice_______2nd Choice_______ Occupancy: (Circle One) Double Triple Quad Single
____________________
Bedding: 1 Bed
2 Beds
Dining Requests: Early Dining is requested for the group. Check here if you prefer Late Dining _______ Table Size: 2 - 4 - 6 - 8 Dining Companions:_________________________________
Continued on reverse
PAYMENT INFORMATION: Deposit of $225.00 per person due with reservation. Reservation confirmation/invoice will be mailed after first deposit is received. Emergency Contact Name: ____________________________________________ Relationship: __________________________Phone: (______)________________ NON-REFUNDABLE CANCELLATION COVERAGE (Circle One) Accept Decline Should you wish to cover any pre-existing conditions & carrier default, insurance is due with your first deposit. Otherwise, insurance can be purchased any time up to the date of final payment without the aforementioned coverage. The following information is required in order to process your insurance policy:
Trip Cost Age 31 - 59 60 - 70 71 - 75 76 - 79 80 + Up to $500 $37 $44 $57 $69 $110
Name: ______________________ Birth Date: ____________ State of Residency: ______________ Name: ______________________ Birth Date: ____________ State of Residency: ______________ Please sign below, showing that you have read the Terms & Conditions. Reservation cannot be processed without your signature. If no selection is circled regarding the insurance we will consider this as acceptance of the insurance and add it to your final payment. Signature:_______________________________________________DATE:______________________
CRUISE DEPOSIT: $_________INSURANCE PAYMENT:$_________TOTAL DEPOSIT:$____________
In Lieu of my Credit Card imprint, I, __________________________, hereby authorize HARBOR CITY TRAVEL to charge my credit card, number ______________________________, expiring on ________, credit card security code number: ___________, in the amount of _____________. Signature as it appears on the card: __________________________________________________
"I/We, the undersigned, do hereby release, absolve, indemnify, and agree to hold harmless Wickham Park Senior Center in Brevard County, Florida, its agents and employees, as well as the organizers and sponsors of the above described activity, for any and all damages and injuries caused or incurred as a result of our participation in the above described activity." Date: __________ Signature(s): ____________________________________________________
Harbor City Tours A Travel Management Company
305 W. Hibiscus Blvd. Melbourne, FL 32901-2720 (321) 727-0946 [email protected]
Office Use Only Cat: ____ Cabin #: ________ Booking #: ___________________ Rate: _______x_____=_________ Ins.: ______x____ = _______ Total: _________ Deposit: ___________ by CK: _____ CC____ Balance: __________ Final due by: ________________
