========== TRANSACTION RECORD ==========
GERMED LTD

NEW HYDE PARK, NY
United States
WWW.GERVETUSA.COM

TYPE: Purchase

ACCT: Mastercard             $ 99.82 USD

CARDHOLDER NAME : Lukasz Zientara
CARD NUMBER     : ############1204
DATE/TIME       : 18 May 21 17:32:39
REFERENCE #     : 003 0859075 M
AUTHOR. #       : 058250
TRANS. REF.     : GV-1621373559

    Approved - Thank You 100


Please retain this copy for your records.

Cardholder will pay above amount to
card issuer pursuant to cardholder
agreement.
========================================