NO ( - % 1.% / 1( I/I/ '‘At 11/1 I NOBILIS CREDIT CARD AUTHORIZATION Tel: Fax: Ship/Waive CFA: Waive Hold for CFA Approval: Date: 1/9/13 Nobilis Customer Number: 1= Account Name: Pattern Number: Order Total: Koala/ 49517 Quantity: 25 yards 3, 195.00 Ship to: Brice Gordon/LSJ/St. Thomas Tropical Shipping sm: VISA MASTERCARD AMERICAN EXPRESS X Credit Card tt: Expiration Date: Name on Credit Card: Billing Address of card: 9 E 71st St Zip Code required: SIGNATURE: New York, NY EFTA00559239