Prepaid Car Rental Voucher AMERICAN EXPRESS TVL SVC Hertz. Customer Name: ‘ax: From: Hertz International Please submit this voucher at time of rental. hone: P| Voucher Number: Fax: ACCOUNT : Rental Information Res ID: #1 Club: Rental City: Location: Address: Telephone: Pick Up Date: Pick Up Time: WARSAL FRYDERYK CHOPIN AIRPORT ZWIRKI_ I WIGURY 1 STREET 19 AUG 2014 12:50 PM Flight: LO 0027 Car Class: Example: Transmission: Air Conditioning: Equipment: Return City: Return Location: Address: Telephone: Return Date: GROUP K CLASS OPEL INSIGNIA 2.0 OR SIMILAR UTOMATIC WARSAW FRYDERYK CHOPIN AIRPORT 30 AUG 2014 05:00 PM Return Time: Rate Information The details of your12 day(s) rental are listed below. Rate Plan/Tariff: AOF IT Number: Rental Rate: s 4718.62 PLN Less Adjustment: Prepayment: 1505.24 USD Your Prepaid Rate Includes: Unlimited MI/KM Loss/Collision Damage Waiver (LDM/COW) Theft Protection Value Added Tax Airport Service Charge/Location Surcharge Your Prepaid Rate Does Not Include: Refueling Personal Effects Coverage (Check availability at counter) Orop Charges if applicable Any Optional Services not listed as included Liability Protection to the Country's Limits Nonwaivable Excess Vehicle Registration Recovery /Vehicle Lic Fee The above items must be paid in local currency at time of rental. Prepayment has been charged to customer's American Express account Terms and Conditions an atempted Meft or vandaliem. Also, ie be issued. Changes requeing te re-msuance af 9 texnc mused portions of ve ay ako wary by Car group (Please check wim your travel etal. An intamatans! Dn O.COVEr any feasinably ant 19 Pent may #30 be Hated changes when have f at least One year prar to rertst date anc efication card which will require leaning cal Is Keptlonger than specifies. (Additional gays beghn after 29 minute grace penod and wil be USCENPLL Parra SBa2 0TH EFTA00308098