artefacto Credit Card Holder's Authorization: hereby authorize Artefacto to charge my exe OPS L/ credit card number in the amount of $ I76. 66 for a purchase order agreement. Security Code 26683 digits on back of card | Amex 4 digits on front of card) PO: ¢ NO CREDIT CARD CAN BE DATE: PROCESSED WITHOUT A COPY OF DRIVER'S LICENSE AND deposi CREDIT CARD FRONT| BACK X Payment in Full ___ Balance By signing below, | acknowledge the charges described hereon. Payment in full to be made when billed or in extends payment in accordance with standard policy of issuing card Company. Billing Address: GE Ptit rel Wiw York NY (0044 Signature 17651 Biscayne Blvd. Aventura, FL 33160 | Phone, | Fax im rns EFTA00520750