Prepaid Car Rental Voucher H C AMERICAN EXPRESS TVL SVC ef(Z. eth | Please submit this voucher at time of rental. Customer Nome: a = Phone: Voucher Number: rion Hertz International Fax: ACCOUNT : Rental Information Car Class: GROUP K CLASS Res ID: | Example: OPEL INSIGNIA 2.0 OR SIMILAR #1 Club: Transmission: AUTOMATIC Air Conditioning: YES Equipment: Rental City: pr ann ress: Telephone: Return City: WARSAW Return Location: Address: Telephone: Pick Up Date: 19 AUG 2014 Pick Up Time: 12:50 PM__ Flight: LO 0027 Return Date: 30 AUG 2014 Return Time: 05:00 PM i IT Number: Rate Information Rental Rate: = 4718.62 PLN The details of your12 canis) rental are listed below. Less Adjustment: Prepayment: 1505.24 USD Rate Plan/Tariff: Your Prepaid Rate Includes: Your Prepaid Rate Does Not Include: Unlimited MI/KM Loss/Collision Damage Waiver (LDW/COU) Theft Protection Value Added Tax Airport Service Charge/Location Surcharge Refueling Personal Effects Coverage (Check availability at counter) Orop Charges if applicable Any Optional Services nat 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 Prepaid ertat date ano present itt Hertz attni e aving a de ° a specifies. (Additional Gays begin after 29 m USCENPLA Pare 380200 EFTA00616042