Hertz Prepaid Car Rental Voucher AMERICAN EXPRESS TVL SVC Please submit this voucher at time of rental. Customer Name Fax From hone: Hertz International Fax: Voucher Number ACCOUNT : Rental Information Res ID: #1 Club: Rental City: Location: Address: Telephone: Pick Up Date: Pick Up Time: WARSAW FRYDERYK CHOPIN AIRPORT DARK! I WIGURY 1 STREET 19 AUG 2014 12:50 PM Flight: LO 0027 Return Date: Return Time: Car Class: Example: Transmission: Air Conditioning: Equipment: Return City: Return Location: Address: Telephone: GROUP K CLASS OPEL INSIGNIA 2.0 OR SIMILAR AUTOMATIC YES WARSAW FRYDERYK CHOPIN AIRPORT 30 AUG 2014 05:00 PM RY 1 STREET Rate Information Rental Rate: The details of your12 day(s) rental are listed below. Less Adjustment: Rate Plan/Tariff: A0F2tiC Prepayment: IT Number: 4718.62 PLN 1505.24 USD Your Prepaid Rate Includes: Unlimited MI/KM Loss/Collision Damage Waiver (LOW/COW) Theft Protection Value Added Tax Airport Service Charge/Location Surcharge Liability Protection to the Country's Limits Vehicle Registration Recovery /Vehicle Lic Fee Remarks: Your Prepaid Rate Does Not Include: Refueling Personal Effects Coverage (Check availability at counter) Drop Charges if applicable Any Optional Services not listed as included Nonuaivable Excess The above items must be paid in local currency at time of rental. Prepayment has been charged to customer's American Express account. Tetras and Conditions I Plead US 0411,1 Pales ale emery marled.inane and canna be can ante one any Orel prantecinal offer 2 Pate5 extUdie One snoen at/We 310 10 0 041lessellrg 01 .00tonal WerIt*S Sad n ds end seas. akI0Cnel gvll 'de S. i.090) WKS OrOnrseao dronestrrencn **Calm ay IP tars)OnSIDIO EXCere0 ItniCe3 Carnet be repair r 'teener) mug be pad local)/ a brie of erne in local carter," in some mimes.. noneavaoa amount mye*a/d me or yam or eanageo anng an arlffiffell0 ref) V remains. A10.4 90e e commas..