AMERICAN EXPRESS TRAVEL INVOICE Generated: Hon. 22 September 2014 it:10.0g Paget of 3 Travel Arrangements for American Express Travel Record Locator AgentDetails Centurion Travel Service 2401 W. Behrend Dr Ste.55 WC 08-03-69 Phoenix Arizona 85027 Toll Free 1-877-877-0987 When Overseas Call Collect 602-537-4000 Ticket Information fo Charges Airline Name Lot Polish Airlines Ticket Date 22/09/2014 Total Charged to American Express 350.00 Ticket Number Invoice Ticket Base Fare 1476.00 Electronic Yes Gov't Taxes/Airline Imposed Fees 484.50 Total (USD) Ticket Amount 1960.50 Ticket Exchange Original FareiTicket Credit - 8632 (1960.50) New Fare/Ticket - 7495392717 1960.50 Amount Charge/Credit 0.00 Airline Ticket Exchange Fee 350.00 The Baggage Rules of Delta Air Lines apply to this itinerary, and can be accessed by visiting gllg tiMvamnAllavol ccritilaciflagr: Travel Details Wednesday 15 Oct 14 Other Information CITIZENS OF ALIST CARRY A VALID PASSPORT Other Information A VISA IS REQUIRED FOR ENTRY INTO USA Other Information CITIZENS OF PASSPORT MUST BE VALID FOR THE PERIOD OF INTENDED STAY" Page 1 of 3 t_x3fff e 55 EFTA_R1_02002364 EFTA02683892