Page I of I RECEIPT DULLES GLASS AND MIRROR 9151 EUCLID AVENUE Mannassas , VA 20110 Phone 703-361-9994 info@dullesglassandmirror.com Transaction Type : Sale Authorization Code : 202880 AVS Result : Y - Match. Street address and 5•dlgit postal code match. Total : 4282.58 USD Cardholder Information Name Credit Card Type : American Express Credit Card Number: xq x*4*.: quad 2037 Level II Fields Tax Exempt : NO 10/15/2012 hups://e6c.cybersource.com/ebc/virtualterminal/PrintSingleReceiptLoad.do 10/15/2012 EFTA00521017