o

Ho
KOTARAJA - PAPUA

Raya Abepura No.80

Papua - lndonesia
T:t42967 557 2222 Guest lnvoice
F :+62967 557 2223
E : info.kotarajapapua@horisonhotels.com

Pr. MGM (MEMBER HPC), Room No 519

Adult 2
6UCSI NAME : ]T/DC}IAMMADGAI.IHTRIEPRATAIVIASOI Arrival 04lL2l2t
Departure osltzl2t
Room Rate
BillNo 3Oe49 I 2

Date Description/Voucher qty RmNo Amount

04lt2l2t ROOM CHARGE 1 519 725,000.00
Balance 725,000.00

Iogree to remain personolly lioble for the payment of the occount if the corporotion
or other third pafty billed foils to pay part or oll of these chorges. _:._..-
My signature is outhorizotion for Horison Hotel Kotorojo Popuo to use credit cord a"\
imprintd for the payment of these chorges. H rrr ISO\I '\,\
Printd by:63 17'a'-
rOIAk. r, nOr.i. ,,1
Dote: 05/72/2027 06:36
\ .

-//

GtestSignoture_
Please check that you have not left any valuables in the in-room personal safe.
Thank You for choosing to stay with Us and we wish you pleasant onward journey

Page 1