EFTA Document EFTA02176126

To: From: confirmation©seamless.com Sent: Thur 1/19/2012 5:03:48 PM Subject: Seamless Order 245276385 ESTIMATED DELIVERY TIME: 30 - 45 Minutes Title: ORDER# 245276385 GRAND TOTAL AMOUNT: $19.04 TIP AMOUNT: $2.00 __...-- --- Blockheads Burritos - 2nd Ave Phone: (212) 879-1999 Order #: 245276385 C Ordered' Thursday. January 19. 2012 12:02 PM Estimated Delivery Time: 30 - 45 minutes Deliver to: Delivery Instructions: Please include plastic utensils, napkins, etc. 301 E 66TH ST Cross Streets: 66th and 2nd City: NY Apt/Flat/Suite/Floor #: 10B 1 Grilled Tofu Burrito $10.95 x 1 = $14.90 • Special Instructions: Please make sure to include the Soy cheese today...it was not included yesterday. thanks! • Soy (w/Soy Cheese) • Brown Rice • Whole Wheat Tortilla • Tofu Sour Cream • Jalapenos in Burrito • Diet Pepsi (Can) $1.95 $0.75 $1.25 I Tofu Sour Cream $0.75 x 1 = $0.75 Product Total: = $15.65 Sales Tax: = $1.39 Tip Amount: = $2.00 Grand Total: = $19.04 EFTA_R1_00863074 EFTA02176126 Order Placed By: Amount: $19.04 Payment Information Amount Order Type Master Card Last 4 $19.04 Personal Personal Credit Card For food or delivery/pickup related issues, please contact Blockheads Burritos - 2nd Ave at (212) 879-1999 For billing questions or support, contact Seamless at (212) 944-7755 or carepamiess.com U. • P..y.“ 2") t 1 Seamless. All rights reserved 232 Madison Ave. Suite 1409 Now York, NY 10016 EFTA_R1_00863075 EFTA02176127