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• <br /> , _, Galaxy Fireworks, Inc. Page 8 of 8 <br /> 204 E. Martin Luther King, Jr. Blvd <br /> �� Tampa,FL33603 — ❑ <br /> t 4 1. - RKS 813.234.2264 Phone rfow <br /> O _ <br /> � r of - rmsW���� 813.234.1516 Fax Free <br /> Items Received Not Listed Above Cross out any unused blank spaces. <br /> " rte° .K. C,�, ,.� �!' #E! . „. " a &o Ili <br /> ?t � � � � a�`.d . „ F •,��f�' .. ,'�''�F. � . , _. �, •,�.�lr if ,�'! . <br /> 00000 <br /> 00000 <br /> 00000 <br /> 00000 <br /> 0000❑ <br /> 00000 <br /> O 000❑ <br /> ❑ 00❑❑ <br /> O 0000 <br /> ❑ ❑0❑❑ <br /> 00000 <br /> O 0000 <br /> O 0000 <br /> O 0000 <br /> 00000 <br /> O 0000 <br /> O 0000 <br /> 00000 <br /> 00000 <br /> 00000 <br /> • <br /> • <br /> Manager's Initials Operator's Initials <br /> • <br />