PLEASE FILL OUT THE REQUIRED INFORMATION BELOW TO RECEIVE YOUR $120 LOYALTY PUNCH CARD VIA USPS.

Can be redeemed at Livia Italian Eatery, GIA MIA, moto imoto, Ella’s Italian Pub and fire+wine locations.

Buy a Gift Card for $100, Receive a $120 Loyalty Bonus Punch Card.*

*Bring your loyalty bonus card in 2025 when you dine with us at any of our locations. Receive a $10 punch off each month. One redemption per month. ($120 yearly value) No cash value. Not valid for gratuity or gift card purchases. Not responsible if lost or stolen . Cannot be combined with any other offers.

Name of Gift Purchaser:

First Name

Last Name

Gift Card Number Starting with 8627 or Check Number:

Located on your e-gift card...

Last 4 digit of cc used for purchase:

Date of Gift Card Purchase:

YYYY

Gift Card Purchase Amount:

Name of $120 Loyalty Bonus card recipient if different than above:

First Name

Last Name

Recipient's Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

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