Date | Time | Venue / Stadium | Attendance |
| 09 September 2009 | 15:00 | La Paz / Hernando Siles | 10200 |
Referee Hector BALDASSI (ARG) | Assistant Referee 1 Gustavo ESQUIVEL (ARG) | |
Fourth Official Diego ABAL (ARG) | Assistant Referee 2 Ariel BUSTOS (ARG) | |
| a.e.t.: | After extra time | (C): | Captain | PSO: | Penalty Shoot-out |
| GK: | Goalkeeper | N: | Not eligible to play | I: | Injured |
| Y: | Yellow cards | Pos: | Positions | A: | Absent |
