Paid

Invoice

From:

515 E. Carefree Hwy.
Phoenix, AZ 85085-8839

insurance@pibinc.com

Invoice Number INV-0011
Order Number 30072
Invoice Date March 30, 2017
Due Date March 31, 2017
Total Due $145.47
To:
Henry J Krzysik, Jr

7301 E 22nd Street, # 3C
Tucson, Az 85710

Hrs/Qty Service Rate/PriceAdjustSub Total
1 PROFESSIONAL LIABILITY INSURANCE - 1ST INSTALLMENT $141.233.00%$145.47
Sub Total $145.47
Tax $0.00
Total Due $145.47