Paid

Invoice
From:
Professional Insurance Brokers Inc.

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

insurance@pibinc.com

Invoice Number INV-0299
Invoice Date June 28, 2021
Total Due $0.00
To:
David A Lotz, CPA, PC

2930 N Swan Rd, # 209
Tucson, AZ 85712

Hrs/Qty Service Rate/PriceAdjustSub Total
1 PROFESSIONAL LIABILITY INSURANCE -ANNUAL PREMIUM $1,928.003.1%$1,987.77
Sub Total $1,987.77
Tax $0.00
Paid -$1,987.77
Total Due $0.00

Payment is due upon receipt or the policy effective date which ever comes first.
By using PayPal to pay this invoice you agree to the 3% charge.

Thanks for choosing Professional Insurance Brokers | insurance@pibinc.com
Page {PAGENO}/{nbpg}