Paid

Invoice

From:

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

insurance@pibinc.com

Invoice Number INV-0342
Invoice Date July 11, 2022
Total Due $0.00
To:
Golden Rule Tattoo LLC

2819 E Calaveros Drive
Phoenix, AZ 85028

Hrs/Qty Service Rate/PriceAdjustSub Total
1 WORKERS COMPENSATION - ANNUAL PREMIUM $6,190.003.6%$6,412.84
Sub Total $6,412.84
Tax $0.00
Paid -$6,412.84
Total Due $0.00