Paid

Invoice

From:

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

insurance@pibinc.com

Invoice Number INV-0114
Invoice Date July 12, 2018
Total Due $0.00
To:
Golden Rule Tattoo LLC

2819 E Calaveros Drive
Phoenix, AZ 85028

PL/GL LIABILITY ANNUAL PREMIUM  8470

CARRIER FEES  250

SURPLUS LINES TAXES & FEES  279.04

Hrs/Qty Service Rate/PriceAdjustSub Total
1 PROFESSIONAL/GENERAL LIABILITY INSURANCE - ANNUAL PREMIUM $8,999.043%$9,269.01
Sub Total $9,269.01
Tax $0.00
Paid -$9,269.01
Total Due $0.00