Paid
515 E. Carefree Hwy.
Phoenix, AZ 85085-8839
insurance@pibinc.com
| Invoice Number | INV-0051 |
| Invoice Date | September 27, 2017 |
| Total Due | $1,379.17 |
2810 S 24th Street Ste #108
Phoenix, AZ 85034
| Hrs/Qty | Service | Rate/Price | Adjust | Sub Total |
|---|---|---|---|---|
| 1 | WORKERS COMPENSATION - PREMIUM DOWN PAYMENT | $1,339.00 | 3% | $1,379.17 |
| Sub Total | $1,379.17 |
| Tax | $0.00 |
| Total Due | $1,379.17 |