Moranco9631 N Nevada St, Ste 309

Spokane, WA 99218P: (509) 324-0640

Test Client Name Spokane, WA 99218

INVOICEInvoice No: 00002

Invoice Date: 01/01/2020

Description Policy Number Eff Date Line of Business Due

Policy Premium RLP00000 08/01/2019 Professional Liability $1,000.00

Broker Fee RLP00000 08/01/2019 Professional Liability $0.00

Total: $1,000.00

Detach and return this portion with your payment

Invoice No: 00002Customer: Test

MAIL TO:

Moranco9631 N Nevada St, Ste 309 Spokane, WA 99218

Due Date: 08/07/2019

Amount Due Enclosed

$1,000.00