Invoice

From:

P.O. Box 848
Hamburg, NY 14075

Invoice Number INV-INV-0137
Invoice Date April 1, 2017
Due Date May 1, 2017
Total Due $199.00
To:
Colonial Voluntary Benefits

Attn: Chris Martoche
5735 Main Street
Williamsville, NY 14051

Level 1 Renewal

Hrs/Qty Service Rate/PriceAdjustSub Total
1 Membership Renewal Invoice

Level 1 Renewal

$199.000.00%$199.00
Sub Total $199.00
Tax $0.00
Total Due $199.00