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Sample Invoice

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Previous balance ($) Premium applied ($) Premium charged ($) Term / Bill plan Balance due ($) Payment / credits Fees ($) Taxes / surcharge ($) Installment amount ($) 8,223.18 0.00 0.00 0.00 1,441.49 3 of 9 6,781.69 0.00 16,872.00* 10/28/2016 - 17 25% & 9 Product Policy XXXXXXXX Account Name Non Prof Pkg PHPK xxxxxxx Fees 0.16 0.00 0.00 0.00 0.00 0.16 0.00 0.16 NYFIF Endorsements to be applied across remaining installments: Return: Added: Description of the endorsement is explained here 0.00 596.00 8,223.34 0.00 0.00 0.00 1,441.49 6,781.85 0.00 16,872.16 2,149.56 0.00 0.00 0.00 429.92 2 of 9 1,719.64 0.00 5,159.00 11/09/2016 - 10/28/2017 25% & 9 PHSD xxxxxxx Cyberliab 2,149.56 0.00 0.00 0.00 429.92 1,719.64 0.00 5,159.00 Payments will be allocated towards these charges first Total Balance: 10,372.90 A Account number XXXXXXXX Page2 of 3 Total amount due for this invoice. This includes any previous balance, as well as, taxes and fees. Balance due for this policy. Prior payments made will be listed here. Current installment amount and installment number. EX: This is installment 3 out of 9 installments. Amount due from the previous invoice. The policy effective dates and the bill plan selected. Eligible bill plans are based on policy premium. EX : 25% & 9 = 25% down payment and 9 installments. Your policy number. Your policy type.