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  • MR Eb Direct Invoice

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    HIMANSHU BHARDWAJ
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    This invoice from The Hartford Steam Boiler Inspection and Insurance Company provides details of an insurance policy renewal for American Family Brokerage. It lists the policy number and period, an invoice date of December 15, 2023, and a total amount due of $14,000 by the due date. No new transactions have been processed since the last invoice.

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    Mr Eb Direct Invoice (28)

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    This invoice from The Hartford Steam Boiler Inspection and Insurance Company provides details of an insurance policy renewal for American Family Brokerage. It lists the policy number and period, an invoice date of December 15, 2023, and a total amount due of $14,000 by the due date. No new transactions have been processed since the last invoice.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    10 views2 pages

    MR Eb Direct Invoice

    Uploaded by

    HIMANSHU BHARDWAJ
    This invoice from The Hartford Steam Boiler Inspection and Insurance Company provides details of an insurance policy renewal for American Family Brokerage. It lists the policy number and period, an invoice date of December 15, 2023, and a total amount due of $14,000 by the due date. No new transactions have been processed since the last invoice.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    Premium Invoice

    The Hartford Steam Boiler Inspection and Insurance Company


    P.O. Box 70658, Chicago, IL 60673-0658

    If you have any questions about this invoice, please call 1-800-472-1866.

    Producer Name and Address


    American Family Brokerage Producer 0009117149
    6000 American Parkway Code
    Madison WI 53783-0000

    Policy Details

    Policy Number: Policy Period: Invoice Date:


    EQB0000610 12/01/2023 to 12/01/2024 12/15/2023

    Invoice Summary Due Date Amount Due

    Past Due $0.00


    Prior Billed Refer Prior Bill $14,000.00
    Current Due $0.00
    Total Amount/Credit Due: $14,000.00
    (If the amount due including taxes and surcharges is less than $10.00, the
    amount due will be waived.)

    Current Due Break Down:

    Transaction
    Transaction Effective Date Premium/Surcharges Amount

    HSB INVOICE 09 2022 Page 1 of 2


    New Transactions Processed Since Last Invoice:

    Transactio Premium/Surcharges Commi Commi Net


    Gross
    Transaction n Effective ssion % ssion Amount
    Amount
    Date Amount

    Please submit payment with a copy of this invoice to the address above. Make checks payable to
    Hartford Steam Boiler.

    HSB INVOICE 09 2022 Page 2 of 2

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