Receipt #06180590

Date Generated: 1/13/2023

Agent: Jessica Grabert

Store: #7074 Slidell - Gause Blvd

Address: 1480 Gause Blvd
SLIDELL, LA 70458 Customer: Christine Breaux
Phone: 985-768-3001 Address: 2201 Bayou Dularge Rd
Email: BU7074@ABCAutoInsurance.com THERIOT, LOUISIANA 70397

Payment Summary
Carrier Policy Description Original Amount
Amount Due
NGIC 2017351434 Downpayment $ 164.18
NGIC 2017351434 LA Auto Application Fee $ 25.00
Balance Due $ 189.18
Payment Method
Items Paid With Payment Method Ref# Amount Paid
Carrier NGIC Credit Card [8893] 020778 $ 164.18
In Store Slidell - Gause Blvd Credit Card [8893] 082565 $ 25.00
Total Paid $ 189.18