Invoice

From:

P.O. Box 848
Hamburg, NY 14075

Invoice Number INV-INV-0495
Invoice Date September 1, 2017
Due Date October 1, 2017
Total Due $225.00
To:
Western New York Immediate Care

Attn: Claire Jones
3050 Orchard Park Road
West Seneca, NY 14224

7162044500

Level 2 Renewal

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

Level 2 Renewal

$225.000.00%$225.00
Sub Total $225.00
Tax $0.00
Total Due $225.00