HomeMy WebLinkAboutCORRESPONDENCE - PURCHASE ORDER - 9142207GArthur J. Gallagher Risk Management Services, Inc.
MONJEI
6399 S. Fiddler's Green Cir., #200
Greenwood Village, CO 80111-4949
Phone: (303)773-9999 Fax: (303)773-9776
Poudre Fire Authority
Attn: Lance Murray
PO Box 580
Fort Collins, CO 80522
Invoice #
882612
Page 1 of 1
Attount Number r.I!}:.
JPIQIGye;'R'%re
Date. j ' I I
POUDFIR-01
4/4/2014
4/4/2014
"OUNr PAID
Amoum Due
$12,384.91
Workers Comp Policy Number: 14W528072002 Company: Safety National Casualty Corporation Effective: 111=14 to 1/112015
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Item# Trans Eff DateL-Due bate.G. Trans;: D ptlon F1.IU` ` eit>k I, , i Amount
4346776 3/31/2014 4/4/2014 ENDT 14-151 st Quarter Deductible Billing $12,384.91
Total Invoice Balance: $12.384.91
To 6,C-r Date K- t S t Y
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Please include invoice number with your remittance to expedite processing. pP
Please send your remittance to: Arthur J. Gallagher Risk Management Services, Inc. / () 3 S/
PO Box 742205
Los Angeles, CA 90074-2205