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Inv# 63745 - PREFERRED GOVERNMENTAL INSURANCE - 10/01/2021
Invoice WC FL1 0062001 21-18 09/28/2021 63745 Workers Compensation City of Dania Beach 100 West Dania Beach Blvd Dania Beach, FL 33004 10/01/2021 _10/01/2022 $39,257.50 Public Risk Insurance Advisors 300 North Beach Street Daytona Beach FL, 32114 10/01/2021 Due DateInvoice Date AmountTransaction DescriptionInvoice through Agmt # WC FL1 0062001 21-186374509/28/2021 10/01/2021 10/01/2022 Premium $39,097.50 10/01/2021 Expense Constant $160.00 10/01/2021 Premium $13,032.50 11/01/2021 Premium $13,032.50 12/01/2021 Premium $13,032.50 01/01/2022 Premium $13,032.50 02/01/2022 Premium $13,032.50 03/01/2022 Premium $13,032.50 04/01/2022 Premium $13,032.50 05/01/2022 Premium $13,032.50 06/01/2022 Premium $13,032.50 07/01/2022 Make Check Payable to Preferred Governmental Insurance Trust P.O. Box 958455, Lake Mary, FL 32795-8455 PGIT accounting (321) 832-1456 Fax (321) 832-1496 accounting@publicrisk.com Administered by Public Risk Underwriters of FL, Inc $156,550.00 Total Premium Current Amount DueWC - 25% Down & 9 Equal Installments $39,257.50 Client: City of Dania Beach