Receipt
| Reference Number | 3043136 |
| Created At | 8/14/19, 10:36 AM |
Registrant Details
| Registrant Type | Full Name | Company | Price |
|---|---|---|---|
| BLUE TRACK Cancelled | Bill Bohn | Associated Benefits & Risk Consulting | $750.00 |
| BLUE TRACK | Mickey Webb | Associated Benefits & Risk Consulting | $1,500.00 |
Selections
| Selection | Quantity | Unit Price | Total |
|---|---|---|---|
| BLUE TRACK (Cancelled) | 1 | $750.00 | $750.00 |
| BLUE TRACK | 1 | $1,500.00 | $1,500.00 |
| Total | $2,250.00 | ||
Billed To
| Company | Associated Benefits and Risk Consulting |
| Full Name | Bill Bohn |
| Line 1 | 711 Eisenhower Dr |
| City | Kimberly |
| State/Province/County | WI |
| Zip/Postal Code | 54136 |
| Country | United States |
| Email Address | bill.bohn@associatedbank.com |
Transactions
| Date | Transaction Type | Amount |
|---|---|---|
| August 14, 2019 | Online Visa Payment (2580) | ($3,000.00) |
| August 14, 2019 | Order Amount | $3,000.00 |
| September 24, 2019 | Order Amount | ($750.00) |
| September 24, 2019 | Online Credit Card Refund | $750.00 |
| Balance Due | $0.00 | |