Paid

From:

19365 Cypress Ridge Terr Unit 909
Leesburg, VA 20176

jcimbalista@hotmail.com

Invoice Number INV-0186
Invoice Date September 5, 2018
Due Date September 19, 2018
Total Due $324.19
To:
Basics First Chiropractic

Village at Leesburg
1509 Dodona Terrace
Suite 100
Leesburg, VA. 20175

Hrs/Qty Service Rate/PriceSub Total
1 Printing

250 new Patient Folders and 100 Large BFC stickers/labels, plus shipping.

$324.19$324.19
Sub Total $324.19
Tax $0.00
Total Due $324.19

By check made out to "Sunny Day Sites LLC" to:
19365 Cypress Ridge Terr
Unit 909
Leesburg, VA 20176