A First Security Insurance 798 Columbia Road-Chicago, Minois 60614 BILL TO: WAREN SPORTS SUPPLY 1978 Michigan Avenue Chicago, Illinois 60612 INVOICE TERMS: Net 10 Days (312) 371-2411 Toll Free: (800) 488-2297 Fax: 312-559-7891 Fourth Quarter 2022 employee health insurances Jim Adams Nancy Ford: Ray Kramer TOTAL PREMIUM $ 540.00 500.00 670.00 $ 1,710.00 REMIT TO: Document No. 18 12-19-22 First Security Insurance Accts Receivable Dept. 798 Columbia Road Chicago, Minois 60614 105963 PAY TO THE ORDER OF First American PART 1-CUSTOMER COPY PART 2-SALESPERSON COPY WAREN SPORTS SUPPLY 7 20th Yes, p.23 30-345-907 PART 3-ACCOUNTING COPY Document No. 20 No. 1152 14-4511726 Date 12/19/22 $1,710.00 SAMPLE- DOLLARS Received vendor invoice No. 105963 (Doc. No. 18) from First Security Insurance for the fourth quarter's health insurance coverage for employees and immediately issued a check (Doc. No. 20) for payment in full. Purchase orders are not issued for services that Waren purchases. 2