P.O. Box 5479
Fresno, CA 93755-5479
(559) 432-0222, License # 0E02096, dibu.com
Remit to:
City of Ripon DiBuduo & DeFendis Insurance Brokers, LLC 259 N. Wilma Ave. License # 0E02096
Ripon, CA 95366 PO Box 5479
Fresno, CA 93755-5479
Employment Practices Policy Number: RENL
POL095022604
Effective: 7/1/2023 to 7/1/2024
Indian Harbor Insurance
Company
Producer: Kelly Cole-Wilson CSR: Angelica Alvarado
Item
No.
Eff Date Description Amount
1 07/01/23 EPL Renewal 16,246.00
Policy Fee 245.00
Broker Fee 250.00
Surplus Lines Taxes & Fees 516.62
Total Invoice Balance $17,257.62
**You can visit our website at www.dibu.com to make payment using the “Pay Here” link. Please note that a third party processor charges a fee of $3.00 for check/ACH and 3.25% of the amount paid for credit card payments as a processing fee.
Invoice # Page 1 of 1
Account Number Invoice Date
CITYOFR-01 6/1/2023
Balance Due By Amount Due
07/01/23 $17,257.62