IA Licensed Broker #IA-BRK-2024-089 ZATCA Phase 1 & 2 Compliant

Elite Insurance Brokerage Co. (LLC)

Licensed Insurance Broker - IA License: IA-BRK-2024-089
ZATCA VAT Reg #: 310123456700003
الرياض، طريق الملك فهد، ص.ب 12345
ZATCA PHASE 1 & 2 COMPLIANT
SIMPLIFIED TAX INVOICE
INV-2026-1003
Buyer Information:
Riyadh Horizon IT & AI Solutions
VAT Number: 310654321000003
CRN / ID: 1010567890
Address: Riyadh, حي السليمانية, طريق العروبة
ZATCA QR Code
Issue Date: 2026-09-06 12:03:32
UUID: b718c154-7020-4c73-86b4-3a5779ae72f5
# Service Description Qty Unit Price VAT % VAT Amount Total with VAT
1 Insurance Brokerage Commission - Medical Policy #POL-2025-MED-0980 1 12,000.00 SAR 15% 1,800.00 SAR 13,800.00 SAR
Bank Wire Payment Details:
Beneficiary: شركة النخبة لوساطة التأمين
Bank: مصرف الراجحي (Al Rajhi Bank)
IBAN: SA0380000000608010167890
Subtotal (Excl. VAT): 12,000.00 SAR
15% VAT Total: 1,800.00 SAR
Total Payable:
13,800.00 SAR