Bill To:


Farmers Insurance
PO Box 268993
Oklahoma City, OK 73126

Services Rendered To:


Policy# 195740810
Roger Howton
415730 E. 1093 Rd.
Checotah, OK 74426


Product
Price
Qty
Amount
  1. 103 Rescue Response (Per Hour)

    $500.00
    1.25
    $625.00
  2. 102 Engine Response (Per Hour)

    $500.00
    1.25
    $625.00
  3. 105 Utility Vehicle Response (Per Hour)

    $500.00
    1.25
    $625.00
  4. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00
  5. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: I 40 WB, MM256, Henryetta, OK

    Ordinance Info: Tiger Mountain - McIntosh County Resolution 72021

Subtotal $2,250.00
Total Due $2,250.00


Updated
May 4, 2022 @ 12:07 pm

Invoice updated by Karen Smith.

Status Update
May 4, 2022 @ 12:07 pm

Status changed: Draft to Pending.