Bill To:


GARRISON PROPERTY & CASUALTY
9800 FREDERICKSBURG ROAD
SAN ANTONIO, TX 78288-4100

Services Rendered To:


Amy Sanders
2101 Dearborn Ave
Missoula, MT 59801
POLICY# 005839180 7104

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
AL-01-403-23-1219 11/09/2023 11/28/2023 On Receipt Jemison Fire Department

Product
Price
Qty
Amount
  1. 102 Engine Response (Per Hour)

    $500.00
    1
    $500.00
  2. 103 Rescue Response (Per Hour)

    $400.00
    1
    $400.00
  3. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  4. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 10400 CR 42- Jemison, AL

Subtotal $1,033.00
Total Due $1,033.00


Updated
November 28, 2023 @ 12:52 pm

Invoice updated by Geoffrey.

Status Update
November 28, 2023 @ 12:52 pm

Status changed: Draft to Pending.