Bill To:


Joey Buttram
4613 Paint Rock Rd
Oneida, TN 37841

Services Rendered To:


Joey Buttram
4613 Paint Rock Rd
Oneida, TN 37841
POLICY# 2023009453

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
TN-76-821-23-723 11/28/2023 11/30/2023 On Receipt Paint Rock VFD

*** Please Submit this to your AUTO Insurance Company for processing and payment, OR YOU MAY CONTACT OUR OFFICE AND PROVIDE US WITH YOUR INSURANCE INFORMATION FOR PROCESSING. ***

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

    $500.00
    3
    $1,500.00
  2. 306 Hose Per 50′ (Amt Used)

    $25.00
    1
    $25.00
  3. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  4. 205 Foam (Per Gallon)

    $65.00
    1
    $65.00

  5. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: 4613 Paint Rock Rd- Oneida, TN

Subtotal $1,840.00
Total Due $1,840.00


Updated
November 30, 2023 @ 11:28 am

Invoice updated by Geoffrey.

Status Update
November 30, 2023 @ 11:28 am

Status changed: Draft to Pending.

Updated
March 12, 2024 @ 2:08 pm

Invoice updated by Geoffrey.