Bill To:


Isaac Vergara
3923 SE 12th St
Oklahoma City, OK 73115
US

Services Rendered To:


Isaac Vergara
3923 SE 12th St
Oklahoma City, OK 73115

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
OK-41-013-22-200 10/23/2023 11/27/2023 On Receipt Wellston FD

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

    $500.00
    1.25
    $625.00
  2. 103 Rescue Response (Per Hour)

    $400.00
    1.25
    $500.00
  3. 418 Environmental Hazard Cleanup/Removal

    $250.00
    1
    $250.00
  4. 310 Hydraulic Tool (# Used)

    $200.00
    2
    $400.00
  5. 206 Latex Gloves (Pairs Used)

    $2.00
    8
    $16.00
  6. 301 Hand Tool (# Used)

    $15.00
    3
    $45.00
  7. 309 Power Tool (# Used)

    $50.00
    1
    $50.00
  8. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00

  9. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: E Hwy 66/S 3350 Rd- Wellston, OK

Subtotal $2,011.00
Total Due $2,011.00


Updated
November 27, 2023 @ 9:06 pm

Invoice updated by Geoffrey.

Status Update
November 27, 2023 @ 9:06 pm

Status changed: Draft to Pending.