Bill To:


Nationwide Insurance
One Nationwide Plaza
Columbus, OH 43215-2220

Services Rendered To:


Chris Lindsey
3025 Pea Ridge Rd
Crossville, AL 35962
POLICY# 7701J0698C7


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

    $300.00
    1.25
    $375.00
  2. 206 Latex Gloves (Pairs Used)

    $2.00
    2
    $4.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00
  4. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  5. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: Hwy 68 & David Rd- Albertville, AL

Subtotal $754.00
Total Due $754.00


Updated
May 30, 2023 @ 12:24 pm

Invoice updated by Geoffrey.

Status Update
May 30, 2023 @ 12:24 pm

Status changed: Draft to Pending.