Bill To:


ALFA INSURANCE
207 Hwy 78 W
Jasper, AL 35501

Services Rendered To:


Kathlyn Tripplet
190 Lime Rock Rd
Tuscumbia, AL 35674
POLICY# A1817229


Product
Price
Qty
Amount
  1. 406 Medical Extrication – Lvl 2

    Patient

    Kathlyn Tripplet
    190 Lime Rock Rd
    Tuscumbia, AL 35674
    POLICY# A1817229

    $1,500.00
    1
    $1,500.00

  2. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 1369 George Wallace Hwy- Russellville, AL

    Ordinance Info: Littleville Volunteer Fire Dept. Resolution

Subtotal $1,500.00
Total Due $1,500.00


Updated
June 5, 2023 @ 11:40 am

Invoice updated by Geoffrey.