Bill To:


Farmers Insurance
PO Box 268993
Oklahoma City, OK 73126

Services Rendered To:


Joe Soriano Jr.
512 Airport Road
Poteau, OK 74953
Policy # 195594838

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
OK-49-016-2021-27 03/01/2021 05/17/2021 On Receipt Paradise Point Fire Department

Product
Price
Qty
Amount
  1. 105 Utility Vehicle Response (Per Hour)

    $250.00
    1
    $250.00
  2. 410 Fire Department Response Fee – Lvl 1

    $200.00
    1
    $200.00

  3. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: US-266 & EW 1040 Road - Council Hill, OK

Subtotal $450.00
Total Due $450.00


Updated
May 16, 2021 @ 6:27 pm

Invoice updated by Geoffrey.

Status Update
May 16, 2021 @ 6:27 pm

Status changed: Draft to Pending.

Updated
May 16, 2021 @ 6:30 pm

Invoice updated by Geoffrey.

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October 24, 2022 @ 10:45 pm

Invoice viewed by 64.124.8.27 for the first time.

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