Bill To:


STATE FARM INSURANCE
PO BOX 52250
PHOENIX, AZ 85072-2250

Services Rendered To:


Hollis McCoy
County Rd 181
Moulton, AL 35650
POLICY# 4307270-E29-01


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

    $350.00
    1
    $350.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    1
    $300.00
  3. 102 Engine Response (Per Hour)

    $350.00
    1
    $350.00
  4. 404 Scene Lighting (Per Hour)

    $75.00
    1
    $75.00
  5. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1
    $100.00

  6. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 1804 George Wallace Hwy- Russellville, AL

    Ordinance Info: Littleville Volunteer Fire Dept. Resolution

Subtotal $1,175.00
Total Due $1,175.00


Updated
January 23, 2023 @ 10:16 am

Invoice updated by Geoffrey.

Status Update
January 23, 2023 @ 10:16 am

Status changed: Draft to Pending.

Viewed
February 1, 2023 @ 11:28 pm

Invoice viewed by Karen Meder - Smith (KarenS) for the first time.

Viewed
June 23, 2023 @ 11:07 am

Invoice viewed by Karen Meder - Smith (KarenS) for the first time.