Bill To:


WESTFIELD INSURANCE
PO BOX 5001
WESTFIELD CENTER, OH 44251-5001

Services Rendered To:


A & C Communications
1118 Garrett Creek Road
Burkesville, KY 42717
Driver: Billy Collins
Policy # CMM1891918


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

    $350.00
    2
    $700.00
  2. 103 Rescue Response (Per Hour)

    $300.00
    2
    $600.00
  3. 401 Debris Cleanup/Removal (# Used)

    $250.00
    1
    $250.00
  4. 206 Latex Gloves (Pairs Used)

    $2.00
    4
    $8.00
  5. 301 Hand Tool (# Used)

    $15.00
    2
    $30.00
  6. 404 Scene Lighting (Per Hour)

    $75.00
    2
    $150.00
  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    2
    $200.00
  8. 215 Trauma Kit (# Used)

    $25.00
    1
    $25.00
  9. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  10. Additional Incident Info

    Incident Type: MVA Response

    Incident Location: 13000 Block of Burkesville Road - Breeding, KY

Subtotal $2,213.00
Total Due $2,213.00


Updated
October 24, 2021 @ 1:05 pm

Invoice updated by Geoffrey.