Bill To:


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

Services Rendered To:


Chase Richard
218 Wall St
Columbia, KY 42728

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
KY-00-921-24-5139 04/03/2024 06/06/2024 On Receipt Breeding Area VFD

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

    $500.00
    1.25
    $625.00
  2. 104 Tanker Response (Per Hour)

    $400.00
    1.25
    $500.00
  3. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00
  4. 207 Wetting Agent (Amt Used)

    $25.00
    1
    $25.00
  5. 306 Hose Per 50′ (Amt Used)

    $25.00
    4
    $100.00

  6. Additional Incident Info

    Incident Type: Vehicle Fire Response

    Incident Location: 375 Weed Sparkville Rd- Columbia, KY

Subtotal $1,375.00
Total Due $1,375.00


Updated
June 6, 2024 @ 1:26 pm

Invoice updated by Geoffrey.

Status Update
June 6, 2024 @ 1:26 pm

Status changed: Draft to Pending.

Viewed
June 7, 2024 @ 11:17 am

Invoice viewed by Ken Kramer (kkramer) for the first time.