Bill To:


ALLSTATE INSURANCE
3075 SANDERS ROAD - SUITE H1A
NORTHBROOK, IL 60062-7127

Services Rendered To:


David Alford
677 Oak Grove Road
Westville, Florida 32464
Driver: David Alford
Policy # 9719739731027

Incident Table
Incident # Loss Date Invoice Date Terms Fire Dept
FL-51-061-2021-39 03/25/2021 04/01/2021 On Receipt Ponce De Leon Fire and Rescue

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

    $350.00
    1.25
    $437.50
  2. 103 Rescue Response (Per Hour)

    $300.00
    1.25
    $375.00
  3. 314 Cribbing – Lvl 1 (Passenger Vehicle) (Used)

    $100.00
    2
    $200.00
  4. 310 Hydraulic Tool (# Used)

    $200.00
    1
    $200.00
  5. 206 Latex Gloves (Pairs Used)

    $2.00
    2
    $4.00
  6. 201 Oil Absorbent Material (# Used)

    $35.00
    2
    $70.00
  7. 403 Traffic Control / Road Closure (Per Hour)

    $100.00
    1.25
    $125.00
  8. 803 Basic EMS Assistance (Response Fee)

    $250.00
    1
    $250.00

  9. Additional Incident Info

    Incident Type: Select One

    Incident Location: 677 Oak Grove Road Westville, Florida 32464

Subtotal $1,661.50
Total Due $1,661.50


Updated
March 31, 2021 @ 6:36 pm

Invoice updated by Geoffrey.

Status Update
March 31, 2021 @ 6:36 pm

Status changed: Draft to Pending.

Updated
September 22, 2021 @ 2:46 pm

Invoice updated by Geoffrey.

Viewed
October 24, 2022 @ 7:03 am

Invoice viewed by 64.124.8.45 for the first time.